Agenda and minutes

No apologies for absence were received.

At this point Members must declare whether they have a disclosable pecuniary interest, or other interest, in any of the items on the agenda, unless it is already entered in the register of members’ interests or is a “pending notification “ that has been disclosed to the Solicitor to the Council.

Members must also declare if they are subject to their party group whip in relation to any items under consideration.

Item 5 Update on the Development of the Shadow Cambridgeshire & Peterborough Clinical Commissioning Group and the Peterborough and Borderline Local Commissioning Groups

Councillor McKean declared a interest in that he was a member of the Patient Participation Group for Eye and Thorney.

The minutes of the meeting held on 20 September were approved as an accurate 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.

A request for Call-in of the Cabinet’s decision on the Older People’s Accommodation Strategy – Consultation Report on the Proposal to Close Greenwood House and Welland House has been received and will be considered at this meeting.

The Commission had been asked to consider a Call-In request that had been made in relation to the decision madeby Cabinet and published on 5 November 2012, regarding Consultation on the Proposed Closure of the Two Care Homes: Greenwood House and Welland House - NOV12/CAB/133.

The request to Call-In this decision was made on 7 November 2012 by Councillor Saltmarsh and supported by Councillors Harrington and Sylvester.  The decision for Call-In was based on the following grounds:

(i)      The decision does not follow the principles of good decision making set out in Article 12 of the Council’s Constitution specifically that the decision maker did not:

(a)     Act for a proper purpose and in the interests of the public.

The reasons put forward by the Councillors were:

1.      Financial reasons have been considered above the care provision and the wellbeing of the permanent residents and the day care centre users.

2.      The public have felt very strongly about the closure of the homes, almost 6000 signatures  were received against closure as were all the letters received, the publics opinion has not been taken into account.

After considering the request to call-in and all relevant advice, the Committee were required to decide either to:

(a)              not agree to the request to call-in, when the decision shall take effect;

             (b)       refer the decision back to the decision maker for reconsideration, setting out its concerns; or

             (c)       refer the matter to full Council.

The Chairman read out the procedure for the meeting.

Councillor Saltmarsh, Harrington and Sylvester each addressed the Committee stating why they had called the decision in.

Questions and Comments from Members of the Commission in response to the Councillors statements:

·         Members commented that all recommendations previously made by the Commission at the extraordinary meeting held on 1 November 2012 had been accepted by Cabinet.

·         The Financial model had been based on full occupancy of both homes.

·         Members sought clarification that any councillor could attend any Scrutiny meeting and ask questions and put forward their points on a matter so that they could be assured that Councillors had had an opportunity to comment on this issue.   The Head of Legal Services confirmed that they could.

·         Members sought assurance that the council had taken all the correct legal steps for reviewing the decision, scrutinising it, calling the decision in and taking everything into account legally.  The Head of Legal Services confirmed that all the correct legal procedures had been taken.

The Cabinet Member for Adult Social Care made a statement in answer to the Call-In request which included the following:

·         It had been a very difficult decision to make. 

·         Financial considerations were not put above the consideration of the people affected.  There were however financial implications.

·         Cabinet Members had an opportunity to see the letters that had been submitted as part of the consultation and they had been available for any Member requesting to see them.

·         The 6000 signatures included in the response to the consultation had been taken into account.  ...  view the full minutes text for item 4.

The report informed the Commission on the development of the shadow Cambridgeshire & Peterborough Clinical Commissioning Group and the Peterborough and Borderline Local Commissioning Groups.  The Chair welcomed the Chief Operating Officer, Cambridgeshire & Peterborough CCG and colleagues.  The Chief Operating Officer introduced the report and provided the Commission with the following information:

·         An update on the Cambridgeshire & Peterborough Clinical Commissioning Group and the developing priorities.

·         An overview of the new NHS architecture.

·         Local decision making and planning for next year 2013/2014.

The Commission were informed that from April 2013 Primary Care Trusts would be abolished and the functions discharged by PCT’s would go in three main directions:

• Clinical Commissioning Groups
• A new body called the NHS Commissioning Board
• Public Health functions would be transferred over to the Local Authority and some areas would go into a new body called Public Health England.

Clinical Commissioning Groups were statutory bodies set up through the Health and Social Care Act but were membership organisations which were built on GP Practices.   Peterborough had 109 member practices spanning the County of Cambridgeshire and Peterborough city and also entering into Northamptonshire and Hertfordshire.  Under the Clinical Commissioning Group which would be the statutory body from April 2013 there would be eight Local Commissioning Groups constituted of local practices that then elected their leadership.   The Governing Body has decided on three main priority areas:

• Frail elderly
• End of life care
• Health inequalities, particularly in relation to coronary heart disease

The business plans for the Clinical Commission Groups were being developed and would be brought before the Commission in March 2013.

Observations and questions were raised and discussed including:

·         Members sought clarification on End of Life Care.  Was there a legal requirement for all doctors to fully explain and obtain consent from the patients, relatives or carers before placing someone on the End of Life pathway?   Members were advised that this was correct.

·         Members wanted to know how doctors could ensure that the procedure for placing people on the End of Life pathway would be followed.  Members were informed that there had been a programme of work around End of Life Care looking at consent issues and services that people need.  A register was in place for people on the End of Life Care pathway and GP’s would gain consent to put people on the register. An assessment would then take place as to what services that person would need as they progressed along the End of Life pathway at each stage.  The Multi Disciplinary Teams would also follow this process.

·         Had the report taken into consideration the latest Census figures when considering the growth in the older population over the next four to five years?  Members were advised that the population projections in the report were based on the Office of National Statistics (ONS) data and these would be updated as new data was received.

·         What patient representatives and other groups were represented on the new Clinical Commissioning Groups.  The Director of Communications, Membership & Engagement, Cambridgeshire  ...  view the full minutes text for item 5.

The Director of Public Health introduced the report which presented the Commission with the draft Health and Wellbeing Strategy 2012-15.  This was the first strategy of the Health and Wellbeing Board and the Commission had been asked to give their views and comments as part of the consultation process. 

The three year strategy was set out to:

·         Identify health and wellbeing priorities 

·         Set clear markers for NHS and Local Authority commissioners as they acted to put in place the right mix of services and initiatives to meet the needs of the population

·         Enable commissioners to mutually hold each other to account for their commissioning decisions

·         Help to develop partnerships that provided solutions to commissioning challenges

Members were informed that the Health and Wellbeing Board was about partnership and seeing the best possible way to deliver service.  The priorities selected in the strategy related closely to the findings of the Joint Strategic Needs Assessment (JSNA):

1. Securing the foundations of good health
2. Preventing and treating avoidable illness
3. Healthier older people who maintain their independence for longer
4. Supporting good mental health
5. Better health and wellbeing outcomes for people with life-long disabilities and complex needs

The consultation would close on 23 November and the final draft including feed back from the consultation would be presented to the Health and Wellbeing Board on 10 December to confirm the priorities and finalise the strategy.

Observations and questions were raised and discussed including:

·         Members noted that under the priority ‘Healthier older people who maintain their independence for longer’ there was evidence that flu vaccination for over 65s was below average.  Members had felt that it had not been well advertised and this could be the reason for it being below average.  The Director of Public Health responded that most practices should have written to all eligible patients advising them of the availability of the vaccination.  The national flu vaccination campaign had not run for the last two years but the government had agreed to reinstate it.

·         How had the consultation been promoted and how many responses have been received so far.  Members were advised that the consultation process was still running.  On 21 November there would be a stakeholder event for 60 delegates.  The feedback through the written consultation route had been relatively limited.  The main feedback would come through the stakeholder event.  There had also been several press releases and the draft strategy had been put on various partnership agendas. 

·         Members noted that under the priority ‘Supporting good mental health’ there was evidence of high level of school exclusions and out of city placements for children and young people with statements with the primary category being behavioural emotional and social difficulties.  Why were children sent to out of city placements?  Officers were unable to comment on Children’s Services but advised Members that it might be because they were children with special needs.  This was in the strategy because it had been an issue of concern.

·         How could you ensure that this strategy would work and improve  ...  view the full minutes text for item 6.

The report provided the Commission with an update on the delivery of Adult Social Care services in Peterborough against the key priorities identified in the business plan, linked against the four outcome domains contained within the national Adult Social Care outcomes framework.  The report covered the second quarter of 2012-13.  The Assistant Director, Quality Information & Performance  informed the Commission that the report was in a slightly different format than previously presented in that it had been mapped to the departmental priorities as well as the national priorities.  New information sets had been included such as reablement statistics which had been identified as a major priority for this year.  Highlights included:

Priority One – promoting and supporting people to maintain their independence

The operating model for Adult Social Care to promote independence and support people for longer in lower care environments was being remodelled.  In particular the reablement service was expanding and delivering good outcomes in respect of the levels of need with which people leave the service. 

Priority 2 – delivering a personalised approach to care

Progress was being made against the key enablers of this priority.  Numbers of Learning disabled people receiving annual health checks was increasing and expected to hit the target of 16% by the end of the year.  Numbers using the shared lives scheme was increasing and the recent campaign had created interest from prospective carers.  The national carer’s survey was currently underway, with just under one thousand carers being sent a survey.

Priority 3 – Empowering people to engage with their communities and have fulfilled lives

Supporting adults with learning disability into employment had continued to do well. However, numbers in settled accommodation was still comparatively low.  There was still a need to improve availability of information for all client groups. Work to introduce an online directory of services was now underway with an expected delivery date of January 2012.

Safeguarding Vulnerable Adults

Progress had been made in the process of conducting safeguarding investigations. The backlog of cases previously reported had now been cleared and the performance against process indicators for alerts, referrals and investigations for quarter 2 have shown a marked improvement.  Focus was now moving on to quality monitoring and a case audit tool for safeguarding investigations was being piloted.

A permanent strategic lead had been appointed for Safeguarding and would be in place by the end of November.

Observations and questions were raised and discussed including:

·         Priority 3 – Empowering people to engage with their communities and have fulfilled lives.  What was being done to help, support and facilitate those in elderly residential care bungalows and supported living and volunteers on those sites?    Members were informed that work was being done on a Prevention Strategy around supporting people at the level of need prior to them needing high levels of intervention.  Volunteer schemes were key to the strategy.  More information would be provided to the Commission at a later date.

·         Had audits now been put in place for the care homes as  ...  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 and requested further information on Healthwatch Commissioning – KEY/30NOV12/02.

Members considered the Commissions Work Programme for 2012/13 and discussed possible items for inclusion.

ACTION AGREED

To confirm the work programme for 2012/13 and the Senior Governance Officer to include any additional items as requested during the meeting.

Wednesday, 23 January 2013