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 advised the closure of the Chiltern Practice in Dunstable had been completed and patients had been allocated a new surgery.

The Bedfordshire Clinical Commissioning Group had appointed a new Accountable Officer, Sarah Thompson, who would be invited to a future meeting of the Committee.

The Chairman also advised of his attendance at the Centre for Public Scrutiny Health Masterclass event that had provided helpful guidance on the scrutiny of STPs and other health related areas.

A campaign by NHS England to promote the use of pharmacies and the purchase of over the counter drugs was brought to the Committee’s attention.  Details would be circulated to Members who requested help to spread the word.  The Interim Chairman of Healthwatch advised that Healthwatch had promoted this campaign and was working closely with GPs to help educate 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 Members for Social Care and Housing and Health had no announcements on this occasion.

To consider and comment on the Bedfordshire Clinical Commissioning Group’s report that provides an overview of the work underway to deliver the Bedfordshire General Practice Forward View Plan.

The Director of Strategy and Transformation, Bedfordshire Clinical Commissioning Group (BCCG) introduced the Primary Care Strategy update that detailed the work underway to deliver the Bedfordshire General Practice Forward View Plan that had superseded and now incorporated the Bedfordshire Primary Care Strategy.  NHS England had received the Forward View submission that would see Primary Care working together with other services to achieve its goals.

Challenges faced by local healthcare services remain and focus on:-

·         Workforce and Estates related issues

·         Financial challenges

·         Delivery of new models of working to ensure the most vulnerable of patients with complex needs receive joined up care and to prevent unnecessary admission to hospital.

The Director outlined the key areas of priority to deliver change that included the reduction in paperwork completed by GPs and the collaboration of neighbouring surgeries to provide services together and at scale.  The CCG had provided funding to support clusters of GP surgeries to support them in the transition period and plans for integrated hubs in Dunstable and Biggleswade and ultimately across the whole of Central Bedfordshire.

Members of the Committee noted the vision and delivery plans and raised the following concerns:-

·         Capacity issues in West Mid Bedfordshire that had resulted in residents unable to join their preferred practice.  In response the Director advised the pressures on the workforce in primary care were well documented and the proposals outlined in the Plan would help to overcome this issue and future delivery of primary care services.

·         Concerns that a strain on Mental Health services was an issue and to some extent was a hidden problem.  Donna Derby, Director of Commissioning and Performance acknowledged that support for patients that received Mental Health services was required and the CCG was involved in the development of the Sustainability and Transformation Plan to ensure support from the service provider, multi-disciplinary teams and the third sector operated together to provide services.

·         That new housing development of 100 houses or less was not commented on by NHS England and the information was not passed on to the Primary Care providers.  The Director advised the BCCG would be taking on this role from NHS England and had recruited an Estates officer to engage with Council planning teams. 

·         How the BCCG intended to reduce the 30% GP vacancy rate?  In response the Director advised on a number of initiatives to attract GPs to the area and for social prescribing to become a common place occurrence in the recovery of patients.  Again the STP would focus on workforce and social prescribing as a key focus.

RECOMMENDED the Committee

1.    Applauded the work underway in Bedfordshire General Practice Forward View Plan, seek to ensure high quality services and implementation of social prescribing.

2.    That Mental Health issues be a necessary part of a high quality primary care service.

3.    Noted the planning application development programme would be considered by the Health and Wellbeing Board.

To consider and comment on the Bedfordshire Clinical Commissioning Group’s report on the Circle Musculoskeletal Service to residents.

The Director of Commissioning and Performance, Bedfordshire Clinical Commissioning Group introduced a report that contained details of the Integrated Musculoskeletal Service (MSK) commissioned to Circle in April 2014 for a period of five years.  The Director was pleased to report the contract had provided positive benefits to Bedfordshire residents that included:-

Improved outcomes in quality and clinical effectiveness for residents in service delivery, financial savings of £600k to date and a forecast of £4m by the end of the contract. The CCG had received excellent feedback from residents through the friends and family test.

In response Members of the Committee were delighted with the success of the contract to date and wished to pass on its thanks to Circle for an excellent service.

RECOMMENDED the committee welcomed the Musculoskeletal Service Performance report that demonstrated a good service to Central Bedfordshire residents.

To receive a verbal update on the Homelessness Reduction Act 2017.

The Head of Housing Solutions delivered a presentation that outlined the main changes required by the Homelessness Reduction Act and detailed the CBC homelessness offer.  Members were advised of the new requirements on the service that would necessitate a change to the Housing Allocations Policy.  Changes included:-

·         a duty to prevent homelessness. 

·         a duty to refer cases of homelessness by statutory agencies including police and hospitals and

·         a duty to produce personal housing plans and to cooperate in all cases.

The Housing Solutions Locality Manager advised that a team of officers would raise awareness of the cultural change expected from the impending Act with colleagues and partners.  It was expected that the numbers of housing staff would be increased in order to deal with case management documentation.  Members welcomed the benchmarking work undertaken that provided evidence the service had started to implement correct service pathways.

In light of the presentation, Members raised the following comments:-

·         whether the proposed case management IT software would be compatible with third party systems.  In response the Director of Social Care Health and Housing advised this was an ambition, but it was a huge challenge for the service.

·         Supported the newly commissioned sub regional service multi area approach to homelessness and the need for additional officers to support the service.

·         That a meeting be arranged with Housing Officers for Members to learn more about the new Act.

RECOMMENDED the Committee

1.    Recognises the challenges and welcomes the processes being put in place to relieve homelessness.

2.    Asks that in 12-15 months there is a report back to the Committee on the homelessness implementation plan as to how successful it has been in reducing homelessness.

3.    Would like to see the amended Allocations Policy.

To consider and comment on the draft Let’s Rent Homelessness Prevention Offer as a key policy to help the Council prevent homelessness and provide recommendations to the Executive.

The Head of Housing Solutions introduced a report that outlined the Let’s Rent Homelessness Prevention Offer to prevent homelessness. 

The draft Let’s Rent Policy outlined how the Council will help prevent homelessness, soon to become a statutory duty in April 2018.  The current position of the private rented market in Central Bedfordshire has meant that officers have had to consider new forms of assistance. 

The Council is required to provide clarity on its position and approach to support those at risk of homelessness that include secure tenancies with private landlords – some of whom are reluctant to rent to low income families.

In response Members raised some concerns that included:-

·         How officers would deal with those residents made homeless and unable to pay rent to the landlord.  In response the Head of Service advised the Council would continue to provide help and support to vulnerable residents, including help to get into training and work.

·         Tenants would receive training on the Let’s Rent service and their part in their tenancy arrangement.

RECOMMENDED the Committee

1.    Welcomes the further steps to be taken to prevent homelessness through its Let’s Rent Offer and when the operational action plan is developed to present it to the Committee.

2.    Sees in 12 months a report to show that the use of temporary accommodation has been reduced along with the financial savings made.

To consider the findings of the Joint Local Government Association Peer Review into Reablement and Rehabilitation, in October 2016 across Central Bedfordshire and Bedford Borough Councils.

The Director of Social Care Health and Housing introduced a report on the Joint Peer Review on Reablement and Rehabilitation across Central Bedfordshire and Bedford.  The review had included health and social care services with the agreement of SEPT and the Bedfordshire Clinical Commissioning Group (BCCG). 

The focus of the review sought to understand where services could be streamlined to avoid duplication and to ensure residents received a good, accessible, consistent experience regardless of their entry-point.  Plans to integrate some services would be considered at the Transformation Board for Bedfordshire and the Assistant Director Adult Social Care had been appointed to oversee services provided to Adults by the Council and SEPT.  An action plan was in development and would form part of the Better Care Fund Plan 2017/19.

Central Bedfordshire Healthwatch were thanked for the survey work carried out to support the review.

Members welcomed the proposal to hold a workshop to guide Members on progress.

RECOMMENDED  the Committee

1.    Welcomes the constructive Peer Group Report.

2.    Notes the ways in which the partnership will work together in the future by refreshing their relationship.

3.    Looks forward to an action plan to take account of the areas for consideration.

A Member workshop be arranged to advise Members on Reablement and Rehabilitation developments.

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

The Committee considered the current work programme and agreed to include the following items:-

1.    A six month review of the Homecare service, Extra Care and Children’s Care Services contract to be considered by Executive be added to the work programme six months after the commencement of the contract on 1st October 2017.

2.    Suggests there is a broader sense of what is emerging for the Central Bedfordshire care/extra care services as opposed to a ‘one by one’ approach when we close a care home and transfer clients to new premises.

3.    Suggests a broader approach as to how the Committee scrutinises the demand and supply of mixed homes for the future.

AGREED the work programme as set out in Appendix A subject to the addition of items 1-3 highlighted above.

To approve as a correct record the Minutes of the meeting of the special Social Care Health and Housing Overview and Scrutiny Committee held on 15 May 2017 and to note actions taken since that meeting.

Deferred