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Agenda and minutes

Venue: Committee Suite - County Hall

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

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Media

Items
Note No. Item

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95.

Minutes

Minutes of the Meetings held on 20 January 2023 (Budget and ordinary),  (previously circulated)

Additional documents:

Minutes:

RESOLVED that the Minutes of the Budget and ordinary meetings held on 20 January 2023 be signed as correct records. .

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96.

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:

No item was raised as a matter of urgency.

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97.

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 representations from Councillor Chris Clarance (Teignbridge District Council), Viv Wilson MBE and Gerald Penney in regard to Item 8; Teignmouth Community Hospital; and

 

Councillor Terry Elliott (Ilfracombe PC), Catherine Bearfield, Councillor Martin Pearce (Exeter City Council) and Richard Jones in regard to item 9: Integrated Adult Social Care Consultations.

 

The Speakers in regard to item 8 (Teignmouth Community Hospital) highlighted their concerns relating to the proposals (for a range of reasons) and need to retain services and reinstate in-patient beds at the Teignmouth Community Hospital and they requested that a further referral be made to the Secretary of State for Health and Social Care by reason that it would be in the best interest of health services in the area.

 

The Speakers in regard to item 9 (Integrated Adult Social Care on consultations on proposed Service Changes) in particular relating to Link Mental Health and Wellbeing Service in Barnstaple, Bideford and Ilfracombe; and the Homeless 18+ Prevention Fund and highlighted the local needs and impact of any proposed service changes or change in financial support. 

 

The Chair thanked the Speakers and indicated that their views would be taken into account when the items were considered.   

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98.

Teignmouth Community Hospital

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

Additional documents:

Minutes:

In accordance with Standing Order 23(2) Councillor M Wrigley had requested that the Committee consider this matter in view of:

 

·         the current situation and the lack of progress in establishing a new health and wellbeing hub since the matter was last considered by this Committee on 21 June 2022; and that not all GP practices in Teignmouth had committed to the relocation;  

·         the current model of working and capacity issues at the proposed centre; and

·         that, in view of the above, a fresh referral should be considered based on the ‘best interests of the health service in the area’.

 

The Committee’s Special Adviser and the Head of Scrutiny outlined the powers of the Independent Reconfiguration Panel (IRP) and process for a referral to the Secretary of State for Health and Social Care.  This included the need for gathering of information and development of a case for referral, which must include putting the case for referral to the NHS and consideration of feedback from the NHS before a decision to refer could be made by this Committee.

 

A local Member referred to the current available evidence and the difficulties at the local Torbay acute hospital due to delayed discharges and that all other local authorities in the Teignmouth locality were calling for the retention of the Community Hospital.

 

It was MOVED by Councillor Wrigley, and SECONDED by Councillor D Cox and

 

RESOLVED that a Task Group (Comprising Councillors Wrigley and Cox [and other Members to be confirmed]) be established to gather evidence (in consultation with NHS Devon) in regard to a proposal to make a referral to the Secretary of State on the grounds that the proposal (from the NHS) to close the Community Hospital ‘would not be in the interests of the health service in the area’ for report to the next meeting of this Committee on 13 June 2023.  

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99.

Integrated Adult Social Care Consultations on Proposed Service Changes pdf icon PDF 129 KB

Report of the Director of Integrated Adult Social Care (ACH/23/170), attached

 

Additional documents:

Minutes:

(Councillor M Wrigley declared a personal interest by virtue of his membership of the Teignbridge District Council’s Executive in so far as this item related to the Homeless 18+ Prevention Fund consultation).

 

(Councillor J McInnes attended in accordance with 25 (1) and spoke to this item with the consent of the Committee and referred to the ongoing consultation exercise and notification of the proposals to all Members following the Council’s annual budget meeting).

 

The Committee considered the Report from the Chief Officer of Integrated Adult Social Care (Devon County Council) (ACH/23/170) on Integrated Adult Social Care current public consultations in regard to proposed changes to services in Devon in order to achieve the Council’s agreed Budget.

 

Information had been provided on 22 February 2023 to coincide with the launch of five (of the six) public consultations on the Council’s ‘Have your say | Help shape services across Devon’.

 

Information had also been provided to all Members on the 9 March when the sixth public consultation had been launched.

 

The Service had directly targeted communications to those who access the services included in the public consultations, their families, and representatives. The Service had also hosted a number of targeted engagement sessions to which Members had been invited.

 

The Report set out the six public consultations currently taking place in regard to: (i) Proposed closure of North Devon Link Mental Health and Wellbeing Service in Barnstaple, Bideford and Ilfracombe; (ii)  Cessation and reduction of buildings-based day services; (iii) Review of New Treetops and Pine Park House adult respite centres to reduce to a single centre; (iv) Homelessness 18+ prevention: cessation of contribution; (v) Carers contract – financial sustainability plan; and (vi) Wellbeing Exeter: Cessation of contribution.

 

Members’ questions and discussion points with the Director of Integrated Adult Social Care Officers, Deputy Director Integrated Adult Social Care Commissioning; Head of Adult Care Operations and Health and the Director of Legal and Democratic Services included:

 

·         the need for collation of data as part and in addition to the consultation process and need for up to date Impact Assessments relating to the proposals directly and indirectly and assessment of the wider costs across all sectors; and the need for emphasis on prevention of future potential problems and ultimately higher costs;

·         assurances by Officers that the needs of clients in regard to the North Devon Link Services; and Day Care respite services for example would continue to be subject to individual assessments and with options for alternative provision, as necessary;

·         confirmation by Officers that following the consultation and analysis of the results, reports would be made to this Committee prior to decision making by Cabinet;

·         confirmation by the Director of Legal and Democratic Services that the relevant statutory consultation arrangements and HR policies were in place for the County Council staff involved; and 

·         any future proposals would align with the Service’s vision and strategies and promote partnership working with other authorities and agencies, as appropriate.

       

It was MOVED by Councillor J Bailey, SECONDED by  ...  view the full minutes text for item 99.

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100.

Update on Integrated Adult Social Care Vision and Strategies pdf icon PDF 261 KB

Report of the Director of Integrated Adult Social Care (ACH/23/172) attached

Additional documents:

Minutes:

The Committee noted the Report of the Director for Integrated Adult Social Care (ACH/23/172) on an outline of the process for updating, and current content of, the Integrated Adult Social Care vision and strategies. In particular, it highlighted the opportunities for providing feedback on the draft Integrated Adult Social Care vision and strategies. The Report also highlighted the opportunity for Members to engage with and give feedback on the updating of the Integrated Adult Social Care vision and strategies via Adult Social Care Vision and Strategies - Have Your Say (devon.gov.uk).

 

Members’ discussion points with the Director included:

 

·         the key points of the high level strategies which would be underpinned by more detailed documents, with a focus on prevention and outcomes (including promotion of independence);

·         the capacity issues with the County Council and other local authorities and partners;

·         partnership working with District Authorities in helping with the development of their local plans and the key question relating to housing and in particular supportive living/extra care provision;

·         promotion of independent living with individual integrated care and support plans; and

·         the importance of strategic role of Public Health.

 

The Chair thanked the Officers for their report.

 

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101.

Carers Spotlight Review: A Follow Up pdf icon PDF 732 KB

Report of the Review, attached

Additional documents:

Minutes:

The Committee considered the Report of the Spotlight Review on a second  progress report on Scrutiny recommendations following on from the Committee’s 12 March 2020 Carers Spotlight Review.

 

It was MOVED by Councillor R Scott and SECONDED by Councillor S Randall Johnson and

 

RESOLVED

 

(a) that the recommendations detailed in the Follow-up report be commended to the Health System in Devon, subject to Recommendation 1 to read: that the Committee recognises the invaluable role of replacement care and urges the Council to develop an effective replacement care offer for unpaid carers; and  

 

(b) that a report back on progress be made to this Committee within 6 months.

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102.

System Development and Improvement: Winter Update pdf icon PDF 426 KB

Report of the Chief Delivery Officer, NHS Devon, NHS Devon, attached

 

 

Additional documents:

Minutes:

The Committee considered the Report of the Chief Delivery Officer NHS Devon on the winter performance of the health and social care system across Devon mid-way through the season.

 

The Report outlined the significant challenges, including staff strikes, increased periods of demand and on-going infection prevention and control issues. It also outlined new ways of working that made a real difference to patients by joining up urgent and emergency care (UEC) services. 

 

As part of this work a set of overarching goals for UEC had been developed to set expectations for the health and social care system, and to enable delivery of the improvement programme. System priorities for urgent and emergency care were:

 

           Effective navigation

           Same Day Emergency Care

           Ambulance Handover Improvement

           Improving flow through Emergency Departments

           Community Urgent Care

           Access to Primary Care

           Access to Mental Health Services

 

It was envisaged that delivery of the goals would be achieved through whole system collaboration involving NHS Devon (the Integrated Care Board), the One Devon Partnership, social care partners, Local Care Partnerships (LCP) and Provider Collaboratives, including partners across public services and the third sector. 

 

The Report outlined current performance in: call abandonment, call answering times, ambulance response times, average hours lost to ambulance handover delays per day, adult general and acute type 1 bed occupancy, percentage of beds occupied by patients who were medically ready to go home or to other care settings, such as social care placements; other actions, and social care actions and outcomes including workforce and recruitment, and capacity and demand funding.

 

Members’ discussion points with the Chief Delivery Officer included:

·         the continued demand pressures through-out the year (and not just Winter); 

·         the NHS 2 year plan to address Urgent and Emergency Care to reduce demand with suitable alternatives for sustained improvement;

·         plans to reduce elective care waiting times on which more information would be provided to a future meeting;

·         the development of a Care Hotel initiative in North Devon;

·         whilst urgent and emergency care was predominantly a 7 day/24 hour operation other areas of NHS services (for example diagnostics) were more limited; and

·         additional resources to make a sustained improvement in the 111 service with a new service provider.

The Chair thanked the Lead Officer for his report and suggested that Healthwatch could be asked to review the performance of the 111 Service.

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103.

Healthwatch Briefing - Respite and Day Services for People with a Learning Disability pdf icon PDF 165 KB

Briefing by Healthwatch, attached

 

The document contains the following recommendations to the Health and Adult Care Scrutiny Committee:

 

(a) that Devon Health and Adult Care Scrutiny Committee seeks reassurance that all families who would be affected by the proposals to reduce day and respite care provision are fully consulted with, before any decision is made to reduce these services, to ensure that all clients with assessed care needs will continue to have their care needs fully met if changes were to be made; and  

 

(b) to note that Healthwatch Devon - who's statutory function is to promote and support the involvement of people in the monitoring, commissioning and provision of local health and social care services - can independently support and help to facilitate the consultation process.

 

Additional documents:

Minutes:

The Committee noted and approved recommendations (detailed below) by Healthwatch contained in a Briefing Note to this Committee in regard to day and respite care provision for People with a Learning Disability (Minute *102 refers).

 

A Member asked that Healthwatch could also be requested to review the consultation process in regard to the 18+ Homelessness Prevent Fund.

 

Healthwatch recommendations:

 

(a) that Devon Health and Adult Care Scrutiny Committee seeks reassurance that all families who would be affected by the proposals to reduce day and respite care provision are fully consulted with, before any decision is made to reduce these services, to ensure that all clients with assessed care needs will continue to have their care needs fully met if changes were to be made; and

 

(b) to note that Healthwatch Devon - who's statutory function is to promote and support the involvement of people in the monitoring, commissioning and provision of local health and social care services - can independently support and help to facilitate the consultation process.

 

 

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104.

Health and Care General Update pdf icon PDF 136 KB

Joint report from Devon County Council and NHS Devon (ACH/23/171)

attached 

 

 

 

Additional documents:

Minutes:

(Councillor J McInnes attended in accordance with Standing Order 25 (1) and spoke to this item with the consent of the Committee and referred to the new Care Quality Assurance framework commencing on 1 April 2023 which would include developing oversight and challenge mechanisms from elected Members and this Committee in particular). 

 

The Committee considered the Joint report from the Council and NHS Devon (ACH/23/158) on the latest news from the Devon Health and Care system. This included updates on the North Devon Link Service, Integrated Adult Social Care 2022/23 budget update as of January 2023; Devon Integrated Care System (ICS) Financial Position as of January 2023; NHS Integrated Care Board (ICB) Financial Position as of January 2023; looking ahead to 2023/24; CQC assurance of adult social care services; and surgical hubs which had won recognition for meeting top clinical and operational standards. 

 

Members’ discussion points with the Director and Executive Lead Chief Delivery Officer NHS Devon included:

 

·         the  number of people which were being served by Integrated Adult Social  Care in excess of the original budget;

·         the revised total savings figure as being deliverable in 2022/23, due to pressures on demand and unit costs and other factors;

·         the Integrated Care System (ICS) financial position and the forecast for the current year (2022/23) was a deficit of £49.2m which was £31 m more than the planned deficit;

·         the requirement for the Integrated Care Board (ICB) to make a 30% real terms reduction in its running costs by 2025/26 with at least 20% being delivered by 2024/25, which whilst challenging was realistic; and confirmation that this did not relate to front-line clinical/care services;

·         strategies to alleviate high risk categories (obesity for example) and the role of primary care on which more information would be provided in future reports; and  

·         the work of the South West Ambulatory Orthopaedic Centre (SWAOC) at the Nightingale Hospital in Exeter which was one of eight to be awarded accreditation as part of a pilot scheme; and plans to increase the scale and specialisms at the Centre.

 

The Chair thanked the Officers for their report and commended the successes outlined.    

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105.

Scrutiny Committee Work Programme

In accordance with previous practice, Scrutiny Committees are requested to review the list of forthcoming business and determine which items are to be included in the Work Programme.

 

The Committee may also wish to review the content of the Cabinet Forward Plan and the Children’s Services Risk Register to see if there are any specific items therein it might wish to explore further.

 

Additional documents:

Minutes:

The Committee noted the current Work Programme subject to inclusion of topics which arose from the meeting. This included the Teignmouth Community Hospital Task Group

 

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

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106.

Information Previously Circulated

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) Dentistry Masterclass Recording & Presentation.

 

(b) Risk Registers for the respective Scrutiny Committees Risk Registers - Democracy in Devon

 

 

Additional documents:

Minutes:

The Committee noted 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) Dentistry Masterclass Recording & Presentation.

 

(b) Risk Registers for the respective Scrutiny Committees Risk Registers - Democracy in Devon


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