To approve as a correct record the Minutes of the meeting of the Social Care, Health and Housing Overview and Scrutiny Committee held on 05 March 2012 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 05 March 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 of the following:-

·        Following the circulation of a briefing to Members relating to a new delivery model for Dermatology Services several questions had been raised by a Member.  A response to those question was circulated at the meeting and any further matters could be raised outside of the Committee.

·        A meeting of the Joint Health Overview and Scrutiny Committee was scheduled for 23 April 2012 from 4pm at Borough Hall, Bedford.

·        A Member request to consider an item in relation to performance on clients receiving self directed support would be considered under Item 20.

The Committee was also informed that Central Bedfordshire Council had successfully applied to become a scrutiny development area (SDA) as part of a Centre for Public Scrutiny (CfPS) health and social care reform programme.  The Council was one of 15 SDAs who would lead on the implementation of reforms in relation to overview and scrutiny.  The programme provided an opportunity to consider the most appropriate means of undertaking health scrutiny and encouraging a more effective ‘critical friend’ challenge.  The Scrutiny Policy Adviser was currently drafting a project plan with the CfPS, Members and partners had been invited to provide their views to be included in that project plan.  Updates would be provided to the Committee regularly throughout the duration of the programme.

NOTED

The response to issues raised on the briefing relating to the new delivery model for dermatology care and that any further issues could be raised outside the Committee.

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 C Hegley, Executive Member for Social Care, Health and Housing updated the Committee on the following:-

·              Meetings, which the Council continued to attend as part of their involvement in the national learning set for Health and Wellbeing Boards.

·              An East of England Local Government Association Leaders’ Network meeting that Cllr Hegley had recently attended, which provided information on European funding that was available.

·              The enactment of the Health and Social Care Bill.

·              The Council recently won the Best Customer Engagement Initiative of the year award at the national Go awards for procurement of Extra Care services.

·              Development in relation to a scheme at Old Warden Park.

·              A public health briefing had been arranged for Members on 4 May 2012.

·              Meetings of the Older Peoples Reference Group continued to be held and were positive.

·              The Council continued to challenge the adequate rating received in 2010 for Adult Social Care by demonstrating change and improvement.  The Council was awaiting a formal letter recognising our significant improvement.

NOTED the update

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

This item is scheduled for 5 minutes.

The Committee received a report from Charlotte Bonser, Bedfordshire LINk Operations Manager highlighting issues of patient experience particularly in relation to nursing care and hospital discharge.

Members discussed issues in relation to hospital discharge including the importance of looking at the whole pathway and meeting the needs of the patient.  Members also discussed issues in relation to instances where patients were inappropriately discharged from hospital late in the evening or early in the morning.

RESOLVED

That a Task Force be established involving the LINk to consider issues in relation to hospital discharge in Central Bedfordshire.

To consider a briefing note relating to Bedford Hospital NHS Trust’s Transforming for Excellence Programme.  The Committee is asked to consider whether the implications of the programme represent a substantial variation in services and whether a Joint Health Overview and Scrutiny Committee is required.

This item is scheduled for 20 minutes.

The Committee received a report relating to Bedford Hospital NHS Trust’s Transforming for Excellence programme (TfE).  In addition to the report Mr Paul Tisi, the Associate Medical Director, stated that there were would be no radical change as a result of the TfE programme, the aim was to improve quality of care whilst improving efficiency.  The Committee were informed that there were three key workstreams:-

1.            clinical effectiveness;

2.            workforce and operational support; and

3.            business unit delivery.

It was commented that as a result of the proposals and specifically ward reconfigurations it was proposed that 26 beds would no longer be needed.  There would be no reduction in the level of service delivered as a result of this reduction.

In response to the issues highlighted in the report and the clarification provided by the Associate Medical Director and the Chief Operating Officer Members raised and discussed the following issues in detail:-

·        The discharge lounge at the hospital would only be used in appropriate circumstances.  It was recognised that waiting in the lounge was not appropriate for all patients.

·        The importance of ensuring that wards were staffed appropriately and that standards of nursing care were monitored.

·        Concerns that issues in relation to hospital discharge had been prevalent for a considerable period of time and improvements had not been made.  Members noted that the sub-acute unit had opened in October/November 2011 in order to improve complex discharges.

·        Whether there were opportunities for the Council and the hospital to work in partnership and for funding to be awarded to the Council in order to prevent people having to attend hospital.

·        The importance of being mindful that Bedford was one of only 6 hospitals that discharged into the Central Bedfordshire area.

·        It was not clear whether the Healthier Together programme, that was presently reviewing the delivery of acute services throughout the South East Midlands, would have an impact on the hospital resulting in further necessary changes in the future.

·        The importance of effective communication with patients in relation to any proposed ward changes.

·        The NHS Hospital Trust did not believe the proposals constituted a substantial variation in service.

·        The proposals did not provide any timescales for the delivery of the workstreams.  The Committee were informed these would be agreed following the feedback from recent consultation and could be included in any updates provided to the Committee.

Following discussion the Committee noted that Bedford Borough Council were due to receive the same briefing at their meeting on 17 April 2012.  If the Committee felt that the programme constituted a substantial variation of service a Joint Health Overview and Scrutiny Committee would be required with Bedford Borough Council.  Members were minded to agree that this was not a substantial variation of service and that a formal consultation was not required.  Members did however agree in principal that if Bedford Borough Council felt a Joint Health Overview and Scrutiny Committee was necessary they would also take part.  If a Joint Health  ...  view the full minutes text for item 107.

To receive the emerging Medium Term Plan for Central Bedfordshire Council for 2012-16 that sets out the Councils proposed priorities for the next four years.  The Committee are asked to provide views to be considered by the Executive on 15 May 2012.

This item is scheduled for 20 minutes.

The Committee received a report from the Leader of the Council that sought the views of Members on the proposed content of the emerging Medium Term Plan prior to its adoption by Full Council.

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

• The importance of customer experience and being mindful that not all residents had access to the internet.  The Council needed to ensure that Customer Services staff did not become de-skilled.
• Whether targets should be included in relation to public health.

·        Whether the 100% coverage target for the operation of Village Care schemes by 2014 was appropriate.

RECOMMENDED TO EXECUTIVE

1.            That the Social Care, Health and Housing Overview and Scrutiny Committee agrees to the approach for adopting the Medium Term Plan 2012-16.

2.            That the Social Care, Health and Housing Overview and Scrutiny Committee has considered the emerging priorities and targets in within the Medium Term Plan and commented that the Council needed to ensure that the focus on customer experience still provided appropriate opportunities for customers who wished to engage with the Council by phone or face to face as well as by other means.  In developing a consolidated customer service team the Council needed to ensure that officers maintained an awareness of a wide number of areas and did not become de-skilled.

(Meeting adjourned at 1125am and reconvened at 1130am

To consider a report that outlines a new model of Musculoskeletal (MSK) care for Bedfordshire.  The Committee are asked to consider the new model of care and comment as appropriate.

This item is scheduled for 20 minutes.

The Committee received a report of the Musculoskeletal (MSK) System Redesign Manager in relation to proposals for a new model of delivery for MSK services.  The Committee were informed that the current delivery model was considered to be outdated and needed to change in order to be more responsive to the needs of patients and to respond to the challenges of an ageing population.

In response to issues highlighted in the report and further clarification from the System Redesign Manager and a Bedfordshire LINk representative Members raised and discussed the following issues in detail:-

·                    That there would be no additional cost to Central Bedfordshire Council as a result of the proposals.

·                    Pathways needed to address concerns that a lack of GP referrals prevented diagnosis or access to services.

RESOLVED

1.                  That proposals for an integrated MSK system across Bedfordshire, with an aim to deliver with better outcomes and improved quality of care for patients whilst realising improved value for money by incentivising a shift of resources from the acute setting to communities across Central Bedfordshire be supported.

2.                  The clinical protocols in relation to the MSK pathway and referrals from GPs be circulated to Members of the Committee.

To receive a report that informs Members of performance in relation to tackling empty homes in Central Bedfordshire.

This item is scheduled for 10 minutes.

The Committee received a report from the Head of Private Sector Housing that informed Member of performance relating to tackling empty homes and properties that would be recommended for further high level enforcement action.

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

·                    Issues relating to an empty property in Leighton Buzzard to which officers would respond outside of the meeting.

·                    The legal options that were open to the Council to enter properties that were empty where complaints had been received from residents.

·                    The procedure followed by the Council once an interim approval had been granted prior to an Empty Dwelling Management Order (EDMO) being served on a property.

·                    The benefit of Members having a list of the empty properties within their wards.  The Head of Private Sector Housing undertook to circulate a list to Members.

NOTED

1.                  The achievements obtained to date in respect of empty homes since April 2009, including the additional revenue the Council is likely to receive.

2.                  The properties that will be recommended to Executive for approval for further high level enforcement action.

(Meeting adjourned at 1215pm and reconvened at 1218pm)

To receive a presentation that informs Members of the provision that is currently available for adults on the autistic spectrum in Central Bedfordshire, as requested at the previous meeting on 05 March 2012.

This item is scheduled for 15 minutes.

The Committee received a presentation (attached) from the Assistant Director for Commissioning and the Head of Commissioning relating to the autism strategy, key joint strategic objectives and the development of a local diagnostic centre.  In addition to the presentation the Director for Social Care, Health and Housing informed Members that the Council was currently enhancing its knowledge of autism and expertise in the area.

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

·                    The importance of managing the transition as children on the autism spectrum become adults.

·                    The importance of fully engaging people on the autism spectrum in society, particularly in relation to improving people’s understanding of autism and helping adults on the autism spectrum into employment.

·                    The autism strategy needed to be sustainable and ensure that support could be delivered beyond the three year life of the strategy.

·                    The need to improve the diagnosis of people on the autism spectrum by GPs.

In addition to the issues raised by the Committee it was noted that the autism strategy would be beneficial and the Council should be congratulated on its work so far

NOTED the presentation.

To receive a report and presentation that provide an overview of the strategic housing agenda, arising from the Localism Act, Welfare Reform and the Government’s National Housing Strategy.  The Committee is requested to consider the changes outlined in the report with a view to commenting on how Overview and Scrutiny should be engaged in developing the Council’s approach to respond to the changes.

This item is scheduled for 30 minutes.

The Committee received a report and presentation from the Assistant Director for Housing that provided an overview of the strategic housing agenda and sought views from the Committee on how they would like to be involved. The presentation covered various areas including:-

1.            the current ‘housing offer’ in Central Bedfordshire;

2.            the current profile of tenants Central Bedfordshire;

3.            the changes and implications of various reforms in relation to housing; and

4.            the Councils successful application to the Local Government Association “Keeping it REAL” programme.

In response to the report and the issues outlined in the presentation Members commented that there were a significant number of issues that needed to be considered.  In order to provide the most effective input to the process Members agreed that a cross-directorate Task Force should be set up to support the process of developing the Council’s strategic approach to housing.

RESOLVED

That a Task Force in relation to the strategic change agenda for housing be established involving all non-Executive members and representatives from each of the Council’s Directorates.

To receive the capital programme report for the Social Care, Health and Housing directorate as at the end of December 2011.

This item is to be considered by exception only.

The Committee received the capital financial position for the Social Care, Health and Housing Directorate as at the end of December 2011.

NOTED the capital position as at the end of December 2011.

To receive the revenue budget report for the Social Care, Health and Housing directorate for the quarter ended 31 December 2011.

This item is to be considered by exception only.

The Committee received the revenue financial position for the Social Care, Health and Housing Directorate for the year 2011/12.

NOTED

1.            the General Fund outturn of £56.307m and £0.225m underspend; and

2.            the Housing Revenue Account financial position.

To consider the quarter 3 performance monitoring report for the Social Care, Health and Housing directorate.

This item is to be considered by exception only.

The Committee received the quarter three performance report for the Social Care, Health and Housing Directorate.  Members queried performance in relation to SCHH2 (clients receiving self-directed support) and the 100% target by March 2013.  Members were told that, as expected, performance to date was at 50.2% of people receiving self-directed support compared to 40% at the end of quarter 3.  There were a total of 4,590 people receiving services, 2,304 of whom received personal budgets and 1,202 of whom received direct payments.  It was agreed that in future reports actual figures would be presented alongside percentages.

NOTED the report

To consider the currently drafted Committee work programme for 2012/13 and the Executive Forward Plan.

This item is to be considered by exception only.

Members considered the draft work programme for 2012/13 and Executive Forward Plan.  It was noted that a report would be added to the agenda in December in relation to self directed support that could include actual figures to date and benchmarking data from other authorities.

RESOLVED

That the draft work programme be approved subject to the addition of an item on self directed support to the meeting in December 2012.