Agenda and minutes

Apologies for absence were received from Diane Blair, Healthwatch Sefton.

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 any disclosable pecuniary interests or personal interests were received.

Minutes of the meeting held on 17 October 2023.

RESOLVED:

That the Minutes of the meeting held on 17 October 2023, be confirmed as a correct record.

Report of the Sefton Place Director, NHS Cheshire and Merseyside.

Further to Minute No. 30 of 17 October 2023, the Committee considered the report of the Head of Primary Care Transformation, NHS Cheshire and Merseyside.

The Committee had previously agreed that the closure of Melling Surgery did constitute a substantial change. The closure was due to be formally rarified at a Cheshire and Merseyside System Primary Care Committee meeting in the coming weeks and therefore, the Committee had requested a further update report on concerns raised at its previous Committee meeting on 17 October.

It was reported that Councillor Danny Burns, a Ward Member for the affected area, had submitted a written representation about the surgery closure which had been shared with NHS Cheshire and Merseyside.

The report set out details of the following:

·       Background to the provision of GP services provided by Dr Maassarani and Partners in the Melling area.

·       A timeline of the events which led to the premises being vacated and the practice closed.

·       The options appraisal carried out by NHS Cheshire and Merseyside

·       The Equality and Quality Impact Assessments

·       The actions taken to ensure responsibility for meeting the health needs and arranging the provision of health services for the population affected.

·       Details of the Taxi service offered to patients in Melling who now use Tower Hill Surgery.

Alistair Macfarlane, Head of Primary Care Transformation, NHS Cheshire and Merseyside, attended the meeting to present information and to respond to any questions or issues raised by Members of the Committee.

Members of the Committee asked questions/commented on the following issues:

·       The reasons for the lease not being renewed and the legalities around that.

·       The costs involved to make the premises NHS compliant

·       The population in the Melling area was increasing with a development of 140 new houses, which added to the concern about access to GP surgeries.

·       The low level of take up of the offer of taxis to transport Melling residents to the Tower Hill surgery and how this service was currently being advertised.

·       How long the offer of taxis would be in place for.

·       What the NHS had done to investigate the feasibility of extra bus services in the area, to include the possibility of the NHS writing to Merseytravel to urge them to consider expansion of services in the area.

·       The circumstances of the closure were understood, but it was concerning that sourcing an alternative premises had not been considered as an option.

RESOLVED: That

(1)          the update be noted;

(2)           a further update be brought to the Committee in 6 months’ time and Councillor Danny Burns be invited to attend that meeting; and

(3)          a written response to Councillor Danny Burns’ representation be obtained and forwarded to Councillor Danny Burns, to be shared with the other Molyneux Ward Councillors, and members of this Committee.

Jon Hayes, Managing Director, Cheshire and Merseyside Cancer Alliance, to attend.

The Committee considered the report of the Cheshire and Merseyside Cancer Alliance that provided an overview of the activities of Cheshire and Merseyside Cancer Alliance in Sefton and was submitted for information and discussion.

Cheshire and Merseyside Cancer Alliance was an NHS organisation that brought healthcare providers, commissioners, patients, cancer research institutions and voluntary and charitable sector partners together to improve cancer outcomes for the local population.

The Alliance was responsible for:

·       Delivering the NHS Long Term Plan objectives for cancer, including the ambition that, by 2028, 75% of cancers would be diagnosed at stages 1 and 2.

·       Reducing unwarranted variation in care, access, patient experience and outcomes.

·       Improving performance against cancer waiting times standards.

·       Supporting innovation and safeguarding the long-term sustainability of cancer services.

The Alliance was funded by, and accountable to, the national cancer programme within NHS England and the Alliance was hosted by The Clatterbridge Cancer Centre NHS Foundation Trust.

The report highlighted the work of the Alliance with reference to improving cancer outcomes for the population of Sefton.

Jon Hayes, Managing Director, Cheshire and Merseyside Cancer Alliance, attended the meeting to present information and to respond to any questions or issues raised by Members of the Committee.

Members of the Committee asked questions/commented on the following issues:

·       The key factors holding back the target of 75% of faster diagnosis

·       Whether Cheshire and Merseyside participated in medication trials

·       Workforce planning and how recruitment is carried out

·       Training for the workforce

RESOLVED: That

(1)                 the report and the information provided be noted; and

(2)                  a further update on the activities of Cheshire and Merseyside Cancer Alliance in Sefton be provided to the Committee in 6 to 9 months’ time.

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:

·       Shaping Care Together Programme

·       Lincoln House Surgery Update

Members of the Committee asked questions/commented on the following issues:

·       The timescales going forward for a resolution to the Lincoln House Surgery issue.

·       The Shaping Care Together programme, in particular why there had been a re-focus.

The Committee noted that there was an update on the Shaping Care Together programme, scheduled for the next formal meeting on 20 February 2024.

RESOLVED:

That the update 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 on Primary Medical Care for NHS Cheshire and Merseyside, Sefton. The report outlined details of the following:

·       Update on the Delivery Plan for Recovering Access to Primary Care

·       Access Data, including appointments

·       Winter Plans

·       Family and Friends Data

·       Primary Care Networks

Members of the Committee asked questions/commented on the following issues:

·       The call-back system used by GP surgeries

·       The 8am appointment system used by GP surgeries

·       The Pharmacy First scheme and the training offered to pharmacists

·       The friends and family data

RESOLVED: That

(1)          the update be noted; and

(2)           the Committee be provided with a breakdown of the Friends and Family data pathway.

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. Ambulance response times were also included within the data.

Members expressed concern that the data was showing signs of pressure, particularly ambulance response times.

RESOLVED:

That the information on Health Provider Performance be noted.

Report of the Sefton Place Director, NHS Cheshire and Merseyside.

The Committee considered the report of the Director of Public Health that provided an update on the Public Health Outcomes Framework.

A briefing previously received by the Cabinet Member - Health and Wellbeing was attached to the report.

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

·       The demographics of Sefton as a Borough and comparative neighbours.

·       Health inequalities and the possibility of exploring good practice seen in other local authority areas.

·       Childhood and adult obesity and the main reasons for this.

The Committee welcomed the report and considered that the information within it would be best explored at an informal meeting to enable Members to obtain a greater understanding of public health issues.

RESOLVED: That

(1)          the report be received; and

(2)          an informal meeting of the Committee be arranged to allow Committee Members to further explore the public health issues affecting Sefton.

Report of the Director of Public Health.

The Committee considered the report of the Executive Director of Adult Social Care and Health which provided an overview of Sefton's data profile to support the upcoming Care Quality Commission (QCQ) assessment.

The data review would help Sefton Adult Social Care understand its strengths and areas for focus prior to a pending Care Quality Commission Assessment, that supported Adult Social Care's service planning.

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

·       The reasons for the 6% drop in satisfaction amongst clients

·       The reasons for the disparity in the data between carers and clients

·       If complaints and compliments data would form part of the CQC assessment data.

·       Members were pleased to note the reported 9% drop in adults requiring secondary mental health care.

RESOLVED: That

(1)          the report be noted and  assurances be received on actions being taken in areas of identified performance; and

(2)          further updates be provided to the Committee as part of regular performance updates and preparation for CQC assurance.

Report of the Executive Director of Adult Social Care and Health.

The Committee considered the report of the Assistant Director, Integrated Life Course Commissioning, that provided an update on the activity that had taken place to plan additional services and prepare for Winter 2023/24.

The report set out the following:

·       The Sefton Winter Planning Process

·       The Sefton Place Winter Plan, Intelligence and Impacts

·       The oversight on winter planning carried out by the Cheshire and Merseyside Integrated Care Board

·       How the winter plan would be funded

·       The next steps.

RESOLVED:

That the report be noted.

Report of the Assistant Director of People (Communities)

The Committee considered the report of the Assistant Director of People (Communities) updating on the serious violence duty which came into force in January 2023 and required specified authorities to publish a strategy by January 2024, to prevent and reduce serious violence; and which indicated that work in preparing the strategy on Merseyside had been coordinated by the Office of the Police and Crime Commissioner.

The report indicated that following public consultation in July 2019, the Government announced that it would introduce legislation relating to a serious violence duty; that this aimed to ensure that relevant services worked together to share information to target interventions, where possible through existing partnership structures, to prevent and reduce serious violence within their local communities; that the Government also announced that it would amend the Crime and Disorder Act 1998 to ensure that serious violence was an explicit priority for Community Safety Partnerships and by making sure they had a strategy in place to explicitly tackle serious violence; and that whilst the guidance did not specify a particular partnership to lead, given the categories classed as “Serious Violence” were contained within the Community Safety Strategy, it made sense that the Safer Sefton Together (SST) was the partnership lead body for Sefton.

Appendix 1 to the report provided a timeline of the work undertaken within the last year relating to the readiness assessment, which identified a need to support the relevant authorities across Merseyside to facilitate stronger co-production across existing governance structures; and the consultation exercise undertaken to understand the perception of the problem, causes and consequences.

The draft Serious Violence Strategy document was attached as Appendix 2 to the report.

The report also provided information on the local delivery plan that was more specific for Sefton’s communities; and advised that the first draft of the delivery plan was currently being developed and would be mapped against the high level strategic aims of the strategy but also cross-referenced to the priorities contained within the Safer Sefton Together Strategy 2023-26 and would be reviewed through 2024; but however, there was no additional funding for LA’s to deliver the duty and therefore the delivery plan would reflect the work already underway in preventing and reducing serious violence in our communities.

The report concluded by seeking the views of the Committee on the draft strategy and the local delivery plan.

The report would also be considered by other Overview and Scrutiny Committees.

Members of the Committee asked questions/commented on the following matters:

·       The reason for not including domestic violence in the serious violence definition.

·       Suggestion of the inclusion of work around social deprivation in the strategy

RESOLVED:

 That the report updating on the serious violence duty be noted

Report of the Chief Legal and Democratic Officer

Cabinet Member Update – Adult Social Care, report to follow.

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:

·       The National Care Quality Assurance update

·       Strategic Commissioning –

o   Domicillary Care

o   Day Opportunities

o   New Directions

o   Care Homes

o   Fee Setting 2024/25

o   Quality Monitoring

·       Hospital Winter Pressures

·       Adult Social Care Budget

·       Adult Social Care Complaints, Compliments and MP Enquiries

·       Principal Social Worker Update – Quality and Practice

·       Performance and Key Areas of Focus

·       Workforce

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

·       We’re Here Campaign

·       Sefton Sexual Health Long Acting Reversible Contraception GP Offer

·       Public Health Performance Framework

·       Happy n Healthy Service for Children and Young People

·       Staff Flu Vaccination Programme

·       Leisure Update

Councillor Cummins, Cabinet Member – Adult Social Care, attended the meeting to present his report and to respond to any questions.

It was noted that the Committee requested an informal session to understand the Adult Social Care Budget.

RESOLVED: That:

(1)          the update reports from the Cabinet Member – Adult Social Care and the Cabinet Member – Health and Wellbeing be noted; and

(2)           The relevant officer(s) be requested to attend an informal meeting on the Adult Social Care budget.

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 2023/24

·       to identify any items for pre-scrutiny by the Committee from the Key Decision Forward Plan;

·       seek the views of the Committee on the Programme of informal briefings/workshop sessions for the remainder of 2023/24;

·       note the intention for the Local Government Association to provide training from Members and Substitutes of the Committee;

·       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; and

·       receive an update by Healthwatch Sefton.

The following appendices were attached to the report:

·       Appendix A – Work Programme for 2023/24;

·       Appendix B – Latest key decision forward plan items relating to this overview and scrutiny committee.

·       Appendix C – Draft programme of informal briefings/workshop sessions for 2023/24

·       Appendix D – Update of recent activities taken by Healthwatch Sefton.

Members noted that the following informal meetings would be added to the work programme:

·       Adult Social Care budget

·       Public Health Performance Framework

RESOLVED: That

(1)          the Work Programme for 2023/24, as set out in Appendix A to the report, be noted;

(2)           the contents of the Key Decision Forward Plan for the period  be noted;

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

(4)          the update on the Cheshire and Merseyside Integrated Care System Joint Health Scrutiny Committee; and

(5)          the update on Healthwatch be noted;

(6)          informal meetings on the Adult Social Care Budget, Public Health Performance Framework be added to the Committee’s programme of informal meetings; and

(7)     the intention for the Local Government Association to provide training from Members and Substitutes of the Committee be noted.