Agenda and minutes
Health Scrutiny Committee
Tuesday, 4th December, 2018 10.00 am
Venue: Council Antechamber, Level 2, Town Hall Extension
Contact: Lee Walker
Webcast: View the webcast
To approve as a correct record the minutes of the meeting held on 6 November 2018.
To note the minutes of the Public Health Task and Finish Group meeting held on 26 October 2018.
The minutes of the meeting held on 6 November 2018 and the minutes of the Public Health Task and Finish Group were submitted for approval and note. Cllr Riasat requested that his attendance at both meetings be recorded.
1. To approve the minutes of the meeting held on 6 November 2018 as a correct record subject to the above amendment.
2. To note the minutes of the Public Health Task and Finish Group meeting held on 26 October 2018 subject to the above amendment.
The Committee will consider the reports detailed below as part of the 2019/20 budget refresh process.
The Committee considered a report of the Chief Executive and the City Treasurer which provided an update on the Council’s financial position and set out the next steps in the budget process. The report summarised Officer proposals for how the Council could deliver a balanced budget for 2019/20.
In conjunction to the above, the Committee also received and considered the Manchester Health and Care Commissioning Pooled Budget 2019/20, Including Adult Social Care, which set out in broad terms the directorate’s key priorities, key activities and Homelessness Business Planning: 2019/20, which was a refresh of the directorate’s Business Plans for 2018/20 in the context of current resources, challenges and opportunities.
Taken together, the report and the directorate Business Plan illustrated how the directorate would work together and with partners to deliver Our Plan and progress towards the vision set out in the Our Manchester Strategy.
Homelessness Business Planning: 2019/20
The Deputy Leader addressed the Committee regarding the issue of homelessness in Manchester stating that the impact of austerity and welfare reform had a significant impact on the levels of homelessness and people who sleep rough, and this presented a significant challenge. She described how Manchester was responding to this challenge by investing in preventative services, utilising the Social Impact Bond that was funding available from the Ministry for Housing, Communities and Local Government (MHCLG) that was conditional on achieving positive outcomes through a payment by results model. She further advised that properties were being purchased to accommodate families and commented that the legal lessons learnt from this exercise would inform any future purchases to reduce the time taken to secure these.
Members noted the Cold Weather funding from the MHCLG of £35,000 for cold weather winter provision for people who sleep rough and commented that this was an inadequate amount for the scale of the challenge. A Member further enquired if any impact assessments of Universal Credit had been undertaken. The Strategic Lead for Homelessness responded by saying that the Welfare Reform Board did monitor and analyse the impact of Universal Credit and information on this would be shared with the Committee. She further commented that they were currently lobbying the MHCLG for additional funding and a decision on this was pending. In response to a comment from a Member regarding the provision of hot water at a facility she said that she was unaware of any issue, however she would make appropriate enquiries.
Members then discussed the issue of Private Sector Landlords and the use of retaliatory Section 21 Notices (eviction notices) if a tenant complained about disrepair in a property. The Deputy Leader responded by saying that she acknowledged the comments made and that the Executive Member for Housing and Regeneration was undertaking work around this issue as part of a broader piece of work around the Private Rented Sector. She said that inspections of private properties were undertaken before placing people in them and officers would reject a property if unsuitable and then work with the ... view the full minutes text for item 50.
Report of the Director of Adult Social Care and the MHCC Chief Accountable Officer
This report sets out the priorities for MHCC during the 2019/20 financial year. It describes the MHCC’s operational plan and progress towards the vision set out in the Our Manchester Strategy. The report provides an update on MHCC’s financial plan for 2019/20, reflecting the Manchester Health and Care Locality Plan and Adult Social Care Business Plan for the period 2017-2020. The report sets out both the progress made to date in delivering savings and the focus over the next year of the three year plan. The report is a refresh of the Joint Financial Plan for MHCC for 2018-20 in the context of changing resources, challenges and opportunities – with a specific focus on the Adult Social Care and Population Health components of the plan.
Report of the Clinical Director, Manchester Health and Care Commissioning
This report provides information on how Manchester Health and Care Commissioning (MHCC) is working collaboratively with partners on a respiratory work programme. The aims are to improve health outcomes and quality of life for patients, support self-management, personalisation and early intervention in the community; and strengthen the quality of end of life care.
HSC/18/51 Adult Respiratory
The Committee considered the report of the Clinical Director, Manchester Health and Care Commissioning(MHCC) that described how MHCC were working collaboratively with partners with the ambition to improve health outcomes and quality of life for patients, support self-management, personalisation and early intervention in the community; and strengthen the quality of end of life care.
The Clinical Director referred to the main points of the report which were: -
· Describing the work of NHS RightCare teams, who worked locally with systems to present a diagnosis of data and evidence across the population to identify opportunities and potential areas where quality could be improved;
· A description of the work streams identified by the Manchester Adult Respiratory Steering Group;
· A data analysis of respiratory emergency admissions for the first 6 months of 17/18 compared to the first 6 months of 18/19, noting the considerable pressure in emergency admissions for respiratory patients and how providers were managing these admissions;
· A description of the Primary Care Respiratory Standards developed by MHCC;
· The work underway to review how these standards were applied to those in receipt of Homecare;
· A description of the COPD (Chronic Obstructive Pulmonary Disease) Virtual Clinic and the impact of this innovation;
· An update on the procurement and distribution of spirometers, noting that Spirometry was a simple test used to help diagnose and monitor certain lung conditions by measuring how much air you could breathe out in one forced breath;
· A description of the Manchester Integrated Lung Service;
· A description of the collaborative work undertaken by Primary, Community and Secondary Care to produce the Manchester Respiratory Referral Criteria that covers the minimum information that should be contained in all respiratory referral letters;
· A description on Pulmonary Rehabilitation, a programme of exercise and education for people with long-term lung conditions;
· The programmes developed through Health Innovation Manchester (HIM);
· The activities to address smoking including information on the CURE Project;
· An update on the developments in relation to social prescribing with a description of the Breathe Better model; and
· Information on the partnership work undertaken in Greater Manchester.
Members welcomed the report and noted the information that had been provided that gave the numbers of COPD and Asthma reviews undertaken at a ward level, and requested that this information, along with other relevant health data is shared with local Members.
In response to a comment regarding the difference in figures relating to these reviews across wards the Clinical Director Members commented that establishment of Neighbourhood Teams would address the issue of variation across the city. The Chair sought clarification as to why some practices appeared to be undertaking significantly more reviews than others. The Primary Care Information Manager responded by saying that this was primarily due to Practices not recording the information correctly on the system. He advised that this information was collected periodically and enquiries were made to individual practices if their returns were low. He said advice and training was offered to those sites to ensure this information was accurately ... view the full minutes text for item 52.
Report of Strategic Director of Children and Education Services, Executive Director of Nursing and Safeguarding, Manchester Health and Care Commissioning and Director of Population Health and Wellbeing
This report provides an overview of work that is being done and work that is plannedto improve the experience and outcomes of those young people moving from children and young people services to adult services and to improve the experience for their families and carers too.
The Committee considered the report of the Strategic Director of Children and Education Services, Executive Director of Nursing and Safeguarding, Manchester
Health and Care Commissioning and the Director of Population Health and Wellbeing that provided an overview of work that was being done and work that was plannedto improve the experience and outcomes of those young people moving from children and young people services to adult services and to improve the experience for their families and carers too.
The Executive Director of Nursing and Safeguarding referred to the main points of the report which were: -
· Describing the services for children and young people and the developments that brought together children and adult social workers under the same management, based in the same team;
· Describing the impact of The Care Act 2014 and the changes that this brought about;
· Describing the 4+1 review process and the strengths and challenges identified and what was being done to address these;
· The work undertaken around the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) and Complex Placements;
· Work delivered around young people’s specialist substance misuse services and the integration of the Eclypse service into the wider integrated adult drug and alcohol service that has afforded the opportunity to develop the approach to supporting young adults who may require treatment beyond the age of 18; and
· Information on reproductive and sexual health services for young people.
Members commented that it needed to be recognised that the transition from services could be a very stressful and worrying period for those in receipt of services, their families and carers and everything should be done to make this transition as seamless as possible. The Executive Member for Adults, Health and Wellbeing said this was acknowledged and understood and the approach adopted was a holistic one. She further commented that she was committed to working with her Executive colleagues to improve transiton.
In response to comments from Members regarding Learning Disables citizens the Director of Adult Services said that a lot of work had been undertaken by the Assistant Executive Member to better integrate services. She said that this work had been overseen by the Learning Disability Partnership Board and that a report on this activity would be reported to the Committee at an appropriate time.
The Assistant Executive Member for Adults, Health and Wellbeing commented upon the work undertaken with teams to improve the transition period with the various teams working much more closely together. She further commented that the workshops that had been arranged to consider this area of work had included parents and carers so that their opinions and experiences were captured. A Member asked that Members be invited to any workshops so they could observe the work that undertaken. The Member further commented that when an update report was submitted for consideration that this would include anonymous case studies.
The Executive Member for Children’s Services commented that whilst he recognised the improvements ... view the full minutes text for item 53.
Report of the Public Health Task and Finish Group
This report presents the findings of the detailed investigation undertaken by the Public Health Task and Finish Group.
The Committee received the final report and recommendations of the Public Health Task and Finish Group and were invited to note the findings of the investigation and endorse the eight recommendations.
Councillor Wilson, Chair of the Task and Finish Group commented upon the importance of Public Health in improving the health outcomes of Manchester residents and called for continued lobbying of central government for a fairer funding deal for Manchester. In response to comments from Members regarding other wider determinants of health he said that he acknowledged this and said that the Group had agreed to focus on the specific areas as described in the report.
The Executive Member for Adults, Health and Wellbeing acknowledged the comments regarding the wider determinants of health, such as housing conditions and reassured the Committee that work was continuing to address these issues.
The Committee: -
1. Note the findings of the Public Health Task and Finish Group;
2. Endorse the eight recommendations of the Public Health Task and Finish Group; and
3. Recommend that the Executive Member for Adults, Health and Wellbeing provide an update report on the implementation of these recommendations to the Committee at an appropriate time.
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
(CQC) within Manchester since the Health Scrutiny Committee last met.
A 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.
To note the report and approve the work programme.