Agenda and minutes

Minutes of the meeting held on 18 June 2019 (previously circulated)

RESOLVED that the Minutes of the Meeting held on 18 June 2019 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.

Presentation by the Joint Associate Director of Commissioning (Devon County Council and NHS Devon CCG) and the Director of Commissioning (NHS Devon CCG), attached    

The Committee received a presentation by the Joint Associate Director of Commissioning (Devon County Council and NHS Devon CCG) and the Deputy Director of Strategy (NHS Devon Clinical Commissioning Group) which covered

·         The NHS Long Term Plan

·         The Implementation Framework

·         The challenge in Devon

·         The Case for Change (highlights)

·         The Engagement Approach including with elected Members

·         Key themes from the engagement

·         The shared system vision and ambitions

·         Ways to achieve four key long-term ambitions; and

·         The Next Steps 

Members’ discussion points/comments with the Officers included:

·         the information now presented outlined the progress to date in the development of a draft plan and referred to the engagement activity, emerging themes and early headlines;

·         a final report when agreed by all the partners would be published in November 2019 and be in the public domain;

·         a draft of the Long Term Plan would be presented to the Committee’s  Standing Overview Group meeting on 18 October 2019 and a report would come back to this Committee on 28 November 2019;

·         the Plan should align with the Joint Health and Wellbeing Strategy and developing Integrated Care System (ICS) arrangements to form a single shared vision;

·         the Plan would reinforce the broader community support for mental health and wellbeing;

·         the Plan and actions would aim to mitigate current financial pressures and projected deficits through meaningful collaboration across health and social care with  emphasis on prevention and address broader determinants of health and wellbeing;

·         the importance of improving access to primary care services through digital technology with infrastructure improvement and cultural change and acceptance;

·         the Brexit question was not referenced as the Plan related to the longer-term over 5 years but issues relating to long term use of prescription drugs for example would be addressed; and

·         the relatively low engagement responses to date and work with Healthwatch in terms of the engagement activity outlined which was backed with detailed questioning and information/options.

The progress of the developing plan would be presented to the next meeting prior to its publication.    

Report of the Chair of the Devon Safeguarding Adults Board (DSAB), attached

The Committee received  a presentation from the Chair of the Devon Safeguarding Adults  Board on its Annual Report 2018/19 and covered:

·         What is Safeguarding Adults?

·         What is meant by Abuse and Personal stories?

·         How to report abuse

·         Safeguarding activity in Devon

·         Deprivation of Liberty Safeguards (DoLS)

·         The Board and its Sub-Groups and their work

·         What had been done: last year actions and priorities?

·         Learning Events and lessons from Safeguarding Adults Reviews (SARs); and

·         Plans moving forward.

Members’ discussion points/comments with the Chair of the Board included:

·         the value of the personal stories as a tool for learning and development and context;

·         the increased number of referrals from the public which was a positive sign of improved awareness (although overall referrals were down);

·         referrals from the public would lead to signposting to the appropriate agencies for actions where there were welfare concerns noting that the Board’s legal remit related  to vulnerable adults in need of care and support irrespective of eligibility for local authority social care or health support; 

·         the role of the Board (and its sub-groups) in providing oversight and coordination of the work of the agencies notably via the County Council’s Adult Social Care and Health services within an agreed framework;

·         liaison and representation on the Safer Devon Partnership to aid communication and help avoid duplication;

·         ongoing work nationally and locally by the County Council to collate data within an agreed framework to help ensure meaningful comparison across local authority areas;

·         an important theme of the Board included transition from children to adult care services;

·         a suggestion from a Member that the Board could look at work around more vulnerable students at university where there were health and care needs; and

·         the importance of the public in making referrals where there were welfare concerns  irrespective of any knowledge about care packages.

The Chair of the Committee thanked the Chair of the Board for the informative presentation and readable and accessible Annual Report.  

Report of the Head of Adult Care Operations and Health (ACOH/19/03), attached

The Committee considered the Report of the Head of Adult Care Operations and Health

(ACOH/19/03) giving an update on the success of the Deprivation of Liberty Safeguards (DoLS) investment project in reducing the risks posed by the service waiting list during June 2018-May 2019; and on an outline of the new statutory functions of Devon County Council under the Liberty Protection Safeguards (LPS) Amended Mental Capacity Act, expected to come into force on the 1st October 2020 and which would replace the Deprivation of Liberty Safeguards.

Members’ discussion points/comments with the Principal Social Worker (Adult Social Care - Operations) and the Senior Solicitor - Adult Social Care (Devon County Council)  included:

·         the clear statutory guidelines relating to the respective responsibilities of the County Council as the supervisory body and that of the NHS Bodies (Clinical Commissioning Groups) and they may decide to develop plans for collaborative working sharing the costs accordingly following adoption of the new legal requirements; and

·         the new requirements would help address the lengthy waiting lists through a more streamlined priority led approach and range of parameters.

The Chair thanked the Officers for the update and the work of the officers in the positive progress made.      

Report of the Joint Associate Director of Commissioning (Devon County Council and NHS Devon CCG) and the Director of Commissioning (NHS Devon CCG) (ACH/19/114), attached. 

The Committee considered the Joint Report of the Associate Director of Commissioning (Devon County Council and NHS Devon CCG) and the Director of (NHS Devon CCG) (ACH/19/114) on performance comparisons of Ambulance Foundation Trusts, urgent and winter planning, the Healthwatch Devon Annual Report 2018-19, communications update, the Living Well at Home initiative, the Proud to Care recruitment initiative; and budget survey by the Association of Directors; Devon Doctors and 111 and out of hours service, the Peninsula Clinical Services Strategy;  and Better Births engagement.

Members’ discussion points/comments with the Joint Associate Director included:

·         questions on the progress of the Proud to Care initiative and strategies to retain staff, current achievements and the impact on future plans and challenges across the health and social care system;

·         the progress of the development of the Primary Care Networks (PCNs) designed to improve joint working within areas across primary care and health services and settings and the Director undertook to circulate Members maps of the local networks and referred to the assessment of the optimum level for the size of each network area and noted that PCNs  could be a worthwhile subject for a future masterclass open to all Members of the Council;

·         use of nurse practitioners to mitigate pressures on GP services to help address work force challenges; and  

·         the varying performances of the four acute trusts in Devon relating to Accident and Emergency admissions/waiting times.

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

RESOLVED that a report be submitted to the next meeting on the work force challenges  across health and social care in Devon and thereafter further consideration be given to a Spotlight Review or Task Group investigation. 

Report of the Members (CSO/19/21), attached

The Committee considered the Report of the Health and Adult Care Scrutiny Members (CSO/19/21) on their visits to community health and care teams in the Tavistock Community Hospital and the Tavistock Wellbeing Hub, on 2 July 2019 and on 5 August to the Ness Dementia Centre, a therapeutic specialist space designed to support the family and individual. 

Broad themes and issues were identified by Members and detailed in the Report.

Members commended the visits as a worthwhile exercise. The Committee in particular acknowledged the innovative model developed by Atlas Care and the valuable services being provided at the Ness Centre. It was hoped by Members that further such dementia centres could be developed across the County.

Shared learning from the visits would be used to inform the Committee’s future work programme.

Report of the Health and Adult Care Members (CSO/19/22), attached

The Committee noted the Report of the Health and Adult Care Scrutiny Members (CSO/19/22) on the Market Position Statement and Primary Care Networks presentations received at the last meeting of the Standing Overview Group on 17 July 2019.

The learning from this would be used to inform the Committee’s future work programme.

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

Report by Councillor M Shaw, attached

[N.B. This Report is from an individual member of the Council and is not written on behalf of Devon County Council ]

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

Councillor Shaw reported on his paper outlining concerns about maintenance and charges at Colyton Health Centre managed by NHS Property Services (the landlord).

Members referred to local contract and arbitration arrangements that would be in place for such matters and the need for the parties involved to resolve the issues in the best interests of the local community.  

It was MOVED by Councillor Sanders, SECONDED by Councillor Saywell and

RESOLVED the Clinical Commissioning Group, NHS Property Services and the Health Centre be requested to meet as quickly as practicable and resolve the issues outlined, in the best interests of the local community.

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.   

The Committee noted the current Work Programme subject to inclusion of the following topics (arising from this meeting) for future consideration:

Officer report on work force planning and challenges across social and health care. 

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

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

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) Better Births in Devon Engagement Report:  Local Maternity System engagement exercise  identifying themes arising from thoughts, experiences and views of parents about births in Devon.

(b) Health & Care Insights Issue 18 - latest issue of Health & Care Insights from Torbay and South Devon NHS Foundation Trust.

(c) Briefing note from University Hospitals Plymouth NHS Trust relating to the temporary closure of Tavistock MIU.

(d) 5G Information – BBC News article

(e)  Press release from Torbay and South Devon NHS Foundation Trust relating to changes to the opening hours at Dawlish and Totnes MIUs.

(f) The latest issue of Pulse, the Northern Devon Healthcare NHS Trust (NDHT) magazine,

including an update on the work of the Trust to develop sustainable plans for hospital services in northern Devon and feedback from patient experience surveys.

(g) An interactive copy of Healthwatch Devon’s Annual Report 2018/19.

(h) The slides of the presentation from a masterclass on 18 June 2019 on Dementia.

Information below which had been previously circulated for Members relating to topical developments which had been or were currently being considered by this Scrutiny Committee.

(a) Better Births in Devon Engagement Report:  Local Maternity System engagement exercise  identifying themes arising from thoughts, experiences and views of parents about births in Devon.

(b) Health & Care Insights Issue 18 - latest issue of Health & Care Insights from Torbay and South Devon NHS Foundation Trust.

(c) Briefing note from University Hospitals Plymouth NHS Trust relating to the temporary closure of Tavistock MIU.

(d) 5G Information – BBC News article.

(e)  Press release from Torbay and South Devon NHS Foundation Trust relating to changes to the opening hours at Dawlish and Totnes MIUs.

(f) The latest issue of Pulse, the Northern Devon Healthcare NHS Trust (NDHT) magazine, including an update on the work of the Trust to develop sustainable plans for hospital services in northern Devon and feedback from patient experience surveys.

(g) An interactive copy of Healthwatch Devon’s Annual Report 2018/19.

(h) The slides of the presentation from a masterclass on 18 June 2019 on Dementia.