Agenda and draft minutes

To receive any apologies for absence from Councillors.

Apologies were received from Cllrs H Allen and N Geary.

To receive information on any changes in the membership of the Committee.

Note – When a member of a Committee is unable to attend a meeting of a Committee or Sub-Committee, the relevant Political Group Leader (or their nominated representative) may, by notice to the Monitoring Officer (or their nominated representative) prior to the meeting, appoint a substitute member from within the same Political Group. The contact details on the front of this agenda should be used for notifications.

Notification was received from the nominated representative of the relevant Political Group Leader that Cllr J Kelly was substituting for Cllr H Allen for this meeting of the Committee.

Councillors are requested to declare any interests on items included in this agenda. Please refer to the workflow on the preceding page for guidance.

Declarations received will be reported at the meeting.

For transparency, Cllr C Johnson declared that she was an NHS employee in the Bournemouth, Christchurch and Poole area. Cllr L-J Evans also declared, for transparency, that she was an NHS employee in the Bournemouth, Christchurch and Poole area.

To confirm the minutes of the meeting on 20 January 2020.

The Committee confirmed the minutes of the meeting held on 20 January 2020 as an accurate record.

To note and comment as required on the action sheet which tracks decisions, actions and outcomes arising from previous Committee meetings.

The Chair gave an update on the Action Sheet. Members heard that item 35, the ‘External Scrutiny Quality Accounts’, and item 46 ‘Clinical Services Review’ were the two items still outstanding.

It was explained that in relation to item 35, the scrutiny leads for the NHS Dorset Quality Accounts had been finalised and that meeting arrangements were being made with the Principal Officer of Planning and Quality Accounts for late March, early April time.

In relation to item 47, members were reminded that a development session will be held in early June at which point the Committee will consider where scrutiny can be best targeted during the implementation and delivery stages of the Clinical Services Review (CSR).

The Corporate Director for Health and Adult Social Care explained that, going forward, actions would remain on the Action Sheet for one Committee meeting cycle after their completion.

RESOLVED that:- The Committee confirmed the action sheet without amendment.

To receive any public questions, statements or petitions submitted in accordance with the Constitution. Further information on the requirements for submitting these is available to view at the following link:-

https://democracy.bcpcouncil.gov.uk/documents/s2305/Public%20Items%20-%20Meeting%20Procedure%20Rules.pdf 

The deadline for the submission of public questions is Monday 24 February 2020.

The deadline for the submission of a statement is 12.00 noon, Friday 28 February 2020.

The deadline for the submission of a petition is 12.00 noon, Friday 28 February 2020.

There were no public questions, statements or petitions received for this meeting.

To receive information on the progress in delivering the actions and outcome contained in The Big Plan 2018-21, which is a Health and Social Care Commissioning Strategy for Adults with a Learning Disability, since it was published in 2018.

The Head of Strategic Commissioning – Disabilities briefly explained Item 6, ‘The Big Plan 2018-21 Commissioning Strategy for Adults with Learning Disabilities Progress’, before introducing the People First Forum.

The Assistant Manager of the People First Forum explained the group’s current structure, their aims and vision, the services they provide to the community and the main enquiries that they receive. These enquiries ranged from questions on emotional wellbeing, assertiveness, being heard and the groups and events that the group organise. Members were told of the Safe Place project, the Witness Profiling service, the Easy Read Information and Quality Checking work that the People First Forum had undertaken. The Committee were told about the main events that the People First Forum arrange in the community, including the Big Night Out with Suttles that is attended by 600 adults with a learning disability.

The trainer for the People First Forum explained what the Bill of Rights Charter was, what the main rights were, how the Charter had been developed and how many organisations had signed up to it. The group’s members had agreed that the Charter should include the following rights: the right to feel safe when going out, to feel safe when at home, to receive support when needed, to relationships, to say no, to confidentiality, to independence, to public facilities, to good healthcare, to be heard and to have feelings and more. The Committee were asked whether they would continue to support the Charter and whether it would be part of BCP Council’s plans in the way they work. Finally, the Trainer provided some significant figures and information on how rights had not been respected for adults with a learning disability or autism.

Members commented on the successes of the People First Forum’s work and noted that over 800 people had become members of the group. It was explained that new members often joined after attending a People First Forum social meeting or after visiting a friendship centre. A question was asked on whether the People First Forum could attend the Council meeting at which the Bill of Rights Charter would be considered. The Democratic Officer advised that if the Committee were minded to include this in their recommendation to Council, this could be investigated and the possible arrangements would be assessed.

One member asked about the challenges that adults with a learning disability or autism may face when voting in elections. The Committee heard that Easy Read material was produced nationally to assist people with a learning disability or autism when voting, and that this was very important in supporting them during this process.

The Head of Strategic Commissioning – Disabilities gave a presentation on the Big Plan 2018-21 Progress Report. To start, an overview of the local population of people with a learning disability across the BCP area was given. 820 people received Adult Social Care services, 2,467 were registered with a GP and 7,772 was the estimated number of those with a learning disability in the local  ...  view the full minutes text for item 59.

To receive an introduction to the contract and priorities of Healthwatch. To include a description of the relationship between Healthwatch, the Council and scrutiny and to ensure the committee understands the contract with Healthwatch and offers input accordingly.

The Manager of Healthwatch introduced item 7, ‘Healthwatch Dorset’, before giving a presentation to the Committee. The Committee heard that Healthwatch Dorset’s main aim is to share the views gathered so that those people at the heart of care see can be heard in seeking improvements to services. Members were told that Healthwatch Dorset undertake proactive engagements from their space at The Bridge at the Littledown Centre and the Manager of Healthwatch Dorset provided examples of the main actions the group undertake, including:

• Promoting the involvement of local people in all areas of health.
• Providing an information and signposting service to assist local people in the choices they have about health and social care services.
• Monitoring the quality of health and care services.
• Utilising the voice of local people to influence commissioners and providers.
• Alerting the relevant bodies to any concerns about local health and care services.

Members were told that Healthwatch Dorset had spoken to over 1000 local people in 2019. During this time, several projects had been undertaken and contributed to, including the NHS Long Term Plan, Diabetes Awareness, A&E Services, homelessness and cancer support services. The Committee heard that over 110 people had volunteered for Healthwatch Dorset over 2019 and a new Steering Group of local volunteers had been created to help create the Healthwatch Dorset Workplan.

This Workplan focused on five main topics: cancer support services in West Dorset, children and young people’s mental health services, access to Primary Care, A&E services and transport. The Committee raised several questions regarding the Workplan and a member enquired as to whether Healthwatch Dorset had been involved in any of the Homelessness Reduction Workgroups, to which members heard they had not but would be happy to contribute. A Member asked how the five Workplan priorities had been reached. The Manager of Healthwatch Dorset explained that the process was lengthy, whereby a year’s worth of feedback was evaluated in line with the framework of key themes. It was explained that the key themes considered were geography, protected charateristics, local priorities and Healthwatch England’s national priorities.

A question was asked on the Diabetes Awareness work that was undertaken by Healthwatch Dorset in 2019 and its outcomes. The Healthwatch Dorset manager informed the Committee that the project delivered good resources in the form of videos and blogs made by young people living with diabetes, which had since been shared among Primary Care providers.

The Manager of Healthwatch Dorset showed the Committee its recent report into patients’ views when using Poole Hospital’s A&E service. A Member asked how future scrutiny could be done on this topic, and the Manager of Healthwatch Dorset suggested that she have a conversation with Poole Hospital to see when the best time to consider their response to the recommendations would be.

The Manager of Healthwatch Dorset informed the Committee that 20 PLACE Visits (Patient Led Assessment of Care Environment) had been conducted in the past year and a working group member that was present  ...  view the full minutes text for item 60.

To receive an update on the Better Care Fund and scrutiny of delivery and performance.

The Head of Strategic Planning and Quality Assurance for Adult Social Care and the Director of Primary and Community Care for Dorset Clinical Commissioning Group presented item 8, ‘The Better Care Fund 2019/20’.

The principles of the Better Care Fund (BCF) were explained to the Committee and it was heard that since 2013, the programme had spanned both the NHS and local government in seeking joined-up health and care services. This was so that people can manage their own health and wellbeing and live independently for as long as possible. Members heard that the BCF requires the NHS and local government to create a single pooled budget, accompanied by the ethos of closer working and a shift of resources into social community services. The Committee were told that the plan, along with descriptions of the schemes and how the money will be spent are required to be agreed and signed off by the BCP Health and Wellbeing Board as well as NHS England.

Members heard that at present several schemes make up the plan and these include:

·       Maintaining Independence

·       Early Supported Discharge

·       Carers

·       Moving on From Hospital Living

·       Integrated Locality Teams

A funding table was then shown to members which broke down the cost of each scheme and how those costs were shared between the Clinical Commissioning Group and BCP Council. From this, the current performance statistics were explained, and the four metrics were discussed. The four areas were: Non-elective spells in hospital (all ages), Admissions to Residential and Nursing Homes (older people 65+), Percentage at Home 91 days after discharge (older people 65+) and Delayed Transfers of Care (18+). Members raised queries on the fact that three of the four metrics were highlighted as underperforming. A question was asked on what was being done to seek improvement in this regard and the Committee were told that, in line with the overarching ethos, the community offer would be developed, and workers will be utilised and mobilised as effectively of possible. This piece of work was highlighted as being in line with Primary Care Networks Stream which would help to make a sustainable difference in ensuring the optimal hospital utilisation.

A question was asked as to whether the performance figures put the funding at risk, to which it was explained that although the metrics were not good reputationally nor for patient outcome, the performance has not previously affected funding at all. The Director of Primary and Community Care for Dorset Clinical Commissioning Group reassured the Committee that the current direction was positive and that there must be commitment to ensure that sustainable community-based work was delivered. The BCF metrics exist within a wider work stream in Dorset focusing on growing our capacity and capability within primary and community services to reduce reliance on hospitals, especially by earlier work within our local population. National pressures, especially in non-elective admissions and delays within hospitals also dictate the starting base of performances. It was further detailed that a major piece of work concerns the  ...  view the full minutes text for item 61.

To receive any updates from the Portfolio Holder on key issues as appropriate and consider the frequency of these updates for future meetings of the Committee.

The Portfolio Holder for Health and Adults provided the Committee with an overview of her key activities and engagements in recent months. These included meetings on the merger of the Poole Hospital Foundation Trust and the Royal Bournemouth Hospital Foundation Trust and Christchurch Hospital Foundation Trust, New Dorset Integrated Care System (ICS) Chair appointment and a providers event for Safeguarding.

Members asked questions regarding Covid-19 and the Portfolio Holder and Corporate Director for Health explained that guidance would shortly be issued by the Chief Executive of Public Health Dorset. The Corporate Director for Adult Social Care informed the Committee that she would take their concerns to the Corporate Management Board and that future briefings would be in line with the framework of national and local guidance.

A member asked a question on the ‘Deprivation of Liberty’ applications and the high numbers that BCP Council had received in recent months. The Corporate Director for Adult Social Care explained that recent case law saw an expansion in the criteria needed for a Deprivation of Liberty application. Due to the extremely high number of cases, BCP Council had triaged the referrals to catch high priority cases. Members heard that ‘Liberty Protection’ had replaced the title of Deprivation of Liberty. The Corporate Director for Adult Social Care expressed that if members wanted detail on the current and future legislation surrounding Liberty Protection

To consider and amend the Committee’s Forward Plan as appropriate.

The Chair introduced item 10, the Forward Plan. The Chair proposed that an item be added to the Forward Plan for the 27 April 2020 meeting, on the merge of two local NHS Foundation Trusts: Poole Hospital NHS Foundation Trust and Royal Bournemouth Hospital and Christchurch Hospital NHS Foundation Trust. The Committee heard that this item would be for information purposes and would allow members to fully understand and comment as necessary on the business case for the merger. The Committee agreed to add the item to the Forward Plan. The Chair ended the discussion by informing members that advice would be provided by Democratic Services on the possible conflict of interest that may arise for those members who also on the Planning Committee as there is, at present, a live Outline planning application for the Royal Bournemouth Hospital that is predicted for decision

The Chair reminded members that a development session was to be arranged for early June 2020 for them to work on developing the Committee’s Forward Plan. The timeframe allowed the Committee to receive informative items on several of the key policies and projects within the service area, which would allow them a knowledge base to then plan how best to target scrutiny throughout the 2020/2021 Municipal Year.

RESOLVED that:- The Committee agreed to add the NHS Foundation Trust merger for local hospitals to the Forward Plan for the meeting on 27 April 2020. The Committee approved the Forward Plan with the above amendment.

In relation to the items of business appearing below, the Committee is asked to consider the following resolution: -

‘That under Section 100(A)(4) of the Local Government Act 1972, the public be excluded from the meeting for the following items of business on the grounds that they involve the likely disclosure of exempt information as defined in Paragraphs 1 and 2 in Part I of Schedule 12A of the Act and that the public interest in withholding the information outweighs such interest in disclosing the information.’

RESOLVED that under Section 100 (A)(4) of the Local Government Act 1972, the public be excluded from the meeting for the following item of business on the grounds that they involve the likely disclosure of exempt information as defined in Paragraph 3 in Part I of Schedule 12A of the Act and that the public interest in withholding the information outweighs such interest in disclosing the information.

Exempt Information – Category 3 (Information relating to the financial or business affairs of any particular person (including the authority holding that information)).

The Committee were advised by the Corporate Director for Adult Social Care of a performance related matter requiring the Committee’s attention. The Committee, following the update, identified two members to monitor the progress of the situation in a rapporteur role.

(Although this item did not appear on the agenda, the Chairman agreed that it be dealt with as a matter of urgency due to the need to appraise members of the committee of the matter in question.)