Agenda and minutes

To receive any apologies for absence received.

Apologies were received from Cllrs Steve Forster and Jan Warwick.  Cllr Neville Penman, as the Conservative standing deputy, was in attendance in their absence.

All Members who believe they have a Disclosable Pecuniary Interest in any matter to be considered at the meeting must declare that interest and, having regard to the circumstances described in Part 3 Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore all Members with a Non-Pecuniary interest in a matter being considered at the meeting should consider whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, consider whether it is appropriate to leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with the Code.

Members were mindful that where they believed they had a Disclosable Pecuniary Interest in any matter considered at the meeting they must declare that interest at the time of the relevant debate and, having regard to the circumstances described in Part 3, Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter was discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code.  Furthermore Members were mindful that where they believed they had a Non-Pecuniary interest in a matter being considered at the meeting they considered whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, considered whether it was appropriate to leave the meeting whilst the matter was discussed, save for exercising any right to speak in accordance with the Code.

No declarations were made.

To confirm the minutes of the previous meeting

The Minutes of the meeting of the Health and Adult Social Care Select Committee (HASC) held on 20 June 2017 were confirmed as a correct record.

There were two matters arising from the Minutes:

·         Minute 3: The Chairman had circulated the response from the Executive Member, and would leave the local County Councillors to take forward the suggestion to work with the Kings Worthy Parish Council.

·         Minute 9: The Care Quality Commission report has not yet been published for the Trust; once available, this would be distributed to the Committee.

To receive any deputations notified under Standing Order 12.

No deputations were received at this meeting.

To receive any announcements the Chairman may wish to make.

The Chairman did not make any announcements.

To consider progress made against the core programme areas of the Sustainability and Transformation Plan for Hampshire and the Isle of Wight

The Sustainability and Transformation Plan (STP) Director of Transformation and Delivery attended for this item alongside officer leads for the work streams covering estates, workforce and new models of care/the GP forward view (see Item 6 in the Minute Book).  The Director of Adults’ Health and Care and the Director of Public Health also joined the meeting for this item, in order to speak to work streams they were leading or contributing to.

The Director of Transformation and Delivery noted that she was newly in post and responsible for overseeing the 11 programmes taking place under the STP heading, which covered the geographical areas of Hampshire, Isle of Wight, Portsmouth and Southampton.  The STP itself was incredibly broad and wide-ranging in its delivery, and therefore there was a significant amount of information in the update.  The HASC would wish to consider how it could break down this information in future, but the aim of today’s session would be to drill down in to the areas of estates, workforce and primary care.

Currently the STP was on course to deliver a surplus, but this was not guaranteed; to this end, significant work was being undertaken to understand the financial risks, with mitigation plans put in place where needed.  This also included checking the commissioner and provider alignment, ensuring that there was a system-wide approach to cost reduction, and no risk of cost shunting from one part of the NHS to another, or from health to social care.  The efficiencies and savings that successful implementation of the STP might realise would see benefits for both providers and commissioners, with, for example, better sharing of back office functions fundamental to savings being achieved.  Another key area where savings could be achieved just through better partnership working was procurement, and using the purchasing power of large organisations working together.

Southern Health NHS Foundation Trust had recently taken the decision as part of their clinical strategy to cease the provision of community physical health services, which would require a transition of these services to a new provider.  Southern Health had requested that this take place by April 2019, when contracts were due to end, and would from this time be a specialist mental health and learning disabilities provider.  A transition board had been set up to this end, with Hampshire CCG Partnership leading this work.  The key aim of this work would be to ensure that services remained safe and of a high quality whilst a new provider was procured.

Overviews were provided of core delivery and enabling programme activity.  Further to the paper circulated, Members heard:

·         That it was important that the STP remained linked into national work in order to exploit resources available and learn from best practice in other areas.

·         That work was being accelerated around out of hospital care, and ensuring that primary care was sustainable.  The STP aimed to enable best practice to be shared and built on faster through local delivery systems.  This would be achieved by setting a  ...  view the full minutes text for item 17.

To receive an overview of the next steps for Adults’ Health and Care in the Transformation to 2019 programme.

The Director and Deputy Director of Adults’ Health and Care attended before the Committee in order to present the Transformation to 2019 report, as well as an accompanying presentation (see Item 7 in the Minute Book). 

Members noted that briefings on Transformation to 2019 were starting to begin, which would see an additional £140m in savings from the County Council’s budget being identified over the next two years.  Of this, £56m would need to be achieved by Adults’ Health and Care.

The report and presentation aimed to provide the Committee with details around the previous transformation programmes, as well as an overview of the potential work streams in the future.  Paul Archer, the Deputy Director, had previously led a number of cost reduction programmes across the Council in his other role as Director of Transformation and Governance, and would bring this experience to Adults’ Health and Care.

Although the transformation programmes often focused on cost-saving, many of the changes since 2010 have seen investments in technology in order to

work as digitally as possible, enabling frontline workers to spend the largest proportion of their time helping people.  Further efficiencies would not result solely in cost reduction through contracts, but would focus more on innovation, reducing specifications where this was not helpful to providing sustainable services, and improving joint working.

The outline budget for Transformation to 2019 would be heard in September, which would outline the major themes of this work:

·      Prevention and demand management

·      Older People and Physical Disabilities – assisting to live (more) independently

·      Learning Disabilities and Mental Health – assisting to live (more) independently

·      Working differently

Similar to the discussions held during the STP item, the Department were aware that changes made should not shunt costs from one organisation to another, and that service users needed to be at the heart of changes proposed.  Additionally, it would be important to remain alive to ensuring that changing ways of working would not result in service users presenting with greater challenges in future because prevention has not central to services.

The £37m being allocated over a three-year period would be monitored by the Health and Wellbeing Board and the Department of Health, and the aim of this funding was primarily investing to save.

In response to questions, Members heard:

·      The ‘Balancing the Budget’ public consultation began at the start of July and would run towards the end of August.  The decision-making cycle would work to a February Full Council budget meeting.

·      That funding for disabled facilities grants are paid to upper tier authorities and routed to District and Borough Councils, a sum of approximately £10m a year.  Decisions on such grants should be collaborative, as the County Council has the social care responsibility and is often therefore required to make recommendations to the District or Borough Council for their funding approval.

·      The County were aware that each District and Borough Council in Hampshire also have their own efficiencies to make and corporate priorities, but the question should still be asked  ...  view the full minutes text for item 18.

To consider and approve the Health and Adult Social Care Select Committee Work Programme.

The Director of Transformation and Governance presented the Committee’s work programme (see Item 8 in the Minute Book). 

RESOLVED:

That the Committee’s work programme be approved, subject to any recommendations made at the meeting.