To
agree the minutes of the previous meeting of the Adults and Health
Select Committee held on 4 December 2019 as a true and accurate
record of proceedings.
Minutes:
Attention was drawn to the mention of
‘care homes’ in the actions of the Cabinet Member
Update item in the previous minutes. A Member suggested that the
phrase ‘accommodation in extra care’ might be a more
appropriate term.
The minutes were agreed as a true record of
the meeting.
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.
Wil House, Strategic Finance
Business Partner for Adult Social Care and Public Health
Ruth Hutchinson, Director of
Public Health
Nick Markwick, Co-Chair, Surrey Coalition of Disabled
People
Sinead Mooney, Cabinet Member
for Adults and Public Health
Kate Scribbins, Chief
Executive, Healthwatch
Surrey
Simon White, Executive Director
of Adult Social Care
Rachel Wigley, Director of
Financial Insight
Key
points raised during the discussion:
With the Equality Impact Assessment (EIA) having
been distributed to Members only the day before the formal Select
Committee meeting, the Chairman emphasised that lateness could
hinder the Committee’s ability to scrutinise. The Director of
Financial Insight responded that the Finance department would have
liked to have distributed the budget earlier, but this was delayed
by the general election in December 2019, coupled with late public
funding announcements.
The Cabinet Member for Adults and Public Health
introduced the item by stating that the budget gave cause for
positivity with a note of caution. This budget aimed to ensure
financial sustainability and investment for residents. The 2020/21
period constituted the first year for some time that the Council
had received additional funding from central government; this was a
recognition of the funding pressures that Local Authorities (LAs)
had faced. The transformation project had been very significant,
and Adult Social Care (ASC) and Public Health (PH) had played an
important part in it. Due to increased financial stability, the
Council was looking forward to delivering an ambitious capital
programme, including investment in supported housing.
The Director of Financial Insight informed the
Committee that:
significant progress had been made in moving from
financial recovery to stability;
the budget proposed significant investment in
Surrey;
the transformation would continue to deliver
efficiencies;
and investment in areas such as extra care
accommodation were aligned with the Council’s 2030
vision.
The Executive Director of Adult Social Care noted
that when creating a budget envelope for ASC, the vast majority of
spending was on provision of care. Surrey County Council was trying
to change the model of care in order to contain spending within the
budget envelope. This could be summarised with the phrase
‘strength-based approach’, which was a focus on how the
Council could facilitate residents living how they wished, and
assessing people at their best. The performance information of the
department indicated that the strength-based approach had been
successful: the number of contacts turning into assessments was
falling, 5,000 people had been taken off the caseload and the
percentage of people going into residential nursing care had been
reduced. This approach was not focused on saving money, but it did
so as a by-product, and the average cost of care in Surrey had
fallen. The 2020/21 budget was more realistic than the previous
year’s, although this still presented a challenge. In 2019/20
there had been a slight increase in spending for the first few
months, until the last three months, when there had been reductions
month-on-month. Finally, the Executive Director wished to commend
the absence of closures of care services in the ...
view the full minutes text for item 5/20
Purpose of report:To updatethe Adults and Health Select Committee on the
Continuous Improvement Plan for the Surrey Integrated Sexual Health
and HIV service and to provide information on key sexual health
indicators.
Minutes:
Witnesses:
Kate Crockatt, Acting Senior Public Health
Lead
Ruth Hutchinson, Director of
Public Health
Jonathan Lewney, Consultant in
Public Health
Fiona Mackison, Service Specialist – Specialised
Commissioning, NHS England South
Mark Maguire, Service Director
of Sexual Health, HIV & Hepatitis Services, Central and North
West London NHS Foundation Trust (CNWL)
Sinead Mooney, Cabinet Member
for Adults and Public Health
Kate Scribbins, Chief
Executive, Healthwatch
Surrey
Alasdair Tudhope, Deputy Service Director of Sexual Health,
CNWL
Key
points raised during the discussion:
A Member asked
whether there was a correlation between a decrease in testing for
Sexually Transmitted Infections (STIs) and an increase in STI
treatment, as shown in Table 2 in the report. The Consultant in PH
explained that the reason testing rates had decreased was that the
table referred only to face-to-face appointments, which had
decreased because online testing had become more popular. Patients
were encouraged to use the online service for testing, and only use
a face-to-face appointment for treatment or complex issues. Table 4
in the report demonstrated a corresponding increase in online
testing.
A Member remarked
that in Epsom there was not a wide awareness of sexual health
services amongst residents and even some councillors. The
university and some deprived areas in Epsom might lead to an
increased need of sexual health services. She queried what was
being done to raise the profile of services in Epsom. The Director
of PH said that work was being done on the website of the service,
and that tests could now be ordered online. However, the Council
wished to continue to do more to promote the service in
‘coldspots’ such as Epsom.
The Consultant added that some of the services offered in
‘spoke’ clinics (smaller, more localised clinics), like
the clinic in Epsom, were not as extensive as those offered at the
‘hub’ clinics (larger clinics).
Vicki Macleod left at 1:35pm.
A Member emphasised
concerns about confidentiality at the Buryfields clinic in Guildford. The Deputy Service
Director of Sexual Health for CNWL reminded Members that as well as
a screen that would shortly be installed in the clinic’s
reception, a TV had been installed to create background noise, and
patients were now simply asked verbally if they had a booked
appointment or required a walk-in appointment at reception, in
order to improve confidentiality. In patient engagement, the issue
of confidentiality had come up with a few people but it was not a
major issue.
A Member recalled
that when the contract had first been granted, references had been
made to young people being able to go to the school nurse, an idea
that had been met with some scepticism. The Director of PH replied
that while school nurses (who were commissioned by the PH team)
were not always the first port of call, they were important
nonetheless. School nurses should be kept up-to-date and should
feed back to other PH services (for
example, GPs) on students’ cases.
Purpose of report:For the Select
Committee to review the attached Recommendations Tracker and
Forward Work Programme, making suggestions for additions or
amendments as appropriate.
Sinead Mooney, Cabinet Member
for Adults and Public Health
Key
points raised during the discussion:
The Select
Committee was updated on the progress of the performance dashboard,
which was currently in development and would be constructed at the
start of February. The first dashboard would be ready for
presentation at the next Committee meeting in April, and from then
on it would probably be presented quarterly, and could be added to
if needed as time went on.
The idea
was discussed of bringing the issue of unpaid carers onto the
Forward Work Programme, but in the end it was agreed that it would
not be included as a standalone item. Instead, the Cabinet Member
would circulate a briefing note to Members on the issue of unpaid
carers.
It was
agreed that a report on ASC debt would be presented to the Select
Committee at an upcoming meeting.
Members
agreed that the approach of the Select Committee to the budget was
that they were satisfied with the content of the report as it was,
but they accepted that there were enormous challenges going
forward. If performance issues were caused by the budget, these
would be detected using the performance dashboard and scrutinised
by the Committee. The Chairman emphasised the importance of the
Committee having a concrete effect on officers’
actions.
Actions/further information required:
1.For the Cabinet Member for Adults and Public Health
to circulate a briefing note to Members on the subject of unpaid
carers.
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