Agenda and draft minutes

Adults and Health Select Committee
Wednesday, 22 January 2020 10.30 am

Venue: Council Chamber, County Hall, Kingston upon Thames, Surrey KT1 2DN

Contact: Ben Cullimore, Scrutiny Officer 

Items
No. Item

1.

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

2.

MINUTES OF THE PREVIOUS MEETINGS: 4 DECEMBER 2019 pdf icon PDF 110 KB

    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.

3.

DECLARATIONS OF INTEREST

    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.

    Minutes:

    None received.

4.

QUESTIONS AND PETITIONS

    To receive any questions or petitions.

    NOTES:

    1.    The deadline for Members’ questions is 12:00pm four working days before the meeting (16 January 2019).

     

    2.    The deadline for public questions is seven days before the meeting(15 January 2019).

     

    3.    The deadline for petitions was 14 days before the meeting, and no petitions have been received.

    Minutes:

    None received.

5.

SCRUTINY OF REVENUE AND CAPITAL BUDGET 2020/21 pdf icon PDF 70 KB

    Purpose of report: To provide details of the budget for scrutiny prior to Cabinet and Council meetings.

     

    Additional documents:

    Minutes:

    Witnesses:

     

    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:

    1. 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.
    2. 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.
    3. The Director of Financial Insight informed the Committee that:
      1. significant progress had been made in moving from financial recovery to stability;
      2. the budget proposed significant investment in Surrey;
      3. the transformation would continue to deliver efficiencies;
      4. and investment in areas such as extra care accommodation were aligned with the Council’s 2030 vision.
    4. 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.

6.

INTEGRATED SEXUAL HEALTH AND HIV SERVICE CONTINUOUS IMPROVEMENT PLAN pdf icon PDF 795 KB

    Purpose of report:To update the 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:

    1. 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.
    2. 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.

     

    1. 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.
    2. 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.
    3. A Member was of the opinion that communications had  ...  view the full minutes text for item 6.

7.

RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME pdf icon PDF 95 KB

    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.

     

    Additional documents:

    Minutes:

    Witnesses:

     

    Sinead Mooney, Cabinet Member for Adults and Public Health

     

     

    Key points raised during the discussion:

    1. 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.
    2. 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.
    3. It was agreed that a report on ASC debt would be presented to the Select Committee at an upcoming meeting.
    4. 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.

8.

DATE OF THE NEXT MEETING