Agenda and minutes

Councillor Janet Clowes – Adult Care and Integration Portfolio Holder

Fleur Blakeman – Eastern Cheshire CCG

Katy Brownbill – South Cheshire CCG

Jenny Fullard – Midlands  and Cheshire CSU

Julia Langley – Eastern Cheshire CCG

Tracy Parker Priest – South Cheshire CCG

Julia Cottier – Cheshire and Wirral partnership

Simon Whitehouse – South Cheshire CCG

To approve the minutes of the meeting held on 9 June 2016

RESOLVED That the minutes of the meeting held on 9 June be confirmed 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.

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 and 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.

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

To consider a presentation from NHS South Cheshire CCG about its financial recovery plan.

Presentation to be circulated at the meeting.

Simon Whitehouse, Chief Executive of South Cheshire CCG attended the meeting and gave a presentation on a proposed financial recovery and improvement plan for the period 2016-20 for Central Cheshire which included South Cheshire CCG and Vale Royal CCG.

Simon explained the challenging circumstances that the CCG faced in the next four years taking account of:

• Expected increase of demand for health and social care;
• Increasing size of population;
•  Lifestyle choices and long term conditions raising demand for care;
• Inflation and costs of new technologies increasing the cost of care delivery;
• Reduction in government grants;
• Increase in the minimum wage and apprenticeship levy.

In summary, Central Cheshire was facing a combined financial challenge of £90.5million by 2020/21.

Simon outlined a range of options currently being considered to bridge the projected gap and informed the committee that if all savings identified were successfully in full, there would still be a financial gap of £27 million in 20/21.

Simon suggested that the CCG was giving consideration as to how it could ration health care in the future under 6 headings:

• Deflection – by passing the care delivery elsewhere
• Delay –  by increasing waiting times for treatment
• Denial – by stopping treating certain things that are considered not to add clinical value
• Selection – By introducing thresholds
• Deterrence –
• Dilution by offering a reduced service.
•  

Simon also outlined the benefits of early intervention which in the long run paid dividends in saving money, for instance in early detection of cancers.

Another major of expenditure related to prescriptions and it was suggested that the annual prescription bill would have to be reduced which was currently running at approximately £31million per annum.

Members expressed initial concern about a number of the measures proposed to reduce costs but highlighted in particular proposals relating to CAMHS and section 256 monies.  

RESOLVED –

(a)          That The presentation be noted and Simon Whitehouse be thanked for his attendance and explanations;

(b)          That the Committee’s concerns regarding future section 256 monies and potential reduction in funding for CAHMS be placed on record and Simon be requested to report to the South Cheshire CCG Governing Body this committee’s grave concerns about the future funding levels;

(c)          That Simon be invited to attend a future meeting of the Committee when the recovery plan has been formally approved by the Governing Body.

To receive a presentation on the new Mental Health Gateway Teams which have been established in South Cheshire

Dr Jean Jenkins Clinical Director and GP attended the meeting and gave a presentation on proposals for a new mental health gateway service across south Cheshire CCG.

The committee was informed that in south Cheshire, 17,720 people per year were expected to experience low level mental health needs.

The current arrangements provided a South Cheshire Single point of Access (SPA) team. This team provided the point of access to secondary mental health services, which had been developed as part of a Community Service redesign and Wirral partnership trust in 2013 in conjunction with the Council.

The new proposed gateway model, would operate in primary care and was for people suffering from a mild to moderate health difficulty.

The gateway was designed to meet the needs of a group of people whose mental health difficulties were not of the severity to access already commissioned services. The gateway would also act as a single point of access for referrers and patients and was part of on-going commitment to develop integrated services within Cheshire East. In connection with the commitment to develop integrated services, the Committee was informed that agreement had been reached in principle between the Council and CCG to introduce an element of social work support within the gateway.

RESOLVED - that the presentation be received and Dr Jenkins be invited back to the Committee in 6 months’ time to report on the effectiveness of the new arrangements.

To consider an update on the Caring Together Programme around emerging options for future configuration of services such as maternity, hospital based children’s services and urgent care.

Fleur Blakeman Strategic and Transformation Director, Eastern CCG attended the meeting and gave a presentation on the progress of the ‘Caring Together’ programme.

In terms of  achievements in 2015/16, Fleur informed the Committee that  the programme delivered:

•      equity of access to and expansion of services in primary care which had commenced January 2016

•      Proactive care and risk stratification, targeted at top 2% of the at risk population

•      commenced Frailty Service in September 2015

•      Introduced reactive community response in September 2015

As far as progress in 2016/17 was concerned, the programme had:

•      Continued development of the community based coordinated care business case

•      Implemented  Integrated Community Teams (without additional resources)

•      Provided single point of access for reactive community services

•      The Shared Care Record went live 1 July 2016

•      The ramp up of Primary Care contract from April 2016 would be

fully implemented by December 2016

As the programme developed, Fleur informed the Committee that Caring Together priorities for 2016/17 were:

•      Maternity Care

•      Children’s Health and Wellbeing services

•      Integrated Urgent and Community Care

•      Specialised Services

RESOLVED –

(a)          That the presentation be received;

(b)          That Fleur Blakeman be invited to report back to the Committee in September 2016 to present final proposal for the Caring together project 2016/17 together with details of a advice on public consultation regarding any proposed changes to services.

To review the current Work Programme

RESOLVED – That subject to an item being added to the work programme regarding Redesigning Adult and Older People’s Mental Health Services in Central and Eastern Cheshire, the work programme be approved.