Agenda and minutes

Health and Wellbeing Overview and Scrutiny Committee
Thursday, 8th November, 2018 7.00 pm

Venue: Committee Room 1, Civic Offices, New Road, Grays, Essex, RM17 6SL. View directions

Contact: Jenny Shade, Senior Democratic Services Officer  Email: Direct.Democracy@thurrock.gov.uk

Items
No. Item

23.

Minutes pdf icon PDF 103 KB

To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 6 September 2018.

Minutes:

The Minutes of the Health and Wellbeing Overview and Scrutiny Committee held on the 6 September 2018 were approved as a correct record.

24.

Urgent Items

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972.

Minutes:

Roger Harris, Corporate Director of Adults, Housing and Health, informed members that the Care Quality Commission had notified the Council that Allied Healthcare was likely to be unable to provide regulated activities because of a business failure. It was confirmed that only 15 packages were provided by Allied in Thurrock and that alternative provider could be sourced if required.

 

Councillor Holloway informed members that due to the continued concerns with the Sustainability and Transformation Plan (STP) she proposed that a call in be made to refer the STP to the Secretary of State on the consultation process and the proposed closure of Orsett Hospital. Members agreed to refer to the Secretary of state which will be formalised in a report to be presented at the extraordinary Health and Wellbeing Overview and Committee outlining the reasons for the referral.

25.

Declarations of Interests

Minutes:

No interests were declared.

26.

HealthWatch

Minutes:

Kim James, Healthwatch Thurrock Representative, stated some concern around the removal of funding by the Clinical Commissioning Group for specific counselling with SERICC for Sexual Abuse Counselling. Kim James continued to state that it did not seem logical to commission these services to provide an interim arrangement when they were not specialists in the subject, and the eventual outcome may be that it went back to SERICC. Kim James had attended a workshop on the 7 November and had raised concerns and asked the Committee to look at how the removal of the service could take place before an alternative pathway had been set up.

 

Mandy Ansell, Accountable Officer, Clinical Commissioning Group (CCG), stated her disappointment that this matter had been brought to the committee rather than directly to her. At the workshop held yesterday it was agreed that resources would be allocated to the relevantpathway and the CCG were committed to get the service right and deliver as soon as possible. Mandy Ansell agreed that a report would be brought back to committee to update Members.

 

27.

Improving Cancer Waiting Times (PowerPoint Slides) pdf icon PDF 403 KB

Minutes:

Tom Abell, Deputy Chief Executive and Chief Transformation Officer, Basildon and Thurrock Hospital Trusts presented the update report on behalf of Andrew Pike who was unable to attend. Tom Abell stated that since the last update the focus had continued on the pathway transformation, operational control and the investment in additional capacity and capability. It was also recognised that improvement must be made to deliver sustainable waiting times. Members were taken through the report slides where the pathway transformation, the snapshots and comparisons of waiting times and performance were discussed.

 

Tom Abell stated that the next steps would be to recruit and to increase the endoscopy capacity to support cancer treatments and to continue to focus on the challenged tumour sites and improve the surgery pathway.

 

Councillor Holloway thanked Tom Abell for the report and the good work undertaken.

 

Councillor C Kent questioned why cancer was being picked up at Accident and Emergency. Tom Abell stated that Thurrock had a high emergency presentation at accident and emergency particularly for lung cancer which was hard to diagnose. That work continued with general practitioners and will take part of a pilot of the proposed national lung cancer screening.

 

Councillor Redsell questioned what other advice could be given to residents.

 

Mandy Ansell stated that lung cancer was hard to diagnose and anyone who had a cough for more than three weeks should seek medical advice. With obesity and smoking being the main factors of concern in Thurrock and residents should be aware of their general life styles. It was noted that Ian Wake, Director of Public Health, had continued to do some good work with the recent report on Cancer Deep Dive.

 

Councillor Redsell stated more should be done to stop people smoking outside the Civic Offices and places such as Thurrock Hospital.

 

Councillor Holloway acknowledged that numbers had been reduced but the numbers were still far too high and needed to be lower and requested that an update report be presented to committee which demonstrated the next steps.

 

Members agreed that an update report be presented at the 7 March 2019 committee.

 

Tom Abel left the Committee Room at 7.30pm.

28.

Mental Health Urgent and Emergency Care pdf icon PDF 58 KB

Additional documents:

Minutes:

Mark Tebbs, Director of Commissioning, Thurrock Clinical Commissioning Group, presented the report that highlighting that the demand for adult acute mental health had increased and as a result the system was under pressure. That over the last 18 months commissioners had focused on developing and delivering an urgent and emergency care transformation programme. This focused on the S136 pathways and the development of street triage services; psychiatric liaison at Basildon & Thurrock University Hospital NHS Foundation Trust which provided expert assessment, treatment and developing 24/7 community crisis care. Mark Tebbs stated that the focus was on the winter plan to improve the operational efficiency of the current service and plans to merge two dementia wards to form an adult inpatient ward with 16 beds.

 

Councillor Holloway thanked Mark Tebbs for the report.

 

Councillor Redsell questioned whether children and young people formed part of the plan. Mark Tebbs stated they were not in the scope of this plan but the opportunity to integrate this will happen going forward and stated that early intervention was critical which would start as young as the age of 14.

 

Councillor Redsell questioned why Thurrock Hospital wards had been empty and when were they planning to be re-opened. Mark Tebbs stated that the empty wards were being refurbished to take on the new requirements.

 

Councillor C Kent welcomed the new beds but had concerns over the small rise of unexpected deaths. Mark Tebbs stated a Zero National Ambitions which was part of the National Suicide Prevention Alliance would focus on suicide prevention. Mark Tebbs stated that it was important to do more with funding coming from the STP.

 

Councillor Holloway questioned whether there were sufficient investments being made to recruit staff into mental health services. Mark Tebbs stated that recruitment was one of the biggest challenges in health but Thurrock were ahead of the national timetable and would look at models being used in other local authorities.

 

Councillor Holloway stated that education played a vital part in this and with great college facilities in the borough this was a great opportunity for training to be undertaken and to keep those skills in the borough.

 

Councillor Redsell agreed with Councillor Holloway’s comments that educating the young and to steer young people in the right direction was vital.

 

Councillor Rigby asked for clarification on the predicted increase in winter. Mark Tebbs stated that peak demands coincide with school holidays with the peak demand being the second week in January.

 

Roger Harris stated that Adult Social Care broadly supported the proposals but wanted further work undertaken to understand the reasons behind the increase in demand and ensure services in the community were better co-ordinated and more integrated.

 

RESOLVED

 

That the Health and Wellbeing Overview and Scrutiny Committee noted the content of the report and proposed urgent and emergency care plan.

 

Mark Tebbs left the Committee Room at 8.05pm.

29.

Thurrock Safeguarding Adults Board Annual Report 2017-18 pdf icon PDF 79 KB

Additional documents:

Minutes:

Les Billingham, Assistant Director of Adult Social Care and Community Development, presented the annual report that had set out the profile of adult safeguarding activity within Thurrock for the period 2017/18. The report described the strategic objectives, achievements and challenges. Les Billingham stated that during this period Thurrock had no cause to commission a Safeguarding Adult Review and welcomed the incoming chair of the Thurrock Safeguarding Board as Jim Nicholson.

 

Councillor Redsell questioned the contingency underspend from 2016/17 of £38,000. Les Billingham stated that this money would be used sensibly and appropriately and forecasted that this figure would come down following the planned funded events and training programmes.

 

Councillor Holloway referred to the Deprivation of Liberty Safeguards (DoLS) and asked what changes and issues would come about and what impact these may have. Les Billingham stated that an analysis of the proposed changes for the future had taken place and that additional challenges were likely but the government was looking to change the law and get greater clarity. Every local authority had waiting lists for DoLS with Thurrock having only a small list.

 

Councillor Redsell questioned how data collection would change. Les Billingham stated that data collection was a national issue problem on the data set and that data was collected differently. In Thurrock the data set had been agreed which included some data for performance. It was planned to have a complete data set in January 2019.

 

RESOLVED

 

That the members of the Health and Wellbeing Overview and Scrutiny Committee noted the report.

30.

Adult Social Care - Fees & Charges Pricing Strategy 2019-20 pdf icon PDF 123 KB

Additional documents:

Minutes:

Roger Harris, Corporate Director Adults, Housing and Health presented the report that set out the charges in relation to services within the remit of the Health and Wellbeing Overview and Scrutiny Committee with any new charges taking effect from 1 April 2019.

 

Councillor Holloway thanked Roger Harris for the report.

 

Councillor Redsell questioned whether meals on wheels were still being used. Roger Harris stated the contract with RVS was due to expire at the end of 2018/19 financial year and that options would be reviewed on how the service should be run following this date.

 

Councillor Redsell stated that the on-line application for Blue Badges was not working well. Roger Harris stated that the Blue Badge application was a national online form that Thurrock Council could not change but agreed to take back and look at how support could be provided where required.

 

Councillor Holloway stated her concern for domicilary care workforce and questioned whether charging more would generate more funds to pay the workforce more. Roger Harris stated that the rates paid to providers were favourable.

 

Councillor C Kent referred to the £1.4 million target to be secured through the demand increases from residents and ask whether this would be profit to the Council. Roger Harris stated that no profit would be made as services were heavy subsidised.

 

Councillor Holloway questioned whether a wide budget report would be presented to the committee. Roger Harris agreed to let the chair know of any planned reports and timescales.

 

Councillor Redsell questioned the Transport fees. Roger Harris explained that these were the core permanent in house service at Elizabeth Gardens provided by Care Watch at £40 per week to which the Council subsidised a further £40.

 

RESOLVED

 

1.         That the Health and Wellbeing Overview and Scrutiny Committee noted the revised fees and that Health and Wellbeing Overview and Scrutiny Committee commented on the proposals currently being considered with the remit of the committee.

 

2.         That the Health and Wellbeing Overview and Scrutiny Committee noted that Director delegated authority will be sought via Cabinet to allow Fees and Charges to be varied within a financial year in response to commercial and legal requirements.

31.

Communities First - A Strategy for developing Libraries as Community Hubs in Thurrock pdf icon PDF 72 KB

Additional documents:

Minutes:

Roger Harris, Corporate Director of Adults, Housing and Health, presented the first comprehensive strategy for Thurrock’s Library Service and Community Hubs. The strategy provided a strong foundation to deliver the Council’s vision for a vibrant service, to meet the needs of the growing population in Thurrock within modern buildings that would run alongside local community activities. Roger Harris stated a consultation had taken place to which 800 residents had responded. The expansion of the library service, the demand for Saturday afternoon opening and extended evening opening where just some of the comments made. Roger Harris was also pleased to confirm that there would be no library closures.

 

Councillor C Kent stated how pleased she was that there would be no library closure and asked for assurance on behalf of the volunteers that staffed the hubs. Roger Harris stated that the Council would be expanding the number of volunteers but there would be no proposal to have a volunteer only service.

 

Councillor C Kent questioned whether the Book Fund was still up and running.  Roger Harris stated that it still existed but the budget had been cut and now stood at only £50,000.

 

Councillor Redsell raised some concern over the size and the future of the Blackshots library and questioned where the consultation process had taken place. Roger Harris stated that the consultation had been on-line, copies had been placed in libraries, schools and as part of the summer reading. Roger Harris agreed to send a copy of the consultation responses to Members.

 

Councillor Holloway stated that the fundamental purpose of libraries was about the books which linked to education and for skills to be developed for the future. Councillor Holloway asked how much of the consultation in producing the strategy had been discussed with staff as they were the professionals.

 

Councillor Rigby stated that each library may be slight different and that the community should be involved in the development of them.

 

RESOLVED

 

That the Health and Wellbeing Overview and Scrutiny Committee commented on the draft strategy.

32.

Developing a new residential care facility and a new model of primary care in South Ockendon pdf icon PDF 102 KB

Minutes:

Les Billingham, Assistant Director Adult Social Care and Community Development presented the update report on the proposed development of a new residential facility in South Ockendon which would make a significant contribution to meeting the demand and set new standards in terms of facilities and services. The development would consist of a new residential facility for older people, an interim care facility and the potential for be a new medical centre with community facilities. Approval had now been sought to progress with the design and development stages.

 

Councillor Redsell asked whether the facilities would be for Thurrock residents. Les Billingham stated that almost certainly for Thurrock residents who had a very high degree of need.

 

Councillor Redsell stated it would be good to see some data on the number of Thurrock elderly residents who still lived at home and received care.

 

Councillor C Kent raised the concern that parking should be addressed as part of the design stages of any new development.

 

RESOLVED

 

1.         That the Health and Wellbeing Overview and Scrutiny Committee noted the request to be made to Cabinet for delegated authority for the Corporate Director Adults, Housing and Health, the Director of Finance and IT, and the Portfolio For Children and Adult Social Care, to tender for and award the building contract for the development of housing and associated facilities for older people requiring residential care, subject to tender returns being in line with an agreed business plan based on the principles within this report.

 

2.         That the Health and Wellbeing Overview and Scrutiny Committee noted the negotiations being undertaken with health partners concerning the development of a phase 2 Integrated Medical Centre to replace the current South Ockendon Health Centre.

33.

Further Transformation to Continue Improving Standards in Primary Care pdf icon PDF 349 KB

Minutes:

Roger Harris, Corporate Director of Adults, Housing and Health, presented the report that provided Members with an update on the Long Term Condition Case Finding and Management Programme which had been led by Public Health as part of a systematic programme of Primary Care Transformation. Mandy Ansell, Accountable Officer Clinical Commissioning Group, stated that the report had been prepared from a public health view of primary care and the programme had been recognised nationally.

 

Councillor Holloway thanked Officers for the fantastic report.

 

Councillor Rigby questioned Flash Glucose Monitoring. Mandy Ansell stated that there was no evidence based for this and was being studied in micro-optic detail. A report would be presented to committee when findings had been made.

 

RESOLVED

 

That the Health and Wellbeing Overview and Scrutiny Committee commented on the programme and approved progress, changes and additions to the programme of performance and improvement and support for primary care with linked demand management for hospital and adult social care services.

34.

Work Programme pdf icon PDF 52 KB

Minutes:

The Chair asked Members if there were any items to be added or discussed for the work programme for the 2018-19 municipal year.

 

Members agreed that the Update on Mental Health Urgent report to be added to the 7 March 2019 committee.

 

Members agreed that the SERICC (for Sexual Abuse Counselling) to be added to the 7 March 2019 committee.

 

Members agreed that the Update on Cancer Waiting Times report to be added to the work programme for the 2019-20 municipal year.

 

Members agreed that the Flash Glucose Monitoring Report to be added to the work programme when information was readily available.