All
Members present are required to declare, at this point in the
meeting or as soon as possible thereafter:
I.Any disclosable pecuniary interests and /
or
II.Other interests arising under the Code of Conduct in
respect of any item(s) of business being considered at this
meeting
NOTES:
·Members are reminded that they must not participate
in any item where they have a disclosable pecuniary
interest
·As well as an interest of the Member, this includes
any interest, of which the Member is aware, that relates to the
Member’s spouse or civil partner (or any person with whom the
Member is living as a spouse or civil partner)
·Members with a significant personal interest may
participate in the discussion and vote on that matter unless that
interest could be reasonably regarded as prejudicial
Purpose of the
report:To share details of the Cabinet
Member’s priority areas of work, including any strategy and
policy developments, and provide an overview of the budget position
and performance of services within the portfolio.
Minutes:
Witnesses:
Sinead Mooney, Cabinet Member for Adults and Public
Health
Liz
Uliasz, Deputy Director, Adult Social Care
Kate Scribbins, Chief Executive, Healthwatch Surrey
Nick Markwick, Co-Chair, Surrey Coalition of Disabled
People
Key
points raised during the discussion:
The Cabinet Member updated the Select Committee with
regard to the Surrey Public Health Peer Challenge, mentioned in
item 15 of the report. At the Peer Challenge meeting in November
2019, agreed-on recommendations included:
To review and simplify the governance of the
system;
To ensure that Surrey County Council was clear about
the expectations of the Public Health team;
To ensure that the Public Health team accepted
change and was clear about how they were delivering against the
priorities set out for them.
The action plan would detail how these
recommendations would be implemented, and the recommendations would
be closely monitored.
The Chairman pointed out that care commitments were
over budget and queried why there had been an overspend and what
was being done to balance the budget. The Cabinet Member explained
that mitigation measures were in place to ensure the budget was
balanced, including a staffing underspend of £1.4 million,
partly because of difficulties around recruitment; the level of
inflation; managing providers’ expectations; an underspend of
around £1.5 million on ASC internal transformation; and
£1.8 million of funding carried forward from the 18/19
budget. Underspends would be offset against an increase in spending
on care packages.
A Member expressed concern about managing
providers’ expectations, as many care providers were already
struggling financially. The Cabinet Member replied that a report
would be coming forward with details of an uplift in funding for
the upcoming year. The importance of working closely with providers
was emphasised, as were improvements in communications in the past
year. The Deputy Director of Adult Social Care added that the
commissioning function had been strengthened and restructured, and
that providers’ requests for increases in spending were dealt
with on a case-by-case basis.
A Member asked for clarification on why there had
been an underspend on transformation, despite the relatively high
level of transformation that had been happening. The Deputy
Director for ASC responded that the underspend was partly due to
incomplete recruitment.
A Member queried whether the Council was working
with district and borough councils to ensure that there were homes
available countywide for people who needed care, with no neglected
areas, and whether existing homes were being adapted or new
facilities built. Cabinet had recently signed off three sites for
the development of homes, with a focus on residents within those
catchment areas. In addition, there were many private developments
going through the planning process. The Council worked with
districts and boroughs to develop residents’ own homes so
that residents could live independently there.
The Select Committee queried stock levels of the flu
jab. The Cabinet Member stated these had increased and would be
available until February 2020.
The Co-Chair of the Surrey Coalition of Disabled
People questioned the efficacy of direct payments, due to frequent
delays, and asked ...
view the full minutes text for item 21/19
Purpose
of the report:To receive an update
on the progress of the Adult Social Care transformation programmes.
The report sets out a summary of achievements in the last month and
the Q2 performance against the Directorate’s key performance
indicators. It also includes a number of case studies which
illustrate the changes underway.
Minutes:
Witnesses:
Sinead Mooney, Cabinet Member for Adults and Public
Health
Liz
Uliasz, Deputy Director, Adult Social Care
Kate Scribbins, Chief Executive, Healthwatch Surrey
Nick Markwick, Co-Chair, Surrey Coalition of Disabled
People
Key points
raised during the discussion:
The Deputy Director of ASC introduced key points
from the report. Mental health and learning disabilities,
reablement for these groups and housing across social care were
being considered.
Members were reminded that Surrey Heartlands was
going through a mental health transformation, and the Select
Committee itself was continuing to hold the Mental Health Task
Group. A Member encouraged the Council to work with the third
sector (charities and voluntary and community groups) and improve
GPs’ relationship with the third sector.
A Member asked what the
balance was of the spend of the care package budget between older
people and people with learning disabilities. The Deputy Director
for ASC informed members that she would obtain this
information.
A Member noted that the council planned to create 90
care units a year in the next few years, in contrast to only seven
units over the last 14 years, and questioned whether there was the
structure and authority in place to realise this successfully. The
Cabinet Member responded that an officer who would work on property
and housing in ASC was being recruited, and the Select Committee
would be kept updated on this. An extra care brief had been
designed and procurement was being examined.
A Member referred to the strategic commissioning
approach, whereby privately-run care services might be taken back
under control of the Council. He questioned whether it could be
guaranteed that the Council could run the services cheaper than the
current owners. The Deputy Director of ASC reiterated that this
approach was needed and emphasised the development of positive
relationships with the market.
A Member asked if there was a target number of
social care package reviews to deliver. The Deputy Director for ASC
responded that the target was not numerical, but rather based on
outcomes for individuals. There was variation between different
teams and how many reviews they completed; reasons for this
included a lack of staff and higher demand in some
teams.
A member observed that the RAG (red, amber, green)
method of rating data could be too focused on financial measures
rather than outcomes for individuals. The Deputy Director of ASC
informed members that she would meet with Simon White, the
Executive Director of Public Health and Heartlands, and the
Chairman of the Adults and Health Select Committee with regard to
this issue.
A Member observed that the conversational approach
of an occupational therapist (OT) could be helpful when reviewing
patients and asked if there were enough OTs to implement this
approach. The Deputy Director for ASC stated that more OTs were
needed to apply this approach more widely and a better offer should
be made to OTs to make it an attractive job. Also, social workers
in general were expected to have a more conversational
approach.
Purpose of the
report:This report updates the committee on
the South East Coast Ambulance Service, with special focus on
changes since the last report of 8 March, especially in the areas
of performance, the recent Care Quality Commission (CQC) report,
executive leadership development and other strategic operational
updates, or local performance and development initiatives of
interest for Surrey.
Minutes:
Witnesses:
Ryan Bird, ePCR Operations Manager, SECAmb
Peter Carvalho,Senior Contracts Manager
(Ambulance Contracts & IUC), Surrey Heartlands
Bethan Eaton Haskins,Executive Director
of Quality & Nursing, SECAmb
Kate Scribbins, Chief Executive, Healthwatch Surrey
Nick Markwick, Co-Chair, Surrey Coalition of Disabled
People
Key points
raised during the discussion:
The Executive Director of Quality and Nursing gave a
summary of the report, including the following points.
The report looked at performance, executive
development and future plans. Despite advances having been made,
the service still required radical improvement. SECAmb examined its
own performance from a quality perspective, not a financial
perspective.
The incoming HR director of SECAmb could be
announced as Ali Mohammed. Details of new executive leadership,
including the new Chief Executive, were covered in the
report.
SECAmb’s top priority was sustaining and
improving response times.
SECAmb received an outstanding rating in the caring
category, which was a good morale boost for staff. They also
received an outstanding rating in the well-led
category.
For category 1 and 2 calls (the most urgent), the
service was close to or exceeding targets. However, SECAmb remained
challenged with regard to category 3 and 4 calls, due to the lower
priority level.
There were struggles in recruiting paramedics, which
might worsen when paramedics started working in primary care, as
this would make the job offer less attractive to some.
Hospital handover delays were also an area of
concern. There needed to be system-wide change to tackle
this.
Ofsted found two out of the three areas inspected in
the clinical education department less than satisfactory. Members
were assured that education programmes were still being run, but
were no longer allowed to be called apprenticeships. An independent
review of this had been commissioned.
Whatever the outcome of Brexit, mutual aid had been
agreed upon in order to mitigate potential negative
impacts.
A Member asked for more information on performance
issues in rural populations. The Executive Director explained that
there was a strategy to ensure that essential framework remained in
place in rural areas. The ePCR Operations Manager added that rural
areas were mainly where category 3 and 4 delays were seen. The
Senior Contracts Manager (Ambulance Contracts & IUC) remarked
that collaborative work was being done with regard to system
resilience and accessing local care pathways that could not
currently be accessed.
A Member requested clarification regarding
SECAmb’s acquisition of the NHS 111 contract. The Executive
Director answered that the commissioning for the 111 and 999
services were separate, and that currently SECAmb ran the 999
contract but until now had not run the 111 service. Qualified
healthcare professionals would handle 111 calls where
necessary.
Members emphasised the importance of SECAmb staff
having special training regarding mental health and learning
disabilities. For example, explaining the situation to patients
with autism was essential for alleviating anxieties that could be
more likely for autistic patients. The Executive Director explained
that there were mental health clinicians in the assessment centres
and this had had a significant impact on improving outcomes.
Members suggested that ...
view the full minutes text for item 23/19
Purpose
of the report:For the Select
Committee to review the attached recommendations tracker and
forward work programme, making suggestions for additions or
amendments as appropriate.
The Select Committee acknowledged that most of the
recommendations had been completed.
Members were reminded that the meeting originally
scheduled for 6 February 2020 had been moved to 22 January
2020.
The Select Committee was informed that an update on
the Winter Pressures Follow-Up report would be possible at the
meeting of 14 July 2020 (later than spring, which had originally
been suggested, since the ‘winter period’ lasted
officially until April for the officers involved).
Members were reminded of upcoming business meetings,
including the mental health briefing on Friday 6 December 2019, and
the Performance Dashboard Working Group meeting on 11 December
2019.
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