Agenda and minutes

Health and Adult Social Care Scrutiny Committee
Thursday, 26th September, 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

14.

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:

14.1 In accordance with the code of conduct the following interests were declared: -

 

·         Mr McAleney declared a personal and prejudicial interest in item 4a - Response to Recommendations by the Cabinet Member for Adults & Health as he is employed by Crawley Open House. The response was not discussed so Mr McAleney did not need to leave the room

·         Mr McAleney declared a personal interest in item 6 - Local Assistance Network as he is employed by Crawley Open House

·         Mr Turner declared a personal interest in items 7 – West Sussex Suicide Prevention Strategy 2017-20, 8 – Health Protection Annual Report and 9 – Substance Misuse – Drugs and Alcohol as a pharmacist

15.

Minutes of the last meeting of the Committee pdf icon PDF 257 KB

The Committee is asked to agree the minutes of the meeting held on 12 June (cream paper).

Additional documents:

Minutes:

15.1   Resolved – that the minutes of the meeting held on 12 June 2019 be approved as a correct record and that they be signed by the Chairman.

16.

Responses to Recommendations pdf icon PDF 243 KB

The Committee is asked to note the responses to recommendations made at the 12 June meeting from: -

 

a) The Cabinet Member for Adults & Health

 

b) The Safeguarding Adults Board Manager

 

c) The Secretary of State for Housing, Communities and Local Government – to follow

Additional documents:

Minutes:

16.1   Resolved – that the Committee notes the responses and the fact that concerns over Housing Related Support can be raised at the next meeting of the Committee.

17.

Forward Plan of Key Decisions pdf icon PDF 349 KB

Extract fromthe ForwardPlan dated 12 September.

 

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:

17.1   Resolved – that the Committee agrees with the Chairman’s proposal that the Review of In-house Residential Care be looked at by a one-off Task & Finish Group on 13 November 2019.

18.

Local Assistance Network pdf icon PDF 163 KB

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

 

The report outlines the proposal to reduce the LAN funding and the proposed consultation approach.

Additional documents:

Minutes:

18.1   The Committee considered a report by the Executive Director People Services and Director of Adults’ Services (copy appended to the signed minutes).

 

18.2   The Cabinet Member for Adults & Health told the Committee that the Council had not been made aware of any significant detrimental impacts on providers as a result of the reduction in funding. She reminded the Committee that the Council did not have a statutory duty to fund this service and needed to make savings where possible.

 

18.3   Dave Sargeant, Acting Director of Adults’ Services, made the following points: -

 

·         Providers had found other sources of funding after the Council reduced its contribution

·         Consultation was taking place with current recipients until 18 October, which would help with the impact assessment

·         The effect on Children’s Services would be monitored

 

18.4   Summary of responses to the Committee’s questions and comments: -

 

·         Members of the Committee expressed that

Ø  those affected might not be able to raise their concerns

Ø  providers might not have complained as the reduction last year was less than originally planned

Ø  the reduction in funding could lead to increased costs later for the Council and other public bodies such as the NHS and Police

Ø  the Council had a moral duty to help

Ø  the decision should not be taken until it had seen the results on the consultation

·         No decision had been made on how the proposed £100k funding would be allocated

·         The current allocated Local Assistance Network funding to Citizens Advice was in addition to the core funding the Council gave to the service

·         The Cabinet Member for Adults & Health encouraged committee members to ask people in their areas to take part in the consultation

 

18.5   Resolved – that the Committee would like a detailed paper covering the outcomes of the consultation with providers of the Local Assistance Network on the proposed reduction in funding from £200k to £100k and that this be presented to the one-off Task & Finish Group on Housing Related Support on 13 November 2019.

19.

West Sussex Suicide Prevention Strategy 2017-20 DOTX 85 KB

Report by the Director of Public Health.

 

The West Sussex Suicide Prevention Strategy 2017-20 outlines priority areas for preventative action in the county.

Additional documents:

Minutes:

19.1   The Committee considered a report by the Director of Public Health and the West Sussex Suicide Prevention Strategy 2017-20 (copies appended to the signed minutes) which were introduced by Daniel MacIntyre, Head of Service, Public Health, who highlighted the age profile of victims, the economic impact and the fact that the number of suicides in West Sussex was reducing. He also told the Committee that: -

 

·       £687k of funding had been awarded for suicide prevention activity in Brighton & Hove, East Sussex and West Sussex

·       Emerging issues and clearer levels of ambition needed to be included in the next version of the strategy

 

19.2   Summary of responses to the Committee’s comments and questions: -

 

·       The YMCA operated Children & Young Peoples’ Improved Access to Psychological Therapiesinterventions in the community and data was inputted into the NHS data set. It also employed a clinical psychologist from Sussex Partnership NHS Foundation Trust (SPFT)

·       Pathfinder West Sussex is an alliance of ten third sector providers working in partnership with SPFT to enable people with mental health support needs, and their carers, to improve their mental health and wellbeing

·       SPFT would be increasing its Crisis Team staff and hoping to engage better with hard to reach groups that might prefer to speak to the voluntary sector or their peers

·       The West Sussex Suicide Prevention Steering Group included representatives from the Council, SPFT, bereavement support, the ambulance service, Police, Transport Police and Network Rail, all of who provided information to update the Group’s action areas

·       Coroners could now pronounce verdicts on suicides which increased the numbers of deaths attributed to suicide ‘on the balance of probabilities’

·       There had been a peer review of the strategy

·       The strategy correctly identified the key at-risk groups

·       The Samaritans could only provide national data

·       Drug and alcohol abuse were large causes of suicide

·       Social isolation was another risk factor and tackling this was a priority for Public Health with services being commissioned to combat it

·       SPFT’s adult services recognised the needs of children transferring to its services more through partnership working with the Council, Children & Adolescent Mental Health Services and Children Looked After teams

·       The YMCA provided information on mental health to schools written by young people

·       Work was taking place to reach LGBTQI people who were considered higher risk of suicide and self-harm compared to the general population

·       Daniel MacIntyre offered to produce a briefing for the Committee on the key groups at risk of suicide

·       From February 2020 the first point of contact for anyone with mental health problems would be the NHS 111 service

·       Educational psychologists provided a wellbeing service to schools – there was also a schools-based mental health team providing emotional support in a pilot scheme

·       Coastal MIND worked with partners to deliver training in schools

·       Young people could be helped with online counselling with therapeutic input and online resources with clinician support

·       It was important that people were encouraged to say if they felt suicidal as they could then be advised where  ...  view the full minutes text for item 19.

20.

Health Protection Annual Report pdf icon PDF 142 KB

Report by the Director of Public Health.

 

The West Sussex Health Protection Annual Report 2018/2019, details the West Sussex data, and activities carried out by the Council and partner organisations during the period 1st April 2018 to 31st March 2019.

Additional documents:

Minutes:

20.1   The Committee considered a report by the Director of Public Health and the West Sussex Health Protection Annual Report 2018/19 (copies appended to the signed minutes) which were introduced by Anna Raleigh, Director of Public Health who told the Committee that it had been a busy year with challenges around immunisation and screening.

 

20.2   Dr Sarah Lock, Consultant in Health Protection Public Health England highlighted the following: -

 

·       Enquiries were up by nearly 43%

·       There were 3,037 cases of infection notified to PHE last year

·       39% of outbreaks were in care homes, which caused difficulties when they had to close, 46% of outbreaks were in schools and nurseries. Outbreaks were mainly flu and norovirus

·       There was low uptake of the flu vaccination by care home staff

·       There had been an outbreak of measles in a Chichester school and an outbreak of cryptosporidium linked to an open farm

·       Work had taken place with schools and hospitals to screen contacts of  tuberculosis (TB) cases

·       There had been problems with commissioning TB screening in north West Sussex

 

20.3   Caroline Vass, Consultant in Immunisation and Screening, Public Health England highlighted the following: -

 

·       The new faecal immunochemical test for bowel cancer should increase screening numbers

·       There was a problem with women not getting breast cancer screening appointments within the 36-month deadline - this was being carefully monitored locally

·       A new process for cervical cancer screening testing was being rolled out using a primary test for human papillomavirus (HPV) to triage further management and treatment

·       HPV vaccinations were now available for boys in schools

·       Take-up of the first MMR vaccination was good, but take-up for the second was poor – there was ongoing activity to try to increase uptake

·       National uptake for shingles vaccine was low at 30% and this was reflected locally against a 60% national target

·       Care home staff were now offered free flu vaccinations at pharmacies

 

20.4   Paul Woodcock, Commissioner Sexual Health highlighted the following: -

 

·       Diagnosis of HIV was decreasing due to treatment as prevention and risk groups being protected with Pre-Exposure Prophylaxis

·       The introduction of the HPV vaccination has helped bring down the number of cases of genital warts and will have an impact on cervical cancer

·       Chlamydia diagnosis in young people was an issue which should improve with the reprocurement of the sexual health service

 

20.5   Rachel Loveday, Public Health Lead - Health Protection highlighted the following: -

 

·       Work was going on with partners to improve air quality

·       Many care homes now had infection control champions

·       Healthcare associated infections in many areas are decreasing but there was still further focus required in some areas

·       Priorities were to increase uptake of vaccinations and the TB pathway for patients in the north West Sussex

 

20.6   Summary of responses to the Committee’s comments and questions: -

 

·       The take up of flu vaccinations in care homes and hospitals was monitored weekly

·       The Health Protection Annual Report did not include every subject – others were covered elsewhere, e.g. diabetes in health improvement plans  ...  view the full minutes text for item 20.

21.

Substance Misuse - Drugs and Alcohol DOTX 410 KB

Report by the Director of Public Health.

 

The report outlines progress on the effectiveness of service arrangements, performance and high level Public Health Outcome Framework outcomes.

Additional documents:

Minutes:

21.1    The Committee considered a report by the Director of Public Health (copy appended to the signed minutes) which was introduced by Philippa Gibson, Senior Commissioning Manager (Substance Misuse) who told the Committee: -

 

·       The £5m cost of the contract with Care, Grow, Live (CGL) to provide a health, wellbeing and recovery service was mainly funded from the Public Health Grant

·       There had been sustained improvements in key measures of treatment outcomes since 2017 despite an increase in demand and complexity of cases

·       There is a shared priority with service and Public Health England to reduce further drug related deaths.

·       The direction and focus of future work would be influenced by an audit into drug-related deaths

·       Over the last four years, there have been a number of successful bids to Public Health England primarily for capital monies but also for revenue.

·        Partnership priorities include the following

Ø  Prevention and Behaviour Change

Ø  Treatment and Support

Ø  Enforcement and Regulation

·       Services needed to be easier to access

·       Better feedback and analysis of risks was required to help service response

 

21.2    Ian Dunster, Service Manager, West Sussex Drug and Alcohol Wellbeing Network told the Committee: -

 

·       Interventions included specialist prescribing and psychosocial interventions were generally working well

·       With numbers of people seeking treatment increasing, help was required with caseloads with 100 – 180 referrals coming in per month

·       People often also had problems with housing, mental health difficultiesand unemployment

·       The Service had a specific team supporting young people and their families

·       Over 200 partner agency staff had been trained to use Naloxone to treat overdoses and three lives had been saved so far by CGL staff using Naloxone

·       Naloxone was available from 28 pharmacies in the county

Hepatitis C testing was available, but many people did not like the fact that it took place in hospitals, so the service was working with health colleagues and partner agencies to improve the offer

 

21.3    Katherine Wadbrook, Service Manager - CGL West Sussex Young Persons and Families Services told the Committee: -

 

·       Innovation fund money from Public Health England was available to help children affected by parental alcohol misuse and pregnant women who were misusing alcohol 

21.4    Kerry Lemon, CGL Service User Involvement Lead told the Committee that she had been addicted to alcohol and heroine and spent time in prison and been homeless in Chichester before receiving help from CGL. She had not always attended appointments with CGL and an end of live care plan had been prepared for her. She went to a treatment centre for nine weeks and has been clear of addiction for two years and now works as a peer mentor for CGL.

 

21.5    Summary of responses to the Committee’s comments and questions: -

 

·       All treatment was voluntary, and the figures took into account those who had moved out of the area

·       Due to the complexities and difficulties of beating addiction, any success was welcomed

·       Outcomes included: -

Ø  People injecting drugs to reduce safely within three months  ...  view the full minutes text for item 21.

22.

Business Planning Group Report pdf icon PDF 59 KB

The report informs the Committee of the Business Planning Group meeting held on 27 June, setting out the key issues discussed.

 

The Committee is asked to endorse the contents of this report, and particularly the Committee’s Work Programme revised to reflect the Business Planning Group’s discussions (attached at Appendix A).

Additional documents:

Minutes:

22.1   The Committee considered a report by the Chairman of the Business Planning Group (copy appended to the signed copy of the minutes).

 

22.2   It was noted by the Committee that a Total Performance Monitor was not provided to the Business Planning Group meeting and as a result the performance of Adult Social Care Services could not be appropriately assessed and examined. The Committee required that the most recent Total Performance Monitor should be presented five business days prior to the Business Planning Group meeting together with an update of any significant issues that have occurred after the preparation of that Total Performance Monitor.

 

22.3   It was confirmed that the Committee would have an opportunity to scrutinise the capacity of the Children & Adolescent Mental Health Service. This would be in conjunction with the Children & Young People’s Services Select Committee.

 

22.4   An update on continuing issues with the Shaw Homes contract was requested to be circulated to Business Planning Group members before the group’s next meeting.

 

22.5   Resolved – that the Committee endorses the Business Planning Group’s report.

23.

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:

23.1   It was requested that the Committee looked at the NHS Human Resources Strategy.

 

23.2   Resolved – that the request that the Committee look at the NHS Human Resources Strategy be referred to the next meeting of the Business Planning Group.

24.

Date of Next Meeting

The next meeting of the Committee will be held on 27 November at 10.30 am at County Hall, Chichester.  Probable agenda items include:

 

·         South East Coast Ambulance Service NHS Foundation Trust Update

·         Proposals to improve mental health services in West Sussex

·         Housing Related Support

·         Low Vision Services in West Sussex

·         Winter Planning

 

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 13 November.

Additional documents:

Minutes:

24.1   The next meeting of the Committee will be held on 27 November at 10.30 am at County Hall, Chichester.