Agenda and minutes

Minutes of the meeting held on 23 September 2019 (previously circulated)

RESOLVED that the Minutes of the Meeting held on 23 September 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.

Report of the Joint Associate Director of Commissioning (Devon County Council and NHS Devon CCG) and the Director of Commissioning (NHS Devon CCG) (ACH/19/116), attached. 

The Committee received the Joint Report of the Associate Director of Commissioning (Care and Health) Devon County Council and NHS Devon CCG and the (interim) Director of Commissioning (NHS Devon CCG) (ACH/19/116) on an update and general information responding to matters raised during the previous Health and Adult Care Scrutiny Committee meeting. The Report covered Integrated Student Mental Health Services, Safeguarding, Integrated Care System and Primary Care Networks, Devon’s Joint Health and Wellbeing Strategy, Personal Care, CQC reports on Health and Care, Suicide Bereavement Support, Torbay Hospital’s Theatre; an Integrated Care Systems conference, a Macmillan Primary Care Services, Devon’s Integrated Urgent Care Service, and a short update on Devon’s Long Term Plan.

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

·         the County Council’s resumption of the management of personal care referrals in three Home zones (from a total of 8 zones) which had been previously handled by Mears Care;

·         session on the case for change in regard to the Long Term Plan had been arranged for the Committee’s Standing Overview Group on 16 December 2019; and

·         the need for further information on the root causes relating to student mental health problems from, for example, the Devon Partnership Trust, Universities and FE Colleges.

(a) Report the Joint Associate Director of Commissioning (Devon County Council), (ACH/19/118), attached;

(b) Report of the Chief Officer for Communities, Public Health, Environment and Prosperity, attached for information (section 4 relating to Public Health, Page 17) as this was considered in detail by the Corporate, Infrastructure and Regulatory Scrutiny Committee at its meeting on 26 November 2019).

(a) Health and Care

The Committee considered the Report of the Report of the Associate Director (Care and Health) Devon County Council and NHS Devon CCG (JACH/19/118) on the progress towards delivering strategic objectives and performance targets within the budget allocated to it for 2019/20 and the key messages from national challenges.

The Report outlined the budget pressures in Adult Care Operations, Adult Commissioning and the continuing financial risks and the delivery of strategic objectives and comparative performance against national and local indicators. The County Council’s Adult Care and Health services overall were forecast to overspend by £6.742 Million, or 2.79% of the total budget, as at month 6. This position considered £890,000 of management action and the forecast was £617,000 better than assessed at month 5. 

Members’ discussion points/comments with the Chief Officer for Adult Care and Health, the Associate Director; and the Head of Adult Care Operations and Health included:

·         the continuing spending pressures within Physical Disability and Learning Disability services;

·         in general terms Adult Care and Health in Devon was managing to hold or improve on its comparative position relative to other comparator Local Authorities;

·         the budget setting process for the next financial year based on current data and information about demand and cost pressures;  

·         work force, demand led and unit cost pressures across Adult Care services, particularly within residential care and nursing settings; and

·         the impact of the Better Care Fund in promoting innovative partnership working and future funding support from this source;

·         the flexibility of the budget within Adult Care and Health with allocations according to need (primary support reasons) and not purely on age, for example; and

·         the effectiveness of the community teams, including commissioning services with the third sector, in helping more people with mental health needs in Devon to remain living independently.

It was MOVED by Councillor Randall Johnson, SECONDED by Councillor Ackland and

RESOLVED that a report be submitted on the Better Care Fund impact and future funding when budget information is available. 

(b) Public Health

The Committee received a Briefing Paper by the Chief Officer for Communities, Public Health, Environment and Prosperity on the mid-year report for Public Health and covered current work within its four main responsibilities: (i) Intelligence and the Joint Strategic Needs Assessment, (ii) Healthcare Public Health, (iii) Health Protection and Emergency Planning; and (iv) Health Improvement and Reducing Inequalities. The Report  had been considered in detail by the Corporate, Infrastructure and Regulatory Scrutiny Committee meeting on 26 November 2019.

Report of the Members (CSO/19/26), attached

The Committee received the Report of the Members (CSO/19/26) on a members’ visit to Chiddenbrook Surgery, and the Report outlined the issues identified.

Members agreed that the site visit provided a valuable insight into how the Model of Care was working from a GP surgery perspective and suggested further visits to other GP settings within a Primary Care Network.

Report of the Standing Over Group (CS/19/27), attached

The Committee received the Report of the Members (CSO/19/27) on a meeting of the Standing Overview Group of the Health and Adult Scrutiny Committee on 18 October 2019 when it had received presentations on work relating to the Devon NHS Long Term Plan covering engagement activities, the case for change, Core Deliverables of the Plan and ambitions of the Plan.

It was MOVED by Councillor S Randall Johnson, SECONDED by Councillor R Peart and

RESOLVED

(a) that the significant role Local Government has played in the development of the Devon Long Term Plan (LTP) and the role it will play in the delivery be recognised and that all Councillors receive information to help them understand and develop as strong Health and Wellbeing leads in their local communities; and

(b) that the learning from the recent Standing Overview Group meeting on the LTP be used to inform its future work programme.

Joint Report of the Associate Director of Commissioning (Care and Health, Devon County Council) and the Chief Executive Officer, Livewell Southwest CIC (ACH/19/115), attached. 

(Councillor Greenslade attended in accordance with Standing Order 25(2) and spoke to this item referring to potential future workforce issues including recruitment from the European Union).

The Committee considered the Joint Report Associate Director of Commissioning (Care and Health) (Devon County Council) and Chief Executive Officer, Livewell Southwest CIC

(ACH/19/115) on Health and Social Care workforce challenges in Devon, the Devon STP Workforce Plan and actions to address the challenges.  The Report detailed the Workforce Strategy Priorities, international recruitment, general STP recruitment, the development of a Recruitment Hub, and training/apprenticeships and career pathways other initiatives and Pay and Reward across the industry, digital and other solutions and population demands and expectations.

Discussion points with the Head of Human Resources (Devon County Council) and  the Chief Executive Officer, Livewell Southwest CIC included:

·         the joint work of the Heads of Human Resources across the STP partners relating to  the communication and support for EU nationals within the current workforce;

·         the focus on developing career pathways for staff across care and health involving recognised NVQ and other vocational qualifications, and apprenticeships and closer working with Higher and Further Education settings; 

·         the Proud to Care initiative across care and health and the important economic impact of the care and health sector within the region;

·         early stage development in joint work involving the international recruitment and cognisance of the ethical issues involved;

·         the multiple factors involved in ensuring workforce sustainability across health and care  within the wider economic, social and political context; and

·         the national and local funding streams across both Adult Care and Health regionally and nationally which would become clearer in time and which would involve more detailed work and analysis as part of the Long Term Plan.    

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

RESOLVED  that  further consideration be made to setting up a Task Group on workforce recruitment and retention when more detail is made available to Members early in the New Year.  

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 planning and progress of the 5 G Spotlight Review.

The current Work Programme was available via the link below subject to inclusion of the following topics (arising from this meeting) for future consideration:

(a) Report on the Better Care Fund impact and future funding;

(b) Task Group Review of the STP Workforce Plan.

[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) Care Quality Commission (CQC), the Urgent and Emergency Care Survey 2018: responses from patients.

(b) CQC published a report of its recent  Devon Partnership NHS Trust inspection.

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) Care Quality Commission (CQC), the Urgent and Emergency Care Survey 2018: responses from patients, and

(b) CQC published a report of its recent Devon Partnership NHS Trust inspection.