(i)            Susan Crowe disclosed, in the interest of transparency, that she was commissioned by the Bradford City and Districts Clinical Commissioning Groups and the Council’s Health and Wellbeing department to deliver services.

(ii)          Councillor A Ahmed disclosed, in the interest of transparency, that she was a Governor for the Bradford District Care NHS Foundation Trust and had been interviewed as part of the Care Quality Commission Local System Review (Minute 14).

(iii)         Councillor Greenwood disclosed, in the interest of transparency, that she had been interviewed as part of the Care Quality Commission Local System Review (Minute 14).

ACTION: City Solicitor

Recommended –

That the minutes of the meeting held on 7 June 2018 be signed as a correct record (previously circulated).

(Palbinder Sandhu – 01274 432269)

Resolved –

That the minutes of the meeting held on 7 June 2018 be signed as a correct record.

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.

There were no referrals made to the Committee.

The Overview and Scrutiny lead will present the Committee’s draft Work Programme 2018/19 (Document “B”).

Recommended –

(1)       That the information in Appendix A of Document “B” be noted and that it, along with any amendments or additions be adopted as the Committee’s Work Programme 2018/19.

(2)       That the Work Programme 2018/19 continue to be regularly reviewed during the year.

(Caroline Coombes – 01274 432313)

The Overview and Scrutiny lead presented the Committee’s draft Work Programme 2018/19 (Document “B”) for adoption.

She recommended that Members view the Healthwatch Annual Report which had recently been published and was available online. 

She also informed Members that, following a resolution of full Council in July 2017 which requested that a report be received by the Health and Social Care Overview and Scrutiny Committee to review the effectiveness of the A-Board ban 12 months after implementation, discussions would be taking place with officers in relation to when a report could be submitted to the Committee following implementation of a district-wide ban in April 2018.  This item had not been included on the draft Work Programme but would be added at a later time once a date had been agreed.  Following a Member’s suggestion of a pre-briefing for Members to discuss the figures relating to the enforcement of the ban, the Overview and Scrutiny lead officer stated that this would be discussed in the Chair’s briefing prior to the meeting which all Members would be invited to attend.

Members were informed that a meeting of the West Yorkshire Joint Health and Social Care Overview and Scrutiny Committee had been scheduled for 30 July 2018 and dentistry provision was due to be discussed.

Resolved –

(1)       That the information in Appendix A of Document “B” be noted and that it, along with any amendments or additions be adopted as the Committee’s Work Programme 2018/19.

(2)       That the Work Programme 2018/19 continue to be regularly reviewed during the year.

ACTION: Overview and Scrutiny Lead

The Care Quality Commission has undertaken a local system review of the health and care system in Bradford District. The Strategic Director, Health and Wellbeing will submit Document “C” which presents the findings of that review and describes the next steps in the review process.

Recommended –

(1)  That the positive assurance provided by the Care Quality Commission local system review be noted.

(2)  That the Committee supports the on-going implementation of the action plan, through the usual scrutiny processes.

(James Drury – 07970 479491)

The Care Quality Commission had undertaken a local system review of the health and care system in Bradford District. The Strategic Director, Health and Wellbeing submitted Document “C” which presented the findings of that review and described the next steps in the review process.

A presentation giving the context, approach and next steps of the review was provided to Members.  It included the following information:

The Approach:

•         Focused on the interfaces  between social care, general  primary care, acute health  services, community health  services and on older people aged over 65

•         Considered system performance along a number of ‘pressure  points’ on a typical pathway of care

•         Each area had a local report and the findings of the reviews would also be  used to inform a national report to give overall advice to the Secretaries of State

•         Reports did not include ratings and the reviews did not affect existing ratings

Progress and Next Steps:

•      The CQC completed the on-site elements of their review in February 2018

•      System-wide Summit took place in May 2018

•      The CQC published their local system review of the Bradford District system in May 2018, and had recently published their national report which in part was based on learning in Bradford

•      An action plan was finalised in July 2018 and shared with the Department of Health and Social Care

•      The Health and Wellbeing Board owned the report on behalf of the system, and the Integration and Change Board would oversee implementation of the action plan on behalf of the Health and Wellbeing Board

•      The Department of Health and Social Care would check on progress periodically

Report Findings:

•      There was a clear shared and agreed purpose, vision and strategy. This was articulated throughout and at all levels of the system.

•      System leaders across health and social care were compassionate and caring. System leaders encouraged the development of communities to build support around the person.

•      There was a defined system-wide governance arrangement that pulled the system together.

•      At an operational level, there was more work to be done to embed integrated working.

•      The system needed to continue to build on relationships to engage all as equal partners.

Recommendations:

•      System leaders needed to address issues around quality in the independent social care market

•      To build on good relationships that existed between stakeholders and extend this to include the independent care sector more fully

•      The commissioning of 15 minute domiciliary care visits needed to be reconsidered.

•      There needed to be clearer signposting systems to help people find the support they needed, particularly for people who funded their own care.

•      System leaders needed to ensure that staff in health services and independent social care provider services had a better understanding of peoples rights, the Mental Capacity Act etc.

•      The commissioning approach to primary care needed to maximise the outcomes from the two at-scale GP models emerging in Bradford.

•      To streamline processes when  ...  view the full minutes text for item 14.

In line with Council Standing Order 4.7.1 all Contracts with an estimated value of over £2m must be reported to the relevant Overview and Scrutiny Committee before inviting tenders.          

The Strategic Director, Health and Wellbeing will submit Document “D” which provides details of the intention to re-commission Home Support Services within the District.

Recommended –

That the Committee discuss the contents of Document “D”  and consider any equality and diversity, TUPE and social value implications at this pre- procurement stage in accordance with Council Standing Orders in 4.7.1.

(Paul Hunt/Leonie Heyes – 01274 431748)

In line with Council Standing Order 4.7.1 all Contracts with an estimated value of over £2m must be reported to the relevant Overview and Scrutiny Committee before inviting tenders.

The Strategic Director, Health and Wellbeing submitted Document “D” which provided details of the intention to re-commission Home Support Services within the district.

A presentation was provided to Members outlining the current situation with Home Support Services and issues the authority needed to address.  The presentation included the following information:

·         Home Support Services had been retendered under a framework agreement in 2016.

·         There were 99 CQC registered providers in Bradford.

·         3,701 people were provided with 35,000 hours per week of home support.

·         Every week 50 new packages were brokered.

·         The annual cost of Home Support Services was £43m.

·         The current framework was due to expire in September 2018 with an option to extend it for a further 12 months.

·         The authority had recently made investments in home support.

·         The market of providers was relatively small in Bradford and there had been a 5% reduction in providers in the last 12 months.

·         There was a need for more out of hours home support.

·         There was a need to improve the number of people who were self-directing their support.

·         Provision needed to be aligned with localities.

·         The intention would be for the tender to include a number of small locality contracts specifically for geographic areas.

·         Contracts covering smaller areas would allow the recruitment of staff who did not drive.

·         The intention would be to adopt the principles of the Ethical Care Charter, develop out of hours services, enhance First Response services and cease the use of 15 minute home care visits.

·         Key principles to underpin the approach:

·         Focus on dignity, compassion and respect

·         Individual-led personalised support plans

·         Focus on reablement

·         Embed sustainable arrangements

In response to a Member’s question, it was reported that ceasing the 15 minute home care visits was about being more outcome focused rather than time focused.  There could be an option for a service user to ‘bank’ time to use later if they only required short visits.  The benefits of locality contracts would mean that the service user saw more of the same staff and travel time for staff would be reduced.

The Strategic Director, Health and Wellbeing stated that significant investments had been made to improve the delivery of home care support and she was confident that the service, with longer home care visits, could be sustained by working differently and with the use of technology to complement the face to face contact.  She also, in response to a Member’s question, stated that reablement services were offered to people in their own homes but she considered there was room to develop the service within a community setting.

A Member praised the use of technology and stated that it was important to consider its use at the beginning of a process, including audio for service users who were blind, and embedding it so it was used effectively.

A Member  ...  view the full minutes text for item 15.

Previous reference: Minute 70 (2016/2017)

NHS Airedale, Wharfedale and Craven, NHS Braford City and NHS Bradford Districts CCGs will submit Document “E” which provides an update on the most recent developments around the future of GP services being delivered from Hillside Bridge Health Centre as presented to the Health and Social Care Overview Scrutiny Committee on 9 February 2017 and through a subsequent update letter to The Chair on the 6 April 2017.  The update letter confirmed that enhanced primary care services as delivered by Local Care Direct would no longer be delivered from Hillside Bridge.

The report outlines a proposal to complete a comprehensive primary medical care service needs assessment and primary care estate review within this locality.

Recommended –

The Health and Social Care Overview and Scrutiny Committee is asked to:

(1)       Receive and note the CCGs’ commitment and actions required to complete the service need and estate review to determine the future provision of primary medical care within this primary care home community serving the population around Hillside Bridge.

(2)       Receive and note initiatives that are being developed that will impact the primary medical service offer to residents.

(Karen Stothers/Victoria Wallace – 01274 237430/237524)

Previous reference: Minute 70 (2016/2017)

NHS Airedale, Wharfedale and Craven, NHS Bradford City and NHS Bradford Districts CCGs submitted Document “E” which provided an update on the most recent developments around the future of GP services being delivered from Hillside Bridge Health Centre as presented to the Health and Social Care Overview Scrutiny Committee on 9 February 2017 and through a subsequent update letter to the Chair on 6 April 2017.  The update letter confirmed that enhanced primary care services as delivered by Local Care Direct would no longer be delivered from Hillside Bridge.

The report outlined a proposal to complete a comprehensive primary medical care service needs assessment and primary care estate review within this locality.

A summary of the report was provided during which it was highlighted that the current contract was due to expire on 31 March 2019 and that an assessment would provide a better understanding of the future general medical service needs within the communities served by the Hillside Bridge Health Centre.  A formal public consultation was due to take place from September to December 2018 in order for the new arrangements to be implemented by the time the current contract ended.

The Chair reminded officers to ensure that all three Ward Councillors were consulted on the proposals as well as fully engaging with the local community.  She thanked officers for flagging the consultation with the Committee and suggested that the outcome of the consultation process be reported to the Committee.

Resolved –

That the Committee:

(1)       Note the CCGs’ commitment and actions required to complete the service need and estate review to determine the future provision of primary medical care within this primary care home community serving the population around Hillside Bridge.

(2)       Note initiatives that are being developed that will impact the primary medical service offer to residents.

(3)       Receive a report on the outcome of the consultation process.

ACTION: Clinical Commissioning Groups