Agenda and minutes

To note any apologies for absence from Members.

Apologies were received from Councillors J Bratherton, M Simon, Julie Smith and R Vernon.  Councillor J Snowball attended as a substitute for Councillor Vernon.

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

In the interest of openness, in relation to agenda item 8 – Community Services Accommodation, Cllr S Adams declared that she was a patient at Schoolhouse Surgery, Disley and was a member of the Patient Participation Group at the surgery.

In the interest of openness, Councillor H Seddon declared that she worked in an office-based role for AstraZeneca, a pharmaceutical company based in Cheshire East.

In the interest of openness, Councillor L Wardlaw declared that she occasionally worked for the Cheshire and Wirral Partnership NHS Foundation Trust as a nurse and that she was a member of the Cheshire Vaccination Team.

In the interest of openness, in relation to agenda item 8 – Community Services Accommodation, Cllr J Snowball declared that she was the chair of the Bollington Patient Participation Group.

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 Thursday 7 September 2023.

RESOLVED:

That the minutes of the meeting held on 7 September 2023 be approved as a correct record.

To receive an update from the North West Ambulance Service on response times and patient outcomes.

Joanne Clauge - Area Director, John Collins - Consultant Paramedic and Caroline Lloyd - Operations Manager, attended the meeting and delivered a presentation which provided an overview of the performance of the North-West Ambulance Services NHS Trust to date in 2023.

The Committee sought clarification on the performance times and handover delays at hospitals. In response it was stated the Service was working with the Integrated Care Boards to address the handover delays and were looking at options such as providing additional stretcher for use in A&E to allow the patients to be unloaded, and also initiatives where extra patients could be moved from A&E onto wards even when they were full.  The hospitals could open corridors for patients to wait and when they cannot staff them one ambulance crew would stay at the hospital and look after several patients allowing other ambulances crews to go back out on the road. The Service had previously had many vacancies and recruitment had been undertaken to reduce the these which had made a significant difference to the number of resources available. They were also looking at provision of an alternative pathway for people who need medical attention but do not need to go to A&E.

Reference was made to the fact that stoke case were category 2   It was reported that additional clinicians were being introduced into the call centre to enable a secondary triage on stokes calls to enable a more comprehensive assessment and, if required, make it a priority category 2 cases. This helps the Service get stroke patients quicker to hospital.

The Service was using PRSIM for electronic patient records. The Committee asked about data protection. It was reported that the system allowed for a NHS number to be entered and this retrieved data about the NHS number and medical history of the individual, which was displayed in a webpage. Once the inquiry had been made the page was closed and no information retained.

Body worn cameras had been introduced to tackle violence and aggression towards staff, with the main benefit of this being prevention. The staff member could either activate it when required and record or have it continuously recording. The recordings on the camera were downloaded with the data transferred onto the Ambulance Trust system. If there had been an occurrence of violence or aggression the Camera Team were notified, and the relevant footage retained so that it could be used for prosecution.

The Committee asked if the statistics relating to the number of dropped calls could be included on future performance reports.

RESOLVED:

That the update provided be noted.

To receive an update on the revised statutory guidance for Prevent and Channel.

Richard Macmahon, Home Office Channel Lead, Moner Ahmed, Home Office Prevent Adviser and Sandra Murphy, Head of Adult Safeguarding, attended the meeting and provided an update on the Prevent and Channel Guidance 2023.

Prevent was an Early Intervention Programme which aimed to stop people becoming terrorists or supporting terrorists by tackling the ideological causes of terrorism and to intervene early to support people who were susceptible to radicalisation which was done through the Channel safeguarding mechanism.

The updated PREVENT guidance had been laid before Parliament in September 2023 and came into force on 1 December 2023. The updated guidance reflected several recommendations of the independent review of Prevent which took a couple of years to do and reported earlier in the year. The Prevent objectives had been updated to clearly tackle the ideological causes of terrorism. The updated guidance did not give any functions to local authorities but set out key areas such as leadership, partnership working and mitigating risks. The guidance also provided more details on training and capabilities to help local authorities to understand the risks. A PREVENT duty toolkit had been developed for local authorities to support and provide practical information and guidance to put the PREVENT duty into action.

CHANNEL was a multi-agency programme for somebody who had been identified as being susceptible to radicalisation. The key change in the update guidance was in terms of language and a change from assessment to someone’s vulnerability to someone’s susceptibility to being drawn into radicalisation. This recognised that not all people who are susceptible to radicalisation were by definition vulnerable. The current CHANNEL assessment would be replaced by the PREVENT assessment framework.

The Committee asked about the success of the intervention programme. In response it as explained that once a person is identified as ben susceptible to radicalisation, the local authority would put support mechanisms in place, which could include children’s social care, education, and probation, plus the work of an intervention provider working on that specific ideology, to hopefully guide them away.

RESOLVED:

That the update provided be noted.

To receive an update from Cheshire and Wirral Partnership NHS Foundation Trust on the Autism Strategy 2022-27.

Maddy Lowry – Associate Director Cheshire and Wirral Partnership NHS Foundation, attended the meeting and delivered a presentation on the Cheshire and Wirral Partnership Autism Strategy.

The Committee was informed of the training being developed and required to be undertaken by NHS staff, which included the Oliver McGowan Mandatory Training on Learning Disability and Autism. All clinical services were required to have a level 3 autism specialist. A system of Autism Ambassadors and Autism Champions had been established. Working with stakeholders the Trust was developing an on-line training package which would be available to the police, criminal justice, and social care officers to help support them to better understand and recognise autism and learning-disabled people in the community. The Oliver McGowan training was being funded nationally for the on-line element and to train the trainers for the face-to-face training, but no finance was provided for the trainers to deliver the training, so was a significant cost pressure to the Trust.

The Committee asked how many had completed the Oliver McGowan training and it was reported that in the Cheshire and Wirral Partnership there was a 70-80% completion rate across the Trust, and that the ICB had been asked if they could collate training uptake across all the Trusts. The level one training was required to be repeated every three years.

RESOLVED:

That the update provided be noted.

The meeting adjourned for a short break.

To receive an update from East Cheshire NHS Trust on the proposed relocation of community services.

Simon Goff, Chief Operating Officer East Cheshire NHS Trust, and Dean Grice, Thriving and Prevention Programme Lead NHS Cheshire and Merseyside attended the meeting and delivered a presentation on the changes to community services accommodation.

It was reported that interim solutions had been found for a number of community services being displaced from a GP practice in Poynton to allow for Primary Care expansion. Public engagement and consultation were being undertaken to find long term solution to the relocations of these services.

There as potential for some community services redesign in the Sandbach, Middlewich, Alsager, Scholar Green and Haslington (SMASH) area. The Ashfields Primary Care Centre in Sandbach currently reviewing their building arrangements but it was not felt that this would impact on any services.

The Committee asked about the wider estate strategy and in response it was stated that there was a need to understand what was required, the key issues relating to how community care was developing and the funding available.

It as asked how the temporary arrangements were working in Poynton and in response it was stated that it was early days as the change had commenced on 6 November, but they were working.

RESOLVED:

That the update provided be noted.

To receive an update on the implementation and roll out of the Right Person, Right Care operating model.

Jill Broomhall - Director of Adult Social Care and Operations, provided an overview of the Right Care Right Person national police initiative. Cheshire Constabulary was one of three early adopter forces with phase 1 commencing on 8 January 2024.

The main areas of current activity which the Police aimed to change the threshold for attending included welfare checks, AWOL mental health patients, people who leave health facilities, support to voluntary mental health patients and use of s135 and s136.

To prepare for the change officers had attended meetings and workshops with the Cheshire Constabulary and liaised with colleagues across the country where Right Care Right Person has been brought in to see what the implications had been for them.  Briefing information was being prepared on what was a Police welfare check, when the Police would be asked to respond and when the local authority would attend.

The Committee raised concerns about staff responding to calls who could be faced with challenging behaviour without the support of the Police. In response it was stated that it could be that two members of staff would have to attend which would create additional pressures on the service. No additional funding was being provided.

The Committee noted that an urgent mental health care centre was being developed in Chester, which would be available in 2025, but there were no plans for a similar centre for Cheshire East.

It was agreed that a report would be brought to the next meeting to report on how phase 1 was working.

RESOLVED:

That the update provided be noted.

To consider the Work Programme and determine any required amendments.

Consideration was given to the Committee’s Work Programme.

It was noted the item East Cheshire Trust Major Service Redesign had been renamed to Sustainable Hospital Services Programme – East Cheshire NHS Trust and would be presented to the Committee in June 2024.

The next meeting would be receiving an update on Flood Risk Management. When this had previously come to the Committee in March 2023, it had been a lengthy item with the Environment Agency taking away several questions for response, and it was suggested that the committee members email the Democratic Services Manager with their questions in advance of the meeting.

The Committee had recently received a briefing on Congleton Memorial Hospital, and it was asked if this item could be removed from the Work Programme. After discussion It was agreed that the item could be removed from the work programme.

Reference was made to the item on the Work Programme to receive a presentation on Fire Safety and possible hold a future meeting at the Fire Safety Centre at Warrington. It was agreed that officers would investigate whether it would be possible to use the venue for a meeting.

RESOLVED:

That the Work Programme be noted.