Agenda and minutes

Health and Adult Social Care Select Committee
Wednesday, 12th June, 2019 10.30 am

Venue: County Hall, Chichester

Contact: Rob Castle on 033 022 22546  Email:  rob.castle@westsussex.gov.uk

Webcast: View the webcast

Items
No. Item

1.

Committee Membership

The Committee is asked to note the appointment of Mr Boram to the Committee in place of Mr Barling and to approve the co-opted membership of the Committee as set out below: -

 

Mr McGregor (Adur District Council)

Vacancy (Mid Sussex District Council) to be appointed on 26 June

Mr Bickers (Worthing Borough Council)

Vacancy (Arun District Council) to be advised

Vacancy (Horsham District Council) to be appointed on 1 July

Mrs Bangert (Chichester District Council)

Mr McAleney (Crawley Borough Council)

 

N.B. The Healthwatch West Sussex representative, Miss Russell, is an ongoing appointment.

 

Additional documents:

Minutes:

1.1       Resolved – that the Committee notes the appointment of Mr Boram in place of Mr Barling and approves the co-opted membership of the Committee as set out below: -

 

Mr McGregor (Adur District Council)

Mr Bennett (Arun District Council)

Mrs Youtan (Horsham District Council)

Mrs Bangert (Chichester District Council)

Mr McAleney (Crawley Borough Council)

2.

Declarations of Interest

Members and officers must declare any pecuniary or personalinterest in any business on the agenda. They should also make declarations at any stage such an interest becomes apparent during the meeting. Consideration should be given to leaving the meeting if the nature of the interest warrants it.  If in doubt please contact Democratic Services before the meeting.

Additional documents:

Minutes:

2.1     In accordance with the code of conduct the following personal

interests were declared: -

 

·         Dr Walsh in relation to item 7, Housing Related Support, as leader of Arun District Council

·         Mrs Bridges in relation to item 11, Low Vision Services, as she runs a club for people with impaired vision

3.

Minutes of the last meeting of the Committee pdf icon PDF 66 KB

The Committee is asked to agree the minutes of the meeting held on 15 March 2019 (cream paper).

Additional documents:

Minutes:

3.       Resolved – that the minutes of the meeting held on 15 March

2019 be approved as a correct record and that they be signed by the

Chairman.

4.

Responses to Recommendations pdf icon PDF 60 KB

The Committee is asked to note the following responses from: -

 

a)   The Department of Health & Social Care - to a recommendation made at the Committee’s 16 January meeting

 

b)   The clinical commissioning groups - to a recommendation made at the Committee’s 15 March meeting

 

c)    Brighton & Sussex University Hospitals NHS Trust - to a recommendation made at the Committee’s 15 March meeting

 

The Committee is also asked to note thatSouth East Coast Ambulance Service NHS Foundation Trust has agreed to send representatives to the November meeting of the Committee, with performance data for West Sussex in response to a recommendation made at the Committee’s 15 March meeting.

 

 

Additional documents:

Minutes:

4.       Oliver Phillips, Brighton & Sussex University Hospitals NHS Trust (BSUH) told the Committee that BSUH and Western Sussex Hospitals NHS Foundation Trust (WSHFT) were keen to provide Radiotherapy services but needed permission from NHS England which was concerned that situating the services at St Richard’s hospital, Chichester, would split cancer services between Chichester and Portsmouth. A review was taking place to see if WSHFT should obtain all its cancer services from one provider.

 

4.1     Summary of responses to Members’ comments and questions: -

 

·         There would be consultation on WSHFT’s broader clinical strategy – engagement would take place during September/October with the revised strategy being launched in late 2019 or early 2020

·         The Committee supports radiotherapy services being based at St Richard’s hospital, Chichester and urged all members of the Committee to write to their MPs in support of radiotherapy services being based at St Richard’s hospital

 

4.2     Resolved – that the Committee notes the responses and that South East Coast Ambulance Service NHS Foundation Trust has agreed to send representatives to the November meeting of the Committee.

5.

Forward Plan of Key Decisions pdf icon PDF 66 KB

Extract fromthe ForwardPlan dated 3 June 2019.

 

Anextract fromanyForwardPlan publishedbetween the date of despatchof the agenda and the date of the meetingwill be tabled at the meeting.

 

The Committee is asked to consider whetheritwishes to enquireinto any of the forthcoming decisions withinits portfolio.

Additional documents:

Minutes:

5.       Resolved – that the Committee notes the Forward Plan of Key Decisions.

6.

Housing Related Support pdf icon PDF 68 KB

a) Report by the Executive Director of People Services.

 

The report sets out the work and progress that has been made in the recommissioning and remodelling of existing and future housing related support contracts in the context of the budget for Housing Related Support.

 

b) Report by the Chair of the West Sussex Supported Housing & Homelessness Task and Finish Group.

 

The report outlines the work of the West Sussex Supported Housing and Homelessness Task and Finish Group between January and May 2019.

Additional documents:

Minutes:

6.       The Committee considered a report by the Executive Director People Services and Director of Adults’ Services (copy appended to the signed minutes) which was introduced by Paul McKay, Director Adults’ Services, who told the Committee that services had been rated red, amber or green and that the findings of the West Sussex Supported Housing and Homelessness Task & Finish Group (TFG) would influence how services would be commissioned going forward.

 

6.1     The Committee also considered a report by the TFG, which was introduced by its Chair, Natalie Brahma-Pearl who told the Committee: -

 

The TFG had been meeting regularly due to the challenging timescale

·         Phase 1 of the TFG’s work was focussed on non-statutory services that would no longer receive funding from the County Council from October 2019. Given this was the most pressing timescale these areas were being prioritised. 

·         The redesign of services going forward would be based on emerging service design principles and applied to green and amber services. Where possible local authorities would collaborate to ensure that user pathways were better joined-up and efficient. 

·         Two key main areas of concern had been identified: -

 

     i.        Older People’s Services – the TFG will meet with Adult Social Services in June to discuss this issue

 

    ii.        High Risk/Multi Agency Public Protection Arrangement (MAPPA) Offender Services

Ø  This was being treated as a priority as funding will cease after September with a very likely immediate increase in rough sleepers expected as a result

Ø  Around 100 MAPPA offenders will be affected each year

 

·         Phase 2 focusses on redesigning for the future with help from a consultancy

·         There had been 11 workshops to date involving commissioners, providers and other agencies. Thirty individuals and groups had also been interviewed

·         A flexible solution was needed to meet future needs and it was unlikely that everything would be sorted at once given time constraints. Likely future phases of service redesign would be required. 

·         Particular areas of risk were around young people, care leavers and adults with complex needs

·         Prevention would be key to avoid crises and work would take place with commissioners over the redesign of services

·         The County Council had provided some money to help during the transition from current to future arrangements from October 2019

 

6.2     The Committee then heard from other interested parties: -

 

6.3     Hilary Bartle, Chief Executive, Stonepillow and Chair of the West Sussex Coalition of Providers told the Committee: -

 

·         The County Council’s rating system had provided clarity, but there was a likelihood from October that more older people would become homeless and more offenders would use hostels 

·         The coalition was also concerned that at present, from October organisations could not budget for the future without knowing what, if any funding they would receive

·         Housing related support services were funded by donations and run by volunteers and were not statutory, but provided a way to bring in statutory services

·         The Criminal Justice Board was looking at offender accommodation

·         The coalition welcomed the work of the TFG and its  ...  view the full minutes text for item 6.

7.

improved Better Care Fund (iBCF) update pdf icon PDF 154 KB

Report by Executive Director Peoples Services and Director of Adults’ Services.

 

The report reviews iBCF investment for 2018/19 in terms of outcomes achieved, scheme suitability and priority.

 

Additional documents:

Minutes:

7.1     The Committee considered a report by the Executive Director People’s Services and Director of Adults’ Services (copy appended to the signed minutes) which was introduced by Paul McKay, Director Adults’ Services who told the Committee that: -

 

·         The iBCF was temporary money and the outcome of the Green Paper was still awaited

·         iBCF money had been used to meet adults’ needs, improve delayed transfers of care between hospitals and social care and allowed care providers to be paid above inflation rates to help stabilise the market

·         There was an underspend of approximately £1m which would be spent as above

 

7.2     Summary of responses to members’ questions and comments: -

 

·         The Council was working with care providers to commission the services it needed

·         Figures for reduced re-admissions would be provided to the Committee after the meeting

·         The Cabinet Member for Adults and Health urged all committee members to write to their local MP seeking clarity over the future of the iBCF

 

7.3     Resolved – that the Committee: -

 

     i.        agrees that the Council has spent its improved Better Care Fund money in line with grant conditions

    ii.        commends the reduction in delayed transfers of care attributable to social care

   iii.        writes to the Minister seeking clarity over the future of improved Better Care Funding highlighting the costs that had been avoided by using it to improve delayed transfers of care

 

8.

West Sussex Safeguarding Adults Board Annual Report 2018/19 pdf icon PDF 55 KB

Report by the Independent Chair of the West Sussex Safeguarding Adults Board.

 

The report documents the activity and initiatives overseen by the Board during 2018/19.

Additional documents:

Minutes:

8.1     The Committee considered a report by the Independent Chair of the West Sussex Safeguarding Adults Board (WSSAB) which was introduced by Annie Callanan, the Independent Chair who told the Committee: -

 

·       The report reflected the work and achievements of the WSSAB which had been restructured to make the most of its resources using a number of sub groups as detailed in the report

·       All partners were actively involved in Making Safeguarding Personal which put people at the centre of safeguarding

 

8.2     Summary of responses to members’ questions and comments: -

 

·       Suicides would be considered as part of a Safeguarding Adult Review if referred to the Board

·       The Board needed more understanding of issues around homelessness

·       The rise in safeguarding concerns is partly due to increased awareness and the fact that there can be more than one concern per person

·       Around 36% of reported concerns needed fuller investigation

·       £2m was needed to clear the backlog of Deprivation of Liberty Standards (DoLS) referrals – assessments are done independently from the Council

·       Multi-agency work was taking place to look at the number of people with repeated safeguarding concerns

·       There were now less concerns coming from care homes than previously

·       Safeguarding concern trends were looked at by providers and addressed where necessary

·       The top three areas of concern in West Sussex matched those nationally

·       The Board heard case studies and could include outcomes in future annual reports

·       The Governance and membership of the Board had been reviewed to ensure the correct decision-makers were at meetings – lay members would also be progressed this year

·       The risk of medicine being given covertly to people was assessed as an example of where a DoLS request might receive higher priority

·       The few complaints received by the Board were resolved and would be included in the next annual report which would also evidence how victims’ voices were heard

 

8.3     Resolved – that the Committee: -

 

     i.        Welcomes the West Sussex Safeguarding Adults Board Annual Report 2018/19 and the timing of consideration by the Committee which has been earlier than in previous years and

    ii.        Welcomes the changes to the governance of the Board

  iii.        Asks that the independent Chair considers the appointment of lay members to the Board

  iv.        Requests that case studies are included in the annual report

   v.        Receives an update regarding the multi-agency audit on repeat referrals

  vi.        Receives detailed information on which sector the increase in referrals has come from

 

9.

Proposals to improve mental health services in West Sussex pdf icon PDF 1 MB

Report by Sussex Partnership NHS Foundation Trust.

 

The report outlines proposals to improve mental health services in West Sussex.

 

 

 

Additional documents:

Minutes:

9.1     The Committee considered a report by Sussex Partnership NHS Foundation Trust (copy appended to the signed minutes) which was introduced by Matt Powls, Director of Commissioning – Mental Health, Crawley and Horsham & Mid Sussex CCGs who told the Committee that the changes were particularly around services for people with dementia, older people and working age adults and that there would be no reduction in bed numbers.

 

9.2     Summary of responses to Members’ questions and comments: -

 

·         Dementia beds were being consolidated in to one unit to provide a better service

·         Sussex Partnership NHS Foundation Trust’s Clinical Strategy aimed to transform community services to keep people well and out of hospital and was developing models to put in place once it had the money to do so

·         The Committee was concerned about the effect changes would have on people in rural areas

·         A group involving the Council had looked at travel implications and views on this would be sought during consultation

·         Healthwatch would be involved in engagement before there was any public engagement

·         Public consultation would be analysed by independent consultants – staff would be consulted after this

·         Staff had mixed views on the proposals – there was a large number of people retiring at the same time – mental health graduates were being employed

·         The proposals should improve quality of in-patient care through the centre of excellence which should help recruitment and retention

·         Community services would be developed in parallel to the changes in mental health services with existing wards remaining open until the new services had bedded-in

·         Staff were being recruited to fill roles needed in community services

·         More crisis lounges were being established where people could be assessed therapeutically and there was a psychiatric decision unit at Brighton that helped avoid admissions to hospital (the clinical commissioning groups were bidding for crisis care money)

·         The police and ambulance service would take people to the psychiatric decision unit (Brighton was chosen as the location for this service as it is for East and West Sussex)

·         People would stay a maximum of 72 hours at the psychiatric decision unit and be taken home afterwards

·         Crisis teams would get more investment than other services as they were currently under funded – recruitment to the teams had begun

·         Crisis teams would work with community teams and go to rural areas

·         The Dementia and Later Life teams were coming back together to provide better care

·         The Oaklands ward at the Harold Kidd Unit, Chichester would stay open as it was a single sex ward

·         Whilst some beds might go from some areas this would be compensated for by nine beds being gained from Surrey and borders – it was expected that the service would run at 80% bed occupancy

·         The Committee wanted to see the results of engagement/consultation and the travel analysis and had concerns over how rural areas would be affected

 

9.3     Resolved – that the Committee: -

 

     i.        Considers the proposals as set out in the report as a  ...  view the full minutes text for item 9.

10.

Low Vision Services pdf icon PDF 46 KB

a)   Report by Coastal West Sussex, Horsham & Mid Sussex, Crawley Clinical Commissioning Groups and Director Adults’ Services.

 

The report sets out the provision of low vision services for residents in West Sussex.

 

b)   Royal National Institute for the Blind policy position on low vision services.

 

c)    Royal National Institute for the Blind low vision service mapping.

Additional documents:

Minutes:

10.1   The Committee considered a report by Coastal West Sussex, Horsham & Mid Sussex clinical commissioning groups and the Director of Adults’ Services (copy appended to the signed minutes).

 

10.2   Paul McKay, Director of Adults’ Services told the Committee that a Task & Finish Group would be established involving interested parties to review the situation in July.

 

10.3   Christine Glanville, Network Manager – South East England, Royal National Institute for the Blind (RNIB) told the Committee that the RNIB felt that low vision services, including the satellite service at the Princess Royal Hospital, Haywards Heath should be reinstated whilst the review took place, especially as patients in Mid Sussex were having to pay for services where there were about 5,000 people with sight loss.

 

10.4   Wendy Young, Deputy Director of Planned Care Crawley, Horsham and Mid Sussex and, Coastal West Sussex clinical commissioning groups told the Committee: -

 

·       It would be difficult to reinstate any services – alternatives were available, but they were not equitable across the county

·       Ophthalmology would be a priority for the clinical commissioning groups when they merged and could look at the service in more detail

·       Clear options had been outlined in the report

 

10.5   Summary of responses to Members’ questions and comments: -

 

·      The Council and the clinical commissioning groups were committed to providing a good service with input from the RNIB

·       Healthwatch has just issued a report on patient experience and service knowledge of people who accessed the eye clinics at Western Sussex Hospitals NHS Foundation Trust - Southlands and St Richard’s Hospitals

 

10.6   Resolved – that the Committee believes that there is not an equity of provision of low vision services for West Sussex residents and welcomes the creation of a Task & Finish Group including representatives from the Council, clinical commissioning groups, RNIB and Healthwatch to review the provision and share the outcomes from this work with the Committee in the autumn.

 

11.

Appointment of the Committee's Business Planning Group pdf icon PDF 41 KB

The Committee is asked to appoint five of its members to its Business Planning Group, to include the Chairman and Vice Chairman of the Committee, with two of the five being minority party members.

Additional documents:

Minutes:

11.1   Resolved – that the Committee appoints the following members to its Business Planning Group; Mr Turner (Chairman), Dr Walsh (Vice Chairman), Mrs Arculus, Mr Boram and Mrs Smith.

 

12.

Possible Items for Future Scrutiny

Members to mention any items which they believe to be of relevance to the business of the Select Committee, and suitable for scrutiny, e.g. raised with them by constituents arising from central government initiatives etc.

 

If any member puts forward such an item, the Committee’s role at this meeting is just to assess, briefly, whether to refer the matter to its Business Planning Group (BPG) to consider in detail.

Additional documents:

Minutes:

12.1   The following topics were suggested and will be considered by the Business Planning Group: -

 

·         The shortage of paediatricians

·         Capacity of the Children & Adolescent Mental Health Service

 

13.

Date of Next Meeting

The next meeting of the Committee will be held on 26 September at 10.30 am at County Hall, Chichester.  Probable agenda items include: -

 

·         Substance Misuse – Drugs and Alcohol

·         Suicide Prevention Strategy

·         Health Protection Annual Report

 

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 12 September.

Additional documents:

Minutes:

13.1   The next meeting of the Committee will be held at 10.30am at County Hall, Chichester on 26 September