Agenda and minutes

Councillor Janet Clowes - Adult Care and Integration Portfolio Holder

Councillor Paul Bates – Communities and Health Portfolio Holder

Councillor Stewart Gardiner – Deputy Cabinet Member

Mark Palethorpe - Strategic Director of Adult Social Care and Health

Julia Cottier CWP

Anushta Sivananthan, Clinical Director, CWP

Avril Devaney, Director of Nursing, Therapies and Patience Partnership CWP

To approve the minutes of the meeting held on 8 September 2016.

RESOLVED – That the minutes of the meeting held on 8 September 2016 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.

Lucy Heath Consultant in Public Healthto give a presentation on the outcomes of Director of Public health reports for 2012/13,2013/14 and 2014/15.

Lucy Heath, acting Director of Public Health gave a presentation on the annual reports of the Director of Public Health form 2012/13, 2013/14 and 2014/15.Each of the three reports had separate themes.

The 2012/13 annual report looked into why some people died early.

It found that premature mortality in Cheshire East was heavily influenced by high death rates in Crewe.

The recommendations from that review had included:

•      Targeting those at risk of premature death

•      Lifestyle support – drinking, smoking, inactivity, diet

•      Promoting NHS Health Checks and NHS Cancer Screening

•      Building health and wellbeing into everyday business

One of the highlights from the 2012/13 recommendations was the ‘every breath you take’ campaign aimed at raising awareness of the signs and symptoms of lung cancer amongst people living in Crewe. This had led to 115 community campaign champions taking part.

In summary, Lucy informed the committee that the outcome of the 2013 report had been very positive and she therefore had no additional recommendations to make.

The 2013/14 report had looked at the main reasons for ill health during childhood which was mostly influenced by family, housing and environmental factors

The recommendations of the report focused on:

•      Improving public health outcomes

•      Increasing self-care for minor illnesses

•      Reducing unintentional injuries in and around the home

•      Reducing road traffic injuries

•      Improving young people’s health

A new app had been produced in Cheshire East called CATCH (Common Approach to Children’s Health) which currently had over 1700 users. The app was aimed at parents and carers of children aged 0-5 to provide information to parents/carers to give them confidence to know when a child needed medical treatment.

The 2014/15 annual report focused on the determinants and outcomes of mental health in children and young people.

The recommendations focused on:

•      Supporting emotional health during and after pregnancy

•      Treating some mental health problems in 2 and 3 year olds

•      Mental health (and other services) were currently structured in a way that did not meet the specific needs of older teenagers and young adults in their twenties. These young people experienced many difficulties (work, money, housing) in their transition to adulthood, which made them highly vulnerable to developing mental health problems.

RESOLVED -

(a)  – That the presentation be noted;

(b)   That Members of this Committee be invited to study the presentation in detail and raise any matters that they would like to review in more detail with Chairman and Scrutiny Manager.

Eastern CCG to provide a presentation on the Cheshire and Wirral STP

Matthew Cunningham from Eastern Cheshire CCG attended the meeting and gave a presentation on the development of the Cheshire and Wirral STP (Sustainability and Transformation Plan)

In December 2015, the NHS had shared planning guidance 2016/17 – 20/21 outlining a new approach to help ensure that health and care services were built around the needs of local populations. To do this, every health and care system in England had been required to produce a multi-year Sustainability and Transformation Plan (STP), showing how local services would evolve and become sustainable over the next five years – ultimately delivering the Five Year Forward View vision of better health, better patient care and improved NHS efficiency.

Care quality across the region varied and preventable illnesses were still common. People were living longer and expectations were changing including expectations to gain access to treatment closer to home. At the same time, more complex, new and emerging treatments were placing additional pressures on the system.

Across the STP area, it was predicted that if services were continued to be provided as at present, a financial challenge of £999m challenge would result by 2021 if no action was taken

It was suggested that by working more co-operatively across organisations (CCGS, LAs, NHS providers) repetition could be reduced, in addition to waste and unnecessary cost, whilst providing a more patient-focused health experience.

The STP would therefore be focusing on:

·         Reducing hospital demand and costs

·         Improving patient experience and reducing unwarranted variation

·         Improving health awareness and illness prevention

·         Using new technology to improve patient care

·         Improving ‘back office’ efficiencies and reducing unnecessary waste.

In order to make the plans a reality, each local plan needed input and support from its stakeholders and from local people. Health and care organisations within the Borough had started to have initial conversations with people about these plans. These initial conversations would be followed by more formal conversations and consultations as plans developed.

RESOLVED –

(a)  That the presentation be received;

(b)  That a briefing be arranged as soon as possible for all Members of the Council.

To consider a report from the Cheshire and Wirral Partnership.

Julia Cottier, Anushta Sivananthan and Avril Devaney from the Cheshire and Wirral Partnership (CWP) attended the meeting and presented a report concerning a proposal to conduct a consultation exercise on the reconfiguration of Adult and Older People’s Mental Health Services in Central and Eastern Cheshire.

The purpose of the consultation was to address five key pressures being experienced by CWP:

1. Suitability of existing buildings

2. Increased demand on services

3. Shortfall in funding

4. Shortage of health professionals in the area

5. Geographical challenges for care close to home

The committee was informed that there were two potential delivery options to either:

·         Sustain inpatient care at all 3 current locations  - Millbrook Unit Macclesfield, Bowmere Hospital and Chester and Springview Hospital, Wirral through a reduction in community mental health to Central and Eastern Cheshire residents;

·         Provide inpatient care from Bowmere Hospital, Chester and Springview Hospital, Wirral and increase community mental health services to Central and Eastern Cheshire residents.

In connection with the Millbrook Unit at Macclesfield Hospital, CWP informed the committee that this facility did not match the standard of facility offered at the other two sites which were also managed by CWP and that it had been estimated that it would cost £15 million to bring the facility up to standard. Unlike the other two facilities, CWP did not own the Millbrook unit.

Members of the committee questioned representatives of CWP on the estimated travel journeys referred to in the report which suggested that journey times to the alternative units in Chester and Wirral from Crewe based on an average distance of 24 miles would take of 41 minutes by car. It was reported that the average journey from Crewe to Springview Hospital, Wirral by car was 48 minutes with an average distance of 36 miles.

Further questions were raised about the availability of transport for relatives of patients; clarification on the numbers of beds affected; the impact of the bed based review being undertaken by the Council ,which would provide a better understanding of current usage and future demand for beds; and whether alternative sites within Cheshire East had been investigated. The committee also expressed its wish to be informed of the views of commissioners on the proposals.

RESOLVED –

(a)  That the Cheshire and Wirral partnership be informed that this committee believes that further work is required on the proposal to redesign Adult and Older peoples mental health Services in Central and Eastern Cheshire and therefore this Committee recommends that CWP delays the commencement of the formal consultation process on the proposal;

(b)  That CWP be invited back to this Committee in November 2016 with further information on:

·         Travel Times

·         Arrangements for visiting relatives

·         Impact on adult Social care

·         Alternative Options

(c) That Strategic Director of Adult Social Care and Health be requested to contact the Chief Executives of Eastern and South Cheshire CCGs to obtain the views of those two organisations on the CWP proposal.

To review the current Work Programme

The Committee reviewed its work programme.

RESOLVED –

(a)  That the work programme be noted;

(b)  That items relating to Access to GPs and GP Services, Pharamcies and cancer screening be deleted.