Members are asked to consider whether they have personal or prejudicial interests in connection with any item(s) on this agenda and, if so, to declare them and state what they are.

Members are reminded that they should also declare, pursuant to paragraph 18 of the Overview and Scrutiny Procedure Rules, whether they are subject to a party whip in connection with any item(s) to be considered and, if so, to declare it and state the nature of the whipping arrangement.

Members were asked 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.

Members were reminded that they should also 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 declare it and state the nature of the whipping arrangements.

No such declarations were made.

To receive the minutes of the meetings of the Social Care, Health and Inclusion Overview and Scrutiny Committee held on 25 March and 5 May, 2009.

Members were requested to receive the minutes of the meetings of the Social Care, Health and Inclusion Overview and Scrutiny Committee held on 25 March and 5 May, 2009.

Resolved – That the minutes be received.

The Committee is requested to appoint a Vice-Chair.

In accordance with minute 4 of Cabinet (16/5/09), the Committee was requested to appoint a Vice-Chair.

It was moved by the Chair and seconded by Councillor Redfern.

Resolved - That Councillor C Teggin be appointed Vice-Chair of this Committee for the current municipal year.

The Committee is requested to note its revised terms of reference – those specific to this Committee, general terms of reference for overview and scrutiny committees and those of the Scrutiny Programme Board.

The terms of reference were submitted for Members’ information.

This minute was subsequently amended by the Committee on 8 September (minute 16 refers) to include the following suggested amendments to the terms of reference:

Paragraph 4:

Social inclusion and to promote the role of the local authority, working with the NHS community on Wirral, to improve Public Health and well-being and to address health inequalities. (This sentence needed to be put into better English).

Paragraph 13:

To support the Council’s equal opportunity policies by promoting and monitoring initiatives to encourage equality of opportunity amongst disadvantaged groups. (Delete all the wording at the end of this paragraph: “including: the disabled, ethnic minorities, the long-term unemployed, the poor, and women”) [This would apply to all portfolios]

Resolved – That the terms of reference be notedand the proposed amendments be referred to Cabinet for consideration.

A report on the work programme is submitted together with a letter from the North West Ambulance Service on possible areas for scrutiny.

The Committee received an update on its work programme, which included the proposed outline meeting schedule for the current municipal year, suggestions for additions to the programme (report 2), and a progress report on in-depth panel reviews. A letter had also been received from the North West Ambulance Service on possible areas for scrutiny.

Resolved – That the proposed additions to the work programme are agreed and that the North West Ambulance Service is invited to give a presentation to a future meeting comprising an overview of its strategic vision and implementation of the patient healthcare initiatives identified in its letter to this Committee.

All of the new overview and scrutiny committees are being asked to consider if they wish to extend or initiate co-opted membership.

The views of the Committee were sought as to whether it would wish to extend its co-opted membership.

Resolved – That this matter be deferred until the next meeting.

The Director of Adult Social Services presented a report supplemented by a presentation which provided an overview of the work to date being carried out to transform Adult Social Services in Wirral.

The Director explained that Adult Social Services in Wirral was undergoing radical reform in line with direction given in the White Paper ‘Our Health, Our Care, Our Say: a new direction for community services’ for a service that delivers to outcomes, working with whole communities, and through integrated working arrangements.  This is endorsed by the ‘Concordat ‘Putting People First’ a government wide agreement with strong support from the Third sector. There were three key strands to the transformation programme; personalisation, localisation and integration, and the department had a three year plan for transformation focussing on these areas.  The report and presentation highlighted work undertaken as part of the programme in 2008/09:-

(i)  Personalisation – one part of which is the development of personal budgets to transform the way people who use services are assessed and how their care will be arranged and delivered. A pilot scheme was currently being undertaken.

(ii)  Localisation – the department’s access and assessment branch had now moved into local communities (localities) which were co-terminous with NHS Wirral.  In Wallasey, Social Services and NHS Wirral staff were co-located and Birkenhead and Bebington and West Wirral would follow.

Work on localising services was also underway.  The Council had made a number of significant decisions in the past twelve months to assist in realising this vision; the renegotiation of residential and nursing home fees, the agreement to explore the possibility of outsourcing Social Services internal provider services, the transfer of in-house home care to the independent sector and the significant development of a Reablement service.  In addition, two extra care housing schemes were being developed with the support of local residents and representatives of the Older People’s Parliament.

(iii)  Integration – was being piloted through Wirral Integrated Service Programme (WISP) to radically reshape the way health and social care services are commissioned and provided as part of a fully integrated network of primary care, social care and community services in local communities.

The Director reported that the department would be focussing on six transformation projects which were set out in its Business Plan 2009/10:

-  Personal budgets and self directed support

-  Provision of Access to Services 24 hours a day, 7 days a week

-  Provision of locality Reablement and Assessment Services

- Development of strategic integrated commissioning and partnerships across health and social care through  WISP: Wirral  Integrated Services Pilot

-  Development and Implementation of an Early Intervention Strategy

-  Care Service Strategy – Viability and Design Study’

Progress against performance indicators and key projects would be provided through regular performance monitoring reports. There was evidence of improved performance demonstrated by:

• the increase in carers receiving assessments, services and information
• the increase in people supported to live independently through social services
• the improved budgetary situation

The Director responded to questions from  ...  view the full minutes text for item 7.

The Director of Adult Social Services submitted a report introducing the Annual Performance Report for the Department of Adult Social Services, (DASS), which would provide an overview of progress against performance indicators and key projects in 2008/09 for which the department was accountable.  The finalised report would be available on the internet – web library - by the end of June.

Resolved – That the report be noted.

The Director of Adult Social Services presented a report which provided an overview of 'Valuing People Now - A Three Year Strategy for People with Learning Disabilities' setting out  the government’s vision to improve services for people with a learning disability.  This report detailed how Wirral would implement this vision in partnership with people with a learning disability their carers and families and a wide variety of other key stakeholders.  This vision would be translated into a local Learning Disability strategy which would be reported to Cabinet and NHS Wirral Board in September 2009

The strategy would be delivered through a partnership between people with a learning disability, their carers and families and Local Authority (including Children’s and Leisure services as well as Department of Adult Social Services), Health (both NHS Wirral and the Cheshire and Wirral Partnership to cover mainstream and specialist health care), Voluntary, Community and Faith Sector, Housing providers, employers, and further education, and it identified targeted areas of work to make improvements in the delivery of services and opportunities for adults with learning disabilities:

-  A review of existing Partnership Board arrangements

-  Improvements in performance management and the ability to report outcomes for people who use services and their families

-  Targeted improvements in the transitions process

-  Streamlined funding arrangements

-  Improvements in the information available and range of supported accommodation available to adults with learning disabilities

-  A major drive to accelerate opportunities for adults with learning disabilities in paid work

-  A whole scale reform of the way people who use services can contribute to assessment, support planning and the delivery of their care through personalisation

-  Targeted programmes to improve the health of adults with learning disabilities

The Learning Disability Partnership Board would deliver the strategy.  It was currently jointly chaired by NHS Wirral Director of Strategic Partnerships and a person with a Learning Disability. In addition, there would be a number of sub groups brought together under the following headings set out in the Valuing People Now strategy;

-  Personalisation – starting with the individual and their family

-  Having a life – better health, home ownership, work, education, leisure, relationships and parenting

-  People as citizens – advocacy, transport and access to leisure and recreational activities, to justice and the right to feel safe

Work was being undertaken with consultation groups such as the Enabling Fulfilling Lives Group, Carers Committee and Transitions Strategy Group to elect members who would represent people with Learning Disabilities and their carers onto the Board, and they would develop the agenda for the Partnership Board, led by the work of the sub groups.

The Director responded to questions from members regarding:

-  joint working arrangements with NHS Wirral 

-  development of opportunities for people with learning difficulties and support to assist them in making make the transition from school into further education and employment

-  the timetable for developing a fully representative Board to deliver the strategy

Resolved – That the Committee notes and  ...  view the full minutes text for item 9.

Diane Hill, Chair of Wirral LINK, gave a presentation on the progress of Local Involvement Networks (LINKs) in Wirral, which was the new mechanism for involving patients, the public, people who use Social Care Services , Carers and interested groups and organisations in improving health and social care. The presentation outlined the objectives of Wirral LINK, the role of the Interim Steering Group in drafting the governance framework, the composition of the elected Board, the range of activities which were currently being undertaken and the future work plan.

Resolved – That this Committee congratulate Wirral LINK on its achievements in developing the local involvement network and look forward to working with them in the best interests of patients and service users.

Further to minute 76 (Social Care and Health - 25/3/09) the Director of Adult Social services presented a report outlining the progress being made in improving the experience of patients and their carers following admission to hospital and subsequent discharge. The committee was asked to formally agree the Wirral Health and Social Care Action Plan which was being implemented and performance monitored via the Wirral Discharge Planning and Review. 

The Director responded to questions from members regarding:

-  monitoring of the Action Plan and the importance of quarterly performance monitoring reports;

-  actions to avoid delays in the medication ordering process;

-  actions to improve communications between professional staff to ensure a smooth transition for individual from hospital

Resolved - That the Committee:

(1)  note the progress being made in improving the experience of patients and their carers following admission to hospital and subsequent discharge.

(2)  formally agree the Wirral Health and Social Care Action plan which is being implemented and performance monitored via the Wirral Discharge Planning and Review Group.

K Doran, Chief Executive of NHS Wirral, presented a paper which informed members of the outcome of the consultation with regards the proposal to build a purpose built One Stop Primary Care Centre on the Warrens nursery site where there was currently some derelict brick buildings and green houses. The paper to NHS Wirral Board on 7 April 2009, provided full information about the consultation process and outcomes.

It was moved by the Chair and seconded by Councillor Redfern that:

“(1)  Committee notes the consultation on the proposed development of the proposed development of a One Stop Primary Care Centre for the West Wirral Group Practice on the site where the Warrens Nursery formerly operated.

(2)  Committee welcomes the positive outcome of the consultation process and the public meetings. It is noted that some 90% of patients who responded were in favour of the new Care Centre.  The Committee also notes that patients recognised that their two highest priorities are “wanting a wider range of health services” and “improving the quality of health care.”

It was moved as an amendment by Councillor Watt and seconded by Councillor Mountney that:

“  (1) Committee notes the reported desire of doctors and some patients for improved primary care facilities in the Pensby and  Thingwall areas but believes that the former Warrens Nursery site is not the ideal location and that there is continuing local opposition to the plan.

(2)  Committee therefore recommends that this scheme is not implemented and that other sites are investigated.”

The amendment was put and lost (4:6)

The motion was put and carried (6:4)

Resolved (6:4) – That

(1)  Committee notes the consultation on the proposed development of the proposed development of a One Stop Primary Care Centre for the West Wirral Group Practice on the site where the Warrens Nursery formerly operated.

(2)  Committee welcomes the positive outcome of the consultation process and the public meetings. It is noted that some 90% of patients who responded were in favour of the new Care Centre.  The Committee also notes that patients recognised that their two highest priorities are “wanting a wider range of health services” and “improving the quality of health care.

Further to minute 81 (25/3/09) the Chair reported that a meeting had been held with the spokespersons to discuss the proposed review of ‘patients with dementia in general hospitals’.  It was proposed that the Review Panel would consist of the three Spokespersons (Councillors Ann Bridson, Sheila Clarke, and Denise Roberts).  A draft scope document was attached (Appendix 1) and it was recommended that this scrutiny review focus on the following issues:

• Management of patients with dementia in an acute hospital setting.
• Impact of patients with dementia on other patients during a stay in hospital.
• Are there alternative approaches which allow more patients with dementia to be cared for outside an acute hospital setting?
• Is it possible to keep more people with dementia in their own home for as long as possible?

Resolved –

(1) That the Committee approve the Scope for the Dementia Scrutiny Review, as detailed in Appendix 1.

(2) That the Panel members, for the new municipal year, be confirmed as Councillors Ann Bridson, Sheila Clarke and Denise Roberts.

K Doran, Chief Executive of NHS Wirral, reported upon the present position regarding cases of swine flu H1N1. She reported that there were 43 cases of swine flu in the North West region who had suffered relatively mild symptoms and were recovering well at home.

Resolved – That the report be noted.