Agenda, decisions and minutes

Health and Social Care Overview and Scrutiny Committee
Thursday, 24th January, 2019 4.30 pm

Venue: Committee Room 1 - City Hall, Bradford

Contact: Jane Lythgow 

Items
No. Item

58.

DISCLOSURES OF INTEREST

(Members Code of Conduct - Part 4A of the Constitution)

 

To receive disclosures of interests from members and co-opted members on matters to be considered at the meeting. The disclosure must include the nature of the interest.

 

An interest must also be disclosed in the meeting when it becomes apparent to the member during the meeting.

 

Notes:

 

(1)       Members may remain in the meeting and take part fully in discussion and voting unless the interest is a disclosable pecuniary interest or an interest which the Member feels would call into question their compliance with the wider principles set out in the Code of Conduct.  Disclosable pecuniary interests relate to the Member concerned or their spouse/partner.

 

(2)       Members in arrears of Council Tax by more than two months must not vote in decisions on, or which might affect, budget calculations, and must disclose at the meeting that this restriction applies to them.  A failure to comply with these requirements is a criminal offence under section 106 of the Local Government Finance Act 1992. 

 

(3)       Members are also welcome to disclose interests which are not disclosable pecuniary interests but which they consider should be made in the interest of clarity.

 

(4)       Officers must disclose interests in accordance with Council Standing Order 44.

 

Minutes:

Councillor Ahmed disclosed, in the interest of transparency and in relation to Minute 63 (Post Diagnosis Support for People with Dementia and their Carers) that she worked closely with the Alzheimer’s Society and was the Council’s Dementia Champion. 

 

ACTION: City Solicitor

59.

MINUTES

Recommended –

 

That the minutes of the meetings held on 22 November and 6 December 2018 be signed as a correct record (previously circulated).

 

(Jane Lythgow – 01274 432270)

Minutes:

That the minutes of the meetings held on 22 November and 6 December 2018 be signed as a correct record.

 

 

60.

INSPECTION OF REPORTS AND BACKGROUND PAPERS

(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. 

 

(Jane Lythgow - 01274 432270)

 

Minutes:

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

 

61.

REFERRALS TO THE OVERVIEW AND SCRUTINY COMMITTEE

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.

Minutes:

There were no referrals made to the Committee.

 

62.

OLDER PEOPLE'S ACCOMMODATION ACROSS THE DISTRICT AS PART OF IMPLEMENTING THE HAPPY, HEALTHY AND AT HOME VISION. pdf icon PDF 180 KB

The report of the Strategic Director, Health and Wellbeing, (Document “AB”) outlines progress made and proposed plans in the implementation of the integrated system vision Happy, Healthy and at Home, in relation to accommodation and support services for older people.

 

Recommended –

 

1.    That the Committee note and comment on Document “AB”.

 

2.    That the Committee note and comment on Section 2.4 of Document “AB” – the proposed plan to develop integrated needs assessments based on wards and constituencies across the Bradford District to be used by the Council, National Health Service and other partners as the basis for planning housing developments for older people and market development of the care market.

 

The needs assessment will map:

 

·         demographic profile – older people, learning disabilities, physical disabilities, mental health

·         health needs profile by locality

·         GP practice location/population

·         current provision of social care paid for by the local authority, support at home, extra care nursing and residential care and day services

·         voluntary and community service assets, including community capital assets owned by the Council.

 

(Lyn Sowray – 01274 432902)

Decision:

Resolved –

 

1.    That the report be noted.

 

2.    That the Strategic Director, Health & Wellbeing, be requested to provide a progress report at a time to coincide with the presentation of the work on the Service Improvement Boards.

 

(Lyn Sowray – 01274 432902)

Minutes:

The report of the Strategic Director, Health and Wellbeing,

(Document “AB”) outlined progress made and proposed plans in the implementation of the integrated system vision Happy, Healthy and at Home in relation to accommodation and support services for older people.  The report revealed that the a Care Quality Commission (CQC) system review had been completed in February 2018 and had found that there was a clear shared and agreed purpose, vision and strategy described across the system.  The vision was articulated throughout all levels of the system. The CQC had observed that the next steps for the system would be to translate the vision into detailed modelling and operational practice.

 

The background to Document “AB” explained that the Council Executive had approved the establishment of the Great Places to Grow Old Programme at the meeting held 15 January 2013. The Transformation Programme was a joint plan with the NHS and incorporated the work commenced in 2009 to develop a strategy for the Council’s in-house residential and day services. 

 

It was reported that the Bradford District had performed well in relation to other areas and, in response to questions; Members were advised that Bradford’s performance was in the top quartile nationally.  Residents were not being delayed in hospital and services were available for them when they returned to their homes.  Visits were made to hospitals to work with partners to assess cases and ways which delays to hospital discharge could be minimalised.  

 

Members were advised that the Bronte development in Keighley would be completed shortly.  The 50 bedded residential unit would accommodate dementia specialist services currently based at Holmewood, Keighley.  The unit would provide short-term care for both assessment and intermediate care in partnership with health services. 

 

The report revealed that, following a tender process using the Yortender framework, the contract for the project had been awarded to Wildgoose Construction at a significantly lower cost than expected.   In response to questions it was explained that the lower tender figure accepted was a result of a change to building costs from the original estimated figure.  It was confirmed that the costs had been budgeted for in the capital investment plan for a Great Place to Grow Old budget and any surplus would remain in that budget.

 

The confidence that the development would be completed on time was questioned and it was explained that at a site visit conducted very recently all the lower ground flats had their kitchens and balconies installed.  Assurances had been received that these would be completed by the end of March 2019 and the residential unit completed between April and May 2019.

 

Potential procurement issues because of the Brexit proposals were discussed and Members were assured that procurement law was enshrined in UK law and should not be affected by Brexit.  It was explained that the tender process considered quality and other factors as well as financial costs.

 

A Member questioned the ability to retain and recruit staff as he believed that the health sector  ...  view the full minutes text for item 62.

63.

POST DIAGNOSIS SUPPORT FOR PEOPLE WITH DEMENTIA AND THEIR CARERS pdf icon PDF 232 KB

Previous reference: Minute 87 (2017/2018)

 

The Bradford District Dementia Strategy Group oversee the implementation of the Dementia Strategy Implementation Plan. The report of the Strategic Director, Health and Wellbeing, (Document “AC”) provides an annual update on progress made since the issue was last discussed by the Committee on 12 April 2018.

 

The Committee is asked to note and comment on the report including the priorities for the coming year outlined in 3.9 and Section 4 of Document “AC”.

 

(Lyn Sowray – 07825175161 / Sarah Exall - 01274 432600)

Decision:

Resolved –

 

That the Strategic Director, Health and Wellbeing, be requested to provide a progress report, including an update on the Dementia Strategy Implementation Plan, in 12 months time.

 

(Lyn Sowray – 07825175161 / Sarah Exall – 01274 432600)

Minutes:

Members were reminded that the Committee had last received a report on post diagnosis support for people with dementia and their carers on 12 April 2018.  The report of the Deputy Director, Health and Wellbeing, Document “AC” provided details of progress since that time.

 

The Deputy Director addressed the meeting and explained that she was the Chair of the Dementia Strategy Group.  She introduced colleagues who were part of that group including a colleague from Shared Services which looked after the needs of Black and Minority Ethnic (BME) groups.  It was explained that Shared Services had a dedicated worker and a South Asian Dementia Café, based in Girlington, to provide provision in the heart of that community.  Its rationale was to raise awareness and ensure people were supported; to break down barriers and stigma and to raise awareness of the disease. 

 

Members were advised that Shared Services had allowed progress to be made with dementia friendly communities and work was on going in the city centre and with faith groups.  Training had been provided to local Imams and the Dementia Cafés complimented memory assessment centres and provided post diagnostic support. 

 

The Alzheimer’s Society Manager, working across the Bradford, Wharfedale and Airedale communities, addressed the meeting.  He explained that the society was funded to provide information and support at the time of diagnosis.  People diagnosed with dementia were automatically offered onward referral to a Dementia Advisor, making contact within two weeks of referral to provide information about diagnosis and treatment, carers’ needs, community support, local services, benefits and legal advice.  In addition, daytime community activities, including Wellbeing Cafés were provided by the Alzheimer’s Society, and were operated across the district.

 

A Speciality Registrar in Public Health explained population changes in the district and that the number of older adults was expected to rise by 43% by 2035.  That figure would have significant  implications for the number of people with dementia.  It was estimated that at the current time there were 5200 people affected in the district and that four out of five of those people were diagnosed.  It was hoped to continue the good work in diagnosis; by 2035 the figure was estimated to rise to 9,000.  It was reported that the proportion of people under the age 65 affected by dementia in the Bradford district was higher than other areas.  That figure was low, however, and out of all those diagnosed in the district only two to three per cent of those were aged under 65.

 

The report revealed the financial implications of the disease and that  the Local Authority currently funded around 1900 people at a cost of £20m a year. 

 

Following a very detailed presentation Members queried a statement that the proportion of younger people (aged under 65 years) recorded as having a diagnosis of dementia in Bradford was higher than the rest of the country.  It was questioned if there were higher trigger factors in the area and it was explained that Bradford had a  ...  view the full minutes text for item 63.

64.

BUDGET AND FINANCIAL OUTLOOK pdf icon PDF 176 KB

The Strategic Director, Health and Wellbeing, will present a report,

(Document AD) which provides information on the initial draft savings proposals which are currently under public consultation and were presented to the Executive on 4 December 2018 and the consequential implications of those proposals on the Health and Wellbeing Services.  The report also discusses the forecast financial outlook for 2018/19.

 

Members are requested to note and provide feedback on the Executive’s draft proposals as summarised in Document “AD”.

 

(Wendy Wilkinson – 01274 434163)

Decision:

Resolved –

 

That the report be noted.

 

(Wendy Wilkinson – 01274 434163)

Minutes:

The report of the Strategic Director, Health and  Wellbeing, presented a report (Document “AD”) which provided information on the initial draft savings proposals which were currently under public consultation and were presented to Executive on the 4th December 2018 and the consequential implications of those proposals on the Health and Wellbeing Services. The report also discussed the forecasted financial outlook for 2018/19.

 

Members were advised that independent consultants  iMPOWER had been appointed to review the agreed savings proposals and were working on what could realistically be achieved.

 

A Member referred to the previous report discussed at the meeting and the increases in support which would be required for the projected increase in people suffering from dementia.  It was suggested that because of those issues and reductions in pension credits there would be an additional need for people to receive advice and support.

 

The Strategic Director, Health and Wellbeing explained that cuts in demand referred to a reduction of placements to very expensive care packages when they were not needed.  An example was quoted of a resident who despite wishing to live independently was placed in very costly residential care.   The provision did not allow him the independence he wanted.  The situation was rectified and whilst still receiving support he was able to live independently in his own home.

 

With regard to welfare advice it was confirmed that technological systems were used to provide support.  A computer system which could be used to calculate what people were entitled to called “Better off” was discussed.  It was acknowledged that not all people had access to computers and it was explained that “community connectors” could help people with social problems and to understand issues regarding welfare and debt.   A system called Debt Buddies, putting people in contact with people who had been in debt who were now trained to help others, was discussed and it was confirmed that links were also made with Bradford Credit Union.

 

In response to concerns about the speed of changes proposed and that people on low incomes, older or disabled persons could be the worst hit it was explained that efforts were made to provide a joined up approach with the public and opportunities to boost funding were being sought.

 

A Member stressed the necessity to begin planning for the proposed changes outlined in the report which would come into force very quickly.   It was questioned how priorities were decided and how areas to invest or cut were selected.  A concern that cuts in certain areas could lead to additional, more costly; support being required in the future was raised.  It was explained that areas providing the best value for money had informed the four year savings proposals.  It was acknowledged that the service would have to deal with pressures. 

 

Resolved –

 

That the report be noted.

 

ACTION: Strategic Director, Health and Wellbeing

 

65.

HEALTH AND SOCIAL CARE OVERVIEW AND SCRUTINY COMMITTEE WORK PROGRAMME 2018/19. pdf icon PDF 63 KB

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

 

Recommended –

 

That the information contained in Appendix 1 to Document “AE” be noted.

(Caroline Coombes – 01274 432313)

 

Additional documents:

Decision:

Resolved –

 

That the report be noted.

 

(Caroline Coombes – 01274 432413)

Minutes:

The Overview and Scrutiny Lead presented the Committee’s Work Programme 2018/19 (Document “AE).  It was agreed that, as there were a number of other reports scheduled for discussion at the meeting on 21 March 2019 that the item on cancer would be deferred for consideration at the first meeting of the 2019/2020 municipal year.

 

Members were requested to advise the Overview and Scrutiny Lead of any issues they wished to be included in the item on Advocacy Services and it was requested that the item include details of performance on both statutory and non statutory requirements.

 

Resolved –

 

That the report be noted.

 

ACTION: Overview and Scrutiny Lead