Agenda and minutes

To receive apologies for absence and notice of substitutes.

Apologies were received from Councillors Curnow-Ford and Craig  with Councillors Ford and Hiscock deputising.  Co-opted member Cllr Garton gave her apologies.

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 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 Personal

Interest in a matter being considered at the meeting should consider,

having regard to Part 5, Paragraph 4 of the Code, whether such interest

should be declared, and having regard to Part 5, Paragraph 5 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.

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 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 Personal

Interest in a matter being considered at the meeting should consider,

having regard to Part 5, Paragraph 4 of the Code, whether such interest

should be declared, and having regard to Part 5, Paragraph 5 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.

To approve the minutes of the meeting of the Committee held on 21 November 2023.

The minutes of the meeting of the Committee held on 21 Novemer 2023 were agreed as a correct record.

To receive any announcements the Chairman may wish to make.

Cllr Withers highlighted the following:

Winter illness In recent weeks winter infections data has shown a mixed picture, though there are very early signs that cases of flu and COVID-19, as well as another winter virus called RSV, might be decreasing in the South East region. Vigilance is required, however, as an increasing trend in these infections continues to be seen at national level. There are also signals that the recent yellow and amber cold weather alerts have had an impact on healthcare service demand. The cold weather has the potential to impact the whole population, both young and old. There is particular risk to those aged 65+ and some other vulnerable groups, such as those sleeping rough and those with long-term health conditions, including respiratory and cardiovascular conditions.

Changes to Health Scrutiny powers – Local authorities’ powers of referral to the Secretary of State have been removed. Instead of the referral power, health overview scrutiny committees and other interested parties can write to request (via a call-in request form) that the Secretary of State consider calling in a proposal. DHSC expects requests only to be used in exceptional situations where local resolution has not been reached. Such a request will then be considered as set out in the statutory guidance.

Portsmouth Medical School – it was pleasing to see the announcement last month that Portsmouth University is going to be training doctorslocally.

Autism and dementia training - There were two very informative presentations at the December member briefing session that were discussed at this Committee and at Children’s Services on autism and dementia. 

Joint Health Overview & Scrutiny Committee for Frimley Park – the Chairman updated the Committee on the proposals for a new hospital.  It was agreed that the Council would appoint members to a Joint Committee.

To receive any deputations notified under Standing Order 12.

The Chairman set out the context for the deputation and agenda item 6/minute 163 – the  proposed changes include, three new builds, three major refurbishments, seven residential home closures, closures of three further standard residential services and the closure of the Solent Mead Day Service.

The Cabinet had approved, in principle, the proposed investment programme that covers the different elements at its meeting of 18 July 2023, subject to the public consultation. 

He called on Anita Barry and Amber Channon to make their deputation in relation to item 6 on the agenda – HCC Care Older Adults Portfolio – Proposed Service Changes.

The deputation was received and the Chairman thanked the speakers.

To pre-scrutinise findings of the Health and Adult Social Care Select Committee Working Group in their work looking at the HCC Care Service proposals formal public consultation, which will be considered by the Executive Lead Member for Adult Social Care and Public Health at her Decision Day on the 8 February 2024.

The Committee received an overarching report (item 6 in the minute book) from the Director of Adults’ Health and Care setting out (i) the draft report of the Care Homes Working Group and (ii)  the draft report of the Director of Adults’ Health and Care for the Executive Lead Member for Adult Social Care and Public Health’s Decision Day on 8 February.  The Insight and Engagement report initially received and reviewed by the Care Homes Working Group was set out in full.

Having previously summarised the context for this item in minute 162 above, the Chairman invited Cllr A Briggs as Chairman of the cross-party Care Homes Working Group to present its findings.

Cllr Briggs outlined the composition and purpose of the working group which was to oversee the public consultation, analyse its results and make recommendations to the Committee.

She emphasised:

(i)            the Working Group’s recognition of the needs and concerns of the 77 residents directly affected by the proposals who lived at the homes proposed for closure;

(ii)          The visits to care homes undertaken by Working Group and several Committee members

On the visits, members had witnessed significant constraints in the delivery of care at Bishops Waltham House and at Emsworth House. These included cramped conditions, personal space that is inadequate, doesn’t meet Care Quality Commission floorspace standards and narrow/tight corridors.

Members had witnessed challenging conditions that staff are asked to operate in and we also noticed other limitations such as inadequate storage space and equipment space challenges.

The lack of personal dignity was of real concern to all members of the Working Group, with the lack of toilets in residents’ rooms, and the need for commodes.

It was noted that Copper Beeches and Cranleigh Paddock had previously been temporarily closed for operational reasons and that permanent closure was part of the proposals.

The Chairman introduced a “virtual visit” video that portrayed the above factors in two of the homes.  It also showed a more modern care environment where more space was available.

Cllr Briggs summarised the findings of the consultation in relation to the care homes under consideration, a full report on which was included in the agenda papers. The Working Group noted that the greatest opposition expressed was to the three proposed full closures.

Members of the Committee raised points as follows:

·         Officers would work with other professionals to mitigate visitor travel impacts

·         There were eight double rooms at Bishops Waltham converted from single rooms

·         There was concern about residents’ dignity in some of the existing settings

·         Resident moves were always handled compassionately

·         Larger homes of 80 beds were sub-divided into units of 20 bedrooms

The recommendations to the Committee from the Working Group, passed unanimously, were set out in the report as follows:

That the Committee

a)         Acknowledge that a robust cross-party Working Group process, Chaired by Councillor Briggs, and consisting of 9 HASC Members, has been in operation since it was established at the end of July 2023. 

b)         Note that Member Working Group  ...  view the full minutes text for item 163.

To consider the report on proposals from the NHS or providers of health services relating to the planning, provision and/or operation of health services in the area of the Committee.

The Committee received a report (item 7 in the minute book) setting out updates from NHS partners on the following matters:

·         Maternity – CQC presentation

·         Winter plan update (including presentation slides from South Central

·         Ambulance)

·         Primary Care Access

·         Strategic Update on primary care networks

·         Whitehill and Bordon Health Hub

Maternity

The Chairman welcomed Julie Dawes and Liz McLeod from Hampshire Hospitals and Margaret Beattie from Hampshire & IoW ICB to address the circulated slides. The slides summarised progress against a number of areas Care Quality Commission actions, safe staffing and listening to patients and staff. 

It was noted that the Trust’s exit from the national programme of support was due to be considered by the National Quality Board.  In relation to questions about  supporting staff with incidents and claims, the National Patient Safety Response Framework was being implemented which promoted a just learning culture.  The issue did not feature strongly in exit interviews.

Communication was the most frequently occurring complaint theme.  The process for handling hospital complaints and concerns was discussed.

Winter pressures

The Chairman welcomed Sara Tiller from the Hampshire & IoW ICB, Paul Jefferies from South Central Ambulance, Paula Anderson from Southern Health and Julie Dawes remained for this item. 

The principal components of the winter plan were described, including keeping people safe at home and effecting the discharge of patients who were deemed no longer to meet the criteria to reside in hospital.  There had been some increased in discharge capacity which had helped to improve length of stay but it remained a challenge to discharge patients in a timely manner.  Provider trusts monitored re-admissions. Discharge of patients with complex needs remained complex to manage effectively across multiple agencies; all agencies had a stake in the discharge process.

In relation to ambulance activity, the following principal points were noted:

·         Category 2 calls made up c55 of calls; category 1 was 6-9%

·         Ambulance delays at hospitals were a factor in a busy winter season

·         The ambulance trusts deployed Hospital Ambulance Liaison Officers to help manage flow

·         Patients were cared for in ambulances while awaiting transfer to hospital

·         Retention of staff was improving and the Trust had a range of support and incentives

More detailed, comparative data on handover delays was requested for the March meeting of the Committee.

Primary Care and Primary Care Networks

The Chairman welcomed Martyn Rogers to support this item, which was led by Sara Tiller.  The Primary care Recovery Plan, described in the report, was highlighted.  

Challenges around primary care access in the Basingstoke area were highlighted by Cllr Taylor.  She described a range of long-standing issues about improving GP access and problems with the effectiveness of the patient participation groups in the locality and whether registered patients were allowed to join.

It was noted that GPs  submitted an annual report to the ICB about the complaints they had handled.

It was agreed to return to the topic of GP access with more information at a future meeting.

Whitehill & Bordon Health Hub

The Chairman welcomed Lisa  ...  view the full minutes text for item 164.

To pre-scrutinise a report for the Executive Lead Member for Adult Social Care and Public Health from the Director of Adults’ Health and Care and Director of Corporate Operations on the proposed capital programme for 2024/25 and provisional capital programme for 2025/26 and 2026/27, the revised capital programme cash limit for 2023/24 along with transfers between years and the carry forward of resources.

The Committee received a report (agenda item 8 in the minute book) to pre-scrutinise the proposals for the Capital programme for 2024/25, 2025/26 and 2026/27 ahead of the Decision Day of Executive Lead Member for Adult Social Care and Public Health. 

The slides showed a porposed capital programme for 2024/25 of £187,733k.

RESOLVED To support the recommendations being proposed to the Executive Lead Member for Adult Social Care and Public Health in of the report.

To pre-scrutinise a report for the Executive Lead Member for Adult Social Care and Public Health from the Director of Adults’ Health and Care, Director of Public Health and Director of Corporate Operations, which sets out proposals for the 2024/25 budget for Adults’ Health and Care in accordance with the Councils Medium Term Financial Strategy (MTFS) approved by the County Council in November 2023. It also proposes a revised budget for Adults’ Health and Care for 2023/24.

The Committee received a report (agenda item 9 in the minute book) the Health and Adult Social Care Select Committee to pre-scrutinise the proposals for the 2024/25 budget for Adults Health and Care ahead of the Decision Day of Executive Lead Member for Adult Social Care and Public Health.

The slides highlighted the local government finance settlement for 2024/25 which would leave the Council with a with a predicted gap of at least £86m.  The budget for adults social care was expected to be £584,760k and £56,187k for public health. 

There was a savings requirement of £5m for achieve in 2024/25. The local government pay award had not been factored in and the National Living Wage had been increased.  Other pressures arose from inflation, and the support needs for people over 65 years being discharged from hospital. However it was confirmed that no new savings were being presented today.

As some members felt unable to support the revenue budget, the Chairman called a vote.

RESOLVED To support the recommendations being proposed to the Executive Lead Member for Adult Social Care and Public Health in the report.

To note a verbal update from the first meeting of the SP25 Working Party.

Following approval at the 21^st November 2023 meeting, a Task and Finish Working Group was established in order to assist the Adults’ Health and Care Directorate with the decision-making process in respect of its SP25 proposals and the associated Stage 2 Consultations.  The agreed purpose of the Working Group is to oversee and scrutinise the approach and outcomes of the Stage 2 Consultation relating to the adult social care grants programme for voluntary, community and social enterprise organisations, the withdrawal of all funding for non-statutory Homelessness Support Services and proposals relating to changes to the way in which contributions towards non-residential social care costs are calculated. 

The Working Group met for the first time on the 18^th December and were provided an overview of the approach being taken for the consultation, including the engagement being undertaken corporately, as well as the additional tailored engagement with potentially impacted stakeholders for each AHC proposal.  The Working Group were also provided with the proposed mitigations if the decision were to be made to approve these proposals.

The Future Services public formal Consultation was launched on 8January and runs for 12 weeks concluding on 31 March 2024.  The Working Group will meet again on 7^th February with a further two meetings currently planned.

To receive the updated work programme.

The Committee received the updated Work Programme (agenda item 11 in the minute book)  for informaiton.

The Chairman requested an update on Continuing Health Care for the next meeting.