Meeting documents

Venue: Mezzanine Room 1, County Hall, Aylesbury. View directions

Contact: Liz Wheaton 

Note: Please note that this meeting will be webcast - please use the "Webcasts" menu link 

Media

Webcast: View the webcast

Items
No. Item

1.

Apologies for Absence / Changes in Membership

Additional documents:

Minutes:

Apologies were received from Mr B Bendyshe-Brown, Mr R Bagge, Mrs L Clarke OBE, Mr C Etholen and Ms C Jones.

 

The Chairman reported that Mrs M Aston would no longer be on the Committee and wished her well.

 

Mr A Hussain attended the meeting as a substitute for Mr B Bendyshe-Brown.

2.

Declarations of Interest

To disclose any Personal or Disclosable Pecuniary Interests

Additional documents:

Minutes:

There were no declarations of interest.

3.

Minutes pdf icon PDF 213 KB

The minutes of the meeting held on Tuesday 24th July 2018 to be confirmed as a correct record.

Additional documents:

Minutes:

The minutes of the meeting held on Tuesday 24th July 2018 were confirmed as an accurate record.

4.

Public Questions

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.  Members of the 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/

Additional documents:

Minutes:

There were no public questions.

5.

Chairman's update

For the Chairman to update the Committee Members on health and social care activities since the last meeting.

Additional documents:

Minutes:

The Chairman reported that he had attended an "Access for All" event at Stoke Mandeville Stadium.  The event was an opportunity for a number of key organisations to showcase their services for people with learning disabilities and their carers.

 

Following the transformation item at the last meeting, the Chairman had received a response from the Cabinet Member for Health & Wellbeing which had been circulated to Committee Members.  The response would be attached to the minutes.

6.

Committee Update

An opportunity to update the Committee on relevant information and report on any meetings of external organisations attended since the last meeting of the Committee.  This is particularly pertinent to members who act in a liaison capacity with NHS Boards and for District Representatives.

Additional documents:

Minutes:

Julia Wassell reported that she had organised a Festival of Wellbeing in Wycombe recently.

 

Thalia Jervis agreed to update the Committee on the work of the Integrated Care System user engagement group which Healthwatch Bucks would be chairing.

7.

Introduction by the joint Strategic Director

Ms Balvinder Heran, Joint Strategic Director, Information Assets and Digital Development will be attending.  Ms Heran joined the Council in September and her post is a joint appointment across the NHS and Bucks County Council.

Additional documents:

Minutes:

The Chairman welcomed Ms Balvinder Heran, who had recently joined as the Joint Strategic Director, Information Assets and Digital Development.  Ms Heran explained that it was a joint appointment across the County Council and the NHS.  Her role would focus on using technology to bring services together and improving responsiveness.

 

A funding bid had been submitted for £6.1m for digital transformation which had received endorsement across the Bucks, Oxfordshire and Berkshire West Sustainability and Transformation Programme.  The funding would be used to improve responsiveness to patients through "real-time" information, better wifi across the locations and better bed management leading to a quicker Hospital discharge.  There would also be a drive towards improving Personal Patient records to reduce the need for paper letters.

 

In response to a question around a plan B if the funding bid was unsuccessful, Ms Heran explained that the programme would still continue but it would be over a longer timeframe.  A successful bid would accelerate the implementation and progress.

 

It was agreed that Ms Heran would attend future meetings to update the Committee on progress.

 

ACTION: Ms Heran/Committee & Governance Adviser

8.

GP provision pdf icon PDF 114 KB

Purpose:

This item is for Committee Members to hear from representatives from the Clinical Commissioning Group and the two GP Federations in Buckinghamshire in relation to GP services across the County.

 

Attendees:

Ms L Patten, Chief Officer, Clinical Commissioning Group

Mr R Majilton, Deputy Chief Officer, Clinical Commissioning Group

Dr P Macdonald, Chair of FedBucks

Dr G Gavriel, Clinical Director of Medicas

 

Papers:

Briefing paper attached

 

Intended outcome:

For Members to have a greater understanding of the priorities and challenges facing GP services across the County and also to receive reassurances around some specific issues affecting GP provision locally.

Additional documents:

Minutes:

The Chairman welcomed Mr Majilton, Deputy Chief Officer (Clinical Commissioning Group), Dr Macdonald, Chair of FedBucks and Dr Gavriel, Clinical Director of Medicas.

 

The following main points were made as part of the introduction.

 

·         FedBucks comprised of 44 practices across the County and by federating it offered a level of sustainability for GP practices.

·         Medicas had 4 practices which looked after around 50,000 patients in the North of the County (including Buckingham, Whitchurch and Wing).

·         Access to and quality of GPs in Bucks was above the national average.  All practices were rated as either "Good" or "Outstanding".

 

1.    Plans for Buckingham GP Practice

 

·         In response to a question about whether an Equality Impact Assessment (EIA) had been undertaken to identify whether there were groups who would be significantly disadvantaged as a result of the proposed changes, Mr Majilton explained that an EIA would be undertaken once the scope had been finalised.  The risks had not yet been identified.

·         The proposals were still in the early stages and have not yet formally been considered by the Clinical Commissioning Group’s Primary Care Commissioning Committee (a meeting held in public).

·         Liaison with Patient Groups and Carers Groups was part of the process in developing the plans.  Any significant change to services would have to be undertaken using the national framework for Patient Engagement and Consultation.  The Clinical Commissioning Group was aware that this would have to be undertaken once the plans were properly developed.

·         A planning application had been submitted to the District Council in June 2017 and a decision was still pending.

·         In response to a question about who was on the Stakeholder Engagement Group and what the remit of the Group was, Dr Gavriel agreed to send the terms of reference for the group and the most recent minutes of the meetings.

ACTION: Dr Gavriel

 

2.    Proposal for the new Primary Care hubs

 

·         Mr Majilton stated that in Wycombe, there were plans to bring together the GP led Minor Injuries and Illness Unit with general primary care provision, as part of the CCG’s commitment to developing services on the Wycombe Hospital site.

·         Any planning for future provision needed to be linked to the Local Plan.

·         There was a general feeling that the word "hub" was being over-used and this should be looked at in order to reduce public misunderstanding.

·         Mr Majilton recognised that, in terms of estates work, the planning can appear to be piecemeal.  Funding opportunities were adhoc and this could also make it appear un-coordinated but lots of work had been undertaken around the One Public Estate.

·         A Member commented that the new hubs provided an ideal opportunity to improve access to mental health services and a chance to profile mental health alongside health services.  Dr Macdonald added that mental health was part of the Provider Collaborative and integrated teams were being piloted across the County which would also reduce duplication.

 

3.    Update on Chiltern House Medical Centre, High Wycombe

 

·         In response to a question about  ...  view the full minutes text for item 8.

9.

The impact of the Government's Green Paper pdf icon PDF 98 KB

Purpose:

The Government’s Green Paper on the future funding options for adult social care is yet to be published so this item will be an overview of what the impact of the various options would be on the Council’s Adult Social Care service.

 

Attendees:

Lin Hazell, Cabinet Member for Health & Wellbeing

Ms G Quinton, Executive Director, Communities, Health & Adult Social Care

 

Papers:

Power point presentation attached

 

Intended outcome:

For Members to gain an understanding of the possible impact of the Government’s funding proposals on the Council’s Adult Social Care service and to provide feedback to inform the Council’s response to the Government’s Green Paper.

Additional documents:

Minutes:

The Chairman welcomed Lin Hazell, Cabinet Member for Health & Wellbeing and Ms G Quinton, Executive Director, Communities Health & Adult Social Care (CHASC).

 

Ms Quinton referred to the presentation in the agenda pack and made the following main points.

 

·         Since 1998 there had been 12 Government Green Papers attempting to grapple with sustainable funding for Adult Social Care.

·         There had been a recent announcement from the Government that a additional £240m would be available for social care to support Hospital services.

·         The Care Act 2014 included a number of new statutory requirements, including the creation of an Adults Safeguarding Board.

·         The Revenue Support Grant had been withdrawn in Buckinghamshire.  The full amount of Council Tax Social care precept had been taken over the next 3 years.

·         Adult Social Care transformation had already realised £5.2m of savings this year.

 

During discussion, Members asked the following questions and made the following comments.

 

·         A Member commented that the link between deprivation and health outcomes were very different and health inequalities needed to be addressed in the Green Paper.  Ms Quinton confirmed that the Council would respond to the Government’s Green Paper once it was published.  She went on to confirm that the Cabinet Member for Health & Wellbeing had responded to the LGA’s Green Paper following the recent debate at full Council.

·         In responding to a question about the biggest risks in Adult Social Care, Ms Quinton stated the following:

o   Demographics – there continued to be an increase in high-end care costs as people were presenting with more complex needs;

o   Fragility of the Care Provider market – the dedication of care workers was acknowledged but pressure remained on the care market.  Work was currently being undertaken to get the right mix of care and there was a need for more supported living and more specialist dementia care;

o   Fragility of the Health system.

·         Self-funders had access to a brokerage service who would charge a small fee for their service.

 

The Chairman thanked the Cabinet Member and Ms Quinton for attending.

10.

Director of Public Health Annual Report pdf icon PDF 730 KB

Purpose:

The Select Committee has, as part of its remit, responsibility for reviewing the Director of Public Health’s Annual report.

 

Attendees:

Mr N Brown, Cabinet Member for Community Engagement and Public Health

Dr J O’Grady, Director of Public Health

 

Papers:

Director of Public Health Annual report – Executive summary (attached)

Link to full report below

http://www.healthandwellbeingbucks.org/resources/Councils/Buckinghamshire/public-health/DPHAR/Public%20Health%20Report.pdf

 

Intended outcome:

For the Committee to discuss the Annual report and seek reassurance that the content of the report is embedded across the Council and the recommendations made in the report are being successfully implemented by key partners and stakeholders.

Additional documents:

Minutes:

The Chairman welcomed Mr N Brown, Cabinet Member for Community Engagement and Public Health and Dr J O’Grady, Director of Public Health.  The full report and executive summary were included in the agenda pack.

 

The following main points were made:

 

·         The Director of Public Health’s Annual report was an independent report which would highlight areas for improvement and aim to improve the health and wellbeing for Buckinghamshire residents.

·         The Annual report was written for all partner organisations in Bucks, particularly the NHS where housing had the greatest impact on health.

·         The Annual report provided evidence and examples and should be used to aid all interested organisations to think about what they could do.

·         In response to a question about how the report could be a catalyst for change, Dr O’Grady explained that a County Council Action Plan would be developed which Members could then use to drive the actions forward.

·         Dr O’Grady confirmed that she would be presenting the report to the District Councils and the Clinical Commissioning Group.

·         The funding for the Prevention at Scale project was mentioned which would provide more effective targeting and messaging.

·         The progress on the recommendations outlined in the Annual report would be reported to the Corporate Working Group.

·         In response to a question about the biggest risks to health and wellbeing, Dr O’Grady referred to lifestyle (inactivity and alcohol), climate change and natural threats, such as building houses in the South where there are water shortages.

·         A Member asked whether the Public Health team responded to planning applications.  Dr O’Grady confirmed that the team works closely with planners and would respond to planning applications, where appropriate.

 

The Chairman thanked the Cabinet Member and Dr O’Grady for attending.

11.

Committee Work Programme pdf icon PDF 53 KB

For Members to discuss and agree the items for future meetings.

 

Papers:

Work Programme attached

Additional documents:

Minutes:

Members noted the work programme.

 

The Chairman updated the Committee on the in-depth review of "Support for Carers" which would be taking place on Tuesday 30th October from 9-5.30pm.

12.

Date and Time of Next Meeting

The next meeting is due to take place on Tuesday 20 November 2018 at 10am in Mezz Room 1, County Hall, Aylesbury.

Additional documents:

Minutes:

The next meeting is due to take place on Tuesday 20th November 2018 at 10am in Mezz Room 1, County Hall, Aylesbury.