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.

Councillor Hussain declared an interest due to his Son working as a Doctor within the NHS

The minutes from the meeting held on 19^th June 2025 are attached for approval.

The minutes of the meeting held on 19^th June 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.

Andrew Hollond Chief Operating Officer for Bury Healthwatch to support this item.

Andrew Holland, Chief Operating Officer for Healthwatch Bury, was invited to present an overview of the latest report. He began by outlining the key findings and developments, supported by a presentation that will be shared with members. The report focused particularly on the Bury CAHMS service, where several recommendations have been made to improve outcomes and experiences for service users. Andrew emphasised that the report is intended to generate feedback, which will inform future revisions and help shape services going forward.

He acknowledged that while Healthwatch Bury has made significant progress, there remains a perception among some stakeholders that the organisation must evolve further to maintain its role as an independent voice for residents.

During the discussion, Councillor McBriar referred to page 16 of the report, noting that 400 individuals had shared their experiences. He asked how this number could be increased. Andrew clarified that the 400 figure relates to specific feedback on defined scenarios, and that Healthwatch Bury has engaged with over 7,000 individuals for signposting and general support.

Councillor McBriar also raised concerns from page 17 regarding dementia services and safeguarding issues. In response, Annemari from Healthwatch Bury explained that a representative attends dementia support workshops to contribute to service development. She confirmed that any safeguarding concerns are referred to the Bury Safeguarding Team. Will Blandamer added further context, highlighting the role of Dementia United in shaping services and noting that a recent workshop held at Radcliffe Football Club was one of the best attended across Greater Manchester, with valuable insights gained from service testing.

Councillor Ryder commended the Healthwatch team for their work over the past year and asked whether constituents could be referred to workshops such as the “Park Bench” sessions. Annemari confirmed that details of upcoming workshops would be shared via the Healthwatch website.

Councillor Rubenstein queried whether Healthwatch Bury plays a role in supporting individuals who have received care. Andrew responded that Healthwatch often acts as an intermediary, liaising with providers to help both parties reach a resolution and ensure that individuals receive the support they need.

Councillor Tariq echoed the praise for Healthwatch Bury and highlighted the importance of the local authority’s commissioning role. He reassured colleagues that Healthwatch’s performance is monitored through KPIs and quality assurance processes. He emphasised the organisation’s role in amplifying the patient voice and ensuring that feedback leads to tangible impact. On a broader level, he acknowledged concerns raised across Bury and Greater Manchester and confirmed that the council remains committed to working with Healthwatch Bury, with updates to be provided once timescales are clarified.

Councillor Fitzgerald noted the strength of the report in demonstrating not only what Healthwatch has done, but also the outcomes achieved. He stressed the importance of commissioning the right services at the ICB level and ensuring that community needs are met.

Councillor Ryder raised a question about NHS dental services, asking whether waiting lists exist and how access varies by location. Councillor Tariq responded that the NHS Choices website provides real-time data on  ...  view the full minutes text for item HSC.68

Dr Catherine Fines, GP Partner at Tower Family Healthcare and Associate Medical Director at the Greater Manchester Integrated Care Board, joined Zoe Alderson, Head of Primary Care in Bury, to present an update on the GP Strategy. The presentation outlined five strategic goals aimed at improving access, quality, and integration of primary care services across the borough. A visual summary of the strategy was shared with the committee, illustrating the ambitions and direction of travel for general practice in Bury.

Dr Fines and Ms Alderson began by addressing the ongoing pressures on A&E departments and the need for primary care services to operate differently to alleviate this strain. They highlighted the expansion of advanced access to GP services, noting that practices across Bury are now offering appointments seven days a week, including evenings and weekends. This enhanced availability is being delivered with a focus on maintaining continuity and quality of care, even out of hours.

To illustrate the scale of current provision, Dr Fines shared data from Tower Family Healthcare, which had offered 503 appointments on the previous day alone. Across Bury, approximately 4,000 appointments were made available, supported by a workforce of around 800 nurses and advanced nurse practitioners. Despite this, she acknowledged that demand continues to outstrip supply and that further expansion of availability is needed.

Councillor Staples Jones queried why public perception of GP services remains negative despite the apparent improvements. Dr Fines responded by emphasising the importance of better communication and public awareness, noting that duplication of appointments and system inefficiencies contribute to frustration. She invited councillors to help disseminate accurate information to residents.

Councillor Ryder echoed concerns about delays in securing appointments, suggesting that some residents feel let down by the system. Dr Fines acknowledged these concerns and discussed the challenges posed by digital platforms such as AskMyGP, which had not worked well for all patients. She confirmed that work is underway to improve online booking systems and ensure more consistent access across practices.

Councillor Fitzgerald noted that while online booking options exist, implementation varies between practices. Councillor Simpson raised the issue of acute respiratory hubs, particularly their role in supporting elderly patients during winter. Dr Fines confirmed that these hubs operate annually in Bury and stressed the importance of ensuring patients are aware of their location and purpose, especially when travel is involved.

Councillor McBriar highlighted the need for better data sharing with elected members and asked what measures are in place to address missed appointments. Dr Fines explained that practices are using SMS reminders and promoting the NHS App to help patients manage their bookings. She also noted that data on appointment attendance and cancellations is being published on practice websites to improve transparency.

Ms Alderson added that there has been a 50% increase in prescription requests via the NHS App, indicating growing engagement with digital tools. Dr Fines concluded by outlining the rollout of cloud-based digital telephony systems across all practices, which are helping to manage high call volumes and  ...  view the full minutes text for item HSC.69

Jon Hobday Director of Public health in attendance to support this item

Jon Hobday, Director of Public Health, provided an overview of health inequalities in Bury, drawing on a presentation that highlighted key data and trends. He began by discussing life expectancy, noting that Bury’s figures are significantly lower in the north of the borough compared to the south. The impact of COVID-19 was substantial, causing a sharp decline in life expectancy, although there has been a slight recovery since 2020.

Jon explained that the gap in life expectancy between the most and least deprived areas in Bury remains wide. He outlined several major contributors to this disparity, including liver disease, lung and other cancers, heart disease, accidental poisoning (including overdoses), dementia, external causes such as accidents, and respiratory diseases like chronic obstructive pulmonary disease (COPD).

Over the past two years, a number of key actions have been taken to address these issues. These include efforts to reduce poverty and respond to the cost-of-living crisis, improve access to pension credit, and implement a new “Live Well” model. Work has also been done to reduce inequalities in smoking-related illness, improve diet through the development of the Bury Food Strategy, and create an alcohol licensing matrix. In addition, care for people with coronary heart disease has been improved, and steps have been taken to increase uptake of MMR vaccines, including additional clinics and outreach into communities and mosques.

Looking ahead, Jon emphasised the importance of continuing work across all four quadrants of the Health and Wellbeing Board. He stressed that this work is ongoing and will be shared through the board to ensure alignment and progress.

Councillor Tariq expressed support for the approach and highlighted the importance of connecting this work to the “Let’s Do It” strategy. He referenced previous discussions around childhood disability, inequalities affecting BME women, and other areas, stressing that aligning with the strategy’s principles is vital. He noted that health inequalities are everyone’s responsibility and that many council objectives are linked to this issue.

Councillor Rubenstein raised a question about the impact of differing service quality nationally and whether this is measurable. Jon responded that certain groups do struggle with access and that quality impact assessments are important. He noted that disparities exist in health access provision, particularly in primary care, and that travel requirements can be a barrier. Ensuring accessibility for all is a key priority.

Councillor FitzGerald commented on the socioeconomic pressures faced by residents, such as the need to work multiple jobs, and how these pressures contribute to health inequalities. She also highlighted the stark contrast in life expectancy between different parts of Bury, referencing the statistic that 11 times more people died during COVID-19 in the north compared to the south.

Councillor McBriar referred to data on breast cancer and asked whether the increase in positive cases was due to improved screening. He also raised concerns about the lack of a national screening programme for prostate cancer. Dr Cathy Fines explained that prostate screening is not offered nationally in the same way as breast screening, as  ...  view the full minutes text for item HSC.70

Verbal update from the Chair Councillor FitzGerald

Councillor Fitzgerald provided a verbal update to the committee regarding recent developments in regional health scrutiny. She noted that she was unable to attend the latest meeting of the Joint Health Scrutiny Committee for the Northern Care Alliance (NCA) due to annual leave, and that Jackie Harris was also unavailable due to the late notice of the invitation. As a result, and due to the absence of a Labour member, the meeting was not quorate. Councillor Fitzgerald offered to attend future meetings and encouraged Labour members of the committee to consider putting their names forward to ensure Bury is represented in future discussions. The committee meets quarterly in Oldham, with three meetings remaining this year.

Councillor Fitzgerald also chaired the Joint Health Scrutiny Committee for the Greater Manchester Combined Authority (GMCA) earlier in the day. While there were no updates on service reconfigurations, the committee was informed that updates on Major Trauma (Salford and MFT) and Procedures of Limited Clinical Value will be presented in September. These procedures include interventions such as varicose vein treatment, hysterectomies, and skin tag removal. Commissioning statements are being reviewed to determine when these services will be provided. Papers are expected on 9th September, and a task and finish meeting will be scheduled shortly after to review them.

An update was also received from NHS Greater Manchester (ICB) regarding organisational restructuring and the second year of the sustainability plan. Key points included confirmation that NHS GM will retain a single organisation with ten localities and that no mergers are planned. The new organisational structure is expected in late August or September, with a voluntary redundancy package going to the NHS GM Board imminently. Consultation with staff will take place in Q3, with implementation in Q4. The restructuring aims to reduce costs by 39%, potentially affecting up to 600 roles, and may result in up to 5,000 staff across GM being displaced or transferred. A Workforce Transition Hub will be established to support affected NHS colleagues.

The committee raised concerns about the impact on commissioning, safeguarding, SEND, and community engagement functions. It was confirmed that these responsibilities would remain, though delivery models may change. The importance of retaining specialist skills, particularly in nursing, was also discussed.

The committee requested a further update in September on the proposed changes and their impact on patients, both at GMCA and local levels. Councillor Fitzgerald suggested sharing the GMCA forward plan with local Health Scrutiny Committees to coordinate efforts and avoid duplication.

Councillor McBriar advised the committee of the opportunity of writing to the Secretary of State regarding the proposed changes. This was discussed noting that while it may be challenging, it is a power available to the committee and could be used if necessary.

Will Blandamer clarified that the ICB is the commissioning organisation and acknowledged the challenges posed by the reduction in roles. He emphasised the need to develop a sustainable operating model and recognised the difficult period ahead for NHS colleagues in Bury.

At the last meeting, it was agreed that a Health Scrutiny Task and Finish Group would be established to focus on developments at the Greater Manchester level, particularly those arising from GMCA and NHS England. The group will meet on a monthly basis to consider and discuss relevant GMCA papers, including the upcoming proposals in September relating to two service reconfigurations and the new Integrated Care Board (ICB) structure.

Members were invited to express interest in joining the group. Councillor McBriar and Councillor Boles confirmed their interest, and it was agreed that meetings would begin at 6:00pm.

To initiate the work of the group, a meeting will be arranged before the end of the summer to develop the Terms of Reference and to identify initial areas of focus. It was further agreed that the date for reviewing the September GMCA papers will be confirmed via email between group members over the coming month.

A standing monthly meeting will be scheduled to ensure ongoing scrutiny of GMCA papers and developments at the regional level. Short minutes summarising this discussion will be circulated to all relevant members.

Forward planner to follow

During the discussion on the forward planner and standing items, the following topics were raised and considered throughout the conversation.

Core Discussion Topics

1. ICB Changes – Structure, services, and workforce implications
2. Neighbourhood Working & Public Service Reform – Including voluntary sector links
3. Maternity and First 1,000 Days
4. Transitions Between Children’s and Adult Services
5. SEND – Connections with maternity, transitions, and the Children & Young People Committee
6. Access to Healthcare – Pharmacy, dentistry, and GPs (GP update received)
7. Elective Care and Winter Preparedness
8. Healthwatch – Patient experience and voice
9. Social Care – CQC, performance, complaints
10. Communications Support – Clarification needed (Cllr Frith)
11. Health Inequalities
12. Housing and Health
    • Housing First policy
    • GMCA-level engagement
    • Locality board and tri-partite agreement
    • Renters Reform

Emerging and Ongoing Issues

13. Industrial Action – Impact on services
14. Palliative Care & Assisted Dying – GMCA work noted
15. Hospice Services 
16. Bereavement Services – Mental health support
17. Social Prescribing 
18. Mental Health Services Update

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