To approve as a correct record the Minutes of the meeting of the Social Care, Health and Housing Overview and Scrutiny Committee held on 12 April 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 12 April 2012 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 updated the Committee on the following:-

1.                  The Quality Accounts for Luton and Dunstable Hospital and the South Essex Partnership University NHS Foundation Trust (SEPT) were circulated to Members of the Committee for comment.  A nil response had been received, which was circulated to those organisations.

2.                  Members were invited to attend the next meeting of the Joint Health Overview and Scrutiny Committee from 4pm on 12 July 2012 in the Council Chamber at Priory House, Chicksands, the meeting was to be held in public.

3.                  Members were invited to attend a meeting from 10am on 2 July 2012 in the Council Chamber at Priory House, Chicksands in relation to the health and social care reforms.  The meeting would discuss the implications of the health reforms for Central Bedfordshire and consider the manner in which the Council undertook scrutiny of health and social care matters.

NOTED the update.

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.

The Committee was informed that 1 person had registered to speak in accordance with the Public Participation Procedure as set out in Annex 1 of Part A4 of the Constitution.  It was agreed that the speaker would be invited to address the Committee at the beginning of Item 11 (Minute SCHH/12/10 refers).

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.

The Committee was advised that Cllr Ms C Maudlin had requested an item in relation to Biggleswade Hospital.  Cllr Ms N Sheppard commented that concerns had been raised by residents in relation to the low numbers of admissions at Biggleswade Hospital.  Poor communication had resulted in a lack of clarity regarding the current situation of admissions.

In response the Director for Social Care, Health and Housing stated that she had discussed the issue with appropriate health professionals and no decision had been taken in relation to the use of Biggleswade Hospital.  The NHS would be required to consult the Overview and Scrutiny Committee on any substantial variation of service at Biggleswade Hospital.  The Director undertook to ensure that the item was received by the Overview and Scrutiny Committee at an appropriate meeting.

RESOLVED

That an item in relation to Biggleswade Hospital be considered at a future meeting of the Social Care, Health and Housing Overview and Scrutiny Committee.

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

Cllr Mrs C Hegley, Executive Member for Social Care, Health and Housing updated the Committee on several issues that were not included on the agenda, these included:-

·                    The improvements in performance demonstrated in the directorate outturn for 2011/12.  Performance criteria were presently being revised to reflect the new Medium Term Plan.

·                    The implications of decisions in relation to telecare services continued to be monitored and a progress report would be provided to a future meeting.

·                    Carers week took place from 18 to 24 June and the Council had issued a press release publicising local activities.

·                    The Executive Member for Social Care, Health and Housing recently attended their quarterly meeting with local Members of Parliament.

·                    The Town and Parish Council Conference, which had been well attended and received a presentation on ageing well and the Arlesey Village Agent.

·                    A recent seminar for Members on public health in Central Bedfordshire that had been well attended.  It was proposed that a further seminar be held in the future to update Members on developments.

·                    Meetings, which the Council continued to attend as part of their involvement in the national learning set for Health and Wellbeing Boards.  It was also reported that the first meeting of the Shadow Health and Wellbeing Board had taken place and was positive.

·                    An event the Executive Member had attended being run by Research in Practice for Adults (ripfa), which promotes the use of evidence informed policy and practice in adults health and social care.

·                    The recommendations of the Committee in relation to the Empty Homes Strategy review of performance had been considered and accepted by the Executive.

·                    Cllr A Turner, the Deputy Executive Member for Social Care, Health and Housing had attended the opening of homes for residents with learning disabilities as a result of the NHS Campus Closure Programme.  Cllr A Turner had also attended a meeting of the Older People’s Reference Group recently.

In response to the issues raised by Executive Member the Chairman of the Committee requested that an update on progress be provided to the Committee in 6 months relating to the Arlesey Village Agent.  The Committee also commented that it would welcome another seminar for Members on public health in Central Bedfordshire.

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.

The Committee received a report from Charlotte Bonser, Bedfordshire LINk Operations Manager highlighting the following issues:-

1.      encouragement of GP surgeries to establish patient participation groups (PPGs); and

2.      feedback on LINk visits to three wards at Luton and Dunstable Hospital.

In addition to the report the Committee were informed that a copy of the PPG survey report had been circulated to Members.  The Bedfordshire LINk Operations Manager commented that PPGs were an effective means of empowering patients to provide their views on services and should be retained during the transition to Healthwatch.  The principle concerns resulting from the visits at Luton and Dunstable Hospital related to wards 16 and 18.  In response to a Member question it was confirmed that a planned visit to Bedford Hospital had been rescheduled.

A Member of the Committee commented on the importance of encouraging family and friends to support the delivery of care for those in hospital.  The Waterlow System of risk assessment of pressure sores/ulcers was also very important and should be encouraged.  The Member also commented on difficulties relating to hospital discharge in the Central Bedfordshire area that resulted from there being several hospitals that discharged into the area.

It was also commented that Members should encourage PPGs to be established within their ward and to ensure they were reflective of the local community.  The Deputy Director of Communications and Public Engagement, NHS Bedfordshire and NHS Luton Cluster commented that clinical commissioning groups (CCGs) would have a strong focus on gathering the views of local communities and would continue to develop engagement with patients.

NOTED the update

To consider a report that details proposals for the future provision of older person’s accommodation in Toddington.  The Committee is asked to provide recommendations prior to consideration of options by the Executive.

In accordance with the Public Participation Procedure as set out in Annex 1 of Part A4 of the Constitution one speaker was invited to speak in relation to this item on behalf of Friends for Crescent Court.  The speaker raised issues including the following:-

·                    More detailed analysis of issues relating to Crescent Court and clearer explanation of issues to residents had been undertaken by the Council, this had resulted in a clearer explanation of the proposals being discussed.

·                    Friends of Crescent Court supported the proposals that had been submitted to the Committee.

·                    The importance of ongoing clear communication and the avoidance of mixed messages during the period of developing a Neighbourhood Plan for Toddington if the preferred proposal was approved.

The Committee received the report of the Executive Member for Social Care, Health and Housing in relation to the provision of housing for older people in Toddington (Crescent Court).  The Committee also received a presentation regarding the outcomes of a feasibility study of the proposals and the preferred option in relation to Crescent Court.

In response to the public speaker officers agreed that the Council should avoid mixed messages and communicate clearly with residents.  It was clarified by officers that those currently living in Crescent Court would be guaranteed a place in any new development if they desired it.  All other applications for a place in any new development would be subject to the Council’s Local Lettings Policy, which was currently under review

In response to the issues raised by the public speaker and the clarification provided by officers the Committee discussed the following issues in detail:-

·                    Concerns regarding the risk of the Neighbourhood Plan not being approved and the effect this would have on the proposal to deliver a new Extra Care Scheme. It was suggested that a contingency be considered in case the Neighbourhood Plan was rejected.

·                    The positive communication and work that had been undertaken to empower residents to comment on and help develop proposals.  It was suggested that this experience be used to inform the way in which proposals for such schemes were developed in the future.

·                    The manner in which demand for additional Extra Care Schemes was identified and delivered by the Council, which could be considered at a future meeting.

·                    The allocations policy that would be applied to the proposed new Extra Care Scheme in Toddington.  Officers confirmed that current residents of Crescent Court would have priority for accommodation in any new development.

RECOMMENDED TO EXECUTIVE

That the Council seek to provide housing for older people on a new site in Toddington, to be identified and brought forward through the Neighbourhood Planning process.

To consider a report that provides an overview of the refreshed Joint Strategic Needs Assessment for Central Bedfordshire.

The Committee received the report of the Executive Member for Social Care, Health and Housing that presented the executive summary of the refreshed Joint Strategic Needs Assessment (JSNA) for Central Bedfordshire.  The Committee also received a presentation from the Assistant Director for Public Health that drew attention to the transition of responsibilities for public health to the Council; a focus on early intervention and prevention.

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

·                    The implications of social isolation and ‘loneliness’ on a person’s mental health and how this was monitored by the Council.  Officers commented that there was a high prevalence of depression in older people, which the ageing well programme aimed to address.

·                    The critical importance of educational attainment in relation to health outcomes, which needed to be stressed throughout the JSNA.

·                    The importance of a cross-cutting approach to promote healthy eating.

·                    The importance of the Council’s Leisure Strategy feeding into the JSNA as a means of improving health outcomes.  Links also needed to be made to the various voluntary groups who could support the improvement of health outcomes.

·                    A greater level of uptake of physical activity needed to be encouraged in Central Bedfordshire.  Only 11% of adults in Central Bedfordshire were physically active enough to benefit their health, which was similar in comparison to the remainder of the region. 

·                    The importance of encouraging people aged between 40-74 years to take up the offer of free NHS Health checks.

·                    The importance of empowering residents to take responsibility for their own healthy lifestyle, which should start with education in schools.

·                    The activity undertaken by the Council to address the prevalence of problem drug users aged 15-24 years, which was significantly higher than the regional average.

·                    Whether the graph presented to the Committee regarding the relationship between health behaviours and life expectancy could be used to promote the uptake of NHS Healthchecks and adopting healthy lifestyles.

RESOLVED

1.                  That an item relating to the implications of social isolation and loneliness on a persons mental health be considered at a future meeting.

2.                  That an item relating to the prevalence of problem drug users be considered by the appropriate Overview and Scrutiny Committee.

3.                  That officers be requested not to lose sight of the critical importance of a cross-cutting approach and improving education attainment as a means of improving health outcomes.

To consider a report that sets out Bedfordshire Clinical Commissioning Group’s first strategic commissioning plan.

The Committee received the report of the Assigned Director of Strategy and System Redesign for Bedfordshire Clinical Commissioning Group (BCCG) that set out the executive summary of the strategic commissioning plan for BCCG.  In addition the Committee received a short presentation that outlined BCCG’s mission, what they would do and how they would do it.

In response to the issues highlighted in the report and the presentation of the Assigned Director of Strategy and System Redesign for BCCG Members raised and discussed the following issues in detail:-

·                    The rationale behind performance targets and why some targets (such as that for ‘increase the proportion of people with a long term condition who feel they have had enough support from local services to help manage their condition’, which had been set at 80% by 2015) were not set to 100%.  In response officers commented that the targets were based on benchmarking data with other areas but were also aspirational.

·                    GP practices would be expected to sign up to the CCG's Constitution to demonstrate their membership of the CCG and therefore their ability to operate as clinical commissioners.

·                    The importance of patient experience and the delivery of services relevant to the demand in a local area.

·                    The importance of providing a greater level of awareness to encourage best use of urgent care and providing additional support to parents.

·                    Whether the Healthier Together programme would have a significant impact on BCCG and the way that patients received care in the region.  In response officers commented that final recommendations are still awaited on what hospitals involved were willing to provide and what CCGs would commission.  The nature of community-based care and primary care would have to evolve in response to the recommendations.  The CCG would need to ensure that residents were aware any changes in services were to achieve better outcomes and, whilst some services might be delivered elsewhere they, they would not cease to be delivered, and other services might be delivered more locally.

NOTED the report

To consider a report relating to pilot schemes at the Short Stay Medical Unit: Houghton Regis (previously known as the Poplars) and the Greenacre Step up, Step down Reablement service in Dunstable.

The Committee received the report of the Executive Member for Social Care, Health and Housing that described two pilot approaches to deliver health and social care services at the Short Stay Medical Unit at Houghton Regis (previously known as Poplars) and the Greenacre Step Up, Step Down reablement service in Dunstable.  The Head of System Redesign (BCCG) also commented that the pilots aimed to achieve value for money and officers were closely monitoring outcomes and performance.

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

·                    Whether it was planned to deliver a similar scheme in the north of Central Bedfordshire.  In response officers commented that a similar scheme could be developed in the north but it would need to be considered as part of the review of community bed use.  The development of a further scheme would need to deliver value for money.

·                    Discussion was currently underway with BUPA about the care model that was required at the Step up, Step down facility and this included whether there needed to be 24/7 access to nursing care at the unit. Members queried whether alternative proposals at the facility not to provide on-site 24/7 nursing support would have a detrimental impact on the success of the pilot.

·                    Concerns that staff were not available to provide support to patients during the night at the Greenacre Step up Step down facility and the impact this would have on patients.

·                    The importance of ensuring that these and subsequent pilot schemes were affordable and provided value for money.

NOTED the report

To consider the draft Private Sector Housing Renewal Policy prior to consideration by the Executive.

The Committee received the report of the Executive Member for Social Care, Health and Housing that proposed the draft revised Renewal Policy and the outcomes of previous public consultation.  In addition to the report the Head of Private Sector Housing informed the Committee that paragraph 3.1 of the draft policy relating to the “contribution towards Vision and Priorities of Central Bedfordshire Council” would be amended to reflect the new Medium Term Plan.

In response to questions from Members the Head of Private Sector Housing confirmed the following:-

·                    The proposed policy resulted in no change in relation to land registry charges.

·                    The Council would continue to publicise the loan assistance that was available to residents and would seek financial support from external sources to enhance this.

·                    Loan assistance would be provided to residents interest-free.

·                    The Council will continue to provide Disabled Facilities Grants to eligible residents with disabilities, to adapt their homes and make them safer and more accessible.

RECOMMENDED TO EXECUTIVE

1.                  That the change in policy approach to provide loan assistance rather than grant assistance in most cases be supported.

2.                  That the revised Renewal Policy be approved.

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

Members considered the draft work programme for 2012/13 and Executive Forward Plan.  It was noted that several items had been requested during the meeting that would be added to the work programme for consideration as appropriate.

RESOLVED

That subject to the addition of those items requested by the Committee during the meeting the draft work programme be approved.