Agenda and minutes

To approve the minutes of the meeting held on 5 December 2013

RESOLVED – That the minutes of the meeting held on 5 December 2013 be approved as a correct record and signed by the Chairman.

To provide an opportunity for Members and Officers to declare any disclosable pecuniary and non-pecuniary interests in any item on the agenda.

There were no declarations of interest

There were no declarations of party whip

There were no members of the public present who wished to speak

To receive a short briefing on proposed service developments from Clatterbridge Cancer Centre

The Committee received a briefing on proposed change to cancer services provided by Clatterbridge Cancer Centre (CCC). Fiona Jones, Project Director of CCC, and Jackie Robinson, from Cheshire and Merseyside Commissioning Support Unit, outlined CCC’s proposals for a new cancer centre in Liverpool to expand on the services currently being provided in Wirral.

The current location would be maintained however as the majority of patients came from the north of the river Mersey the site was no longer at the geographical centre of the catchment area. The new centre in Liverpool would serve those patients coming from the north of the Mersey with the site in Wirral continuing to provide for those living south of the Mersey. CCC aimed to expand the services provided from its centres by having access to specialist clinicians for a variety of illnesses, to treat those who had illnesses additional to cancer.

The new centre would be opened in Autumn 2018. Development and design of the business case would take place in 2015 to allow building work to commence in mid 2016. To meet these deadlines CCC would consult the public on its proposals in July 2014 and separately it would formally consult each of the local authorities affected by the proposal.

Currently a small number or Cheshire East residents were being treated by CCC. At the formal consultation stage, the Council would have to decide whether the project was a substantial development for the Borough.

RESOLVED:

(a)  That the briefing be noted.

(b)  That CCC be requested to supply information about the number of Cheshire East residents using CCC services that may be affected by the development of a new cancer centre in Liverpool.

To receive a briefing from the Director of Strategic Commissioning

Lorraine Butcher, Strategic Director of Commissioning, gave a presentation about the transformation that health and adult social care was undergoing nationally and locally. The presentation focused on the following issues:

·         Quality of health and care services

·         Shifting services from hospitals to the community

·         Stronger engagement and integration between local authorities and NHS bodies

·         Connecting budgets and avoiding fragmented services (Better Care Fund)

·         Helping to relieve the pressure on A&E by providing services in different ways

·         Early intervention and prevention of illness and deterioration

The Committee was asked to consider how it would engage in the transformation process.

RESOLVED – That the issues raised in the presentation be noted for future consideration

To consider the latest draft of the Protocol

The Committee considered the latest draft of the Cheshire East Health Overview and Scrutiny Protocol to replace the previous protocol between the previous Health and Adult Social Care Scrutiny Committee and the former East Cheshire Primary Care Trust (PCT). The PCT had been replaced by two Clinical Commissioning Groups (CCGs), with most of the PCT’s responsibilities transferred to them with others transferred to NHS England, Public Health and Cheshire East Council. All health bodies providing or commissioning services in the Borough and the Committee would need to agree and abide by the protocol.

Amendments to the draft protocol contained in the Agenda were tabled by Eastern Cheshire CCG. The Committee agreed to the amendments however reference to social care or care services was removed from the Protocol as these issues were the responsibility of the Corporate Scrutiny Committee according to the Council’s Constitution.

It was suggested that since health services and social care services were becoming more and more integrated, that the Constitution should be changed to make the Health and Wellbeing Scrutiny Committee responsible for both health and social care. There was currently a review of scrutiny and policy development group arrangements being conducted by a sub group of the Constitution Committee; the suggestions would be reported to the sub group for consideration.

RESOLVED – That the proposed amendments to the draft protocol be accepted and the new draft be approved as the final version.

To consider the draft protocol and submit comments to the Constitution Committee

Mark Nedderman presented a draft protocol for the arrangement of joint health scrutiny committees with other Cheshire and Merseyside local authorities. The Health and Social Care Act 2012 required that any substantial variation or development in services proposed by health services providers/ commissioners which substantially affected more than one local authority’s area must be considered by a joint scrutiny committee of all those authorities.

The Committee was requested to give its views on the draft protocol, particularly in relation to options on political balance of any joint committees, and on how nominations to a joint scrutiny committee should be made. The Committees views were to be submitted to the Constitution Committee which was responsible for recommending changes to the Constitution to Full Council.

The Committee agreed that option one “that the joint committee is made up of Councillors to reflect the political balance of each of the constituent local authorities” be the preferred option. The Committee agreed that any Councillor(s) nominated to a joint committee should be nominated by the Committee and be chosen from its membership because those Councillors would be the most qualified to be on the joint committee, due to their knowledge and experience developed working on this Committee.

RESOLVED:

(a)  That the Committee supports the draft protocol.

(b)  That it be recommended to the Constitution Committee that option one regarding political balance be the preferred option of the Council.

(c)  That it be recommended to the Constitution Committee that nominations to any joint scrutiny committee which Cheshire East Council takes part in should be made by the Health and Wellbeing Scrutiny Committee from the members of that Committee.

To consider a presentation from South Cheshire Clinical Commissioning Group about its Connecting Care initiative

Diane Eden, Programme Director for Central Cheshire “Connecting Care” Programme, presented a briefing on the Connecting Care Programme. The programme was an initiative of seven health service commissioners/providers working in partnership to ensure quality care and support for their service users. Diane played a short video clip which demonstrated how fragmented services provided to a single individual by various organisations could be. The video clip illustrated the need for organisations to work together to provide integrated services that work together to provide better outcomes overall.

The seven partners were:

·         Mid-Cheshire Hospital Trust

·         Cheshire West Partnership

·         East Cheshire Trust

·         Cheshire East Council

·         Cheshire West and Chester Council

·         Vale Royal CCG

·         South Cheshire CCG

The Programme’s plans for working included:

·         Focusing resources on prevention rather than treatment to reduce emergency admissions to hospital.

·         Increasing the access to services in the community rather than in hospitals alone.

·         Modelling the services provided around the needs of the individual rather than using a standard model dictated by the providers.

The Committee was encouraged by the prospect of the programme providing better outcomes for services users and was keen to see action to implement the plans in the near future. The Committee agreed that it would be looking to monitor performance in the future to see if the programme had been effective in achieving its aims and improving outcomes for service users.

RESOLVED – That the presentation be noted.

To consider and comment on the Commissioning Policy of the Clinical Commissioning Groups presented by Cheshire and Merseyside Commissioning Support Unit

Julie Curtis, Project Manager for the Cheshire and Merseyside Commissioning Policies Review, attended the meeting to consult the Committee about the Clinical Commissioning Groups’ new Commissioning Policies. Cheshire and Merseyside Commissioning Support Unit (CMCSU) had produced a new commissioning policy for Eastern Cheshire CCG and South Cheshire CCG.

Julie gave an overview of the process to develop the new policies which included a large number of services which the CCGs were responsible for commissioning. The new policies contained a variety of changes and additions to the current policies which had previously been updated in 2011. Julie then provided more detail about four services/treatments/procedures which experienced the most important changes or additions; they were:

·         Varicose Veins treatment

·         Infertility treatment

·         Penile Implants procedure

·         Continuous Glucose Monitoring

The Committee was asked to submit any comments it had about these four and any other services/treatments/procedures contained in the policies to be considered as part of public consultation. The following comments were made:

·         Infertility treatment was less effective for older people however the NHS wanted to avoid age discrimination by banning older people from having the treatment.

·         It was suggested the NHS providers could link up with the Council’s adoption service to suggest adoption to patients as an alternative to infertility treatment. The Council was currently campaigning to increase its foster carers and adopters.

·         The Committee would support any recommendations made by the National Institute for Health and Care Excellence (NICE) due to their expertise and reputation.

·         Members wanted more information about each of the four main services/treatments/procedures to allow them to comment further.

The Committee was informed that even though comments were to be submitted from the Committee to CMCSU for consideration Councillors would still be able to submit their own individual comments online.

RESOLVED:

(a)  That the presentation be noted.

(b)  That the Committee’s comments on the Commissioning Policies be submitted to Cheshire and Merseyside Commissioning Support Unit for consideration.

To discuss the use of “Champions” in the work of the Committee

The Committee discussed the use of “Champions” in the work of the Committee. The Chairman suggested that rather than Members each championing an individual topic or issue the whole Committee should act as champions for all health and wellbeing issues so that they weren’t working in isolation or limited themselves to understanding one or two topics.

RESOLVED – That the individual members are not assigned to be Champions of specific topics or issues in the Health and Wellbeing remit.

To review the development of the Committee’s Work Programme

This item was deferred until the next meeting