Agenda and minutes

Apologies for absence were received from Councillor Allen and Councillor Peach attended as substitute.

There were no declarations of interest or whipping declarations.

There were no requests for Call-in to consider.

The Chair advised the Commission that due to unforeseen personal circumstances the officer presenting item 4 on the agenda Draft Young Peoples Sexual health and Wellbeing:  Summary of Needs and Commissioning Strategy had been unable to attend the meeting to present her report.  The Chair asked the Commission if they would agree to defer the item until the next meeting in September.  The Commission agreed in favour of this request.

The report provided the Commission with an update on the work on the three priority areas for Cambridgeshire and Peterborough Clinical Commissioning Group.

The Chief Clinical Officer presented the report and highlighted items within the first priority; which was ‘The Older People Programme.   Areas highlighted included:

• Programme overview
• Stakeholder engagement
• Provider engagement
• Critical success factors
• Contract length
• Funding options
• Scope of services

Observations and questions were raised and discussed including:

·         Members had noted from previous presentations to the Commission from the NHS and Adult Social Care regarding reablement and the elderly leaving the hospital and then having to go back quickly was an issue. Members asked if the CCG was aware of this and did they know why this was happening? Members were advised that the reasons patients go in and out of hospital were varied and each case would have to be looked at individually. The CCG had been working with the hospital and the Council to identify the causes for readmission. It had been found that some were related to community provision. The services currently provided by Cambridgeshire Community Services (CCS) in the community for district nursing services and community matron services needed to be strengthened. The CCG continued to work with CCS to identify where the attention needed to be as well as community provision regarding communication aspects.

·         Members asked what flexibility was built into the programme of priorities as healthcare needed to be flexible. Members were informed that flexibility was essential and that this was exactly what the CCG were trying to achieve and change the way care was commissioned in the city as the current method was very rigid. Members were advised that the aim was to move to a method that would enable them to look beyond yearly budgets and move to longer contracts.

·         Members also sought clarification on what was being done for End of Life Care in Peterborough. Members were advised that there was a separate programme for End of Life Care.

·         Members noted that funding for the NHS was very restricted at the moment and asked if this meant more work would be given to the current staff or was there provision for more staff should they be required. Members were informed that financial modelling had been built around the predicted budget that would be available. It was noted that this would be changed when they had further information as to what funds would be available.

·         Members commented that having long contracts could be better at times but it could also allow for complacency. There would need to be very clear contractual terms about outcomes and achievements. Members were advised that a good proportion of time was spent managing the contracts that they sign with providers. Contracts would be monitored carefully and the CCG would work closely with organisations to ensure patients were getting what they signed up for.

·         Members asked about lead providers and whether the reference to lead providers under the section ‘scope of services in voluntary sector’ indicated  ...  view the full minutes text for item 5.

The report provided the Commission with an update on the work of the CCS Transition programme. A steering group had been formed to ensure a clear timetable and process to find alternative services due to the expectation that CCS would cease to function in April 2014. CCS provided three groups of services of which the largest in Peterborough was services for Adults and Older people. 

Due to some changes in responsibilities the future of CCS was now determined by a body called The Trust Development Authority. This Trust was currently looking at the organisation and had indicated that by the end of July 2013 they would confirm either continued support for a set period of time or a date at which the CCS would dissolve.

Observations and questions were raised and discussed including:

·         Members asked if CCS would still be able to procure for services as they currently do or would the organisation be completely dissolved. Members were advised that if CCS was NOT dissolved they would still be able to bid when the procurement exercise took place and may therefore still be involved in Adult and Older People’s work if they were a successful bidder. In terms of other services whilst they continued to exist they could continue to provide those services and theoretically continue as bidders for those services in the future if other procurement exercises took place.

·         Members asked about the status of the Trust Development Authority, how long they had been around and who was on the board. Members were advised they have not been around for long as their previous function was exercised by the Strategic Health Authority under the Provider Support function. Their role as a national body was for about 120 NHS Trusts that were not yet foundation trusts and over which there was some question about the future. Their responsibility was to work with those organisations to find an appropriate future for them. The consisted of a group of senior managers within the Department of Health and their funding was national.

·         Members referred to page 67 and the term ‘Shadow Running’ and asked it was in the correct time frame on the work plan. Members were advised that one of the options was to transfer the services to another organisation. If this happened although the official date at which they might transfer was on a given date there would be a period where the services were in a transitional period (where management was transferred, but the transfer was not yet formal). ‘Shadow Running’ was a description of this transitional period. It was confirmed that the Shadow Running period would be in May and June and the Jan to Feb description was incorrect in the report.

·         Members asked if the CCS Transition group was confident that service quality would not reduce in the period between now and the possible end of CCS. Members were assured that the Trust Development Authority had a responsibility to ensure that the quality of services was still  ...  view the full minutes text for item 6.

The report provided the Commission with an update on progress made with developing an Adult Social Care Prevention Strategy.  The Director of Adult Social Care introduced the report and informed Members that the development of the strategy arose from the consultation on eligibility and charging which was approved by Cabinet on 25 February 2013.  The Prevention Strategy aimed to set out the Council’s offer to people who were not eligible for statutory social care support but who would benefit from support to maintain their independence and wellbeing.  The transformation would result in a significant improvement to the preventative offer.

Observations and questions were raised and discussed including:

·         Members asked if the £165k was in addition to the current funding.  Members were informed that it was additional funding.

·         Members referred to page 90 of the report which provided a list of items that early interventions should be focused on and suggested a more holistic approach is required for this work. Transport services for example had just been cut and one of the items listed in the report was the promotion of mobility e.g. transport services. Members asked how this kind of problem could be dealt with.  The Director of Adult Social Care agreed that it was important for people to work together. A lot of the issues regarding transport were about particular specialist transport requirements such as people not able to get on a bus or in taxi. While the Council did not necessarily provide this transport they wanted to be able to provide information and guidance about what sort of transport was suitable and where it could be obtained.   This was what ‘promoting mobility’ was about.

·         Members mentioned that Local Link buses were used by people who did not need specialised transport but were unable to walk very far. As a preventative measure the buses would be an ideal service to have before these people reached a stage where they needed specialised transport. In preventative care a certain element of independence was needed for people and by taking away the Local Link bus services the people were losing that element of independence. Members highlighted that they felt this should have been dealt with together and not as two separate issues. The Director of Adult Social Care agreed that this was an important point but there was only so much that the Preventative Strategy could do with regards to that. Feedback about what worked and what did not would continue to be obtained. Part of the transformation would result in a new section that would look at a wider customer service. This would be a front-door service providing information and advice that would offer low-level prevention which would be accessible to as many people as possible.

·         Members asked how the team would ensure that resources for prevention were not reduced due to budget pressures. Members were advised that one of the ways this would be achieved was by the Cabinet agreeing that Prevention would be essential for the future. It was  ...  view the full minutes text for item 7.

The Commission received the latest version of the Council’s Notice of Intention to Take Key Decisions, 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 Notice of Intention to Take Key Decisions and, where appropriate, identify any relevant areas for inclusion in the Commissions work programme.

ACTION AGREED

The Commission noted the Notice of Intention to Take Key Decisions.

Members considered the Commission’s Work Programme for 2013/14 and discussed possible items for inclusion.

·         Members requested the presentation on Sexual Health and Wellbeing to be included in the work programme at a future meeting.

ACTION AGREED

To confirm the work programme for 2013/14 and the Senior Governance Officer to include any additional items as requested during the meeting.

Thursday, 19 September 2013

The meeting began at 7.00pm and finished at 8.30pm