{meta} Agenda for Health and Adult Care Scrutiny Committee on Thursday, 21st September, 2017, 2.15 pm

Agenda and minutes

Venue: Committee Suite - County Hall. View directions

Contact: Gerry Rufolo 01392 382299  Email: gerry.rufolo@devon.gov.uk

Webcast: View the webcast

Items
Note No. Item

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12.

Minutes pdf icon PDF 95 KB

Minutes of the meeting held on 19 June 2017 (previously circulated) and 25 July 2017 attached.

Additional documents:

Minutes:

RESOLVED that the Minutes of the meeting held on 19 June 2017 and the special meeting held on 25 July 2017 be signed as correct records.

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13.

Items Requiring Urgent Attention

Items which in the opinion of the Chairman should be considered at the meeting as matters of urgency.

Additional documents:

Minutes:

There was no item raised as a matter of urgency.

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14.

Public Participation

Members of the public may make representations/presentations on any substantive matter listed in the published agenda, as set out hereunder, relating to a specific matter or an examination of services or facilities provided or to be provided.

Additional documents:

Minutes:

In accordance with the Council's Public Participation Rules, the Committee received and acknowledged oral representations made by Mr D Clinch on a matter to be considered by the

Committee, namely ‘Sustainability and Transformation Plan:  Update and Progress’ (Minute   *15 refers).

 

The Chairman responded, thanking the speaker for his attendance and presentation which would be taken into account by the Committee during its subsequent deliberations.

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15.

Sustainability and Transformation Plan: Update and Progress to Date pdf icon PDF 51 KB

Report of the Joint Director Strategy (South Devon and Torbay CCG and NEW Devon CCG) attached 

 

Additional documents:

Minutes:

Dr S Manton, Joint Director (Strategy) North, East and West (NEW) Devon CCG and South Devon and Torbay CCG, attended and spoke to this item at the invitation of the Committee.

 

The Committee considered the report of the Joint Director on the wider Devon Sustainability and Transformation Plan, which had been published in November 2016. The Plan set the vision and strategic direction for health, wellbeing and care services across the areas covered by NEW Devon and South Devon and Torbay Clinical Commissioning Groups.  

 

The Committee also received a presentation on the Plan covering:

 

·         challenges: increased demands, ageing population, funding limits and recruitment;

·         how the challenges would be funded in the next 10 years;

·         changes required and the current position;

·         health challenges;

·         prevention and promotion of health;

·         the integrated care model;

·         priorities relating to: primary care, mental health, learning disabilities, acute hospital and specialist services, children and families;

·         productivity; and

·         working together with key stakeholders.  

 

The Joint Director responded to Members’ questions and/or commented:

 

·         that the County Council was not a formal signatory to the Sustainability and Transformation Plan (STP) at this stage (confirmed by County Council’s Chief Officer for Adult Care and Health);  

·         that there was County Council and other local  authority involvement in the ongoing development of the Plan and integrated delivery of services;

·         on the importance of workforce planning by the CCGs with providers across the range of services and professions and the current mapping exercise and that staffing represented approximately 75% of costs;

·         on initiatives with academic bodies and providers to encourage and promote training, recruitment and retention of staff and the significant challenges involved both locally and nationally;

·         on staffing issues as a result of turnover of staff (for example 30% domiciliary care);

·         that there were no planned redundancies at this stage, but posts would change with reconfiguration of services;  

·         on the impact of current and projected funding shortfalls and implications for staffing and service delivery across the range of services if no action was taken;

·         on the ongoing work to achieve savings in prescription and pharmacy services;

·         on the IT transformation programme;

·         on the development of a property/estate management plan;

·         on adoption of national best practice;

·         on in-patient bed provision across the County on which more work was being undertaken by the CCGs;

·         on the current and developing effective integrated working in the County between social care and health;

·         on provision of acute services across the four acute hospitals in Devon, involving dialogue and engagement with their respective local communities;

·         on NHS England engagement with all GP practices in Devon in relation to the national aspiration for 7 day cover; and

·         on the importance of early intervention and prevention across the board.  

 

The Chairman reported on the proposed establishment of a Standing Overview Group to look at the STP in detail. This would include for example (as referred to above) issues relating to: current/projected funding challenges, work force planning/mapping exercise, safe service delivery across Devon and property/estate management plans. The Group would report  ...  view the full minutes text for item 15.

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16.

Temporary Service Change: Framework for Decision Making pdf icon PDF 46 KB

Report of the Joint Director Strategy (South Devon and Torbay CCG and NEW Devon CCG) attached  

 

Additional documents:

Minutes:

Dr S Manton, Joint Director (Strategy), North East and West Devon (NEW Devon CCG) and South Devon and Torbay CCG), attended and spoke to this item at the invitation of the Committee.

 

The Committee considered the report of the Joint Director on the process for approving temporary service changes arising from circumstances that were urgent and necessary, for example, due to safety or welfare of patients or staff.

 

Such decisions were the responsibility of the service provider responsible for the safe and effective operation of services and the CCG would be informed on these matters.

 

In particular the CCG would be interested in specifically: the adequacy of reasons for temporary change; the interim solutions that were being put in place; the steps to address the issues; and the expected duration of the change.

 

The Joint Director also reported on the temporary closure of maternity units at Okehampton and Honiton due ongoing staffing issues. The full range of maternity services was available at Exeter and Tiverton units and ante-natal services remained at the Okehampton and Honiton Units.

 

The Head of Scrutiny reported on a draft ‘Health Changes Template’ for the Clinical Commissioning Groups and providers, designed to extract relevant information for members on temporary or permanent service change or developments. 

 

The template would be circulated to Members of the Committee for comment.

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17.

Public Health Annual Report: 2016/17

Chief Officer for Communities, Public Health, Environment and Prosperity to report.

 

The Report has been circulated to all Members and is available on-line at

 

http://www.devonhealthandwellbeing.org.uk/aphr/2016-17/

 

 

Additional documents:

Minutes:

The Chief Officer for Communities, Public Health, Environment and Prosperity reported on the  Public Health Annual Report 2016/17 which provided a detailed overview of health and wellbeing in Devon. 

 

The Chief Officer responded to members questions and/or commented on:

 

·         her role within the County Council and the Public Health role and close working with the CCGs and district local authorities, voluntary sector and other stakeholders in terms of early intervention and prevention through the promotion of health and wellbeing;

·         the Joint Strategic Needs Assessment (JSNA);  

·         the Public Health Budget of approximately £28 m and funding challenges within the ring-fenced grant arising from past in-year and recurrent funding cuts, resulting in reduced discretionary preventative initiatives and projects; 

·         support for the Sustainability and Transformation Plan in promoting joint working and prevention measures.    

 

[N.B. The Public Health Report was available online at: 

http://www.devonhealthandwellbeing.org.uk/aphr/2016-17/]

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18.

Performance Using Data for the Year Ending July 2017 pdf icon PDF 566 KB

Report of the Head of Adult Commissioning and Health (DCC) and Joint Director Strategy (South Devon and Torbay CCG and NEW Devon CCG) attached    

Additional documents:

Minutes:

The Committee considered the Report of the Head of Adult Commissioning and Health (DCC) and Joint Director Strategy (South Devon and Torbay CCG and NEW Devon CCG)   (ACH/17/70) on a whole system view of performance across the wider Devon health and care system.  The performance commentary reflected the reported position as at July 2017 (Month 4) and focussed on a range of metrics covering acute and community hospital settings, primary care and social care selected by system leaders to give an overview of health and care in Devon.  

 

The Chief Officer (Adult Care and Health), the Head of Adult Commissioning and Health, and the Joint Director (Strategy), North East and West Devon (NEW Devon CCG) and South Devon and Torbay CCG responded to Members’ questions and/or commented on:

 

·         the role as the Chief Officer for Adult Care and Health and the County Council’s Chief Executive’s role within the Sustainability and Transformation Plan as the lead for Prevention;

·         the encouraging reduction in unplanned admissions and the consequent need for good home based support and care;

·         the relatively high number of bed day delays and possible reasons for the upsurge in September 2016 in the ‘average daily number bed days lost to delayed transfers by non-acute provider’;

·         the relative performance in terms of response times of the South Western Ambulance Service Trust (SWAST) in the NEW Devon CCG area; and

·         the valuable work of the Air Ambulance in rural Devon and discussions with the CCGs.

 

The Chairman of the Committee’s Better Care Fund Task Group outlined the work of the Task Group in addressing issues reflected in the Report including for example delayed transfers from acute and non-acute providers.     

 

It was MOVED by Councillor Crabb and SECONDED by Councillor Twiss and

 

RESOLVED that the concerns in respect of the performance of the SWAST be noted and  that a representative be invited to report to a future meeting of this Committee.

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19.

Ownership, Community Stakeholding and the Governance of Community Hospitals pdf icon PDF 49 KB

(In accordance with Standing Order 23(2) Councillor Shaw has requested that the Committee consider this matter)

 

Brefing Note by Councillor Shaw, attached

Additional documents:

Minutes:

In accordance with Standing Order 23(2) Councillor Shaw had requested that the Committee consider this matter.

 

The Committee considered a briefing note by Councillor Shaw on the community involvement and support for hospitals in Devon and impact of the change of ownership of NHS buildings to NHS Property Services (wholly owned by the Secretary of State and charged with managing the NHS estate in line with national priorities). NHS Property Services was able to sell off parts of the estate and to charge NHS organisations market rents for their use.

 

Councillor Shaw requested that the Health and Adult Care Scrutiny undertake an investigation into:

 

(a) The changing ownership and governance of community hospitals in Devon and its implications.

 

(b) The historic and ongoing contributions of local communities and Leagues of Friends to funding the hospitals.

 

The purpose of this investigation would be to address the question of

 

(c)  How community stakeholders' interests should be secured in the future governance of community hospitals.

 

Members referred to the significant contributions of community groups throughout Devon to local health facilities which could be lost with any sale of buildings by the NHS, noting the legal constraints in protecting their interests in terms of the contributions made.  

 

It was MOVED by Councillor Randall Johnson and SECONDED by Councillor Sanders and

 

RESOLVED that advice be sought in terms of the legal position in securing the interests of contributions or legacies left by community groups and other benefactors.

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20.

Work Programme

(a) In accordance with previous practice, Scrutiny Committees are requested to review the forthcoming business (previously circulated) and determine which items are to be included in the Work Programme. The Work Programme is also available on the Council’s website at

 

https://new.devon.gov.uk/democracy/committee-meetings/scrutiny-committees/scrutiny-work-programme/

 

to see if there are any specific items therein it might wish to explore further. 

 

(b) Task Group Scoping Exercise: NHS in Devon (response to the Notice of Motion referred by the Cabinet).

 

(c) Better Care Fund Task Group Update.

 

(d) Commissioning Liaison Member update.

Additional documents:

Minutes:

(a) Councillor Greenslade reported on the progress of the NHS in Devon Task Group looking at services now and into the future over a 5 year time frame.

 

(b) Councillor Ackland reported on the progress of the Better Care Fund Task Group following its first meeting and gave an update on her role as the Commissioning Liaison Member.

 

The Chairman reported the receipt of letter from the Department of Health stating that no further action would be taken on the referral which had been made in 2016 by the former Health and Wellbeing Scrutiny Committee relating to closure of community hospital beds in Torrington.

 

RESOLVED that the current outline Work Programme be noted subject to inclusion of the

following topics for future consideration:

 

(a) the role of Devon Health Watch; and

 

(b) the legal duties of this Committee in holding the NHS to account.

 

[NB: The Scrutiny Work Programme was available on the Council's website at

https://new.devon.gov.uk/democracy/committee-meetings/scrutiny-committees/scrutiny-work-programme/

and the Council/Cabinet Forward Plan is available at http://democracy.devon.gov.uk/mgListPlans.aspx?RPId=133&RD=0&bcr=1]

   ]

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21.

Information Previously Circulated

Below is a list of information previously circulated for Members, since the last ordinary meeting, relating to topical developments including ones which have been or are currently being considered by this Scrutiny Committee.

 

(a) Your Future Care Implementation: letter to stakeholders from RD&E NHS Foundation Trust;

 

(b) Dashboard Report by NHS England on STP Comparisons;

 

(c) Care Quality Commission (CQC) published findings of its comprehensive inspection programme of all specialist mental health services, giving the most complete picture ever of the quality of mental health provision for people in England;

 

(d) CQC monthly update for Overview and Scrutiny Committees

 

 

Additional documents:

Minutes:

The Committee noted the list of information previously circulated for Members, since the last ordinary meeting, relating to topical developments including ones which have been or were  currently being considered by this Scrutiny Committee.

 

(a) Your Future Care Implementation: letter to stakeholders from RD&E NHS Foundation Trust;

 

(b) Dashboard Report by NHS England on STP Comparisons;

 

(c) Care Quality Commission (CQC) published findings of its comprehensive inspection programme of all specialist mental health services, giving the most complete picture ever

of the quality of mental health provision for people in England; and

 

(d) CQC monthly update for Overview and Scrutiny Committees.