Agenda and minutes

Mrs. Charlotte Atkins declared an interest in Item No. 4 on Agenda – “Autism Implementation Plan”, owing to her daughter having been diagnosed with Autism.

The Chairman declared an interest in all matters included on the Agenda as they related to services for the deaf/hard of hearing owing to a diagnosis he had received for this condition.   

RESOLVED – That subject to Paragraph 6, Page 4 being amended to provide greater clarity as follows, the minutes of the meeting held on 28 October 2019 be confirmed and signed by the Chairman:-

“Following the merger of the former Staffordshire and Stoke-on-Trent Partnership NHS Trust (SSOTP) and South Staffordshire and Shropshire Healthcare NHS Foundation Trust, four operating arms had been established within the new organisation ie (i) Children and Families Services ; (ii) Staffordshire and Stoke-on-Trent Services; (iii) Specialist Services and; (iv) Telford and Wrekin Services. Whilst strategic oversight of the four arms was maintained centrally, the structure enabled greater flexibility to respond to operational issues as they arose. Furthermore, under these arrangements it was expected that partnership working with other service providers in their areas would be developed”.         

Report of the Cabinet Member for Health, Care and Wellbeing  

The Committee considered a joint report of the Deputy Leader and Cabinet Member for Health, Care and Wellbeing and Cabinet Member for Children and Young People (Appendix A to the signed minutes of the meeting) (i) informing them of the draft Staffordshire Autism Implementation Plan 2020-2023 which had been prepared following adoption of the County Council’s Staffordshire Whole Life Disability Strategy (WLDS), in June 2018 and; (ii) seeking pre-decision scrutiny of the policies/procedures contained in the draft Plan.

The meeting was attended by the Deputy Leader and Cabinet Member for Health, Care and Wellbeing who presented the report.

The WLDS aimed to ensure that people with any disability (i) were able to do things for themselves as much as they could with a focus on ability rather than disability; (ii) were as independent as they could be for as long as they could and; (iii) used what was available in their communities first rather than using paid for services.  

The draft Autism Plan (i) aimed to encourage all services and organisations to ‘think autism’ so as to maximise opportunities to help people live fulfilling lives and feel part of society and; (ii) bring together the various organisations which funded and provided care and support so that services were configured in such a way as to best meet the needs of Autistic people using the scarce resources available

During the full and wide-ranging discussion which ensued, a Member sought details of current waiting times for people wishing to access Autism services. In reply the Director of Health and Care undertook to contact Clinical Commissioning Groups in this respect and forward the information on to the Member in due course.   

Members then commented/gave their views on the draft proposals, as follows:- (i) efforts should be made to maintain engagement by Clinical Commissioning Groups in order to ensure that the Plan could be implemented in a timely manner; (ii) there should be a greater emphasis on the role of the NHS in particular in meeting the needs of people with Autism through staff training and awareness raising; (iii) the importance of developing an Autism friendly culture with all stakeholder organisations should be highlighted in the Plan; (iv) the transport needs of people with Autism should be considered as part of their assessment process; (v) there should be consideration of the various dangers faced by people with Autism in respect of exploitation, safeguarding and the Prevent Agenda; (vi) the Authority’s commitment to work with the Department for Work and Pensions should also include Job Centre Plus; (vii) the commitment to work with Criminal Justice Services should include identification of how the needs of people with Autism could be embedded within the system; (viii) an awareness of the needs of people with Autism should be raised within schools, particularly at Primary level and; (ix) all Stakeholders (including District and Borough Councils) should commit to share relevant information regarding people with Autism, where necessary to ensure successful delivery  ...  view the full minutes text for item 48.

Report of the Cabinet Member for Health, Care and Wellbeing

The Committee considered a report of the Deputy Leader and Cabinet Member for Health Care and Wellbeing (Appendix B to the signed minutes) regarding a draft report and recommendations to be made to Staffordshire County Council’s Cabinet at their meeting on 19 February 2020, following a review of carers’ services in the County.

The meeting was attended by the Deputy Leader and Cabinet Member for Health, Care and Wellbeing who presented the report.

‘All Together for Carers’ was a carers strategy for Staffordshire which had been developed jointly with the five Staffordshire Clinical Commissioning Groups (CCGs) and adopted in the Autumn of 2019. The Strategy included a commitment to review services for carers and, if necessary, develop a new service model and explore options for its delivery. Following engagement with stakeholders to evaluate current provision/pathways, a draft revised model had been prepared and was to be considered by the Council Council’s Cabinet at a forthcoming meeting. However, in the meantime, the Committee had invited to provide pre-decision scrutiny of the proposals in order to assist Members in their decision-making process.

During the full and wide-ranging discussion which ensued, a Member questioned the reasons for the decline in financial payments made to carers over recent years, in the absence of a corresponding decline in need. In response the Director of Health and Care referred to improvements in partnership working which had enabled carers to receive support from alternative sources and undertook to provide the Member with further information on these payments, in due course.        

Members then commented/gave their views, on the draft proposals, as follows:- (i) there should be further consideration of the options for young carers to contact service providers via alternative channels eg the World Wide Web, email etc; (ii) there should be further consideration of the information needed by “Local Members”, District and Borough Councillors so that carers could be better signposted to relevant sources of information or services; (iii) current engagement with schools should be expanded to include liaison with Special Education Needs and Disabilities Hubs to support awareness raising and identification; (iv) Primary Care Services including social prescribers should understand where to signpost carers for help and support; (v) mitigation of the various risks highlighted in the report should be a priority.

In reply the Deputy Leader and Cabinet Member for Health, Care and Wellbeing undertook to liaise with Cabinet Support Member for Learning and Employability as necessary and take account of the above-mentioned views/comments in the final report to Cabinet.

The Chairman then thanked the Deputy Leader and Cabinet Member for an interesting and informative presentation and the opportunity to provide pre-decision scrutiny on a key area of Authority’s health and wellbeing policy.

RESOLVED – (a) That the report be received and noted.

(b) That the above-mentioned views/comments comprise the Committee’s formal response to the draft report and recommendations regarding a future model for carers’ services in Staffordshire. 

Report of the CCGs’ Accountable Officer

NB. Copy of Chairman’s letter to CCGs’ Accountable Officer (Marcus Warnes) dated 20 December 2019 and his reply dated 23 December 2019, attached for information.

The Committee considered a report of the Clinical Commission Groups (CCGs) Accountable Officer (Appendix C to the signed minutes) regarding various matters which had been raised with him by the Chairman in his letter dated 20 December 2019 including:- (i) the proposed merger of the CCGs (which he understood was not now taking place) and their commissioning intensions going forward; (iii) scrutiny of out of County care provision received by Staffordshire residents and; (iii) General Practitioners’ concerns regarding Integrated Care Proposals.

The meeting was attended by Marcus Warnes, Staffordshire CCGs Accountable Officer who presented the report.

The Committee heard that the CCGs intended to continue developing a strategic commissioning function within an Integrated Care System (ICS) involving three locality-based divisions which aligned with the ICS partnerships in the north, south-east and south-west of the County. Their commissioning intensions were in-line with the Long-Term Plan for the NHS and would be set out in a Local Plan to be published in the Spring of 2020. However, whilst the commissioning of services would be co-ordinated to ensure inequalities across the area and unwanted variations were addressed, there might be occasions where local sensitivities would need to take priority.

With regard to scrutiny of out of county provision, they learned that over half of CCGs acute activity was with hospitals outside Staffordshire. However, well developed contracts and systems had been implemented by the CCGs to monitor quality and performance of services including:- (i) Locality Based Multi-Disciplinary Teams which met bi-monthly; (ii) Financial Triangulation meetings which met monthly; (iii) meetings of the Contract Management Executive Team which met monthly; (iv) Contract Steering Groups meetings which met monthly and; (v) the Quality Teams at Trusts which reported monthly to their Governing Bodies, so that appropriate remedial action could be taken, where necessary.

With regard to GP concerns over Integrated Care Proposals (ICP) the Committee learned that CCGs had held their first ICP Development Workshop on 26 November 2019 to which representatives of General Practice and Primary Care Networks had been invited to attend and further workshops were planned. The aim of ICPs was to encourage providers to come together, where possible, to share contracting arrangements that allowed strategic Commissioners to focus on outcomes and give providers the freedom and autonomy to develop and deliver services to meet them. However, commissioning of General Practice was currently delegated to CCGs and therefore could not be delegated further to individual practices. 

The Chairman then thanked the Accountable Officer for an interesting and informative presentation and requested that the Committee be kept informed of any significant developments in the three areas mentioned above.

RESOLVED – (a) That the report be received and noted.

(b) That the Committee keep a watching brief on the matters raised by the Chairman in his letter to the Clinical Commissioning Groups (CCGs) Accountable Officer dated 20 December 2019.   

Report of the Scrutiny and Support Officer

The Committee considered a report of the Scrutiny and Support Manager giving a summary of the health scrutiny activity which had been undertaken by Staffordshire District and Borough Councils under the standing joint working arrangements, since their previous meeting.

During the discussion which ensued Members expressed disappointment that most District/Borough Council had not provided a written update for inclusion into the summary report. They also noted that, in some instances, where this was the case, representatives of the Authorities concerned were unavailable to give a verbal update too. Therefore, they requested the Scrutiny and Support Manager to:- (i) remind all District/Borough Health Scrutiny Officers that, Under the Code of Joint Working Arrangements – Local Authorities (and having regard to the recommendations of the Francis Report),  District/Borough Councils had committed to the General Working Principle of Co-operation including a willingness to share knowledge and maintain links and; (ii) request that they submit short written updates in time to be included into summary reports to future meetings highlighting that verbal updates would no-longer be taken owing to constraints on the Committee’s time.

RESOLVED – (a) That the report be received and noted.

(b) That the Scrutiny and Support Manager pass on the views/requirements of the Committee to District/Borough Health Scrutiny Officers with regard to future District/Borough Health Scrutiny Updates, as set out above.     

Report of the Scrutiny and Support Manager

The Committee considered their rolling Work programme for 2019/20 (Appendix D to the signed minutes).

During the discussion which ensued the Chairman highlighted the proposed inclusion of a review of Urgent Care provision in the County in their Work Programme. The need for this Review had been raised by the Deputy Leader and Cabinet Member for Health, Care and Wellbeing at a Health Triangulation Meeting held on 15 January 2020 having regard to current Delayed Transfer of Care Statistics for the County and certain quality issues which had arisen. He went on to outline the proposed Terms of Reference for the review and expressed support for its inclusion into their current Work Programme.

A Member raised her concern regarding a lack of scrutiny given to West Midlands Ambulance NHS Foundation Trust’s recent changes to their Rapid Response service in the Cheadle area. She referred to significant concern locally over the removal of 4x4 Rapid Response vehicles previously been based in Staffordshire Moorlands, particularly owing to the predominantly rural terrain of the District and the difficulties in relying solely on conventional ambulances in this locality. She went onto express her view that the decision to remove these vehicles had been based on flawed statistics and therefore requested the Committee hold the Trust to account for their decision at a future meeting. In reply, the Chairman informed them of (i) Staffordshire County Council’s Leader’s response to the above-mentioned service reconfiguration and; (ii) Staffordshire Moorlands District Council’s Health Overview and Scrutiny Panel’s decision to include the matter in their current Work Programme. He therefore went on to propose that further consideration by the Committee be deferred pending the outcome of the District Council’s work and that an additional item be included in their Work Programme at that juncture, if it was found to be necessary.

The Scrutiny and Support Manager informed them that in light of the above-mentioned Review of Urgent Care it was proposed the informal Primary Care information gathering session which had been planned for February 2020 be postponed until Autumn 2020.

RESOLVED – That the proposed changes to their Work Programme as set out above be agreed.