Agenda and minutes

Apologies for absence were received from Councillor R Bailey (Councillor P Redstone substituting), Councillor D Marren and Councillor A Gregory.

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 interest of openness, Councillor L Wardlaw declared that she occasionally worked for the Cheshire and Wirral Partnership NHS Trust.

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 registered to speak.

To approve as a correct record the minutes of the previous meeting held on 1 September 2022.

RESOLVED:

That the minutes of the meeting held on 1 September 2022 be approved and signed by the Chair.

To receive a three part presentation on the Prevent and Channel agenda:

1) An overview of Prevent, to consider the national overarching strategy;

2) Prevent and Channel at Cheshire East, to consider how the national agenda works locally across Cheshire East; and

3) The Member expectation, to consider how Members can raise awareness of Prevent and Channel in their Community Champion roles.

Clare Little, Home Office Regional Advisor for NW/NE England attended the Committee meeting and provided a joint presentation with officers on the national Prevent strategy. Members received an overview of how this national agenda works locally across Cheshire East and how Elected Members can raise awareness within their communities. Committee Members noted that:

The current national terrorism threat in the United Kingdom was ‘substantial’ which meant that an attack was highly likely. There had been over a dozen terrorist attacks in the UK since 2015 which had led to over 40 fatalities. Since 2017, the Home Office had been able to foil over 30 late-stage terrorist plots. It was highlighted that the financial impact of the attacks on the economy had been significant, with attacks in 2017 costing £137m in direct costs and nearly £2bn in indirect costs.

Sandra Murphy, Head of Adult Safeguarding and Chair of the Prevent Channel Panel in Cheshire East provided the Committee with an overview of the Channel Panel process and also the Dovetail Programme which covered nine Local Authorities in the Northwest. 

Richard Christopherson, Locality Manager (Community Safety), provided some key headlines from the Annual Channel Panel report. Committee Members noted the following:

• The main referral source came from the education sector (53%), and the age profile of those referrals ranged between 12-43.
• 86% of the referrals were male.
• A number of the referrals of young people often had autism and/or mental health conditions.
• There were an increasing number of referrals from within the Congleton area.

Committee Members were updated on the future of the Dovetail Programme. It was confirmed that the pilot project may come to an end – a formal decision had not yet been made. A decision was expected to be taken by Ministers early in the New Year.

Committee Members were invited to ask questions. Key discussions were noted as follows:

·         Members queried how success would be measured, how much Cheshire East spent on Prevent, and where the funding came from. 

Officers confirmed that the work of Prevent was part of ‘business as usual’ duties under safeguarding procedures. It was confirmed that Cheshire East received £160k annually from the Police and Crime Commissioner Fund to support all priorities through SCEP. Funding for Intervention Providers came directly from the Home Office. There was no other dedicated funding from national Government to Cheshire East for the Prevent programme. It was highlighted that success could be measured through the action and self-assessment plans which were overseen by the Home Office and rated as ‘Good’ overall.

·         Members queried the use of percentage figures, and requested the total number of individuals being referred, rather than percentages.

Officers agreed to provide a written response to all Committee Members.

·         Members queried the overall number of individuals that had accessed support in Cheshire East.

Officers agreed to provide a written response to all Committee Members.

Jill Broomhall, Director of Adult Social Care, provided Committee Members with an overview of the roles and responsibilities of Elected Members in supporting  ...  view the full minutes text for item 57.

To receive a presentation by Paul Devlin Deputy, Director of Nursing and Quality

Fiona Walton, Deputy Director of Operations East Cheshire Trust and Adele Gatley, General Manager for Planned Care attended Committee (virtually) and provided a presentation on the Waiting List at East Cheshire NHS Trust.

The Committee noted that:

Elective recovery targets:   

• No patients waiting more than 104 weeks for elective treatment – this target was achieved in June 2021.
• Next target was to ensure that no patients were waiting more than 78 weeks by March 2023.

There were three key risk areas:

• Gastroenterology – currently at 28 potential breaches reduced from 174 from 1 August.
• General surgery – currently at 13 breaches reduced from 74 from August.
• Orthopaedics – currently at 37 breaches reduced from 309.

Productivity was being continually reviewed to maintain health services. Members received an overview of the GIRFT national programme (getting it right first time) and the Patient Initiated Follow Up pathway (PIFU). Recent data highlighted that:

• East Cheshire Trust had the third highest rate of theatre utilisation within the Northwest region at 83%.
• A review by the Cheshire and Merseyside Elective Productivity team also showed that the Trust had the third highest undertaking day case rate (86%) in the ICS which indicated a highly productive surgical service.
• Cheshire and Merseyside data showed that the Trust had the third highest rate of patients referred to PIFU.
• Outpatient data demonstrated that at 5%, the Trust had the second lowest ‘did not attend’ rate.

RESOLVED:

a) That the presentation from East Cheshire Trust be received and noted.

b) Presentation slides to be circulated to all Committee Members.

To receive a presentation by Mark Wilkinson, Cheshire East Place Director.

Mark Wilkinson, Cheshire East Place Director, attended the Committee meeting and provided a presentation on Integrated Care Systems (ICS) and Working with Scrutiny. Committee Members noted the following:

An overview was provided on the NHS structures in England since 1 July 2022. Historically, a single Cheshire CCG served the Cheshire area. CCGs were abolished and replaced with Integrated Care Boards (ICBs) – statutory organisations commissioned to meet the health needs of Cheshire and Merseyside residents.

Another key element of the ICS was the Integrated Care Partnership (ICP) which brought together key organisations (Local Authorities, NHS, Healthwatch etc) to look at effective partnership working.

Members received an update on plans to return maternity services to Macclesfield District General Hospital. Services at Macclesfield were suspended at the start of the COVID pandemic. It was highlighted that whilst there had been a clear focus to return services, there were four factors that needed to be achieved before this could be done:

• The Trust needed a partner to work with and this had been identified in the form of Stockport NHS Foundation Trust.
• Funding was needed – higher staffing standards and levels were required as a result of several maternity scandals across the NHS. There was a reasonable expectation of additional investment.
• Additional staffing would be needed – additional recruitment of midwives, consultants, and anaesthetists would be required in order to safely bring back maternity services. There were concerns around the ability to recruit sufficient anaesthetists as there was a general shortage across the NHS.
• Beds on the Macclesfield site would need to be made available as maternity beds had been reused for those attending A&E. Work was underway to resolve this.

Committee Members were invited to ask questions.

• Members queried why the staff from Macclesfield Maternity Unit couldn’t return to Macclesfield hospital.

It was confirmed that staff would return to Macclesfield Hospital, when the services returned.  Additional staff were needed to meet higher NHS wide standards on staffing maternity units.  No decision had yet been made as to whether it would be possible for maternity services to return – the current suspension remained in place and would expire in April 2023. A decision would need to be taken before this date to determine if the suspension needed to be extended further or another option identified The NHS were fully committed to returning maternity services to Macclesfield however there was key criteria that needed to be met before services could safely return. It was noted that those members of staff who worked within the Maternity Unit pre-COVID had been temporarily relocated to other hospitals.

Cllr M Simon left the meeting at 12.33pm.

• Members queried at what point the issue of maternity services at Macclesfield hospital became a significant variation and require full consultation and formal discussion at Scrutiny Committee.

It was confirmed that the next stage of decision making on maternity services would be early in the New Year. It was suggested that should the NHS make a decision to not return maternity  ...  view the full minutes text for item 59.

To consider the Work Programme and determine any required amendments.

Katie Small, Democratic Services Manager, updated the Committee on the Work Programme. The Committee was advised of the following updates to the Work Programme since the last meeting.

·         Flood Risk Management – there would be a representative from the Fire Authority and United Utilities attending.

RESOLVED:

a)    That the Committee Work Programme be received and noted.

b)    Update on the return of maternity services to Macclesfield Hospital to be added to the Committee Work Programme.

c)    Update on the delivery of the ICS and the impact on residents to be added to the Committee Work Programme.

d)    Update on the Prevent Programme (including the Dovetail Project) to be added to the Committee Work Programme.