Agenda and minutes

An apology for absence was received from Councillor Moncur, Cabinet Member – Health and Wellbeing.

The Chair welcomed Councillor Pugh as a Member of the Committee.

Members are requested to give notice of any disclosable pecuniary interest, which is not already included in their Register of Members' Interests and the nature of that interest, relating to any item on the agenda in accordance with the Members Code of Conduct, before leaving the meeting room during the discussion on that particular item.

No declarations of interest were made.

Minutes of the Joint Meeting of the Overview and Scrutiny Committee (Adult Social Care and Health) and the Overview and Scrutiny Committee (Children’s Services and Safeguarding) held on 12 October 2017.

Minutes of the meeting held on 17 October 2017.

RESOLVED:

That the Minutes of the Joint Meeting of the Overview and Scrutiny Committee (Adult Social Care and Health) and the Overview and Scrutiny Committee (Children’s Services and Safeguarding) held on 12 October 2017 and the Minutes of the meeting held on 17 October 2017, be confirmed as a correct record.

Joint report of NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group.

The Committee considered the joint update report of the NHS South Sefton Clinical Commissioning Group and the NHS Southport and Formby Clinical Commissioning Group (CCG) providing an update about the work of the CCGs. The report outlined details of the following:-

·         Encouraging Sefton residents to examine their options;

·         Take control and self-care for life;

·         Community services update;

·         Update on Southport and Formby’s children’s community audiology service; and

·         Date change for New Year governing body meetings.

Fiona Taylor, Chief Officer for NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group, was present from the CCGs to present the update report to the Committee.

Members of the Committee asked questions/raised matters on the following issues:-

·         Seasonal Flu Campaign – the staff vaccination programme had been delivered across Hospital Trusts, the Clinical Commissioning Groups and the Local Authority within the Borough. It had been widened to include staff working within care homes and to include targeted groups, including pregnant women. The Council’s Public Health function would be requested to share statistics available with Committee Members.

·         Concerns regarding healthcare at HMP Liverpool in Walton - Lancashire Community NHS Foundation Trust had given notice to cease provision of healthcare services at the prison from 1 April 2018. NHS England was the commissioner for healthcare at prisons.

·         Lancashire Community NHS Foundation Trust had been identified as a possible Trust to scrutinise when Quality Accounts were considered by the Committee during 2018.

RESOLVED: That

(1)       the joint update report by the Sefton Clinical Commissioning Groups be received; and

(2)       the Chief Officer for NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group be requested to liaise with the Council’s Head of Health and Wellbeing, in order to supply statistics for the seasonal flu campaign vaccination uptake to Members of the Committee.

Joint report of NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group.

The Committee considered the joint report of NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group (CCG), providing data on key performance areas and the Friends and Family Test for both Southport and Ormskirk Hospital NHS Trust and Aintree University Hospital NHS Foundation Trust.

Fiona Taylor, Chief Officer for NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group (CCG), was in attendance to present the data, highlight key aspects of performance, and respond to queries from Members of the Committee.

Members of the Committee asked questions/raised matters on the following issues:-

·         A comparison of the clostridium difficile (C.diff) cases between the 2 Trusts – A number of variables could impact on cases and it was important for Trusts to learn good practice from each other.

·         A comparison of the A&E response in the Friends and Family Test between the 2 Trusts – There was a need for Trusts to ensure the systems for data collection were user-friendly for the public and Trusts could possibly learn good practice from each other.

·         Performance levels for Ambulance Category A (Red 1) 8 minute response time – The figures provided reflected the position as at July 2017 and key performance indictors did not necessarily accurately reflect performance, particularly as performance standards for the North West Ambulance Service (NWAS) had changed recently. NWAS had been identified as a possible Trust to scrutinise when Quality Accounts were considered by the Committee during 2018.

·         Recent waiting experiences of several hours at A&E – Aintree NHS Foundation Trust had increased its bed capacity in order to deal with the high demand of winter pressures. Due to the size of its estate, Southport and Ormskirk Hospital NHS Trust experienced more difficulties in dealing with additional demand for beds. All NHS staff were doing their best to cope with the high demand.

·         Reference was made to recent media coverage of the winter pressures within the NHS and of ambulances queuing at A&E. What statistics were available to reflect current A&E waiting times? – Commissioners received daily updates providing data and statistics. The most recent data available showed significant pressures on the waiting time target and ambulance turnaround times.

·         Experience of poor advice/sign posting of a patient to A&E during the busy Christmas/New Year period – Good advice and sign posting for patients was important, particularly during the winter pressures experienced by the NHS. Locally, the NHS continued to promote “Examine Your Options”.

RESOLVED:

That the information on Health Provider Performance be noted.

Report of the Head of Regulation and Compliance

The Committee considered the report of the Head of Regulation and Compliance formally presenting the final report of the Residential and Care Homes Working Group.

The Committee had established the Working Group at its meeting on 28 June 2016 and the Final Report of the Working Group was attached to the report.

Terms of reference for the Working Group had been as follows:-

• Current and future population needs, demand and market supply;
• The Council’s “market shaping” duties;
• Key risks within the market in relation to meeting the needs of all people in Sefton who need care and support (whether arranged or funded by the state, by the individuals themselves, or in other ways); and
• Recommendations to shape Sefton’s approach to commissioning services and shaping the local market in the future.

There were no financial implications arising for the Council as a direct result of the report. However, if consideration was being given to the gross payment of Providers, as opposed to net of Service User financial contributions for care placements, then the financial implications of doing so would need to be considered as it would potentially increase the risk of bad debts to the Council.

Councillor Linda Cluskey, Lead Member of the Working Group, presented the Working Group’s Final Report to the Committee and thanked the other Members of the Working Group and appropriate officers. Tribute was paid to Councillor Cluskey for her role in continuing to lead the Working Group under difficult personal circumstances.

Members of the Committee asked questions/raised matters on the following issues:-

·         Inspection of residential and care homes - Reference was made to the fact that Members of the Council used to visit residential and care homes as part of their role some years previously and that this role should be revived. – Members had been requested to make visits to inspect Council-run homes in the past. The Council no longer operated any such homes and it did not have the powers to permit elected Members to visit private homes in an inspection capacity. The Care Quality Commission’s role was to monitor, inspect and regulate care homes. Healthwatch had “Enter and View” powers and could undertake unannounced visits to residential and care homes, if considered necessary. A small number of officers within the Council’s Commissioning Support and Business Intelligence Department undertook visits to homes and any concerns could be raised with them.

·         The social care system was struggling to cope with demands, not just in terms of insufficient finances, and greater integration was required.

The Cabinet Member – Adult Social Care thanked Working Group Members for the work undertaken and referred to the challenges facing the care sector, together with joint working initiatives being undertaken across the City Region to address some of the issues concerned.

The Chief Officer for NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group (CCG), was pleased that the Working Group had acknowledged the on-going joint working between the CCGs and the Council, particularly with respect  ...  view the full minutes text for item 37.

Report of the Head of Regulation and Compliance.

The Committee considered the report of the Head of Regulation and Compliance submitting the most recent Update Reports from the Cabinet Member – Adult Social Care, and the Cabinet Member – Health and Wellbeing, whose portfolios fell within the remit of this Committee.

The Cabinet Member Update Report - Adult Social Care, outlined information on the following:-

·         Financial Update;

·         Personalisation / Personal Budgets;

·         Extra Care Housing;

·         Delayed Transfer of Care; and

·         Domiciliary Care.

Councillor Cummins, Cabinet Member – Adult Social Care, was in attendance at the meeting to present his Update Report and highlight particular aspects of it.

The Cabinet Member Update Report – Health and Wellbeing outlined developments on the following aspects of Public Health:-

·         Public Health Service Plan;

·         Public Health Annual Report (PHAR);

·         0-19 Integrated Healthy Child Service;

·         Healthy Living Pharmacies;

·         Health Checks;

·         Health Protection Forum;

·         Seasonal Flu Campaign;

·         Know Your Numbers (Blood Pressure Awareness);

·         Suicide Update;

·         Drug Related Deaths: Injecting Drug Use, Treatment And Recovery; and

·         Improving Resilience to Debt – Central Southport.

The Cabinet Member Update Report – Health and Wellbeing also outlined developments on the following aspects of Parks and Greenspaces:-

·         World Parks Congress;

·         CPOs continue to support volunteering and Friends Groups up and down the Borough;

·         Sporting Lights;

·         Community self-management/Market testing of empty buildings;

·         Community Hubs;

·         Benchmarking/ Awards:

o   Green Flag Award;

o   Green Flag Community Award;

o   Britain in Bloom;

·         Community / Partnerships:

o   Santander;

o   Pinfold Woodland;

o   Killen Green Park; and

o   Hesketh Park.

Councillor Moncur, Cabinet Member – Health and Wellbeing, had submitted his apologies for the meeting.

Members of the Committee asked questions/raised matters on the following issue:-

·         Seasonal Flu Campaign – was it still worth having the vaccination at this time of year? – Yes, the prevalence of the influenza virus at this time of year still made vaccination worthwhile now.

The Chair requested any queries or issues on the Cabinet Member Update Report – Health and Wellbeing to be directed to Councillor Moncur via the Senior Democratic Services Officer.

RESOLVED:

That the update reports from the Cabinet Member – Adult Social Care and also the Cabinet Member – Health and Wellbeing be noted.

Report of the Head of Regulation and Compliance.

The Committee considered the report of the Head of Regulation and Compliance seeking the views of the Committee on its Work Programme for the remainder of 2017/18; noting the progress to date by the Working Group established; noting the progress to date by the Joint Health Scrutiny Committee for Cheshire and Merseyside (Orthopaedic Services); and identification of any items for pre-scrutiny scrutiny by the Committee from the Key Decision Forward Plan.

A Work Programme for 2017/18 was set out at Appendix A to the report, to be considered, along with any additional items to be included and agreed.

It was reported that representatives of Aintree University Hospital Foundation Trust had been requested to attend the next meeting of the Committee and it was hoped that they would attend. Additionally, a new Chief Executive had been appointed at Southport and Ormskirk Hospital Trust and was anticipated to be in post by spring 2018. He would be requested to attend a meeting of the Committee once he took up his post.

Further to Minute No. 37 above, the Residential and Care Homes Working Group had now been completed.

Further to Minute No. 30 (4) of 17 October 2017, NHS England and Public Health England were now undertaking a review on dentistry and in view of this review, it was preferable to defer consideration of this topic, until such time as the outcome of the review was completed.

It was reported that the topic of DNAs (Did Not Attend) in terms of missed appointments at GP surgeries could be considered as a possible topic for review during 2018/19, possibly to include general complaints and with a view to sharing best practice.

The first meeting of the Joint Health Scrutiny Committee for Cheshire and Merseyside (Orthopaedic Services) had taken place during June 2017 and site visits at both Broadgreen and Aintree Hospitals had been held since.

There were four Key Decisions within the latest Key Decision Forward Plan, attached to the report at Appendix B that fell under this Committee’s remit, and the Committee was invited to consider items for pre-scrutiny.

Further to Minute No. 4 (b) of the Joint Meeting of the Overview and Scrutiny Committee (Adult Social Care and Health) and the Overview and Scrutiny Committee (Children’s Services and Safeguarding) held on 12 October 2017, it was reported that representatives of the Liverpool Clinical Commissioning Group had now requested deferral of the final decision of substantial reconfiguration, in relation to the review of services provided by Liverpool Women’s NHS Foundation Trust, until the meeting of Sefton Council scheduled for 19 April 2018.

The report also sought views on the process to be undertaken for the scrutiny of a number of draft Quality Accounts from NHS Trusts during May 2018. The report set out the process adopted during 2017 and suggested following the same procedure in 2018.

It was reported that the Committee could consider draft Quality Accounts from Mersey Care NHS Foundation Trust, insofar as the Trust provided community health services in  ...  view the full minutes text for item 39.