Agenda and minutes

Minutes of the meeting held on 21 September 2017(previously circulated)

RESOLVED that the Minutes of the meeting held on 21 September 2017 be signed as a correct record.

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

There was no item raised as a matter of urgency.

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.

There were no oral representations from Members of the Public.

County Solicitor to report

The County Solicitor reported on the Local Authority (Overview and Scrutiny Committees Health Scrutiny Functions) Regulations 2002 and The Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013 which enshrined in law the role and duties of Health Scrutiny.

.

The three strands in the legislation were summarised as follows:

(a)  to require an officer of a local NHS body to attend before the committee to answer such questions as appear to the Committee to be necessary for discharging its functions;

(b) to be consulted by a relevant NHS body or health service provider on substantial developments. (there is no definition of ‘substantial development’);

(c) to refer issues to the Secretary of State for Health – subject to the constraints outlined in the legislation.

Briefing notes on these duties and powers would be circulated to Members together with a spotlight review report on a 360 degree review of the work of the former Health and Wellbeing Scrutiny Committee.    

(a) Report of the Chief Officer for Communities, Public Health, Environment and Prosperity, attached (Page 1)

(b)  Report of the Chief Officer for Adult Care and Health (ACH/17/74), attached (Page 3)

(a) Public Health

The Committee received the report of the Chief Officer for Communities, Public Health, Environment and Prosperity on how the Council’s strategic objectives were being delivered, the mid-year budget position, and future strategic issues for this service area.

The Chief Officer and Assistant Director of Public Health responded to Members’ questions and/or commented:

·         on the provision of mandated public health services and aim to improve the health and wellbeing of the people of Devon, while reducing health inequalities;  

·         on the re-procurement of sexual health services, substance misuse and domestic and sexual violence services in 2017/18 leading to the commencement of new contracts in 2018, and additionally recommencement of the universal NHS Health Check programme,   as part of the Council’s responsibilities to reduce health inequalities;

·         on targeting towards those families and communities which were in greatest need, with some services such as the Specialist Stop Smoking Service focused wholly on those most vulnerable;

·         on the Public Health Team’s work to commission a number of public health services to support the delivery of its strategic objectives and statutory responsibilities, working collaboratively with the local NHS delivering its statutory function to provide public health expertise to the Clinical Commissioning Groups; 

·         on the success of the Public Health Team in drawing in additional funding to support the delivery of new programmes and services, including funding from NHS England to support the development of Cranbrook as part of the NHS Healthy New Town Programme, Big Lottery funding to support the introduction of a new targeted Diabetes prevention programme and funding from Public Health England for a Making Every Contact Count (MECC) training programme;

·         on the current budget position in keeping within the budget set and published in the Budget Book; 

·         on the future strategic issues for this service area, notably the continued annual reduction in the Public Health Grant, with significant budget reductions from 2016 – 2020 and on the production of a medium term financial plan to ensure affordability over the coming years; and

·         on the future provision of the 0-19 Public Health Nursing Service on which options for the future delivery mechanism for this service were currently being appraised and would be subjected to public consultation prior to any final decision being taken. 

(b) Adult Commissioning and Health:  Position Statement – Budget 2017/18

(Councillor A Leadbetter attended in accordance with Standing Order 25(1) and spoke to this item at the invitation of the Committee)

The Committee considered the Report of the Head of Adult Commissioning and Health (ACH/17/73) on the budget which was forecast to underspend by £4.170 million as at month 6, covering data up until 30th September. The total budget represented approximately 47% of the Council’s revenue budget.

The Head of Service, Assistant Director - Health and Social Care Community, East; and the Cabinet Member for Adult Social Care and Health Services responded to Members’ questions and/or commented:

·         on the total Adult care and health services budget which represented some 47% of the Council’s revenue budget;

·         on the majority  ...  view the full minutes text for item 26.

Joint Report of the Chief Officer for Adult Care and Health and the Joint Director (Strategy) NEW Devon CCG and Torbay and South Devon CCG, (ACH/17/73) attached 

(Councillor A Leadbetter attended in accordance with Standing Order 25(1) and spoke to this item at the invitation of the Committee)

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

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/17/73) on performance using data for the year ending September 2017. The performance commentary reflected the reported position as at September 2017 (Month 6) 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 Head of Adult Commissioning and Health (DCC) and the Joint Director (CCGs) and Chief Executive (South Devon and Torbay CCG) responded to Members’ questions and/or commented:

·         on the continuing work with Members and processes to develop future performance reports with improved and timely data and analysis;

·         on the data relating to Delayed Transfers of Care from acute or non-acute care, and the differences, in particular  between the Royal Devon and Exeter Hospital (R D and E) Data from the others acute hospitals and the possible reasons for this and work to reduce the level of delays including use of community beds where appropriate, recruitment and retention of domiciliary care staff and social work reablement staff and other projects and actions as listed in the Report; and the Chief Executive of the CCG undertook to provide further information on the overall bed capacity of the R D and E Hospital; 

·         on the ongoing commitment to develop a strategy to enable full access to significant additional resources from the Better Care Fund; and

·         the role and work of the Devon Safeguarding Adults Board (on which a report would be submitted to the next meeting of this Committee).

The Chair thanked the presenters for their report.    

Report of the Chief Officer for Adult Care and Health (ACH/17/75), attached

(Councillor A Leadbetter attended in accordance with Standing Order 25(1) and spoke to this item at the invitation of the Committee)

The Committee considered the Report of the Head of Adult Commissioning and Health (ACH/17/75) on the ‘Promoting Independence’ policy agreed by Cabinet at its meeting on 14th June 2017 (http://democracy.devon.gov.uk/documents/s7773/ACH1767.pdfn)

The report outlined the engagement work with users, carers, providers and other relevant parties to consider implementation of the policy.  The approach was particularly important for disability services with increasing numbers of individuals with disabilities (learning, physical, sensory and/or autism) who presented to statutory services.  There was no change to the threshold (eligibility) for support from social care, but the engagement process would be  asking ‘what matters to people’ and could the Council with partners meet those needs in a different way. 

The Chief Officer for Health and Adult Social Care with the Senior Commissioning Manager, (disabilities and mental health) in response to Members’ questions reported on initiatives to promote the independence of adults with learning disabilities including educational, vocational training and employment advice and support, and including a Carer Household (Adult foster care), and generally adopting a needs based approach. They also referred to the importance of the preparing children and young people with disabilities for adulthood. 

The Chair also referred to wider community responsibilities in terms of, for example, housing design and building control, working with health, and highways and promotion of safe and easy access and vocational education and early years.

HealthWatch to report

Mr J Rom (Devon HealthWatch Trustee) and Mr C Potter (Devon HealthWatch, Chief Executive) attended and spoke to this item at the invitation of the Committee.

The Committee received a presentation from HealtWatch covering

·         the purpose of Healthwatch, their funding, functions and achievements

·         Opportunities for collaboration with the Scrutiny Committee; and

·         the way forward and their Business plan.

In response to Members’ questions the representatives reported their future aspiration to develop a comprehensive shared database and links providing salient information about local health services. HealthWatch could also consider a targeted piece of work in collaboration with the Committee subject to their work programme commitments.   

Report of the SWAST,  attached  

This item was deferred to the next meeting.  

(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 http://democracy.devon.gov.uk/mgPlansHome.aspx?bcr=1 to see if there are any specific items therein it might wish to explore further.  

(b) Standing Scrutiny Group (STP): notes of the meeting held on 9 November 2017, attached

(c) Commissioning:  Liaison Member to report

(Councillors Shaw attended in accordance with Standing Order 25(2) and spoke to this item)

(a) Work Programme

Councillor Shaw requested that further to Minute 19 and noting the County Solicitors advice in regard to legacies left by community groups or individual benefactors (previously circulated to Members), more investigation was now required on how local interests could be secured.

It was MOVED by Councillor Wright and SECONDED by Councillor Way and

RESOLVED that the NHS Property Services and the NEW Devon Clinical Commissioning Group and Torbay and South Devon CCG be invited to the next meeting to report on their proposals and plans for the Community Hospitals. 

[N.B. In accordance with Standing Order 32(4) Councillor Sanders requested that his vote

against the Motion be recorded]

(b) Commissionng Liaison Member

The Committee received the report of Councillor Ackland (previously circulated) on her work as the commissioning liaison member.  

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

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

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

(a) New Service Change template (for significant service changes) for commissioners and providers produced by the Head of Scrutiny and endorsed by members.

(b) The Kings Fund update on their video on how the NHS works, giving an overview of how change is happening.

(c) Devon Partnership NHS Trust:  New Mother and Baby Unit at Wonford House: public drop-in session at the Wonford Community and Learning Centre , Wednesday 18 October.

(d) The Care Quality Commission’s (CQC) annual assessment of the quality of health and social care in England.

(e) NEW Devon CCG monthly newsletter to GPs, which included a letter from both NEW Devon and South Devon and Torbay CCG clinical chairs. 

(f) CQC recommends Royal Cornwall Hospitals should go into special measures.

(g) The legal position regarding contributions or legacies left by community groups and other benefactors.

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

(a) New Service Change template (for substantial service changes) for commissioners and providers produced by the Head of Scrutiny and endorsed by Members.

(b) The Kings Fund update on their video on how the NHS works, giving an overview of how change is happening.

(c) Devon Partnership NHS Trust: New Mother and Baby Unit at Wonford House: public drop-in session at the Wonford Community and Learning Centre , on Wednesday 18 October 2017.

(d) The Care Quality Commission’s (CQC) annual assessment of the quality of health and social care in England.

(e) NEW Devon CCG monthly newsletter to GPs, which included a letter from both NEW Devon and South Devon and Torbay CCG clinical chairs.

(f) CQC recommends Royal Cornwall Hospitals should go into special measures.

(g) The legal position regarding contributions or legacies left by community groups and other benefactors.