Agendas, Meetings and Minutes - Agenda and minutes

Agenda and minutes

Venue: County Hall, Worcester

Contact: Samantha Morris/Alyson Grice  Overview and Scrutiny Officers


No. Item


Apologies and Welcome

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The Chairman welcomed everyone to the Meeting.


No apologies from Members were received.


An apology was received from Sarah Wilkins, Interim Assistant Director for Early Help and Commissioning.



Declaration of Interest and of any Party Whip

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Public Participation

Members of the public wishing to take part should notify the Head of Legal and Democratic Services in writing or by e-mail indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 27 February 2018).  Enquiries can be made through the telephone number/e-mail address below.


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Confirmation of the Minutes of the Previous Meeting

(previously circulated)


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The Minutes of the Meeting held on 30 January 2018 were agreed as a correct record and signed by the Chairman.




Assessment of Children and Young People who may have Autism pdf icon PDF 260 KB

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In attendance for the discussion were:


Philippa Coleman, Interim Lead Commissioner, Children's Community Health Commissioning Team, Children, Families and Communities Directorate

Stephanie Courts, Children’s Clinical Service Manager, Worcestershire Health and Care NHS Trust

Sally-Anne Osborne, SDU Lead for Children Young People & Families & Specialist Primary Care, Worcestershire Health and Care NHS Trust


A Notice of Motion from Council on 9 November 2017 was referred to the Board. It noted the length of time it could take in Worcestershire from referral to a diagnosis of autism and also the high demand for the Umbrella Pathway. The Board was asked to consider the outcomes of the recent review of the assessment and diagnostic pathway for children and young people who it was considered were, or may be, on the autistic spectrum.


Following the Review, a report to the Integrated Commissioning Executive Officers Group (ICEOG), which included representatives from the County Council and the Worcestershire Clinical Commissioning Group's, was made in January 2018. It agreed measures to manage the demand of the Pathway.


The Review included recommendations to ensure that appropriate referrals were made to and accepted on the Umbrella Pathway. Only when other possible causes had been addressed, appropriate support provided and there was a strong indication of possible ASD should a referral be made.  This should ensure that the Pathway would be completed in a more timely way for those children who needed it.


The National Institute for Health and Care Excellence (NICE) guidance indicated that an autism diagnostic assessment should be started within 3 months of a referral to the Autism Team, however there was no recommended maximum timescale for completion of the process.  The Umbrella Pathway currently complied with this standard in Worcestershire but the whole process could take months to complete and varied on a case by case basis.  In most cases, the full assessment process could take about twelve months.


During the discussion, the following main points were made:


·       As the assessments were multi-disciplinary and staff were integrated into various teams, it was difficult to quantify whether there was sufficient staffing capacity to cope with the number of assessments coming or likely to be coming through the system

·       A year or in some cases more than a year to obtain an ASD diagnosis was a very long time for families to wait

·       Nationally and locally there had been an increase in the number of referrals for ASD assessment.  In 2016, the average number of referrals was 20, currently there could be 100+ a month, whereas the expected number of referrals was 40

·       There was an increased emphasis on early intervention and a graduated response, which over time should reduce the number of full ASD assessments enabling them to be carried out in a more timely and efficient way for those who actually needed them

·       It was unknown what the waiting times were for referrals in other authorities. Not all authorities had a formal assessment process in place, but waiting times were known to be a widespread problem

·       There  ...  view the full minutes text for item 1025.


Scrutiny Proposal: Abbey Bridge Tendering, Monitoring and Delivery Processes pdf icon PDF 186 KB

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At its last meeting, the Board agreed that the Chairman (and couple of other Councillors) would carry out a short scrutiny looking at lessons learned from Evesham Abbey Bridge project delays ensuring that links were made with the Audit and Governance Committee to avoid duplication and that a scrutiny proposal confirming the terms of reference would be considered at this meeting.


The proposal attached to the Agenda suggested Terms of Reference:


To investigate the project planning, tendering and project management processes used by the Council to deliver the Abbey Bridge project.


It was suggested that as this was a very technical area, it may be necessary to seek the advice of an independent expert.  It was also suggested that as the Audit and Governance Committee was due to consider the matter, it would be helpful to see the report to that committee and if appropriate review the scope to avoid potential duplication.


After discussion, subject to the proposal being amended to include reference to the expert adviser, and linking with the Audit and Governance Committee to avoid duplication, the proposal was agreed.


Councillor Bloore would lead the Scrutiny and Cllrs Adams and Middlebrough would also be members of it .  As a first step a meeting would be arranged between Councillors Bloore and Middlebrough with Cllr Nathan Desmond, Chairman of the Audit and Governance Committee, to take into account the audit outcome and if necessary amend the scope .



Member Update and Cabinet Forward Plan pdf icon PDF 99 KB

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Adult Care and Well-being Overview and Scrutiny Panel


At its next meeting, the Panel was being briefed on Replacement Care Services for adults with a learning disability, in particular the planned engagement with service users, carers, staff and stakeholders on options for future provision of replacement care for adults with a learning disability. All Members had been made aware and invited as observers to attend the planned informal meetings with carers around the County.


The Panel would also be looking at Public Health's work on Prevention and on Social Isolation which stemmed from concerns about depression in older people and how social isolation impacted on this.  The Vice-Chairman advised that in due course she would be providing a report on Bus Services to the Economy and Environment Overview and Scrutiny Panel which may impact on social isolation too.


The Chairman requested that the Panel Chairman find out more information about Extra Care provision in Worcestershire in view of proposals for potential service changes.


Corporate and Communities Overview and Scrutiny Panel


The Chairman advised that at its March meeting the Panel would be looking at Councillor ICT which had been deferred from its November and January meetings.


Children and Families Overview and Scrutiny Panel


The Chairman of the Panel advised that in respect of the Scrutiny of overnight short breaks for children with disabilities, meetings had been held with parents/carers and visits carried out to the short break units. 


Concerns were emerging in respect of the consistency in approach of officers carrying out the one to one meetings with parents/carers of children who took overnight short breaks at the Ludlow Rd Unit.  The Chairman referred to the question that she had asked at February's meeting of Council, which was for the CMR for Transformation and Commissioning to give assurance that that there was consistency in approach of officers asking questions during a consultation process, she was given this assurance but nevertheless had concerns that this that this was not the case in this instance.  Other concerns were emerging about the emergency provision and increased travel time for those children who were very frail, if they were required to travel further afield..  The Task Group were meeting with the Worcestershire Health and Care NHS Trust (HACT) on 5 March, who it was understood were likely to challenge some of the financial information presented in the 14 December 2017 Cabinet Report. It was further understood that the parents of the Children who attended the Ludlow Rd unit were meeting with CMR and the HACT


Cllr Oborski also referred to the Nascot Lawn High Court ruling which seemed to imply that the Clinical Commissioning Groups (CCG) needed to be involved in funding of overnight short breaks.


The Task Group were due to meet with the CMR shortly.


Health Overview and Scrutiny Committee (HOSC)


At its January meeting, the Committee received an update on the progress of Herefordshire and Worcestershire Sustainability and Transformation Partnership and the CQC requirements for improvement.  The Committee were pleased  ...  view the full minutes text for item 1027.