To consider any items which the Chair has agreed to have submitted as urgent.

The Chair introduced an item of urgent business by advising that she had requested the Interim Deputy Place Based Lead, NHS Greater Manchester Integrated Care and the Executive Director of Adult Social Services to address the Committee on the local response to the current national NHS crisis that had been widely reported in the media.

The Committee noted that an extraordinary meeting of the Health Scrutiny Committee had been called for 22 February 2023 to specifically discuss the issues currently experienced by Manchester residents accessing acute NHS services. The Chair stated that this would be a further opportunity to discuss the points raised by the Committee at today’s meeting in further detail.

The Interim Deputy Place Based Lead, NHS Greater Manchester Integrated Care informed the Committee that the health service had experienced unprecedented demand since October 2022. He stated that these pressures were added to because of the increased incidents of Covid infection rates and an earlier start to the flu season, commenting that during the month of December, 500 patients had been admitted to hospital due to flu across Greater Manchester. He advised that this situation would continue to be monitored. He stated that these illnesses had also impacted on staff and front-line health workers that had also added to the pressures experienced across the service. He advised that the System Operation Response Task Force, which consisted of senior leaders and clinical practitioners across Greater Manchester had been meeting weekly, increasing to now daily to understand the levels of demand and manage resources appropriately system wide. He provided an example of mutual aid as being when other local district hospitals had responded to relieve bed pressures experienced at the Children’s Hospital, adding that this care had been managed by paediatric specialists.

In noting the industrial action being taken by Ambulance workers, the Interim Deputy Place Based Lead, NHS Greater Manchester Integrated Care advised that the impact of this was being closely monitored by the System Operation Response Task Force and urged anyone experiencing a life threating emergency to contact 999 immediately. He also advised the NHS 111 service was still available, both online and via the telephone.

The Executive Director of Adult Social Services described the established multi-disciplinary teams that worked to manage patient flow. She described that Patient Target Lists were reviewed daily, six days a week to discuss and facilitate the safe discharge of patients into the most appropriate setting with the appropriate care pathways using the discharge to assess approach. She stated that data and activity was monitored at the Integrated Care Control Room, using real time data obtained via the Hive System. She also advised that Winter Discharge Monies had been used to support people living safely in their own homes, and this work had been supported by various Voluntary Community and Social Enterprise groups. She acknowledged that recruitment and retention of staff remained an issue nationally across the Adult Social Care sector, however work was ongoing locally with providers to address this. She commented  ...  view the full minutes text for item 1.

To approve as a correct record the minutes of the meeting held on 7 December 2022.

Decision

To approve the minutes of the meeting held on 7 December 2022 as a correct record.

Report of the Executive Director of Adult Social Services

This report provides details on the forthcoming Assurance Framework by the Care Quality Commission (CQC) and set out what their proposed inspection methodology will be, and the timeframe suggested. It will also update Members of the Test and Learn pilot undertaken by CQC of Adult Social Care and advise what the key outcomes were.

The Committee considered the report of the Executive Director of Adult Social Services that provided information on the forthcoming Assurance Framework by the Care Quality Commission (CQC).

Key points and themes in the report included:

·         Noting that the Health and Care Act 2022 gave the CQC new regulatory powers to undertake independent assessment of local authorities’ delivery of regulated care functions;

·         A description of the four themes of the CQC assessment framework and their associated quality statements;

·         Information on the Test and Learn pilot undertaken by CQC of Adult Social Care in July 2022 and the key outcomes; and

·         Next steps.

Some of the key points that arose from the Committee’s discussions were: -

·         Welcoming the report and welcoming the findings of the CQC;

·         The indicative rating was testament to the hard work and dedication of staff working across Adult Social Care on behalf of Manchester residents, led by the Executive Director of Adult Social Services; and

·         Noting that this external evaluation of the service provided the Committee with further assurance of the good work and strong leadership of the service.

The Executive Director of Adult Social Services stated that she had welcomed the opportunity to partake in the pilot scheme, noting that it provided an opportunity for an external audit and review of the service and gave the residents of Manchester an assurance in the service provided. She stated that the CQC had met with a number of senior leaders, the Executive Member for Healthy Manchester and Adult Social Care and staff across a range of services and the feedback from the inspectors had been very positive. She stated that the positive feedback from the Committee would be communicated to staff. In response to a Member’s comment regarding a specific case relating to Adult Social Care she advised that if the Member forwarded her the specific details she would make enquiries and liaise with her directly.

The Principal Social Worker stated that the inspection had been an opportunity to showcase the excellent work that was delivered in Manchester. She stated as a result of this experience other Local Authorities had been in contact with a view to learning and adopting the good practice delivered in Manchester.

The Executive Member for Healthy Manchester and Adult Social Care paid tribute to the Executive Director of Adult Social Services and all her staff. He drew the Members’ attention to the section of the report that described that there was a real commitment from leaders for the local authority to be a learning organisation and that Senior leaders, including councillors, had a good understanding of the issues affecting the people of the City of Manchester. He concluded by stating that Manchester was an exemplar Authority and was recognised nationally as a beacon of good practice.

Decision

To note the report.

Report of Executive Director of Adult Social Services

This report is presented to provide information and receive comment on updates to Liberty Protection Safeguards  planning work in progress in preparing for major statutory changes.

The Committee considered the report of the Executive Director of Adult Social Services that provided information updates to Liberty Protection Safeguards (LPS) planning work in progress in preparing for major statutory changes.

Key points and themes in the report included:

·         The Mental Health (Amendment) Act 2019 for England and Wales introduces new statutory changes updating the current Code of Practice Deprivation of Liberty Safeguards (DOLS) to become the new Liberty Protection Safeguards (LPS);

·         The draft code of practice was published in July 2022 and is yet to be finalised;

·         It requires there to be new Responsible Bodies in Health as well as Adult Social Care and key new duties requiring organisational change and staff roles and practice;

·         The main changes widen the scope to those aged 16 from 18 and applicable in all community housing and settings not just those in hospital and 24-hour care where people are assessed as lacking mental capacity to make specific decisions in relation to receiving necessary and proportionate treatment, care and support enabling them to be appropriately involved and independent throughout the process;

·         New duties including evidence assessors put people at the heart of the LPS process and enable the voice of the person by respecting their experience, wishes, values and feelings supported by those who know them, or by independent advocacy throughout the LPS process and review;

·         Information on the Learning Disability / Autism and Mental Health Act reform and the joint work with the Learning Disability and Autism Service and Greater Manchester Mental Health Trust; and

·         Information on the Deprivation of Liberty Safeguards Team.

Some of the key points that arose from the Committee’s discussions were: -

·         Further clarification was sought in relation to that paragraph that described Learning Disability / Autism and Mental Health Act reform; and

·         Further detail was sought in relation to the figures presented within the report.

The Assistant Director Adult Social Care stated that this was a very complex piece of legislation and work was ongoing across a range of teams to understand and plan for its implementation, adding that at the time of reporting the LPS final code of practice was yet to be released. He gave an assurance that this would not change the interventions and support for patients with mental health conditions and would rather strengthen the right of citizens with Autism / Learning Disability, ensuring that the citizen was at the heart of all decision making.

The Chair advised that the Committee would revisit this subject before April 2024 and requested that any future update report included cases studies and examples. The Committee also requested that consideration was given as to how data was presented in reports.

Decision

To note the report and request that an update report is submitted for consideration at an appropriate time.

Report of the Interim Deputy Place Based Lead (Manchester),NHS Greater Manchester Integrated Care; the Director of Strategic Projects, Manchester University NHS Foundation Trust and the Director of Finance, IM&T and Estates, Greater Manchester Mental Health NHS Foundation Trust

This report provides an overview of the key health infrastructure developments in Manchester.

The Committee considered the joint report of the Interim Deputy Place Based Lead (Manchester) NHS Greater Manchester Integrated Care, the Director of Strategic Projects, Manchester University NHS Foundation Trust and the Director of Finance, IM&T and Estates Greater Manchester Mental Health NHS Foundation Trust that provided an overview of the key health infrastructure developments in Manchester.

Key points and themes in the report included:

·         An update on the Wythenshawe Hospital master plan;

·         The developments encompassed under the umbrella of the North Manchester Strategy, including the redevelopment of the North Manchester General Hospital site and the reprovision of the Park House mental health facility; and

·         Key developments in primary care and community estates in the city.

Some of the key points that arose from the Committee’s discussions were: -

·         That a visit and briefing to North Manchester General Hospital be arranged for all North Manchester Councillors, with an invitation extended to all members of the Health Scrutiny Committee;

·         Was there an opportunity to increase the number of jobs and apprenticeship opportunities created through the development and investment in North Manchester;

·         Welcoming the Victoria North Development and asking if consideration had been given to health infrastructure to meet the demands on the local population;

·         Welcoming the improvements identified for North Manchester General Hospital and noting that this had only been made possible as a direct result of the decision taken to disaggregate North Manchester General Hospital from Pennine Acute Hospitals NHS Trust;

·         Expressing disappointment of progress in delivering the Wythenshawe Hospital masterplan;

·         Noting the uncertainty of Government adequately funding the Wythenshawe Hospital masterplan;

·         Noting the challenges and limitations presented by current Treasury rules in securing alternative funding opportunities to deliver the Wythenshawe Hospital masterplan;

·         Calling for the continued lobbying of Government to secure funding to deliver the Wythenshawe Hospital masterplan;

·         Expressing concern that Manchester University NHS Foundation Trust would utilise New Hospital Programme fees for 2022/23 to fund resource to March 2023, noting that there was currently no funding beyond March 2023 in place, noting that this situation could have implications for both North Manchester and Wythenshawe sites;

·         Had the issues relating to historic Private Finance Initiatives (PFI) and associated contractual arrangements been addressed at Wythenshawe Hospital;

·         Recognising that the number of GP practices was as a result of practices consolidating;

·         Was there any information relating to the provision of dentist practices; and

·         Had the views of service users been taken into consideration during the design of the Park House inpatient mental health facility.

The Interim Deputy Place Based Lead, NHS Greater Manchester Integrated Care informed the Committee that a letter dated 10 January 2023 from Manchester partners, headed by the Leader of the Council and the Chief Executive of MFT had been sent to the Secretary of State for Health and Social Care emphasizing again the vital importance of the North Manchester General Hospital redevelopment proposals. He further commented that he was happy to facilitate a visit and briefing at North Manchester General Hospital for all North Manchester Councillors, with  ...  view the full minutes text for item 5.

Report of the Governance and Scrutiny Support Unit

The monthly report includes the recommendations monitor, relevant key decisions, the Committee’s work programme and items for information. The report also contains additional information including details of those organisations that have been inspected by the Care Quality Commission.

The report of the Governance and Scrutiny Support Unit which contained key decisions within the Committee’s remit and responses to previous recommendations was submitted for comment. Members were also invited to agree the Committee’s future work programme.

The Chair commented that the 24 May 2023 meeting would be dedicated exclusively to scrutinising improvements at the Greater Manchester Mental Health Trust.

Decision

The Committee notes the report and agrees the work programme, noting the above comment.