Agenda and minutes
Health Scrutiny Committee - Tuesday, 8th October, 2019 2.00 pm
Venue: Council Antechamber, Level 2, Town Hall Extension
Contact: Lee Walker
To approve as a correct record the minutes of the meeting held on 3 September 2019.
To approve the minutes of the meeting held on 3 September 2019 as a correct record.
Report of The Director of Population Health, Nursing and Safeguarding, Manchester Health and Care Commissioning
This report provides the Committee with an update on the paper on suicide prevention submitted in December 2017 and specifically reports progress on the delivery of the local suicide prevention plan (2017 - 2019) and on the development of a refreshed plan for 2020 – 2025.
The Committee considered the report of the Director of Population Health, Nursing and Safeguarding, Manchester Health and Care Commissioning that provided Members with an update on the paper on suicide prevention submitted in December 2017 and specifically reported progress on the delivery of the local suicide prevention plan (2017 - 2019) and on the development of a refreshed plan for 2020 – 2025.
The Director of Population Health referred to the main points of the report which were: -
· The national and local strategic context of suicide prevention;
· Key trends, facts, figures and risk factors relating to suicides in Manchester;
· A summary of key areas of activity contributing to suicide prevention;
· Progress on delivery of specific actions within the local plan; and
· Development of a refreshed plan for 2020 – 2025.
The Committee then heard from Prof Navneet Kapur, Head of Research at the Centre for Suicide Prevention, University of Manchester. He informed the Members that the issue of suicide prevention had begun to take a more prominent role both locally and nationally, commenting that a Minister for Suicide Prevention had been appointed. He stated that nationally, NICE (National Institute for Health and Care Excellence) guidance had been refreshed and published in relation to both suicide prevention and self-harm. Locally he described the work undertaken to raise awareness of this issue and described the work of the Greater Manchester Shine a Light campaign delivered to coincide with World Suicide Prevention Day, and the powerful Exhibition of Hope delivered in the Town Hall that had been designed and coproduced with people who had experience of suicide. He further described the establishment of a dedicated Bereavement Service, to support people affected by suicide.
Prof Kapur further described recent changes to the legal recording of suicides. He stated that previously a coroner had to apply the criminal test of ‘beyond reasonable doubt’ when determining cause of death. He said that this had changed and the test now was ‘balance of probability’. He stated that this had the potential to increase the number of recorded deaths by suicide, and in response to a question from a Member he advised that consideration would be given to how this data was used to understand comparative information to reflect this change.
The Committee then heard from Cllr Midgley, Mental Health Champion who described the work of the Manchester Suicide Prevention Partnership. She informed Members that the partnership steering group met regularly and oversaw the operational delivery of the local suicide prevention plan and shaped the strategic direction of this work. She described that the Partnership was comprised of a range of stakeholders and they were all committed to working together. She further described examples of this and the positive outcomes achieved by adopting this approach. She stated that the Partnership was working to deliver awareness training around this issue to frontline workers, including staff working within housing providers and school nurses. She described that demand for this training was very high and they were continuing to ... view the full minutes text for item 35.
Report of Director of Public Health/Population Health Consultant in Public Health
As part of the statutory role of the Director of Public Health there is a requirement to produce an annual report on the health of the local population. This report can either be a broad overview of a wide range of public health programmes and activities or have a focus on a particular theme. The 2019 report has a focus on the first 1,000 days of a child’s life, from conception through to the age of 2 years old.
The Committee considered the 2019 Public Health Annual Report prepared by the Director of Public Health/Population Health Consultant in Public Health that focused on the first 1,000 days of a child’s life, from conception through to the age of 2 years old.
The Director of Public Health referred to the main points of the report which were: -
· In 2018 there were an estimated 37,768 children aged 0-4 years old in Manchester, accounting for 8.3% of the population;
· Providing comparative data on a range of health indicators and metrics;
· Providing information on the range of activities and initiatives to tackle health inequalities within the first 1,000 days of a child’s life using an Our Manchester approach to Bring Services Together for People in Places;
· Noting Under 18 conception rates had reduced;
· The number of mothers smoking during pregnancy had reduced;and
· Providing an update on the Start Well Board, a multi-agency Board established to improve health outcomes, ensure children were ready for school, ensuring a good level of development throughout early years, reduce infant mortality and reduce inequality.
The Committee welcomed Councillor Bridges, Executive Member for Children and Schools who said that the report was a very accessible document. He stated that it was important to recognise the impact of austerity and the levels of childhood poverty experienced across the city and the impact this had on health outcomes. He stated that the Early Years Delivery Model was a partnership approach and the intention was to increase the numbers of Health Visitors to respond to the increase in demand. He concluded by saying that he commended the report and its recommendations to the Committee.
In response to a question from a Member regarding the recruitment of Health Visitors the Director of Public Health informed the Committee that the intention was to recruit an additional 108 Health Visitors over a four year period. He said that they were seeking to attract experienced nurses to attend the one year course delivered by the Manchester Metropolitan University.
Members discussed the negative and detrimental impact austerity and welfare reform had on the health outcomes of young people in Manchester. Members commented that this influenced wider determinants of health, such as homelessness, poor housing conditions within the Private Rented Sector and fuel poverty, and this needed to be addressed. A Member commented that more needed to be done to regulate and enforce standards within the Private Rented Sector to improve standards for people and families.
The Consultant in Public Health responded by stating that they had good relationships with Housing Providers however the challenge remained to address issues experienced within the Private Rented Sector. She said the multiagency approach in Neighbourhoods would help identify residents at risk and sign post for assistance with issues such as fuel poverty.
The Consultant in Public Health acknowledged that the levels of Infant Mortality in the city were the same as they were 25 years ago. She said that the link between poverty and health outcomes was understood and ... view the full minutes text for item 36.
Report of the Head of Policy and Planning, Manchester Health and Care Commissioning (MHCC), the Head of Operational Finance, MHCC and the Performance Lead, MHCC
This report provides the Committee with information on the NHS Long Term Plan (LTP), published in January 2019, that set out a ten year programme of phased improvements to NHS services and outcomes, including a number of specific commitments to invest the agreed five year revenue settlement.
This has been followed in June 2019 by the publication of the NHS Long Term Plan (LTP) Implementation Framework.
The Committee considered the report of the Head of Policy and Planning, Manchester Health and Care Commissioning (MHCC), the Head of Operational Finance, MHCC and the Performance Lead, MHCC that informed Members on the NHS Long Term Plan (LTP), published in January 2019, that set out a ten year programme of phased improvements to NHS services and outcomes, including a number of specific commitments to invest the agreed five year revenue settlement.
The Head of Policy and Planning, MHCC referred to the main points of the report which were: -
· An overall summary of the guidance;
· National financial analysis;
· National Performance Indicator Requirements;
· National five year planning submission; and
· Key planning milestones across health over the next 6 months.
The report was accompanied by a presentation that summarised the information provided within the report.
Members commented that the Financial Tests described appeared to be extremely challenging, in particular the requirement to reduce growth in demand and return a financial balance in light of the inadequate funding for services. A Member commented that experience had demonstrated that notions of fair funding for Manchester were anything but fair and asked if there was any indication at this stage as to what the funding would be for Manchester.
The Head of Policy and Planning, MHCC informed the Committee that the funding for Manchester was not currently known. Members expressed concern at this and questioned how any plans for important services, such as Mental Health Services could be confidently made if the funding arrangements had not been finalised.
The Head of Operational Finance, MHCC responded by informing the Committee that the Clinical Commissioning Groups were planning based on assumptions on previous funding levels pending any decisions.
In response to comments from Members regarding the complexity and bureaucracy to set and agree budgets, the Head of Operational Finance, MHCC advised the Committee that they were working with colleagues in Adult Social Care and all partners so that the resultant single MHCC plan would encompass health, public health and adult social care.
Members discussed the use of technology and a move towards online consultations and sought further explanation regarding the NHS App. The Head of Policy and Planning, MHCC stated that online consultations were to be used for secondary care and follow up consultations and not solely for primary care consultations. The Performance Manager informed the Committee that the NHS App allowed patients to check their symptoms, book appointments, request repeat prescriptions, view their own personal records and register to become an organ donor.
A Member commented that funding should be used to reintroduce Walk In Centres to assist those patients who were unable to secure an appointment with their own GP and to avoid the number of unnecessary presentations at Accident and Emergency Departments. The Member commented that whilst the NHS App could be useful for some, the majority of people still required face to face consultations and discussions with a health professional. The Member further commented that we were about to enter the winter ... view the full minutes text for item 37.
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.
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.
The Chair informed the Committee that the Work Programme would be updated to reflect the reports requested during consideration of the previous agenda items.
To note the report and approve the work programme subject to the above amendments.