Agenda and minutes

An apology for absence was received from Councillor Lamb.  Councillor Todd was in attendance as substitute.

At this point Members must declare whether they have an interest, whether personal or prejudicial, in any of the items on the agenda. Members must also declare if they are subject to their party group whip in relation to any items under consideration.

There were no declarations of interest or whipping declarations.

The minutes of the meeting held on 17 January 2012 were approved as a correct record.

The decision notice for each decision will bear the date on which it is published and will specify that the decision may then be implemented on the expiry of 3 working days after the publication of the decision (not including the date of publication), unless a request for call-in of the decision is received from any two Members of a Scrutiny Committee or Scrutiny Commissions.  If a request for call-in of a decision is received, implementation of the decision remains suspended for consideration by the relevant Scrutiny Committee or Commission.

There were no requests for call-in to consider.

The report provided an update on the Primary and Urgent Care Strategy following our meeting in September 2011.

Following the meeting in September 2011, the PCT had been informed that the Cooperation and Competition Panel (CCP) had decided to accept for investigation a complaint that they had received from 3Well Medical which alleged that the PCT’s conduct and process had breached national Principles and Rules of Cooperation and Competition.  The CCP investigates breaches of the Principles and Rules and makes independent recommendations to the Department for Health on how such breaches should be resolved.

The CCP had undertaken a three month investigation into the complaint and following investigation had found in favour of the PCT on the majority of issues, specifically that NHS Peterborough:

• Had followed a process for developing and consulting on its strategy which engaged widely and in a meaningful manner
• Did not discriminate against 3Well in terms of the management of their contract or considering possible options for the future
• Met  its requirements to commission services from those providers best placed to provide the service, i.e. it had considered a full range of options and adapted the options following feedback
• The strategy appropriately offered patients choice and ensured competition

However the CCP also concluded that NHS Peterborough had failed to manage a potential conflict of interest resulting from the involvement in its consultation process of two lead clinicians who were partners in GP practices that would be directly affected.  The CCP had recommended that an independent panel of clinicians should review the clinical case for reconfiguration and that NHS Peterborough put in place measure to manage conflicts of interest.  Following these recommendations the PCT had received a letter from Earl Howe from the Department of Health stating that he agreed that NHS Peterborough should have better managed potential conflicts of interests and that measures should be put in place to ensure that potential conflicts are managed more effectively going forward.  He did not require NHS Peterborough to undertake an independent clinical review.

Whilst NHS Peterborough were not required to undertake an independent review they did commission Collingham Healthcare Education Centre to undertake a review to ensure maximum assurance for the Board and people of Peterborough. Their summary conclusion was that either the original or revised Option 3 (the recommended change ) would be clinically desirable and appropriate.

A number of practice changes had also happened since September 2011.  The Orton Medical Practice closed in December 2011 and patients had now registered with Orton Bushfield or other nearby practices.  The PCT had reached an agreedment with Nene Valley Medical Centre for them to be aligned to the Longueville Court Care Home and lead the provision of medical care to residents at the home, a role previously fulfilled by Orton Medical Practice.

The proposal by Alma Road, Burghley Road and Church Walk to join together as one team at the Healthy Living Centre as an alternative to closure had now been withdrawn by the practices.

The provider of caretaking  ...  view the full minutes text for item 5.

The report provided an overview of the new Adult Social Care department.

Until 1 March 2012 adult social care had been delivered on the City Council’s behalf by NHS Peterborough under a Partnership Agreement.  This Partnership Agreement included all aspects of adult social care commissioning and service delivery.  Subsequently the delivery side of the functions had been transferred by Peterborough PCT to Peterborough Community Services, the local NHS provider arm.  The Director of Adult Social Care was a joint appointment between the PCT and the City Council.

A number of factors had led to the City Council and NHS Peterborough concluding that the partnership should come to an end.  These included the proposed abolition of PCTs, the merging of Peterborough Community Services with Cambridgeshire Community Services and a range of operational, performance and financial issues.

Whilst the ending of the Partnership Agreement marked a return of the formal managerial responsibility for statutory adult social care functions to the City Council, it had not meant an end to partnership working.  The strengths and benefits achieved through the former partnership agreement including multidisciplinary teams and co-location of health and social care staff would continue, wherever it could be demonstrated to be delivering benefits.  Similarly a number of areas of joint commissioning activity had been maintained to ensure that health and social care investment was aligned to best meet the needs of Peterborough residents.

Transferring the services back to the City Council had been a complex process and involved detailed project planning and implementation. Since January 2012 this work had been led by Terry Rich, interim Executive Director for Adult Social Care who would be with the City Council throughout 2012 during the maternity leave of Denise Radley.

The Adult Social Care Department now represented close to a third of the total Council’s direct workforce and was responsible for approximately a third of the overall revenue budget spend and 490 staff transferred under TUPE arrangements to the Council on the 1st March.  A further 20 adult social care staff remained seconded to the Cambridgeshire and Peterborough (Mental Health) Foundation Trust where they worked within an integrated model of service delivery.

The Department had established three key priorities for its first year of operation:

• To promote and support people to maintain their independence
  • This included developing and extending access to “reablement” services and other ways to reduce the reliance on long term care

• To deliver a personalised approach to care
  • This included giving people more choice and control over how their care was delivered and extending the use of “direct payments”

• To empower people to engage with their communities and have fulfilled lives
  • This included brokering access to mainstream community resources and reducing the need for separate institutional provision. It also included promoting work opportunities for people with learning disabilities or recovering from mental ill health.

Adult Social Care referred to the services that were provided to help individuals, who due to disability or frailty (either permanent or temporary), needed  ...  view the full minutes text for item 6.

The report provided an update on the delivery of adult social care services in Peterborough against the four outcome domains contained in the national Adult Social Care outcomes framework and information of Safeguarding adults at risk.

Key areas where performance had improved since the last report were:

• The number of people receiving self direct support via a personal budget was increasing, although was still behind target.  The target needed to be revised in light of the new model of working, and in particular re-ablement as it did not take account of people receiving focussed services for a short period and then leaving before a permanent self directed support plan was needed.  Performance at 52.8% was greater than last years top quartile for all Councils (35.2%)

·         The percentage of adults with learning disabilities in settled accommodation was increasing and was now just below target at 74.3% (target was 75%).  The top quartile for all England councils was 70.2%.

·         The numbers delayed in being discharged from hospital was back under the target maximum, and continued to be in line with top quartile of all council’s performance.  In December there had been no delays from mental health beds.

·         The numbers of carers receiving assessment and services had increased, but at 28.7% it was still below the target of 36%.  28.7% was the national average. An audit of two months assessments was being undertaken to ensure that carers were appropriately assessed.

Key areas where performance had declined since the last report were:

·         The number of new people coming on to direct payments was lower this year than last year and we were investigating the potential causes of the drop.  Overall numbers receiving direct payments were still at a comparable level to other Councils.

·         Permanent admissions to residential care from adults aged 18-64 were up on last year, but still comparatively low. There had only been 11 placements, therefore a brief audit of these cases would be undertaken to ensure there was no underlying gap in community service provision.

Councillor Fitzgerald, the Cabinet Member for Adult Social Care, advised that it needed to be noted that the shortfall in some of the targets was against the stretch targets that the Council had set itself and was not failing to meet the national averages.

ACTION AGREED

To note the latest performance report.

            The Commission received the latest version of the Council’s Forward Plan, containing key decisions that the Leader of the Council anticipated the Cabinet or individual Cabinet Members would make during the course of the following four months.  Members were invited to comment on the Plan and, where appropriate, identify any relevant areas for inclusion in the Committee’s work programme. 

ACTION AGREED

The Commission noted the Forward Plan.