Agenda and minutes

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.

26.1     In accordance with the code of conduct, Cllr Pudaloff declared a personal interest in item 6, Financial Assessments Improvement Programme, as a user of Adults’ Services.

27.1     No urgent matters were raised.

The Committee is asked to agree the minutes of the meeting held on 26 November 2021 (cream paper).

28.1     Resolved – that the minutes of the meeting held on 26 November 2021 are approved as a correct record and are signed by the Chairman.

The Committee is asked to note the responses to recommendations made at the 26 November 2021 meeting from the Cabinet Member for Adults’ Services and the Executive Managing Director, NHS West Sussex Clinical Commissioning Group.

29.1     Resolved – that the Committee notes the responses to recommendations made at its 26 November 2021 meeting.

Report by the Director of Law and Assurance.

The Committee is asked to consider the reports by NHS England and Healthwatch on access to dentistry services.

30.1     The Committee scrutinised the impact of Covid-19 on access to dental services taking into account reports by NHS England (NHSE) and Healthwatch West Sussex (copies appended to the signed minutes).

30.2     The Committee expressed concerns around finding an NHS dentist, getting appointments, treatment backlog, fluoridation rates, meeting targets, training, recruitment and retention of dentists, dental practices closing, distribution of money from closed contracts, the link between poorer areas and poorer dental health, the wider impact on health due to lack of dental care, what to do when NHS practices close and the prohibitive costs of private dentistry and felt that it was essential that website information was kept up to date to ensure residents were able to find a dentist when required.

30.3     Summary of responses to committee members’ concerns: -

·         The Cabinet Member for Public Health & Wellbeing promised to share the 2018 West Sussex Oral Health Needs Assessment in Children and Young People report with the Committee and said that the Council had a responsibility to monitor the standard of the dental health within its area through needs assessments and could commission dental public health services

·         Fluoridation was not an area covered by NHSE

·         Money from discontinued contracts was returned to NHSE for reinvestment in dentistry - temporary contracts were offered to fill gaps until services were recommissioned

·         NHSE was not involved in the recruitment, training or retention of dentists – Dental Contract Reform was being looked at by the Department for Health and Social Care and would cover these issues

·         Dental Contract Reform would also cover establishing a body to look after patients if their NHS dental practice closes

·         NHS England helped GPs with signposting people to where they could get dental treatment

·         Dental practices were prioritising those with urgent need to minimise the number of people going to A & E for dental reasons

·         The funding offered to most dental practices is based on historical claiming profiles - some earning lower amounts have terminated their contracts for financial reasons – NHSE is not able to increase contracts and payments without an associated increase in activity

·         There is no target to look at the backlog of dental work

·         Patients can look for NHS dentists via the NHS UK website, but this relies on dental practices keeping their information up to date

·         NHSE had embarked on a commissioning programme to increase access to dentistry in West Sussex before the pandemic

·         A practice in Haywards Heath had increased its contract and temporary contracts were in place in other areas with work continuing to increase capacity in the county

30.4     Resolved – that

     i.        The 2018 West Sussex Oral Health Needs Assessment in Children and Young People report be circulated to the Committee

    ii.        The West Sussex Oral Health Needs Assessment in Children and Young People report be refreshed

   iii.        That Democratic Services explores whether data on fluoridisation rates in West Sussex is available to the Committee

  iv.        The Chairman writes to the relevant Secretary of State to highlight the need  ...  view the full minutes text for item 30.

Report by the Director of Law and Assurance.

The Committee is asked to consider the reports by West Sussex County Council and Healthwatch on the improvement programme put in place to develop the quality of customer service provided as part of the financial assessment for people in receipt of adult social care and support.

31.1     The Committee scrutinised the Financial Assessments Improvement Programme taking into account reports by the Interim Deputy Director of Finance and Healthwatch West Sussex (copies appended to the signed minutes) and a verbal contribution from Cllr Milne who said that the increase in people’s contribution towards the cost of their social care and support package had caused distress and was difficult for vulnerable people to afford. He suggested that in future any proposed increase of e.g. 20% should trigger an automatic investigation.

31.2     The Committee’s raised the following concerns/comments: -

·         The impact on individuals of the application of Disability Related Expenses (DRE)

·         The impact arising from the reduction in the Minimum Income Guarantee (MIG) despite financial assessments not being completed

·         Use of out of date disability data

·         The Improvement Plan needed to ensure it prioritised a personalised approach with the need to see demonstrable improvement within a clear timescale that delivered against the priorities for improvement addressing the Committee’s comments

31.3     Summary of responses to committee members’ concerns/comments: -

·         The Council is implementing a national charging regime which generates approximately £60m, a fundamental part of the Council’s Adults’ Services budget

·         Without charging there would have to be reductions in services

·         Managing the financial assessment process has to be transparent and clear with improved communication and information

·         Reviews of financial assessments not being carried out in a timely manner has contributed to the problems arising – the review of financial assessments reflected within the report has addressed this and timely reviews will be an on-going priority of the improved service.

·         Challenges exist in terms of maintaining up to date information about individual’s financial circumstances, which emphasises the importance of improving communication.

·         DRE is an integral part of the financial assessment and as such is something that can be explored, discussed and resolved as part of finalising the assessment and the assessed contribution.

·         The Minimum Income Guarantee is an integral part of the financial assessment and is applied as appropriate on an individual basis.

·         Decisions about what is included as DRE are linked to the care and support assessment of an individual.  There is a separation of duties applied to ensure that there is no conflict of interest and to support consistency in application.

·         The approach to assessing DRE will be part of the review of the ASC Charging Policy that is currently being undertaken.

·         The Council recognises the need to provide more public information and transparency about the application of DRE.

·         The Council has dealt with complaints openly and encouraged people to use the appeals process if they had any concerns about the outcome or accuracy of the financial assessment.

·         Complaints have primarily been about outcomes, not the assessment calculation

·         The Government has announced that it will increase the value of the MIG in 2022/23

·         When services were insourced, it was clear that there were capacity and management issues that needed to be addressed

·         The Council Plan describes the budget and what services will be provided

·         On 1 February the Cabinet  ...  view the full minutes text for item 31.

The Committee is asked to review its current draft work programme taking into account the Forward Plan of Key Decisions and any suggestions from its members for possible items for future scrutiny.

32.1     The Committee considered its work programme taking into account the Forward Plan of Key Decisions and suggestions from members.

32.2     Resolved – that the Business Planning Group consider proposals in the Adults’ Strategy as topics for future scrutiny.

There has been one request for call-in to the Scrutiny Committee within its constitutional remit since the date of the last meeting. A report on the call-in is attached.

The Director of Law and Assurance will report any further requests since the publication of the agenda papers.

33.1     The Committee noted the outcome of the call-in request relating to residential based in-house services - Marjorie Cobby House, Selsey decision (CAB07 21/22).

The next meeting of the Committee will be held on 7 March at 10.30 am at County Hall, Chichester.  Probable agenda items include:

·         An update on the West Sussex Stroke Programme

·         Adult Social Care Quality Assurance

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 18 February 2022.

34.1     The next meeting of the Committee will take place on 7 March 2022.