The Chair welcomed everybody to the Committee, in particular new Members and thanked the previous Chair, Councillor Ann Bridson, for all her work over the past few years as Chair.

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 arrangement.

Councillor P Glasman declared a personal general interest due to a member of her family being employed at Arrowe Park Hospital.

To receive the minutes of the Health and Well Being Overview and Scrutiny Committee held on 25 March, 2010.

Members were requested to receive the minutes of the meeting of the Health and Well Being Overview and Scrutiny Committee held on 25 March, 2010.

Resolved – That the minutes be approved as a correct record.

The Committee are invited to appoint a Vice-Chair for the ensuing municipal year.

The Committee was requested to appoint a Vice-Chair.

On a motion by the Chair, seconded by Councillor Smith, it was -

Resolved - That Councillor Brian Kenny be appointed Vice-Chair of this Committee.

The Director of Adult Social Services will give a presentation on this item.

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 Department had a three year plan for transformation focussing on the three key strands of personalisation, localisation and integration, to deliver the milestones set down in ‘Putting People First’. The milestones reflected the radical reform needed and the changing shape of adult social care. The milestones were as follows:

Milestone 1:  Effective partnerships with People using services, carers and other local citizens

Milestone 2:  Self-directed support and personal budgets

Milestone 3:  Prevention and cost effective services

Milestone 4:  Information and advice

Milestone 5:  Local commissioning

The Government had recognised that to meet these goals, social care would need to undergo significant changes in process, practice and culture to ensure people had access to high quality information and advice, appropriate early interventions and could exercise choice and control over the services and support they needed. It also required investment in training and support for the workforce to enable councils to meet the challenges of the new ways of working. To support this transformation a Reform Grant had been made available for councils to invest in the necessary developments.

The delivery of this agenda was not limited to public services targeted at people eligible for state support. It was also about how people helped themselves and each other as individuals and in groups and communities and how they made best use of the resources available for all citizens in their area.

The Chair commented upon the huge challenge which the transformation agenda presented and how best change could be managed.

Kathy Doran, Chief Executive of NHS Wirral, informed the Committee that a Government White Paper was due on the Health Service in early July to coincide with the anniversary of the NHS.

Resolved –

(1) That Committee supports the direction of travel for Adult Social Services, as detailed in the report and presentation.

(2) That a further report be brought to this Committee on the transformation of adult social care in Wirral.

The Quarter 4 Performance Report on activities relevant to Health and Well Being Overview and Scrutiny Committee will be available to view in the web library and a presentation will be made by the Director of Adult Social Services.

Mike Fowler, Head of Service (Finance and Performance) gave a presentation on the progress made against the indicators for 2009/2010 in the fourth quarter and key projects which were relevant to the Health and Well-Being Overview and Scrutiny Committee.

Outlining what was working well, he reported the following:

·  1,037 people supported by NHS Stop Smoking Service (target 896)

·  86% (758 people) receiving intermediate care were still at home 3 months later

·  99.34% of equipment delivered within 7 days (target 93%)

·  855 new installations of Assistive Technology (target 750)

·  1,109 reduced packages as a result of re-ablement (target 1,100)

·  723 people no longer needing support following re-ablement services

·  26.8% of identified carers receiving a service (target 21.5%)

·  Improved mortality rate from circulatory diseases (target exceeded by 28%)

In his presentation, Mike Fowler also referred to key performance issues which weren’t achieving on target and these included:

·  People receiving a review in a year

·  Adults with a learning disability in settled accommodation

·  Adults with a learning disability in paid employment

·  People receiving self directed support

In respect of the financial position the projected overspend for the year end was £2.4m.

At the request of the Chair, a copy of the ‘End of Year Performance Report 2009/10’, which was available in the Council’s web library, had also been circulated.

Responding to Members’ comments Mike Fowler explained that as a member of the Pricewaterhouse Coopers benchmarking club indicators could be measured in comparison to other authorities across the area. Work continued on identifying further efficiencies.

A Member commented upon the need for more specific and accurate data in the report which had been circulated particularly on what was working well, such as ‘life expectancy improving’, but by how much and the numbers accessing ‘personal budgets’.

Mike Fowler acknowledged the improvements needed for the report.

On a motion by the Chair, duly seconded, it was –

Resolved –

(1) That the presentation and report be noted.

(2) That the Committee look at those Performance Indicators either on red or amber and either deteriorating or not improving and requests more detailed reports on these and these be included in the Committee’s work programme.

The Director of Adult Social Services submitted a report updating the Committee on Quality Accounts. The draft Quality Account for the North West Ambulance Service was circulated with the report, and commentaries from LINks on the Wirral University Teaching Hospital NHS Foundation Trust and on the Cheshire and Wirral Partnership NHS Foundation Trust had also been circulated.

In addition the Quality Account from Liverpool Heart and Chest Hospital NHS Foundation Trust had been circulated and also the minute from the Cheshire and Wirral Joint Scrutiny Committee on the Cheshire and Wirral Partnership Trust Quality Account.

The Chair suggested that future quarterly reports could be reported in a different manner so that commentaries were linked to the actual quality accounts.

On a motion by the Chair seconded by Councillor Kenny, it was –

Resolved –

(1) That this Committee accepts the commentary from LINks and thanks LINks for the significant piece of work they are doing and for their positive contribution across Wirral.

(2) That the process for future updates on a quarterly basis be agreed.

(3) That the commentary on the quarterly reports be used as the feedback to the health providers for 2010/11 purposes.

Further to minute 33 (10/11/09), Pat Higgins, Assistant Director of Strategy and Planning, Wirral University Teaching Hospital NHS Foundation Trust gave an update on the progress which had been made in respect of eliminating mixed sex wards at Arrowe Park Hospital. The then Health Secretary had announced in January that performance measures would be put in place via the standard contract from April 2010 to ensure that same sex accommodation was provided for every patient. An action plan was also submitted with the report.

She reported that there were still issues within the Intensive Care, High Dependency and Coronary Care Units but these were due to the more substantial building works which would be required to deliver same sex accommodation within these units.

Responding to comments from Members Pat Higgins informed the Committee that a monitoring system was in place and any breaches were reported to the PCT. The guidance and the target of 100% compliance had not in itself led to any bed reduction in the hospital and the creation of a greater number of single sex rooms was being achieved by reducing the lengths of stays. She also stated that she would be happy to bring an analysis back to the Committee of responses to the PALS questionnaires which had since January incorporated a question on delivering same sex accommodation.

A Member suggested that regulations forcing hospitals to make intensive care and high dependency units single sex, when clearly there were other priorities was a nonsense.

The Chair and other Members commented that for many people this was a very important issue and that the situation should never arise whereby a person’s dignity or privacy was compromised.  

Len Richards, Chief Executive of Wirral University Teaching Hospital NHS Foundation Trust, in response to comments from Members informed the Committee that patients could now make a choice of being able to be seen by male or female staff.

Resolved - That the Committee notes the progress being made at Wirral University Teaching Hospital NHS Foundation Trust to deliver same sex accommodation and that regular reports on the issue be brought back to the Committee through the Quality Accounts.

The Director of Adult Social Services submitted a report which provided the Committee with background information on the national eligibility criteria for Adult Social Care, recent updates to guidance in February 2010 and made recommendations to Committee for the future application of the FACS (Fair Access to Care Services) eligibility bands. The report would be considered by Cabinet at its meeting on 24 June, 2010.

In the light of the transformation agenda and more recent policy guidance, it would be expedient and beneficial to undertake a wider consultation exercise on the application of FACS in Wirral to gain a more comprehensive understanding from people who used services and community groups about its application. Any recommendations arising from this consultation would form part of the future reports to Elected Members on determining the future FACS banding.

As of March 2010, 5157 people who were receiving services were assessed as having substantial needs and 151 people receiving services were assessed as having critical needs. 

The 2010-11 budget had been set on the basis of the existing FACS criteria of “substantial and critical”. Raising the threshold to “critical” only would mean many people having services removed which would reduce spending in the short term. However, people with “substantial” need would quickly deteriorate into crisis without support and lead to higher costs in the long term. Conversely, many Councils had lowered their threshold to include “moderate” needs as part of the early intervention and prevention agenda. The Early Intervention Strategy (see minute 80 post) would form part of the proposed wider review.

Responding to Members’ comments the Director stated that a review could be held within a 6 month period. Research had been undertaken around national projects such as Partnership for Older People.

Resolved –

(1) That this Committee endorses the decision to continue to provide social care services to individuals in Wirral who have critical and substantial needs.

(2) Committee notes the revised guidance on FACS and the need for Councils to support universal services which promote reablement and prevention.

(3) Committee endorses the decision to undertake a wider consultation on the Council’s FACS criteria to enable Council to determine FACS levels for 2011/12.

The Director of Adult Social Services reported upon the Early Intervention and Prevention Strategy, one of the key transformational projects of the Department of Adult Social Services. It offered a way forward for the local authority to concentrate efforts on enabling older people and people with disabilities to build their capacity to deal with their own wellbeing.

To achieve the vision set out in the strategy, there had to be investment in preventative and community based services that met the needs of local people. This would require disinvestment in some services in order to reinvest in those which had positive outcomes. Early intervention and prevention would be increasingly central to the work of the department. It would require an approach to existing service delivery that encouraged people to take control of their own life, offered choice and enabled creative solutions to situations.

Sandra Wall referred to the bereavement service run by Age Concern which picked up around 7 or 8 referrals a week. Funding for the service was due to cease in July. She also referred to the service provided by CRUSE bereavement care which was about to close on Wirral.

Kathy Doran, Chief Executive, NHS Wirral responded that NHS Wirral had commissioned a report into end of life care and bereavement services from Voluntary and Community Action on Wirral (VCAW) and they were due to submit a report by the end of June to put to the board of NHS Wirral on the services required.

Responding to further comments, the Director stated that moving forward with the strategy would be a real test in changing the way services were provided and in communicating the message of early intervention effectively. The seven work streams which made up the strategy would be infinitely flexible and constantly evolving.

On a motion by the Chair, seconded by Councillor Bridson, it was –

Resolved –

(1) That Committee thanks the Director for the production of the Early Intervention Strategy for Wirral and notes its contents.

(2) That Committee recognises the importance of it and the need to develop those services which support the vision of a society which values all its citizens and enables them to fully participate in their communities and in arranging their own support.

The Committee received an update on its work programme and the Chair circulated a list of suggested future items for the Committee as a rolling programme as follows:

·  Alcohol Related Hospital Admissions

·  ‘Out of Hospital’ Scheme

·  Prostrate Cancer in Wallasey and Moreton

·  Hospital Discharge Review/Discharge Turnaround Team

·  Health and Homelessness Update

·  ‘Your Reason, Your Way’ - Stop Smoking Campaign

·  Transforming Adult Social Care

·  Update of the Work Programme

In addition it was also suggested that an item on Performance Indicators on ‘red’ or ‘amber’ be added (see minute 76 ante) and the Dementia Review continue until its conclusion. Three further suggestions were also made:

·  The impact of the budget on services

·  Chiropody services

·  Report from health colleagues on the Coalition Government’s changes to the health service

Responding to the latter point, Kathy Doran, Chief Executive, NHS Wirral, outlined some of the changes just announced including the revision of targets regarding accessing a GP within 48 hours, hospital appointments within 18 weeks and 4 hour waiting time target when attending Accident and Emergency.

Resolved – That all the suggestions for the Committee’s Work Programme listed above be agreed and the Chair and Party Spokespersons meet on a regular basis to discuss the programme.

The Forward Plan for the period June to September 2010 has now been published on the Council’s intranet/website and Members are invited to review the Plan prior to the meeting in order for the Committee to consider, having regard to the Committee’s work programme, whether scrutiny should take place of any items contained within the Plan and, if so, how it could be done within relevant timescales and resources.

The Committee had been invited to review the Forward Plan prior to the meeting in order for it to consider, having regard to the Committee’s work programme, whether scrutiny should take place of any items contained within the Plan and, if so, how it could be done within relevant timescales and resources.

Resolved – That the forward plan be noted.