Agenda and minutes

Apologies for absence were received from Councillor Bill Welsh and his Substitute Councillor Webster; Councillor Marianne Welsh and her Substitute Councillor Killen; Councillor Cummins, Cabinet Member – Adult Social Care; and Councillor Moncur, Cabinet Member – Health and Wellbeing.

Members are requested at a meeting where a disclosable pecuniary interest or personal interest arises, which is not already included in their Register of Members' Interests, todeclare any interests that relate to an item on the agenda.

Where a Member discloses a Disclosable Pecuniary Interest, he/she must withdraw from the meeting room, including from the public gallery, during the whole consideration of any item of business in which he/she has an interest, except where he/she is permitted to remain as a result of a grant of a dispensation.

Where a Member discloses a personal interest he/she must seek advice from the Monitoring Officer or staff member representing the Monitoring Officer to determine whether the Member should withdraw from the meeting room, including from the public gallery, during the whole consideration of any item of business in which he/she has an interest or whether the Member can remain in the meeting or remain in the meeting and vote on the relevant decision.

No declarations of personal or pecuniary interest were received.

Introductions took place.

The Chair reported that Mr. Roger Hutchings, Healthwatch Sefton Co-opted Member, was absent from the meeting as his daughter had recently passed away.

RESOLVED:

That a sympathy card be forwarded to Mr. Hutchings, extending the condolences of the Committee on his sad loss.

Minutes of the meeting held on 27 February and the Special meetings held on 22 March and 3 April 2018.

RESOLVED:

That the Minutes of the meeting held on 27 February and the Special meetings held on 22 March and 3 April 2018 be confirmed as a correct record.

Joint Report of the Sefton Clinical Commissioning Groups and NHS England (Cheshire and Merseyside).

Further to Minute No. 55 (2) of 3 April 2018, Fiona Taylor, Chief Officer for NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group; and Anthony Leo, Director of Commissioning; NHS England (Cheshire and Merseyside), will be in attendance at the meeting to present the report to the Committee and respond to questions put by Members.

Further to Minute No. 55 (2) of 3 April 2018, the Committee considered the joint report on Primary Care in Sefton, submitted by the Sefton Clinical Commissioning Groups and NHS England (Cheshire and Merseyside), describing the National and Local landscape for primary medical care across NHS South Sefton and NHS Southport and Formby Clinical Commissioning Groups (CCGs).

The report set out the background to the matter; the national summary that included five key areas for support, namely investment, workforce, workload, practice infrastructure, and care re-design; and the local summary for both NHS Southport and Formby CCG and NHS South Sefton CCG.

The Committee also considered a presentation submitted by NHS Southport and Formby CCG and NHS South Sefton CCG.

The presentation provided a General Practice update that included the following information:-

·         Local Context 2018/19;

·         Delegated commissioning;

·         Contracting for primary care;

·         Local Quality Contract (LQC);

·         An overview of NHS South Sefton CCG;

·         An overview of NHS Southport and Formby CCG;

·         General Practice Forward View (GPFV);

·         GPFV Progress to date;

·         Enhanced Access – GPFV;

·         Primary care work-streams;

·         Southport and Formby workforce;

·         South Sefton workforce;

·         Care Quality Commission (CQC) visits - Southport and Formby;

·         CQC visits - South Sefton;

·         Patient survey results to July 2017 - Southport and Formby;

·         Patient survey results to July 2017 - South Sefton;

·         Challenges;

·         Role of General Practice;

·         Aims;

·         Strategy;

·         How will we get there?;

·         Integrated care; and

·         Targeted care.

Fiona Taylor, Chief Officer for NHS South Sefton CCG and NHS Southport and Formby CCG; Anthony Leo, Director of Commissioning; NHS England (Cheshire and Merseyside); and Dr. Rob Cauldwell, Chair of NHS Southport and Formby CCG; were in attendance at the meeting to present the report and presentation to the Committee and respond to questions put by Members.

Fiona Taylor explained aspects of the presentation that was included within the Committee agenda.

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

·         How could sufficient numbers of GPs be attracted from overseas to work in the NHS?

Some 5,000 additional doctors would be required to work in general practice by 2020 and there were issues around international recruitment. Lobbying of relevant Government Departments was currently taking place concerning the decision to refuse doctors whose first language was not English.

·         Where was the detail on the Enhanced Access Service, with regard to the General Practice Forward View (GPFV)?

This was in the process of procurement. Patients would have access to primary care services delivered from a primary care hub in each CCG area. Services were anticipated to be provided up to 8.00 p.m./8.30 p.m. on week days, plus weekend access, although there would be some flexibility permitted by the Provider regarding precise details.

·         Would consultation on Enhanced Access Service take place beforehand?

Engagement was key although a Provider was required to be procured first in order to carry it out.

·         Was the delivery of an Enhanced Access Service dictated by national directive?

Attempts were being made to take national policy and shape it for Sefton requirements. Feedback would  ...  view the full minutes text for item 5.

Report of the Head of Health and Wellbeing.

Prior to consideration of the attached report, a short video on the latest Public Health Annual Report will be shown to the Committee.

The Committee considered the report of the Head of Health and Wellbeing on the Annual Report of the Director of Health and Wellbeing 2017/18 that was a statutory requirement and identified key issues affecting health in the Sefton population. This year’s annual report had been produced as a short film that explored the emotional wellbeing and mental health of children and young people, together with the services and resources available to support them.

Prior to consideration of the report, a short video presenting the latest Public Health Annual Report (PHAR) was shown to the Committee, which was entitled “Growing Up Healthy and Happy”. The film explored the emotional wellbeing and mental health of children and young people and the services and resources which were available to support them. The film recognised the importance of building resilience, promoting good mental health and wellbeing and enabling children and young people to grow up happy and healthy. The PHAR also covered key facts and figures and highlighted a number of recommendations for implementation during 2018/19.

Following the meeting of the Council on 19 July 2018, the video would be available for viewing via the Council’s web-site and would be widely disseminated.

Matthew Ashton, Head of Health and Wellbeing was in attendance at the meeting to present the PHAR and respond to questions put by Members of the Committee.

Hard copies of the PHAR were circulated at the meeting.

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

·         Were mental health first aiders being introduced in schools and colleges?

Yes. An on-line app was being developed to assist in this area. On-line counselling was also being considered.

·         Reference was made to a project being undertaken by the Merseyside Police and Crime Commissioner on children with a parent in prison.

RESOLVED:

That the Public Health Annual Report be received and its contents be noted.

With the agreement of the Committee, Matthew Ashton, Head of Health and Wellbeing, reported on the above matter that would set out the principles for a proposed joint Public Health Service between Sefton and Knowsley Councils. Matthew Ashton had undertaken a joint role as Director of Public Health with both Councils since February 2016 and work was being undertaken to explore the possibility of providing a Public Health Service on a wider footprint in order to maximise resources available to both Councils and provide a more efficient service for users.

A period of consultation on the proposals was anticipated to commence during August 2018 and detailed proposals would be presented to Members during September 2018.

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

·         What consultation would take place?

Consultation would take place with staff, trade unions and key stakeholders, including the Clinical Commissioning Groups. Agile working was likely to be implemented for staff.

·         Would the proposals involve a change of employer for staff?

Staff would remain with their current employer and on their existing terms and conditions.

·         Would services, such as the substance misuse service be re-contracted?

Existing provision and contracts would remain in place for the duration of their provision. Consideration could be given to combining individual services, such as the smoking cessation service, in order to simplify systems.

RESOLVED:

That the information provided on the proposed joint Public Health Service between Sefton and Knowsley Councils be noted and the matter be considered further at the next meeting of the Committee.

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

Further to Minute No. 48 (2) of 27 February 2018, Martin McDowell, the Deputy Chief Officer and Chief Finance Officer of NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group (CCG) will be in attendance at the meeting to present the report to the Committee and respond to questions put by Members.

Further to Minute No. 48 (2) of 27 February 2018, the Committee considered the joint report/presentation submitted by NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group (CCG), providing a financial update.

The presentation outlined the following:-

·         NHS Southport and Formby CCG – Financial spend 2017/18;

·         NHS Southport and Formby CCG – Financial performance 2013/14 -  2017/18;

·         NHS South Sefton CCG – Financial spend 2017/18;

·         NHS South Sefton CCG – Financial performance 2013/14 -  2017/18;

·         Health care spending by age group;

·         2018/19 allocations: Merseyside and West Lancashire CCGs – Financial Allocation, Target and Distance from Target;

·         Shaping Sefton;

·         Vision: 5 year strategy;

·         Triple aim triangle;

·         Challenges facing CCGs.

Martin McDowell, the Deputy Chief Officer and Chief Finance Officer of NHS South Sefton CCG and NHS Southport and Formby CCG was in attendance at the meeting to make the presentation to the Committee; to explain aspects of it; and to respond to questions put by Members.

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

·         With regard to the total spend for acute services, how much was provided by the independent sector?

About 2% of acute services for South Sefton CCG and 3% for Southport and Formby CCG was provided by the independent sector, procedures for eye care being the main service provided by this sector.

·         Reference was made to the demographics within Sefton.

The financial allocations received by both CCGs per head of population did not necessarily reflect the high level of frail older populations who tended to acquire multiple and chronic conditions and there was a need for the CCGs to target resources.

·         Was the Council’s Local Plan, together with future plans for additional housing taken into account for financial allocations?

The Council’s Local Plan and communication with the Council’s Planning function was taken into account although the increased population forecast for Sefton was relatively low at present. Planning documents were also publicly available via the Council’s web-site. Financial resources were considered to be challenging for the CCGs, even before taking into account any increased population forecast.

Challenges for the CCGs also included the proportionately high use of emergency care across Merseyside and the need to start shifting this use towards primary care provision.

RESOLVED:

That the Finance Update submitted by the Sefton Clinical Commissioning Groups be noted.

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:-

·         Sefton Health and Care Partnership;

·         Medicines management scheme “highly commended”;

·         Children’s audiology services in north Sefton;

·         CCG staff vote Sefton Council for Voluntary Service NHS 70 community partner of the year;

·         CCG governing body membership;

·         “Annual review meets Big Chat” events; and

·         Next governing body meetings.

Fiona Taylor, Chief Officer for NHS South Sefton CCG and NHS Southport and Formby CCG, was in attendance from the CCGs to present the update report to the Committee.

RESOLVED:

That the joint update report submitted by the Clinical Commissioning Groups be received.

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 CCG and NHS Southport and Formby CCG, was in attendance to present the data.

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 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:-

·         Delayed Transfers of Care (DToC);

·         Domiciliary Care Contracts;

·         Sefton New Directions – James Dixon Court;

·         Transfer of Care Connect Domiciliary Support into Sefton New Directions;

·         Extra Care Housing;

·         Consultation Plans on Direct Payments; and

·         National Autistic Society – Sefton Parent Carer Group Launch.

Councillor Cummins, Cabinet Member – Adult Social Care, had submitted his apologies for the meeting.

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

·         Well Sefton;

·         Living Well Sefton;

·         Public Health Annual Report;

·         Health Checks;

·         Public Health Performance;

·         Healthy Life Expectancy (males);

·         Smoking at Time of Delivery;

·         Obesity in Reception and Year 6;

·         Successful Completion of Drug Treatment;

·         Excess Winter Mortality;

·         Domestic Abuse Campaign; and

·         Suicide.

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

RESOLVED:

That the update reports from the Cabinet Member – Adult Social Care, and 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 the draft Work Programme for 2018/19; requesting the identification of potential topics for scrutiny reviews to be undertaken by any Working Group(s) appointed by the Committee; and identification of any items for pre-scrutiny scrutiny by the Committee from the Key Decision Forward Plan.

A Work Programme for 2018/19 was set out in Appendix A to the report, to be considered, along with any additional items to be included and agreed. The Director of Social Care and Health reported that the item on the “Green Paper on Care and Support for Older People and Long Term Funding” had been delayed and would be submitted to the Committee at its meeting to be held on either 16 October 2018 or 8 January 2019.

The Committee was invited to consider any potential scrutiny review topics, including issues arising as a result of consideration of Agenda Item 4 above; to establish a Working Group for the topic; and appoint at least 3 Members of the Committee to each Working Group. Further to Minute No. 5 above, the Senior Democratic Services Officer suggested that the Committee might wish to defer consideration of a Working Group, to be re-considered at a future meeting.

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

Progress to date by the Joint Health Scrutiny Committee for Cheshire and Merseyside (Orthopaedic Services) was set out within the report, together with the Sefton Member representatives on the Joint Committee for 2018/19.

The Chair reported that both she and the Vice-Chair had met recently with Silas Nichols, the recently appointed Chief Executive for Southport and Ormskirk Hospital NHS Trust and that it was anticipated that he would attend the next meeting of the Committee.

The Chair also reported on processes undertaken recently with regard to consideration of draft Quality Accounts for 2017/18.

RESOLVED: That

(1)       the Work Programme for 2018/19, as set out in Appendix A to the report, be agreed, subject to the item on the “Green Paper on Care and Support for Older People and Long Term Funding” being deferred to the meeting of the Committee to be held on either 16 October 2018 or 8 January 2019;

(2)       the appointment of any new Working Group(s) during 2018/19 be deferred to a future meeting of the Committee;

(3)       the contents of the Key Decision Forward Plan for the period 1 July to 31 October 2018 be noted,

(4)       the progress of the Joint Health Scrutiny Committee for Cheshire and Merseyside (Orthopaedic Services), together with the Members representatives for 2018/19, be noted;

(5)       the intention for the recently appointed Chief Executive of Southport and Ormskirk Hospital NHS Trust to attend the next meeting of the Committee, be noted; and

(6)       the information provided in relation to processes undertaken  ...  view the full minutes text for item 12.