Agenda and minutes

Apologies for absence are listed above.

Members of Health Scrutiny Committee are asked to consider whether they have an interest in any of the matters on the agenda and if so, to formally declare that interest.

There were no declarations of interest.

The minutes from the meeting held on 29^th January 2025 are attached for approval.

The minutes of the meeting held on 29^th January 2025 were agreed as an accurate record.

Questions are invited from members of the public present at the meeting on any matters for which this Committee is responsible.

There were no public questions.

A period of up to 15 minutes will be allocated for questions and supplementary questions from members of the Council who are not members of the committee.

There were no member questions.

Presentation attached to be presented by Will Blandamer Executive Director for Health and Adult Care, supported by Kath WynneJones Chief Operating officer, IDCB

To reflect the inclusion of children’s health within the Bury Locality Plan, members of the Children and Young People’s Committee were invited to join this item. The Locality Plan is scheduled to be presented to the Locality Board in April. This Committee has been asked by the GMCA Health Scrutiny Committee to review the local document in the context of the Greater Manchester Sustainability Plan for the next five years.

Members were expected to have reviewed the presentation in advance of the meeting.

Will Blandamer, Executive Director for Health and Adult Care, supported by Kath Wynne-Jones, Chief Operating Officer of the Integrated Delivery Collaborative Board (IDCB), presented the item.

Will Blandamer provided an overview of the presentation, noting that the Locality Plan is due to be submitted to the Locality Board, which is chaired by Dr Cathy Fines and the Leader of the Council. He emphasised that what happens in GP practices has a direct impact on outcomes and opportunities for children, and that the plan offers a comprehensive overview of the health and care system, including urgent care and other key areas across the year.

He stressed the need for a strategy that supports both transformation and business-as-usual operations.

The Bury Locality Plan is embedded within the broader “Let’s Do It” strategy and reflects the integrated care partnership model shared across all ten Greater Manchester localities. The plan identifies four key priorities, which are detailed in the presentation slides, and includes references to health checks in primary care and the growing demand within the community.

Will acknowledged the ongoing challenges, describing the current situation as unsustainable for residents. However, he highlighted progress in neighbourhood working, with five integrated neighbourhood teams and community children’s services now working together effectively.

This integrated model is seen as a cornerstone of the plan and is well advanced. He drew attention to page 18 of the presentation pack, which outlines key challenges in Bury. These include the need to build greater confidence in the first 1,000 days of a child’s life and to strengthen operations around SEND services. While there are still gaps in mental health provision, investment is beginning to close those gaps. The plan also focuses on ensuring that primary care services are equipped to deliver early intervention and that services are co-designed with people who have lived experience.

The plan aligns with the “Let’s Do It” strategy and recognises the vital role of the voluntary sector in supporting health and wellbeing. Will also noted challenges around clinical sustainability and the need to consider changes to the configuration of local hospital services, particularly in relation to critical mass and clinical specialisms. Urgent mental health needs, especially in children’s services, were also highlighted.

Kath Wynne-Jones added that the team has developed a series of user case studies to illustrate the plan’s ambitions and bring the strategy to life for both the population and the workforce. She shared examples including:

• Brenda, whose case focuses on menopause awareness and how community support can improve  ...  view the full minutes text for item HSC.45

Presentation Submitted by Salina Callighan Head of Medicines Optimisation in Bury, along with Jo Aldham from NHS

Salina Calighan Head of Medical Optimisation in Bury provided an overview of the campaign, emphasizing its importance in reducing delays and ensuring effective use of medications to avoid waste and improve patient care. She highlighted the need to stop stockpiling medicines and the impact of small details on patient outcomes.

Jo Aldham Programme Manager for Greater Manchester Pharmacy Programme discussed the existing infrastructure and policies, such as drug lockers and patient stores, and the benefits of utilizing these resources to minimize waste and reduce costs. The project is subsidized by the NHS and addresses medicine shortages. Jo mentioned that an audit was conducted to ensure the right medicines are available for discharge, reducing the need for new supplies.

Emphasis was placed on using existing medicines to avoid waste and the risk of medicines going unused. Updating records around repeat prescriptions is crucial to minimize waste and improve patient care. Nurses and pharmacies are encouraged to ensure medicines are used up and records are updated when patients go home.

Councillor Boles inquired about the challenges in the next three months. Jo Aldham responded that the main challenge is engaging with residents and ensuring they are aware of the campaign. Patients and family members need to be informed and encouraged to participate. Jo emphasized the importance of secondary care providers and wider communications to continue promoting the campaign.

Councillor Lancaster asked about engagement with GPs and the role of local councillors. Jo Aldham mentioned the implementation group and another board that will be involved when the campaign is ready. Primary care boards will also be engaged, and campaign materials will be circulated to the committee. Councillor Ryder shared positive feedback about the system based on personal experience, highlighting its effectiveness.

Jo Aldham discussed the difficulties with timely availability of medicines in care homes and the steps being taken in pilot projects to address these issues. The MARS chart and baby steps with the pilot are aimed at ensuring the majority of patients receive timely medication.

Councillor Fitzgerald expressed support for the campaign and the committee's role in promoting it. He inquired about additional support and resources. Adrian Crook mentioned the availability of a toolkit to support the campaign, which will be promoted to ensure effective implementation.

The campaign aims to improve the efficiency of medicine use, reduce waste, and enhance patient care through better engagement and communication with healthcare providers and the community. The committee expressed strong support for the campaign and its objectives.

It Was Agreed:

• The report be noted
• Circulate campaign materials to the committee.
• Continue engagement with residents, patients, and family members.
• Promote the campaign using the available toolkit.

Presentation attached from Fin McCaul

Fin McCaul presented an update on the Pharmacy First initiative and its implementation across the Bury locality. He began by thanking the Committee for reviewing the presentation in advance. He noted that although the programme had a slow start in January 2024, it has since gained momentum, with increasing consultations across seven clinical conditions, including hypertension. Collaboration with GPs has been key to this growth.

He referred to slides 63 to 65, which demonstrated that Bury had achieved one of the highest completion rates across primary care boards. Slide 68 highlighted the initiative’s role in protecting public health during challenging times, with no increase in costs and stable core finances. Page 69 outlined the advice provided across Greater Manchester, showing consistency in delivery and uptake.

A question was raised about the variation in referral rates between practices, specifically whether lower-performing practices were simply not engaging or whether the higher-performing ones were significantly larger. Fin responded that both factors could be contributing. Some practices may not yet be fully utilising the service, while others, despite their size, may face internal barriers. He acknowledged that further analysis is needed to understand these discrepancies.

Another member asked how residents could better access the service and why awareness remains limited. Fin explained that while the service is accessible, it is transitioning from a walk-in model to an appointment-based system to manage capacity more effectively. He agreed that awareness needs to improve and committed to sharing a communications pack with the Committee to support local promotion efforts.

Concerns were raised about public confidence in pharmacists’ ability to prescribe. In response, Fin assured the Committee that pharmacists undergo extensive training, including a four-year university degree followed by a foundation year. Only after this are they qualified to prescribe. He added that patient feedback has been positive, and that cultural change is underway, though it takes time.

A member shared a positive personal experience with Pharmacy First and asked how awareness could be expanded beyond word of mouth. Fin noted that NHS England has been involved in advertising the service and that a bedding-in process is ongoing at the Greater Manchester level to ensure consistent messaging and uptake.

There was a question about whether the initiative was designed to relieve pressure on GPs and whether pharmacists have the capacity to take on this additional workload. Fin confirmed that reducing GP pressure was a key goal. He stated that while capacity exists, the service is currently only 50% funded, which limits its full potential. He emphasized the need to move towards appointment-based models to ensure efficiency and avoid overburdening staff. Concerns were expressed that if the service is not run efficiently, it could become counterproductive. Fin acknowledged this risk and stressed the importance of sustainable funding and operational planning.

Another concern was raised about the increasing workload placed on pharmacists and the risk of burnout, especially given that they are not being fully compensated. There was also worry that the sector could be pushed towards privatization or bankruptcy.  ...  view the full minutes text for item HSC.47

Presentation attached

Adrian Crook was invited to present an update on the new CQC inspection framework and the outcomes of the recent LGA peer challenge. The Committee had previously received updates on the new framework earlier in the year and had been kept informed of developments since.

The Chair opened by thanking Adrian and his team for their continued efforts and dedication, particularly noting the positive comments about staff in the presentation. Appreciation was expressed for the hard work being done across the service.

An overview of the LGA peer review process was provided. The review team, made up of professionals from across the country, recognised that staff are the service’s greatest asset. It was noted that, for the first time in a long while, the service has a full complement of leadership, practitioners, and social workers. This was acknowledged during World Social Workday, and the support provided by Adrian Crook and Sue Massel was highlighted.

The review also praised the contributions of individual staff members, including a senior social worker from Bolton and a newly appointed social worker from Tameside, both of whom were commended for their ability to manage multiple roles effectively. The integration of health and care services in Bury was described as outstanding and among the best seen nationally.

The peer review was seen as timely, particularly in light of the upcoming CQC inspection.

It was noted that Bury could have been subject to intervention but instead is now well-positioned, with strong foundations and a clear direction. Only 27 councils remain to be inspected in the next six months and Bury is considered well-prepared. The feedback received during the review was described as emotional and affirming, with leadership across health services present and engaged in the process.

Verbal feedback from the review team was described as the best received in recent years. The final report is expected within the next few weeks, and work is already underway to implement the recommendations, which are considered achievable before the CQC inspection.

Adrian Crook added that staff are proud to work in Bury, with only four vacancies currently open. He emphasised that the level of integration achieved is exemplary, and that the team has travelled extensively to learn from best practices across the country. The peer review confirmed that Bury’s collaborative approach is among the best observed.

Page 89 of the report highlighted the strength of political leadership, noting the skilled cabinet member, cross-party support, and the high regard in which the scrutiny committee and its chair are held by the independent peer reviewers.

A member expressed appreciation for the staff’s efforts and reiterated the importance of transparency in reporting. They emphasised that the Committee should continue to receive updates on both successes and areas for improvement, to avoid any surprises and maintain public confidence.

Another member thanked Adrian for the report and acknowledged the hard work of the team.

A question was raised about safeguarding practices and whether there is sufficient awareness of safeguarding pathways. Adrian responded that the integrated  ...  view the full minutes text for item HSC.48

Scrutiny report attached from Clare Postlethwaite (NHS Greater Manchester)

Clare Postlethwaite was invited to present an update on the progress of the programme, particularly in relation to national funding and local implementation. The Chair opened by thanking Clare for the presentation and invited any additional comments from other members.

Clare provided an overview of the report, highlighting that national funding has now been agreed, which marks a significant and positive milestone for the programme. She described the current position as encouraging and full of opportunity, with key steps having been taken to secure NHS England funding. This funding agreement has now been signed, and the team is working through the necessary transactional processes with GP practice accounts. While there are some minor differences in how these are being handled, they are expected to be resolved by year-end.

She also confirmed that the lease agreement has been finalised, and the capital funding has been secured. Although there are still some risks to manage, Clare emphasised the importance of articulating these clearly. The construction team is expected to be on site by September, and while there is still work to be done, the overall update was described as very positive.

A question was raised about the status of agreements with GP practices. Specifically, it was asked how the process of getting these agreements signed is progressing. Clare responded that the agreements have largely been signed and that the team is now working through the financial and administrative aspects with individual practices. She acknowledged that there are slight variations in how practices are managing this but confirmed that the process is on track and being actively supported.

Will Blandamer added a note of appreciation, stating that Clare has been outstanding in her role and is fully aware of the issues involved. He thanked her for her dedication and effective leadership throughout the process.

The Committee noted the report and expressed appreciation for the progress made. Members acknowledged the significance of the funding agreement and the positive trajectory of the programme. The Committee extended thanks to Clare and the wider team for their continued efforts and looked forward to further updates as the project moves into the construction phase.

It Was Agreed:

·         The update be noted

The Chair started the update by informing members of a change in role, having moved from Vice Chair to Chair of the GMCA Health Scrutiny Committee following the resignation of the previous Chair.

The Chair provided a summary of the March GMCA Health Scrutiny Committee meeting, which covered several key areas:

Elective Recovery

The Committee received an update on elective recovery across Greater Manchester. Members were asked to recognise the progress made in reducing the number of long-waiting patients and to support cross-cutting system programmes aimed at improving access. It was noted that waiting times over 18 weeks had been rising prior to the pandemic, increasing from 194,000 in 2015 to 284,000 in 2020, and reaching approximately 500,000 during the pandemic. This figure has since stabilised.

Greater Manchester has made significant progress in reducing the number of patients waiting over 18 months, down from 15,000 in 2022. The current focus is on ensuring patients begin treatment within 18 weeks. As of November 2024, Greater Manchester was achieving this for 54% of patients, placing it fourth lowest nationally. The government target is to reach 92% by 2029. The Committee noted that variation exists across localities and treatment types.

Initiatives to support recovery include the development of a single point of access for referrals, the establishment of a GM-wide specialist service to support Primary Care, expansion of community services, and the optimisation of surgical hubs and Community Diagnostic Centres.

Major Trauma Centres Review

The Committee received a briefing on the review of Greater Manchester’s Major Trauma Centres. Approximately 1,600 people in the region experience major trauma annually. The two designated centres are Salford Royal and Manchester Royal Infirmary. The review follows a national peer review in September 2024 and aims to ensure the best patient outcomes while making optimal use of resources. The site selection process is ongoing.

Service Reconfiguration Updates

Updates were provided on the reconfiguration of ADHD services for both adults and children. NHS England has approved the options appraisal for Adult ADHD services, with public consultation expected in July 2025. Children’s ADHD services are currently progressing through governance for implementation.

The review was prompted by a significant increase in ADHD diagnoses, attributed to improved understanding and broader diagnostic criteria. The Committee noted the need to move away from the current “first come, first served” model and towards a system that prioritises those with the most severe needs. The proposed model includes single points of access in each locality, local hubs for support, and a focus on practical interventions. Officers highlighted the importance of face-to-face assessments and the need for early intervention. Engagement with families and young people has been extensive, and the approach aligns with national recommendations.

Action: The Committee agreed that this update should be shared with the Children’s Committee.

Other Reports

The Committee also received updates on Dentistry, Pharmacy, and Urgent Treatment Centres and Emergency Access.

NHS GM Sustainability Plan

The Chair raised a question regarding the future of the NHS Greater Manchester Sustainability Plan in light  ...  view the full minutes text for item HSC.50

Any other business which by reason of special circumstances the Chair agrees may be considered as a matter of urgency.

There was no urgent business.