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.

13.1     Cllr Cooper declared a personal interest as a University Hospitals Sussex NHS Foundation Trust governor, under agenda item 5.

13.2     Cllr Pudaloff declared a personal interest as a Friend of the care provider, Independent Lives, under agenda item no 6.

Items not on the agenda which the Chairman of the meeting is of the opinion should be considered as a matter of urgency by reason of special circumstances, including cases where the Committee needs to be informed of budgetary or performance issues affecting matters within its terms of reference, which have emerged since the publication of the agenda.

14.1     No urgent matters were raised.

The Committee is asked to agree the minutes of the meeting held on 19 June 2024 (cream paper).

15.1     Resolved – That the minutes of the meeting held on 19 June 2024 are approved as a correct record and are signed by the Chairman.

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

16.1     It was confirmed that the Task and Finish Group (TFG), in conjunction with the Children and Young People’s Scrutiny Committee, had been established to look at issues identified in the Local Area Special Educational Needs Inspection.  Members that had been unaware of this were reassured that there would be a further opportunity for discussion when a formal report, from the TFG, is submitted to the committee.

16.2     Concerns were raised for the future of Zachary Merton Hospital which remained closed. Information had not been forthcoming from the Sussex Community Foundation NHS Trust and so there was a consensus that a further letter from the committee was required.

16.3     Resolved – That the Committee requests:   

1.   That a letter is written, by the Chairman, to Sussex Community NHS Foundation Trust expressing further concern and the lack of information provided on the closure of Zachery Merton and that an update is provided at the next Business Planning group on 23 October 2024.   

2.   That the other responses to recommendations are noted.

Report by NHS Sussex.

The Committee to consider the report on diabetes technology and outcomes for people living with diabetes in West Sussex.

17.1     The Committee considered a report (copy appended to the signed minutes) on access to diabetes technology for people living with diabetes in West Sussex, presented by NHS Sussex Director of Clinical Outcomes and Effectiveness (Rachel Harrington) and Sussex Diabetes Network clinical lead and Consultant Diabetologist at UHSX (Dr Ali Chakera).

17.2     In presenting this report the following key points were made.

17.3     The differences between type 1 and type 2 diabetes were outlined. Type 1 was noted as being characterised by deficient insulin production and requiring daily administration of insulin with its causes, nor the means to prevent it, being fully understood. It was informed that the Management of type 1 diabetes is delivered by specialist diabetes services.

17.4     Some cases of Type 2 diabetes may be prevented or delayed. Factors that contribute to developing type 2 diabetes included genetics, being overweight, not getting enough exercise, and older age, of which only weight can be affected by interventions and lifestyle changes. This was noted as the most common form of diabetes. People with type 2 diabetes are predominately cared for by primary care, with specialist services managing the most complex patients.

17.5     The NHS Sussex offer of access to diabetes care in West Sussex was outlined as:

Type 1 diabetes - predominantly managed by specialist services as per national recommendations. Care within specialist services includes the provision of diabetes technology.  It was clarified that the new Locally Commissioned Service (LCS) within primary care outlines people living with type 1 diabetes should be offered specialist care (in line with national guidance). The LCS states this choice should be made on an individual basis and encourages the decision to be patient led with Care for those with type 1 diabetes who have declined specialist services is still supported in primary care under the new LCS.

Ø  Type 2 diabetes – more common than type 1 and predominantly treated within primary care. In July 2024, the new ‘improving diabetes care’ locally commissioned service (LCS) went live resourcing practices to deliver enhanced care over and above the General Medical Services (GMS) contract and the Quality and Outcomes Framework (QOF). Newly diagnosed type 2 diabetes patients are offered lifestyle care planning, pre-pregnancy counselling, optimising care prior to surgery, and type 2 Diabetes Path to remission Programme (T2DR) as well as ongoing management of insulin in general practice. In terms of type 2 Diabetes prevention there is access to risk reviews for patients at high risk of diabetes, and referral to the NHS Diabetes Prevention Programme (NHS DPP).

Ø  Access to Type 1 diabetes technologies in West Sussex was noted as Continuous Glucose Monitoring device (CGM), Continuous Subcutaneous Insulin Infusion (CSII) pumps and Hybrid closed Loop (HCL) systems, with the pathways to access these technologies variable. It was informed that these prescribable CGM devices are initiated by specialist diabetes nurses or doctors and prescribed within primary care. Prescribed CGM technology currently supports just over 70% (National Diabetes Audit 2022/23) of the adult type 1 population  ...  view the full minutes text for item 17.

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.

18.1     The Committee considered the report updating on the delivery of the two-year improvement programme by Director of Adults and Health and Assistant Director, Improvement and Assurance. (copy appended to the signed minutes).

18.2     In receiving the report, the Chairman gave the Committee’s continued support to the Adults Services Team on the Care Quality Commissions imminent (CQC) Inspection of Adult Social Care.

18.3     It was reminded that the County Council received notification on 9 September 2024 from the Care Quality Commission (CQC) of the start of the Assurance process. CQC Assurance assesses how well local authority adults’ services perform against their duties under Part 1 of the Care Act 2014. The Adult Services team were undertaking preparations, collating, and submitting the required reports, data and paperwork to the CQC ahead of their visit. This included the self-assessment report. It was noted that CQC Assessors will visit in person in the next six months, at a time to be confirmed. 

18.4     Summary of responses to Committee members’ questions and comments follows.

18.5     The Committee noted that the self-assessment report was being shared with the CQC prior to the assessment visit. The document sets out a number of areas for improvement, which had been identified for delivery as part of the two-year improvement programme.

18.6     The Director of Adults and Health and the Strategic Business and Improvement Lead pointed out that the areas of improvement had been clearly outlined within the improvement programme with both shorter and longer-term pieces of work. Improvement work highlighted included:

Ø  The Early Support Digital Directory (CLIO) platform developed between the service, partners and providers had been launched to support and enable people to retain their independence for longer in their communities.

Ø  A provider portal was in the process of being implemented to improve the current provider payment process, with suitable domiciliary care service providers, aligned to the new Care and Support at Home contract, moving to the portal for payment from July. This was part of a phased approach up until October 2024. Work would then move to residential/nursing care providers in 2025.

Ø  Work had continued to build, test, and roll out Microsoft PowerBI dashboards. This work was noted as improving data quality, providing access to live performance information and case data, and ultimately improve confidence in performance data both internally and externally. This would support a recently agreed Performance Framework, which was to be implemented across the service.

Ø  The opportunities that extra care housing and supported living presents the County Council in terms of customer and strategic outcomes as well as financial efficiencies.

Ø  Work to manage adult social care demand was recognised as essential in relation to customer outcomes, staff workload and financial pressure. Therefore, work would be fast tracked within commissioning in relation to the County Council’s reablement offer, which was noted as currently subject to a re-procurement exercise.

Ø  The Council’s Direct Payment policy had been reviewed and will be republished to include reference to a strength-based approach, looking  ...  view the full minutes text for item 18.

Report by Interim Director of Finance and Support Services, setting out the finance and performance position as at the end of June 2024.

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.

19.1     The Committee received a report by Interim Director of Finance and Support Services, setting out the finance and performance position as at the end of June 2024. (Copy appended to the signed minutes).

19.2     A summary of responses to Committee members’ questions and comments follows.

Adult Social Care

19.3     In receiving this report, the committee noted that of the 7 performance Adult Social Care measures, 14% were reporting as ‘green’, 43% as ‘amber’ and 43% as ‘red’. The number of red rated Key Performance Indicators (KPIs) had decreased since the last quarter, but this was explained as not a strict comparison as there were two new measures for this year which had not yet collected data.

19.4     The Head of Service for Community Safety and Wellbeing provided context with respect to KPI44 – ‘Percentage of people affected by domestic violence and abuse who feel safe upon leaving the service’. It was explained that the target had been increased to 95% with performance below target. It was informed that the way the service was being delivered split across the County Council as a combination of statutory and voluntary process, through the Children and Young People’s Family Safeguarding model and the Community, Wellbeing and Safety team. There had been a continuing increase of demand for these services over the last year which included a 97% increase in victim support referrals as well as an increase in demand of the most complex cases with 20% more requiring escalated processes.  Whilst the team were working to try and reduce demand it was also important for the service to increase the reporting of domestic abuse.

19.5     Members of the committee were invited to pose any further questions on this KPI directly to the Head of Service for Community Safety and Wellbeing or through the Chairman.

19.6     The Committee expressed concerns at the financial forecast for the Adult Services Portfolio being a projected overspend of £12.8m. Demand, complexity of needs and price of care were a contributing factor with the underlying issue of the need to deliver on savings for 2024/5 budget.

19.7     The Director of Adults and Health acknowledged that the Adult Social Care (ASC) budget is precarious with two of the proposed 2024/25 budget savings unlikely to be delivered. The service was working to achieve savings whilst balancing the impacts and risk of doing so. Open and honest conversations, regarding the ASC budget were being held with the Cabinet and the County Council’s Executive Leadership Team. There was a degree of uncertainty and lack of direction from central Government on what future funding could be expected. It was emphasised that ASC was working hard to achieve balanced budgets but at some point, it was agreed that this does become a whole County Council responsibility in taking the difficult decisions that become necessary.

19.8     The Committee noted that other councils across the country were in much the same position. With an ageing population and increasing demands members expressed concern that it would be  ...  view the full minutes text for item 19.

The Committee is asked to review its current draft work programme (Appendix A) in accordance with the scrutiny checklist attached (Appendix B) and highlight any further possible items for future scrutiny.

The Committee is also asked to review the Forward Plan entries relevant to its remit (Appendix C) and consider whether it wishes to enquire about any of the forthcoming decisions within its portfolio.

20.1     The Committee considered its Work Programme, and the following key points were made.

20.2     A Forward Plan entry was tabled at this meeting, Hospital Discharge Care Contracts, added to the plan on 12 September 2024 for decision in December 2024. This decision would be considered at the BPG meeting in October.

20.3     The winter preparedness report was confirmed as on the BPG agenda for consideration at the October meeting.

20.4     A date, in the current administration year, was requested for the Mental Health item with a report updating on the broader picture of mental health provision in West Sussex, to include Child and Adolescent Mental Health Service (CAMHS) provision.

20.5     A timeline for the work on the development of the Shaw Healthcare Contract was requested. It was informed that this item would be timetabled following a forthcoming meeting between Adults Services and Shaw on the next stages.

20.6     Resolved - That the Committee;

1.   Asks the BPG to consider at its next meeting: Mental health, Shaw Contract and winter readiness for scheduling into the HASC work programme; and  

2.   Notes its work programme.   

There have been no requests for call-in to the Committee and within its constitutional remit since the date of the last meeting.  The Director of Law and Assurance will report any requests since the publication of the agenda papers.

21.1     There had been no requests for call-in to the Committee within its constitutional remit since the date of the last meeting or since the agenda was published.

The next meeting of the Committee will be held on 27 November 2024 at 10.30 am at County Hall, Chichester.  Probable agenda items include:

·         End of September (Quarter 2) Performance & Resources Report

·         Update on the Council Plan, Medium-Term Financial Strategy and Preparations for 2024/25 Draft Budget

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 12 November 2024.

22.1     The next meeting of the Committee will be held on 27 November 2024 at 10.30 am at County Hall, Chichester.