Agenda item

The Committee will hear from the Cabinet Member for Health and Wellbeing on the key challenges for the service over the last few months and the key priorities over the next 12-18 months.

Presenters:

Mrs A Macpherson, Cabinet Member for Health and Wellbeing

Ms G Quinton, Corporate Director

Papers:

Report attached

The Chairman welcomed Cllr A Macpherson, Cabinet Member, Health & Wellbeing, who introduced her report to the Committee. The Cabinet Member thanked all staff working in adult social care and public health and outlined a number of priorities and challenges within her portfolio.

Priorities

·       That the voice of Buckinghamshire and its neighbourhoods are heard in the new ICS set-up. The Health & Wellbeing Board would also ensure this is a priority.

·       Support and safeguard vulnerable residents.

·       Work with health partners to tackle health inequalities which had widened nationally during the pandemic.

·       The Better Lives strategy would be refreshed to include a focus on preventative measures.

·       Quality improvement of services.

·       Improve mental health provision across a range of services (e.g. acute interventions, eating disorders and suicide prevention).

·       Offer greater support to carers including unpaid carers.

·       Increase partnership working with a cross cutting public health agenda across the Directorates. This included delivery of public health initiatives via Community Boards and working with housing teams, Children’s Services and the development of the Local Plan.

·       Resident and Healthwatch involvement in shaping services when recommissioning.

Challenges

·       The ongoing disruption to teams and services whilst adapting to the pandemic.

·       As restrictions ease, there was an expected increase in service demand across areas such as mental health and substance misuse. Support was also expected for those who were clinically vulnerable or had faced social isolation and those deconditioned due to the pandemic.

·       The provider market faced financial demands and the Council would continue supporting with its enhanced offer.

·       Continue strengthening the workforce through the recent Buckinghamshire Health & Social Care Academy and the Cadet scheme.

Ms G Quinton, Corporate Director, added the following points.

·       In 2019, detailed audits of casework showed 75% were rated Inadequate. This year, 63% of audited cases were rated Outstanding or Good.

·       Over the past 12 months, complaints had reduced by 32% and compliments had increased by 30%.

·       The Safeguarding service had received an additional 1,774 safeguarding enquiries in the past year.

·       In the first three weeks of the pandemic, 18,000 phone calls had been made to vulnerable adults in Buckinghamshire.

The Committee raised a number of points during their discussion:

·       The HASC’s past inquiry around support for carers highlighted issues of hourly rates of pay and unpaid travel time. Carers were undervalued nationally however the Council ensured its providers paid the national living wage to its carers.

·       Key worker housing was a priority for the Council and was being considered by the Cabinet Members for Planning & Regeneration and Property & Assets.

·       Complaints received were addressed in detail every month at Board meetings so that any commonality could be identified or any lessons could be disseminated across the Directorate. Despite the complaints often being complex, response lead times had been reduced significantly by 20 days.

·       Carers Bucks was commissioned by the Council to provide support to carers however it was likely that the full extent of unpaid carers was unknown across the county. Transformation work being carried out intended to avoid care crisis through carrying out an individual care assessment on each client with each carer also being entitled to a carer’s assessment. Additionally, there were mental health specialists in each hospital to manage any care escalations that took place in A&E Departments.

·       Scrutiny of care providers took place through checking CQC ratings and quality control settings. The Council also had oversight on the unregulated element of the care market.

·       The HASC had carried out an inquiry into carer support in 2018 and was considering a refresh on this piece of work. A copy of the inquiry, including its recommendations, would be circulated to the Committee.

ACTION: Mrs E Wheaton

·       The Council had assisted care homes during the pandemic by distributing Government funding and supported care homes with a range of measures such as PPE provision, training and infection control. The Government had recently announced the mandatory vaccination of care home staff from October 2021.

·       Members had a role in identifying gaps in service provision and working on funded projects within their Community Board to fill these.

·       Phase 2 of the Better Lives Strategy was being developed to incorporate the Cabinet Member’s priorities as well as a wide range of other programmes. The strategy was governed by a Transformation Board which held Service Directors to account to meet their objectives.

·       The Preparing for Adulthood (PFA) workstream had involved collaboration and co-production and this would inform the service improvement work between children’s services and adult services. 

·       The current service restructure had reallocated caseloads more effectively and made teams more manageable. Detailed outcomes of the restructure would become more apparent over the next six months.

·       The CQC was likely to inspect the service however the new regime had not been agreed nationally. Any inspection would be a partner inspection and not focus entirely on adult social care.

·       The employee assistance programme was a corporate scheme available to all staff across all Directorates.

·       New hospital discharge initiatives had been introduced nationally by NHS England to all local authorities during the pandemic. Funding had been made available to allow patients to be discharged from hospital quickly and cared in the community for six weeks to allow assessment outside the hospital. The funding had now been reduced to four weeks and was due to cease in September 2021 so there was uncertainty on future funding.

The Chairman thanked the Cabinet Member and Ms G Quinton for the report and for answering questions from the Committee.