Meeting documents

An opportunity for Committee Members to ask questions of the Cabinet Member for Health & Wellbeing and the Cabinet Member for Community Engagement and Public Health.

Lin Hazell, Cabinet Member for Health and Wellbeing, reported that the budget was under constant focus. In December, £2.8 million had been released from the contingency fund reducing the year end overspend forecast to £1.3 million.  Since then the department had found £700,000 of efficiencies resulting in a projected overspend of approximately £700,000.  The Cabinet Member acknowledged that demand fluctuated and the budget situation was volatile.  More controls would be put in place and a more robust transformation programme had been devised which would be closely monitored through weekly meetings. 

The following questions/points were raised:

• In response to a question on how well the service had coped under the recent winter pressures, L Hazell informed the Committee that the number of Delayed Transfers of Care (DToC) had been good.  However, some of the Hospitals outside of the county, with patients from Buckinghamshire, were struggling.  The Buckinghamshire County Council (BCC) Adult Social Care service had also been doing well, particularly the Re-ablement service, which provided packages to enable people to live independently in their homes after leaving hospital.  L Hazell offered to provide an update report if required.  The Chairman added that Buckinghamshire Healthcare Trust (BHT) had planned well and coped better than some other areas.  A lot of A & E staff had been off sick which had increased the pressure but the situation was improving.

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• A member of the Committee asked what was being done to help people in their 60’s become more resilient as the care packages provided now were not sustainable in the future.   L Hazell explained that the Adult Social Care Service was working with Public Health and was confident that changes would be seen.

It was asked whether L Hazell could provide assurance that domiciliary care providers would not undertake the practice of "clipping", i.e. reducing the time spent with the client.  L Hazell had not heard of the term and had not received any feedback that this was happening and agreed to find out.

Ms J Bowie, Director of Joint Commissioning, had provided the following update after the meeting. 

Post Meeting Note

Locally, BCC referred to a practice called "call cramming" and work had been taking place with our providers to stop this occurring. BCC commissioned domiciliary care with our main providers on a time and task basis with allocated hours for this work.  The actual hours of care delivered were reconciled with the commissioned hours over 4 week periods. Any complaints received that visits had been significantly shorter than planned were investigated.  Care workers were generally paid for the hours of care they delivered so there was no personal incentive to shorten the visit times. 

• L Hazell did not know how many older people were readmitted to hospital and agreed to report back.   Ms Bowie had provided the following update after the meeting. 

Post meeting note:

Readmissions to hospital after 30 days stopped being routinely monitored nearly 5 years ago so there were no current national comparisons of rates. However local Buckinghamshire system figures showed a slight upward trend.

The number of readmissions for 2017-18 was for year end to date but if the number reported in Q4 of this year was consistent with Q4 averages from previous years the full year outturn for 2017/18 would be slightly higher than 2016/17

• It was confirmed that partnership work with the Clinical Commissioning Groups (CCGs) was integral to cope with the extra demand due to the forecasted increase in the population.

• Work was continuing on the provision of respite care.

• L Hazell agreed that care homes were closing in some cases due to lack of funding and that it was a national issue.  Prices had been checked and found to be competitive with other authorities.  People were placed in care homes outside of the county on occasion if need be.  Families were always consulted in order to deliver their needs wherever possible.