Agenda and minutes

Minutes of the budget and ordinary meetings held on 20 January 2022  (previously circulated)

RESOLVED that the Minutes of the budget and ordinary meetings held on 20 January 2022 be signed as correct records.

The Chair referred to the national Social Care Day of Remembrance and Reflection on this day.

This marked a tribute or thank you to anyone working across social care including those in frontline care roles, managerial roles, administrative roles, maintenance roles, and more. The Chair referred to the exceptional work in Devon particularly in Care Homes and across health and social care in mitigating the impacts of the pandemic across the population in the County.  

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

No item was 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 Chief Executive (CX/22/01), attached

(Councillor J Hart attended in accordance with Standing Order 25 and spoke to this item and referred to the Council’s commitment with additional resources to strengthen the process)

The Committee considered the Report of the Chief Executive (CX/22/01) on the role of Scrutiny in implementing the recommendations of the January 2022 Race Equality Audit report.

The Audit’s objectives were to provide an honest assessment of how it felt for Black and Asian colleagues to work for Devon County Council, to challenge assumptions and advise on actions to ensure the County Council became a place where Black, Asian and other ethnically diverse staff felt safe, included and welcomed. The full report was available, together with an accompanying summary infographic, at https://www.devon.gov.uk/equality/performance-and-monitoring/raceaudit21.

The Report’s recommendations were set out under six themes:

•      Denial of Racism.

•      ‘Small Numbers’ Rhetoric.

•      “No Data” Excuse.

•      White Fragility in Leadership.

•      Lack of Sufficient and Consistent Leadership for Diversity and Inclusion.

•      Unwelcoming culture for Black and Asian People.

Members’ discussion points with the Chief Executive and Corporate Equality Officer included:

•      the national context and recent publication by Government of the Inclusive Britain strategy which set out actions to tackle racial disparities, boost opportunity and promote fairness;

•      areas of disparities across health and social care highlighted and exacerbated as a result of the pandemic;

•      the real life experience of the front line and other staff within the organisation,

•      the commitment of additional resources to address the issues highlighted in the Audit and the role of management, members and staff across the organisation;

•      mandatory training proposals for members and staff, to include member masterclasses;

•      work with health across the health and care system in Devon through the Integrated Care System; and

•      the importance of qualitative as well as quantitative data and information with regular review.       

Members noted the role of Scrutiny in holding those responsible across the  Council to account in implementing the recommendations in the Race Equality Audit report.

Report from NHS Devon Clinical Commissioning Group, attached

(Councillor I Hall declared a personal interest by virtue as a Member of the Royal Devon and Exeter Hospital Trust Governing Body).

The Committee considered the Report from NHS Devon Clinical Commissioning Group on the current status of planned care waiting lists in Devon, highlighted actions already underway and the longer term plans of how healthcare providers would  work together to continue to bring down waiting lists into the future, in light of the Government announcement in February. This followed the publication of the Department of Health’s published NHS Elective Recovery Plan which described how the NHS would tackle the backlog of care built up during the Covid 19 Pandemic.

The Report covered data on patient waiting lists, the challenges, aims for delivering elective recovery and solutions, support for patients on waiting lists; and funding. 

Members’ observations and discussion points with the Deputy Accountable Officer and the GP Clinical Lead (Planned Care), NHS Devon Clinical Commissioning Group included: 

·         operational pressures as a result of the increasing number of patients with COVID-19 in the wards, noting that the majority of these would have been admitted for other reasons and the protection of beds for elective care in the RD&E for example;

·         the longer term solutions and actions to address the backlog in planned elective care and it was anticipated that significant pressures could continue for a further 3 years;

·         the current schemes in place to address the backlogs including the Nightingale Hospital in Exeter, improved diagnostic capacity, digital access and Modular Theatres to cover more remote areas in the northern part of the County for example;

·         the current engagement exercise and formal consultation in due course (expected for early winter 2022)  with input from this Scrutiny Committee;

·         hospital consultants’ contracts which were agreed nationally and not by individual CCGs; and

·         impact on and consideration of work force welfare as a result of the  backlog (with 7 days/week services).

The Chair thanked the NHS Officers for their report and input and referred to the desire and commitment of the Committee to contribute and shape emerging plans to address the waiting lists across Devon. 

Joint report from NHS Devon Clinical Commissioning Group and Devon County Council Adult Care and Health, attached.

(Councillor J McInnes attended in accordance with SO 25 and spoke to this item in support of the principles of partnership approach through the ICS).  

The Committee considered a joint report from NHS Devon Clinical Commissioning Group and Devon County Council Adult Care and Health on the progress of the development of the Integrated Care System for Devon and Scrutiny involvement. The Report also highlighted work happening at place-level to create Local Care Partnerships within the system.

Members’ observations and discussion points with the Deputy Accountable Officer NHS Devon CCG and the Locality Director North and East Devon (Adult Care and Health) included:

·         an additional core purpose of the ICS was helping the NHS support broader social and economic development;

·         the Governance arrangements outlined in the Health and Care integration White Paper, including the Integrated Care Boards aligned with the Integrated Care Partnership committees, and five Local Care partnerships across the County and additionally the Mental Health Care Partnership;

·         the key role of the Local Care Partnerships to promote subsidiarity, the model for which was already established in Devon through the Integrated health and care teams;

·         the LCPs would be consistent with shared outcomes but with local tailoring; and

·         the important role Scrutiny in the Governance arrangements and involvement of local authorities within the Integrated Care System.   

The Committee would continue to engage with local health and care organisations, teams and partnerships to support the development of local care partnerships. 

Joint report from Devon County Council and NHS Devon Clinical Commissioning Group (ACH/22/146), attached

(Councillor McInnes attended in accordance with SO25 and spoke to this item in regard to the North devon Link Service and implementation of the plans which had been approved by Cabinet)

The Committee considered the Joint report from Devon County Council and NHS Devon Clinical Commissioning Group (ACH/22/146) on updates on the latest news from the Devon Health and Care system.

Discussion points by Members with the Locality Director – North and East; and Head of Adult Care Operations and Health included:

·         The Appreciative Inquiry report, the COVID-19 care homes outbreak, and the update on the North Devon Link Services;

·         the service would consult with local members on the implementation of the Link Service in northern Devon and in accordance with the plans approved by the Cabinet; 

·         grants for patients to support hospital charges (and which further information was requested in regard to actual numbers) which had been variably deployed by the Trusts; and

·         the impact of the covid outbreaks in care homes and the service was awaiting further government guidelines for homes before the end of the month.

The Chair thanked Officers for the report and requested that an update on the 111 Service be included for the next meeting. 

Report of the Chief Officer for Adult Care and Health, Devon County Council (ACH/22/145), attached

The Committee considered the Report of the Chief Officer for Adult Social Care in Devon for 2021. This covered introductions by the Chief Officer and Cabinet Member  and Chair of the Committee, adult social care reform and the role of the Annual report, the impact of the Pandemic in adult social care in Devon, the workforce, activity, cost and spend, performance and outcomes, safeguarding and quality and a summary and key points.

Discussion points with the Locality Director – North and East; and Head of Adult Care Operations and Health included:

·         the annual report provided a good summary of activity and was a good reference document for all members;

·         commendation of the work of Jennie Stephens (outgoinf Chief Officer for Adult Care and Health) and contribution to the Service over many years;

·         the new duty for the Care Quality Commission to independently review and assess local authority performance in delivering adult social care;

·         the importance of the care workforce and recruitment, retention and development of staff across the sector as a top priority through the  ‘Love Care Programme’ and ‘Proud to Care’ initiative;

·         the increase in recorded safeguarding activity as a result of the action to address the low rate of reported concerns and the changing nature of concerns relating to self-neglect;

·         reasons for the relatively high rates of turnover within the care sector relating to pay, career development and esteem, age profile and  competition generally across all sectors;  

·         work by the service to support individual providers where appropriate,   particularly in the current environment of increasing unit costs and difficult market pressures; and

·         generally the care Providers’ good standards and monitoring by the Service through the quality assurance and contract arrangements.        

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.

The Committee noted the current Work Programme subject to inclusion of topics arising from this meeting and the following topics

• inclusion of finance details/budget pressure information in the next report on the development of the Integrated Care System (ICS) for Devon, alongside invitation for attendance of its Chief Executive on this item; and
• Health assessments for Children in Care (issue to be discussed with Chair of Children’s Scrutiny).

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

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) NHS England delivery plan for tackling the backlog of elective care. The delivery plan is also available online - Coronavirus » Delivery plan for tackling the COVID-19 backlog of elective care (england.nhs.uk).

(b) NHS Devon CCG briefings concerning the ongoing vaccination programme.

(c) Briefing from the Devon CCG on ‘Procurement of Integrated Urgent Care services in Devon’.

(d) CQC report on Torbay Hospital. A summary is also available.

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

(a) NHS England delivery plan for tackling the backlog of elective care. The delivery plan is also available online - Coronavirus » Delivery plan for tackling the COVID-19 backlog of elective care (england.nhs.uk).

(b) NHS Devon CCG briefings concerning the ongoing vaccination programme.

(c) Briefing from the Devon CCG on ‘Procurement of Integrated Urgent Care services in Devon’.

(d) CQC report on Torbay Hospital. A summary is also available.