To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 24 October 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 24 October 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.

None.

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

The Chairman thanked the Executive Member for Social Care and Housing and officers for an excellent Housing Briefing event.

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 advised Members that the Council had been nominated at the Inside Housing for an award for the Priory View development in Dunstable.  Although the scheme did not win, it was amongst the top 5 nominated.

Following on from the successful Member Briefing on Housing, the Executive Member proposed to hold a further briefing on Care Markets.

The Executive Member for Health announced details of the Sustainability and Transformation Plans (STPs) had been published.  An all Member briefing on STPs would be held in January 2017.

There had been some delays in the CCG led re-procurement of Community Health Services which included the 0-19 Children’s Services.  However this had now commenced with the Pre Qualification Questionnaire (PQQ) issued to potential providers.

To consider and comment on the work undertaken by the Bedfordshire Clinical Commissioning Group to delivery the Primary Care Strategy and General Practice Plan for Bedfordshire and receive an update on the current position.

The Director of Strategy and Transformation (Interim), Bedfordshire Clinical Commissioning Group (BCCG) introduced a report that outlined the planned modernisation and help to be provided to GPs through the Primary Care Strategy in Bedfordshire.  Members were reminded that responsibility for Primary Care lay with NHS England, however, full delivery of this service would be taken on board by CCGs at a future date.

STP plans and the proposed establishment of locality hubs in Central Bedfordshire would continue and the importance of working together at a local level was paramount.  A Transformation Board had been established that included primary care, community groups and local authorities.  The Director reiterated that GPs managed their own contracts and CCG would continue their engagement work to ensure plans were delivered.

RECOMMENDED The Committee:

1.    Has a responsibility for Central Bedfordshire and requests that future reports inform us more specifically about this local authority area.

2.    Suggests a need to map out a simple ‘citizen pathway to good health’ to further educate the public as to the right place to go – pharmacy, GP or A&E and to reinforce self help in appropriate circumstances.

3.    Request action to be taken in relation to ‘no-show’ appointments at GP surgeries and inform the public the associated costs.

4.    Welcome investigation into different forms of GP consultation at surgeries as an alternative to face to face consultation.

5.    While welcoming the aspirations towards improving primary care, with a raft of ‘programmes’, the committee needed to be convinced that delivery could be achieved within current or reduced budgets.

6.    Look to a meaningful outcome within the stated time scales.

To receive the Bedfordshire Clinical Commissioning Group’s Board report on Value Based Elective Commissioning, the outcome of the public consultation  and a verbal update on the Board’s decision to continue or stop commissioning of the following services:-

·         IVF

·         Gluten free foods

·         Over the counter medicines

The Director of Commissioning and Performance introduced a report that outlined the value based elective commissioning consultation and recommendations considered by the BCCG Board.  Over 10,000 responses in Bedfordshire had been received by the BCCG.

With regards to the proposal to stop providing gluten-free foods unless specific circumstances existed whereby a dependent patient could be at risk of dietary neglect, 48% of CBC residents supported the proposal.

The proposal to stop providing over the counter medicines that included anti histamines, paracetamol and similar products saw 54% of residents that agreed with the proposal.

Proposals to cut the number of IVF cycles did not produce a clear steer from residents with 40% that disagreed, 36% agreed and 23% did not know. 

The BCCG Board agreed to stop providing gluten-free foods and over the counter medicines on prescription.  A campaign to raise public awareness of this decision was proposed.  The Board did agree to continue to routinely commission specialist fertility services according to the current policy.

RECOMMENDED The Committee recognise the outcome of the public consultation and agree with the governing body’s recommendations.

To receive the Bedfordshire Clinical Commissioning Group’s Board report on finances and a verbal update on the Board’s consideration of this matter.

The Chief Finance Officer, BCCG, introduced a report that outlined the current financial position of the BCCG.  Current figures showed a £9.3m surplus.  The BCCG had been directed to deliver a higher level of surplus by NHS England of £12m.  Members raised their concerns at the overall size of the deficit that amounted to £63m in repayments over the next 4 years.  It was noted that funding per person was lower in Bedfordshire compared to other parts of the country.

The Executive Member welcomed the detailed report and forecasted figures and noted the challenging target.

RECOMMENDED the Committee

1.    Note the current position of a reduced forecast surplus for 2016/17 in the context of the repayment of £63m over a four year period and the resultant financial challenge.

2.    Sees a lower funded local health service per head of population compared with many other authorities and sees a certain irony that, while there is to be an investment in transformation, a large debt hangs over the BCCG.

3.    Requests a further report on the financial position be submitted in March 2017.

4.    Urge the BCCG to make what representations it can to Government to alleviate the current financial position.

5.    Urge the Council to make such representations to the local MP’s.

To receive a verbal update on the Commissioning of Adult Social Care Services and Associated Contracts.

The Head of Commissioning provided a verbal update on the commissioning of Adult Social Care Services and associated contracts considered originally in a report to the Committee in December 2015.  In 2016 voluntary and community sector and housing support service sector organisations had been invited to bid for a range of preventative (non-statutory) support services for vulnerable adults including some jointly commissioned services, with Bedford Borough Council and Bedfordshire Clinical Commissioning Group and all of Bedfordshire (excluding Luton).

A number of engagement activities took place and following the procurement process, most contracts started on 1st October 2016, with the exception of the Dementia services contract that would start on 1^st December. All contracts would run for 3 years and include an option to extend by up to a further 2 years.

The concerns raised by carers in the dementia service had been dealt with within the new contract arrangements.

Recommended The Committee

1.    Note the recently commissioned services which intend to respond to local needs.

2.    Requests a briefing note and associated costs be circulated to Members.

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 rescheduled the following items:-

20 March 2016

1.    Peer Review Report into

2.    Musculoskeletal Service (BCCG)

3.    Support for Pharmacies (BCCG)

4.    STP Update

5.    BCCG Finance Report

6.    The Enquiry into the Integration of Health and Social Care will have reported by this time.

RECOMMENDED that the items identified in the minute above be added or rescheduled on the work programme.