Agenda and minutes

To approve as a correct record the minutes of the meeting of the Health Overview and Scrutiny Panel held on 3 October 2013.

The minutes of the Panel held on 3 October 2013 were approved as a correct record and signed by the Chairman.

Matters Arising

Actions Taken:

The Head of Overview and Scrutiny reported that a special meeting of the Health O&S Panel had now been arranged on 4 February 2014 to meet with representatives from Heatherwood and Wexham Park Trust to discuss progress with their action plan following the critical inspection report from the Care Quality Commission (CQC).

The Chairman reported that the latest CQC report concerning the Trust would be available online at midnight on 7 January 2014 on the CQC’s website.

Members are requested to declare any Disclosable Pecuniary Interests and/or Affected Interests and the nature of those interests, including the existence and nature of the party whip, in respect of any matter to be considered at this meeting.

Any Member with a Disclosable Pecuniary Interest or an Affected Interest in a matter should withdraw from the meeting when the matter is under consideration and should notify the Democratic Services Officer in attendance that they are withdrawing as they have such an interest. If the Interest is not entered on the register of Members interests the Monitoring Officer must be notified of the interest within 28 days.

There were no declarations of interest.

Any other items which, pursuant to Section 100B(4)(b) of the Local Government Act 1972, the Chairman decides are urgent.

There were no urgent items of business.

To receive submissions from members of the public which have been submitted in advance in accordance with the Council’s Public Participation Scheme for Overview and Scrutiny.

There were no submissions from members of the public.

To consider the parts of the Quarter 2 2013/14 (July to September) quarterly service report of the Adult Social Care, Health and Housing department relating to public health, to include a progress briefing on Public Health activities and the Public Health Survey.

Please bring the previously circulated Quarterly Service Report to the meeting. Copies are available on request and attached to this agenda if viewed online.

The Director of Adult Social Care, Health & Housing (ASCH&H) delivered a presentation and made the following points about quarter 3:

• The Public Health structure was now fully recruited. The Joint Strategic Needs Assessment (JSNA) had been redesigned and the Public Health Survey was on schedule.
• Health improvement services (eg, Health Checks, Smoking, Flu jab uptake) were performing well.
• A new weight management service was in place, improving access to this service.
• Large scale promotional campaigns delivered (Stoptober and DrinkAware)

In addition, the Public Health Consultant stated:

·         Efforts had been made to reduce avoidable/preventable health conditions; there had been roadshows across the borough for Stoptober. A great deal of high profile work had also been undertaken around alcohol.

The Executive Member for (ASCH&H) reported that the efficacy rate of the flu vaccine was high and that this was a nationally mandated vaccine and that uptake should be widely encouraged particularly for vulnerable groups.

The Chairman stated that ward councillors would be able to see issues emerging in their wards from the online JSNA. There would also be a full narrative alongside the data. This information would be available online from the end of February 2014. It would act as a data repository not just for health issues but also the wider determinants of health.

The Public Health Consultant reported that neighbouring local authorities were now interested in replicating the model used by Bracknell Forest. She also reported that the Health & Wellbeing Strategy would shape the priorities of the JSNA. A summary document highlighting key priorities would be produced.

The Chairman asked if the Panel could propose priorities based on the data produced.

The Executive Member ASCH&H stated that this would be possible as the localised data would allow local input into developing priorities.

The Panel asked what would happen now this data was available.

The Public Health Consultant stated that depending on what issues emerged a cost effective means of tackling these would be identified. This would include social outcomes, such as loneliness and isolation. There would also be an opportunity to engage local communities in their own services.

The Panel understood that dementia was emerging as a significantly prevalent condition in the borough, was this the case?

The Public Health Consultant stated that this was the case and that more work was being done to identify dementia as it was clear that a dementia diagnosis gap existed. A similar situation existed for depression.

The Chairman queried whether there was enough funding available for the Alcohol Strategy?

The Director ASCH&H reported that funding for substance misuse had moved around to an extent, payment by results had allowed the Council to drive the agenda. In terms of outcomes, the work in this area had directly impacted A&E, particularly on Friday and Saturday nights.

The Chairman asked for further detail around how the Health & Wellbeing Board would be involved in decommissioning?

The Executive Member ASCH&H stated that the Board would work jointly to make these decisions  ...  view the full minutes text for item 34.

To receive an update on the Government’s plans for the further integration of health and social care.

The Executive Member ASCH&H reported that following the publication of the Care Bill, the Government announced in, ‘Integrated Care and Support: Our Shared Commitment’, that local areas must develop integrated health and social care services over the next five years.

He reported that integration at the Government level was also required and that he had raised this with the Secretary of State for Health. The Council would need to consider how it could integrate its services more to reduce duplication and inefficiency. A culture change would be critical and there would need to be an integration of cultures. The timescale to develop this mandatory work was tight.

The Chairman expressed concern that this work appeared to have been hurried and expressed concerns about funding and other complexities.

The Director reported that this was a Government sponsored mandatory initiative and as a result timescales had been imposed. This would be the most significant piece of work that the Council was currently undertaking, aside from the regeneration of the town centre.

The Council would need to respond to Government timescales and submit their Integration Plan by 15 February 2014. The Council had a strong history of working closely with colleagues in the provider services and the clinical commissioning group (CCG) and would build on this. Some integrated work was already underway, for example, the integration teams that worked with people with complex needs. This work was now paying dividends.

Government guidance on this area had now been issued; the Integration Plan would need to be signed off by the CCG, the Council’s Executive and the Health & Wellbeing Board. The Plan would be a high level plan and detail would be added at a later stage.

£6.1m would be allocated to the Bracknell and Ascot CCG, some of this would be existed funding that would be rebadged. It was clear that a measure of success of integration work would be to reduce hospital admissions and to provide seven day services.

A task force had been established to develop an Integration Plan and all partners were committed to this work. It was anticipated that the Integration Plan would be implemented in 2015-16. The detailed planning of this work would involve all key stakeholders.

The Panel queried how performance targets would be set?

The Director stated that this was as yet unknown; however performance indicators would be the same for all local authorities and partners would be striving continually to enhance and add value to services.

The Panel queries the extent to which the I.T systems of the Council and NHS partners could be integrated?

The Director stated that the Council’s current system was capable of using NHS numbers and this would be explored, however there would be other challenges with some I.T systems.

The Chairman queried if the South Central Ambulance Service was part of the integration plans?

The Executive Member stated that this was yet to be considered.

The Panel queried the Care Cap?

The Director stated that this prevented individuals from  ...  view the full minutes text for item 35.

To consider key themes and priorities for the Public Health element of the Council’s draft budget proposals for 2013/14.

Panel members are asked to raise any detailed questions with finance officers in advance of the meeting.

The Director ASCH&H reported that the Public Health budget was ring fenced and that he would be reporting regularly to the Panel on spend of this funding.

The Panel asked the Director what his greatest concern was about this budget.

The Director stated that his greatest concern was that these services were demand led, much like Social Care or Housing. As a result while forecasts could be put forward, the actual numbers requiring services was always an unknown. It was always a challenge to manage this within budget.

The Executive Member ASCH&H reported that data was improving allowing predictive analysis to be more robust and information around efficacy and commissioning also played a role.

The Chairman asked if accounting systems were robust.

The Director confirmed that they were. A Finance and Contracting Group acted as consultants for each of the six unitary authorities and played a role in bringing contracts together where this was cost efficient and desirable.

The Panel queried the provider that was being used for the weight management scheme?

The Consultant for Public Health reported that they used Slimming World and used a holistic approach, for example, smoking cessation could link into weight management work.

The Chairman thanked officers and the Executive Member for their input and asked that the Panel receive regular updates of this work.

To consider and adopt the report of the Panel’s Working Group which reviewed the lessons of the report by Robert Francis QC for Health Overview and Scrutiny.

The Lead Member for the Working Group, Councillor Mrs McCracken thanked the Head of Overview and Scrutiny for his dedication and hard work and for all the support he had given the working group. She also thanked the Director of Adult Social Care, Health & Housing (ASCH&H) and the Executive Member ASCH&H.

She reported that the review was not convened through any concerns that the Council’s arrangements were in any way lacking but rather to determine whether there were areas where O&S practices could be enhanced in light of the Francis report and recommendations.

The review highlighted that Members needed to take an active role in Health O&S in order to be fully aware of and challenge when necessary, any changes that occur in the NHS and its agencies.

The Chairman thanked the Lead Member and the Working Group for their thorough work on this. It was clear that if Members were to get into the heart of statistics and areas of the NHS they would need to lead on specific areas of health. It was agreed that the following Members would lead in the following areas:

(i)         Hospitals, Cllrs Virgo and Kensall

(ii)        Mental Health & Ambulance Service, Cllrs Baily, Mrs McCracken, Finch (re dementia) and Virgo

(iii)       Primary Care, to include the CCG, GPs, Dentists, Opticians and Pharmacists - Cllrs Mrs McCracken and Mrs Angell

(iv)       Public Health, Health and Wellbeing Board, and Local Healthwatch - Cllrs Mrs Temperton, Thompson and Ms Wilson (re Health and Wellbeing Board)

The Panel agreed that they were all committed to this work and if the right effort was made, real changes could be achieved. The Executive Member felt strongly that whilst there was apathy among the members at Mid Staffs, this was simply not the case at Bracknell Forest; members were passionate and demanded excellent services.

The Panel adopted the Working Group’s report, noting that the Overview and Scrutiny Commission were being asked to consider how the necessary officer resources were to be provided to implement the recommendations and decided to stand down the Working Group.     

To consider the current information from the NHS Choices website, for the NHS Foundation Trusts providing most NHS services to Bracknell Forest residents.

The Panel noted that the friends and family test scores had been a valuable key indicator yet had been removed from the NHS Choices website. The Chairman agreed to investigate whether this information was still accessible and report back to the Panel.

To receive a report on the progress of the Panel’s Working Groups.

To propose items for inclusion in the Panel’s work programme for 2014/15.

The Panel noted the progress achieved to date by the Panel’s working groups.

The Head of Overview and Scrutiny reported that he was in the process of gathering views of each directorate on the draft future work programme of each O&S Panel. Draft work programmes would then be submitted to the Overview and Scrutiny Commission to agree.

The Chairman regarded the current plan to review the Brants Bridge facility as being too early. The Panel considered that final proposals should derive from specialist member activity in due course, but possible future review topics might include:

-          Mental Health

-          Sexual Health

-          The agenda of the Health & Wellbeing Board

-          Alzheimer’s

-          The Joint Strategic Needs Assessment

The Chairman suggested that Members be given more time to consider this further and report back to the Head of Overview and Scrutiny.

To consider scheduled Executive Key and Non-Key Decisions relating to Health.

The Panel noted Executive Key and Non-Key decisions relating to health.

To note the Bi-Annual Progress Report of the Assistant Chief Executive.

The Panel noted the bi-annual progress report of the Assistant Chief Executive.

13 March 2014

4 February 2014 (special meeting)