Meeting documents

Apologies were received from Mrs P Birchley, Ms S Adoh and Mrs S Jenkins.

The Chairman welcomed Mrs V Letheren, Chairman of the Children’s Social Care and Learning Select Committee to the meeting.

Julia Wassell declared an interest in Item 7, Recruitment and Retention of Adult Social Care Staff, as she works at Bucks New University.

The minutes of the meeting held on 2^nd February 2016 to be confirmed as a correct record

The minutes of the meeting of the 2 February 2016 were confirmed as an accurate record, subsequent to the following minor amendment.

Page 8 - Waddeston Pharmacy – to be amended to Waddesdon.

This is an opportunity for members of the public to put a question or raise an issue of concern, related to health.   Where possible, the relevant organisation to which the question/issue is directed will be present to give a verbal response.  The member of public will be invited to speak for up to four minutes on their issue.  A maximum of 30 minutes is set aside for the Public Questions slot in total (including responses and any Committee discussion). This may be extended with the Chairman’s discretion. 

For full guidance on Public Questions, including how to register a request to speak during this slot, please follow this link:

http://www.buckscc.gov.uk/about-your-council/scrutiny/getting-involved/

Mr Trevor Snaith was welcomed to the meeting.  Mr Snaith asked the following question about the closure of Lynton House surgery and lack of Surgery in East end of High Wycombe.

 ‘The east end of High Wycombe is seeing massive housing growth.

We are faced with the only Surgery in east end of High Wycombe (Bowerdean/Ryemead/Wycombe/Marsh/Micklefield) moving to Wycombe Hospital with reduced services and hours.

We are also faced with Chiltern Clinical Commissioning Group allowing it to happen and also failing to submit for NHS funds for 2016/2017 which can be secured for investment in primary care infrastructure in future years (There is a deadline for submission of April 2016).

A petition and letters to organisations regarding the closure of Lynton House and a call for Chiltern CCG to submit for funding is being ignored. The residents of Wycombe are incensed by the lack of action on this by Local MP and the statutory authorities.

We are calling for BCC to investigate the situation on behalf of residents, for BCC to press for Lynton House to remain and for pressure to be put on Chiltern CCG to make the necessary effort to secure funding and land/building for a Health Centre in the east end of High Wycombe’.

Mr Snaith asked if pressure could be put the CCG to make an application for the necessary funding grant to secure the infrastructure and funding that would allow for a surgery to be built or land acquired in the east end of Wycombe. Mr Snaith explained that the submission of the application for funding was time critical as applications had to be made by April for infrastructure and support funding and that opportunities to purchase vacant land or buildings in the area could be lost if the timeline was missed.

The Chairman explained that HASC had already sent a letter to NHS England expressing concerns that the consultation did not cover the whole patient population of the area, particularly raising communication concerns regarding elderly residents and those whose first language was not English. The Chairman confirmed that the request had been made for the consultation to be readdressed and extended to encompass the full range of those affected. It was noted that the advice had been received that an overarching plan was being developed by the CCGs in terms of GP provision across the county.

Julia Wassell said that the consultation process had given a good overview for the planning arrangements for the infrastructure in east Wycombe. Julia Wassell explained that a multi-agency infrastructure group with links to the CCCG and Dr Anette Gamell, had the GP surgery on its agenda for a meeting at the end of March.  

The Chairman said it would be useful for members of Committee to receive clarity from the CCGs on the longer term plans of GP provision and location across the area as well as the consultation process.

Action

The Chairman to write to the CCCG and NHS England  ...  view the full minutes text for item 4.

This will include an update on the Chairman’s meeting with the Chief Executives of Chiltern and Aylesbury Vale Clinical Commissioning Groups,  key findings from the review of Learning Disabilities Services and the response from NHS England to the Committee’s concerns around local dental NHS provision, outlined at the Committee’s meeting on 2nd February 2016

Attached is the letter sent from Chairman and reply from the Regional Lead Commissioner for NHS Dentistry.

Buckinghamshire Hospitals Trust

Following discussions at the February meeting of the Committee, Buckinghamshire Hospitals Trust were asked to submit the strategic plans for Wycombe Hospital to the 22 March meeting of HASC. Members of the Committee expressed disappointment and concern that the strategic plans had not been submitted as requested.

The Chairman reported that she had communicated with the Hospital Trust regarding their Estates strategy in relation to Wycombe Hospital and had been informed that ‘a rebuild had never been spoken about and their Strategy is linked to the development of their clinical strategy which will determine how the future estate develops for the Trust’.

The Chairman had also been informed that the Clinical Strategy was still in the development process and needed to go to the Trust Board for approval before submission to the HASC, which was unlikely to be before mid-spring.

A member whether it was correct to say that there was no plan to develop the Wycombe site in terms of its estate and buildings? The Chairman explained that the Trust had not used the term ‘rebuild’ and the focus was on how services were going to be deployed at the site, perhaps including reviewing how the space could be used differently.

Harlow House

The Chairman reported that the following response had been received from Oxford Health Trust:-

‘Two years ago Oxford Health NHS Foundation Trust made significant improvements in the design of adult and older adult mental health services in Buckinghamshire. These changes included providing seven day services from High Wycombe (Valley Centre, Shrublands and Harlow House), as well as our services operating out of Amersham.

We will be continuing to provide seven day mental health service at the same time as creating three distinct service hubs in High Wycombe.  The Valley Centre will provide all of our adult services, Shrublands, our older adult services and Harlow House, our children’s services.  Oxford Health will be investing £1m in capital to improve these three bases and expect that they will be fully refurbished by the end of June 2016.

We will be continuing to provide services in Amersham and are in the process of relocating from the Haleacre site there to newly sourced accommodation’.

Julia Wassell advised that adult mental health services had moved to the Valley Centre and services had been combined with the Acute Day Hospital. Julia Wassell went on to say that children’s services would be commencing which would mean there would not be a loss in facility; however it was believed that there was a reduction in service for adults at the Valley Centre.  There was also the increase in pressure to discharge patients from the acute day hospital and from patients requiring rehabilitation from the Whiteleaf Centre. This issue needed to be followed up.

The Mandeville Practice

The Chairman reported that there had not been any real change since February and that a new interim provider would be in place from April 2016, once the existing GP Partnership had dissolved. The  ...  view the full minutes text for item 5.

Affordable Housing for Healthcare Workers

The Chairman advised the Committee that in relation to this issue raised at a previous HASC meeting, responses had been received from all District Councils apart from Aylesbury Vale.

Inquiry into Adults with Learning Disabilities – Social Integration

Mrs M Aston who is chairing the Inquiry advised that the report was currently in its draft stage with three major issues emerging from the Inquiry: transport: communication and safeguarding (the greatest concern is safeguarding of those with learning disabilities). Mrs Aston said that the video taken during the meeting with young people as part of the Inquiry would be edited and presented to HASC and Full Council. Mrs Aston thanked Ms J Woodman, Committee and Governance Advisor for the work on the Inquiry. The Chairman thanked Mrs M Aston, Mr B Adams, Mrs A Davies and Mr S Lambert for the work undertaken.

The Chairman highlighted the special meeting of HASC on 18 April to discuss the recommendations from the Inquiry before it is presented to Cabinet.

ACTION:

The Chairman to chase the response from AVDC to the letter sent about affordable housing for healthcare workers.

The Committee is looking at the issue of recruitment and retention of adult social care as it presents potential significant challenges to service provision for Adult Social Care.

The Committee will receive:

·         An overview of current workforce pressures and recruitment and retention issues. A Position Statement is attached providing contextual information of the current workforce.

·         A presentation on the draft Workforce Strategy for Adult Social Care. An outline of the strategy is attached which sets out key objectives and short to longer terms actions to mitigate current issues.

·         An overview of workforce development and succession planning to meet future demands.

Contributors:

Rachel Rothero, Service Director, Communities, Health & Adult Social Care Directorate, (CHASC)

Selena Gardiner, Workforce Development Manager – CHASC

Isobel Gardiner, HR Business Partner - CHASC

Sinclair Coward, Head of Department of Social Work, Buckinghamshire New University

Mr T Boyd, Managing Director, Communities, Health and Adult Social Care, Ms I Ellison, Business Partner, Ms S Gardiner, Learning and Development Team Manager, Mr J Drury, Prime Care Support Limited and Mr S Coward, Head of the Academic Department, Social Work and Integrated Care, Bucks New University were welcomed to the meeting.

Members received an update on:

·           Position Statement of the ASC Workforce

·           Background to Adult Social Care Sector

·           The Buckinghamshire Picture

·           Bucks workforce overview and key issues

·           Risks

·           Workforce Strategy & Implementation Plan

During discussions, the following key points were highlighted.

·         It is predicted that there will be 124,865 people aged 65+ in Bucks by 2026 - an increase of 31.84%.

·         In terms of the Adult Social Care (ASC) workforce nationally, there would be an increase in all roles which could be difficult in terms of recruitment. More workers would be needed for all roles.

·         There had been an increase in the number of Personal Assistants as a result of Direct Payments.

·         There was the issue of an aging workforce as well as an aging population.

·         An increase in National Living Wage (NLW) would put pressure on care providers, with a knock on effect on those paid the minimum wage and well as an effect on future contracts and spot purchasing.

·         Over 300 establishments were involved in the delivery of ASC in Bucks covering 10,200 jobs.

·         The number of care workers was expected to rise by 55% by 2025.

·         There was an average turnover of 25.4% of the workforce in Bucks, a figure similar to the rest of the country.

·         In terms of workforce churns, 2 in 5 members of staff move role within their sector.

·         A large number of care workers would reach retirement age in the next 10-20 years.

·         Vacancy rates for ASC were higher than the average of other sectors.

·         80% of care workers were female.

·         Staff sickness rates were high as a result of the high pressures on resources. The average sickness rate for ASC workers was 6.7 days of sickness per person per year.

·         It was difficult to recruit to senior roles, particularly given the better pay from agencies and the higher rates of pay in London and other neighbouring authorities 

·         There were a lot of newly qualified social workers but an improved infrastructure needed to be in place to provide them with the necessary support. This would be an area of focus.

Mr Drury explained that Prime Care had been a care provider for 20 years and a platinum provider for 5 years.

Implementation Plan

Ms Ellison referred to the abridged version of the Adult Social Care workforce strategy in the agenda pack which looks at key priorities such as labour demand and supply issues, recruitment and retention planning, working with external providers and partners and the development of a Memorandum of Co-operation (MoC) for adult Social Workers in conjunction with ADASS in the South East region.

Key areas of work included:

·         Visits to schools, colleges, universities and recruitment fairs to  ...  view the full minutes text for item 7.

To provide a 6 month progress update on the recommendations on the HASC inquiry report into the use of 15 minute domiciliary care visits. 

Mr S Goldensmith, Service Manager Strategic Commissioning was welcomed to the meeting.

Members of the Committee were advised that the 15 mins Care Review was progressing well.

During discussions, the following comments were made:

·         It was encouraging to see that the recommendation to incorporate travel time in the new contract had taken place. Members were advised that how the provider accounted for travel time was now part of the evaluation process.

·         Travel time continued to be a high profile issue in the national press. More transparency was needed around this issue as well as appropriate monitoring. Members were advised that contract monitoring had been put in place. 

·         Members were keen to follow up on how their recommendations had been implemented through more field visits. It was suggested this could be in six months time.

ACTION:

·         A report on travel time would be included as part of the update in September 2016 (Mr Goldensmith to action).

·         A field visit to the providers, post new contractual arrangements would be arranged (Mr Goldensmith to action).

For Members to note the work programme

The Work Programme was noted.

Members expressed concern about the following:

·         Delays in consultant appointment times at Bucks Hospital Trust (BHT)

·         Ambulance Trust response times in the south of the county

ACTIONS:

·         The Chairman is to meet with the Ambulance Trust SCAS and will raise concerns about response times and report back to the Committee.

·         An update would be requested from BHT on the current resources in specialist units and consultant staff over a 5 year period (Committee and Governance Advisor to action).

·         A senior officer from Bucks Fire and Rescue Service would be invited to attend the June meeting of the HASC (Mr R Reed to action).

The next meeting will take place on Tuesday 10^th May 2016, at 10.00am in Mezzanine Room 2.  There will be a pre-meeting for Committee Members at 9.30am.

The next full webcast Committee meeting will take place on 10 May 2016, 10.30am, Mezzanine 2, County Hall, Aylesbury.