Agenda and minutes

Apologies for absence were received from Councillors A Harewood (substitute Councillor M Grant), B Livesley and J Weatherill

Councillor M Grant, substitute for Councillor A Harewood

Councillor J Clowes, Portfolio Holder for Health and Adult Social Care

Councillor S Gardiner, Cabinet Support Member

Councillor O Hunter, visitor

Councillor B Silvester, visitor

B Towse, Local Involvement Network

L Scally, Head of Strategic Commissioning

D French, Scrutiny Team

F Field, South Cheshire Clinical Commissioning Group

To approve the minutes of the meeting held on 6 December 2012. 

RESOLVED: that the minutes of the meeting held on 6 December 2012 be confirmed as a correct record.

There were no declarations of interest made.

To provide an opportunity for Members to declare the existence of a party whip in relation to any item on the agenda

There were no declarations of the existence of a party whip.

A total period of 15 minutes is allocated for members of the public to make a statement(s) on any matter that falls within the remit of the Committee.

Individual members of the public may speak for up to 5 minutes, but the Chairman will decide how the period of time allocated for public speaking will be apportioned, where there are a number of speakers.

Note: in order for officers to undertake any background research, it would be helpful if members of the public notified the Scrutiny officer listed at the foot of the agenda at least one working day before the meeting with brief details of the matter to be covered.

Charlotte Peters Rock addressed the Committee as follows:

·        She noted in the report relating to item 6 “Learning Disability Service Redesign” that reference was made to services being local and that people should “remain in their communities” and sought clarification as to what that meant in practice;

·        She felt that the consultation regarding the Tatton Ward was not well publicised and explained that the organisation Cheshire Area for Cheshire Action was undertaking its own publicity;

·        She referred to day respite provision for people with dementia and the difficulties caused by a lack of public transport as well as parking issues at Macclesfield Hospital;

·        She referred to instances where social care respite places were being purchased by the NHS which caused difficulties for family carers;

·        Public meetings held regarding the Foundation Trust application consultation by the East Cheshire Hospital Trust were poorly attended.

To consider the report of Andy Styring, Director of Operations, Cheshire and Wirral Partnership NHS Foundation Trust

Andy Styring and John Courtney from the Cheshire and Wirral Partnership NHS Foundation Trust (CWP) briefed on proposed changes to learning disability inpatient and community services.  The Committee was informed that CWP provided various services including both inpatient and in the community; the organisation had 3300 staff providing services across 95 sites; the budget was over £155m.

Mr Courtney explained the background to the proposals – the Winterbourne View review and reports from the Department of Health had said that there was an overdependence on inpatient beds in learning disability services; too much use of out of area placements; and a need to enhance learning disability community services.  There was also a requirement to make savings in the NHS, with CWP required to save £13m over the next 3 years.  In reference to the question raised at public speaking time, Mr Courtney explained that the term community services had a broad definition and referred to any service that was not an in patient service.   

The Learning Disability Service Review had identified the need for the following improvements:

·        Care Pathways – establish an improved clinical model with better service user outcomes.  There should be a defined pathway for each area of need (Challenging Behaviour; Mental Health; Physical Health including profound intellectual multiple disability; Forensic Needs (offending behaviour), with individualised packages of care;

·        Community Learning Disability Teams – redesign to provide a core team in each area of need with emphasis on specific therapies such as speech and language therapy and occupational therapy;

·        Inpatient Services – reduce reliance on inpatient services – close one Assessment and Treatment Unit and reduce bed numbers in the longer term. 

The Review considered the option of making no changes to learning disability services.  However, based on the need to make savings as well as a desire to improve services based on the review, this was not considered a viable option.  It was proposed that changes to the learning disability service were introduced whereby a care pathway model was introduced which promoted supporting people in the community, with access to enhanced community services and access to inpatient services for those people who needed it. 

A public consultation on the proposals would be undertaken for three months starting from 14 January.  The consultation would include an easy read paper based document and questionnaire, online questionnaire and public meetings.

In discussing the proposals, Members raised the following issues:

·        Health issues were often a concern for people with learning difficulties.  In response, the Committee was advised that CWP staff undertook training and awareness raising sessions for GPs and medical staff in relation to treating patients with learning difficulties, who tended to have higher levels of illness.  The development of neighbourhood teams would improve links with GPs with each GP practice having a named contact at CWP to assist with any issues regarding patients with learning difficulties.  Ms Field of South Cheshire Clinical Commissioning Group explained that it was intended to integrate as many services as possible around the GP service  ...  view the full minutes text for item 86.

To consider extracts of the Forward Plan that fall within the remit of the Committee.

There were no items on the Forward Plan for the attention of the Committee.

To note any consultations referred to the Committee from Cabinet and to determine whether any further action is appropriate.

There were no consultations from Cabinet.  However, Councillor Clowes, Portfolio Holder, updated on some current issues. 

The Public Health budget figure was still awaited.  All current Primary Care Trust contracts would be taken on by public health on 31 March 2013; contracts would be rolled over for one year during which time an assessment would be undertaken of the services required.  When new contracts were introduced they would have clear outcomes and be transparent.  It was also intended that contracts would be focused to the specific needs of the area eg an area with a higher proportion of older people would have different needs to an area with a lot of young people; contracts would reflect this.

In relation to Healthwatch, the procurement process was complete and a consortium from the Council of Voluntary Services (including the Citizens Advice Bureau, Age UK, Youth Federation and Macclesfield Disability Bureau) had been successful in winning the contract.