Agenda and minutes

To receive apologies for absence and to note the attendance of any substitute members.

Apologies for absence were received from Councillors Kensall and Thompson.  Councillor Brossard was present at the meeting as substitute member for Councillor Thompson.

To approve as a correct record the minutes of the meeting of the Health Overview and Scrutiny Panel held on 3 July 2014.

RESOLVED that the Minutes of the Overview and Scrutiny Commission meeting held on 3 July 2014 be approved as a correct record and signed by the Chairman.  The Chairman welcomed the news that Frimley Park Hospital Trust had acquired Heatherwood and Wexham Park Hospitals Trust

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.

In accordance with the Council’s Public Participation Scheme for Overview and Scrutiny the following question was submitted by Mr Pickersgill, a resident of Bracknell Forest:

Bracknell has a serious problem with substance abuse and mental illness which I find myself increasingly impacted by as I go about my daily business.*  In addition disability assessments are in chaos with waiting times from 26-52 weeks.  It is estimated one third of drug addicts can be helped get off drugs and that there comes a time when intervention has an optimum effect. Unfortunately, in the cases I am familiar with, people with such problems have been pushed further into crisis by the way the welfare departments work. In particular, the expectation that totally dysfunctional people achieve deadlines, a refusal to make back payments (often to help budgets) and the almost default position of making claimants go to appeal which is often dropped before reaching tribunal stage.  This has increased the workload on already over-stretched departments and of course the CAB, which is about to lose one of its most experienced advisors.  Will the Director of Social Services whom I understand now has responsibility for welfare, undertake to look into this so that a much more joined up system can be achieved without the problems being passed from department to department or spilling out into society.

* I am sending a short paper later today with specific cases (not identifiable) which I have tried to assist. You can publish any or none of this paper as you see fit.

A written response was provided by Glyn Jones, Director of Adult Social Care, Housing and Health:

Disability assessments:

It is unclear what is meant by “”disability assessments are in chaos with waiting time from 26-52 weeks”, although it appears it may be in relation to assessment carried out by Department of Works and Pensions (DWP).   We are therefore unable to comment on this.

It also appears from the question that Mr Pickersgill’s concerns relate to the full range of welfare benefits.   The Council is responsible only for the administration of Housing Benefit and Council Tax Benefit, within legislation as determined by Government, The Director of Adult Social Care, Health and Housing has communicated this separately to Mr Pickersgill.   Other benefits are administered by the Department of Works and Pensions.  

As such, the Council has no control over the timescales, waiting times or assessment processes of the DWP.

Mr Pickersgill alludes to specific concerns relating to people with mental ill health and those who misuse substances.  The following is background information relating to the support available for people in Bracknell who have needs arising from mental ill health or substance misuse.

The Drug and Alcohol Action Team (DAAT) supports people with substance misuse issues to stop, or reduce, using substances. For this to be effective, people must be willing to both recognise that they have a problem, and to engage with evidenced-based programmes designed to assist them.  

The range of services for people with  ...  view the full minutes text for item 18.

To meet Julian Emms, Chief Executive of Berkshire Healthcare NHS Foundation Trust, with particular reference to the Trust’s mental health and community health services to residents of Bracknell Forest,

The Chairman welcomed Julian Emms, Chief Executive, Alex Gild, Director of Finance, Performance and Information, and David Townsend, Chief Operating Officer, of Berkshire Healthcare NHS Foundation Trust to the meeting to speak on the Trust’s mental health and community health services to residents of Bracknell Forest.

Background information had been circulated to the Panel in advance of the meeting, as follows:

·                     Extract from the Monitor website, setting out details of the Trust’s current ratings;

·                     Extract from the Trust’s website, setting out the Trust’s role and vision, values and goals;

·                     Annual Plan Summary 2014;

·                     The Patient Experience Annual Report;

·                     The Care Quality Commission’s Inspection report for Prospect Park Hospital;

·                     Results of the National NHS Staff Survey 2013.

Julian Emms spoke to the Panel and the points made included the following.  A summary document was also circulated at the meeting.

·                     The Trust was the main provider of community and mental health services to the population of Berkshire.  The Trust had an annual income of around £220million, employed in the region of 4,000 staff and provided services from just over 100 sites.  The Trust’s core values underpinned their operations.

·                     The Trust services were delivered via a locality structure organised around the six areas of Berkshire, matching local authority boundaries.  There were eight main sites in Bracknell Forest, the largest of which was Churchill House.  Each locality was overseen by a Locality Director and Clinical Director.  The Trust provided just under 100 different services, mainly jointly with local authority partners.  These were split approximately half and half between mental and community health services.

·                     Some of the successes of the Trust included 28 major service improvements during 2013/2014, full details of which had been included in the Annual Report.  This included moving a fully-established ward to Prospect Park Hospital.  The Trust ranked in the top 10% nationally for staff engagement, which translated into better patient care.  In addition, the Trust was registered without condition with the Care Quality Commission and held the two lowest risk ratings from Monitor. 

·                     The Trust was on track with its financial plan but improving quality was difficult where the gap between income and cost was widening.  This was anticipated to be approximately £50million by 2018/19.  Internal efficiencies to save £20million had been identified but a gap still remained.

·                     In response to pressures the Trust had revised its Five Year Strategy to close the financial gap, develop new ways of working as a Trust and to reassure stakeholders that sufficient plans were in place to ensure longer-term sustainability. Five workstreams had been established to achieve these goals.

·                     Some of the key challenges facing the Trust included significant increases in demand for particular services; difficulties in recruiting some professional staff and a national shortage of nurses; a risk that the new workstreams would not deliver the identified savings or productivity increases; financial pressures faced by partner organisations; the pace of the reform system; and the complexity of the health and social care system.

The Chairman queried the impact on mental health  ...  view the full minutes text for item 19.

To receive a presentation on Public Health’s first year in the Council, and a presentation on future plans.

The Panel welcomed Dr Lisa McNally, Public Health Consultant, to the meeting to address the Panel on Public Health activities and answer questions.

Dr McNally gave a presentation in respect of the activity and performance of public health during 2031/14.  She explained that Public Health had become the responsibility of local authorities 18 months ago.  In Bracknell Forest public health had been successfully integrated across the whole authority and introduced new ways of working.

The presentation gave details of the main areas of work undertaken by the public health team.  One of the key areas was providing support to help people stop smoking, as this was the leading cause of mortality, disability and morbidity in the area.  The authority offered a 12 week support programme, and the quit success rate in Bracknell Forest was one of the highest in England at 70%.  A total of 763 people had quit smoking in 2013/13, a third of who were in priority groups including pregnant women and people who were unemployed.  New services in 2013/14 included support for people with mental health problems and patients waiting for elective surgery.

With regard to diet and activity, Public Health had expanded the range of referral routes into weight management for those who were obese from January 2014.  As a result the number of people accessing the programme had increased four-fold.  Children and family initiatives had also been introduced, including ‘Beat the Street’, which had encouraged children to compete against other schools in walking competitions.  One local school had been placed third worldwide.

Substance Misuse services had maintained high treatment success rates across the year, and the proportion of opiate patients who completed treatment was above the national average.  A pre-Christmas campaign had been run in collaboration with Drinkaware to improve awareness of alcohol units, with significant results, and the programme had been highlighted as an example of best practice at the UK Faculty of Public Health Conference.

Bracknell Forest was now hitting national targets for conducting Health Checks, helped partly by the introduction of a new workplace Health Check programme run in collaboration with Human Resources colleagues. 

The Joint Strategic Needs Assessment (JSNA) was a tool being used to examine the local level of need in relation to health and well-being to highlight areas for future work development.  The Bracknell Forest JSNA had been selected for presentation as an example of best practice at the 2014 Public Health England national conference.  A key innovation within the JSNA had been the public health survey of 1,800 residents, which had been the first council-led large scale survey in the UK and would be an invaluable aid to future planning.

Other work during the year had included mental health ‘first aid’ training, a full review of sexual health services, a food hygiene improvement programme, an older people’s ‘holistic health’ programme, the implementation of drug and alcohol learning sets and the commissioning of a number of school nursing services aimed at protecting and improving the health and well-being of  ...  view the full minutes text for item 20.

To give Members the opportunity to raise questions on the 2013-14 Annual report of Healthwatch Bracknell Forest.

The Panel received the Healthwatch Bracknell Forest Annual Report for 2013/14. 

Mark Sanders of Healthwatch was present at the meeting to answer questions.  He drew the Panel’s attention to page 13 of the report, where a statistic that 94% of the public thought that NHS and social care services could be improved.  He clarified that this was a national figure, covering all services, and did not relate just to Bracknell Forest.

The Panel asked why the Healthwatch budget was being reduced.

It was explained that there had been initial start-up costs included in the first year’s budget.  There were also anticipated changes to ring-fencing of some funds, and possible budget cuts of up to 20%.  It was anticipated that Healthwatch would be given greater powers and responsibilities in the future.

The Panel thanked Healthwatch Bracknell Forest for their work, including tackling the use of premium rate phone numbers by GP Practices.

To consider the parts of the Quarter 1 2014/15 (April to June) quarterly service report of the Adult Social Care, Health and Housing department relating to health.

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

The Panel was asked to consider the parts of the Quarter 1 2014/15 (April to June) quarterly service report of the Adult Social Care, Health and Housing department relating to health.

Zoe Johnstone outlined some of the challenges facing the department.  These included finding sufficient suitable housing for people with learning difficulties and Asperger’s, where a number of people had been served notices to leave their properties.  The department was working closely with colleagues to address this.  The Better Care Fund was focussed on reducing non-elective admissions by 3.5%, calculated on the baseline for 2014.  Councillor Birch, as Executive Member for Adult Social Care, Health and Housing, reported that a great deal of work had been done on creating a plan to address this, but expressed his frustration that a week before submission the format had been altered which had created more work.  The aim was to move funding from acute care into community care, but the level of funding received would be dependent on whether the reduction in non-elective admissions was achieved.  In addition, there were still difficulties in recruiting domiciliary care staff but the authority had set up a group working with domiciliary care agencies to address this.  The falls prevention work was much valued by the public.

Mark Saunders of Healthwatch expressed thanks of behalf of members of the public at the huge amount of work that had been completed in a short space of time.

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

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