To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 31 May 2016 and to note actions taken since that meeting.

RESOLVED that the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 31 May 2016 be confirmed and signed by the Chairman as a correct record.

To receive from Members any declarations of interest and of any political whip in relation to any agenda item.

To receive any announcements from the Chairman and any matters of communication.

The Chairman extended his thanks to the Committee on the work undertaken to review the Quality Accounts at the last meeting.

The Joint Health Overview and Scrutiny Committee meeting would take place on Thursday 30 June and Members were advised that the Review had been put on pause.

The next meeting of the Committee had been rearranged and would now take place on Tuesday 20 September, 2016 at 10am.

The Chairman wished to congratulate everyone involved in the Priory View Independent Living scheme that had received significant praise from residents and the public. 

To receive petitions from members of the public in accordance with the Public Participation Procedure as set out in Annex 2 of Part A4 of the Constitution.

None.

To receive any questions, statements or deputations from members of the public in accordance with the Public Participation Procedure as set out in Annex 1 of part A4 of the Constitution.

None.

To consider any decision of the Executive referred to this Committee for review  in accordance with Procedure Rule 10.10 of Part D2. 

None.

To consider any items referred to the Committee at the request of a Member under Procedure Rule 3.1 of Part D2 of the Constitution.

None.

To receive a brief verbal update from the Executive Members for

·         Social Care and Housing and

·         Health

The Executive Member for Social Care and Housing announced a new Deputy Executive Member had been appointed and would help in the development of Houghton Regis  Central development. 

The re-provision of residents at Greenacre in Dunstable was underway and 4 residents remained at the home.  An event for developers and operators of care homes was planned on 15 July 2106 at the Rufus Centre, Flitwick to share the Council’s plans for future developments.

The Executive Member for Heath advised that no new date had been advised regarding the resumption of the Healthcare Review, however, Strategic Transformation Plans would be submitted by 30 June 2016. Members were also advised that the Sexual Health Services contract had been renewed and the new provider was Cambridgeshire Health Services.

NOTED the updated.

To scrutinise the First Year update on the Bedfordshire Mental Health and Wellbeing Service and provide comment on the progress made.

The Director for Bedfordshire Mental Health & Wellbeing Service, East London Foundation Trust, introduced a presentation that outlined the year 2 Plan and progress to improve services for patients.  Of particular note was the successful launch of the Bedfordshire and Luton Recovery College in May 2016 in partnership with the University of Bedfordshire.

A Member raised concerns regarding the work with Carers to ensure better outcomes for patients.  The Director advised that the plans had been co-designed with carers and staff who ensure checks were made and the plans fully understood.

Whether access to services targets had improved.  The Director assured the Committee that all targets had been met and ELFT would continue to open more services across the District.  The training and recruitment of local residents and the group programme initiative would ensure those referred for treatment could access support from a local group.

A Member referred to the implementation of the single point of access for CAHMS patients.  The Director advised a soft launch had been made whilst arrangements were tested.  The Trust had achieved a reduction from 15 to 10 weeks waiting time for routine referrals.  The Trust was also working towards a 7 day a week Crisis service for CAMHS patients. 

The Executive Member had been reassured by the rate of improvement made by the Trust and their commitment to improve the experience and outcomes for patients.  The Committee endorsed their support for a whole system approach to ensure vulnerable residents were kept safe.

RECOMMENDED

1.    The Committee wished to affirm its approbation of ELFT for their work to date and were encouraged by the visible achievements thus far.

2.    The Committee welcomed the Year 2 plan which further cements issues around mental health into the public and health conscience.

3.    As part of an up-date in 6 months the Committee wished to consider emerging  figures to show improvement for the residents of Central Bedfordshire.

To receive for information the Bedfordshire Plan for Patients 2016/17 report and comment on the provision of service for our residents.

The Acting Director of Strategy and System Redesign, Bedfordshire Clinical Commissioning Group (BCCG) introduced the Bedfordshire Plan for Patients 2016/17 and outlined the key challenges and strategic priorities to ensure services were provided in the right place for patients.  A number of outdated models to be developed included Out of Hospital Care and would ensure joint working between Health and Social Care colleagues.

A Member asked whether the CCG’s financial position would continue to be overspent or whether it was under funded.  The Acting Director referred to ambitions in the plan to work jointly with Public Health to improve services and expand on the prevent agenda to help balance the budget.

A question was raised regarding the national 9 ‘must do’s’ and whether there was a conflict with local needs and the national and mandatory focus.  The Acting Director advised it was necessary for the BCCG to achieve the 9 outcomes as prescribed by NHSE in partnerships with partners including Public Health and Social Care.

RECOMMENDED

The Committee

1.    Notes the actions taken towards financial recovery from a deficit budget to a balanced budget and expects to see further improvements 2016/2017

2.    Welcomes the detailed plan for patients and expects to see measureable positive outcomes for patient experience in Central Bedfordshire as set out under ‘Plan on a page’.

3.    Urges further cooperation between the health service and social care to achieve a further improving integrated service.

To scrutinise the effectiveness of the NHS System Resilience and Seasonal Pressures in Urgent Care 2015/16 and the impact of the Junior Doctors strike on Central Bedfordshire patients.

The Acting Director of Strategy and System Redesign introduced a report that outlined the key themes that had caused pressures in urgent care in 2015/16 that included the increased needs of some patients with more than one complex need and the long delays faced by ambulances crews to hand over patients to hospital staff.  A public awareness campaign had helped to direct the public for advice in non-emergency cases. 

Faced with the added pressure of the Junior Doctors strike, the CCG’s emergency plans had been successful with the support of GP’s, Social Care workers and Consultants.

The Resilience Group continued to meet with Community Health services and the 111 service plans pathways would help improve services.  The delayed transfer of care target had been achieved and a further cut of 2% was proposed.

A Member questioned whether Better Care Fund plans would ensure that care homes were fully resourced with skilled staff.  The Director advised that the CCG worked jointly with providers to ensure care homes were safe and well staffed.  A policy on Delayed Transfer of Care (DTC) was in development to support these plans.

The Acting Director advised steps had been taken to ensure patients taken into hospital by ambulance were not delayed on arrival.   Bed occupancy issues were a problem, however, it was not a daily occurrence.  The CCG was working with partners on discharge planning soon after admission to hospital and help avoid delays after treatment.  The Luton and Dunstable hospital had appointed ‘flow managers’ and patient discharge had been more efficient.

RECOMMENDED

The Committee

1.    Commends the public awareness campaigns.

2.    Appreciates the response to the junior doctors’ industrial action maintaining services.

3.    Expects improving discharge practices by working with partners through plans under the Better Care Fund.

4.    Looks for an improved flow of patients from ambulance to A&E.

The report outlines the proposed set of guiding principles for the “aligned” tendering process between Bedfordshire Clinical Commissioning Group and Central; Bedfordshire for the re-procurement of Community Health Services.

Members views are sought on the proposals outlined.

The Executive Member for Health introduced a report that outlined the proposed joint arrangement for the procurement and commissioning of Community Health Services with Bedford Borough and the Clinical Commissioning Group.  The report detailed the changes in the way the Council would recommission contracts and effected legal and procurement arrangements.  To maximise best value The Executive Member advised that joint procurement was the best option.  A memorandum of understanding would be drawn up and signed by each party, subject to agreement of the CCG Board of Governors at their next meeting.

The Committee was in agreement with the proposal, however, recognised the amount of work that was required to accomplish the procurement and commissioning proposals.

RECOMMENDED

The Committee supports the principle of a joint arrangement for procuring and commissioning community health services with a view to providing a better integrated service recognising the principles for the design for community services at para 8.

Members are requested to consider the findings of the public consultation on the reviewed Housing Assistance policy for Central Bedfordshire.  Comment on the draft Housing Assistance policy and the Council’s duty to promote equality in this regard.

The Assistant Director Housing introduced the reviewed Housing Assistance Policy.  The Committee was advised the current policy had been successful and the revisions would provide further assistance for some vulnerable groups. 

The Assistant Director advised the reviewed policy would provide opportunities to use Better Care Fund monies to help facilitate early discharge from hospital. The policy priorities outlined in the report had been set out in order to help officers make the difficult decisions that were required. 

In light of the update, Members raised the following issues:-

·         What safeguards were in place to guard against money laundering and exploitation of vulnerable people by Right to Buy (RTB) applicants? The Assistant Director advised the service was vigilant and had successfully identified and dealt with a fraud case involving a RTB applicant.

·         Whether the Housing and Social Care teams worked together to provide housing solutions?  The Assistance Director assured the Committee that the Housing Solutions Team worked collaboratively with officers from a variety of services to ensure funds were spent to achieve best value for the Council.

·         That officers consider repairing the least dilapidated empty homes first so they can be made available quickly. The Assistant Director agreed that we should seek a more balanced approach to identify relatively easy wins, rather than concentrate mainly on those homes which blight neighbourhoods.

The Committee noted the comments raised by residents in the public consultation and wished to ensure Housing Assistance advice was accessible to residents and that it avoided unnecessary jargon.

RECOMMENDED

The Committee

1.    Recognises the need to be able to respond to present and future housing needs in homes which are decent, affordable and safe.

2.    Notes the need to make some significant improvements in some aspects of housing condition and the need to determine priorities as set out at para 4.2.1 for discretionary financial assistance.

3.    Expects to see that advice is accessible and understandable to all to enable those requiring financial assistance to seek such.

To receive a presentation regarding relevant capital and budget monitoring information outturn for 2015/16. 

Full details of the outturn capital and revenue budgets is available from the Executive papers dated 07 June 2016 available from the link below:

http://centralbeds.moderngov.co.uk/documents/g5156/Public%20reports%20pack%20Tuesday%2007-Jun-2016%2009.30%20EXECUTIVE.pdf?T=10

The Assistant Director Resources introduced the 2015/16 Revenue and Capital outturn report that showed a general fund outturn of £64.8m after the use of reserves with an overspend of £0.223m (4%).  Public Health outturn position for 2015/16 showed a balanced budget. 

The Landlord Services outturn showed 33 RTB sales had been made. A Member raised the question of reinvestment of this money and what schemes had been developed.  The Assistant Director Housing advised a new skilled team was planned and would use the reserves to create phased housing schemes.  The Executive Member would Brief Members on garage and housing developments in the autumn. 

RECOMMENDED

The Committee received and noted the Revenue and Capital Financial Outturn reports.

The report provides Members with details of the currently drafted Committee work programme and the latest Executive Forward Plan.

The Committee considered the current work programme and agreed to include an ELFT update in January 2017.

RECOMMENDED

1.   The Committee noted that the next meeting will be held on Tuesday 20September replacing the one otherwise due on 22 August.

2.   An up-date report from ELFT is expected in 6 months – January 2017 meeting

3.   It was hoped that the Quality Accounts for 2017 would be presented in time for Members to make a proper study of them.