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 18^th September 2024 are attached for approval.

The minutes of the meeting held on 18^th September 2024 were agreed as an accurate record.

There were no matters arising.

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

Sarah Jones asked Whether the cabinet member agree with me, that a defibrillator on Holcombe Hill is necessary due to the amount of residents and visitors who walk in this isolated area on a daily basis. And particularly since the death of a young man due to cardiac arrest which happened on 7th November 2024.

Councillor Tariq explained that this is a great question and point raised and will look to follow this up at looking at how electricity and permission can be granted to get this set up for the defibrillator.

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

An update on Urgent Care and Winter Preparedness began with David Lathan, Senior Programme Manager at NHS Bury, presenting an update on current performance and winter planning activities. He provided an overview of how Bury is managing urgent care and preparing for the winter season.

David highlighted several key performance metrics. Bury's performance in October for the 4-hour target was 67.3%, which is below the national target of 76%. However, Bury is the second-best performing locality in Greater Manchester when compared to other sites with fully functioning A&E departments. In terms of A&E attendances, Bury is the fifth best in Greater Manchester, with 33.7 attendances per 1,000 patients. For non-elective admissions, Bury is also fifth in Greater Manchester, showing a downward trend. The efficiency of discharging patients has significantly improved, with a reduction in the number of patients classified as "days kept away from home" (DCAP), consistently below planned targets. The number of 12-hour waits in A&E has been reduced from 924 in April to 517 in September. Additionally, the decision to admit has improved from 197 in January to 28 in September.

David then outlined the winter planning activities. Bury has a winter plan and subgroup that has been meeting bi-weekly since August, involving all stakeholders, including the Hospice. The local operational planning and escalation levels (OPEL) system ensures that Bury has never reached the highest level of crisis (OPEL 4). Over 30 admission avoidance schemes have been refreshed and included in the plan. The NHS 111 Directory of Services has been updated for all services in Bury. Communication and training for core managers have been provided, and the local system meets twice a week, with plans to increase to daily meetings as winter approaches.

David mentioned ongoing and future initiatives, including significant investment in staffing at Fairfield and the reconfiguration of the A&E department. A new streaming tool is being implemented, and the Same Day Emergency Care (SDEC) service is increasing the number of patients treated and discharged on the same day. These efforts aim to improve the overall performance and efficiency of urgent care services.

Several questions and comments were raised during the meeting. A councillor acknowledged the improvements but emphasized the need for continued progress, especially in reducing 12-hour waits and improving discharge efficiency. Councillor Brown asked why people apply for jobs they do not want and how the Council deals with time-wasters and no-shows. David explained the centralized recruitment support to address this issue and improve efficiency. Another councillor inquired about the strategy for international recruitment, and David confirmed active pursuit of international recruitment and updated contract monitoring.

Councillor Lancaster asked about the start date and current status of Bury Flex. David explained that Bury Flex had been running for 18 months and highlighted its positive impact. Councillor Gold asked about the winter plan's key elements and any unmet goals. David highlighted staffing and reconfiguration as key elements and mentioned the need for investment in ambulance service pilots.

A councillor inquired  ...  view the full minutes text for item HSC.26

Attached is a report by Matthew Logan

Matthew Logan, the Strategic Lead for Integrated Commissioning, presented an overview of the support for the adult social care provider workforce. He expressed gratitude for the opportunity to share the progress made with partners and hoped to deliver a positive update.

Matthew highlighted the structure of the adult social care provider market in Bury, noting that there are 93 commissioned providers, with two-thirds being small or medium-sized local organizations. These providers employ 4,600 people in Bury, including 2,500 in care homes. He emphasized the importance of having a robust and vibrant care market to meet the growing demands of the sector, especially with the projected increase in the elderly population.

The government funding received was aimed at market sustainability and improvement activities. To determine the best use of these funds, the Council committed to co-designing the Adult Social Care Workforce Support Programme with providers. The programme focused on three main priorities: attraction, process improvement, and retention.

Attraction involved strategies to bring more people into the sector, including capital support for recruitment. Process improvement aimed to enhance recruitment processes, making them more efficient and effective. Retention focused on creating clear career pathways to keep experienced staff within the sector.

The Workforce Support Programme comprised three main components. The first was the centralized recruitment function, which allowed providers to share their open care roles. A team was responsible for advertising, screening, and developing candidate lists, thus relieving registered managers from the burden of handling numerous applications.

The second component was the Care Development Programme, which involved collaboration with Bury College and health and social care education departments. This programme aimed to streamline the transition of students into social care providers, offering them work experience and training resources. A leadership development programme for registered managers was also developed to support succession planning.

The third component was Bury Flex, a shared workforce initiative designed to reduce reliance on agency staff. Bury Flex provided ready-to-work care and support workers to fulfil urgent demands. Unlike traditional agencies, there was no cost to providers for accessing these staff members.

Matthew shared the positive impact of these initiatives, noting an increase of 400 staff in adult social care in Bury, a decrease in the vacancy rate from 12.9% to 8.5%, and a reduction in the leaver rate from 44% to 27.1%. The use of agency staff had also decreased, and the quality of care had improved, with a higher percentage of good and outstanding care ratings.

Looking ahead, Matthew discussed plans to expand Bury Flex across Greater Manchester and establish a framework for student work experience. The goal was to develop an independent provider workforce strategy for Bury, fostering a culture of collaboration with providers.

A councillor congratulated Matthew for his leadership and the significant improvements achieved. They emphasized the importance of the relationship between the Council and providers and the progress made in workforce stability.

Councillor Brown expressed appreciation for the report and noted the impressive improvement in how Bury has coped with workforce challenges. He asked  ...  view the full minutes text for item HSC.27

Reports to Follow

Councillor Fitzgerald gave an overview of the Other External Bodies standing items. It was detailed emphasizing that the work being scrutinized was not their own but rather the work of others. They highlighted the increased activity and the establishment of various bodies over the past two years, contrasting it with the previous situation where there was minimal activity between scrutiny committee meetings.

There was a focus on the sustainability plan and mentioned attending a meeting about the evolution of combined authorities across the country. The Greater Manchester Combined Authority (GMCA) Health Scrutiny meeting on October 15th covered topics such as dealing with the deficit and the growth in demand due to poor population health. An update from Health Innovation Manchester was also provided.

It was noted that every locality must submit its own plan by December, and the committee decided to scrutinize Bury's localities plan in January. This plan would include contributions from hospital trusts and address issues related to various illnesses and conditions.

It was also mentioned the importance of service reconfiguration in achieving sustainability and highlighted the role of Health Innovation Manchester in initiatives like virtual wards and the use of data for better healthcare outcomes.

Councillor Fitzgerald informed the committee she attended a Joint Health Reviews Group meeting for the Northern Care Alliance, where issues such as virtual wards and the demand for services were discussed. The group also raised concerns about the lack of prevention and its impact on increasing demand. It was suggested that this issue should be further explored in future meetings.

Another group, the Test and Finish Group on gender-based violence, was mentioned. This group, which emerged from the combined authority's overview and scrutiny, focuses on women's health and crime. The presenter noted the importance of addressing safety in travel as part of this group's work.

It was informed attended a national Combined Authority chairs meeting, which discussed the scrutiny protocol for combined authorities, holding mayors accountable, and the English devolution. The meeting emphasized the need for proper scrutiny at the combined authority level and the challenges of achieving political balance in these groups.

The update concluded by highlighting the importance of understanding national changes and their potential impact on local scrutiny processes. It was stressed the need for the committee to stay informed and involved in these developments.

Councillor Gold raised a point about the use of acronyms in reports, suggesting that the first instance of an acronym should be accompanied by its full form. The presenter agreed to work towards this.

Another member emphasized the importance of aligning Bury's submission to the GMCA sustainability plan with the locality plan for health and care transformation. They highlighted the ongoing efforts to improve population health, reduce unnecessary hospital admissions, and enhance the quality of care.

There was also a discussion on the role of Healthwatch in providing feedback and ensuring quality in health and care services. It was acknowledged the valuable contributions of Healthwatch and the importance of continued collaboration.

It was Agreed:  ...  view the full minutes text for item HSC.28

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