Present at the meeting:
- Councillor N D Ash (Chairman)
- Councillor S Dawber
- Councillor M A Dewhurst
- Councillor Mrs S Dewhurst
- Councillor Mrs D Fairhurst
- Councillor Mrs J Hurst
- Councillor P A Liptrot
- Councillor K W McManus
- Councillor E Russon
- Councillor R T Splaine
- Councillor K Cunliffe – Cabinet Champion for Healthier Communities and Older People
Officers in attendance
- Gary Finch – Principal Officer – Scrutiny
- Margaret McKenzie – Solicitor
- Kay Cullen – Trainee Committee Clerk
Officers presenting reports
- Bernard Walker – Executive Director of Health and Well-being
- Louise Sutton – Service Director – Personalisation and Community Services
- Stuart Cowley – Service Director – Strategy and Commissioning
- Simon Barber – Chief Executive – 5 Boroughs Partnership NHS Trust
- Dr Kate Ardern – Executive Director – Public Health for the Borough of Wigan
- Dr Kate Fallon – Managing Director – Ashton, Leigh and Wigan Community Healthcare
11 Welcome to new Members: The Chairman welcomed Councillor K W McManus as a new Member of the Adult, Health and Well-being Scrutiny Committee.
12 Apologies for absence: Councillors Mrs J M Peet (Vice Chariman), N A Bradbury, Mrs L E Fagan, Mrs S J Greensmith and J Talbot.
13 Minutes: The minutes of the meeting of the Adult Health and Well-being Scrutiny Committee held on 2 June 2009 were approved as a correct record, subject to the inclusion of Councillor K Cunliffe (Cabinet Member for Healthier Communities and Older People Champion) in the list of Members present.
14 Whipping Declarations: There were no declarations made.
15 5 Boroughs Partnership NHS Trust overview: The Chief Executive of the 5 boroughs partnership NHS Trust, Simon Barber, presented to the Committee an overview of the services provided by the Trust. The Chief Executive informed Members that the Trust specialised in mental health and learning disability services.
Members asked a number of questions which included the following points:-
- Have the separate wards for younger people aged of 16/17 been opened yet?
- What are the top priorities for over the next year?
- Is there an action plan for development of the assessment centre for older people with dementia?
The Chief Executive informed Members that all children under the age of 16 had separate wards and that there was now a new unit that had been opened in June 2009 and the new unit was called the Fairhaven Young People’s Unit. This was a unit for teenagers, providing assessment, intervention and in-patient treatment that was 'close to home' and gave young people the intensive support they need in times of crisis to prevent admission to paediatric or adult acute wards.
The Chief Executive advised Members that the two main priorities for the Trust over the next year were:
- to develop an assessment and treatment centre for early diagnosis and treatment of dementia commissioned by the Ashton, Leigh and Wigan PCT; and
- to improve the structure of two large adult wards into smaller ones to help create a better environment.
Members were informed that there was an action plan on the development of the assessment and treatment centre for dementia and that the progress could be tracked and be brought back to a future meeting of this committee.
The Chief Executive also informed Members that there would be an annual general meeting held in Wigan at the DW Stadium on the 23 September 2009 and that video interviews with service users would inform the event. Any which were specific to Wigan could be brought back to a future meeting of this Committee.
Resolved: The Committee:-
- thanks the Chief Executive of the 5 boroughs partnership NHS Trust for his presentation;
- requests that he presents the action plan on the development of the assessment and treatment centre for dementia and the progress made to this Committee; and
- requests that he presents the video presentations from the annual general meeting (if relevant) to a future meeting of this Committee.
16 Health inequalities: The Executive Director of Public Health for Wigan, Dr Kate Ardern, gave a presentation on tackling health inequalities in Wigan. The Executive Director advised Members that the three key factors that led to inequalities and were closely linked were:
- the conditions in which you live (including your start in life);
- the life that you lead; and
- the services that you use.
The Cabinet Champion for Healthier Communities and Older People, Councillor K Cunliffe, reported to Members that there were newly appointed health improvement officers for each Township across the borough. He advised Members that health needs across the borough were, different depending on the area and would need different commissioning.
Members asked a number of questions, which included the following points:-
- Who is the township officer for Shevington?
- We have a huge problem with the community being hard to reach, what are you doing to improve this?
- How long will it take to see an improvement in the health of this borough and be able to see evidence of this?
The Executive Director informed Members that the health officers had only been in post for a few months and that she would send out to all Members a list of contact details for each township in the borough. She advised Members that there were a lot of different groups that were working in partnership to help get the message of good health out to the community and help reach those who have proven difficult to contact. Examples of these were the neighbourhood health and improvement team, tenant participation team, church groups and the Wigan and Leisure Culture Trust. The Executive Director informed that they were monitoring the improvement of health in the borough and thought that it would be helpful if this Scrutiny Committee could look at certain topics in detail and the action plans. She stated that it would not be a quick turn round time in seeing a great improvement for the health in Wigan and that it was looking to be around three to five years.
Resolved: The Committee:-
- thanks the Executive Director of Public Health for her presentation;
- requests that she provides all Members with a contact list of all health township officers for the borough; and
- requests that she brings a series of presentations to future meetings of this Committee, covering work that has been undertaken in helping to improve the health in Wigan.
17 Ashton, Leigh and Wigan Community Healthcare: The Managing Director of Ashton, Leigh and Wigan Community Healthcare, Dr Kate Fallon presented a report, which informed Members that the borough faced significant challenges to improve the health of the local population and that the national policy directive for the Primary Care Trust, (PCT) was to separate their commissioning and provider functions. The PCT was able to concentrate on assessing the local needs and commissioning appropriate services to those needs.
The Managing Director, advised Members that Wigan was among the first in the country to undergo the separation which placed the local health services in an ideal position to deliver significant improvements in the health of the local population. The chosen option for the provider arm for the PCT to become a Community Foundation Trust would mean that local people would be able to have a greater say in how their services were run and also allow services to respond to the need, being able to manage their finances appropriately.
Members asked a number of questions, which included the following points:-
- Is it safe the way you are splitting the PCT and community nurses further so that you have nurses performing blood transfusions at the patient’s own homes?
- What is the progress to date and do we have any feed back on this?
The Managing Director assured Members that the process for performing blood transfusions at patients homes was safe and that the nurses followed strict protocols very carefully. She informed Members that these patients were selected very carefully and that they were no more at risk at home than they were in hospital. In respect of feedback for ‘providing quality care, closer to home’ the Managing Director informed Members that the feedback they had received had been excellent and patients were becoming much more aware of the services available.
Resolved: The Committee notes the report and thanks the Executive Director of Public Health for her presentation.
18 Adult Services budget monitoring 2009-10: The Executive Director of Health and Well-being, Bernard Walker reported to Members, the budget monitoring position for Adult Services after the first three months of 2009-10.
The Executive Director advised Members of the significant underlying budgetary pressure of £1.4 million for 2009-10, that related to transition. He informed Members that the monitoring position after three months showed a £540,000 overspend and that the Adult Services Improvement Plan 2 had been put into place to deliver a reduction in savings of £244,000 in a year.
The report showed cost pressures associated with care costs; these were partially offset by the decreasing impact from continuing care and that the current projected out-turn for the Department is an over-spend of £2.455million. The Senior Management Team was considering further measures that sought to mitigate the level of the overspend.
Members asked a number of questions, which included the following points:-
- What have you done to minimise the cost impact of the transfer for the new cohort of young adults into Adult Services from Children and Young People’s Services?
- Can you produce an action plan in relation to what measures the Senior Management Team seeks to mitigate the level of overspend?
The Executive Director informed Members that they had introduced a service to the borough called ‘Young friends together’. This scheme worked with young people and their carers and gave support and advice in what benefits were on offer and whether the outcome was contrary to what they first thought they needed. They did not know what was available in the borough and this helped young people to look for better and more local provision. The Executive Director informed Members that he could provide the Committee with quarterly reports containing the action plans.
Resolved: The Committee:-
- thanks the Executive Director for the report;
- notes that the action plan request will be provided with the quarterly report; and
- notes the information provided.
18 Adult Services charging policy: The Executive Director of Health and Well-being, recommended to Members a change to the charging policy for non-residential services. Individuals receiving personal injury awards where part of the award, and received future care needs and pay at an increased charge for services.
He informed Members that the changes to the charging policy proposed would ensure that the policy was fair and equitable for all service users in receipt of non residential services. It ensured that the Council does not incur additional cost for potentially large packages of care when part of a personal injury award is made by the courts specifically to cover future care needs.
Members were assured that re-assessments were done on an annual basis and that a re-assessment would always be provided if people requested this.
The Principal Solicitor, Margaret McKenzie informed Members that Adult Services had consulted with local personal injury solicitors and financial advisors on the charging policy.
Resolved: The Committee:-
- thanks the Executive Director for the report; and
- requests the Executive Director to inform this Committee of any cases that are the subject of a legal challenge.
19 Performance Monitoring Report – Quarter 4: The Executive Director, Health and Well-being, presented a report, which provided Members with the Adult Services performance monitoring position for the fourth and final quarter for 2008/09.
The report outlined the overall performance for all four quarters of 2008/09, which indicated that for all indicators where targets have been finalised the data was available and that 60% of indicators were on target or better than the target.
The Executive Director informed Members that remedial action was being taken on those areas where performance was shown to be below target and that the Senior Management Team will continue to monitor the position closely.
Members asked a number of questions, which included the following points:-
- When will the fundamental review and the adaptations happen?
- Can you bring back to this Committee the progress that is being made on the targets that you are falling below on?
The Executive Director advised Members that the fundamental review and adaptations should happen at the end of July, but it was difficult to give a specific timescale. He informed Members that the national performance indicators came into the remit of this Committee and that the management of Adult Services believe that it was important that the whole of Adult Services national performance indicators were included in the performance reports not just those which were currently below target.
Resolved: The Committee:-
- thanks the Executive Director for the report;
- notes the performance against the targets in 2008-09; and
- notes the action that will be taken in 2009-10 to deliver further improvements in performance.
20 Adult Services Performance Plan 2009/12: The Executive Director, Health and Well-being presented a report, which informed Members of the service priorities, performance targets and work programme, through the Adult Services Performance Plan 2009-12.
The Executive Director reported that the Performance Plan was a key monitoring document for the department which performance and the delivery plan will be assessed against.
Progress would be reported through quarterly performance monitoring reports and an overall progress report at the end of the year.
Resolved: The Committee:-
- thanks the Executive Director for the report; and
- notes the Performance Plan, which sets out the work programme that enables Adult Services deliver its local and national priorities.
21 Single Commissioning Agency – Joint Shadow Board: The minutes of the meeting of the Single Commissioning Agency – Joint Shadow Board from 5 June 2009 were submitted for information.
Resolved: The Committee notes the minutes now submitted.
22 New Scrutiny arrangements and consequential amendments to the call in procedure: The Principal Solicitor presented a report, on the amendments to the call in procedure following the establishment of the five new Scrutiny Committees. The report set out who was eligible to call in a decision and the process that a call in could follow.
Resolved: The Committee:-
- thanks the Principal Solicitor for the report; and
- welcomes the changes to the call in procedure.
23 Feedback from the portfolio holder: Councillor K Cunliffe informed Members of a Green Paper that had been produced by the government called ‘Shaping the future of care together’. He advised Members that the Green Paper set out a vision for a new care and support system. With people living longer that meant that more people would also live with the need for care and support. The Green Paper outlined the vision for a National Care Service and what people should expect from it. There were five proposals in the Green Paper and these would bring about some of the most fundamental reforms ever in care and support.
Members were informed that there was a public consultation on the Green Paper closed on 13 November 2009. Councillor Cunliffe asked Members if they could discuss the Green Paper either personally, in Committee or at townships and send in a submission.
The Executive Director informed Members that there were regional events on the green paper and that they could find details on the website www.careandsupport.direct.gov.uk
A copy of the Green Paper ‘Shaping the future of care’ was distributed to the Members of the Committee.
Resolved: The Committee notes the reports and agrees to discuss the green paper at its next meeting on the 22 September 2009.
Chairman
