Councillor Alan White, Deputy Leader and Cabinet Member for Health and Wellbeing, and Councillor Mike Sutherland, Cabinet Member for Finance, John Tradewell, Director of Corporate Services and Rob Salmon, County Treasurer, attended the meeting to present the report and answer questions.
The Integrated Business Report Quarter One, showed the progress and financial performance in delivering against the Strategic Plan for the first quarter of 2019/20. During the period, there had been many challenges and successes particularly in the Adult Social Care programme and the support for practitioners.
Members of the Committee asked a number of questions concerning the Social Care performance, including:
· The Local Authority had managed to reduce delayed discharges to 43% but the net effect when the NHS performance was added was 20%. In February 2019, the Committee was informed that the North of the County was performing at 50% so where was the discrepancy? Members felt that this may be an area for the Healthy Staffordshire Select Committee to look at in more detail.
· It was felt that the discharge process was not as efficient as it should be with examples given of patients discharged with no plan in place.
· Discharge back to Nursing Homes also seemed to be problematic.
· A question was asked on the partnership with Fire and Rescue service and the work to reduce falls.
In response, the Committee was informed that performance in the South of the County was particularly difficult due to the number of out of county placements and working with up to 20 different hospital and discharge teams.
In the report it stated that only 62% of discharge assessments were being carried out and this was not acceptable. Discussions were taking place with the Midlands Partnership Foundation Trust (MPFT) to improve this. Part of the issue could be the transfer of the Staffordshire and Stoke on Trent Partnership (SSOTP) contracts by MPFT last year and the efforts made to bring inline the processes and procedures.
The Fire and Rescue Service still carried out fall prevention work and worked with District and Borough Councils to access Disabled Facilities Grants. It was suggested that the Healthy Staffordshire Select Committee should raise this at their meeting as the Committee contained representation from all the District and Boroughs and this had a wider determinant on health.
It was acknowledged that there was an issue with care homes and end of life care and an officer group had been set up to look at the way residents were cared for towards the end of their lives and what the issues were which resulted in high numbers of people drying in hospital and not their care home.
It was understood that the Better Care Funding had been allocated in full and if this was not the case the Cabinet Member would report back to the Committee.
A Member asked over what period was the £10.3m in business rates generated from sites such as Liberty Park in Lichfield, Four Ashes in South Staffordshire, Meaford near Stone and the MacArthur Glen Designer Retail Outlet in Cannock. In response the Committee was informed that of the £10.3m was an annual amount, however, 50% went to Central Government and only £1.8m going to the County Council. It was felt that this information would have been useful in the report.
The unallocated school patrol budget saving was explained as a number of vacancies had not been advertised. Information on the current positions with regard to the review that had previously been agreed was requested.
The Committee asked questions on the reasons for the additional funding needed for the maintenance of the buses and the withdrawal of the vacant seats scheme. It was explained that this was due to the buses not being fit for purpose and needing to be replaced and the vacant seat scheme being withdrawn as the fleet was not accessible for wheelchair users. A review of the fleet had taken place approximately six years ago and it was suggested that this may need to be looked at again. Members felt that the whole provision of internal transport should be reviewed, from fleet hire, how it is operated, funding, facilities, accessibility, future need and the green agenda.
A Member raised an issue with a local bus service which was overcrowded, resulting in children being refused access and unable to get to school. It was agreed that this would be taken up outside the committee meeting.
Following a question on staff absence due to psychological reasons, it was explained that across the authority all managers were being trained to spot the signs of mental health problems and they were being given the tools to help staff to deal with pressure. A Member of the Committee asked why there was a discrepancy in the report on the sickness figures. It was explained that the figure in one paragraph referred to last year’s outturn and the second figure was at the end of quarter one.
A Member asked if the Local Authority was replacing boilers with gas operated boilers. The Committee was informed that the priority in the short term was the replacement of boilers in homes to improve quality of life. Longer term the Local Authority would be working with its partner, Staffordshire Warm Homes, looking at ways of improving systems without the need to use Gas.
a) That the Healthy Staffordshire Select Committee be requested to look at delayed transfer of care issues.
b) That the Healthy Staffordshire Select Committee be requested to look at the involvement of Districts and Borough Councils and fall prevention.
c) More information on the progress of the review of School crossing patrols be sent to the Committee.
d) That a review be carried out on the County Fleet Care and that the information be bought back to a future meeting of this Committee.