Agenda and minutes

There were no declarations of interest made at the meeting.

There were no questions from members of the public present at the meeting.

Minutes of the meeting held on 18 September 2019 are attached.

Clarification around the number of health visitors was provided following the last meeting. It was confirmed that there are three Health Visitors for Complex Needs but there are more that provide universal work across the Borough.

It was agreed:

That the minutes of the meeting held on 18 September 2019 be approved as a correct record.

In attendence will be Karen Whitehead, Strategic Lead Bury Council, Gemma Billing, Bury Clinical Commissioning Group and Nicola Grey, Healthy Young Minds Operations Manager. Report attached.

Karen Whitehead, Strategic Lead Inclusion & Partnerships, Jemma Billing, Bury Childrens Clinical Commissioning Lead  and Nicola Gray, Health Young Minds Operational  Manager submitted a report for information  updating on children and young people’s mental health services in Bury. It was reported that a single point of access is established that can direct young people to the best services to support their needs. There has been an upward trend in referrals to Healthy Young Minds  over the last seven years and therefore it has been acknowledged that waiting times must be managed well to ensure needs are met. Currently Healthy Young Minds offer four types of assessment and they are determined by risk or clinical need; Emergency (within 24 hours), Urgent (within 7 days), Priority (within 14 days) and Routine (within 12 weeks). The majority of young people’s needs are met within 4-6 sessions however, it is acknowledged some individuals may require much longer interventions and should this occur evidenced interventions would continue.

It was discussed that around 25% of cases are re-referrals and themes for access to the service include exam stress, social media pressures, cyber bullying and loss. The importance of increasing accessibility across many faith groups, ethnicities, religions, LGBTQ+ was raised. There were discussions around the invaluable support that Bury third sector and other voluntary and charity based groups provide to support young people wo may not meet the threshold for  Healthy Young Minds but are signposted to the right service for support..

The report concluded that Bury is consistently meeting all key performance indicators however this data does not adequately represent the young persons and their family’s experience. Therefore, to support transition services further investment will be provided so young people have well managed transition pathways. It was reported that the success of a unified approach will remain a key priority for the success of this service and to stop young people reaching crisis. It was reported that Bury perform 3rd nationally due to a collaborative approach to service delivery.

It was agreed:

1.   That the report be noted.

2.   A further update be provided in the next municipal year. This update will include information in respect of key performance indicators and national benchmarks.

A report from Julie Gonda Interim Executive Director, Communities and Wellbeing is attached.

Julie Gonda, Interim Executive Director Communities and Wellbeing and Councillor A Simpson, Cabinet Member for Health and Wellbeing submitted an update report on residential care top-up fees established as part of the Care Act 2014. At the conception of the charges a public consultation was held along with a helpline to engage with those directly affected to ensure as many people as possible are aware of the charges.

The report set out the main focus for change related to Residential Care Home top-up fees and the introduction of a Day Care attendance charge. There are currently 108 top-up arrangements across 22 care homes, representing approximately 15% of the total value of residents. The value of fees range from £5-£496.95 per week with an average of £85.17 per week. There are currently five people in arrears with their third party top-up invoice payments however these people have been supported and received a financial assessment to organise payment plans. Since the introduction of the scheme six people have declared charges as a reason for stopping their care service. From the six that have cancelled all have and will receive welfare checks to ensure that the individual is receiving the correct support.

Julie Gonda and Councillor Simpson discussed the importance of family preference when choosing a care home. The committee were informed that top-up fees are only applicable when families opts for one that charges additional fees. This is a choice as the Council always has vacancies at the Local Authority rate. Should a family decide to opt for a care home that charges a top-up staff will explain the fees they will be liable for. Bury Council own 723 beds and care homes are distributed amongst each township to ensure a care home close to their social networks can be established however staff also provide information on care homes on bus routes or within close proximity to public transport to support social interaction with loved ones.

Members of the committee raised questions about why five care homes have still not engaged with the Council regarding top-up fees and it was concluded that in these circumstances negotiations lie directly between the care home and the family regarding fees.

       It was agreed:

      That the report be noted.

Nicky Parker, Programme Manager, Urgent Care Review will report at the meeting.

Nicky Parker, Programme Manager, Urgent Care Review and Dr Jeffrey Schryer, Bury CCG Chair provided a verbal update on urgent care which is an important service for the most vulnerable people in the Borough. Challenges encountered are an increasing workload and managing patients and services to fit the needs of the population. So far the services that have been redesigned are extended working hours for GP’s, GP Quality Scheme, expansion of the Green Car Scheme and development of a local integrated service.

              It was acknowledged that all these services are correct for meeting the needs of residents however, Bury residents are not navigating through service integration of the above initiatives and therefore not accessing support that is available to them. Areas pointed out for improvement under the review of urgent care is to improve four hour wait at the hospital, reduce admissions to hospital, make efficiencies and savings in services, redesign and simplify services.

              Members discussed the scope of the urgent care review and it was concluded that all urgent care services would be reviewed these will include; Fairfield General Hospital, urgent treatment centres, walk in centres, GP out of hours, GP extended access, green car and same day emergency service. The aim of the review is to empower and support people to access the correct services. The current schedule for the review is as follows:

§  October – Shareholder Engagement

§  November – Shape what services may look like and gather further information on urgent care in the Borough.

§  December – Determine the pieces of work required to deliver the review

§  January – Engage in a public consultation with the public including Health Watch and the voluntary sector.

§  February/March – Design the reviewed service

§  April – Begin Implementation.

The committee raised concerns in respect of governance arrangements for overseeing the Urgent Care Review process. The Chair of the Clinical Commissioning Review reported that a steering group comprising of clinicians, politicians, Pennine Acute, Pennine Care and the OCO has been established to oversee this process. Further discussions took place in relation to GP screening and in particular the recently published statistics that 60% of people stated they gave up trying to get a GP appointment and attended walk in centres instead. It was reported that GP accessibility as well as a public information campaign will be central to the review. The Chair of the CCG acknowledged that expectations will need to be managed throughout the process this will include highlighting areas of good practice.

The committee concluded with discussions on the importance of having an urgent care service that will support and grow to meet the needs of the growing population and anticipated population from new houses.

              It was agreed:

1.   That the update be noted. 

2.   A further update will be considered at the next meeting scheduled to take place on the 15^th January 2020.

3.   Members also agreed that the Urgent Care Review will be considered at further appropriate meetings within the council.  ...  view the full minutes text for item HSC.213

Nicky O’Connor, Director of Transformation will provide members with a verbal update.

Nicky O’Connor, Director of Transformation and Dr Jeffery Schryer, Bury CCG Chair provided members with a verbal update regarding health and social care reform.

It was reported that the purpose of the reform is to bring together services by looking at an organisational development programme to develop people’s skills and help with organisational cultural differences. Discussions took place regarding the importance of exercise for individual’s mental and physical health and wellbeing. Members discussed the importance of working with representatives from the Planning and Licensing Departments in respect of the numbers of takeaways and premises selling alcohol across the Borough. 

It was agreed:

1.   That the update be noted.

2.   An update provided at the next meeting in relation to the notice of motion –Tackling Obesity agreed at the September 2018 meeting of full Council.

3.   The Minimum Unit briefing discussed at the most recent meeting of the Health and Wellbeing Board be circulated to all members of the Committee.

An elected member raised concerns about food portion sizes in Primary Schools.

               It was agreed:

1.   The Senior Democratic Services Officer would provide a response and circulate to all committee members.

               (Note: This item, which did not appear on the agenda for the meeting, was allowed by the Chair to be considered as a matter of urgency, to enable the Committee to look into this update prior to the next meeting).

Work Programme attached.

DIGITAL AUTOPSY AND MRI SCANNING

A committee member raised concern around a previous request for local residents having access to the option of a Digital autopsy. The importance of this was discussed due to the multitude of faiths in the Borough that do not wish to have invasive autopsies. There has also been a Council motion passed in relation to this so an update should be sought.

               It was agreed:

1.   It was acknowledged this is a matter the Board could consider. The Coroner will be invited to a subsequent meeting of the Committee.