Decisions

Consideration was given to a report responding to the Notice to Motion raised at Council relating to the opportunities for town or parish councils and local communities to promote initiatives, as part of World Car Free Day, entitled “Car Free Days and Parklets”. 

The Committee generally supported the Notice of Motion put forward which encouraged people to change their mode of transport for one day.  It was pointed out  that the motion did not prevent those people who needed to access a car from doing so.

A point was raised that any communication needed to make it clear to the public how any requests for events put forward to the Council would be dealt with.  Officers reassured the Committee that if an event promoter could not demonstrate that they had engaged with the community then a street closure notice would not be granted.

Councillor A Gage expressed a number of reservations about the motion submitted.  He advised he had spoken to a number of individuals, none of whom had responded positively to the initiatives.  He felt that the Committee were being expected to hand over a level of power to officers with very little control and therefore could not support the recommendation. 

In response the Chair confirmed that the powers Councillor A Gage had referred to were already in existence and that the Committee were merely being asked to approve a communication plan making it clear to those individuals who wanted to set up a parklet or road closure the process to be followed in order to achieve this.

Councillor L Crane requested that the Committee support the motion subject to a minor amendment to the last sentence contained at paragraph 6.4.2of the report which replaced the words ‘on the 22^nd September 2022’ with the following the words ‘World Car Free Day 2023.  To be brought back to this Committee for review’ in order for Members to be given the opportunity to debate the matter further.

RESOLVED

That the Highways and Transport Committee endorse the proposed response to the Notice of Motion (subject to the inclusion of the amendment as outlined above) which would be made available on the Council’s highways webpage.

Consideration was given to a report on seeking Members approval for the delivery of electric vehicle charging points that supported residents who did not have the ability to charge their vehicle at home.

Members welcomed the recommendations contained within the report with comments focussing on the practicalities of the proposals including the siting of electric vehicle charging points, particularly for those properties fronting on to the highway with no off street parking, how the Council would ensure people only parked in electric charging spaces for charging and how would displacement parking be managed.

Further points were made in relation to including an item on the work programme regularly updating the Committee on the subject, that the costs of using EV charge points should be fair throughout the borough, and that the proposals were not being used as a method of taxing those individuals who did not have driveways.

In response to the request for an item to be included on the work programme, the Chair advised it could be included within the annual review rather than as a stand-alone item on the work programme.

RESOLVED (Unanimously)

1.That the delivery of the next phase of charge point locations noted in this report to support residents who did not have off street parking be approved, subject to formal approval of the application by Government.

2.That the next steps for the development and delivery of the wider electric vehicles infrastructure programme as set out in paragraph 2.7of the report be noted, and that further reports would be submitted to the Committee to seek necessary approvals.

(Prior to consideration of the following item, the meeting was adjourned for a short break).

To receive a report on the Annual Performance Review.

Consideration was given to a report updating Members on the performance across the Infrastructure and Highways services for the financial year 2021-22.

Comments were made in respect of the new monthly work programme on the website which was welcomed as well as the return of ‘Fix My Streets’.  In addition the extra emphasis the Council had placed on tree maintenance within the last year was also welcomed.  Further to this it was requested whether or not it would be possible for the Committee to reconsider the matter relating to car parking charges and if this request be looked into expediently. 

Reference was made to training on page 49 of the report and whether there was an update on this matter.  In response to this Mr T Moody, the Director of Transport and Infrastructure advised he investigate the issue raised outside of the meeting and provide a written response.

Councillor L Gilbert reiterated his request he had made earlier in the year for copies of Highways policies.  He had been informed operational policies existed and that a schedule of policies would be provided by the previous Director Of Highways and Infrastructure.  It was agreed that this matter would be investigated outside of the meeting and any relevant information would be circulated to Committee Members.  The Chair suggested that any existence of such policies could form part of a future training exercise for Members.

It was noted bus patronage was still poor particularly in rural areas and that as much as possible should be done, including Members writing to local MP’s in order to garner stronger support for the provision of public transport in rural areas. 

Members asked if there had been any response from the DfT in respect of the decision by government not to allocate any funding to the Council’s BSIP.  In response officers confirmed that the DfT had written to the Council and the response would be circulated to Committee Members.

RESOLVED

1.That the report and comments outlined above be noted.

2.That the on-going work of the Highways Service to support delivering the Council’s Brighter Futures customer strategy be noted.

A review of the 2021/22 Highway Winter Service activities and if required any proposed amendments.

Consideration was given to a report updating Members on the implementation of the revised policy for the winter gritting route network in the Borough during the winter of 21/22.

Members thanked officers for their hard work in what had been a long process to get to the stage the where officers were now able to put forward final recommendations for approval by the Committee in respect of the winter treatment network for 2022/23.

Councillor D Stockton proposed an amendment to the recommendations to include a further recommendation under paragraph 3.1 of the report as follows:-

‘The inclusion of Lacey Green, Wilmslow into the 2022/23 treated network’.  This amended was seconded, debated and a vote was taken in which the amendment was lost.

Councillor A Gage commented that the winter getting network should be expanded in order to safeguard against the potential for loss of life and he expressed his surprise that Coole Lane had not been included previously within the winter gritting network.  In addition he requested further reconsideration should be given by officers to those routes with tights bends which he felt were as important and should be treated with the same priority as those routes with inclines and declines.  The Chair responded that he was sure all Members would advocate expanding the gritting network, however any decision relating to this matter would form part of the budget setting process and therefore outside the remit of the Committee.

RESOLVED (Unanimously)

1.That the following amendments to the winter treatment network for implementation from the start of the 2022/23 winter season onwards be approved:

-       The inclusion of Coole Lane, Audlem into the treated network.

-       The inclusion of Brook Street, Macclesfield into the treated network.

2.That authority be delegated to the Director of Highways and Infrastructure in consultation with the Section 151 Officer to approve entering into funding agreements with Town and Parish Councils in relation to winter gritting ‘top up’ funded routes as described in paragraphs 7.19 to 7.21 and Appendix 2 of the report, to be implemented for the 2022/23 winter season.

3.That authority be delegated to the Director of Highways and Infrastructure to make minor operational changes to the Winter & Adverse Weather Policy, Adverse Weather Plan and roads included in the treated network, with any changes being subsequently reported to the Highways and Transport Committee.  

To update on DfT’s response to the proposals for an Enhanced Partnership Agreement relating to local buses services.

Consideration was given to a report updating Members on the progress towards making the Cheshire East Enhanced Partnership (EP) Plan and Scheme documents, including an update on the Department for Transport’s (DfT) Local Transport Fund and Network Review process.

It was commented that it was disappointing to hear no further update on funding opportunities beyond 4 October 2022.  A request was made for Members to have access to the Network Review.  In response Richard Hibbert, the Head of Strategic Transport and Parking confirmed that a concise summary of the review could be circulated to Members.

A further comment was made in respect of whether there should be an amendment to the recommendation to allow the opportunity for the Chair and Vice Chair to be consulted.  The Chair reassured the Committee that as both he and the Vice Chair were Members of the EP Board, therefore they would provide that oversight as members of the Board and as part of the governance arrangements there was a requirement the Chair and Vice Chair report back to the Committee.

RESOLVED (Unanimously)

1.That it be agreed the EP Plan and EP Scheme be made in Cheshire East in accordance with the regulations and that the Director of Highways and Infrastructure and the Director of Governance and Compliance be authorised to take all steps necessary to bring the EP Plan and EP Scheme into effect.

2.That it be agreed that arrangements be made for the inaugural meeting of the EP Board in September – with subsequent meetings arranged as defined in the EP Plan.

3.That the the Director of Highways and Infrastructure be authorised to make all necessary arrangements to commence works as defined in the EP Plan and EP Scheme.

4.That the completion of a whole Network Review as required to access the final instalment of the Local Transport Fund be noted.

To review the 2021/22 Quality Accounts Cheshire & Wirral NHS Foundation Trust, and agree to any feedback and comments it wishes to provide.

Dr. Anushta Sivanathan, Medical Director and Consultant Psychiatrist at Cheshire & Wirral Partnership (CWP) attended the meeting via Microsoft Teams and presented the CWP Quality Account to the Committee.

The Committee was advised that CWP was regulated by the Care Quality Commission (CQC) and at present there was no concerns.  CWP complete a book of best practice each year to improve performance.

There were three priorities for 2021-22, these had been met but some achievement had stalled due to pandemic challenges.  There had been improvement in clinical effectiveness, patient experience and patient safety.

The outreach vaccination service had successfully vaccinated 30,000, specifically those hard-to-reach who wouldn’t have been reached by traditional GP services.

The impact of the pandemic and lockdown had affected the mental health of young people.

There had been investment in 24/7 acute psychiatric services and two crisis cafes in Crewe and Macclesfield.

Services for children and young people had seen a significant impact from the pandemic from 1 in 9 to 1 in 6.

A Well-Being Hub with access to specialist mental health had been developed, this had been piloted in South Cheshire and rolled out to East Cheshire.

1,793 compliments had been received all of which were communicated back to staff.

The Committee were given the opportunity to ask questions or make comments, there was an acknowledgement of the challenges faced by the pandemic but awareness that the pandemic has created future issues for children and young people including, learning and self-esteem.

Whilst engagement and focus was with the community the Committee noted that schools are on front-line, and prevention measures needed to manage emerging issues and to recover from the pandemic.

The Medical Director and Consultant Psychiatrist noted that Cheshire East Council had been instrumental in ensuring support was provided to schools and teachers to support others.  Not all schools were covered but CWP in partnership with the council was working towards that as part of a long-term plan.

There was some discussion about the Crisis Cafes, and future plans for expansion, the Medical Director and Consultant Psychiatrist noted that both cafes were recently opened in areas where the greatest need was.  The next phase would be to assess how CWP can work in partnership with the council to ensure crisis cafes can support communities across Cheshire East. 

The Committee noted the quality of services was high but spreading people across services could impact those services and/or become a staffing issue.  The Committee was advised that staffing was a serious challenge, and together with the impact of the pandemic, plus cover/cross cover, CWP was looking at the workforce, new roles, and types of roles, skill mix and moving away from the traditional approach of doctors, nurses and therapists.  CWP had a comprehensive work force offer through workforce development however in terms of recruitment to retention it was acknowledged there was a national shortage of nurses trained in learning disabilities.

RESOLVED: That:

a) the Medical Director and Consultant Psychiatrist be thanked for attending the meeting and presenting to the Committee;

b) the 2021/22 Cheshire and Wirral Partnership Quality Account be received and noted; and

c) That the committee’s feedback and response to the 2019/20 Quality Account for sent in the form of a letter.

For the Committee to provide commentary on the East Cheshire NHS Trust Quality Accounts which will be incorporated into the final document before it is published, as per NHS England and NHS Improvement recommendations to allow scrutiny and comment.

Paul Devlin, the Deputy Director of Nursing at East Cheshire Trust attended the meeting via Microsoft Teams and updated the Committee on the progress through the Quality Account.

The Committee were advised that all services had seen pressures that related to the pandemic, however there had been a number of achievements such as:

the trust became a Disability Confident Employer;

the opening of The Christie at the Macclesfield site;

the opening of same day emergency care unit; and

ongoing support from community for staff.

Staff had continued to respond to the development of care models, and progression of recovery plans. The focus for teams was now on improved care and this work had carried into current year through an improvement plan. 

A designated panel now investigated when falls had occurred and staff were supported in prevention work.

In terms of Infection and prevention control, the focus continued, and other infection rates remained within trajectory.

Wait times at East Cheshire had increased and this was a focus for teams. 

Intrapartum services had been paused at Macclesfield General Hospital but it was planned to re-establish the service this year, the Trust had been working closely with patients to support this.

Priorities for 2022/23 were outlined within quality strategy and mirrored the key lines of enquiry that Care Quality Commission (CQC) used when inspecting.

The Committee were invited to ask questions and make comment, there was some discussion about:

Bad patient feedback, the Committee were advised that in terms of response rates to feedback, the Emergency Department tended to be low, comments that related to length of wait were reflective of operational challenges. 

The Committee noted that despite intrapartum care being paused, planned home births still went ahead.

There had been Improvements in diagnostic waiting times, scanning and radiology and in terms of number of patients who had waited over 52 weeks for treatment.  Those who waited over 104 weeks had been supported with surveillance, however the Deputy Director of Nursing acknowledged that 52 and 104 week waits were unacceptable, a Harm Review was undertaken to assess if harm had occurred during wait times and that was reported to the Trust assurance committee.

The Committee acknowledged the challenges with waiting times, and asked for a more detailed report to be brought back to a future meeting with comparative data to other Trusts.

The Committee noted that both local hospitals had participated in the Ward Accreditation Scheme, and queried the burden on staff to achieve the accreditation.  The Deputy Director of Nursing gave reassurances to the Committee that the monthly audit process sampled three patients in significant detail and conducted a detailed review of patient safety and feedback.  Audit compliance was good but if patients had negative experiences this was a cause for concern to the Trust.  In terms of workload, this was not considered an unmanageable burden for ward managers.

RESOLVED: That:

·         Paul Devlin be thanked for his attendance and presentation to the Committee;

·         the East Cheshire NHS Trust Quality Account be received and noted; and

·         comments from the meeting be fed back to the Trust for inclusion within the Quality Account 2021/22.

To receive an update from representatives of East Cheshire NHS Trust following a six-week engagement period with the public on the subject of how clinical teams are being supported in working together to develop a joint clinical strategy that sets out new, single clinical pathways, and innovative solutions to best meet the growing care needs of local populations.

Katherine Sheerin, Director of Transformation and Partnerships at East Cheshire NHS Trust attended the meeting and addressed the Committee since last updating at the previous meeting on the 21 March.  During that meeting the Committee were advised that a statement of intent had been circulated to all partners that outlined the continued intention to work collaboratively for acute services with NHS partners, and support clinical teams to continue working together to develop a joint clinical strategy that would set out new, single clinical pathways, as well as innovative solutions to best meet the growing care needs of local populations.

This update followed the six-week engagement exercise, with the results available for review.

The Committee were advised there had been 273 responses, this was expected for this kind of exercise.  Unique web-page views were in the thousands.  Of the 273 responses, these were reflective of patients, employees, carers, and other public sector bodies, 83% were female, however the respondents were skewed towards affluent areas. 

Critical care was given positive ratings, however given the low number of responders it was acknowledged that it was difficult to determine a service-users view.

Waiting times, communications with patients and difficulties with parking had negative ratings.

Maternity services and bringing back of Intrapartum care was also mentioned within the responses.

The Committee were advised the results will be in public domain from the 30 June, NHS assurance had been given and the case for change had been approved, and would be published in full alongside a summary version.

The next steps would be to submit a pre-consultation business case to NHS England.

The Committee were invited to ask questions or make comments, it noted that there had been very low responses from voluntary groups and this cohort supported many NHS functions.  The Director of Transformation and Partnerships noted that communication had taken place with existing networks but this was an area to address with Phase 2.

The Committee highlighted the importance of dynamic consultations to help restore confidence with patients and those negatively affected through reduction of services during the pandemic.

The Committee questioned mitigation towards long waiting lists, and were advised that the Trust was working across Cheshire and Merseyside to determine a collective approach rather than trying to impact as individual organisations.

Some success had been achieved using international nursing; using clinical support workers in innovative ways; the induction of more medical students into the Trust, for longer periods of time; and rotations within the Trust and into primary care. 

RESOLVED:

That the Director of Transformation and Partnerships be thanked for their attendance and presentation to the Committee; and that the presentation be received and noted.

For the Committee to note the progress on the new governance arrangements for local Health and Care services, to consider and comment on the proposed joint scrutiny arrangements for Cheshire & Merseyside and approve the amended ‘Protocol for the establishment of Joint Health Scrutiny Arrangements in Cheshire and Merseyside’.

Helen Charlesworth-May, Executive Director of Adults, Health and Integration introduced the report to the Committee, the report was considered by the Adults and Health Service Committee on 30 May, who had been asked to make decisions, detail of which was contained within the report that was for review by the Scrutiny Committee.

The report outlined progress with design and implementation and the proposed scrutiny arrangements for Cheshire East when the Integrated Care System (ICS) would be implemented across the Cheshire and Merseyside (C&M) footprint on the 1 July. 

The key considerations for the report included the joint scrutiny arrangements and the political balance arrangement across the nine authorities, the Committee was advised that these did not impact on any existing stand-alone arrangements the local authority had in place for Health Scrutiny.

Deborah Upton, Senior Lawyer advised the Committee that as an example, if the Integrated Care Board (ICB) wished to implement any new policies across the C&M area, the joint committee would consider the referral.  Political balance has to be calculated across all nine authorities, and would be reviewed post-elections and on an annual basis to ensure that any changes were taken into account.

The Chair noted there had been a point raised by members of the Adults and Health Committee, as to the proportionality of the joint committee, as Cheshire East had a larger population than some others and Members felt that this should have been taken into account when considering the proportionality.  The Senior Lawyer advised that, the calculation of political balance had been adhered to across C&M as a collective and this did not take population numbers into consideration. 

The Committee were invited to ask questions and make comments.

There were comments of concern that related to the proportionality of the joint committee.

The Senior Lawyer advised the Committee that there had been a request to write to the Secretary of State (SoS) by Members of the Adult and Health Committee.  The Monitoring Officer had advised that any appeal to the SoS would require a change to legislation and therefore was unlikely to be successful.

The Committee were pleased to note that rural proofing had been retained within the report, however there was some discussion about coterminous boundaries.  The Committee had a strong desire to retain co-terminosity across Cheshire.  The Executive Director of Adults, Health and Integration advised that patient choice was recognised, and there are options for those requiring care into Greater Manchester, Derbyshire, or Staffordshire, however Cheshire East would be part of the wider C&M footprint and even if Cheshire East had local arrangements with Cheshire West, there were no guarantees that funding would flow from C&M equally.

The Chair asked that the specific and unique requirements of the rural borough be acknowledged, and additionally she requested further information for the Committee regarding the 2 seats allocated to Cheshire East for the Joint Scrutiny committee who was responsible for choosing/nominating Cheshire East representatives, and on what premise was the political proportionality of the Cheshire East representation to the Joint Scrutiny Committee based?

The recommendations within the report were considered, there was agreement to split the two parts of the second recommendation as the Committee were unable to reach an accord on the third recommendation.

RESOLVED: That:

1) the progress to date on the Place Partnership Board (working title) be noted;

2) the establishment of a Cheshire and Merseyside Integrated Care System Joint Health Scrutiny Committee be recommended to Council; and

3) a meeting date be sought for this Committee in July to discuss in more detail the ‘Protocol for the establishment of Joint Health Scrutiny Arrangements in Cheshire and Merseyside’.

To receive early consultation findings and options and next steps with the opportunity to feed the view of the Committee through to the Health and Wellbeing Board for its consideration.

Doctor Susan Roberts, a Consultant in Public Health attended the Committee and presented the report.

The Committee were advised that the Pharmaceutical Needs Assessment (PNA) needed to be published by the 1 October 2022, and that Dr. Matt Tyer, the Director of Public Health had responsibility to do this.

Between 1 April 2021- 10 June 2022 there had been 105 consultations responses with 354 partial responses.  The Draft PNA provisional findings were deemed adequate (this was the target for the public health team) and the conclusions needed to be tested. 

The Committee had some concerns regarding:

·         automated medication from robots in hospital pharmacies;

·         the expansion of the Basford area of the borough and the impacts on medical centres;

·         there were no reviews of accessibility within the consultation (this was to be reviewed for future consultations);

·         The Pharmaceutical offer and challenges to Cheshire East villages (the challenges were acknowledged and articulated within the PSA response); and

·         that despite advertising the consultation within pharmacies, no paper copies were available.

The public health team would take these comments to inform future learning and gave reassurances to the Committee that all comments during the consultation period would be analysed to feed into the consultation results.

RESOLVED:

That the production of the PNA and the consultation findings be received and that it be noted that the consultation findings may result in an amendment to the draft PNA once evaluated.