Agenda and minutes

To receive any apologies for absence from Councillors.

Apologies were received from Cllr Duane Farr and Louise Bates, Healthwatch.

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.

Cllr Cameron Adams substituted for Cllr Duane Farr on this occasion.

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.

Cllr Joe Salmon declared a personal interest as an employee of Dorset Healthcare and Cllr Hazel Allen declared a personal interest as an employee of University Hospitals Dorset NHS Foundation Trust.

To confirm the Minutes of the meeting held on 15 July 2024.

The minutes of the meeting held on 15 July were confirmed as an accurate record and signed by the Chair.

To check on any outstanding actions.

The action sheet was noted.

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 midday on 18 September 2024 (3 clear working days before the meeting).

The deadline for the submission of a statement is midday on 23 September 2024 (the working day before the meeting).

The deadline for the submission of a petition is 9 September 2024 (10 working days before the meeting).

There were no public issues on this occasion.

This report proposes an approach to scrutiny of the Adult Social Care transformation programme, Fulfilled Lives.  This follows on from Council’s agreement establish the programme and to an initial £1.79m investment.

Council agreed that the Health and Adult Social Care Overview and Scrutiny Committee should provide regular scrutiny of progress towards benefits and sustainable change.  In particular, the Committee is invited to review the progress against the four priority areas of the Fulfilled Lives programme and the risks and opportunities of data with ASC transformation.

The Corporate Director for Wellbeing presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'A' to these Minutes in the Minute Book.

The report proposed an approach to scrutiny of the Adult Social Care transformation programme, Fulfilled Lives.  This followed on from Council’s agreement establish the programme and to an initial £1.79m investment.

Council agreed that the Health and Adult Social Care Overview and Scrutiny Committee should provide regular scrutiny of progress towards benefits and sustainable change.  In particular, the Committee was invited to review the progress against the four priority areas of the Fulfilled Lives programme and the risks and opportunities of data with ASC transformation.

The Chair advised that the proposed starting point for this long term scrutiny would be an informal briefing session on 4 November which would focus on the two areas of ‘how we work project’ and the ‘risks and opportunities of data’.

The Committee discussed the report, including:

• In response to a request for more information regarding micro providers and the Committee was advised of the plan to develop the smaller providers to enable a wider available market.  The Committee was advised of the process and the timescales being worked towards.  The Committee discussed the most appropriate time for this to be scrutinised to ensure the Committee could add value and it was highlighted that this fell under the strand of ‘Self Directed Support’ which would come to a future Committee.  ADD TO WORK PLAN
• In response to a query regarding the 3.5 million saving detailed in the report, the Corporate Director for Wellbeing requested that this be considered under the next item of the budget presentation when the Committee would receive fuller detail around the transformation programme.
• In response to a query regarding the transformation programme, the Committee was advised that it had been built on advice from the Local Government Association (LGA) which was drawn from a wealth of experience from many local authorities. 
• The Overview and Scrutiny Specialist suggested that time to scrutinise the different elements of the Fulfilled Lives Programme be plotted into the Committee’s Work Plan to ensure capacity.  ADD TO WORK PLAN.

RESOLVED that the Committee agree to the proposal at paragraph 7 of the Report, to consider a series of sessions over the next 18 months, starting with two areas – the how we work project and the risks and opportunities of data.

The Health and Adult Social Care Overview and Scrutiny Committee will receive a Budget Awareness presentation as part of the enhanced scrutiny engagement for the 2025/26 budget.

The presentation will cover budget, pressures, assumed savings for those areas within the remit of the Committee. The Committee will have the opportunity to ask questions around the budget and is also asked to consider how it wishes to engage further with the development of the 2025/26 budget.

The Overview and Scrutiny Specialist introduced the purpose of the item and invited the Corporate Director for Wellbeing and the Director of Public Health to present to the Committee.

The Corporate Director for Wellbeing’s presentation highlighted the following:

• Wellbeing Directorate – Overview
• Total wellbeing budget 2024/25 – including a breakdown of gross expenditure
• Where the money is spent: 2024-25 BCP ASC/Commissioning Gross expenditure
• Budget narrative
• 2024/25 projected outturn
• Wellbeing MTFP – pressures
• Wellbeing MTFP – one off and transformation savings
• Wellbeing – ASC Transformation (Fulfilled Lives Programme): Investment per scheme, £ and % of total programme
• Wellbeing – ASC Transformation (Fulfilled Lives Programme): Programme Investment and Savings Schedule.

The Director of Adult Social Care highlighted the £5.1 million virement to Children’s Services and explained that the budget had been set using assumptions on levels of care which, due to changes in circumstances, may no longer be required.

The Committee discussed the presentations, including:

• The Chair highlighted the slides detailed how the £3.5 million savings were going to be achieved.
• Following a query, clarification was given over the different ways the pie charts cut the budget
• In response to a query about consideration given to bringing services back in house as part of the transformation programme, the reasons why this had not been considered was provided including the large number of providers ASC commissioned.  The Committee was advised that consideration had been given to how best to maximise the potential of the services commissioned, to ensure efficient services at the best value and ensuring there was no gaps within the provision.
• The Committee was reassured that Adult Social Care were a major player in the local market, who also commissioned on behalf of health partners and could use its influence as a positive.
• In response to concerns regarding the virement to Children’s Services, the Committee was advised that the anticipated budget for some complex cases was not required and in order to balance budgets where possible, the virement was processed.
• In response to queries regarding waiting times within the service including for reviews and assessments, the Director of Adult Social Care suggested this could be a good area to focus on within the deep dive working group.
• In response to a query regarding the £10 million variance detailed, the Committee was given the reasons for that which included an increase in income generated, transferring users or sharing costs with health partners and changes in circumstances.  It was noted that there was a breakdown of the variance which could be shared with the Committee.

The Director of Public Health’s presentation highlighted the following:

• 24/25 Public Health arrangements
• 24/25 forecast
• Transition to 25/26 new arrangements
• 25/26 budget proposals
• Implications of agreements to date
• Risks, issues and uncertainties.

The Committee discussed the presentations, including:

• In response to a query regarding the cost and impact on residents of splitting the Public Health function, the Committee was advised that there would still be a lot of collaboration between the Directors of Public Health and their teams  ...  view the full minutes text for item 34.

The O&S Board/ Committee is asked to confirm the establishment of a budget working group, including membership and key lines of enquiry, to undertake detailed scrutiny work to contribute to the developing 2025/26 council budget during September – November 2024.

The Overview and Scrutiny Specialist presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'B' to these Minutes in the Minute Book.

The Committee was asked to confirm the establishment of a budget working group, including membership and key lines of enquiry, to undertake detailed scrutiny work to contribute to the developing 2025/26 council budget during September – November 2024.

The Committee discussed the report, including:

• Following some discussions it was decided that Cllrs Canavan, Moriarty and J Salmon would be the working group members, and that Cllr Canavan would be the lead member.
• The Committee discussed the Key Lines of Enquiry and the Chair provided the suggestions which had been detailed in the report.
• Areas highlighted by Committee Members during the discussion included ensuring there was adequate budget to support people within their homes.
• In response to a query, the Committee was reminded that the focus of this working group was to scrutinise and influence, where appropriate, the budget for Adult Social Care for the 2025/26 financial year only.
• The Committee was advised that demand management would be a good focus for the working group with specific strands under that umbrella targeted.  Examples of targeted areas had been discussed which included care given, waiting times and what did data tell us.
• There was some discussion about the savings proposed within the transformation programme and it was highlighted that this would be scrutinised by the Committee but not before the budget working groups would be held.
• The Corporate Director for Wellbeing advised of the possibility at the start of the working groups that the members receive a briefing regarding how the ASC budget was structured looking at what where the data has come from to shape the proposed budget.

The Overview and Scrutiny Specialist advised she would capture the discussions and add them to a key lines of enquiry form.  The limited time available for the working group was highlighted and the need to really focus and target the scrutiny to enable value to be added.

It was agreed that the Director of Adult Social Care would be the lead officer for the working groups.

RESOLVED that:

a.    The establishment of a budget working group, including the membership (Cllrs Canavan, Moriarty and J Salmon), lead member (Cllr Canavan) and lead officer (Director of Adult Social Care) for the group, as detailed at paragraphs 5 to 9 of the report.

b.    Key lines of enquiry for the working group (agreed to focus on demand management), as detailed at paragraphs 10-14 of this report.

c.    The measures of effectiveness for the working group, as set out at paragraph 15 of this report.

This is the annual report of the Statutory Scrutiny Officer on Overview and Scrutiny (O&S) activity within BCP Council.  There is a requirement to report on the work of O&S to Council, to ensure good visibility of the function and Council ownership of activity and any improvements required.

The annual report contains a summary and analysis of O&S activity during 2023-24, reflections on working practices and an action plan identifying strategic improvements to the O&S function.

All O&S committees will receive the annual report for consideration, providing opportunity for comment prior to the supply of the final report to Council.

This was an information only report with no presentation or discussion planned and a copy of which appears as Appendix 'C' to these Minutes in the Minute Book.

To receive a verbal update from the Portfolio Holder for Health and Wellbeing.

The Portfolio Holder for Wellbeing provided an update as follows:

• Highlighted meetings and discussions regarding Tricuro including commencing recruitment process for Chief Executive and Independent Chair following the sad passing of Charlie Sheldrick
• The closing of Fairways Care Home
• Progress on the implementation of the Day Opportunities Strategy
• Information regarding the progress in the NHS Clinical Services Review
• The need for the Transformation Programme in Adult Social Care to be integrated with the health system during this time of change
• Information regarding the Urgent and Emergency Care system review
• The date of the next Health and Wellbeing Board was the 21^st October 2024
• The service was still waiting for an inspection from the CQC.

The Chair concluded by thanking the Director of Adult Social Care for arranging a visit for him and the Portfolio Holder to the Beach building.

The Overview and Scrutiny (O&S) Committee is asked to consider and identify work priorities for publication in a Work Plan.

The Overview and Scrutiny Specialist presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'D' to these Minutes in the Minute Book.

The Committee was advised of the proposed items for the next meeting and was informed that a key lines of enquiry form would be circulated to scope out the ASC waiting times scheduled.  ACTION.

The Chair advised of the addition of Healthcare for the Homeless for the December meeting, which he requested following the circulation of the Healthwatch report - urgent need for improved health and social care for homeless.  The Committee discussed the report and considered the way in which it could scrutinise the issue.  It was agreed that a key lines of enquiry form would also be circulated for this item.  ACTION.

In response to a concern regarding the Gender Identity Services scrutiny request submitted, the Committee was advised that the Chair had been in contact with NHS Dorset to request an update and advised that a report on this matter was going to the NHS Dorset Quality Committee in October and could be shared with this Committee after that time to consider any future action.

There was some discussion over the lack of awareness of the closure of Fairways Care Home and the need for the Committee to be better informed on these important issues.

The Chair highlighted the All-Ages Neurodiversity Review which was on the work plan and advised he may request some information about that for the Committee to be better informed.

RESOLVED that the Overview and Scrutiny Committee review, update as necessary and adopt the draft Work Plan at Appendix B, which is based on recent annual work programming activity.