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 2011 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 2011 be confirmed and signed by the Chairman as a correct record.

To receive from Members any declarations and the nature thereof in relation to:-

(a)    personal interests in any agenda item

(b)    personal and prejudicial interests in any agenda item

(c)     any political whip in relation to any agenda item.

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

The Chairman informed the Committee that a housing briefing had been arranged to take place following the meeting on 23 January 2012 to which all Members would be invited.  Members were asked to keep the afternoon of 23 January available so they could attend.

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.

No petitions were received from members of the public in accordance with the Public Participation Procedure as set out in Part D2 of the Constitution.

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.

No questions, statements or deputations were received from members of the public in accordance with the Public Participation Procedure as set out in Annex 1 of Part A4 of the Constitution.

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

The Panel was advised that no decisions of the Executive had been referred to the Panel under the Call-in Procedures set out in Appendix “A” to Rule No. S18 of the Overview and Scrutiny Procedure Rules.

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.

No items were referred to the Committee for consideration at the request of a Member under Procedure Rule 3.1 of Part D2 of the Constitution.

To receive a verbal update from the Executive Member for Social Care, Health and Housing.

This item is scheduled for 5 minutes.

Cllr Mrs Carole Hegley, Executive Member for Social Care, Health and Housing informed the Committee of the following:-

• The launch of the Houghton Regis Helpers scheme.
• A consultation was to be undertaken on the Local Lettings Policy.
• Progress in relation to the (shadow) Health and Wellbeing Board.
• The success of the recent staff awards event.

To receive an update from Bedfordshire LINk on local health matters affecting LINk activity as defined by the Health and Social Care Act 2001.

Please note – this item will be dealt with by exception.  Any questions by Members will be answered at the meeting.

Charlotte Bonser, Bedfordshire LINk Operations Manager informed the Committee that the Bedfordshire LINk was currently focusing on work in relation to Mental Health Community Services and Luton and Dunstable Patient Experience.  Bedfordshire LINk was also planning a series of “enter and view” visits to care/nursing homes to be undertaken in the next 6-8 months.

In response to a Member question it was stated there would be full terms of reference agreed prior to any visits to care/nursing homes taking place. Residents and family members would be informed of the visits in advance.

Concerns were also raised by the Chairman of Bedfordshire LINk that Bedford Hospital were failing to review concerns of the LINk within statutory timescales.

The Committee will receive a presentation regarding the role of the Care Quality Commission (CQC) and how information sharing could be enhanced between the Committee and the CQC

Members are requested to bring to the meeting their copies of the Guide for Overview & Scrutiny Committees for Health & Social Care and Guide for Local Councillors produced by the Care Quality Commission and sent out separately with this agenda.

This item is scheduled for 30 minutes.

The Committee received a presentation from Maggie Hannelly, Care Quality Commission (CQC) Compliance Manager for the East region.  The presentation outlined the services that CQC monitors and how they carried out checks.  The presentation also introduced guides for scrutiny committees and local councillors in relation to CQC.

Following the presentation Members discussed how CQC and the Committee might work in partnership.  It was agreed that a process was required for the OSC to submit comments to the CQC and vice-versa.  This process should also involve Bedfordshire LINk and other care providers.  The OSC would continue to be a forum for discussion on health and social care issues and a means by which Members could refer comments to the Commission.

Resolved

That a report be presented to a future meeting containing proposals as to how the Committee and the CQC might work more effectively in partnership to raise concerns and provide information to Members.

To inform members of the Acute Services review and timetable for consultation.

This item is scheduled for 30 minutes

The Committee received an update from Ed Neale, Bedford Hospital Medical Director, on proposals for a review of South East Midlands Acute Services.  In addition to the presentation Simon Wood, Director of Commissioning for Bedford and Luton PCT, informed the Committee that phase 1 of the public engagement detailed in the report had been completed.  It was proposed that a Joint Health Overview and Scrutiny Committee (JHOSC) be established with other local authorities in order to scrutinise the proposals and engage in future consultations.

In response to the issues highlighted in the report Members raised and discussed the following issues in detail:-

• The need to be mindful throughout the review of the stress caused to patients by having to travel to receive treatment.
• The importance of retaining patient choice whilst also improving service quality.
• There were presently no plans to include tertiary services within the review.
• The importance of family support as a key principle of the review.

The Committee considered whether or not a JHOSC should be established.  Whist the Committee agreed that a JHOSC was necessary Members felt it was essential that feedback from the group be provided to this OSC.  It was also felt the Council should not be prevented from submitting its own comments in response to the review despite the outcomes of the JHOSC.

Resolved

1. That the Social Care, Health and Housing Overview and Scrutiny Committee considers the South East Midlands Acute Services Review to be a substantial variation or development of services and therefore a formal public consultation is required.

2. That the Social Care, Health and Housing Overview and Scrutiny Committee agree in principle that a Joint Health Overview and Scrutiny Committee be established in order to consider the South East Midlands Acute Services Review.

To receive a report outlining the progress on the transition of Bedfordshire Community Health Services to the South Essex Partnership University NHS Foundation Trust (SEPT).

This item is scheduled for 30 minutes

The Committee received a presentation from Richard Winter, Executive Director of SEPT Community Health Services, Bedfordshire on the progress of transition from Bedfordshire Community Health Services to SEPT, which took effect on 1 September 2011.

In response to the presentation Members raised and discussed the following issues in detail:-

• The importance of exploring partnership working opportunities across services in order to reduce duplication, contribute to the cost saving agenda and improve patient outcomes.
• The importance of a clear pathway of care.
• To date the feedback received from patients following the changes had been positive.
• The development of an Autism Strategy, which Bedfordshire LINk wished to be involved in.
• The importance of patient choice and consulting with patients on the most effective means of delivering services locally.

The Committee commented that they would welcome a further update on progress with the transition at a future meeting.

Noted the report

(Note: The Committee adjourned at 11.30am for a short break and reconvened at 11.40am)

To consider the Social Care, Health and Housing draft Budget for 2012/13

Members are requested to bring the budget papers issued for the meeting of the Executive on 6 December 2011 to the Committee meeting.

This item is scheduled for 10 minutes.

The Committee received a report from the Deputy Leader and Executive Member for Corporate Resources relating to the Draft Budget 2012/13, Medium Term Financial Plan 2012 – 2016 and the Capital Programme 2012/13 to 2015/16.  The Committee were asked to consider the draft budget proposals and provide their comments for consideration by the Customer and Central Services OSC and the Executive.

In response to the proposals the Committee commented as follows:-

Draft Budget 2012/13 and Medium Term Financial Plan 2012-2016

• The need for a further report on “EA37 Direct Services” at a future OSC meeting to consider any future delivery model.
• Challenges in relation to the 100% delivery of personal budgets.
• Challenges in relation to “EA51 Commissioned services” and reducing the amount of funding in residential care placements.
• The importance of enhancing communication with residents who self fund their residential care so as those residents achieve value for money for the services they receive.

Capital Programme 2012/13 to 2015/16

The Committee discussed issues in relation to the asbestos management scheme contained in the Housing Revenue Account (HRA).  It was proposed by a Councillor that schemes within the HRA should be amended to permit the earlier removal of asbestos and that the health and safety aspects of asbestos should be fully considered.  The Committee did not agree with this proposal but did request that a further technical report be provided to Members in the future.

In addition to these comments Members also requested that a market position statement be submitted to a future meeting of the Committee.

Noted

The Draft Budget 2012/13, Medium Term Financial Plan 2012-16 and the Capital Programme 2012/13 to 2015/16.

Recommended

That the issues considered by the Committee be brought to the attention of the Customer and Central Services OSC and the Executive during their consideration of these reports.

To consider the Social Care, Health and Housing draft Budget for 2012/13

This item is scheduled for 10 minutes.

The Committee received a report from the Deputy Leader and Executive Member for Corporate Resources that proposed revised fees and charges for the Council to be effective from 1 April 2012.

In response to questions from Members it was commented that the 2% increase in fees and charges was advised by the consumer price index.  It was also confirmed that the proposed charge for 2012/13 of £1,863.20 per week in relation to Linsell House was the charge for the whole service.

Resolved

That the report and schedule of proposed fees and charges be noted.

To receive a report explaining the implications of self-financing of council housing and the options available.

This item is scheduled for 10 minutes.

The Committee received a report that sought their comments on the Housing Revenue Account (HRA) within the new self-financing regime.  The introduction of the new regime resulted in the Council taking on a debt of £165m but enabled the Council to retain its rental income in order to repay this.  In addition to the report the Committee heard that the Council would take a flexible approach to the debt so that some money from rental income could be reinvested elsewhere.  The new regime presented the Council with an opportunity where there was also close monitoring within the financial management strategy. Due to the good standard of the housing stock the Council should retain approximately £11m in rental income that had previously been paid to the Government.

In response to the report and comments of Member the Committee raised and discussed the following issues in detail:-

• Further reports to the Executive should identify any changes in interest rates.
• The Council should consider if there was an opportunity to reinvest rental income by purchasing additional property.  It was noted it would be important to discuss the use of any rental income with local tenants.
• The Council was awaiting further guidance on the implications of ‘right to buy’ schemes, projections had been made in the HRA based on current information.

The Committee considered the future role they should undertake in order to examine opportunities, issues and risks related to the HRA under the self-financing regime.  The Committee agreed that a further briefing by email on this would be welcome.  Updates and further proposals should be provided to the Committee in a timely manner prior to the approval of a policy by the Executive.

Resolved

That a briefing be provided to Members in relation to the future financial model.  A further report was also to be presented to the Committee to consider how it might examine opportunities, issues and risks related to the HRA under the self-financing regime.

Recommended to the Executive

That the comments of the Social Care, Health and Housing OSC be considered and that the draft budget report for the Housing Revenue Account within the new Self-Financing Regime be approved.

To receive a report explaining how the harmonisation of housing needs will affect Central Bedfordshire.

This item is scheduled for 10. minutes.

The Committee received a report that set out proposals to harmonise housing needs across Central Bedfordshire, with the Council operating an in-house service from April 2012 to allow for a £200k efficiency saving from 2012-13 onwards.  The Assistant Director for Housing drew the attention of the Committee to the primary reason for harmonising the Housing Needs Service in order to achieve a coherent and consistent service across Central Bedfordshire.

In response to the report Members commented on the importance of ensuring that residents were able to access all of the benefits they were entitled to.  It was also commented that partnership working between Aragon and Council officers in the past had been good.

Recommended to the Executive

That proposals to harmonise the Housing Needs Service across Central Bedfordshire as a single and coherent “in house service from 1 April 2012” be adopted.

(Cllr Drinkwater left the room during consideration of this item only and the Vice-Chairman, Cllr Sheppard took the Chair).

To consider a proposal to the Executive to introduce a charge for council-provided Telecare Services, following on from the review into all charges for non-residential social care services conducted in 2010.

This item is scheduled for 10 minutes.

The Committee received a report that set out proposals to introduce a charge for Telecare Services provided by the Council.  The proposals would deliver an additional £192k of gross income to the Council in a full year.  The Head of Business Systems drew the attention of the Committee to the recommendations of the previous Task Force review of the Social Care, Health and Housing OSC, which recommended the introduction of a charge for Telecare Services.

In addition to the report it was highlighted that charges for Telecare Services would be included in current packages for those that already received locality services.  Those currently outside of the needs analysis group would pay a £4 charge per installation per week (plus VAT).

In response to the report and the outcomes of a public consultation, which were detailed in the body of that report the Committee raised and discussed the following issues in detail:

·        The importance of carrying out risk assessments with those residents who leave the service due to their inability to pay charges.  The additional charge should not create a health and safety risk for residents.  It was commented that the majority of current service users would not pay any additional charge as it was already incorporated into their current contribution.

·        The potential need to assist residents who were unable to complete VAT exemption forms.

·        The Council provided a relatively cheap service when compared to other local authorities.

·        The means by which the Council would pursue unpaid fees.

·        The Council needed to be mindful of the marketing of this additional charge to ensure residents were informed in an appropriate manner.

Recommended to the Executive

That the comments of the Social Care, Health and Housing OSC be considered and that proposals to introduce a charge for Telecare Services provided by the Council be adopted.

To receive the Quarter 2 revenue positions for the Social Care, Health and Housing Directorate.

Please note – this item will be dealt with by exception.  Any questions by Members will be answered at the meeting.

The Committee received a report that set out the financial position for the year 2011/12.

Noted

1. The General Fund Outturn of £56.453m and £0.379m overspend.
2. The Housing Revenue Account financial position.

To receive information on the Directorate capital financial position as at the end of June 2011.

Please note – this item will be dealt with by exception.  Any questions by Members will be answered at the meeting.

The Committee received a report that set out the Directorate capital financial position as at the end of September 2011.

Noted

The Capital position as at the end of September.

To consider details of the currently draft Committee work programme and the Executive Forward Plan.

Please note – this item will be dealt with by exception.  Any questions by Members will be answered at the meeting.

Members considered the Committee’s draft work programme for 2011/12 and the Executive Forward Plan.  In addition to the report it was noted that the item on “improving the experience of people leaving hospital through more effective practice and partnerships”, which had been scheduled for 23 January 2012 would now be considered on 5 March 2012.

Resolved

That subject to amendments in relation to the item on “improving the experience of people leaving hospital through more effective practice and partnerships” the draft work programme be approved.