Agenda and minutes

Health and Adult Social Care and Communities Overview and Scrutiny Committee
Thursday, 8th February, 2018 10.00 am

Venue: Committee Suite 1,2 & 3, Westfields, Middlewich Road, Sandbach CW11 1HZ. View directions

Contact: Helen Davies  Scrutiny Officer

No. Item


Apologies for Absence


Councillor O Hunter.


Also Present


Jerry Hawker- Chief Executive Officer, Eastern Cheshire Clinical Commissioning Group (CCG)

Janet Clowes- Portfolio Holder for Adult are and Integration

Liz Wardlaw- Portfolio Holder for Health

Linda Couchman- Interim Director of Operations

Fiona Reynolds- Director of Public Health

Jill Broomhall- Director of Adult Social Care Operations.


Minutes of Previous meeting pdf icon PDF 69 KB

To approve the minutes of the meeting held on 18 January 2018.



Councillor L Smetham advised that during the last meeting, she did not declare a disclosable pecuniary interest in her role as Vice President of Cheshire Community Action



(a)  That the written record be amended by the Scrutiny Officer accordingly; and

(b)  That the minutes of the meeting held on 18 January 2018 be confirmed as a correct record and signed by the Chairman.


Declarations of Interest

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


Councillor G Baxendale declared a personal interest in minute number 82, North West Ambulance Service, as he recently used the Ambulance Service for his wife.


Declaration of Party Whip

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.


Public Speaking Time/Open Session

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 who wished to speak.


North West Ambulance Service pdf icon PDF 114 KB

NWAS Ambulance Response Programme Performance Report for period 7 August 2017- 31 December 2017.




Additional documents:


Jerry Hawker, Chief Executive of NHS Eastern Cheshire Clinical Commissioning Group (CCG), attended the meeting, in the capacity of commissioner to present the North West Ambulance Service (NWAS) Ambulance Response Programme Performance Report for period 7 August 2017-31 December 2017.


Jerry advised the Committee that NWAS had experienced significant challenges over the last two years.

In July 2017, the Secretary of State had introduced new ambulance response standards for the NHS in England.  NWAS had rolled out the new reports, this was to be completed by August 2018.


Until now, ambulance services were measured on the time it took for a call handler to receive an emergency call, to the vehicle arriving at the scene, the target for this was eight minutes.  The process had now moved away from call handlers to trained clinicians being the call handlers and that enabled more time on the call to assess the urgency of the patient.  This process was part computer generated and part clinical.  Patients would be asked a set of questions that would determine the urgency of a call and then a trained clinician (a General Practioner (GP) or former GP) would make an additional clinical decision.


Jerry explained the new changes enabled ambulance vehicles to be utilised more effectively and efficiently.

NWAS targets were based on the performance of the provider, not the CCGs and this was the same for the whole of the north-west.  This has led to significant disparity across urban and rural areas.


The four new standards were:


·         Category One: for calls about people who had time-dependent, life-threatening injuries and illnesses, they would be responded to in an average time of 7 minutes;

·         Category Two: for emergency calls such as a stroke or major burn incidents and these calls would be responded to in an average time of 18 minutes;

·         Category Three: for urgent calls that are not life threatening but not severe accidents such as falls, these calls would be responded to in 120 minutes (2 hours); and

·         Category Four: for none urgent calls, these calls would be responded to in 180 minutes (3 hours).


Category one and two were the most critical, NWAS had responded to category one 90% of the time in 15 minutes and category two 90% of the time in 40 minutes.  Jerry acknowledged that NWAS had not met the performance standards but that the scale of change for all ambulance services across the country had been challenging.  The statistics particularly for Cheshire showed that NWAS had maintained performance, although this reflected as better than other areas in the north west.  One key area was the time it took the clinicians to make a decision and dispatch a vehicle, sometimes Rapid Response cars were despatched but then an ambulance was needed which had resulted in two or three vehicles arriving to the same scene.


The Committee were advised that an action plan would be available from the 16 February 2018.


The Committee asked if waiting times at the Emergency Department impacted on  ...  view the full minutes text for item 82.


Health and Adult Social Care Performance Scorecard pdf icon PDF 392 KB

To receive an overview of performance across the Health and Adult Social Care Service for Quarter 3 2017/18.

Additional documents:


Mark Palethorpe, Director of Adult Social Services, introduced the item for the Health and Adult Social Care Performance Scorecard, this was the first time the scorecard had been presented to this Committee and will be a standing item on the agenda.


Fiona Reynolds, Director of Public Health, was responsible for the Joint Needs Strategic Assessment (JNSA).  Fiona was conducting a review of the document and the evidence gathered would help to commission a more effective piece of work that would sit alongside the Outcomes Framework.


Fiona advised the Committee that the Public Health scorecard related to Quarter Two and contained a mixture of data, some was local and some was commissioned locally.  The data had been ratified but it was a position in the past that helped to acquire a snapshot of progress across all Local Authorities across the country.


The Committee asked for clarification on point 1.3 “Adults- Successful completion of drug treatment, who do not represent within 6 months” the narrative stated that the decrease from 38.7% to 34.8% was not significant.  Fiona advised the decrease was not as significant as to be concerned, overall it was above the national average other than the latest quarter but it would be flagged with providers.


Points 1.5 “Adults- Proportion of service users seen within 10 working days from Referral to Assessment for Drug Treatment” and 1.6 “Adults- Proportion of service users seen within 10 working days from Referral to Assessment for Alcohol Treatment” showed significant improvement (14.4% and 21.8% increases) from Quarter 1, yet the target was still coloured red.  Fiona advised this was because the target for both was 100% so that target would be pushed to achieve in full.


The Committee requested clarification of the acronym LARC, Fiona confirmed this was Long Acting Reversible Contraception, such as an implant or an injection.


Point 3.3 “Percentage of children that receive a 6-8 week review by the time they reach 8 weeks” showed a drop from 88% to 54%.  Fiona advised this was a substantial decrease that linked to the recording of the data and the staffing capacity to get the data in 6-8 weeks.  This was being monitored closely.


The Committee made the comment that there was a lot of red within the scorecard, Fiona acknowledged this was disappointing, but advised that many targets had been stretched and were above the national average, the outcome was to achieve quality of contracts.


Point 3.1 “Percentage of pregnant women that receive an antenatal visit by a Health Visitor” was shown as a figure rather than a percentage, this was a typo within the document.


The mental health of children was mentioned in the scorecard but not specifically included as this was included on the scorecard for Children and Families, Mark advised this could be cross-referenced for the future.


The Committee considered the Performance for Adult services, this showed benchmarking Adult Social Care Outcomes Framework (ASCOF) indicators.  Jill Broomhall, Director of Adult Social Care Operations advised the Committee that the full figures  ...  view the full minutes text for item 83.


Work Programme pdf icon PDF 66 KB

To review the current Work Programme

Additional documents:


The Chairman advised the Committee that the Spotlight Review of Mental Health Services across Cheshire East will be coming to the Committee for a full day on 12 April.




(a)  That the Work Programme be received and noted;

(b)  That the item for Integrated Carers Hub be moved to the 8 March; and

(c)  That the item for the Voluntary, Community and Faith Framework be moved to the 3 May.


Forward Plan pdf icon PDF 172 KB

To note the current forward plan, identify any new items, and to determine whether any further examination of new issues is appropriate.


The Chairman advised the Committee that an urgent item had been to Cabinet on the 6 February that related to Patient Passport- Delivering Access to Health and Care Records.  The Committee requested this item be added to the Work Programme for 3 May.


The Committee noted the Early Help Framework had been to Cabinet to  seek approval for the setting up of an Early Help Framework across the People Directorate in order to streamline the procurement of early help services.  Mark Palethorpe, Acting Director Adults Social Services, confirmed the Framework would be implemented in October 2018, and be in a position to come to this Committee for performance review earlier in 2019.



(a)  That the Forward Plan be received and noted;

(b)  That Patient Passport be added to the Work Programme for 3 May 2018; and

(c)  That the Early Help Framework be added to the Work Programme for 2019.