To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 27 June 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 27 June 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 announced a successful housewarming event for residents had been held at Priory View in Dunstable.

Members were advised that work undertaken as part of the Healthcare Review, recently put on hold, would now feed into the Sustainability and Transformation Plans (STP’s).  The Joint Health Overview and Scrutiny Committee would meet to receive an update on progress of the STPs in November.

A Regional Health Chairs and Officers meeting with EEAST would take place on 4 October 2016, 10.00am in Ipswich.  The Trust had agreed to update Members on the planned action following the CQC Inspection in April.  A volunteer to attend the meeting was request for this occasion.

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 Member for Social Care, Health and Housing.

The Deputy Executive Member for Adult Social Care announced that meetings with residents of the Sheltered Accommodation Schemes to be affected by the intended re-designations of buildings in Leighton-Linslade and Dunstable had been positive.  Residents had received reassurances that no immediate changes to their circumstances would be made unless they requested them.

The Deputy Executive Member welcomed the report on the Day offer for Older People and Adults with Learning Difficulties.  An excellent response to the service user engagement had resulted in 799 responses received.

The Executive Member for Health announced that the South Essex Partnership Trust (SEPT), provider of Community Health Services, would merge with the North Essex Partnership Trust (NEPT) in April 2017.  The Executive Member also advised that the Luton and Dunstable Hospital Trust had been chosen, amongst others, to lead on Digital Road Map pilot. 

The Executive Member had been invited to attend a Quality Summit at Bedford Hospital that was in response to its CQC inspection.  A similar invitation had been extended by ELFT following their CQC inspection.

In response to the update, a Member raised a concern regarding the cleanliness of wards at the Luton and Dunstable Hospital Trust (L&D).  The Executive Member advised that a new cleaning contract had been awarded.  The new contract would be closely monitored and improvements would be evident. 

A concern arose regarding elderly patients at the Luton and Dunstable hospital did not receive regular exercise and were not moved out of their beds.  The Executive Member advised the Chief Executive of the L&D was keen to ensure mobility of elderly patients on wards.

In response a question on the merger of SEPT and NEPT, The Executive Members advised that SEPT were keen to continue to support the residents of Central Bedfordshire and had been advised that the merger presented a small risk to our residents.

The Committee is requested to scrutinise the arrangements for the integrated procurement for Community Health Services (including 0-19 Children’s Services) outlined within the Memorandum of Understanding.

Comment on the model of care and outcomes for the 0-19 Children’s Services outlined in the report.

The Executive Member for Health introduced a report that outlined the detailed Commissioning arrangements for the integrated procurement of Community Health Services (including 0-19 Children’s Services) and Memorandum of Understanding (MoU). 

The Monitoring Officer advised multiple partners were involved in the delivery of services and it was imperative that the governance arrangements were resilient and clear so all partners could have their say.  Although not legally binding, the MoU did create requirement and compliance of all partners.  The Monitoring Officer explained the roles and responsibilities of Partnership Board, Leaders Group and Programme Delivery Team were clearly define.

In light of the report Members of the Committee raised the following concerns:

·         That given the difference in diversity of Bedford and Central Bedfordshire residents, whether the two authorities could work together successfully to deliver Community Health Services to satisfy all our communities’ needs.  The Executive Member advised that Central Bedfordshire had run successfully commissioned the Health Child Programme. Clarification on the age range and why it specially supported the 0-19 age group.  The Assistant Director Public Health advised the age range was in line with children in education and the Bedfordshire Clinical Commissioning Group commissioning provision.

·         How the Committee might continue to scrutinise the performance of Community Health Services.  The Executive Member advised that the Executive would undertake the scrutiny of the Healthy Child Programme.

·         That the initial basic responsibility of parents be emphasised within the document. 

RECOMMENDED that the Committee

1.       Appreciated the purpose of the MoU and approved the contents. It looked forward to the continued constructive working between partners in this area.

2.    Approved the vision in the Commissioning Plan for the Healthy Child Programme and looked to be assured that the well being and needs of Central Bedfordshire residents are met.

To inform the Committee of the process planned to determine the future of day services in Central Bedfordshire and the outcome of work undertaken thus far.

To seek the views of the Overview and Scrutiny Committee on the key themes and issues set out in this report

The Head of MANOP Services introduced a report that outlined the process plan to determine the future of day services in Central Bedfordshire and the outcome of work undertaken so far.  The key challenges faced by the service and the opportunities identified were highlighted and this along with the significant response to the customer and stakeholder consultation that would be fed into the work undertaken by the co-production group.

The new model of care would include basic needs, psychological needs and self-fulfilment needs and subject to Executive approval, a formal public consultation would be undertaken and completed in January 2017.

In light of the report Members raised the following issues:-

·         Whether staff had been involved in the future planning process and whether weekend services might be provided by e.g. voluntary groups in buildings left empty on a weekend. The Head of MANOP advised that staff had been engaged with and would investigate if there was a requirement for weekend services.

·         That the day offer provided by Hospices be explored.

·         That officers consider an approach to successful companies and explore the idea of an occasional day service offer to the elderly or those with disabilities.

·         That the provision of services in rural areas be of equal importance and consideration as urban in the process.

·         That a mapping exercise to establish the voluntary groups offering services in Central Bedfordshire be undertaken to identify where resources might be combined or complemented by joint working.

RECOMMENDED

1.    The Committee

• Welcomes the approach to define the purpose of day care services in a new era putting customers and carers at the centre of our deliberations.
• Approves the process to better understand the  needs and preferences of our customers to help determine the Council’s offer and the  proposed wider, formal consultation.
• Asks that regard is given to what other groups in the voluntary sector are currently providing and could provide in the future with a view to integrating or complementing provision?
• Would like it to be determined whether it is feasible or necessary to extend provision to Saturdays and Sundays.
• Understands the necessity to consider where and how we deliver these services.

2.    The Committee further requests that a report on the progress of the formal consultation is brought to its meeting on 23rd January 2017.

To consider the emerging approach for the integration of health and social care in Central Bedfordshire that aims to redesign how residents can access health and care services in the future.

Members are requested to approve an Scrutiny Enquiry on the approach to integration and deliver services to improve the health and wellbeing of the population of Central Bedfordshire.

The Executive Member for Health introduced the report outlined the emerging vision and approach to deliver Integrated Health and Social Care services including locality based hubs in Central Bedfordshire.  The Executive Member sought the help of the Committee on the approach to be taken on integration and proposed that an Enquiry be undertaken to examine proposals. 

It was agreed that a Scrutiny Enquiry be arranged and include a mixture of cross party and ward Members to examine the approach to integration, the ambition and capacity to deliver integrated services and aim to improve the health and wellbeing of our residents. It was also agreed to use the overview shown at Appendix B to form the basis of the work for the Enquiry.

RECOMMENDED the Committee

1.    Welcomed the move towards a viable, integrated health and social care service working constructively with partners to provide a more efficient complementary service.

2.    Agreed to set up a Scrutiny Enquiry inviting Members for an expression of interest with a view to establishing a cross party, cross area group to examine the approach to integration, the ambition and capacity to deliver integrated services to improve the health and wellbeing of residents.

To consider the performance monitoring information for Social Care Health and Housing and Public Health for the first quarter of 2016/17.

The Head of Business Systems introduced the quarter one performance report (April to June 2016) for the Directorate.  The report incorporated the new measures following the implementation of the new five year plan 2015-2020.  With no comparative data available, the next quarterly report would start to show trends.

Members were keen to see progress to reduce the number of non-elective admissions to hospital, and the premature deaths indicator.  The Assistant Director Public Health advised that not all premature deaths were avoidable and the focus was on those that were. 

Details of village care schemes were welcomed and Members raised issues that inhibited the number of volunteers from applying to the scheme.  There was also an issue with the storage of equipment in some areas. An audit of skilled volunteers would be of benefit to the Village Care Scheme administrators and it was proposed that Bedfordshire Rural Communities Charities be approached to discuss this action.

Recommended the Committee     

·         Acknowledged the overall good performance.

·         Looked forward to the development of a measure related to the avoidance of admissions to care homes

·         Recognised the value of the Village Care Schemes and the role played in supporting clients, welcomed the moves to increase the number of volunteers and clients and looked to a simplified method to join a scheme

·         Ask that thought be given to any equipment needed for client’s support and its storage

·         Suggested that the Bedfordshire Rural Communities Charity might set up an audit of the skill set of its volunteers

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 update on the Day Offer for Older People and Adults with Disabilities at the January 2017 meeting.

RECOMMENDED that the work programme be approved subject to the additional items detailed in the Minutes above.