(i)            Councillor Berry disclosed, in the interest of transparency, that he was employed by Touchstone Support, Leeds (Minute 23)

(ii)          Trevor Ramsay disclosed, in the interest of transparency, that was a Member of Healthwatch Bradford (Minute 21)

(iii)         Susan Crowe disclosed, in the interest of transparency, that she had delivered easy read materials for West Yorkshire and Harrogate Health and Care Partnership (Minute23)

ACTION: City Solicitor

Recommended –

That the minutes of the meeting held on 12 July 2018 be signed as a correct record (previously circulated).

(Palbinder Sandhu – 01274 432269)

Resolved –

That the minutes of the meeting held on 12 July 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 Manager of Healthwatch Bradford and District will submit Document “F” which sets out the findings from a new report by Healthwatch Bradford and District on the experiences of autistic people across the area.  It sets out the challenges that people face accessing both diagnosis and support and the impact that these have on them and their families and carers.  The report makes a number of recommendations to the Council and NHS.

The views of Members on the options contained in Document “F” are requested.

(Sarah Hutchinson – 01274 01535 665258)

The Manager of Healthwatch Bradford and District submitted Document “F” which set out the findings from a new report by Healthwatch Bradford and District on the experiences of autistic people across the area.

It was explained that it was estimated that 1.1 per cent of the UK population was autistic and that figure suggested that there were 5,877 autistic people living in the district.

Healthwatch Bradford had, in February 2017, published a report on the experiences of diagnosis for autistic spectrum conditions (ASC).  Since that time they had continued to hear from people about the challenges accessing a diagnosis or support and had prepared a new report, to be published in September 2018, focusing on access to support.

A detailed presentation was presented which gave Members a background to Healthwatch Bradford; the rationale for the production of the latest report and the findings and subsequent recommendations arising from that report.

The presentation revealed that since February 2017 people who thought they may be autistic continued to face delays in diagnosis and in receiving support. 

It was explained that an Autism Strategy was being developed by the Autism Partnership and although that strategy had not yet been formally adopted conversations had begun.  The strategy included, amongst other things, that:-

·         Local Authority and NHS staff should include autism awareness training for all staff.

·         Those making decisions affecting autistic people should have a demonstrable knowledge of that condition.

·         GPs should have adequate training in autism and a good understanding of the local diagnostic pathway.

·         The NHS should provide access to diagnostic services.

·         Local authorities and the NHS should jointly ensure the provision of an autism pathway.

The manner in which children could receive a diagnosis and support for autism was explained and it was confirmed that children, unlike adults, could access support prior to a formal diagnosis.  Members were advised that adults required a GP referral for diagnosis and that the service, provided by Bradford and Airedale Neurodevelopment Service (BANDS) had been closed to new referrals for three years.  It was stressed that without diagnosis adults could not access support and without an understanding of their condition appropriate care could not be put in place.

The findings of the new report had confirmed that BANDS continued to be closed to new referrals. People were left in limbo without an explanation of their needs or access to support services.  The report revealed difficulties with communication and information including that people were asked to use methods of communication they found difficult e.g.phone calls and, despite the introduction of the Accessible Information Standard in 2016, autistic people were often given information which was unclear.

The findings of the report showed that people felt desperate and vulnerable at times because support was not in place and  that the effect on carers was significant.

Recommendations arising from the report included:-

·         Implementation of the Autism Strategy.

·         Expansion of the diagnosis service to include those on the waiting and those waiting for referral.

·         Collection and publication of length of time  ...  view the full minutes text for item 21.

The Director of Public Health will submit Document “G” which provides an overview of local performance based on the Public Health Outcomes Framework, highlighting how indicators compare with England.

The report also provides additional focus on a number of indicators which are high profile; where the Committee has asked for more detail; or where there have been noteworthy changes in performance.

Recommended –

That the content of the report be acknowledged and the Director of Public Health be requested to provide a further performance report on Public Health Outcome Framework indicators in 2019. 

(Jonathan Stansbie – 01274 436031)

The Director of Public Health submitted Document “G” which provided an overview of local performance based on the Public Health Outcomes Framework and highlighted how indicators compared nationally.

The report also provided additional focus on a number of indicators which were high profile; where the Committee had asked for more detail; or where there had been noteworthy changes in performance.

Document “G” revealed that the PHOF was introduced by the Department of Health (DH) in April 2013 as part of health and social care reforms which gave local authorities statutory responsibilities for the health of their population.  The PHOF examined indicators that helped to understand trends in public health and how well public health was being improved and protected.  The framework was broken down into a set of overarching indicators which related to life expectancy; reducing inequalities in life expectancy, and healthy life expectancy between communities.  The remaining indicators were grouped into four different domains:

-       Wider determinants of health

-       Health improvement

-       Health protection

-       Healthcare and premature mortality

The PHOF data for all local authorities was presented for each indicator.  Figures were generally based on annual information or an aggregate of years where numbers were small.   Figures for each local authority were compared against the average for England and demonstrated if an indicator was ‘significantly worse’, ‘not significantly different’ or ‘significantly better’ than the England average.

A full list of all indicators and sub indicators along with their current figures were appended to Document “G” and showed current values and provided an indication of trends.

It was explained that of the 131 indicators and sub indicators where significance against the England average had been tested, 51 were significantly worse, 54 were not significantly different and 26 were significantly better.  A breakdown of that information by domain was provided.

The health improvement indicators included child excess weight and a Member reported her concern that whilst visiting an authority run swimming pool she had witnessed children purchasing high sugar energy drinks for sale at the pool.  The Portfolio Holder with responsibility for Healthy People and Places agreed to take up the matter with officers immediately.

Whilst acknowledging the complexity of the indicators under discussion, and the variety of determinants which could influence those figures, a Member requested that subsequent reports provide a more detailed explanation of indicators which had worsened and what had affected that outcome.

In response to questions about the year on year reduction in incidents of tuberculosis it was explained that this was likely to be in part due to changes in migrant screening undertaken before people moved to the UK. 

Members requested information on a potential north/south divide or between ethnic groups for the indicators provided. It was explained that there was a clear link between deprivation and lower life expectancy.  Figures were not recorded on ethnicity. 

Following discussions on screening for prostate cancer it was reported that a decision had been made nationally not to screen for that type of cancer.  That decision was  ...  view the full minutes text for item 22.

The report of the Strategic Director, Health and Wellbeing (Document “I”) is to inform Members of the increased local authority oversight of the West Yorkshire and Harrogate Health and Care Partnership. 

A report seeking the Health and Wellbeing Board’s approval of the Memorandum of Understanding for the Partnership is to be presented to the Health and Wellbeing Board on 4 September 2018. 

Members are asked to note and comment on the Memorandum of Understanding for the West Yorkshire and Harrogate Health and Care Partnership.

(James Drury – 01274 431057)

The report of the Strategic Director, Health and Wellbeing (Document “I”) was presented to inform Members of the increased local authority oversight of the West Yorkshire and Harrogate Health and Care Partnership. 

Members were advised that a report seeking the Health and Wellbeing Board’s approval of the Memorandum of Understanding for the Partnership had been approved by the Health and Wellbeing Board on 4 September 2018.

It was explained that the Council’s commitment to the partnership would provide more control over the way the NHS bodies in England were regulated and present a clear route for Members to represent the voice of residents. 

The partnership would be in place by April 2019 and would include the Leader of Council; the Chair of the Health and Wellbeing Board and one other representative.  The body would meet on a quarterly basis and meeting locations would rotate around the partnership area.

It was questioned if the partnership would involve the voluntary sector and the amount of funding to be spent in the Bradford and Craven district by the third sector was discussed.

In response to questions it was reported that the Memorandum of Understanding did not make reference to autism services, however, the partnership did have a number of programmes including mental health/learning disabilities and autism.

Resolved –

That the report be noted.

ACTION: Strategic Director, Health and Wellbeing

The report of the Strategic Director, Health and Wellbeing  (Document “H”) provides details of Bradford Council’s Health and Wellbeing Department’s safeguarding activities.

The views of Members are requested and it is:-

Recommended –

That the report be noted.

(Andrea Richards – 01274 436519)

The report of the Strategic Director, Health and Wellbeing (Document “H”) provided details of Bradford Council’s Health and Wellbeing Department’s safeguarding activities.

It was explained that following discussions at the meeting on 16 November 2017 regarding the Adult Safeguarding Annual Report Members had requested that the refreshed Safeguarding Adults Board Strategic Plan be presented in conjunction with a report on the implementation of a Multi-Agency Safeguarding Hub (MASH) to a future meeting.  Document “H” included the response to that request and endeavoured to summarise the most recent actions undertaken in a period of transition.

The background to the report explained that the Care Act 2014 set out a clear legal framework for how local authorities and other parts of the system should support and protect adults at risk of abuse or neglect and summarised a number of safeguarding duties arising from that Act which were being undertaken in the district. 

The report revealed that Safeguarding Adults Concerns (SAC) data for the period 17/18 has demonstrated a significant increase on the numbers of safeguarding concerns received with an increase of 57 % from 3064 in 16/17 to 4815 in 17/18. Previously only 20% of concerns indicated further enquiries were undertaken, in comparison to regional variations of between 37% and 100%. This had increased in Bradford in the period 17/18 to a conversion of 61%. The statistics suggested that more enquiries were being made in response to concerns raised about Adults at Risk (AAR) in Bradford.

The increase, both on amount of concerns raised and the increased enquiries undertaken, had significant resource implications to meet the increased demand. A business case was being completed to consider the necessary resources for the future sustainability of the safeguarding service in Bradford.

Members were reminded that the Multi Agency Safeguarding Hub (MASH) had been established in October 2017 and the rationale, composition and functions of the MASH were reported.  It was explained that a recent review of the MASH had been undertaken by both Adult Social Care and the Police and the findings of that evaluation were reported.

The report explained that the Safeguarding Adults Board (SAB) had a statutory responsibility to complete a Strategic Plan.  The SAB was in the process of collating its three year Strategic Plan which was a culmination of information, discussions and deliberations obtained by engaging with people, professionals and community groups in Bradford.  It was reported that a new chair of the SAB had recently been appointed and had recommended that further priorities may need to be included in the Plan.

Following a detailed presentation the improvements made to safeguarding adults at risk were acknowledged and welcomed.

In relation to concerns raised about funding issues assurances were provided that the work being undertaken by the ‘Voice’, a user sub group of the Safeguarding Adults Board, would continue to be supported.  It was explained that the involvement of adults at risk was fundamental to receiving feedback and an understanding of safeguarding by users of that service.

Members questioned  ...  view the full minutes text for item 24.

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

Recommended - 

That the information contained in Appendix A to Document “J” be noted.

(Caroline Coombes – 01274 432313)

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

Members were advised that a report on progress on the Health and Social Care Industrial Centre of Excellence (ICE) programme; Bradford District and Craven Integrated Workforce Programme’s workforce strategy and two reports on the findings of the consultation on carers’ services in the District would be presented to the meeting on 25 October 2018.

Resolved - 

That the information contained in Appendix A to Document “J” be noted.

ACTION: Overview and Scrutiny Lead