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
Webcast: View the webcast
Apologies for Absence / Changes in Membership
Apologies were received from Mr W Bendyshe-Brown, Mrs P Birchley, Mrs L Clarke OBE, Mr C Etholen, Mr B Roberts, Ms S Jenkins, Dr W Matthews and Mr N Shepherd.
Ms J MacBean substituted for Mr N Shepherd.
Declarations of Interest
To disclose any Personal or Disclosable Pecuniary Interests
Julia Wassell declared an interest in item 7 as she worked for Mind, mental health services in Wycombe.
Mr R Bagge declared an interest in item 8 as he was Chairman of a Public Health Advisory Committee at NICE which was investigating alcohol and the use of digital interventions.
Mr T Green declared an interest in item 8 as he was a designated supervisor for two licensed, charitable premises in Buckinghamshire.
To confirm the minutes of the meeting held on Tuesday 2nd July 2019 as a correct record.
The minutes of the meeting held on Tuesday 2nd July 2019 were agreed as a correct record.
Julia Wassell reported that a resident had further questions regarding ear operations and grommets and would send these to the Committee & Governance Adviser.
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:
There were no public questions.
The Chairman updated the Committee on the following.
· Buckinghamshire Healthcare NHS Trust’s Open Day and AGM would take place on Saturday 21st September between 11am-3pm at Stoke Mandeville Hospital;
· The Child Obesity RAG status would be attached to the minutes;
· An informal Scrutiny Chairman meeting was being arranged for the Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System.
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.
Ms T Jervis, Chief Executive, Healthwatch Bucks provided the following update.
· Two Healthwatch Bucks reports had been published – Outpatient services (feedback from Stoke Mandeville, Amersham and Wycombe Hospitals) and Live Well, Stay Well;
· Healthwatch Bucks had been shortlisted for a national award in recognition for their work around readability;
· Recruitment was underway for a new chief executive.
The Committee has been regularly reviewing and challenging Adult Social Care’s Better Lives transformation programme which is organised into three tiers. This item reviews progress within Tier 3 "Living with Support".
Tier 3 focuses on delivering strength based, outcome focused approaches to long term support planning that encourage independence, progression and a reduction in reliance on traditional services.
Lin Hazell, Cabinet Member for Health & Wellbeing
Ms G Quinton, Executive Director, Communities, Health and Adult Social Care
Ms J Bowie, Service Director, Integrated Commissioning
For Members to assess whether sufficient progress has been made within the work streams to enable a successful and timely delivery of Tier 3 transformation. For Members to seek reassurance that the projects within the work streams will deliver better outcomes for social care clients.
The Chairman welcomed Lin Hazell, Cabinet Member for Health & Wellbeing, Ms J Bowie, Service Director, Integrated Commissioning and Ms L Spencer, Lead for Transformation.
The following main points were made during the discussion.
· The transformation programme was organised into three tiers:
o Living Independently (Tier 1);
o Regaining Independence (Tier 2);
o Living with Support (Tier 3).
· There were 9 workstreams within Tier 3, as follows:
o Prevention Commissioning;
o Mental Health services;
o Direct Care and Support;
o Housing and Equipment;
o Planned reviews of existing care packages;
o Direct Payments;
o New Learning Disability service model;
o Continuing Health Care – create a single point of access for providers and reduce duplication.
· A Member commented that the use of acronyms and structure of the report made it difficult to understand how many clients were affected by the proposed changes in services, what the actual spend was in each area and the impact of the service improvements on the clients. Ms Bowie agreed to look into this and come back with the number of clients and the actual spend in each area.
ACTION: Ms Bowie
· The Better Lives Strategy was about making sure individual service users had better experiences.
· A Member sought assurance that the transformation work being undertaken was delivering the right level of care deemed acceptable by service users and families. The Member commented that it was not just about delivering financial savings, the Committee needed to know that the quality of services had not been adversely affected.
· Ms Bowie confirmed that the Transformation Board had requested evidence on the impact of the service changes, to include feedback from users and carers as well as measuring the impact via key performance indicators.
ACTION: Ms Bowie
· A Member expressed concern about delivering the savings in this tier and asked particularly about the living with dementia financial savings in light of an increase in demand on services and the complexity of peoples’ needs. Ms Bowie explained that the £285k savings sat within the mental health project overview and the savings would come from reviewing existing service users plans and looking at alternative provision. The savings would be made from offering more independent tenancies to service users who are currently in residential homes and other types of support. There would also be a review of s117 after care packages to ensure these were aligned with current policies and procedures.
· A Member commented that it was difficult to see how the Better Lives Strategy was being delivered across all the tiers and suggested that future presentations needed to include action plans for each tier with deliverables and timeframes, as well as budget savings. Ms Bowie confirmed that there should be consistent approach to reporting on the transformation programme.
· It was agreed that representatives from the HASC Select Committee would meet with Adult Social Care Officers to help shape and structure future reports on Transformation.
ACTION: Chairman/Committee & Governance Adviser/Jane Bowie
· A Member commented that "cuckooing" (where drug dealers take over ... view the full minutes text for item 7.
At its Committee meeting on 29th January 2019, Members agreed to set-up a Task & Finish Group to undertake pre-decision scrutiny on the proposals for the re-provisioning of residential short breaks (respite) for older people and adults with a learning, mental, sensory or physical disability.
Evidence gathering took place between February and May. A letter was sent to the Cabinet Member for Health & Wellbeing outlining the key findings and suggestions. A response was received from the Cabinet Member to the substantive points.
Cabinet is due to take a decision on Monday 30th September.
Letter from the Chairman of the Task & Finish Group to the Cabinet Member for Health & Wellbeing and the response from the Cabinet Member (attached).
Members of the Task & Finish Group:
County Councillor Steven Lambert, Chairman of the Task & Finish Group
County Councillor Anita Cranmer
County Councillor David Martin
County Councillor Brian Roberts
Thalia Jervis, Chief Executive, Healthwatch Bucks
For Committee Members to discuss and note the work of the Task & Finish Group.
A Task & Finish Group was set-up to undertake pre-decision scrutiny on the proposals for the re-provisioning of residential short breaks (respite) for older people and adults with a learning, mental, sensory or physical disability.
Mr S Lambert, Chairman of the Task & Finish Group, updated the Committee on the key findings of the Group which were outlined in a letter to the Cabinet Member for Health & Wellbeing. The Cabinet Member responded by letter, both were attached to the papers for the meeting.
Committee Members thanked the Task & Finish Group for the work they had undertaken on this issue. Mrs Wheaton, Committee & Governance Advisor, was also thanked for her work in supporting the Task & Finish Group.
A Member asked for clarification around the recent decision to temporarily close Seeleys House and asked whether it included the Day Opportunities Centre. Ms Bowie confirmed that it was only the residential respite care service that was temporarily closed.
In response to a question about the level of involvement of the voluntary sector in the proposed changes, Ms Bowie confirmed that the key stakeholder groups had engaged in the process and had made a good contribution throughout the consultation. The service users and carers were thanked for providing valuable feedback during the initial consultation period. It was acknowledged that beneficial feedback had been gained as a result of extending the consultation for a further 6 weeks and focussing on the Aylesbury Opportunities Centre.
The proposal would be presented to Cabinet on Monday 30th September 2019 for a decision.
It is a statutory duty for the Director of Public Health to produce an annual report on the health of their population. The theme of this year’s annual report is the impact of alcohol on the health and wellbeing of the residents of Buckinghamshire.
Mr G Williams, Cabinet Member for Community Engagement & Public Health
Dr J O’Grady, Director of Public Health
Director of Public Health Annual report for Buckinghamshire 2019 – Alcohol and Us, Key Messages (attached)
Link below to full version of the annual report
For Members to note the annual report and to discuss the implementation of the recommendations made in the report.
The Chairman welcomed Mr G Williams, Cabinet Member for Community Engagement & Public Health and Dr J O’Grady, Director of Public Health.
The following main points were made during the discussion.
· 1 in 4 of Buckinghamshire residents were drinking at levels that could be harming their health. Most of the people drinking over the Chief Medical Officer’s recommended weekly intake (14 units) were not dependent on alcohol.
· The proportion of people drinking over 14 units a week was highest in highest income households, older people (women 55 to 64 years and men 65-74 years) and men.
· The annual report provided an overview of alcohol in Buckinghamshire and the harms it can cause. It included stories from residents and frontline staff about the impact of alcohol on them.
· The report contained a number of recommendations to stimulate conversation and action across partners and communities in Buckinghamshire. The main aim was to increase awareness of safer drinking levels and what could be done to help reduce the harms from alcohol. There was a role for all partners in this, but particularly for frontline staff in health and social care to routinely ask the simple questions that might result in someone getting the help they need and changing their life for the better.
· In response to a question, Dr O’Grady confirmed that the Director for Public Health chose the topic for the annual report but used the priorities identified in the Joint Strategic Needs Analysis to highlight specific issues.
· A Member suggested "Nutrition and the effects of too much processed food" as a topic for a future annual report.
· Members discussed the benefits of lobbying Government and when the Government introduced policies around smoking, it had had an immediate effect.
· In response to a question around the social side of drinking, Dr O’Grady explained that her annual report was about helping people to make informed choices and to raise awareness around the safe levels of drinking alcohol.
· A Member suggested that leaflets should be sent to all households in Bucks informing people about the number of units and safe levels of alcohol.
· Concerns were raised around the effects of "hidden drinking" and it was acknowledged that this was a problem.
· Dr O’Grady explained that the annual report had been discussed and agreed at the recent Health & Wellbeing Board meeting so key partners were signed up to the recommendations. The report would also be discussed at the next Safer, Stronger Bucks meeting.
· The Cabinet Member said that partner workshops had been set-up to review the recommendations and develop specific delivery plans with timescales.
· A Member asked about the metrics being used to measure the success of the campaign. Dr O’Grady explained that data links were being developed, including capturing alcohol related admissions to A&E, deaths from cirrhosis of the liver and referrals to specialist services.
· In response to a question about the sustainability of funding for specialist services, Dr O’Grady clarified that the Government had committed to no cuts in Public Health funding and ... view the full minutes text for item 9.
For Members to discuss and note the work programme.
Work programme attached
The Committee noted the items for the November meeting:
· Temporary closure of Chartridge Ward, Amersham Hospital;
· Support for Carers Inquiry – 6 month recommendation implementation monitoring.
Members discussed possible items for the February meeting (date to be agreed) as this would be the last formal meeting before the Unitary council comes into being on 1 April 2020.
· A composite report on ASC Transformation, which tells a story of the success of the transformation programme across the tiers, from a service user viewpoint;
· An update on the Primary Care Networks, including evidence of progress to date and patient improvements;
· Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System and the alignment of priorities within the long term plan;
· Community hubs – plans for further roll-out across the county;
· Digital strategy – how the improvement plans impact on Bucks residents.
Date and Time of Next Meeting
The next meeting is due to take place on Thursday 14th November 2019 at 10am in Mezz Room 1, County Hall, Aylesbury.
The next meeting is due to take place on Thursday 14th November 2019 at 10am in Mezzanine Room 1, County Hall, Aylesbury.