Agenda and minutes

To approve as a correct record the minutes of the meeting of the Health Overview and Scrutiny Panel held on 5 October 2017.

RESOLVED that the minutes of the meeting of the Panel held on 5 October 2017 be approved as a correct record and signed by the Chairman.

In answer to a question regarding the difficulties faced by the Council in the recruitment of carers compares to the Frimley Health and Care NHS Trust, it was noted that carers normally found that working in a hospital setting with less travelling and a more established career path was a more attractive job package than that offered by the Council.  However, it was noted that changes flowing from the Transformation Programme and the new integrated community care service would help to address a number of these issues and assist in the recruitment of carers for the Care Providers working with the Council.

Members are asked to declare any disclosable pecuniary or affected interests and the nature of that interest, 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 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 disclosable pecuniary interest is not entered on the register of Members’ interests the Monitoring Officer must be notified of the interest within 28 days.

Any Member with an affected interest in a matter must disclose the interest to the meeting and must not participate in discussion of the matter or vote on the matter unless granted a dispensation by the Monitoring Officer or by the Governance and Audit Committee.  There is no requirement to withdraw from the meeting when the interest is only an affected interest, but the Monitoring Officer should be notified of the interest, if not previously notified of it, within 28 days of the meeting.

There were no declarations of interest, nor any indications that members would be participating while under the party whip.

There were no items of urgent business.

There were no submissions under the Council’s Public Participation Scheme for Overview and Scrutiny.

To consider key themes and priorities for Health as outlined in the Council’s Draft Budget Proposals for 2018/19.

The Panel noted that the Executive had agreed the Council’s draft budget proposals for 2018/19 as the basis for consultation with the O&S Commission, O&S Panels and other interested parties.  The detailed figures were of little relevance to the Panel as the Public Health grant was almost entirely funded from ring-fenced specific grant.

The Borough Treasurer’s report indicated that the Public Health Grant in 2017/18 was £4,157,000 and the Panel was informed that although the allocation for 2018/19 was likely to be around 2.5% lower, it would be possible for the Council to work within a slightly lower Public Health budget.  The Panel noted the report and reserved comment in the absence of any further detail on the 2018/19 budget.

To receive a presentation in respect of the results of the recent Primary Care Survey.

The Panel received a presentation on the preliminary results of a recent survey of primary care.  An independent survey, conducted by Ipsos MORI, was carried out across the country, usually in January each year and results from the 2017 survey in respect of Bracknell Forest GP Surgeries had been made available from July 2017.

The data had been assembled from 50 questions in the survey and it was proposed to analyse this across eight subject areas:

• Quality expected of GP surgeries
• Access to GP services
• Making an appointment
• Waiting times at GP surgeries
• Perceptions of care at last GP appointment
• Perceptions of care at last Nurse appointment
• Satisfaction with practice opening hours
• Out of hours service

The aim was to look closely at those surgeries that were achieving the highest satisfaction levels in each of the areas, talk to GPs and staff, and to share good practice across all surgeries in the Borough, highlighting the areas that patients had indicated did most to make their experience better/easier.

This work was to be taken forward by the Working Group of the Panel established to review the Primary Care Patient Experience and Councillor G Birch as Lead Member outlined his hopes regarding this opportunity to understand and share what drives good GP practice.

The Panel recognised this as a valuable exercise which should provide a powerful tool for surgeries to use.

To be advised of the proposed changes to the services purchased from the Berkshire Shared Public Health Team from April 2018.

The Panel considered a report of the Chief Executive, due to be considered by the Executive on 23 January 2018, proposing changes to the relationship between the Council and the Berkshire Shared Public Health Team and to establish a dedicated Director of Public Health post for Bracknell Forest.

A Strategic Director of Public Health covering all six unitary authorities supported by a shared core team had been set up to ensure a ‘safe landing’ for each Council’s new Public Health responsibilities when they were transferred to local government in 2013.  The pan Berkshire Director of Public Health and shared team have been hosted by Bracknell Forest since 2013.  The arrangements worked well initially but increasingly individual local authorities have pulled back from areas of shared responsibility as budgets have come under pressure.

The local Bracknell Forest Council Public Health Team has enjoyed significant success in delivering its Public Health responsibilities, winning national awards for its work and being cited by the LGA as a national example of good practice for its public health communications and self-care initiatives.  The Consultant in Public Health reminded the Panel of the different approach taken to a number of public health issues in Bracknell and referred to the range of skills and expertise within the Team that meant that there were fewer services that needed to be bought in from the Berkshire shared team.

It was therefore proposed that Bracknell Forest should withdraw from some of the Berkshire Shared Public Health Agreement functions from April 2018 and, specifically, cease investment in the Strategic Director function, the data analytical / informatics functions and (with some exceptions) the contracting support function.  Instead it was proposed that a Director of Public Health (DPH) for Bracknell Forest post be created to lead the local Public Health function, reporting to the Director of Adult Social Care, Health and Housing.  The new DPH would be supported by a part-time, local Public Health Consultant for Bracknell Forest, with specific duties around collaborative work with local and regional healthcare partners.  Overall, it had been calculated that the proposals would deliver savings against current costs of £35k in 2018/19, and rising in future years based on the estimated costs of the new shared arrangements.  All financial implications would be absorbed within the ring-fenced Public Health grant.

The Panel endorsed the proposals in the report for consideration by the Executive, recognising the opportunity for the Council to play a prime role in setting the agenda for Public Health within the Borough.

To receive an update in respect of the Working Group of the Panel reviewing the Primary Care Patient Experience.

The Panel received a report of the initial meeting of the Working Group established to review the Primary Care Patient Experience in the Borough.  Further meetings were planned to analyse data gathered via the GP Patient Survey (as reported above) and other sources of evidence available locally.

To discuss the 2018/19 Work Programme and suggest topics for inclusion.

The Panel received a report about the Overview and Scrutiny Work Programme for 2018/19, including three suggestions for possible future reviews.  Given that it was unlikely that resourcing to carry further reviews would be available until 2018/19 or later, it was agreed to defer consideration of the item until the next meeting of the Panel in April.

To consider the parts of the Quarter 2 2017/18 (July to September 2017) Quarterly Service Report of the Adult Social Care, Health and Housing department relating to health.

The Panel considered the Quarter 2 (July to September 2017) Quarterly Service Report of the Adult Social Care, Health and Housing report relating to health.

The Consultant in Public health made a presentation highlighting recent and current activity:

• The conversations model had been bedded into practice, early data had been gathered and was being analysed to help shape Adult Social Care operational delivery in the years ahead.
• Although "conversations" was being introduced, people who met the eligibility criteria for a service would  continue to receive one.
• The two Community Connectors have made a good start introducing themselves to the community and have received referrals from Learning Disability and Adult Community teams.
• The Out of hours Multi-Agency Adults Safeguarding Hub (MASH) was being set up having regard to the needs of each unitary Authority and buy-in from the Strategic Partnership was now sought to ensure a successful and timely operational delivery.
• Forestcare had been successful in winning two external monitoring contracts.
• Town Centre Community Safety had improved with a 32% reduction in shoplifting and a 27% reduction in criminal damage compared to same quarter last year.
• BFC My Benefits had gone live from mid November 2017.  In the first month 1,392 customers had opened an account and of these, 734 went on to open access to and progress their claim.
• Work has begun on preparation for the Homeless Reduction Act, using new funding to help meet the expected increased demand for services.
• The Council entered into a contract with Places for People to develop the Council owned site the Lodge for people with learning disabilities.
• Self Care Week had been most successful and the biggest ever, comprising 42 events, with 17 student volunteers, 95,000 people reached on social media, 16,000 video views, 12,500 community map visits, and the largest walking group session organised.
• Public Health ran their largest ever mental health event for children and young people which took place at the Madejski Stadium.
• Preparation for a range of new health improvement programmes have been put in place, all of which were partnership projects with residents.
• On-line health improvement programmes with residents continued to extend their reach with a steady increase in the size of the Facebook Community and the number of Portal views each quarter.

Arising from questions and discussion, the Panel noted:

• The reported reduction in social isolation was as measured by the national annual survey carried out.  The range of social and community initiatives run by the Council was clearly having a beneficial effect.
• Continuing low rates of teenage conception were testimony to the ongoing work of Youth Services, Public Health video films, work in schools etc.
• The mental health of children and young people was a priority and focus of the Health and Wellbeing Board, and the ongoing support of the KOOTH online service was a key element of this.
• The first week of January had shown a sharp increase in the number of seasonal flu cases reported, including some hospital admissions.  It was important to continue  ...  view the full minutes text for item 36.

At the time of agenda publication there were no scheduled Executive Key and Non-Key Decisions relating to health. Any scheduled decisions which subsequently arise will be circulated for consideration at the Panel meeting.

The Panel noted that there were currently no scheduled Executive Key and Non-Key decisions relating to health.

To receive oral reports from Panel Members on their specialist roles since the last Panel meeting.

Members reported that:

• Some recent performance figures for the treatment of patients by the Frimley Health and Care NHS Trust were reported. For Accident & Emergency, while some targets had not quite been met, they remained above the national average for England.
• Chief Executive of the Trust, Sir Andrew Morris was due to retire in six weeks time.  He was to be replaced by Neil Dardis, currently Chief Executive of the Buckinghamshire Healthcare NHS Trust.
• Sustainability and Transformation Plans were moving forward towards the introduction of new Accountable Care Systems which would draw together the different funding streams to deliver all health care interventions.  The Accountable Care Partnerships which would come into place would need to be carefully positioned in order to ensure that they were fully accountable and subject to proper and appropriate scrutiny.