To approve as a correct record the Minutes of the meeting of the Social Care, Health and Housing Overview and Scrutiny Committee held on 18 June 2012 and to note actions taken since that meeting.

The Scrutiny Policy Adviser commented in relation to Minute SCHH/12/7 that a petition had been received by the Council relating to Biggleswade Hospital.  This petition would be received by full Council on 13 September 2012 and subject to the decision of Council could be referred to this Committee. It was also commented in relation to Minute SCHH/12/11 that items on the implications of social isolation and loneliness on a persons mental health; and the prevalence of problem drug users would be considered by the Committee at a future meeting.

RESOLVED

That the minutes of the meeting of the Social Care, Health and Housing Overview and Scrutiny Committee held on 18 June 2012 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.

The following Councillors declared an interest in the business to be transacted:-

·                Councillor D Bowater as a governor of SEPT (Item 4)

·                Councillor Mrs S Goodchild as member of her family was a service user (Item 10).

There was no political whip declared in relation to any agenda item.

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

The Chairman informed the Committee that all Members had been invited to attend a Member Seminar on 10 August 2012 in relation to the housing change agenda.  A Member raised concerns that this event had not been advertised in the recent Members’ Information Bulletin.  The Executive Member undertook to email all Members directly inviting them to attend the event.

An update had also been requested by the Chairman to be received at the meeting in September relating to the Healthier Together review.  This update would inform Members of the latest developments and progress in relation to the review.

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.

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:-

·              Meetings of the Centre for Public Scrutiny development area programme and the Joint Health Overview and Scrutiny Committee that the Executive Member had attended.

·              Recent discussions that had taken place to understand the process for allocating blue badges, which had been very useful.

·              A meeting of the shadow Health and Wellbeing Board that had taken place since the previous Overview and Scrutiny Committee meeting.

·              Time-bank and micro-enterprise events that the Executive Member had attended.

·              The Executive Member had recently attended a very positive meeting of the Carer’s Forum.  The Deputy Executive Member had attended the Older People’s Reference Group meeting.

·              A housing action day that the Executive Member had attended in relation to sheltered housing, which had been positive.

·              A meeting that the Executive Member had recently attended with Greg Barker MP, Climate Change Minister, in relation to the housing agenda and promoting the Green Deal.

·              Ongoing issues in relation to Biggleswade Hospital.

NOTED the update

To receive an update from Bedfordshire LINk on health matters affecting LINk activity.

The Committee received a report from the Chairman of the Bedfordshire LINk that provided an update on the key work items and issues the LINk was presently engaged with.  In addition to the report the Chairman of Bedfordshire LINk highlighted the following:-

·              a meeting that was due to take place between the LINk and the Care Quality Commission (CQC); and

·              two visits that were due to take place to the coronary and orthopaedics wards at Bedford Hospital.

Members queried whether the Hertfordshire LINk should be engaged in a meeting of the Hospital Discharge Task Force as a means of discussing issues in relation to the Lister Hospital.  Members also commented that whilst patients do not usually want to make formal complaints they should be encouraged to provide constructive feedback.

Members also discussed the circumstances in which the LINk would undertake an unannounced visit, it was stressed that where concerns related to a safeguarding issue the Council or CQC would be responsible, not the LINk.

NOTED the report and requested that the Hertfordshire LINk be invited to attend a future meeting of the Hospital Discharge Task Force.

To receive an update on the introduction of a charge for Telecare services by the Council.

The Committee received a report from the Director of Social Care, Health and Housing that provided an update on the introduction of charges for Telecare Services provided by the Council.  The Director commented that the introduction of charges had not greatly affected the total number of users, however monthly updates continued to be received by Executive Member to alleviate any concerns.

In response to the update the Committee discussed the following issues in detail:-

·              Whether the Council was aware of any clients who had left the Council’s service following the introduction of charges, chosen not to receive an alternative service and had suffered as a result.  The Director responded that the Council had tried to prevent this from happening, further information would be sought for the Committee.

·              How the Council intended to decontaminate the equipment that was returned by clients who no longer used the service, further information would be sought for the Committee.

·              The process by which the Council reviewed those clients that were eligible to receive the telecare service as part of their care package.  It was commented that the Council should continue to review the number of customers using the service to ensure that people did not cease to use it because they could not afford it.

·              Whether the Council highlighted the benefits of telecare services to patients and carers during the process of hospital discharge.  The Council needed to ensure that residents and carers were aware of the benefits and the equipment that was available as part of the service.  The Executive Member for Social Care, Health and Housing responded that they would consider an awareness campaign targeted at carers.

In addition to these issues the Committee commented that the Council’s persistence in pursuing the introduction of these charges was welcomed, the service provided value for money.

RECOMMENDED

That the Executive Member for Social Care, Health and Housing be requested to circulate to Members of the Committee further information in relation to:-

1.                  any clients who no longer receive the Council’s telecare service following the introduction of charges and having not taken up another service have suffered as a result;

2.                  the process for decontaminating equipment that had been returned to the Council by clients who no longer used the telecare service; and

3.                  a campaign to raise awareness of the benefits of the telecare service targeted at carers.

To receive a report outlining potential criteria to determine if a development or variation of service is substantial and thus requires further consideration by the Overview and Scrutiny Committee.

The Scrutiny Policy Adviser introduced a report that proposed the use of standard questions to help the Committee determine whether a variation or development of an NHS service was substantial and required further consideration.  In addition the Deputy Director of Communications and Public Engagement, NHS Beds and Luton Cluster, commented that there would be a substantial amount of service changes in the NHS in the future and there needed to be a pragmatic approach to developing these changes and deciding which would be presented to the Committee.  The use of the proposed questions provided consistency across the region and a fully auditable process.

In response to the issues highlighted in the report and the further clarification provided by officers the Committee discussed the following issues in detail:-

·              The manner in which issues relating to the integration of health and social care would be addressed by the questions.  It was suggested that question 12 be amended to read “what is the impact of the proposals on other health and social care services?”

·              The manner in which the Council engaged with other authorities in joint health overview and scrutiny committees, particularly with Hertfordshire in relation to issues at the Lister Hospital.  The Scrutiny Policy Adviser commented that issues relating to joint scrutiny would be considered by the Centre for Public Scrutiny health and social care programme that the Council was presently engaged in.  Colleagues from Hertfordshire could be invited to attend those meetings.

RECOMMENDED

That the Social Care, Health and Housing Committee supports the use of the questions to assist in the determination of whether a variation or development of service is substantial subject to the comments as contained in the Minutes set out above.

To receive a report and respond to a Department of Health consultation on local authority health scrutiny.

The Scrutiny Policy Adviser introduced a report that provided an overview of a Department of Health consultation on the health scrutiny regulations for local authorities.  The consultation sought Member’s views on two key areas:-

1.            the process for referring matters to the Secretary of State (SoS); and

2.            proposals to formalise requirements for joint health overview and scrutiny committees.

The views of Members were sought on these so as a response could be provided by the Council.

In response to the issues highlighted in the report and the further clarification provided by officers the Committee discussed the following issues:-

·              The difficulty in prioritising and managing workloads due to there being so many cross-border issues to be considered.  It was suggested that scrutiny of health, housing or social care could be split in the future so as to make this workload more manageable.  On balance however the Committee agreed that it was important to ensure that work on these areas was joined up, it would not be beneficial to split them into separate committees.

·              Whether there was any requirement for organisations to ensure that the Council was made aware of any variations or developments of services that may be used by residents of Central Bedfordshire.  In response the Deputy Director of Communications and Public Engagement, NHS Beds and Luton Cluster, commented that whilst there was no requirement it was hoped that organisations would consider the flows of patients and invite Central Bedfordshire to be involved where proposals affected the area.  The Committee agreed that it was important to ensure that Central Bedfordshire Council was aware of discussions regionally and involved in consultations on proposals if it wished to be.

·              The need to provide appropriate briefings in relation to the role of the Clinical Commissioning Group and to circulate meeting dates to Members for the shadow Health and Wellbeing Board.

·              The benefit of providing a map to Members showing the interactions of various health services in Central Bedfordshire and their responsibilities.

·              The manner in which health scrutiny was currently undertaken by Central Bedfordshire Council was considered to be effective.  Whilst Councils could now determine their own arrangements there did not seem to be a need to change things.

·              Proposals to amend the referral process to the Secretary of State, including a requirement for referrals to originate from full Council, could be seen as an additional hurdle in the process rather than making it easier.  As the overview and scrutiny committee had the expert knowledge in relation to health issues it was considered more appropriate for detailed discussion to take place in those meetings.  On balance however Members agreed that the full weight of Council could strengthen the referral to the SoS.  Discussion of the issues at full Council would also ensure that a wider number of Members were aware of the issue and how it might affect their residents.  Members did however raise concerns that due to the frequency of Council meetings this could hold up the process of  ...  view the full minutes text for item 27.

To receive the Social Care, Health and Housing directorate revenue financial outturn position for 2011/2012.

The Committee received the 2011/12 provisional outturn revenue budget monitoring report for the Social Care, Health and Housing Directorate.  In addition to the report the Director commented that in the future the Housing Revenue Account would be presented to the Committee separately.  It was also commented that the Council was currently in discussions with another service provider, other than SEPT, to provide a wider choice of mental health services in the area.

In response to the issues highlighted in the report and the further clarification provided by the Director the Committee discussed the following issues:-

·              The difficulty of making robust budget forecasts in relation to an ageing population.

·              The difficulty of setting the budget when Central Government had not set the level of any cap on the amount that a person may have to pay for their care.

·              Sanctions that could be applied to SEPT where the Council had paid for services that had not been delivered in Central Bedfordshire.  In relation to the specific case discussed by the Committee the Director confirmed that the budget provided to SEPT for delivery of these services had been returned to the Council.

·              Whether any increase had been indentified in the budget to respond to demographic change and particularly the increase in residents suffering from dementia.  The Director commented that 4% had been included in the budget for growth relating to demographics.

·              The use of the Council’s earmarked reserves and capital reserves from the NHS that were used at appropriate times to deliver projects.

·              The costs of residential block beds and the importance of ensuring that they were filled before the use of more expensive spot purchased beds.

·              Whether ‘external home care packages’ referred to packages delivered out of county, the Director agreed to seek further information in relation to this.

·              The importance of the step-down facility as a means of supporting patients to ensure that they did not enter residential care too soon.

NOTED

1.                  The General Fund outturn of £53.907m and £1.8m underspend; and

2.                  the Housing Revenue Account financial position. 

To receive the Social Care, Health and Housing directorate capital financial position as at the end of March 2012.

The Committee received the 2011/12 provisional outturn capital budget monitoring report for the Social Care, Health and Housing Directorate.  In addition to the report the Executive Member for Social Care, Health and Housing commented that the Directorate was working closely with housing to ensure that adaptations were being implemented in homes to make them suitable for a person’s lifetime.  It was also suggested by the Executive Member that the Council may develop a longer list of Empty Dwelling Management Order (EDMO) properties so that if progress on one stalled the Council could focus on a property that had been identified as being of less priority.

In response to a question from a Member the Director commented that several projects such as the NHS Campus Closure and Stepping Stones were challenging to deliver and would slip into 2013/14.  Progress in relation to these projects would be reported on a quarterly basis.

NOTED the report

To receive the Q4 performance position for the Social Care, Health and Housing directorate.

The Committee received the quarter 4 performance monitoring report for the Social Care, Health and Housing Directorate.  In addition to the report the Director commented specifically on progress in relation to clients receiving self directed support.

In response to the issues highlighted in the report and the further clarification provided by the Director the Committee discussed the following issues:-

·              The use of personal budgets, which did not apply to residential care.

·              The importance of the Council updating its approach in relation to ‘clients who receive a review’ to ensure that reviews occur in a timely fashion as appropriate.

·              The importance of focusing on outcomes and what the Council has achieved rather than just focusing on numbers.

·              The importance of ensuring that residents take advantage of block contracts in appropriate circumstances when using their personal budget.

In addition to these issues it was commented that future reports should include case studies to highlight examples where the Council had improved outcomes for residents as a result of improved performance

NOTED the report

To receive 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.