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 28^th November 2024 are attached for approval.

Matters arising from the last meeting update on how urgent and emergency care held up over the winter provided by Will Blandamer Executive Director (Health and Adult Care)

The minutes of the meeting held on 28^th November 2024 were agreed as an accurate record.

Matters arising:

Will Blandamer (Executive Director Health and Adult Care) discussed matters arising from the last meeting this included an update on urgent care over the Christmas period.

Will provided updates and discussions around urgent care in Bury. Here's a brief summary of the key points:

1. System Performance: The health and care system worked well together, avoiding reaching OPAL 4 status despite challenges. Ambulance waiting times were kept to a minimum and resolved quickly.
2. Staffing and Sickness: Staffing and sickness were challenging areas, but plans have been put in place to address these issues. There was a growth in demand for other services.
3. Ambulance Service: Staff morale within the ambulance service was generally good despite the pressures. The number of delayed discharges was significantly lower, and the system felt calmer given the circumstances.
4. A&E and Urgent Care: A&E was busy, but the system didn't break, and there were no OPAL 4 incidents. Efforts were made to keep people active and manage the threshold effectively.
5. Nursing Staff: Issues around nursing staff banks were discussed, with the NCA operating a nursing staff bank to allow staff to work elsewhere. Nurse staffing in corporate areas was suspended.
6. Acknowledgements: Councillor Tariq acknowledged the hard work of staff during a busy period and expressed gratitude for their efforts. The integration of leadership in the hospital system and the role of 111 in navigating people to the right place were highlighted.

Overall, it seems that despite the challenges, the urgent care system in Bury has performed well, and there is a sense of pride in how the system has managed under pressure.

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.

Report from Healthwatch representative Annemari Poldkivi

Annemari Poldkivi acting Chief Officer from Healthwatch Bury provided an update on their recent activities. She began by giving an overview of the report submitted before the meeting, clarifying an error regarding information provision. Annemari highlighted that Healthwatch Bury now has a town centre office where they hold weekly drop-in sessions for the public. She encouraged other organizations to use this space for health and social care services. Additionally, she mentioned a public office launch in October and a stakeholder event on November 19th.

During the discussion, Councillor Tariq expressed gratitude for Healthwatch's great work. Councillor Brown raised a concern about a patient finding a staff member going through their belongings. Annemari assured that the incident was addressed and provided details about what happened.

Councillor Boles inquired about the CAHMS response and action plan. Will Blandamer discussed the CAHMS platforms and executive plan for the ICB, expressing confidence in the report's outcome.

Looking ahead, Councillor Boles suggested focusing on the CAHMS within the locality plan and prioritizing the SEND partnership in Bury.

The Chair noted the need to visit more areas across the borough and recommended visiting six townships. Adrian Crook suggested organizing events for older people. Councillor Duncalfe offered a place at his community centre for future events.

Councillor Walsh raised an issue about patient transport no longer being available, and Will Blandamer agreed to provide details to the committee.

Overall, the update highlighted Healthwatch Bury's ongoing efforts and future plans, addressing various concerns and suggestions from councillors.

It was agreed:

·         The report and update be noted

·         Provide an update around patient transport

Performance slides attached to be presented by Will Blandamer Executive Director (Health and Adult Care)

The item began with an introduction where members and the committee were reminded to have reviewed the slides in advance. The chair acknowledged the extensive data and proposed a discussion on the best approach to review it, suggesting either a page-by-page review or focusing on the summary.

Will Blandamer Head of Health and Adult Care provided a brief overview of the ICP Locality Performance Report, noting that it is a report in development and highlighting some gaps, particularly in key indicators and children's services. The report is used by the locality board to review the operation of the health and care system.

During the discussion, several key points were addressed. Will Blandamer explained that the report is owned and coordinated by the ICB (Integrated Care Board) and acknowledged that there are gaps in the report, especially in key indicators and children's services.

He emphasized that the report is used by the locality board to review the health and care system's operation.

The performance metrics included in the report were discussed, with Blandamer highlighting the importance of indicators related to primary care, hospital discharge, and prevention work. He specifically pointed out the health checks for those with learning disabilities on Page 55 and the number of GP appointments within 14 days on Page 68.

Councillor Rubenstein questioned the rationale behind using 14 days as a measure for GP appointments. Will Blandamer explained that the 14-day measure is a national indicator and provided context on how GP appointments are recorded.

A Councillor inquired about the impact of COVID-19 on the data and figures presented in the report. Blandamer addressed the impact of COVID-19 on various areas, including elective care, mental health services, and routine health checks.

A Councillor asked about the assurance that the health side of the locality plan is meeting its objectives, particularly for children starting school ready to learn. Will highlighted the work of the Starting Well and Early Health Partnership Board in supporting children and families.

Councillor Lancaster raised concerns about the safety of the inpatient mental health unit following recent newspaper reports. Blandamer preferred not to comment on that at the moment but agreed to provide a briefing to the committee outside the meeting.

Councillor Gold questioned the accuracy of the 14-day GP appointment measure and how it accounts for patients who cannot get an appointment within that timeframe. Will provided context on how GP appointments are recorded and emphasized the importance of looking at a range of indicators to assess the overall performance of the health system.

Adrian Crook provided additional context on the performance of the health system, emphasizing the importance of primary care and community-based interventions. He discussed the correlation between primary care performance and hospital admissions.

The importance of presenting data in a way that reflects the patient journey was discussed, and the need for better access to data on the quality of maternity services for Bury residents was highlighted.

It was Agreed:

·         The report be noted 

• Will Blandamer to check the rationale  ...  view the full minutes text for item HSC.36

Adult social care performance report to be presented by Adrian Crook Head of Adult Social Care

Councillor Tariq, the cabinet member for Health and Well-being presented the Adult Social Care Performance report. He highlighted key points from the report, which is regularly presented to the cabinet. The report covers the performance of the adult social care department up to September, with the next quarter's report to be presented soon.

Councillor Tariq noted several achievements, including the new transition service for 17-year-olds in children's services and progress on the new parent strategy. He also mentioned the department's efforts in reducing the number of people waiting for social work and the positive impact of additional staff in the reviewing team.

Councillor Gold raised a question about the demand for personal therapy and the speed of implementing disability assessments and adaptations. Councillor Tarrick responded that while there has been progress in reducing waiting times, there are still concerns about bottlenecks in the adaptation process. He mentioned the implementation of a framework of builders to address this issue and the need for better measurement of the entire pathway.

Councillor Boles asked about the positive outcomes of increased social work staff recruitment. Councillor Tariq explained that the council has multiple recruitment routes, including a "grow your own" program and degree apprenticeships, to manage vacancies and turnover. He also mentioned the use of consultants and advertising campaigns to attract staff.

Councillor Gold inquired about the impact of additional government funding for disability adaptations. Councillor Tarrick acknowledged the positive news but noted that the details for Bury are still unknown.

A Councillor highlighted the upcoming peer review facilitated by the LGA on social care, which will assess the council's performance and provide feedback for further improvement. He emphasized the significant changes made in the past 18 months to prepare for this review.

The meeting concluded with a reminder of the upcoming LGA peer review and an acknowledgment of the hard work done by the council's social care team.

It was agreed:

·         The report be noted

·         Implement the framework of builders to address bottlenecks in the adaptation process.

• Develop measures to better track the entire pathway for disability adaptations.
• Continue efforts to recruit and retain social work staff through various programs and campaigns.
• Prepare for the upcoming LGA peer review and incorporate feedback for further improvement.

Chair's Report to include updates from:

• Health & Wellbeing Board - 16th January.
• NCA Joint Health Scrutiny informal meeting - 19th December.
• GMCA Health Scrutiny - 21st January.

Chair Councillor Fitzgerald provided an update on several key items during the chairs update. Starting with the Northern Care Alliance Joint Health Scrutiny Committee, Councillor Fitzgerald mentioned that both she and Councillor Gold attended the last meeting. It was an informal session because Salford had decided to withdraw from the committee. Despite this, Bury decided to continue participating to ensure that residents could still benefit from the information and services provided by the Northern Care Alliance.

Moving on to the Health and Well-being Board, the discussion focused on the scope of work for 2025, particularly around housing and its impact on health. Councillor Fitzgerald raised concerns about the private rental sector, highlighting issues such as damp and mould, and the need for secure housing. She emphasized that poor housing conditions could significantly affect both physical and mental health.

Councillor Walsh then asked how housing affects health. Councillor Fitzgerald explained that poor housing conditions, like damp and mould, could lead to health problems. Insecure housing could also impact children's education and overall well-being. Councillor Frederick suggested having a report on the wider impact of housing on health, to which Councillor Fitzgerald agreed, noting that it would be beneficial to explore how different types of housing affect health and what responsibilities the Council has in this area.

The update also covered the Greater Manchester Combined Authority Health Scrutiny Meeting. Councillor Fitzgerald discussed ongoing service reconfiguration and workforce updates. She mentioned that diabetes engagement had started, focusing on improving diabetes education. Additionally, procedures of limited clinical value were being monitored, with an engagement exercise set to begin in February.

A Councillor enquired about the impact of increased employer National Insurance contributions on the workforce. Will Blandamer responded that the increase had significant financial implications, particularly for primary care and the voluntary sector. The Council was trying to cover these costs as part of their fee setting.

Regarding hospice capacity, Councillor Fitzgerald noted that Bury Hospice had increased its capacity to eight beds and was exploring community-based care. The Council recognized the importance of hospices and was providing additional funding to support them. Councillor Frith asked about the current capacity of Bury Hospice and what it would be if fully maximized. It Was explained that Bury Hospice currently operated with eight beds but could potentially increase to twelve beds if fully maximized.

It Was Agreed

·         The report and update be noted

·         Look at the potential to bring an item around housings impact on health

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