Agenda and draft 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 15^th July 2025 are attached for approval.

The minutes of the meeting held on 15^th July 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.

Member questions were submitted in advance but these were addressed in urgent business at the end of the meeting.

David Latham – programme Manager for Urgent Care, NHS GM (Bury) and Kath Wynne-Jones – Chief Officer, Bury integrated delivery board to present this item

The Chair invited David Latham, Programme Manager for Urgent Care at NHS GM (Bury), and Kath Wynne-Jones, Chief Officer of the Bury Integrated Delivery Board, to provide an update on the operation of the urgent care system and winter planning preparations.

Kath Wynne-Jones began by offering a strategic overview of the Hospital at Home services and the Live Well programme. She emphasized the importance of integrating neighbourhood teams and refreshing the approach to multi-disciplinary working. The presentation slides outlined the integrated delivery programme, which aims to standardize health services and foster collaboration between neighbourhood and healthcare teams. Kath highlighted the positive outcomes achieved in terms of admission avoidance and managing patient volumes. She confirmed that the refreshed neighbourhood model would be brought to the committee in the coming months to provide further context for winter planning over the next 18 months.

David Latham followed with a performance update, focusing on urgent care metrics. He reported improvements in the four-hour A&E target, with Bury achieving 74% in July and 72% in August, and Fairfield Hospital reaching between 73.3% and 75%, making it the second-best performer in Greater Manchester. He also noted a significant reduction in 12-hour waits, with figures dropping from 341 in July to 314 in August, well below the national ceiling of 577 patients. Ambulance handover times were another area of success, with Bury achieving an average of 16 minutes and 28 seconds, surpassing both the national target of 35 minutes and the GM stretch target of 25 minutes and 24 seconds.

David acknowledged a slight increase in patients staying in hospital for more than 21 days in August and mentioned ongoing efforts to understand and address this issue. He also discussed the Days Kept Away from Home (DKAH) metric, noting that while targets are not yet met, improvements are being made. Unplanned hospital admissions for patients over 65 were reported to be better than most areas in Greater Manchester, with some pockets of improvement still needed.

Regarding winter planning, David described a regional event held to discuss transfers and escalation procedures, with a Bury team scheduled to attend a major event on October 3rd. He confirmed that the Northern Care Alliance (NCA) had submitted its winter plan, incorporating local input. Daily escalation and planning meetings are now in place, and a Winter Planning Subgroup has been established to coordinate efforts across local partners. This subgroup is responsible for refreshing OPAL cards, setting escalation triggers, and providing training for on-call managers. Plans for respiratory hubs and vaccination targets were also outlined.

During the discussion, several councillors raised questions and comments. Councillor McBriar expressed concern about the impact of anti-vaccination sentiment. Jon Hobday from Public Health responded by explaining the multifaceted reasons behind low vaccination uptake, including misinformation and access issues. He emphasized ongoing work with primary care to address inequalities and the importance of councillors advocating for vaccinations.

Councillor Duncalfe inquired about COVID-specific planning. Jon Hobday assured that symptom awareness and self-care are being promoted,  ...  view the full minutes text for item HSC.80

Report of the Cabinet Member for Adult Care, Health and Public Service Reform is attached.

The Committee considered the Q1 Adult Social Care performance report, which had previously been presented to Cabinet. Members were reminded of their responsibility to scrutinise the performance of service providers and to ensure that the health needs of local residents are central to the commissioning, delivery, and development of services.

Councillor Tariq, Cabinet Member for Adult Care, Health and Public Service Reform, introduced the item and highlighted areas of progress and concern. He noted that performance improvements are ongoing, with digital transformation underway and developments in care home provision. Bury has achieved a strong national ranking 8th out of 154 and has secured its first veteran-friendly care home accreditation this quarter. Recruitment and retention remain key priorities, with 83 new carers identified and 5 carers supported under the current carers strategy.

Adrian Crook director of adult social care provided further detail, referencing the safeguarding audit which engaged 150 individuals, most of whom reported feeling safe. However, he acknowledged that further work is needed. The national Adult Social Care survey had a low response rate, and while some indicators have improved, others have declined. Locally, efforts are being made to make surveys more personal and conversational, including live verbal questioning. A supervision framework has been introduced to support social workers dealing with complex cases, and feedback on workforce engagement and internal systems has been positive.

Councillor Simpson welcomed the veteran-friendly accreditation and requested an update on the specific care home undergoing the accreditation process. This was noted as an action for follow-up. Councillor Quinn raised concerns about the limitations of national surveys, and Adrian Crook confirmed that while national formats cannot be changed, local surveys are being adapted to better reflect individual experiences.

Councillor Boles asked about support for carers managing increasingly complex cases. Adrian Crook explained that the new supervision framework allows staff to access support flexibly and efficiently.

Councillor Haroon expressed concern about the report’s findings on social anxiety and mental health decline, particularly the data on page 56. Adrian Crook confirmed that this issue has been flagged in red and will be added to the work plan following further discovery work. He also noted that the number of people reporting adequate social contact has increased.

Councillor McBriar stressed the importance of learning from areas of decline, particularly in relation to people with learning disabilities. Adrian Crook responded that while the sample size was small, this remains a priority area. Improvements to the Council’s website were also noted, with usability shifting from “really difficult” to “fairly difficult,” which was seen as a positive development.

Councillor FitzGerald welcomed the low vacancy rates and improvements in apprenticeship uptake. She requested clarification on the data presented on page 8 regarding resolution at first contact, and whether differences in local authority service models might explain the outcomes. Officers will investigate and report back.

The Committee agreed to revisit the issue of social isolation in six months and to schedule a future agenda item focused on carers and the evolving nature of their support  ...  view the full minutes text for item HSC.81

Presentation supported by Jon Hobday Director of Public Health

Francesca Vale Public Health Practitioner (Food & Health) opened the agenda item on Bury’s Food and Health Strategy - Eat, Live, Love Food with a presentation on Bury’s food journey.

Bury Food Partnership launched in 2021 with 25+ cross sectors partners interested in healthier and sustainable food, this has now expanded to 85+ partners working collaboratively across the borough. Francesca explained how the food strategy is integrated within Bury’s Lets Strategy and alignment with complementary strategies has opened the way for food related issues to be considered in many areas (anti-poverty, climate action, cultural and economic growth).

The Partnership used the Sustainable Food Places themes to map activity, impact, and collective achievements (encompassing food governance, healthy food for all, catering and procurement, good food movement, sustainable food economy, food for the planet). Bury was awarded the Sustainable Food Places Bronze Award in 2022 and quickly progressed to achieving the Silver Award in 2024,  the first area in Greater Manchester to do so.

The Committee heard that Bury’s food system transformation has gained national and internation attention, with the Partnership presenting at Westminster and being invited to participate in the EU Cascade Cities Peer Learning Programme and EU Clever Food Programme, embracing many learning insights, and applying these into our local policies.

Bury Schools Catering serves 10,000 meals per day. Francesca described how the service has set high standards and seasonal menus, shortened supply chains, brought SME’s into procurement framework, increased organic procurement and made cost savings.  Bury Catering have now achieved the prestigious Food for Life Served Here Gold certification from the Soil Association for serving healthy and sustainable meals across 56 sites in Sept 2025.

Francesca also highlighted the recent launch of the “Right to Grow” campaign in June.  This growing initiative aims to bring residents together, nurture local environments, and boost health and wellbeing across the borough.  Growing offers many benefits, from improved mental and physical wellbeing through activity in nature, increased access to fresh food, and the strengthening of community bonds.  A lack of available land close to people’s homes can be an obstacle to more people growing.  To help address this issue, Incredible Edible Prestwich and District, Lancashire Wildlife Trust, Bury Council’s Planning, Parks & Countryside, Grounds Maintenance, Public Health and the Bury Voluntary, Community and Faith Alliance have all come together to look at planning, licensing, and to create a single food map of established community growing sites and potential future growing spaces.  Community growing advice and resources are available, and successful applicants will be issued with a Licence Agreement. 

The Committee discussed the national challenges around Free School Meal auto-enrolment.

The Partnership have supported the implementation of Free Schools Meals Auto Enrolment in Bury and has seen amazing first results from bringing in this new process.  Bury Schools Catering Service reaches 52/69 primary schools and 4/14 secondary schools.  Since auto-enrolment meal uptake for Free School Meals increased by 18.4% in our Bury Catering managed schools.  6281 meals were ordered in the week before Easter (April) compared  ...  view the full minutes text for item HSC.82

For information: Will Blandamer, Executive Director for Health and Adult Care, will respond to questions regarding the recognition of collaborative work between the local authority and the NHS as a partnership.

The Committee received a verbal update regarding the recent regulatory scrutiny of services for children and young people, particularly those with Special Educational Needs and Disabilities (SEND). A note from Will Blandamer was referenced, which will be read into the record.

It was acknowledged that services for children delivered by the Council had previously been judged inadequate by Ofsted. Furthermore, the joint inspection of SEND services by Ofsted and the Care Quality Commission (CQC) identified widespread and systemic failures across both the Council and NHS Greater Manchester (GM), acting as the Integrated Care Board (ICB).

The Children’s Scrutiny Committee continues to be the primary forum for monitoring the improvement plan for children’s services. However, it was noted that the Health Scrutiny Committee retains the authority to scrutinise NHS services, which is particularly relevant given the joint nature of the SEND inspection.

The improvement plan for Council Children’s Services recognises the essential role of partnership working, involving Health partners, Greater Manchester Police (GMP), and other agencies. In relation to SEND, the inspection and subsequent improvement efforts are a shared responsibility between the Council and NHS GM.

Councillor Boles raised concerns regarding the level of assurance that NHS partners would provide in supporting the improvement plan. In response, Will Blandamer confirmed that he would continue to work closely with NHS colleagues to ensure robust support for looked-after children and broader SEND services.

The Committee heard updates on the involvement of community paediatrics and the Voluntary, Community and Faith Sector (VCFS) in supporting improvements, particularly around Education, Health and Care Plans (EHCPs) and the NHS’s role within the Multi-Agency Safeguarding Hub (MASH).

Councillor Fitz queried the development of the Children’s Neurodevelopment Hub and its potential impact on children in Bury. Will Blandamer responded that while Child and Adolescent Mental Health Services (CAMHS) face significant challenges in meeting demand—especially for children with autism and ADHD—there is a growing emphasis on providing support during waiting periods. He highlighted the pilot work underway in Bury to establish Neurodiversity Hubs, which aim to offer a focal point for support and interventions based on a social model of care.

Ten localities have commissioned a provider to define the service model for Bury’s Neurodiversity Hub. The Parent Carer Forum, including the well-established FIRST POINT group, has been actively engaged, alongside the Change Makers group, to shape the service in collaboration with the neighbourhood team.

Councillor Fitzgerald asked whether all relevant roles within the service had been filled. It was confirmed that additional funding from the ICB has been allocated to CAMHS in Bury, including support for SENCOs. However, it was acknowledged that current demand continues to outpace capacity, and further development of CAMHS services is required.

The Council, through its Medium-Term Financial Strategy (MTFS), has established a specialist SEND Health Visitor team, which is now fully staffed. This initiative is subject to recognition through an NHS Health Service Award.

Given the increasing demand for services, the Committee discussed the appropriate timing for receiving a formal report on the Neurodiversity  ...  view the full minutes text for item HSC.83

GMCA Health Scrutiny – Report Attached from the chair

NCA Alliance – Verbal Update from the chair

Will Blandamer Executive Director (Health and Adult Care) will provide a verbal update on the ICB reform

Councillor E. FitzGerald gave a brief overview of the GMCA Health Scrutiny Committee, highlighting its role in overseeing health-related developments across Greater Manchester and ensuring accountability in decision-making. She introduced the first item on the agenda: the final report from the “In Her Shoes” Task and Finish Group, chaired by Councillor Helen Hibbert. This review focused on the safety of women and girls on public transport and included 15 sessions with contributions from senior figures such as Vernon Everitt and Kate Green. The report, which had previously gone to full Council but was not discussed due to time constraints, contains 26 recommendations ranging from strategic design improvements to practical interventions like increased staffing and better digital tools. The committee discussed issues including misogyny, the experiences of disabled women, and how the findings could be applied locally—particularly in Bury, where a new bus station is planned. Members also raised the importance of bystander training and the broader health impacts of transport insecurity, especially for women who avoid public transport or outdoor exercise due to safety concerns. It was agreed that the report should be raised locally and shared with the Bee Network Committee if not already done.

The second item was an update from NHS Greater Manchester on workforce challenges following national reforms. The committee expressed concern over the closure of NHS England, a 39% budget cut to the ICB, and the pressures on local Trusts. The report presented was found to be outdated, missing key data such as the 600 job losses resulting from the budget cut. Members questioned how staff were being supported and how survey participation could be improved, noting that the consultation process had not yet begun. It was confirmed that changes to SEND and Safeguarding responsibilities would be delayed by 12 months. Due to the lack of detail, the committee did not endorse the reform approach but acknowledged the work being undertaken.

Further updates included the monthly service reconfiguration report, which tracks progress on various changes. Notably, Adult ADHD and IVF services will undergo clinical decision-making before implementation, while Children’s ADHD and Diabetes Education services are already being rolled out.

The committee also reviewed NHS GM’s revised engagement plan for procedures of limited clinical value. Instead of reviewing 50 procedures at once, the new approach will assess them in batches over a five-year cycle. Current procedures under review include split/torn earlobes, shoulder impingement, and assisted conception, with a new commissioning statement being developed for shockwave therapy for tendinopathies. Finally, the committee updated its work plan to include elective waiting times and NHS league tables for future scrutiny.

The Chair provided a verbal update from the Northern Care Alliance this included an overview of the designated clinical offer, noting limitations in implementing outcomes. Key concerns were raised around staff sickness absence, stress, and target achievement, particularly in Bury where performance is below expectations. Post-Christmas fracture rates have improved due to elective waiting list reductions, though around 80% of patients on the list may need committee attention. The  ...  view the full minutes text for item HSC.84

To follow

A meeting was to discuss the anticipated scope of the upcoming review. The discussion focused on two key areas:

1. National Reforms – including changes within NHS England (NHSE), the reduction in Integrated Care Boards (ICBs), developments in Healthwatch, and the introduction of NHS league tables.
2. NHS Greater Manchester Sustainability Plan – including ongoing service reconfigurations already underway across the region.

The group agreed that the central concern of the review should be to ensure that residents of Bury are not adversely affected by these changes, and that the reforms and reconfigurations lead to improved health services locally.

Timelines were considered during the meeting. It was noted that many of the NHS GM plans are already being implemented, and the group will need to monitor these changes closely. The national reforms are expected to be largely in place by April 2026, providing a clear timeframe for scrutiny and engagement.

The next step identified was to engage with Will Blandamer and to circulate relevant documents to ensure that all group members are fully informed of the changes and their implications.

Given that the work of this group is likely to continue into the next council year, it was agreed that additional members would be welcome. Expanding the group would help ensure its resilience and continuity over time.

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

Questions submitted in advance of the meeting by Councillor D Quinn as these were unable to be asked at member question time these were addressed at urgent business.

• Please could I have an update regarding dementia screening for people with learning disabilities now that the learning disability team does not undertake this process.

Adrian Crook Director of Community Commissioning explained that Guidance is contradictory and we are doing the discovery of what we should be doing

• Have GP’s been made aware of this change and provided the appropriate screening tool.

The elements within the health check and should be delivered in primary care not done by pennine Will update Councillor Quinn and will get back to Cllr Quinn from Adrian Crook