Agenda and minutes

Apologies of absence were received from Councillors Suzanne Brookfield (Councillor Anthony Critchley was substituting), Councillor Penny Butterill (Councillor David Edwardes was substituting), Councillor Connor Naismith (Councillor Brian Puddicombe was substituting) Councillor Sarah Pochin and Councillor Rob Vernon.

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

In the interests of openness Councillor Liz Wardlaw declared that she occasionally works for Cheshire and Wirral Partnership NHS Foundation Trust.

To approve as a correct record the minutes of the previous meeting held on 28 June 2021.

RESOLVED:

That the minutes of the meeting held on 28 June 2021 be approved as a correct and accurate record and be signed by the Chair.

There is no facility to allow questions by members of the public at meetings of the Scrutiny Committee. However, a period of 10 minutes will be provided at the beginning of such meetings to allow members of the public to make a statement on any matter that falls within the remit of the committee, subject to individual speakers being restricted to 3 minutes.

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

To receive an update from the Head of Primary Care NHS England North  (Cheshire and Merseyside) on oral surgery and orthodontic service model development for Cheshire East.

Tom Knight, Yvonne Dailey and Ross Keat attended the meeting virtually via Microsoft Teams to update the Committee on Dentistry and answer any questions the Committee had.

Tom advised that the Committee that because of the impacts of the pandemic, patients awaiting oral surgery had been referred to their nearest site, at either Stafford, Warrington or Leighton.

Orthodontists were in the middle of a procurement exercise of orthodontic provision within the community in Primary Care, this had been paused during the pandemic.  Stakeholders were consulted between December 2020-February 2021 and the consensus was the procurement should be continued and will include standardisation of contracts, increasing activity and improving access. 

During 2020 dentistry was closed down and practices were asked not to see patients.  Twenty two urgent dental care centres had been established two of which were in Cheshire East, one in the north of the borough and one in the south.  These had been maintained despite other areas taking a decision to cease this provision.

In the meantime dental practices had been reopening, and there were challenges associated with this such as:

·         access to the practices under the new infection control had led to a reduced number of patients being able to be seen;

·         workforce issues and pressures both local, regionally and nationally and recruitment and retention of workforce; and

·         Personal Protective Equipment (PPE) had been an issue at the start of the pandemic but this was quickly resolved.

The Committee were advised that additional resources had been identified to support two new key initiatives:

1)    Child friendly practices as part of the health inequalities agenda with the key initiative of seeing children earlier; and

2)    Older Peoples project particularly those who were frail and elderly, linked into the care home population.

The Committee noted that two Urgent Care Centres seemed ambitious for the size and population of the borough and were disappointed to hear of the number of nurses who had left the profession, but looked forward to the redesign and how that would progress and the two new key initiatives.

RESOLVED: That:

·         Tom, Yvonne and Ross be thanked for their attendance and contribution to the Committee; and

·         The update be received and noted.

To consider the 2020/21 Quality Account and provide feedback to be included in the final version of the accounts.

Madeleine Lowry from Cheshire and Wirral Partnership (CWP) NHS Foundation Trust attended the meeting virtually via Microsoft Teams to answer any questions on the Quality Account that the Committee may have had.

There was some discussion that focussed specifically on:

·         Crisis Cafés- there was one in Macclesfield and residents had expressed a desire for one in Crewe.  The response and capacity had been managed during the pandemic but CWP had ambition for more than one Café but recognised this was one option for those experiencing difficulties.

·         Emotionally Healthy Schools- now schools had resumed it had given CWP the opportunity to engage with children more.  CWP recognised the impacts of the pandemic on children and young people and how important the Emotionally Healthy Schools agenda would be at this time.  The Committee were advised that the Clinical Commissioning Group (CCG) had put additional resources towards third sector organisation to enable support to children during the pandemic, and CWP were grateful for this proactive approach during a challenging time.

·         the two further Acute Beds that had been expected- the Committee heard that CWP had experienced a surge in mental health admissions and as a result had to extend capacity of acute beds rather than reduce it.  It was noted that the isolation, lack of social contact and extreme personal changes through the pandemic has had a significant impact on mental health across the population and the type of people currently presenting were not previously known to services.

The Committee was specifically interested in:

·         the work being carried out in the Poppy Factor and work with the veterans as mentioned in the Quality Account; and

·         enabling this Committee to act as a critical friend with matters of overview and scrutiny to CWP in ensuring any anticipated funding in the area of eating disorders best met the needs of the residents.

RESOLVED: That:

·         Madeleine be thanked for her attendance and contribution to the Committee;

·         the Scrutiny Officer provide the feedback from this Committee to CWP for inclusion in the Quality Account;

·         the Scrutiny Officer contact Sarah Quinn at CWP to invite a presentation to the Committee on the work being carried out with veterans.

·         the Scrutiny Officer contact the Children and Young Peoples Service within CWP to ask for an update later this year specifically on Eating Disorders across the borough.

The Health & Adult Social Care & Communities Overview & Scrutiny Committee considered this item in April 2021.  Since May 2021 Cheshire East has transitioned to a Committee System form of governance and as such there have been changes to the Scrutiny Committee and Membership.

Therefore, this item is to consider an overview and update on the development of the Cheshire and Merseyside Integrated Care System, proposed to come into effect from April 2022.

Guy Kilminster, Head of Health Improvement, attended the Committee and gave an update presentation on the Cheshire and Merseyside Integrated Care System (ICS), following this the Committee were given the opportunity to ask questions.

There was some discussion about the level of change in relation to powers between the NHS and Local Authority.  The published guidance had indicated two elements with more NHS reorganisation and Local Authorities being talked to.  If there had been a single table the power would have been divided between the organisations more. There will the potential for positive change and influence.

Guy advised that Cheshire and Merseyside understand that Cheshire East share common boundaries with Greater Manchester and Staffordshire and that the Integrated Care System cannot operate purely within its own boundaries.

The Committee agreed that the Council would need to consider how the new service committees could influence the process of strategy development and the impact each of the Committees can have on the strategy in terms of health outcomes e.g. housing, education, special educational needs etc. to the Integrated Care Partnership (ICP) and then the aspiration of influencing the Board.  In turn this committee can then see how it can influence the work in its wider form.

RESOLVED:

That Guy Kilminster be thanked for his presentation and contribution to the committee.

To consider a presentation by the Director of Adult Social Care, on the work and remit of the Safer Cheshire East Partnership (SCEP) with a thematic review of deaths following accidental dwelling fires in Cheshire East (Feb 2020 to March 2021).

Richard Christopherson, Sandra Murphy, Jill Broomhall and Super Intendent Peter Crowcroft attended committee and presented an update on the Safer Cheshire East Partnership (SCEP) and a thematic review of fire safety in the home.  All officers  were available to answer any questions the committee had.

The Committee were advised there had been sex deaths from house fires in the borough during 2020-2021, when previously there had been none.  This had triggered an emerging trend for the SCEP.  Because of this, a task and finish group had been established to draw together the learning and produce an action plan in order to raise awareness.  The group had an opportunity to share the outcomes, review emerging theme and threats

The key achievements for SCEP had been:

·         There had been the production of a new Serious and Organised Crime (SOC)/Contextualised Safeguarding Strategy;

·         Training was delivered across a range of areas to upskill staff and partners; and

·         Extended partnership working into the review areas of work e.g. completed thematic fire review and engagement with Afghan refugees.

The areas for development for SCEP were:

·         A Governance and website refresh for SCEP;

·         To develop a closer working relationship with the new Police and Crime Commissioner (PCC); and

·         To align projects to the delivery of a new Domestic Abuse (DA) and Housing Strategy.

The Committee noted there was no focus on rural communities and that the borough was 52% rural or any animal welfare focus.  This was noted by officers for future work planning.

RESOLVED:

That Richard, Sandra, Jill and Peter be thanked for their presentation and contribution to the committee.

To consider the Work Programme and determine any required amendments.

The Committee considered its Work Programme.  The Chair noted that the two items on the Programme had been addressed during this meeting and that the Committee would be meeting later that day with the Scrutiny Officer and the Director of Governance and Compliance to determine appropriate items for inclusion on the Work Programme.

RESOLVED:

That the Work Programme be received and noted and that appropriate new items of work be added to the Work Programme by the Scrutiny Officer.