Agenda and minutes

Apologies for absence were received from Councillor Cluskey; Diane Blair, Healthwatch; 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.

In accordance with Paragraph 9 of the Council’s Code of Conduct, the following declaration of personal interest was made and the Member remained in the room during the consideration of the item:

Minutes of the meeting held on 18 October 2022

RESOLVED:

That the Minutes of the meeting held on 18 October 2022, be confirmed as a correct record.

Anne-Marie Stretch, Managing Director, and Lesley Neary, Chief Operating Officer, Southport and Ormskirk Hospital NHS Trust, to attend to provide a presentation

Anne-Marie Stretch, Managing Director, Southport and Ormskirk Hospital NHS Trust, attended to give a presentation that outlined information on the following:

·       Winter pressures:

o   Winter Plan and Winter performance

·       Financial pressures

·       Progress against delivering the agreement for long term collaboration (ALTC - Southport & Ormskirk Hospitals NHS Trust and St Helens & Knowsley Teaching Hospitals NHS Trust), including:

o   Additional funding secured during ALTC

o   Progress on fragile services

·       Progress on improvements since CQC unannounced inspection March 2021:

o   Key Findings

o   Focus of Improvement

·       Progress on Shaping Care Together

·       Early findings on new arrangements for hyper acute stroke service with Aintree

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

·       Current demand for treatment at the Trust and admission rates.

·       Re-admission rates.

·       Financial pressures.

·       The possibility of potential industrial action.

·       Hyper acute stroke services and the impact of journey times for ambulances travelling to Aintree Hospital.

·       The underlying deficit for the Trust.

·       Capital investment on the estate.

·       The future of Maternity and Paediatric Services.

·       The future of children’s A&E.

·       Treatment of hyper acute strokes within 4 hours.

·       Stroke service provision by the Trust and clinical cover provided at Southport Hospital. Additional information could be obtained.

·       Financial deficits carried by the NHS Trusts involved in the long-term collaboration.

RESOLVED: That

(1)      Anne-Marie Stretch, Managing Director, be thanked for her attendance;

(2)      the presentation be noted; and

(3)      the Managing Director be requested to provide additional information on stroke service provision and clinical cover provided at Southport Hospital, in due course.

Report and presentation submitted by the North West Specialised Commissioning Team – NHS England

Andrea Doherty, Head of North West Women and Children’s Transformation, North West Acute Strategy & Transformation (Specialised Commissioning), NHS England, attended the meeting to present a report on the Proposed Cheshire & Merseyside Paediatric Radiotherapy Service Transfer. Ms. Doherty also gave a presentation that outlined the following:

·       Radiotherapy

·       Background Information and Current Service Challenges

·       Planned Future Service Arrangements

·       Limiting the potential impact for patients and their families

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

• The situation faced by families when treatment continued for some time.
• Recruitment of anesthetists for general anesthetics.
• The journey home following treatment.
• Future monitoring of clinical cases.
• Numbers of children affected by the proposed transfer.
• The clinical case for change.
• Assurances were sought that the proposals did not represent a substantial variation.
• The possibility of providing feedback on the impact of travel, once the clinical pathway had been completed. Further information could be provided in due course.

RESOLVED: That

(1)      Andrea Doherty be thanked for her attendance;

(2)      the report and presentation be noted and it be agreed that the proposals for Paediatric Radiotherapy Services for Cheshire and Merseyside do not represent a substantial variation and that the approach taken to engage with patients to inform the proposal is commensurate with the scale of the proposed change; and

(3)      NHS England be requested to provide further feedback on the impact of travel in due course, once the clinical pathway has been completed.

Joint Report of the Director of Public Health and the Executive Director of Adult Social Care and the Sefton Place Director, NHS Cheshire and Merseyside

The Committee considered the joint report of the Director of Public Health and the Executive Director of Adult Social Care and the Sefton Place Director, NHS Cheshire and Merseyside, that sought to provide an update on current cost of living interventions across Sefton and assurance on the actions being taken to mitigate risks to the health and wellbeing of residents. The report set out information on at risk groups in Sefton; the impact on services and emerging issues; and the response by the Council. The report concluded that the scale of the cost-of-living crisis was unprecedented and the response was being delivered across the Council, voluntary sector and NHS partners, and aimed to maximise people’s income, together with mitigating the multiple increasing risks to health and wellbeing.

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

• Any measures taken to mitigate risks to lower paid staff within the local authority and NHS, to prevent them from falling into poverty.
• Any trade union representation on the Cost-of-Living Reference Group.
• The balance between the costs associated with certain leisure facilities, such as swimming pools, and their connection with well-being.
• Any figures available for increases to costs associated with swimming pools and other high maintenance leisure facilities. Figures could be requested.
• Any monitoring of pay and pensions associated with the care sector. Information could be obtained.
• Ensuring any employer contributions were met when contracts were commissioned. Information could be obtained.
• Tracking of increases in respiratory conditions, as a result of inadequate housing conditions. Information could be obtained.
• Tracking of dentistry usage.
• Work undertaken by the Affordable Warmth Team in liaising with fuel providers.
• Venues for Warm Spaces and how this is communicated to the wider public. Additional information could be obtained.

RESOLVED: That

(1)      the contents of the report be received and noted; and

(2)      the Director of Public Health and the Executive Director of Adult Social Care and the Sefton Place Director, NHS Cheshire and Merseyside, be requested to provide additional information to the Senior Democratic Services Officer for circulation to Members of the Committee on:

• increases to costs associated with swimming pools and other high maintenance leisure facilities;
• monitoring of pay and pensions associated with the care sector;
• payment of any employer contributions when contracts are commissioned;
• increases in respiratory conditions, as a result of inadequate housing conditions; and
• how venues for Warm Spaces are communicated to the wider public.

Report of the Executive Director of Adult Social Care and Health

The Committee considered the report of the Executive Director of Adult Social Care and Health that provided an overview of the activity to plan additional services and prepare for Winter 2022/23 and the expected increased demand and challenge to service delivery this may bring. The report indicated that there had been a delay in allocating additional monies to Health and Social Care which had led to a delay in developing new services and bolstering existing ones. The report set out the background to the matter; the Sefton winter planning process; the Sefton place winter plan, intelligence and impacts; oversight and risk oversight undertaken by the Cheshire and Merseyside Integrated Care Board; how the Winter Plan was funded; together with next steps to be taken regarding priorities and investments.

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

• Whether the implementation of the Winter Plan was achieving a positive impact on patient flow.
• Any difficulties associated with delays in funding.
• Workforce planning, particularly associated with carers and their training and pension contributions.

RESOLVED:

That the information contained within the report be received and noted.

Report of the Executive Director of Adult Social Care and Health and the Sefton Place Director, NHS Cheshire and Merseyside

The Committee considered the report of the Director of Public Health that presented the findings of the recent Local Government Association (LGA) Peer Review into Adult Social Care in Sefton. For assurance, it also provided details of the actions being taken following the review.

The report set out the background to the matter, indicating that the Executive Director of Adult Social Care, with the approval from the relevant Cabinet Member and Chief Executive, invited the LGA to complete a review of the service ahead of the arrival of the Care Quality Commission’s assurance inspections which could be as early as 2023.

The Peer Review was conducted in July 2022 by colleagues from the LGA, Northwest Association of Directors of Adult Social Services (NW ADASS) with senior officers from other participating local authorities. The Peer Review team was led by the Director of Adult Social Services from Leeds City Council and consisted of colleagues from Lancashire, Leeds, Tameside, Waltham Forest, and Wigan Councils. Representatives from the LGA also formed part of the challenge team, The Peer Review mirrored the scope of the new assurance approach which would be implemented by the Care Quality Commission into all Councils with Adult Social Care responsibilities.

Following the review, a detailed improvement plan had been developed to address the areas identified for strengthening by the Peer Review Team and this was detailed within Appendix 1 of the report. It was proposed that progress against the plan should be provided to Committee on a regular basis, with ongoing monitoring being undertaken by the Cabinet Member - Adult Social Care and the Executive Director of Adult Social Care and Health.

The report set out the background to the matter; the local context; an overview of the review; findings from the review; and action taken post-review.

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

• Challenges associated with a lack of carers.
• The political leadership of Adult Social Care.
• Frequency of reporting progress to the Committee.

RESOLVED: That

(1)      the content of the report and the full LGA Peer Review be noted;

(2)      the improvement plan and feedback provided be noted;

(3)      the proposal for on-going monitoring of the plan through this Committee, the Cabinet Member - Adult Social Care and the Executive Director of Adult Social Care and Health, be confirmed; and

(4)      updates to the Committee on progress within the improvement plan, to enable robust assurance on progress, be provided as and when deemed necessary.

Report of NHS Cheshire and Merseyside (Sefton)

The Committee considered the report of NHS Cheshire and Merseyside (Sefton) that presented the findings of the GP General Access engagement that had been carried out to gather feedback from residents on their GP practice. The findings outlined the following:

·       Introduction and background

·       Demographic profiling

·       Experiences of accessing the GP practice during the pandemic

·       Experiences of being triaged

·       Experiences of appointments during the pandemic

·       Experiences of using the GP practice website

·       Summary of findings

·       Next steps

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

• The way the data was presented within the survey for accessing GP practices by telephone.
• Different approaches taken by different receptionists.
• Patient care for different conditions.
• How the data contained within the survey had been obtained.
• Advice for patients struggling to access a GP.
• Concerns that opportunities for early diagnosis of conditions were being missed.

RESOLVED:

That the report be noted.

Report of the Sefton Place Director, NHS Cheshire and Merseyside

The Committee considered the report of the Sefton Place Director, NHS Cheshire and Merseyside, that provided an update about the work of NHS Cheshire and Merseyside, Sefton. The report outlined details of the following:

·       An update from Primary Care 24

·       Residents reminded about enhanced access service

·       Keeping warm and well in the cold weather

·       Winter planning

·       Advice on Strep A in children

·       HSJ Partnership Awards 2023 Shortlist Announcement

·       New Sefton Partnership website

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

• Congratulations were extended to the team short-listed for an award.
• The re-opening of GP practices in Seaforth and Netherton was welcomed.
• An apparent lack of liquid form antibiotics for children with streptococcus A infections.

RESOLVED:That

(1)      the update report submitted by the Sefton Place Director, NHS Cheshire and Merseyside (Sefton) be received; and

(2)      the congratulations of the Committee be extended to the High Intensity Use (HIU) of Services team for being shortlisted at the HSJ Partnership Awards 2023.

Report of the Sefton Place Director, NHS Cheshire and Merseyside

The Committee considered the report of the Sefton Place Director, NHS Cheshire and Merseyside, that provided data on key performance areas for North and South Sefton, together with responses for the Friends and Family Test for both Southport and Ormskirk Hospital NHS Trust and Liverpool University Hospital NHS Foundation Trust (LUHFT). Information on the monitoring of the7-day GP extended access scheme, and ambulance response times were also included within the data.

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

·       Ambulance response times.

RESOLVED:

That the information on Health Provider Performance be noted.

Report of the Chief Legal and Democratic Officer

The Committee considered the report of the Chief Legal and Democratic Officer 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 the Committee.

The Cabinet Member update report – Adult Social Care, attached to the report at Appendix A, outlined information on the following:

• Update on the National Assurance Update for Adult Social Care
• Integration and National Policy Update:

o   Sefton Partnership Maturity

o   New Sefton Partnership Website

·       Life Course Commissioning:

o   Domiciliary Care

o   Day Opportunities

o   Care Homes

o   Winter Planning

o   Charging Reform

·       Adult Social Care Budget

·       Adult Social Care Complaints, Compliments and MP Enquiries

·       Principal Social Worker Update (PSW)

·       Performance and Key Areas of focus:

o   Admission into Care and Reablement

o   Self-directed support and direct payments

o   Employment

o   Housing

o   Safeguarding

·       Service User Engagement

·       Learning and Development

The Cabinet Member update report – Health and Wellbeing, attached to the report at Appendix B, outlined information on the following:

Public Health:

• Public Health Risk Register
• Suicide Audit
• Flu and Respiratory Update
• Public Health Outcomes Framework

Leisure Update:

·       Leisure Development

·       Sefton Active Summer Holiday Programme

·       Procure and Replacement Leisure Management System

·       Essential Leisure Facility Repairs and Improvements

RESOLVED:

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

Report of the Chief Legal and Democratic Officer

The Committee considered the report of the Chief Legal and Democratic Officer that sought to: review the Committee’s Work Programme for the remainder of the Municipal Year 2022/23;note that there were no items for pre-scrutiny by the Committee from the latest Key Decision Forward Plan;report on progress of informal briefing sessions for Committee Members held during 2022/23 to date and indicate if there were any further briefing sessions that Members would wish to be arranged;agree the recommendations made at the informal workshop session for Committee Members on health inequalities;receive an update on the Liverpool City Region Combined Authority Overview and Scrutiny Committee;receive an update on the Joint Cheshire and Merseyside Scrutiny Committee, established to scrutinise the work of the Cheshire and Merseyside Integrated Care Board;consider the process to be undertaken during 2023 regarding draft Quality Accounts; andreceive an update by Healthwatch Sefton.

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

• Thanks were extended to Margaret Jones, Director of Public Health, for providing the informal workshop session for Committee Members on health inequalities.

RESOLVED: That

(1)      the Work Programme for 2022/23, as set out in Appendix A to the report, be noted, along with any additional items to be included and thereon be agreed;

(2)      the fact that there are no items for pre-scrutiny from the Key Decision Forward Plan that fall under the remit of the Committee, on this occasion, be noted;

(3)      progress of informal briefing sessions for Committee Members held during 2022/23 be noted and no further informal briefing sessions be arranged for the time being;

(4)      the Public Health Director be requested to submit the Public Health Outcomes Framework to the Overview and Scrutiny Committee (Adult Social Care and Health) on a six-monthly basis, for information;

(5)      the Head of Highways and Public Protection be requested to investigate the possibility of obtaining information on sales of vaping products, with a view to the Public Health Director identifying possible trends;

(6)      the update on the Liverpool City Region Combined Authority Overview and Scrutiny Committee be noted;

(7)      the update on the Joint Cheshire and Merseyside Scrutiny Committee, established to scrutinise the work of the Cheshire and Merseyside Integrated Care Board, be noted;

(8)      consideration of draft Quality Accounts during 2023 be delegated to the Chair and Vice-Chair of the Committee, in consultation with the Healthwatch representatives; and

(9)      the recent activities undertaken by Healthwatch Sefton, as outlined in Appendix B to the report, be noted.