Agenda and minutes

Adults and Health Select Committee - Thursday, 7 December 2023 10.00 am

Contact: Sally Baker, Scrutiny Officer 

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Items
No. Item

40/23

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

    Purpose of the item: To report any apologies for absence and substitutions.

    Additional documents:

    Minutes:

    Apologies were received from Dennis Booth, Michaela Martin, Rebecca Jennings-Evans and Immy Marwick. Robert Evans and Abby King delayed. Remotely, Frank Kelly and Carla Morson.

     

41/23

MINUTES OF THE PREVIOUS MEETINGS: 7 OCTOBER 2023 pdf icon PDF 252 KB

    Purpose of the item: To agree the minutes of the previous meeting of the Adults and Health Select Committee as a true and accurate record of proceedings.

    Additional documents:

    Minutes:

    The minutes were agreed as a true and accurate record.

     

42/23

DECLARATIONS OF INTEREST

    Purpose of the item: 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.

    Additional documents:

    Minutes:

    The Chairman declared that he was a Frimley Health Community Representative.

     

    Carla Morson declared a personal interest with a close family member who works in the Emergency Department at Frimley Park Hospital.

     

43/23

QUESTIONS AND PETITIONS

    Purpose of the item:To receive any questions or petitions.

    NOTES:

    1.    The deadline for Members’ questions is 12:00pm four working days before the meeting (1 December 2023).

     

    2.    The deadline for public questions is seven days before the meeting(28 November 2023).

     

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

    Additional documents:

    Minutes:

    No questions or petitions were received.

     

44/23

SCRUTINY OF 2024/25 DRAFT BUDGET AND MEDIUM-TERM FINANCIAL STRATEGY TO 2028/29 pdf icon PDF 128 KB

    Purpose of the item: Scrutiny of the Draft Budget and Medium-Term Financial Strategy.

    Additional documents:

    Minutes:

    Witnesses:

    Mark Nuti, Cabinet Member for Adults and Health

    Sinead Mooney, Cabinet Member for Adults Social Care

    David Lewis, Cabinet Member for Finance and Resources.

    Nicola Kilvington, Director of Corporate Strategy & Policy, Surrey County Council

    Rachel Wigley, Director, Finance Insights & Performance

    William House, Strategic Finance Business Partner for Adults, Wellbeing and Health Partnerships

    Sarah Kershaw, Strategic Director of Adults, Health, and Wellbeing

    Nicola O’Connor, Strategic Finance Business Partner

    Paul Richards, Area Director East & Mid Surrey, Adult Social Care (ASC)

    Jonathan Lillistone, Assistant Director of Integrated Commissioning

    Nikki Roberts, CEO, Surrey Coalition of Disabled People

     

     

    Key points raised during the discussion:

    1. The Cabinet Member for Finance and Resources introduced the Item and provided an overview on the draft budget for 2024/25 and the Medium-Term Financial Strategy (MTFS) for 2028/29.

     

    1. The Chairman questioned if there had been any further opportunities identified to work cooperatively with the borough and district councils to close any budget gaps. The Strategic Director of Adults, Health and Wellbeing explained that the Directorate worked closely with the district and borough councils in delivering care, but there were several financial challenges within some of these councils that increased difficulties in how the Directorate would deliver services in the future, but options to work together more effectively would always be explored. A Member asked if the Directorate was anticipating service withdrawals from borough and district councils. The Cabinet Member for Finance and Resources explained that there could be a risk partners resorting to statutory rather than discretionary services, which could have consequences for the Council. There was currently no direct indication that services would be withdrawn. The Cabinet Member for Adult Social Care highlighted that the Council funded some district and borough council schemes such as ‘meals on wheels’ and the Directorate were committed to continue this.

     

    1. A Member questioned whether the Service was being ambitious enough in extra care housing numbers.The Cabinet Member for Adults Social Care explained the Directorate was bound by the Care Quality Commission (CQC) regulations, which restricts the size, height and density of properties, and number of residents. The Director of Integrated Commissioninghighlighted that the Directorate would avoid introducing risk and officers who were working on the programme had been as ambitious as possible with the number of units. Good progress had been made on Regulation 3 applications, with planning approval on the Guildford site and construction starting in 2024, outline planning approval for three sites in the next part of the programme, and the remaining three sites would be due to come forward for outline planning approval. Overall, this means that the Directorate are at 360 units towards the 725 targets, with further plans in the pipeline to achieve the full target.

     

    Abby King and Robert Evans arrived at 10.32 am.

     

    1. In reference to the Medium-Term Position being uncertain with continued pressures, the Chairman asked what opportunities there were to put in place Transformation programmes, which could alter major cost drivers. The Strategic Director of Adults, Health and Wellbeing explained there were  ...  view the full minutes text for item 44/23

45/23

ADULT SAFEGUARDING UPDATE pdf icon PDF 184 KB

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    Purpose of report: To provide the Committee with an update on adult safeguarding in the county.

    Additional documents:

    Minutes:

    Witnesses:

     

    Mark Nuti, Cabinet Member for Adults and Health

    Sinead Mooney, Cabinet Member for Adults Social Care

    Sarah Kershaw, Strategic Director of Adults, Health and Wellbeing

    Paul Richards, Area Director East & Mid Surrey, Adult Social Care (ASC)

    Jonathan Lillistone, Assistant Director of Integrated Commissioning

     

    Key points raised during the discussion:

     

    1.    The Strategic Director for Adults, Health and Wellbeing provided a brief overview of the Adults Safeguarding Update. The paper set out a rise in both concerns and enquiries and covered the decision making, legal duties, and how the Directorate was working to strengthen the learning received.

     

    2.    A Member referred to the Adult, Wellbeing and Health Partnerships (AW&HP) current process of reviewing safeguarding arrangements to ensure there would be the right capacity, and asked what the timeline was for this. The Area Director for East & Mid Surrey (ASC) explained that the newly appointed Interim Executive Director had started the process of reviewing the arrangements. The Service had received additional capacity with the recent appointment of a Principle Social Worker, who would work across the AW&HP teams to identify good practice and where improvement was needed, and an Assistant Director for Safeguarding and Quality, who would review Safeguarding teams and their processes, and the continued review of performance plans and finalisation of the wider Safeguarding Adults Improvement Plan. The Service would expect this to ensure the right capacity to work effectively with partners and care providers. A new team manager with previous experience as a social worker and an approved mental health practitioner is expected to join the Adult Safeguarding Hub in January 2024. The Service would expect this team, from January onwards to be effective and to see good improvements within the next six months.

     

    3.    A Member asked if the Safeguarding Adults page on the Council’s website would be accessible to those who were digitally excluded and how the Directorate were advertising it. The Area Director for East & Mid Surrey (ASC) explained that the Directorate recognised some people experience issues with online access, but they were fairly confident people were able to access this information, based on the volume and types of referrals and concerns the Service received. The Area Director stressed that the Directorate would always want arrangements in place to enable digitally excluded people to voice their concerns and highlighted the reference in the report to providing information in a physical form, which work with partners in communications would be done to distribute this to parts of the county with digitally excluded people.

     

    4.    A Member queried if there was an intention to support people who experience language barriers. The Director of Integrated Commissioning stated that it would be a key area where the Directorate would need to work with partners, providers and care staff who have these skills, and an area where the Directorate would need to make sure staff were having conversations with Surrey residents.

     

    5.    A Member asked if online training had been offered to libraries to support safeguarding issues. The  ...  view the full minutes text for item 45/23

46/23

A NEW HOSPITAL TO REPLACE FRIMLEY PARK HOSPITAL pdf icon PDF 229 KB

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    Purpose of the item: To seek the committee’s views on the criteria that Frimley Health NHS Foundation Trust will use to evaluate a shortlist of possible sites for a new hospital, and the committee’s feedback on the Trust’s approach to comprehensive engagement with patients, public, and staff.

    Additional documents:

    Minutes:

    Witnesses:

     

    Mark Nuti, Cabinet Member for Adults and Health

    Sinead Mooney, Cabinet Member for Adults Social Care

    Carol Deans - Director of Communications and Engagement Frimley Health NHS Foundation Trust

    Kishamer Sidhu, Chief Finance Officer & Executive Lead for New Hospital, Frimley Health NHS Foundation Trust

    Emma Boswell, Director of Partnerships and Engagement, Frimley Integrated Care Board Known as NHS Frimley

     

    Key points raised during the discussion:

     

    1. A Member asked why Frimley Health was planning to build a bigger hospital and how modern healthcare standards would better cater for Surrey’s ageing population. The Chief Finance Officer explained that the new hospital would be built to international standards allowing for more space, and the size would be about specifications rather than the quantity of facilities. The Director of Partnerships and Engagement explained that with regards to modern healthcare standards, the commitment to integrated care would be key to the plans of the new hospital and built on ongoing work around integrated care teams, virtual wards, and remote monitoring. This work would need to continue to support the new hospital for the increasing demand and capacity management needs. The Chief Finance Officer explained that part of the aim would be to predict where the future services would need to be, which would involve integration. Three ways that integration would be important and help to provide care in a different way would be with technology; the volume and types of patients changing; and how and what would be treated in the hospital compared to the connected facilities around it, such as virtual wards, community facilities and diagnostics.

     

    1. The Chairman asked how much Frimley was working with NHS Hampshire Hospitals, that would also be building a new hospital and referred to potential conflicts it could cause. The Director of Communications and Engagement confirmed that both Frimley Health NHS Foundation Trust and NHS Frimley were working with Hampshire hospitals and the Royal Berkshire hospital. The Director clarified that Hampshire are considering a reconfiguration of their services between their two hospitals, whereas Frimley Health NHS Foundation Trust are focussing on their site location and would keep services the same with no intention to change the patient flow. The Director of Partnerships and Engagement added that Frimley Health and care system were working in partnership with neighbouring systems, and collaboration between senior responsible officers of the three different builds had been supported by the integrated care system.

     

    1. The Chairman referred to the new rules in the National Planning Policy Framework, which requires large projects to demonstrate a 10% biodiversity net gain, and questioned if Frimley Health NHS Foundation Trust were aware of this new challenge, and of how they would take it into account. The Chief Finance Officer stated that details around this had not been checked but stated that the new rule may indicate a more general issue, as the NHS was already required to change the way they build, to meet energy efficiency and net carbon zero impact standards. The Chief Finance Officer also highlighted the  ...  view the full minutes text for item 46/23

47/23

RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME pdf icon PDF 28 KB

48/23

DATE OF THE NEXT MEETING: 7 MARCH 2024

    The next public meeting of the committee will be held on Thursday 7 March at 10:00am.

    Additional documents:

    Minutes:

    The next public meeting of the committee will be held on Thursday 7 March 2024 at 10.00am.