Agenda and minutes

Apologies were received from Councillors L Durham, I Faseyi and S Gardiner.

To approve the minutes of the meeting held on 5 July, 2018.

RESOLVED:

That, subject to noting an apology for absence from Councillor D Mahon, the Minutes of the meeting of the Health and Adult Social Care and Communities Overview and Scrutiny Committee held on 5 July, 2018 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.

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.

To consider an update from the NHS South Cheshire CCG regarding future plans for the CCGs across Cheshire East.

The Chief Accountable Officer for the NHS South Cheshire Clinical Commissioning Group (CCG) delivered a presentation on the potential future arrangements for health commissioning in Cheshire.

Members were informed that the four CCGs in Cheshire had worked closely to consider different joined-up working arrangements that would help to secure improved outcomes for residents, accelerated development of new integrated models of care, and help to address the growing financial and operational pressures faced by the CCGs.

It was noted that, subject to the approval of a business case submission to NHS England, the four CCGs planned to merge and create a singular pan-Cheshire CCG by April 2020 that would consist of a single Executive Team and Accountable Officer. 

It had been agreed by the CCGs that the new Accountable Officer post would be recruited for, and filled by, April 2019 to ensure coordinated leadership during the merge.

Members made comments and asked questions in respect of:

·         the potential impacts to present CCG commissioning arrangements during the merge;

·         the financial benefits;

·         the implications of the potential organisational restructure on current staff;

·         consultation and engagement with stakeholders and the public;

·         the undertaking of risk assessments and maintaining a risk register; and

·         the potential for joined-up meetings between the CCGs and Cheshire West and Chester Council.

RESOLVED:

That the committee be kept informed of progress on this matter through updates at future meetings.

To consider an update from the NHS Eastern Cheshire CCG on the Capped Expenditure Programme and the move towards a Home First Model.

The Interim Chief Accountable Officer for the NHS Eastern Cheshire CCG delivered a presentation on the Capped Expenditure Programme and the Home First approach to care.

The presentation provided context as to why the Capped Expenditure Programme was introduced, as well as detail on the savings achieved as a result of the programme during the financial year 2017/18.

Members also received information on how the Home First approach had been used to deliver improved levels of care, and the key targets and planned work to be undertaken.

Members raised concerns regarding the deficit budget and resultant pressure on the CCG and the impacts that this has had, and may continue to have, on service provision.

Mr Mitchell advised the committee that the CCG had ensured that robust plans were produced and put in place each year to make certain that the overall deficit could be reduced in a sustainable way that did not significantly impact on service provision or delivery.

RESOLVED:

That the update be noted.

To consider a report and update from the NHS Eastern Cheshire CCG on the Elective Care Model and the six specialisms being rolled out.

The committee considered a report on the work carried out to improve access and outcomes in relation to elective care for residents of NHS Eastern Cheshire CCG.

The report updated Members on NHS Right Care, the Referral Assistance Scheme, access to physiotherapy services, and the revised commissioning policy for procedures of limited clinical value. 

In response to questions from Members, the Commissioning Director for NHS Eastern Cheshire CCG advised that the policy relating to procedures of limited clinical value had been revised to ensure that the wording was robust and clear, and that best practice was being followed to deliver resource efficiencies and the best outcomes for residents.

RESOLVED:

That the committee receive further updates and information with regard to improved access to care for residents of NHS Eastern Cheshire CCG.

To consider an update from East Cheshire Trust on the working arrangements for the Congleton Minor Injuries Unit.

The committee considered a report from East Cheshire NHS Trust updating on the temporary closures at weekends at the Minor Injuries Unit at Congleton Hospital.

In response to questions from the committee, it was advised that patients would be able to access any of the sites across eastern Cheshire during the periods of extended hours.

Members raised comments and questions in respect of:

·         how the Minor Injuries Unit could be better used to offset staffing pressures;

·         how the broader challenge of recruitment and retention of staff is being dealt with;

·         how effective and beneficial extending the hours of GP surgeries would be for members of the public. (Members referenced concerns raised on this matter at previous meetings.)

RESOLVED:

That the report be noted.

(The meeting adjourned for a short break.)

To consider a report and update from the NHS Eastern Cheshire CCG on dermatology services in Eastern Cheshire Dermatology Contract.

The committee considered a report from NHS Eastern Cheshire CCG on work that had been undertaken to identify alternative options for commissioning and providing dermatology care services.

Pursuant to a previous report considered by the committee on this matter (Minute No. 111, 2017/18), Members were advised that Vernova Community Interest Company had continued to provide dermatology care services in this area.

Members were advised that, despite engagement with the NHS market for provision of dermatology care, no potential alternative providers had been identified to date.

In response to Members’ questions and concerns, the Portfolio Holder for Adult Social Care and Integration advised that Cheshire East Council is one of many authorities across the country working hard with local commissioning bodies and providers to meet the growing demand for dermatology treatments, and ensure the provision of a good and effective service through the NHS.

RESOLVED:

That the committee be kept informed of progress on this matter through updates at future meetings.

To consider the 2017/18 end of year report on the Better Care Fund and Improved Better Care Fund.

The committee considered the year-end report on the performance of the Better Care Fund in Cheshire East during the financial year 2017/18.

Information on the different schemes supported through the Better Care Fund and how many people were helped through these, was set out at paragraph 5.7 of the officer’s report. 

Members were informed that the Council’s current Better Care Fund plan covered the two year period through 2018/19.  The report provided comparative information that outlined how the Council’s performance compared to national metrics during the last year, as well as the work that remained outstanding to be completed in 2018/19.

RESOLVED:

That the committee monitor performance against the Council’s Better Care Fund plan in the financial year 2018/19.

To consider an update on progress made against the Local Safeguarding Adults Board Improvement Plan.

The committee considered a report that updated Members on progress made against the Adult Safeguarding Improvement Plan since its adoption in October 2017.

The Adult Safeguarding Improvement Plan, which was attached at Appendix 1 to the officer’s report, had been reviewed twice since its implementation and updated with Red/Amber/Green (RAG) ratings and supporting narratives to evidence progress made to date.

It was reported that Cheshire East had adopted PAN Cheshire Adult Safeguarding Policies, including the North West Adult Safeguarding and Person in Position of Trust policies, to enable a more consistent approach towards safeguarding across the wider geographical area.

RESOLVED:

That further updates on progress made against the Adult Safeguarding Improvement Plan be received in due course.

To consider the Local Safeguarding Adults Board Annual Report 2017/18.

The committee considered the 2017/18 annual report from the Cheshire East Safeguarding Adults Board.

The report informed Members about the key statistics relating to adult safeguarding in 2017/18, the work carried out and completed by the Board during the year, and the priorities for the Board in 2018/19.

RESOLVED:

That the committee monitor the work of the Cheshire East Safeguarding Adults Board in 2018/19.

To give consideration to the areas of the forward plan which fall within the remit of the Committee.

The committee considered the key decisions listed on the Forward Plan for the four month period ending 31 December 2018.

It was suggested that the committee receive an update on key decision ‘CE 18/19 – 15’ relating to the proposed Mental Health Strategy, prior to consideration by Cabinet.

RESOLVED:

That the Mental Health Strategy be added to the work programme of the committee to be considered at the earliest possible meeting date.

To review the current Work Programme

The committee considered the updated work programme for 2018/19.

RESOLVED

The committee resolved that:

1          the work programme be updated to reflect the committee’s preferred option to receive written reports with presentations to be delivered as a supplement;

2          the update on NHS Dental Services in Cheshire East be added to the meeting on 6 December 2018;

3          the update on the potential impacts to adult social care services following the recently concluded consultation on mental health service provision in Eastern Cheshire be added to a specific meeting once timescales for completion had been confirmed; and

4          further updates with respect to Future Arrangements of CCGs in Cheshire East and Dermatology Services be added to the work programme with dates to be confirmed.