Agenda and minutes

There were no disclosable pecuniary interests declared.

The minutes of the meeting held on 15^th October, 2014 were signed as a true record. There were no matters arising.

Briefing Note of the Director of Public Health

Northbrook Boys have been invited to the meeting and the Board are to be shown the video of their song ‘Better be Safe than Sorry’ which highlights the importance of young people practising safe sex. The song was the winner in the Council competition, the Sex Factor. Their video has been included on the NHS Choices website. 

The Scrutiny Board considered a briefing note of the Director of Public Health which provided an update on the outcome of the recent Sexual Health Services Procurement for Coventry and Warwickshire and informed of the follow up to actions raised by the Board at their meeting on 2^nd April, 2014 when consideration was given to the proposed retendering of the service. Northbrook Boys attended the meeting for the consideration of this item and the Board viewed the video of their song ‘Better be Safe than Sorry’.

The City Council retendered sexual health services jointly with Warwickshire County Council and NHS England Specialised Commissioning Team. The new five year contract for Coventry, which commences on 1^st April, 2015, was awarded to Coventry and Warwickshire Partnership Trust (CWPT), the current providers of the service. The new service would continue to provide contraception, screening and treatment for sexual health and would include improved use of technology to make it easier for people to access services.

The note provided an update on how the service would pick up on the recommendations from the previous meeting which included working with the faith communities including the free schools; continuing to provide appropriate sensitive support for lesbians, gays and bisexuals; continuing to work with the different community groups including supporting black Africans including individuals whose immigration status was not clear; and continuing to develop links with the mental health, drug and alcohol services.

The Board questioned the officers on several issues and responses were provided, matters raised included the potential to link with the current work to raise awareness and prevent female genital mutilation and whether there were plans to replace former Councillor Sehmi who had supported the work with the faith communities and schools.

The Board were introduced to Northbrook Boys, three pupils from Coundon Court School, whose song ‘Better be Safe than Sorry’ was the winner of the recent Council competition, the Sex Factor. The song highlighted the importance of young people practising safe sex. The Board viewed the video of the song which had been included on the NHS Choices website and congratulated the Group on their success.

RESOLVED that:

(1) The outcome of the retendering process and the responses to the Board’s recommendations be noted.

(2) A progress report be submitted to a future meeting of the Board.  

Briefing Note, Report and Presentation of the Director of Public Health

The following representatives have been invited to the meeting for the consideration of this item:

Dr Jamie Macpherson, Secretary of the Local Medical Council

Dr Steve Allen, Accountable Officer, Coventry and Rugby Clinical Commissioning Group

Dr Francis Campbell, Medical Director and Sue Price, Director of Commissioning, Arden, Hereford and Worcestershire Area Team

The Scrutiny Board received a presentation from the Director of Public Health concerning her Annual Report ‘Primary Care at the Heart of our Health’. The Board also considered a report of the Director which detailed the recommendations contained in her Annual Report. Both the summary and full reports were set out at appendices. The Annual Report focused on the primary care system and its role in addressing health inequalities, with a particular emphasis on general practice.

The report had been considered by the Health and Well-being Board at their meeting on 10^th November, 2014 who supported the recommendations. The report was also to be considered by Cabinet at their meeting on 2nd December, 2014. Dr Steve Allen, Accountable Officer and Dr Peter O’Brien, Clinical Locality Lead, Coventry and Rugby CCG, Dr Jamie Macpherson, Coventry Local Medical Committee, and Dr Francis Campbell, Medical Director and Sue Price, Director of Commissioning, Arden, Hereford and Worcestershire Area Team attended the meeting for the consideration of this item. The partner representatives addressed the Board about their involvement with the production of the Annual report.

The presentation highlighted the recent improvements for keeping people healthy and improving care and quality; detailed the persisting challenges which included the management of long term conditions, the structure of GP practices and patient experience; and detailed future new models of care. 

The report put forward the following recommendations:

Keeping People Healthy

1) Public Health should work with GPs and communications to continue to promote healthy lifestyles to ensure people stay healthier for longer

2) Public Health and GPs should work together to enable practices to better understand the population in their local areas 

Making the Right Choice

3) Patients should have a more active role in managing their health

4) Patients should choose the most appropriate service for their needs

5) Patients should be involved in co-designing services

Collaborative and innovative primary care

6) General practice should be open and accessible

7) Practices should collaborate and share learning

A health and social care system that supports primary care

8) A workshop should be organised to consider the future configuration of general practice in the city to ensure that services are fit for purpose in the future

9) Mechanisms to celebrate and share success should be continued

10) Communication materials should be developed to engage with and inform the public

11) Commissioners should continue to provide feedback and support to practices that are the most challenged.

The Scrutiny Board questioned the officer and representatives on a number of issues and responses were provided, matters raised included:

·  Concerns about the availability of GP appointments

·  The increasing work pressures faced by GPs

·  How improvements in partnership working could better support patients with mental health issues

·  The importance of better information sharing across partner organisations

·  How the involvement of pharmacists, opticians, practice nurses could help to improve service delivery

·  What were the aims and objectives of the report and how would outcomes be measured to ensure improvements in general practice and addressing  ...  view the full minutes text for item 30.

Report and Presentation of the Executive Director, People

The Scrutiny Board considered a report of the Executive Director, People which provided an overview of the Care Act 2014 and informed of the Council’s preparations for 1^st April, 2015, when Local Authority Adult Social Care services were required to work to the new legal framework.

The Care Act overhauled the existing legal framework for adult social care, but in reality whilst it did create some new duties and responsibilities, it largely codified existing best practice, placing it on a statutory footing. The key themes underpinning the Care Act were well-being, prevention and integration. The emphasis of the Act was on enabling people to be as independent as possible in the management of their own care and support needs.

A Care Act Implementation Board had been set up to oversee and co-ordinate the implementation of the new legislation. The adult safeguarding processes were being reviewed to ensure that they were Care Act compliant. Five key workstreams were established to plan and implement the changes required in the following areas: charging/paying for care; care markets; assessment and eligibility, personalisation and support planning; information, advice and prevention; and information technology.

The Board were informed that the biggest potential impact on demand would be driven by self-funders and carers and it was not known how many additional people would present themselves from 1^st April. There were 1,400 people funding their own care and support, all potentially requiring an assessment. In addition an estimated 2,600 additional carers could require an assessment. The Board noted that the major funding reforms such as the Care Cap, which limits the lifetime costs an individual has to pay for care, were to be introduced from 1^st April, 2016. A new charging policy was to be developed which maximised income.

Councillor Gingell, Cabinet Member (Health and Adult Services) informed of her concerns for the Council relating to the potential financial implications.
 

The Board questioned the officer on a number of issues and responses were provided. Matters raised included:

·  Details about the potential support required by carers

·  Information about the potential funding allocation that the Council would receive, the details of which should be available in December 2014

·  Support for the work being carried out to ensure readiness to implement the legislation and assess the implications

·  Further information about the £76,000 care cap

·  Clarification about potential financial risks and legal challenges that the Council could face

·  The financial support to be offered to third sector organisations. 

RESOLVED that the work in progress and the plans in place to ensure the effective implementation of the Care Act 2014 be noted.

Briefing Note and Presentation of the Executive Director, People

Further to Minute 43 /13, the Board received a briefing note and presentation of the Executive Director, People which provided an overview of the impact of implementation of the six proposals that formed the A Bolder Community Services (ABCS) Programme.

The six proposals related to the following Adult Social Care service areas: housing related support; housing with care; day opportunities; information, advice and support; the Aylesford; and home support short-term services. A range of both qualitative and quantitative methods had been used to assess the impact of the implementation which included meetings with service users and providers.

The review work identified that those directly impacted by the proposals had been supported well through the change process and, in some cases, better outcomes were being realised as a result of the change. While the amount of support available to some people had been reduced, people were still being supported.

The Board were reminded that since the programme was still in its early stages of implementation there were still challenges to delivery which included the full impact not yet being realised or evidenced and the need for the Council to make further significant budgetary reductions.

There was an acknowledgement that the limited detrimental impact to date was in some part attributable to the amount of support provided to users, carers and providers during the change process.

Members questioned the officers and responses were provided. Matters raised included:

·  Whether there had been any unintended consequences of the implementation

·  The current position at Brandon Wood farm

·  Partnership working with West Midlands Fire Service

·  Further details about the impacts of the reduced amount of direct support

RESOLVED that the outcome of work completed to date be noted.

Report of the Executive Director, People

The Scrutiny Board considered a report of the Executive Director, People concerning the annual report on complaints and representations received in Adult Social Care from April 2013 to March 2014. A copy of the annual report was set out at an appendix. The report provided details of the complaints and representations across Adult Social Care Services in the city. Service improvements and learning from feedback were highlighted and the report also included information on future developments in complaint handling and reporting. The report was also to be considered by the Cabinet Member (Health and Adult Services) at her meeting on 9^th December, 2014.

It was a statutory duty for Adult Social Care Services to provide a system for receiving complaints and representations from people who used its services, or those acting on behalf of users.

The report indicated that 61 formal complaints were received during the year which represented less than 1% of the 9,208 people who contacted the service and the 7,227 people who received support. This was a decrease from the 81 representations received during the previous year. Service delivery and effective communication were the most common topics and 82% were dealt with at a local service level.

13 complaints/enquires relating to Adult Social Care were referred to the Local Government Ombudsman, of which five were fully investigated. Of these, three were upheld, two of which the Council had already agreed to the resolution and one was upheld with a formal report of maladministration.

The Board questioned the officers on a number of issues and responses were provided, matters raised included:

·  A lack of detailed information about the nature of the complaints and a request for examples to be included in future reports

·  What did the service do differently as a result of these complaints

·  An acknowledgement of the decrease in the number of complaints

·  A request for further information about the nature, resolution and learning concerning the five complaints fully investigated by the Ombudsman.

·  An assurance that the Council had discharged all of its duties relating to these complaints.

RESOLVED that:

(1) The Annual Report on complaints and representations be noted.

(2) Future reports to include detailed information about the nature of the complaints and any changes introduced as a result of lessons learnt.

(3) The Cabinet Member (Health and Adult Services) be informed of the Board’s considerations at her meeting on 9^th December, 2014.

Outstanding issues have been picked up in the Work Programme

The Scrutiny Board noted that all outstanding issues had been included in the Work Programme for the current year.

Report of the Scrutiny Co-ordinator

The Scrutiny Board considered the Work Programme for 2014-15.

RESOLVED that the work programme be updated to include the following:

(i) Sexual Health Services - progress report, minute 29 above refers

(ii) Recommendations for primary care in the city – progress report, minute 30 above refers

(iii) Update on the impacts of the patient transport services at UHCW. 

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

There were no other items of urgent public business.