(i)            Councillor A Ahmed disclosed that she was employed by the Yorkshire Ambulance Service NHS Trust.

(ii)          Susan Crowe disclosed that she had a commissioning contract with the Health and Wellbeing Department.

(iii)         Cllr Griffiths disclosed that he was a General Practitioner and Head of the Local Medical Committee.

ACTION: City Solicitor

Recommended –

That the minutes of the meetings held on 6 April and 5 October 2017 be signed as a correct record (previously circulated).

(Claire Tomenson – 01274 432457)

Resolved –

That the minutes of the meetings held on 6 April and 5 October 2017 be signed as a correct record.

(Access to Information Procedure Rules – Part 3B of the Constitution)

Reports and background papers for agenda items may be inspected by contacting the person shown after each agenda item.  Certain reports and background papers may be restricted. 

Any request to remove the restriction on a report or background paper should be made to the relevant Strategic Director or Assistant Director whose name is shown on the front page of the report. 

If that request is refused, there is a right of appeal to this meeting. 

Please contact the officer shown below in advance of the meeting if you wish to appeal. 

(Claire Tomenson - 01274 432457)

There were no appeals submitted by the public to review decisions to restrict documents. 

Any referrals that have been made to this Committee up to and including the date of publication of this agenda will be reported at the meeting.

No referrals had been submitted to the Committee.

The Overview and Scrutiny lead will present the Committee’s Work Programme 2017/18 (Document “Z”).

Recommended - 

That the Committee notes the information in Appendix 1 of Document “Z”.

(Caroline Coombes – 01274 432313)

The Overview and Scrutiny Lead officer informed Members of the upcoming training sessions and amendments to the Work Programme.

Resolved - 

That the amendments to the Work Programme be noted.

ACTION: Overview and Scrutiny Lead

The Strategic Director, Health and Wellbeing will submit areport (Document “V”) whichprovidesinformationontheinitialdraftsavingsproposals some of whichare currently underpublicconsultation andwerepresentedtoExecutiveonthe5 December2017andtheconsequentialimplicationsofthoseproposalsontheHealth andWellbeingServices. ThereportalsoremindstheCommitteeofthesavingsthatwereagreedaspartofthe2017/18 and 2018/19 budgetproposalsapprovedbyCouncilon 23 February2017.

Recommended –

(1)       ThattheCommitteenotesandprovidesfeedbackontheExecutive’sdraftproposalsfor2018-19and19-20assummarisedin thisreport.

(2)       ThattheCommitteeprovidesfeedbackandcommentsonanyoftheExecutive’sotherdraftproposalsfor2018-19and2019-20,whichmayha  ...  view the full agenda text for item 58.

The Strategic Director, Health and Wellbeing introduceda report (Document “V”) which provided information on the initial draft savings proposals, their consequential implications on Health and Wellbeing Services and the savings that were agreed as part of the 2017/18 and 2018/19 budget proposals.  Members were informed that only 14% of the Department’s budget was spent on staff and the largest part funded care.  A comparison had been undertaken with other Local Authorities in the Region and a team had been established that would engage with people.  The Strategic Director, Health and Wellbeing explained that the number of people needing care was increasing, however, the funds were decreasing.  The Department was trying to shift the culture from the reliance on in-house provision to people having their own care packages and if services were delivered differently then the Council could achieve better outcomes.

Members raised the following points:

·         There was a risk of the opposite effect occurring and services would not be provided.

·         Would early intervention assist more people and have long term savings?

·         Why was there a need to measure against the Regional average?

·         Out of area care for people with Learning Disabilities was being reduced.  Was this working?

The Strategic Director, Health and Wellbeing confirmed that:

·         The pre-work was not being undertaken at present and the biggest challenge was to manage the culture and practice.

·         Research showed that early intervention worked for Local Authorities in the long term and results had been achieved.

·         The Oxford Brookes model took best practice and it had been modified to a West Yorkshire perspective.

·         Results were not being achieved in the Learning Disabilities area and a rethink was being undertaken.  It was an area of overspend and work was currently being carried out on day services.  The issue had been discussed in Management Team meetings.

The Business Advisor, Health and Wellbeing, informed Members that savings in all budgets had to be identified due to the continuing national austerity measures. The proposed savings for Adult and Community Services was £8 million for three years with a total savings target of £11.4 million for Health and Wellbeing in 2018/19.  Further cuts had been proposed and these had been presented to the Council’s Executive on 5 December 2017.  Members were informed that a great deal of activity was ongoing, however, the culture could not be changed any quicker.  The culture was embedded within the staff and it would take time to bring in the changes.  The Business Advisor stated that a £6 million overspend, which was less than had been expected, had been predicted and savings would be achieved in some areas.  The District had an increasing demographic growth and savings over £75 million had been required to be made over the past few years.  The purchase of care was an enormous challenge and there had been increasing pressure on the budget for No Recourse to Public Funds.  It was noted that a review of the Better Care Fund, including where it had been spent  ...  view the full minutes text for item 58.

The Programme Director, Integration and Change Board will present Document “W”, the first draft of Happy, Healthy and at Home: A Health and Care Plan for Bradford District and Craven.  This initial draft of the Plan has been considered by the Health and Wellbeing Board in December 2017 and is due for further consideration there once amended to take account of stakeholder comments including those of the Overview and Scrutiny Committee.

Recommended -  

That the Committee provide feedback and receive the finalised version of the Plan at a later meeting following approval by the Health and Wellbeing Board.

(James Drury – 07970 479491)

The Programme Director, Integration and Change Board, presented a report (Document “W”) which introduced the first draft of ‘Happy, Healthy and at Home: A Health and Care Plan for Bradford and Craven’ and then gave a presentation which covered the following:

·         Engagement by Healthwatch

·         The existing Plan

·         Context and connectivity

·         Need to refresh the Plan

·         Review process and planned changes

·         Key messages of the Plan

·         Financial implications of the Plan

·         Proposal to complete the Plan

Members made the following comments:

·         There had been a great deal of input into the Plan.  How would the general public become involved in the consultation process? Different ideas may be obtained from service users.

·         Service users should be approached.

·         There had been a lack of accessible information available for the Healthwatch sessions.  Bradford City Clinical Commissioning Group’s (CCG) ‘Engaging People’ work was a good example and their Head of Engagement should be contacted.

·         Any communication should be carefully undertaken.

·         The public did not want change, so it should not be claimed that they did.

·         It was not possible to have quick, good and cheap healthcare.  The Plan should be more realistic.

·         What about the Child and Adolescent Mental Health Services (CAMHS) funding?  Would there be a new building?

·         What was the measure for air quality?

·         Would Bradford be introducing any hybrid buses?

·         The cost of hybrid vehicles should be addressed with the Government.  

In response the Programme Director confirmed that:

·         A communication plan would be published.

·         The Plan was owned by all parts of the system and the Head of Engagement would be approached.

·         If people were helped to keep well there would be fewer interventions down the line.

·         A funding model had been secured and a site found for a CAMHS in-patient facility at St Mary’s Hospital in Armley, Leeds.  Information on the building would be provided after the meeting.

With regard to the issues regarding air quality, the Portfolio Holder for Health and Wellbeing stated that:

·         Information on the air quality measure would be provided following the meeting.  A campaign in relation to ‘No Idling’ was due to start and would be chased up.

·         Any decision to introduce hybrid buses in Bradford would be taken by the West Yorkshire Combined Authority.

In conclusion the Overview and Scrutiny Lead officer requested that Members sent comments to the Programme Director and the Chair requested that the Committee be kept updated on issues.

Resolved - 

That the draft Health and Care Plan be noted and Members’ comments be taken into consideration.

ACTION: Programme Director, Integration and Change Board

The Care Quality Commission has notified the Council and other partners within the District that they will be undertaking a review of the Bradford Local System in February 2018.  The Strategic Director, Health and Wellbeing will present a report (Document “X”) which provides an overview of the scope of the review process, the approach the Care Quality Commission will be taking and an outline of the preparation work that local partners will need to put in place in advance of the review.

Recommended -

That the Committee notes the methodology outlined for the Care Quality Commission review set out in the report.

(Imran Rathore – 01274 431730)

The Strategic Director, Health and Wellbeing, submitted Document “X” and explained that a peer review was taking place in Bradford, which was not an inspection and there may be a review of the leadership process.  Members were informed that a number of reviews had taken place prior to Christmas and the remainder would be completed by the end of March.  There had been a great deal of criticism of the whole system and the Care Quality Commission (CQC) was visiting Bradford as it was a Local Authority with good practice.  The Council needed to concentrate on the things that were being done well and preparations had already commenced.  The Strategic Director reported that each area had to submit a System Overview Information Return (SOIR) in advance of the review and Bradford’s should be completed by 26 January 2018.  The CQC would be visiting Bradford on 31 January 2018 for two days and return to complete the full review.  It was noted that it was a balanced process, as the Council had examples of good practice, however, work was required in other areas.  A ‘Relational Audit’ had to be completed and if the CQC found issues regarding people under 65 years of age they would be pursued, however, the visit was predominantly about those over 65 years old.

A Member stated that the reason the Council had been selected was due to it being good in not delaying transfers of care, which was positive, however, all other aspects would be reviewed.  He then questioned where the weaknesses were in the movement through the social care system.  The Strategic Director confirmed that certain areas had poor outcomes and the key messages summary was important.  Another Member requested that the Department’s Action Plan was included when the issue was reported back to the Committee.  Members were informed that the CQC would inform the Bradford and Airedale Health and Wellbeing Board of the outcome. 

Resolved -

That the report be noted.

ACTION: Strategic Director, Health and Wellbeing

The Strategic Director, Health and Wellbeing will submit Document “Y” which provides an update on the resolutions made at the Health and Social Care Overview and Scrutiny Committee held on Thursday 8 September 2016.

Recommended –

That the report be noted.

(Bev Tyson – 01274 432921)

The Strategic Director, Health and Wellbeing, presented Document “Y” and explained that a new charging policy had been introduced for Health and Social Care, which had created issues and the Council had been legally challenged in relation to the decision.  A consultation had been undertaken and the process delayed, however, the policy had been implemented from 2 October 2017, though charges would not change until users had been re-assessed.  The Strategic Director stated that it had been specified that clarity would be provided in relation to what was classified as disability related expenditure and the policy had been clarified in relation to wellbeing.  Members were informed that the charges would be phased in for those affected by the new policy.

A Member reported that disabled people would be on a low income when Universal Credit was introduced and the cost to the Local Authority would be increased.  In response the Strategic Director confirmed that work was ongoing in relation to the issue.  There would have to be a set level before a charge could be made and safeguards for vulnerable people.  Another Member questioned whether it had been factored in that a significant number of people would have less income and was informed that Universal Credit was a very difficult system.  The Council had tried to re-profile the budget and the drop in its income had been taken into account as much as possible.

Resolved  –

That the report be noted.

ACTION: Strategic Director, Health and Wellbeing