Meeting documents
Social Care, Health and Inclusion Overview and Scrutiny Committee
Tuesday, 19th June 2007
Present
Chair
A Bridson
Councillors
IO Coates, SR Mountney, Sarah Quinn, DE Roberts, PA Smith, GCJ Watt
Index to Minutes
- Minute 1 - DECLARATIONS OF INTEREST
- Minute 2 - MINUTES
- Minute 3 - APPOINTMENT OF VICE-CHAIR
- Minute 4 - ORDER OF BUSINESS
- Minute 5 - NORTH WEST AMBULANCE SERVICE: REGIONAL JOINT COMMITTEE AND WIRRAL PILOT
- Minute 6 - ASSISTIVE TECHNOLOGY SERVICE
- Minute 7 - TOWNFIELD CLOSE GP SURGERY
- Minute 8 - ANNUAL REPORT 2006-07
- Minute 9 - FINANCIAL MONITORING 2007-08
- Minute 10 - CAPITAL PROGRAMME MONITORING REPORT
- Minute 11 - REVIEW OF WORK PROGRAMME FOR 2006-07 AND INITIAL PROPOSALS FOR WORK PROGRAMME 2007-08
- Minute 12 - YOUR DOCTOR, YOUR EXPERIENCE, YOUR SAY
- Minute 13 - TENDERING FOR GENITO URINARY AND SEXUAL HEALTH SERVICES IN WIRRAL
- Minute 14 - ANNUAL HEALTH CHECK DECLARATIONS
- Minute 15 - APPOINTMENT OF CARERS' CHAMPION
Minute 1 - DECLARATIONS OF INTEREST
Minute Text :
The Head of Legal and Member Services invited members -
(a) to consider whether they had a personal or prejudicial interest in any matters to be considered at the meeting and, if so, to declare them and state what they were;
(b) to declare, pursuant to paragraph 18 of the Overview and Scrutiny Procedure Rules, whether they were subject to a party whip in connection with any matter to be considered and, if so, to disclose the nature of the whipping arrangement.
No declarations were made.
Minute 2 - MINUTES
Minute Text :
The Head of Legal and Member Services requested that the minutes of the meetings of the Social Care, Health and Inclusion Overview and Scrutiny Committees held on 19 February and 6 March which were received by Council on 1 March and 16 April, 2007, respectively, be received.
Minute Decision :
Resolved - That the minutes be received.
Minute 3 - APPOINTMENT OF VICE-CHAIR
Minute Text :
In accordance with minute 5(8) of Cabinet (16/5/07), the Committee was strongly recommended to appoint a Vice-Chair.
On a motion by the Chair, seconded by Councillor Roberts, it was -
Minute Decision :
Resolved - That Councillor S Quinn be appointed as Vice-Chair of this Committee.
Minute 4 - ORDER OF BUSINESS
Minute Text :
The Chair suggested, and it was agreed, that the order of business be varied and items 11, 4 and 12 on the agenda be considered next.
Minute 5 - NORTH WEST AMBULANCE SERVICE: REGIONAL JOINT COMMITTEE AND WIRRAL PILOT
Minute Text :
The Director of Adult Social Services submitted a report on proposals to reduce the number of ambulance 999 control rooms in North West Ambulance Service. The specific proposals were to reduce the number of 999 control rooms from four to three. Control rooms at Manchester, Liverpool and Preston would continue, and 999 call taking would cease in Cumbria. NWAS had indicated that this did not mean that the Cumbria office would close.
The health overview and scrutiny committees at Blackpool, Lancashire and Cumbria Councils considered that the proposals amounted to a substantial change and intended to establish a joint scrutiny committee to look into the matter in more detail. In addition to the control room issue, the health OSCs at Blackpool and Lancashire also took into account NWASs wider service strategy document and considered that the proposals contained therein also amounted to a substantial variation of service. In view of that, they intended that these proposals would form part of the wider issues being considered by the joint committee.
The Councils intending to set up a joint committee had contacted the other North West OSCs to ask them to formally consider whether in their view the proposals amounted to a substantial change to service, and whether they wished to form part of the joint committee.
NWAS had also contacted Wirral to inform the OSC that this summer they would undertake a pilot described as follows: ‘A pilot to decide the most appropriate resource to convey the patient to hospital either by appropriately qualified staff of the emergency paramedic service or high dependency service. The pilot will also capture audit data through attending Paramedics who have been trained in additional patient assessment, treatment and referral skills to provide evidence to support pilot outcomes and feasibility of future alternative response strategy.’ NWAS had indicated that additional resources would be allocated to Wirral for the period of the pilot which would start in August.
John Burnside, Chief Executive of the NWAS, was present at the meeting and together with his colleague, Paul Ferguson, Area Director for Cheshire and Merseyside, gave a presentation to the Committee on the proposals.
In response to questions from Members, John Burnside and Paul Ferguson made the following comments:
- Ambulance stations on the Wirral included, Wallasey, Birkenhead, Bebington and Moreton but there had been a move away from traditional station based operating to a more efficient mobile based system of operating.
- The current target for response times was to be on the scene of 75% of life threatening emergencies within 8 minutes, additional targets included having a resource on the scene of 95% of emergency calls within 19 minutes. In NWAS's region 40% of calls were emergency / life threatening calls, which, compared with other parts of the country was high.
- There was a great deal of unfulfilled potential for the service in taking health care to the patient as 80% of current activity was for non-emergency transport. This would not distract from emergency services as specific funding from PCT commissioners would be identified for this area.
- Extra resources for the pilot would give the service an opportunity to look at how much performance improved and the resource profile across the whole of the North West region.
- They explained their work with the ordnance survey and how every telephone landline was on their system so taking a call enabled the service to pinpoint the nearest response vehicle. Developments were taking place with mobile 'phone companies too to enable accurate geographical mapping of where a call was being made from.
The Chair suggested that as there wasn't to be a change in the Wirral area there would be no need to join the North West joint committee which Blackpool Council would be co-ordinating.
Minute Decision :
Resolved -
(1) That this Committee declines to join a North West Joint Committee but requests that it be kept informed.
(2) That further information be provided on the Wirral pilot at future meetings of this Committee.
Minute 6 - ASSISTIVE TECHNOLOGY SERVICE
Minute Text :
The Director of Adult Social Services submitted and reported upon the progress made on the development of the Assistive Technology Service funded through the Preventive Technology Grant 2006/08. During 2006/07 a range of telecare and telemedicine equipment was identified to be commissioned as part of an individual's health and/or social care package. Telemedicine was particularly relevant in supporting people with long term conditions and the avoidance of hospital admissions. A full cost benefit analysis would be presented as part of a future investment plan which would be presented to Cabinet. To date the highest cost telecare package had been £500 per annum.
A ‘SMART’ house had been developed in a one bedroom flat in ‘Flambards’ on the Woodchurch estate. This facility was fully equipped with the range of technology and provided assessors, people who used services, the public and other professionals an opportunity to view and try out the equipment in a home environment. It was suggested that a visit of the Committee be arranged to this facility.
Jennifer McGovern, Joint Commissioning Manager, gave a presentation to the Committee on the service and responded to Members' questions as follows:
- During the pilot no charges were made for the service but in future people would pay a proportion of the cost but this would be needs related.
- The grants for the service were ringfenced and the Department had 2 years to demonstrate the cost effctiveness of the scheme.
- In some cases the telecare ran alongside existing care package arrangements and in others people were happy not to have a visit, the right kind of assessments would provide the right kind of equipment.
Minute Decision :
Resolved - That the report be noted and that a site visit be organised to Flambards, the Smart House on the Woodchurch Estate.
Minute 7 - TOWNFIELD CLOSE GP SURGERY
Minute Text :
The Chief Executive of Wirral PCT submitted a report which was presented to the Committee by Dr A Mantgani, Chair of the Birkenhead Locality, and Dr J Howard, GP at the practice. The report summarised the consultation process and the consultation results for proposals to relocate Woodchurch Road Surgery to a purpose built health centre in Townfield Close, Noctorum. The paper had been considered by the PCT Board in April where it was advised that the PPI Forum had indicated its satisfaction with the consultation and that it would formally give its report to the Overview and Scrutiny Committee in June. The Wirral Health Forum’s report was also submitted for the Committee's information. The Committee were advised that the PCT Board had supported the relocation of Woodchurch Road Surgery.
Robin Eley Jones, Chairman of the Wirral Health Forum, whilst expressing the Forum's support for the proposals, did report two concerns to the Committee:
(i) the notice given of just one week for the proposed consultation leaflet - he had been assured that this concern had been addressed and that future projects would involve more notice.
(ii) the distance some patients would have to travel to the new practice and the lack of adequate public transport - he had been assured by Dr Mantgani that this was being addressed with Merseytravel.
Minute Decision :
Resolved-
(1) That Committee notes the outcome of the consultation being in the main in support of the proposal, and the comments of respondents.
(2) That Committee notes the comments from Wirral Health Forum and their support for the proposals.
(3) That Committee notes the concerns of patients regarding the inadequate public transport links to the new surgery site and requests a formal approach is made to Merseytravel to improve these connections.
Minute 8 - ANNUAL REPORT 2006-07
Minute Text :
The Director of Adult Social Services submitted and reported upon the Annual Report of the Department which detailed how the Department had performed in the Corporate Objectives of the Council in 2006/07. The report focused on the performance of the Department of Adult Social Services although some of the indicators related to the performance of Health services in Wirral. The Annual Report would be provided to the Commission for Social Care Inspection at the Annual Review Meeting on 5th September 2007.
The report demonstrated there had been significant improvements in the Department’s performance in most areas, but there were a number where it was recognised that further improvements were required. These were highlighted as:
- The number of older people helped to live at home
- The number of people admitted to residential or nursing care
- Performance across a range of specialist Mental Health Services
- Assessment and Care Management Reviews
All were subject to action plans within the 2006-07 Business Plan presented to Members earlier this year.
The report also outlined the results of inspections over the last 12 months which had included the routine regulatory visits for the Department’s in-house care services and a formal inspection of Older Peoples services from CSCI in February 2007. The Audit Commission also undertook reviews of Health Partnerships and financial management arrangements.
The report went on to give details of user involvement and community engagement and detailed the outturn for the Department’s Performance Indicators for 2006/07. Whilst the overall direction of travel remained positive particular attention would be given to those areas that needed to be improved.
In response to Members' questions, the Director made the following comments:
- There were a large number of PI targets to meet, some were health targets and some were in the process of being refreshed.
- The inter-relationship between health and social care was being further explored and the whole system was being looked at, nowhere more so than the way in which commissioning took place.
- The outturn for the Department of some £400,000 overspend, including central recharges, out of a gross spend of £140m, was he suggested not that far off target.
- Cabinet would be considering an efficiency plan which would contain a number of options but once the details became clear this would have to be subject to detailed scrutiny.
The Chair informed the Committee that the Director would be giving a monthly update to the Chair and Spokespersons on the financial situation of the Department.
On a motion by the Chair, it was -
Minute Decision :
Resolved -
(1) That the report be noted.
(2) That this Committee supports the Director and his staff in making the budget work and would hope to come out of the year with a balanced budget and improved services for local people.
Minute 9 - FINANCIAL MONITORING 2007-08
Minute Text :
The Director of Adult Social Services reported upon the current financial position of the Adult Social Services Departmental budgets. At the time of preparing this report work continued on completing the accounts for the 2006/07 financial year and further details would be included in the report to the next meeting. The indications were that there would be an overspend of approximately £400,000 (including recharges from central Departments) due to the variations reported previously to Members.
Since the budget was reported to this Committee in January it had been revised to reflect the agreed savings, policy options and the re-allocation of internal recharges. The budget approved by Council on 1 March 2007 was £77,616,400. The report also gave details of progress on savings amounting to £3,302,700, and service re-engineering savings amounting to £1,295,000.
In response to comments from Members, the Director reported upon the Invest to save budget from the Government, which was a competitive process and any schemes had to show a potential to save money.
Minute Decision :
Resolved - That the report be noted.
Minute 10 - CAPITAL PROGRAMME MONITORING REPORT
Minute Text :
The Director of Adult Social Services provided an update on the progress of Adult Social Services Capital Expenditure. The Capital Programme was formulated and planned on a three-year basis within the Council’s Capital Strategy and was based upon resources expected to be received from Central Government, contributions from other sources, and assumed the use of capital receipts generated from the sales of assets. The programme approved by the Council on 1 March 2007 was £3,680,000 in 2007/2008, and the Director provided details of the programme on a scheme by scheme basis.
Minute Decision :
Resolved - That the report be noted.
Minute 11 - REVIEW OF WORK PROGRAMME FOR 2006-07 AND INITIAL PROPOSALS FOR WORK PROGRAMME 2007-08
Minute Text :
The Director of Adult Social Services submitted a report on items for the Committee's programme for 2006-07. The report reviewed last year’s work programme and proposed a process for determining items for the current year.
A number of topics were identified for follow up reports including:
- NHS dental provision.
- Audiology - to be considered at the September meeting.
- LINks – Committee to consider any significant national or local developments.
- Clatterbridge Centre for Oncology – a follow up presentation identifying the progress of CCO as a Foundation Trust.
- Wirral Hospital Trust – a follow up presentation identifying the progress of WHT into foundation status.
- Occupational therapy – Committee agreed to receive more information on case-loads and case examples.
- The Warrens – Committee agreed to receive regular updates.
Regular items would include:
- Adult Social Services performance (including LAA performance).
- Adult Social Services financial reports and capital strategy.
- Annual Health check.
After some debate and discussion by the Committee, it was -
Minute Decision :
Resolved -
(1) That Committee agrees to follow up reports as identified in paragraphs 11.2 and 11.3 of the Director’s report.
(2) That the Committee work programme for 2007/08 include:
(i) Transition from children’s to adult services
(ii) Carer’s strategy and action plan
(iii) Adult Protection.
(3) That the Chair and party spokespersons meet to discuss potential topics for reviews / major themes on the whole system approach Health and how integrated activity can be scrutinised, informed by officers from the Council and NHS as relevant, and that a report is submitted to the September Committee.
Minute 12 - YOUR DOCTOR, YOUR EXPERIENCE, YOUR SAY
Minute Text :
The Joint Director of Public Health submitted a report on the national GP survey 'Your Doctor, Your Experience, Your Say.' At its meeting in January, (minute 42 - 8/1/07) the Committee was informed about the national survey and agreed that it would consider the results at its meeting in June. Results had not yet been published either nationally or broken down for local interpretation. Wirral PCT expected to able to report locally and respond to the findings of the survey in due course and would provide a full report to a future Committee.
Minute Decision :
Resolved - That the report be noted.
Minute 13 - TENDERING FOR GENITO URINARY AND SEXUAL HEALTH SERVICES IN WIRRAL
Minute Text :
The Joint Director of Public Health submitted a report which informed the Committee that Wirral Primary Care Trust had invited tenders for the provision of Genito Urinary Medicine and Sexual Health Services (GUMSH). This service was currently provided by Wirral Hospital Trust based in Arrowe Park Hospital. Latest guidance highlighted the need to provide such services in a range of highly accessible venues to increase access to groups most likely to engage in high risk sexual behaviour. Rates for sexually transmitted infections were higher in areas of deprivation and young people were high users of GUMSH services. Therefore, the tender process aimed to secure high quality service provider/s who would meet the needs of a range of age groups, but particularly under 25’s, at a choice of venues and times.
In response to Members' questions, Kathy Doran, Chief Executive of Wirral PCT, made the following comments:
- A number of providers had expressed an interest in tendering for the service with an anticipated commencement date of April 2008, depending on who the successful tenderer was. If it was feasible for the contract to start earlier then it would.
- The PCT was, where possible, working with the Children's and Young People's Department but there were a number of issues around working with schools on the subject of sexual health which could be problematic.
Minute Decision :
Resolved - That the report be noted.
Minute 14 - ANNUAL HEALTH CHECK DECLARATIONS
Minute Text :
The Director of Adult Social Services submitted the annual healthcheck declarations which had been submitted to the Healthcare Commission in May. Since the last Committee took place in March it was not possible to see the declarations before the Committee signed off its comments. Therefore the declarations from Clatterbridge Centre for Oncology, North West Ambulance Service, Wirral Hospital Trust and Wirral PCT were included with the agenda for the information of Members.
Minute Decision :
Resolved - That all 4 of the NHS organisations’ declarations be noted.
Minute 15 - APPOINTMENT OF CARERS' CHAMPION
Minute Text :
At the meeting of this Committee on 7 June, 2006 (minute 5 refers), fomer Councillor Mrs J McKelvie was appointed Carers' Champion. The Champion’s role included acting as a figurehead, offering leadership and representing the interests of Carers. The Committee was requested to appoint a new Carers' Champion.
Minute Decision :
Resolved - That further consideration be given to this appointment once more members other than those on the Committee have been approached and that more information be provided on the Carers' Champion role.
(Minutes Published: 5 July 2007)