Agenda and minutes

Health and Adult Social Care Scrutiny Committee - Wednesday, 6 March 2024 10.30 am

Venue: County Hall, Chichester, PO19 1RQ

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

Media

Items
No. Item

41.

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:

41.1     In accordance with the code of conduct, the following personal interest was declared: -

 

41.2     Cllr Cooper in respect of item 6, University Hospitals Sussex NHS Foundation Trust: Report by the Care Quality Commission as a governor of the Trust

42.

Minutes of the last meeting of the Committee pdf icon PDF 82 KB

The Committee is asked to agree the minutes of the meeting held on 10 January 2024(cream paper).

Additional documents:

Minutes:

42.1     Resolved – that the minutes of the meeting held on 10 January 2024 are approved as a correct record and are signed by the Chairman.

43.

Responses to Recommendations pdf icon PDF 125 KB

The Committee is asked to note the responses to recommendations made at previous meetings of the Committee.

Additional documents:

Minutes:

43.1     In response to the recommendation: -

 

‘The Cabinet Member for Public Health and Wellbeing to consider if future reporting could include data on water/sea pollution and measures to report safety levels for the public’ which has been outstanding since June 2023, the Director of Public Health, gave the following response: -

 

The County Council’s Public Health Directorate does not receive monitoring data relating to water/sea pollution and measures to report safety levels to the public. The team works closely with the UK Health Security Agency (UKHSA) who provide specialist health protection advice on infectious diseases, chemical and radiation hazards, and major emergencies. The UKHSA lead on any outbreaks or incidents in relation to these areas, linking in with WSCC Public Health, where required at local authority level. Whilst the County Council is the Lead Local Flood Authority (LLFA), and is responsible for managing the risk of flooding from surface water and groundwater in the county, the responsibility for water quality and resources falls within the remit of the Environment Agency (EA).’

 

43.2    Resolved – that the Committee notes the responses to recommendations.

44.

South East Coast Ambulance Service Update pdf icon PDF 55 KB

Report by South East Coast Ambulance Service NHS Foundation Trust.

 

The report provides an update on Trust performance across its 999 and 111 service.

 

The Committee is asked to assess whether services provided by SECAmb have improved in line with the requirements of the Care Quality Commission inspections.

Additional documents:

Minutes:

44.1     The Committee considered a report by South East Coast Ambulance Service NHS Foundation Trust (copy appended to the signed minutes).

 

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

 

·         The Trust expects to exit the Recovery Support Programme in May, subject to having a plan regarding financial sustainability, development of a strategy, stable leadership and satisfactory assessment by commissioners and NHS England

·         Work with the Police and the wearing of body cameras has helped to reduce aggression towards ambulance staff

·         The following measures have been taken to improve recruitment and retention of staff at call centres: -

Ø  ensuring that courses for call handlers are filled

Ø  reducing the time from hiring to commencement of employment

Ø  improving career pathways for non-clinical staff

Ø  introducing flexible roles that cover more than one aspect of the Trust’s work

·         The Trust does not use zero hours contracts

·         A virtual response component is being worked up as part of the Trust’s emerging strategy, this could reduce attendance at scene by 50%, but an ambulance would always be dispatched to someone who has a physical need for one

·         Community First Responders now have riser chairs to get people off the floor, which also reduces the need for ambulance attendance at some incidents

·         The Trust does not provide transport to hospital for patients with planned appointments

·         There was a query about referrals to 111 by GPs

·         Response times to category 1 incidents have improved by 1 minute 13 seconds and to category 2 incidents by 8 minutes

·         The is currently developing plans to trial a range of electric vehicles in the new financial year as part of a wider fleet review

 

44.3     Resolved - that the Committee: -

 

                i.      Welcomes the report and has received assurances on the improved performance of South East Coast Ambulance Service NHS Foundation Trust

               ii.      Supports the preferred Option 2 model whilst recognising challenges set out in the report

             iii.      Requests an updated report is presented to the Committee in March 2025 with discussion for its format at a prior meeting of the Committee’s Business Planning Group

             iv.     Aks South East Coast Ambulance Service NHS Foundation Trust to ascertain if there is any data available on the amount of people referred to using the 111 service by GPs

45.

University Hospitals Sussex NHS Foundation Trust: Report by the Care Quality Commission pdf icon PDF 56 KB

The Committee to consider an update from University Hospitals Sussex NHS Foundation Trust on its response to the Care Quality Commission findings.

Additional documents:

Minutes:

45.1     The Committee considered a presentation by University Hospitals Sussex NHS Foundation Trust (copy appended to the signed minutes).

 

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

 

·       The Trust will meet the 75% 28 day fast diagnosis of cancer standard by the end of March 2024

·       Less than 5% of patients referred into cancer pathways are diagnosed with cancer

·       The number of patients on the cancer pathway waiting more than 62 days for treatment has reduced to around 60%

·       Patient safety is a subjective view by the Care Quality Commission which says long waiting times (which are reducing) and insufficient staffing (which has increased by 600 since this time last year) are detrimental to patient safety

·       Waiting lists have been reduced by commissioning services from the independent sector for some simple cases, being part of an acute wide collaborative (for quicker patient access to other hospitals if it can be arranged) and negotiating extra weekend and evening work with staff – to keep workloads sustainable, extra staff have been employed

·       There are no plans to introduce radiotherapy services at St Richard’s hospital, Chichester

·       Brighton’s Royal Sussex County Hospital’s (RSCH) Trauma, Tertiary and Training (3Ts) redevelopment mainly replaced existing capacity. Due to site restrictions some services have moved e.g. stroke services to St Richard’s hospital, Chichester. The Trust invests in all its hospitals, not only the RSCH

·       Waiting times are measured from referral to treatment

·       The number of planned referrals has remained fairly static, but cancer referrals have risen by 15%

·       Covid has caused longer waiting times

·       Staff morale is upheld by investing in staff development, health & wellbeing offers and listening to staff – a recent staff survey had a high response rate and showed improved morale

 

45.3     Resolved – that the Committee: -

 

               i.     Recognises that long waiting lists are a national issue

             ii.     Has received assurances on the improvement plans going forward, and requests an update on the actions identified in the report at an appropriate time as considered by the Committee’s Business Planning Group

 

 

46.

Update on the delivery of the two-year improvement programme 2023-25 to assist the delivery of the Adult Social Care Strategy 2022-25 and preparation for Care Quality Commission Assurance of Adult Social Care pdf icon PDF 156 KB

Report by Director of Adults and Health and Assistant Director – Improvement and Assurance.

 

The Committee is asked to consider the update on the delivery of the two-year improvement programme.

Additional documents:

Minutes:

46.1     The Committee considered a report by the Director of Adults and Health and Assistant Director – Improvement and Assurance (copy appended to the signed minutes).

 

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

 

·         There is funding for the two-year improvement programme, but social care will continue to need improvement beyond that as people’s needs and demands change

·         The two transitions protocols reflect the differing needs of young people with mental health needs where needs may not be longer tern and for young people with a learning disability where long term needs are more likely

·         One steering group co-chaired by the Director of Children, Young People and Learning and the Director of Adults and Health oversees the delivery of both transition protocols

·         The Special Educational Needs & Disabilities report has an action plan developed by the Council and the NHS to address issues around transition for young people to adults’ services and for those with complex needs

·         There is a Workforce Strategy that sets out how social care staff will be supported and actions to improve retaining them

·         There will be a market position statement setting out how the Council is working with the independent market in relation to the work it wants to do for the models of care that it wants to purchase and its expectations of providers about how they will support and develop their staff

·         Skills for Care, the Local Government Association and the Association of Directors of Adult Social Services have been sponsoring a national workforce strategy

·         Plans for digital care and the use of Individual Service Funds were welcomed by the Committee

 

46.3     Resolved – that the Committee: -

 

                i.     Asks its Business Planning Group to determine if any issues identified in the Local Area Special Educational Needs & Disabilities Inspection require further scrutiny specifically relating to the Action Plan

               ii.     Requests an update on the Digital Carers Pathway and Individual Service Funds at an appropriate time

47.

Performance and Resources Report - Quarter 3 2023/24 pdf icon PDF 75 KB

Report by Director of Finance and Support Services, setting out the finance and performance position as at the end of December 2023.

 

The Committee is asked to examine the data and supporting commentary for the Performance and Resources report and make any recommendations for action to the relevant Cabinet Member.

Additional documents:

Minutes:

47.1     The Committee considered the Quarter 2 Performance and Resources Report (PRR) by the Director of Finance and Support Services summarising the position on finance, performance, risk and workforce as at the end of September 2023 (copy appended to the signed minutes).

 

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

 

Adults

 

·         Care assessments are statutory and mean that customers get the right service

·         The Council’s residential care model is expensive, so a different model is being introduced that includes supported living and is better for customers and is better value for money

·         The Carers’ contract will be the first time the Council has opted for an outcomes-based contract – this type of contract gives providers more flexibility about how a services is delivered. The contract is for five years and will be monitored to make sure it is giving value for money

 

Public Health

 

·         The response rate to the Council’s ‘Your Health Matters – West Sussex Community Health and Wellbeing Survey 2024’ is looking positive and the outcomes will be reported to the Committee in the future. The survey is being undertaken to gain an understanding of what the needs are around the health of our residents and whether the current services provided are delivering what they need and want.

·         In response to a question regarding the Worthing Sexual Health Services clinic, the Director of Public Health advised that the Council would be reviewing the commissioning of Integrated Sexual Health Services (ISHS), including the approach and model. As such, the Worthing clinic will be considered as part of this approach, which will be taking into account the needs of local residents.

·         Alternative opportunities for chlamydia screening, not only online, are also being explored with the Council’s current providers of sexual health services

·         Healthwatch West Sussex had received insight from local people with lived experience suggesting that domestic abuse and violence is a wider issue than perhaps recognised, with an increasing number of people coming forward for help. This had been seen by Safe in Sussex outreach support, which had more than tripled from 2021-2022 to 2022-2023. It was recognised as positive that people leave the service feeling safe but raised concerns regarding the increasing demands on service. 

 

47.3     Resolved – that the Committee asks: -

 

                i.      That feedback on the Carer’s contract is considered by its Business Planning Group at the appropriate time

               ii.      To be provided with comparison statistics on new victim referrals in the last quarter to the Domestic and Sexual Violence and Abuse Service

48.

Forward Plan of Key Decisions pdf icon PDF 141 KB

Extract from the Forward Plan dated 27 February 2024 – attached.

 

An extract from any Forward Plan relevant to the Committee’s portfolio published between the date of despatch of the agenda and the date of the meeting will be tabled at the meeting.

 

The Committee is asked to consider whether it wishes to enquire into any of the forthcoming decisions within its portfolio.

Additional documents:

Minutes:

48.1     The Committee considered an extract of the Forward Plan of Key Decisions (copy appended to the signed minutes) and learned that procurement of a new contract for the Healthy Child Programme will not lead to any significant changes to this national programme.

 

48.2     Resolved – that the Committee

 

                i.      Asks for an update on the Healthy Child Programme to be provided to the committee at an appropriate time to be considered by its Business Planning Group.

               ii.      Notes the Forward Plan of Key Decisions.

 

 

49.

Work Programme pdf icon PDF 78 KB

The Committee to review its draft work programme taking into consideration the checklist at Appendix A.

Additional documents:

Minutes:

49.1     The Committee considered its work programme (copy appended to the signed minutes).

 

49.2     The Committee’s Business Planning Group agreed that the decision by University Hospitals Sussex NHS Foundation Trust to permanently relocate Haematology Inpatient Services from St Richard’s Hospital, Chichester to Worthing did not constitute a substantial variation in service and supported the proposal.

 

49.3     Reablement was suggested as a possible topic for future scrutiny.

 

49.4     Resolved – that the Committee: -

 

                i.    Endorses the recommendation by its Business Planning Group that the change to service provision at University Hospitals Sussex regarding the permanent relocation of Haematology Inpatient Services from St Richard’s Hospital, Chichester to Worthing Hospital is not a substantial variation and requires no further consideration by the Committee

               ii.    Asks its Business Planning Group to consider reablement as a potential item for scrutiny

50.

Date of Next Meeting

The next meeting of the Committee will be held on 19 June 2024 at 10.30 am at County Hall, Chichester.  Probable agenda items include:

 

·         End of March 2023 (Quarter 4) Quarterly Performance and Resources Report

 

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 4 June 2024.

Additional documents:

Minutes:

50.1     The next meeting of the Committee will be held on 19 June 2024 at 10.30 am at County Hall, Chichester.