Agenda and minutes

The Chair welcomed everyone to the meeting, his first as Chair of the Committee. Particular welcome was extended to the Committee's new members.

Apologies had been received from Councillors Tony Baker, June Griffiths, Pattie Hill, Tony Miller and Fran Oborski.

Cllr Frances Smith declared a pecuniary interest, as her husband was the new Cabinet Member for Health and Well-being – she would therefore not enter into the discussion and holding to account of Cllr John Smith (Agenda Item 5 – Public Health Ring-fenced Grant Update).

The Democratic Governance and Scrutiny Manager clarified that the Health Overview and Scrutiny Committee had many roles, not just to hold to account the Cabinet Member with responsibility (CMR) for Health and Well- being, who was also the Chair of the Health and Well Being Board;  – therefore Cllr Frances Smith would be able to participate in HOSC, as long as she declared her interest and did not participate in discussions which did involve the CMR.

Members of the public wishing to take part should notify the Head of Legal and Democratic Services in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 29 June 2016). Enquiries can be made through the telephone number/email address below.

None.

Previously circulated

The Minutes of the meeting held on 27 April 2016 were agreed as a correct record and signed by the Chairman.

In attendance for this item were:

Frances Howie, Interim Director of Public Health at Worcestershire County Council

Cllr John Smith, Cabinet Member for Health and Well-Being

Sue Harris, Director of Strategy and Business Development at Worcestershire Health and Care Trust.

In addition to the agenda report, the Interim Director of Public Health gave a presentation to provide further information.

From April 2013 the County Council gained new statutory duties on Public Health to improve population health and well-being, which came with a specific ring-fenced grant (PHRFG).  The range of statutory requirements included mandated services (such as sexual health and health checks), specialist staffing, as well as discretionary services (such as drug and alcohol services).

In June 2015 the Government announced in-year cuts of 6.2%, which was very unexpected, and strong concern was communicated to the Government.

Cabinet gave initial approval of a proposed response to the funding reductions in July 2015, requesting further discussions with providers and review of prevention services over the Summer.

Following discussion with Public Health, the Cabinet Member with responsibility (CMR) for Health and Well-being, lead scrutiny members, partners and providers, as well as input from a public survey, revised proposals were approved by the CMR in November 2015. Key themes were the scale of reductions across the system, the potential for cumulative impact, continued uncertainty on funding and unprecedented financial pressures.

There was now more certainty, and a national consultation was soon to be announced, as part of the Government's shift from local government funding, to business rates funding.

The proposals approved in November prioritised services which the county council was required to deliver (mandatory). Prevention services would be focused on reducing the chances of people coming into high cost social care services.

A key decision was to use council reserves to delay reductions, to allow for planned redesign and measured changes to services to take place, which would seek to mitigate the unprecedented financial pressures.

For some services, such as drugs and alcohol, it was difficult to measure the impact of what might have been and there was a need for a stronger evidence base.

Key messages for HOSC were:

·         Good progress had been made in implementing the November 2015 Cabinet decisions

·         Difficult decisions had been taken but there had also been realism from providers and other partners in accepting them

·         There was now closer partnership working between the Council, commissioning partners and providers – which was a positive base to work with constant changes and challenges ahead

·         The focus was on a careful and measured approach to change allowing opportunities for service redesign, requiring use of reserves

·         Decisions would be reviewed following further announcements on grant funding and further consideration enabled some flexibility

·         It was too soon to measure the impact, and HOSC would be kept informed

Updates on reduction decisions

Public Health had a very wide remit, and included many non-health areas.

Within community safety projects, reductions of 75% in 2015/16 and a further 25% in 2016/17 had been fully achieved, as  ...  view the full minutes text for item 790.

The Democratic Governance and Scrutiny Manager reported that on 12 May Council had approved the 2016/17 scrutiny work programme put forward by the Overview and Scrutiny Performance Board.

The following observations were made:

Public Health - the Chairman would like to prioritise this work item.

Health Accountability: CCGs, GPs and Health and Wellbeing Board – HOSC members were keen to establish the detail of this area.

Future of Acute Hospital Services in Worcestershire – an update would be provided at the 19 July meeting, following approval of the revised proposed clinical model by the West Midlands Clinical Senate.The model would be subject to assurance by NHS England, before being put to public consultation late this year.

Cllr Vickery pointed out the need to include consideration of travel arrangements, following discussion by the Economy and Environment Overview and Scrutiny Panel, which he had chaired.

Process relating to the closure of St Johns Dental Practice– the Chairman highlighted  the large number of complaints, the need for earlier advance notice and access issues for some patients. A report to HOSC would be included within a broader review of dental practice capacity, being carried out by NHS England.

The HOSC noted the work programme, and the Chairman encouraged  Committee members to contact him with further suggestions – the following were suggested:

-       Performance of the NHS111 contract

-       Obesity

-       Access to services in rural areas and the impact on the vulnerable – it was pointed out that this could potentially be picked up by other planned scrutiny work (a task group on bus access and the Economy and Environment Scrutiny Panel's discussion of 'getting round the county'.

For the benefit of new HOSC members, the Chairman explained the purpose of this standing agenda item, which provided a formalised process for members to report back on news/issues from their district area, and for 'lead members' to report news from the various NHS organisations. 

Following changes in HOSC membership the lead roles would be refreshed and expressions of interest would be sought.

The Chairman had commenced his induction to health scrutiny, and met with a range of organisations. He had also chaired the West Midlands Scrutiny Chairs and Officers Network; the focus had been mental health and presentation slides would be circulated.

The Overview and Scrutiny Performance Board had agreed that children's health matters should now come to HOSC in the first instance. 

The new Worcester City Council HOSC member reported concerns from residents in her area who had felt ill-informed about the closure of St Johns Dental Practice

In Bromsgrove, residents were very worries about the future of the Alexandra Hospital, and also had concerns about changes to Mental Health Services.

In Redditch, there was concern about access to maternity services and mental health services, following re-organisation.

The Wychavon District Council member had found a visit to Healthwatch Worcestershire very beneficial, and suggested that meeting them would be helpful to other members.

In Wyre Forest, a new model for intermediate care was being worked on, and embraced by all GP surgeries.

Lead member reports

Cllr Vickery was thanked for the notes circulated following his attendance at board meetings of the Health and Wellbeing Board and Redditch and Bromsgrove Clinical Commissioning Group.

Cllr Rayner reported that a recent meeting of West Midlands Ambulance Trust had been less informative than usual. There were good news stories but she had concerns that ambulance targets for Wyre Forest and rural areas were not being met. The format of these Board meetings allowed for public questions only if they were submitted two weeks in advance.