Skip to content

Agenda and minutes

Venue: Committee Suite - County Hall

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

Media

Items
Note No. Item

*

86.

Minutes

Minutes of the meeting held on  20 September 2018 (previously circulated)

Additional documents:

Minutes:

RESOLVED that the Minutes of the meeting held on 20 September 2018 be signed as a correct record.

87.

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.

*

88.

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 Councillor D Cox (Teignbridge District Council) on a matter to be considered by the Committee, namely Modernising Health and Wellbeing Services in Teignmouth (Minute *92 refers). He expressed local and the Town Council’s concerns about the proposal to close the Community Hospital and relocation of services and referred to the past support of the League of Friends and the deprivation in the local Ward.

 

The Chair responded, thanking the speaker for his attendance and presentation which

would be considered by the Committee during its subsequent deliberations.

*

89.

Finance and Performance Mid-Year Update pdf icon PDF 114 KB

(a)  Report of the Chief Officer for Adult Care and Health (ACH/18/94), (Page 1) 

 

(b) Report of the Chief Officer for Communities, Public Health, Environment and Prosperity, attached for information (section 3. relating to Public Health) as this will be considered in detail by the Corporate, Infrastructure and Regulatory Scrutiny Committee at its meeting on 27 November 2018), (Page 7).  

 

 

Additional documents:

Minutes:

(Councillor A Leadbetter attended in accordance with Standing Order 25 (1) and spoke to this

item at the invitation of the Committee)

 

The Committee received the Report of the Head of Adult Commissioning and Health

(ACH/18/94) on how Adult Social Care in Devon County Council was performing regarding delivering its strategic objectives and performance targets within, the budget allocated to it, highlighting any significant variation from agreed plans. The Report covered the Adult Social Care Budget at month 6, the financial risks faced by the Service, the vision of the Service to ‘Promoting Independence in Devon’ which aligned with the Council’s objectives with the desired outcomes and priorities agreed across health and care through the local Sustainability and Transformation Partnership, delivery of the strategic objectives and headline analysis in achieving the objectives. 

 

Members discussion points/comments with the Cabinet Lead for Adult Social Care and Health Services, the Chief Officer for Adult Care and Health and the Senior Manager - Strategic Commissioning Older People included:

 

·         cost of care and work force pressures within the domiciliary care services in Devon and initiatives by the County Council with Health to encourage recruitment into the care and health services offering worthwhile and rewarding careers;

·         IT initiatives and innovations to help support independent living and to drive efficiencies, through the Better Care Fund which could be the subject of a future Master Class or Briefing on a County Council meeting day open to all Members;

·         the good quality of Devon’s care providers as highlighted by the Care Quality Commission which could partially explain the low referral rates to the Devon Safeguarding Adult Board and which more research was being undertaken by the Service;

·         cost pressures and demand with the working age adult physical and learning disability services; and              

·         unplanned admission into hospital rates, on which further information was requested for circulation to members.

 

The Committee also received the Report of the Chief Officer for Communities, Public Health, Environment and Prosperity in so far as it related to a mid-year briefing on Public Health. The Report which covered the other functions in Environment and Prosperity would be considered by the Corporate, Infrastructure and Regulatory Scrutiny Committee on 27 November 2018. 

*

90.

Northern Devon Healthcare NHS Trust: Action Plan Care Quality Commission: Update pdf icon PDF 210 KB

Report of the Northern Devon Healthcare NHS Trust, attached

Additional documents:

Minutes:

(Councillor Greenslade attended in accordance with Standing Order 25 (2) and spoke to this item asking for an update on the progress of the planned and current improvements) 

 

D Allcorn (Northern Devon Healthcare NHS Trust (NDHT)) and S Tracey (Chief Executive of the RD&E Hospital Trust and the Northern Devon Health Trust) attended and spoke to this item at the invitation of the Committee.

 

The Committee received a briefing note from the Northern Devon Healthcare Trust on the context of the most recent CQC inspection of North Devon District Hospital, managed by Northern Devon Healthcare NHS Trust with support from the RD&E Hospital Trust, and covered the findings from the inspection, actions that were being taken and how improvements would be assured.

 

In response to Members’ questions the representatives from the Trusts commented on:

 

·         progress had been made in addressing previous concerns and now systems and processes needed more time to fully embed and progress needed to continue;

·         actions in key areas were outlined relating to staff training, maternity services, oversight and audit and assessment of the end of life service, inpatients and waiting lists, and improvements in emergency care services;

·         collaboration with the RD&E Trust in terms of leadership, sharing of staff and ability to offer greater opportunities in the recruitment and retention of specialist staff;

·         the time required for cultural change with new leadership and the level of external scrutiny from NHS regulators;  

·         the planned and forecast deficit budgets to ensure delivery of the improvement plans;

·         the inpatient surveys in helping assess the quality of services provided and use of patient experience volunteers in providing further ‘soft’ evidence of the patient views and quality of care; and

·         no further service warning notices had been issued by the CQC and the normal inspection and reporting regime now operated with the next inspection expected in 2019.

 

The Chair thanked the representatives for their attendance and for the hard work of the NDHT staff in the continuing improved progress achieved for the communities of North Devon.  

 

           

 

*

91.

Winter Planning 2018-19 pdf icon PDF 139 KB

Presentation by the Head of Adult Commissioning and Health (Devon County Council) and Associate Director of Commissioning (South Devon and Torbay CCG and NEW Devon CCG), attached

Additional documents:

Minutes:

J Turl (Associate Director of Commissioning - Devon CCGs), Dr S Kerr (Clinical Chair, Eastern Locality, NEW Devon CCG), and J Harrison (Chief Operating Officer, South Devon and Torbay NHS Trust) attended and spoke to this item at the invitation of the Committee.

 

The Committee received a presentation prepared by the Associate Director of Commissioning, Devon CCGs and the Head of Adult Commissioning and Health (Devon County Council) on a joint single system winter plan 2018/2019 underpinned by individual locality plans and approved by the Devon A&E Delivery Board. The 2018-19 plans described how the Devon health and care system would operate over the winter.

 

The NHS representatives and the Senior Manager - Strategic Commissioning Older People (Devon County Council) responded to Members comments and questions relating to:

 

·         high risk areas were identified according to recent performance notably in Plymouth and Torbay but across Devon as well and in terms of the availability of acute, intermediate and domiciliary beds;

·         workforce, demand and capacity profiling, which ensured that the workforce was available across known busy periods;

·         a shared approach to risk assessment and prioritisation

·         management of flu, including learning from Devon Partnership Trust’s successful frontline health care workers campaign;

·         enhancing the role of the Integrated Urgent Care Service (including 111) to reduce demand in the emergency care system

·         more timely repatriation of people from specialist services; and

·         improved pathways into specialist mental health services;

·         the 5.2% increase in ambulance activity compared to last year represented some 17,400 call outs, which was significant; and

·         collaborative work between the Health and Adult Social Care (Devon County Council).

 

The Chair thanked the Officers for their informative presentation and asked for further information in relation to the County Council’s road gritting network and access to GP surgeries and Community Hospitals. 

 

 

*

92.

Modernising Health and Wellbeing Services in Teignmouth pdf icon PDF 2 MB

Report of the South Devon and Torbay Clinical Commissioning Group, attached 

Additional documents:

Minutes:

Dr S Manton, Joint Director ((Strategy) North, East and West (NEW) Devon CCG and South

Devon and Torbay CCG), J Turner (Head of Commissioning South Devon and Torbay CCG), Dr C Karakusevic (GP Teignmouth) attended and spoke to this item at the invitation of the Committee)

 

The Committee considered the Report of the Director of Commissioning (South Devon and Torbay CCG) on the proposals to move to public consultation regarding re-locating community clinics from Teignmouth Community Hospital and co-locating the three GP practices in Teignmouth, alongside the health and wellbeing team and voluntary sector in a new build in Brunswick Street, Teignmouth.

 

The report outlined the patient and public engagement exercise undertaken, the rationale for the proposals building on the success of the model of care, the proposed formal consultation process and timescale. An eight-week consultation was planned to start in early 2019.

 

The NHS representative and Assistant Director (Health and Social Care Management South Devon, Devon County Council) responded to Members’ questions and/or commented:

 

·         some specialist services would move to Dawlish within the same Locality with associated additional financing and resources and generally GPs in Teignmouth were supportive of the proposals;

·         the details of the proposal would be included in the consultation process, following the public engagement which had already taken place;

·         the environmental impact assessments of the proposals had been carried out and the CCG would communicate with Devon Highways about the implications;

·         overall the revenue cost implications were neutral and there would be capital costs which formed part of the full business case; and

·         the proposals represented an improved offer to the Coastal Locality.

 

Members’ other views included:

 

·         that it would be helpful to have a clearer description of the implications of the proposal for services in Dawlish -and it would be advisable to show how matters related to traffic, highways and air quality which had been discussed with the County Council;

·         that a more complete description of the financial costs and benefits would strengthen the proposal; and

·         that a description of how service continuity would be sustained during any changes made would strengthen the proposal and provide assurance.

 

The Committee understood that the intention was to consult upon a proposal rather than a range of options and to consult for 8 weeks (rather than 12 as was commonly done). In the light of these points the Committee would value assurance prior to the launch of consultation, that the NHS assurance process, overseen by NHS England, provided adequate justification of these two points.

 

Members noted the proposals and the outcome of the consultation would be reported to this Committee.

*

93.

Risk Management Mid-Year Update 2018/19 pdf icon PDF 302 KB

Report of the County Treasurer (CT/18/98), attached

Additional documents:

Minutes:

The Committee considered the Report of the County Treasurer (CT/18/98) on an update 

of the Risk Management processes and this included revised reporting structures and timelines, and this had resulted in the compilation of a midyear update for this Scrutiny Committee. 

 

As the process evolved, the aim was to work with Health to provide an updated report which coordinated both Council and Heath Risk Management Information.

 

The Report summarised the risk management position, the currently recorded risk position and the most significant risk related to the workforce, both in terms of sufficiency and staff development.

 

Members highlighted the Audit Masterclass that had taken place on 8 November 2018, where Councillors were provided with training on risk management as well as access to the risk management database.

 

Councillors Twiss, Scott and Wright would meet with Officers to test the prototype real time  risk database.

*

94.

Better Care Fund Response to the Health and Adult Care Scrutiny pdf icon PDF 117 KB

Report of the Head of Adult Commissioning and Health, Devon County Council; and Director of Strategy (South Devon and Torbay CCG and NEW Devon CCG) (ACH/18/96), attached

Additional documents:

Minutes:

(Councillor Ackland and Leadbetter attended in accordance with Standing Order 25 and spoke to this item).

 

Dr S Manton, Joint Director ((Strategy) North, East and West (NEW) Devon CCG and South

Devon and Torbay CCG) and J Turl (Associate Director of Commissioning - Devon CCGs), attended and spoke to this item at the invitation of the Committee)

 

The Committee received the report of the Head of Adult Commissioning and Health and the Director of Strategy, NEW Devon and South Devon and Torbay CCGs on a response to the recommendations in the June 2018 report of the Health and Adult Care Scrutiny Committee task group, “Better Care Through Integration?”.

 

The NHS representatives and the Senior Manager - Strategic Commissioning Older People (Devon County Council) responded to Members comments and questions relating to:

 

·         the Section 75 Agreement on pooled funding that underpinned the Better Care Fund; and

·         the joint workshop with this Committee and the Health and Wellbeing Board on 13 December 2018 Members, which was likely to include exploratory conversations as part of any future ICS development.

 

The Committee thanked Councillor Ackland for her work on the Better Care Fund.

*

95.

Emerging Mental Health and Wellbeing Strategy - A Scrutiny Members Perspective pdf icon PDF 70 KB

Report of the Health and Adult Care Scrutiny Committee, attached 

Additional documents:

Minutes:

The Committee considered the Report of the Health and Adult Care Scrutiny Committee (CSO/18/36) on a members’ review, held on 11 October 2018, of the visions and priorities of the draft Mental Health and Wellbeing Strategy. In Phase 1 of the engagement programme, from 7 September 2018 to 8 October 2018, people across Devon had been invited to share their thoughts and feelings about the vision and priorities for mental health and wellbeing. The outcomes of this engagement process would inform the vision and priorities in the Mental Health and Wellbeing Strategy.

 

During discussion reference was made to delays in access and the availability of services; and the role of the voluntary sector.

 

It was MOVED by Councillor Randall-Johnson, SECONDED by Councillor Way, and

 

RESOLVED

 

(a) that a 6-month performance update be presented to the June 2019 Committee to review progress in terms of the Mental Health and Wellbeing Strategy’s implementation and delivery; and

 

(b) that as part of the update, officers include a detailed breakdown of the figures relating to access to services and waiting times.

*

96.

NHS in Devon Spotlight Review: Update pdf icon PDF 74 KB

Report of the Director of Strategy (South Devon and Torbay CCG and NEW Devon CCG) and Head of Adult Commissioning and Health, (ACH/18/97) 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 received and noted the Report of the Director of Strategy (NEW Devon CCG and South Devon and Torbay CCG) and the Head of Adult Commissioning and Health, Devon County Council (ACH/18/97) on an update on activities and progress against the recommendations in the NHS Inquiry Spotlight Review (CS/18/05) which had been presented to this Committee on 25 January 2018. The Spotlight Review had described three ambitions with ten specific recommendations across these ambitions. This Report provided an update against each recommendation.

 

 

           

*

97.

Rapid Response Spotlight Review pdf icon PDF 759 KB

Report of the Spotlight Review, attached   

Additional documents:

Minutes:

The Committee considered the Report of the Spotlight Review which covered:

 

·         how the Rapid Response system should work and how it was working;

·         a survey among GPs in Devon to ascertain if the concerns raised were typical of other primary care practitioners; and

·         identification of pressure points in the system and what action might be taken to ameliorate them.

 

The Chair of the Review highlighted the increased national profile of the Rapid Response service given the Government plans announced that morning.

 

NHS Rapid Response teams were on call 24/7 to help elderly patients who fell or suffered infections to help keep people out of hospital.

 

It was MOVED by Councillor Scott, SECONDED by Councillor Russell and

 

RESOLVED that the Spotlight Review be welcomed, and the recommendations be commended to the Cabinet, subject to minor revisions to the wording and deletion of recommendation 2.4 and substitution thereof with:

 

That consideration be given to provide a comprehensive description of the amount and type of community health and social care required at a local level.

 

*

98.

Work Programme

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.   

Additional documents:

Minutes:

The Committee noted the current Work Programme and

 

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

following topics (arising from this meeting) for future consideration:

 

(a)   LGA Green Paper for Adult Social Care and Wellbeing;

(b)   Using Technology and Digitally Connected Care and Support; and

(c)   further visits to Health and Adult Social Care settings.

 

[NB: The Scrutiny Work Programme was available on the Council's website at https://new.devon.gov.uk/democracy/committee-meetings/scrutinycommittees/ scrutinyworkprogramme/]

*

99.

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) Response to Better Care Fund Task Group Report from the Minister of State for Care - Health & Adult Care Scrutiny Committee.

 

(b) Update on GP Services in Hatherleigh and Shebbear - Health & Adult Care Scrutiny Committee.

 

(c) Briefing on the outcomes of a procurement exercise to secure new NHS orthodontics providers across Devon, Cornwall and Somerset from next spring.

 

(d) Digital Minor Illness Referral Service Pilot Devon - Health & Adult Care Scrutiny Committee: covering letter and briefing paper outlining a pilot supported by the Pharmacy Integration Fund which was due to begin in Devon on 8 October and run until 31 March 2019.

 

(e) Issue of Health and Care Insights from Torbay and South Devon NHS Foundation Trust.

 

 

 

 

 

Additional documents:

Minutes:

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

 

(a) Response to Better Care Fund Task Group Report from the Minister of State for Care

- Health & Adult Care Scrutiny Committee;

 

(b) Update on GP Services in Hatherleigh and Shebbear - Health & Adult Care Scrutiny

Committee;

 

(c) Briefing on the outcomes of a procurement exercise to secure new NHS orthodontics

providers across Devon, Cornwall and Somerset from next spring;

 

(d) Digital Minor Illness Referral Service Pilot Devon - Health & Adult Care Scrutiny

Committee: covering letter and briefing paper outlining a pilot supported by the Pharmacy

Integration Fund which was due to begin in Devon on 8 October and run until 31 March

2019; and

 

(e) Issue of Health and Care Insights from Torbay and South Devon NHS Foundation

Trust.


Top