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.

No such declarations were made.

To receive the minutes of the Health and Well Being Overview and Scrutiny Committee held on 22 March, 2011.

Members were requested to receive the minutes of the meeting of the Health and Well Being Overview and Scrutiny Committee held on 22 March, 2011.

Sue Lowe referred to minute 77 (Contracts for Residential and Nursing Home Care and Personal Support) and that a progress report should have been brought to the Committee.

The Interim Director of Adult Social Services apologised that a report had not been brought to the Committee and proceeded to give a verbal update on contracts and provision for:

• Residential and nursing support for older people
• Short term provision
• Personal support
• Intermediate care
• Reablement

A written report on all the above matters would also be provided and appended to the minutes.*

In respect of residential / nursing homes owned by Southern Cross, the Interim Director gave an update to the Committee on the 6 Southern Cross homes on Wirral. He expressed his confidence in the quality of the provision and stated that he had received assurances that the existence of the homes was not threatened by the current financial difficulty which the company was in. With 450 beds across the 6 homes, Southern Cross was the largest single provider on Wirral and the department continued to place people in the homes. There were no plans to re-open any of the former Council run homes nor was there a need to do so.

Resolved – That the minutes be approved as a correct record and the comments of the Interim Director be noted.

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

The Committee was asked if it wanted to appoint a Vice-Chair.

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

Resolved - That Councillor D Roberts be appointed Vice-Chair of this Committee.

The Chair agreed to vary the order of business and take item 6 (Cheshire and Merseyside Vascular Surgery Review - Update) next in view of the presence of Dr Tom Dent for this item.

Len Richards, Chief Executive of Wirral University Teaching Hospital NHS Foundation Trust and Dr Tom Dent will give a verbal update to the Committee.

Further to minute 72 (22/3/11) Dr Tom Dent, public health physician and adviser to the review, addressed the Committee and gave an outline of the responses to the consultation on the proposed establishment of two specialist vascular centres for Cheshire and Merseyside. Of the 2000 responses via the internet and the public meeting, 2 out of 3 said that the most important consideration was patient safety but only 1 in 6 stated local access was most important.

He gave details of the membership of the Review Panel and the procedures they had followed in making their recommendations to the Project Board. They had recommended the joint application received from the Wirral University Teaching Hospital NHS Foundation Trust and the Countess of Chester Hospital NHS Foundation Trust for a South Mersey Vascular network with the specialist vascular centre based on the Countess of Chester site.

Dr Dent acknowledged that there were a group of clinicians at Arrowe Park Hospital who disagreed with the proposal. A meeting had been arranged for Thursday 23 June at which the 2 Trust managers and leading clinicians from both trusts would be present and it was hoped that a position would be reached where all the issues would be dealt with satisfactorily.

Dr Dent and Len Richards, Chief Executive of Wirral University Teaching Hospital NHS Foundation Trust, responded to comments from the Committee, Dr Dent stated that the UK had the worst mortality rate in Western Europe for aortic aneurysms. There was universal support to centralise vascular services with clear evidence that it would save lives. In respect of the consultation he would look into the figures of Wirral residents who had responded. There would be two vascular centres for Merseyside and Cheshire, the other being in Liverpool.

Len Richards commented that vascular surgery had been carried out at Arrowe Park Hospital since it opened, although since then it had developed into a separate specialist branch of surgery. The vast majority of vascular services would continue at Arrowe Park Hospital, relatively few patients, between 150 -180, would have part of their surgical pathway carried out at the Countess of Chester. For this relatively few number, all their pre and post surgery consultations / procedures would still be carried out at Arrowe Park Hospital.

He also outlined the reasons why this specialist centre could not be developed at the Clatterbridge site, in the main because there was no critical care support there.

The Chair then invited Dr Abi Mantgani, Executive Clinical Lead for Wirral GP Commissioning Consortium (representing 27 GP practices), to give a GP perspective on the proposals. As a GP in Birkenhead he commented that he would always prefer to see most services provided in Wirral but he did understand the clinical case presented for this high quality service to be provided at the Countess of Chester. He expressed some concern that the clinicians at Arrowe Park Hospital were not all on board at this stage. Although the Consortium had  ...  view the full minutes text for item 5.

The Scrutiny Programme Board at its meeting on 2 March, 2011 (minute 56 refers) referred this report with the following resolution:

‘That each of the five themed Overview and Scrutiny Committees be requested to receive the presentation by the Corporate Equality and Cohesion Manager, to assist them in further developing the Council’s scrutiny function so that the Council is on course to achieve Excellent status of the new Equality Framework for Local Government in November 2011.’

Further to minute 56 (Scrutiny Programme Board – 2/3/2011) Jacqui Cross, Corporate Equality and Cohesion Manager, gave a presentation on the Equality Duty 2010 to ensure that Members were fully equipped to provide effective scrutiny in the areas identified as being necessary for Excellent accreditation by the summer of 2012.

Jacqui Cross outlined the requirements of the new Equality Duty and highlighted the general and specific duties contained within it together with the timetable for the publication of workforce and service information and specific and measurable equality objectives.

With regard to the Government’s Equality Strategy for a Fairer Britain she highlighted some specific areas relevant to the work of this Committee such as:

·  Health inequalities

·  Patient recovery

·  Hospital targets

·  Assistive technology in homes

·  Homelessness and health

·  Independent living

·  Domestic violence

Jacqui Cross then referred in particular to the role of scrutiny to demonstrate that the Council had met its general and specific duties and was able to demonstrate improvements and outcomes as a result of its equality objectives.

Resolved – That the report and presentation be noted.

Len Richards, Chief Executive of WUTH NHS Foundation Trust, will give a verbal update on the Site Strategy and waiting times for tests.

Further to minute 65 (22/3/11) John Foster, Director of Facilities at Wirral University Teaching Hospital NHS Foundation Trust, gave an update to the Committee on the Trust’s site strategy. Over the last three months the Trust had held a total of 61 meetings regarding its site strategy, which the Trust Board would be considering at its meeting on 29 June. He outlined developments due to take place with a number of services, including dermatology, the breast clinic and the child development centre. The site strategy would see further investment at both sites, Arrowe Park and Clatterbridge.

Members expressed their delight at the proposals for the development of services, particularly at the Clatterbridge site.

Len Richards, Chief Executive of Wirral University Teaching Hospital NHS Foundation Trust, also commented on the partnership with the Countess of Chester Trust and the potential for orthopaedic elective services being built up at Clatterbridge. Following agreement with the Countess of Chester Trust to include their population with Wirral’s it would also mean that cardiology angioplasty services could be developed on Wirral. Investment was also being made in a new microbiology laboratory at Bebington.

The Interim Director of Adult Social Services commented upon the possible co-location of services for children at the Child Development Centre on the Clatterbridge site and that discussions were ongoing.

Resolved – That the verbal update be noted and a full written report be brought to the next meeting on the Hospital Trust’s site strategy.

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

Steve Rowley, Head of Service (Finance and Performance) gave a presentation on the progress made against the indicators for 2010/2011 in the fourth quarter. A copy of the report had been made available to view in the web library.

He referred to those performance indicators which had exceeded or met their target and expanded on those performance issues which weren’t achieving on target, and the corrective action being taken to address them, these included:

·  Paid Employment (Learning Disability)

·  Customers being reviewed

·  HART users no longer requiring a support package

·  HART users whose support package had been reduced

·  Assistive Technology

·  Self Directed Assessments

·  Safeguarding Alerts (24 hours)

·  Safeguarding Incidents (28 days)

In respect of the financial position he outlined the key financial pressures. The projected overspend was now expected to be £3.3m down from the previous reported figure of £3.5m.

Steve Rowley and the Interim Director of Adult Social Services then responded to comments from Members and explained the reasons behind the figures for the high number of safeguarding alerts. The Interim Director assured the Committee of the immediate response which was made when the Department was notified of any safeguarding concerns. He also stated that he would look into the numbers of adults with learning disabilities in the Council’s employment and the possibility of providing some of the indicators broken down by locality.

Resolved – That the report and presentation be noted.

The Audit and Risk Management Committee at its meeting on 28 March, 2011 (minute 83 refers) considered a report of the Director of Technical Services, at which a Member referred to the ‘risks associated with the non-delivery of benefits of the Strategic Change Programme‘ and at which the following resolution was passed:

‘That the Health and Well Being Overview and Scrutiny Committee be requested to seek assurances from the Director of Adult Social Services in relation to the risks associated with the decision of the Cabinet to retain Fernleigh respite centre in the light of key staff having left under Early Voluntary Retirement/Voluntary Severance.’

The Audit and Risk Management Committee at its meeting on 28 March, 2011 (minute 83 refers) had considered a report of the Director of Technical Services, at which a Member referred to the ‘risks associated with the non-delivery of benefits of the Strategic Change Programme‘ and at which the following resolution was passed:

‘That the Health and Well Being Overview and Scrutiny Committee be requested to seek assurances from the Director of Adult Social Services in relation to the risks associated with the decision of the Cabinet to retain Fernleigh respite centre in the light of key staff having left under Early Voluntary Retirement/Voluntary Severance.’

The Interim Director gave an update to the Committee on the current situation and assured the Committee that Fernleigh continued to operate in the same way as it had previously. A number of staff had been allowed to leave under the Council’s EVR / Severance scheme but other staff had been redeployed to Fernleigh from other facilities which the Council had closed. The staff complement at Fernleigh was therefore up to full strength.

Resolved – That the comments of the Interim Director be noted.

The Cabinet at it meeting on 14 April, 2011 (minute 399 refers) considered the Dementia Scrutiny Review, referred from this Committee at its meeting on 22 March and passed the following resolution:

‘That the Cabinet:

(1) welcomes the report of the Dementia Scrutiny Review and thanks all those who have contributed to it;

(2) asks the Interim Director of Adult Social Care, in partnership with NHS Wirral, Cheshire and Wirral Partnership NHS Trust and Wirral University Teaching Hospital NHS Foundation Trust to facilitate the integration of services for people with dementia and similar conditions to produce a single pathway of support; and

(3) invites the Health & Wellbeing Overview and Scrutiny Committee to consider whether they would undertake a scrutiny review of the provision of Local Authority services for people with dementia, and what further steps could be taken to enhance outcomes through early intervention and support.’

The Committee is therefore asked to consider this request.

Cabinet at it meeting on 14 April, 2011 (minute 399 refers) had considered the Dementia Scrutiny Review, referred from this Committee at its meeting on 22 March and passed a resolution, which amongst other things had resolved to:

‘Invite the Health & Wellbeing Overview and Scrutiny Committee to consider whether they would undertake a scrutiny review of the provision of Local Authority services for people with dementia, and what further steps could be taken to enhance outcomes through early intervention and support.’

The Interim Director of Adult Social Services suggested that following the dementia review of the health economy he would welcome a review of the local authority provision.

Sandra Wall suggested that a report could also be brought to the Committee on the effectiveness of assistive technology for those with dementia.

Resolved – That a scrutiny review be undertaken on the provision of Local Authority services for people with dementia once the Domestic Violence review is complete and that membership of the Review Panel include Sue Lowe.

To follow.

The Committee received an update on its work programme.

The Chair invited the Committee to make any suggestions for the future work programme. The Sub-Group monitoring the implementation of the improvement plan following the CQC inspection report would provide a report to the next meeting.

The review panel into domestic violence would also continue and additions to the work programme should include further reports on the implications of changes to the Independent Living Fund (ILF) and also the Disability Living Allowance (DLA). Once the review panel on domestic violence had completed its work, a review panel on the provision of Local Authority services for people with dementia would then be established (see minute 10 ante).

The Chair suggested that, in consultation with the Scrutiny Support Officer and the Committee Officer, amendments be made to the layout of the work programme document to make it more user friendly and a revised format would then be circulated to the Committee for comments.

Resolved – That the report and additions to the work programme be noted.

The Forward Plan for the period June to September 2011 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.

In response to comments from Members, the Interim Director reported that Fiona Johnstone, Director of Public Health would be able to update the Committee on public health issues and shadow arrangements which were due to be established prior to public health becoming a local authority function in 2013. A report on the proposed establishment of a shadow Health and Well Being Board was due to be considered by the Cabinet at its meeting on 23 June, 2011.  

Resolved – That the forward plan be noted.

The Committee is requested to note the minutes of the meetings of the Cheshire and Wirral Councils’ Joint Scrutiny Committee held on 10 January and 4 April, 2011.

The Committee received the minutes of the meetings of the Cheshire and Wirral Council’s Joint Scrutiny Committee held on 10 January and 4 April, 2011.

Resolved – That the minutes be noted.

With the agreement of the Chair, Councillor Povall raised two matters:

(i) When would the independent report by Anna Klonowski reviewing the Council’s response to concerns raised by Mr Martin Morton be made available?

The Interim Director of Adult Social Services, in response stated that he understood the independent reviewer was in the process of completing her report and once it had been delivered to the Council would be due to go to Cabinet on 23 July, 2011.

(ii) The current situation with the former Meadowcroft home.

The Interim Director reported that following the closure of the home some day provision was still being provided but most of the building had been declared surplus and passed over to Asset Management. He confirmed that an approach had been received from Age UK and discussions were ongoing.

Resolved – That the comments of the Interim Director be noted.

Report attached (see minute 2).