Agenda and draft minutes

The Scrutiny Board is asked to elect a Vice Chair for the 2023/24 Municipal Year.

RESOLVED - That Councillor McLaren be appointed as Vice-Chair of the Adults Social Care and Health Scrutiny Board for the 2023/24 Municipal Year.

Apologies for absence were received from Councillor Ball.

There were no items of urgent business received.

Councillor J Harrison declared a personal interest as she is Chair of the Health and Wellbeing Board and her daughter in law is manager of the Schools Swimming Service.

There were no public questions for this meeting of the Committee to consider.

To note the Minutes of the Health Scrutiny Committee held 7^th March 2023

Members were informed that the NCA summary of the Inspection report with specific focus on Royal Oldham Hospital to include previous inspection ratings for comparison and the actions needed to improve as a consequence of the current Inspection findings had not been received as referred to in the resolution of Minute 7.

Similarly the NCA Localities Board membership and its Terms of Reference had not been received as referred to in the resolution to Minute 7.        

RESOLVED – That subject to the officers following up on the resolution to Minute 7, the Minutes of the Health Scrutiny Committee held on 7 March 2023 be noted.

To note the Scrutiny Board’s terms of reference as reported to the Council on 24^th May 2023

RESOLVED – that the Terms of Reference of the Adults, Social Care and Health Scrutiny Board be noted.

Interim Director of Public Health to report

The Board received an update presentation from Rebecca Fletcher, Interim Director of Public Health, of the Health and Wellbeing Strategy.

Members were informed that the report provides an introduction to the strategy, and includes the Health and Wellbeing Strategy itself.  The Health and Wellbeing Strategy was approved by the Health and Wellbeing Board in March 2023 and contains five themes that are to be subject to ‘deep dives’ at Health and Wellbeing Board meetings in 2023/24.

The Joint Local Health and Wellbeing Strategy, and the Health and Wellbeing Board aim to improve the health and wellbeing of people in Oldham and reduce inequalities for all ages. The responsibility for developing and delivering the Health and Wellbeing Strategy (and the Joint Strategy Needs Assessment) sits with the Health and Wellbeing Board and rests with all the members of the board.  Oldham Health and Wellbeing Board is chaired by Cllr Jenny Harrison, and has good representation from partners.  

The strategy outlines the principles that the board members agree the system needs to work to in order to make the changes needed. These are:

• We are resident focused
• We have a well-managed health and care system
• We are champions of equality
• We prioritise prevention

There are then five priorities which the Board have agreed would make a significant impact on the health and wellbeing of the borough.  These are:

• Supporting our residents to gain the knowledge and skills to confidently make choices and participate in decisions about their own health
• Giving children the best start in life
• Improving mental wellbeing and mental health
• Reducing smoking
• Increasing physical activity

On discussion the following points were raised

·         Feedback on mental health and wellbeing

·         Effective approaches to tobacco and vapes non smoking

·         Cycle lane and cycle parking infrastructure and the positive effect on wellbeing

Reference was made to principles and priorities as detailed above and the need to manage and promote those principles with a view to achieving better lifestyles and health of residents thus reliving pressure on the NHS. It was suggested that the voluntary sector could combine to help to achieve the objectives set out in the Strategy.

Mike Barker, Strategic Director of Commissioning/Chief Operating Officer, emphasised the need for the various objectives and goals to be achieved via one programme rather that  hospitals, GP’s Mental health and other bodies running their own programme.

Rebecca Fletcher thanked members for their input regarding strategy objectives. She also emphasized that any positive outcomes of the strategy objectives would be as a result of the combined contributions of Board members and the interaction with the various groups.

RESOLVED – that

(1)       The involvement of Oldham Districts to take forward the development of a programme regarding the achievement of the objectives and goals of the Oldham Health and Wellbeing Strategy be raised Councillor Dean, Cabinet Member for Communities and Culture;

(2)       the Board to receive updates on the progress of the programme regarding the objectives and goals for the Strategy at future meetings of the Board; and  ...  view the full minutes text for item 8.

Consideration was given to a report which gives an update on Urgent and Emergency Care for Oldham Paediatrics. This report was submitted to the Health Scrutiny Committee meeting on 7 March 2023 but was deferred to the this meeting due to the lateness of submission to Members.

Mike Barker, Strategic Director of Commissioning/Chief Operating Officer, made reference to the winter of 2022, referred to post Covid and 2023 winter pressures on Children’s Services and Paediatrics services with the added current pressure of the medical professions strikes. He informed the Board these pressures combined with the regular fluctuations in demand emphasized the challenges and objective to provide the best quality care.

Members were advised that this year has shown an increase in A and E attendances. It was also emphasized that attendances were difficult to predict due to random virus outbreaks.

Members attention was drawn to the 4 hour target for childrens admissions and the previous target of childrens attendances of 95 per cent at A and E alongside adults. This had now been reduced nationally by NCO (National Casemix Office) down to 76 per cent by April 2024 with this committed target by NCO of September this year . The target should be complimented by the fact that queues for A and E had been nullified.

The Board was informed that although the paediatric workforce was difficult to source the workforce establishment is at its highest but is hampered by industrial strike action.

In response to a question regarding the improvement in A and E attendances and the Health and Wellbeing Strategy, the Board was informed that the balance of risk was being managed and the much improved performance progress was having the desired affect on A and E attendances.

Mike Barker advised that the previous unplanned activity approach had been replaced by a planned activity approach which had resulted in better efficiency. There is a structure in place at hospitals to enable care homes to be aware and ready to admit patients being discharged from hospital.

Jayne Ratcliffe, Director of Adult and Social Care informed the Board that the current positive timely discharge rate at Oldham has attracted the attention of other health authorities in the way that this has been achieved.

RESOLVED that the report and current update on urgent and emergency care for Oldham Paediatrics be noted.

Director of Adult Social Care to present

The Board received a presentation from jayne Ratcliffe, Director of Adult and Social Care, regarding a Care Quality Commission (CQC) inspection CQC Presentation.

Members were informed of the following Scrutiny schedule prior to the CQC Assessment inspection in April 2024 –

1. CQC preparation – July 13^th 2023
2. Safeguarding – September 6^th 2023
3. Care market – December 5^th 2023
4. Transition / Preparing for Adulthood – January 16^th 2024
5. Workforce  - March 7^th 2024

The following was emphasised to Members –

•         In March this year, it was announced that Care Quality Commission (CQC) inspections are changing. Their aim is to streamline and simplify the assessment process and replace the four individual frameworks that are used currently to one single assessment framework.

•         Whilst streamlining the assessment process, the CQC have also been given the power to scrutinise and assess how well local authorities are delivering the legislation from the Care Act 2014.

•         These inspection changes are not supposed to take place until April next year but in that time, preparing for these changes are key.

The Board was also informed of the following –

1)    Areas of Inspection

2)    How the areas will be rated

3)    The Peer Review Process

4)    The Peer Review Outcomes

5)    The Council’s approach to Inspection

6)    The Adult and Social Care Change Board which assesses Governance an Assurance

7)    The role of elected Members

8)    The Next Steps which will focus on –

·         A focus on priority improvement areas within the Adult Social Care improvement plan (workforce and the Target Operating Model as 2 of the biggest priorities)

·         Leadership and project sub groups established supported by detailed plans

·         Reporting, measurement and risk log developed

·         Month assurance update to ASC Change Board

It was emphasised that it is essential to properly prepared for the inspection.

In response to an issue raised regarding overlaps with the Health and Wellbeing Strategy, members were advised integration with the Strategy is key eradicating duplication.

It was suggested that Member drop in sessions would be a useful tool and feed as to progress being made.

With regard to way forward regarding achievements and progression and Get to Good’ factor, Jayne Ratcliffe advised that the Areas of Inspection - Working with People, Providing Support, Ensuring Safety and Leadership (as set out in the presentation) underlines these elements. She also highlighted working with the community via the Residents Council Panel which will help to show the connection with the community.

RESOLVED the CQC presentation be received and noted.

The Board received a draft Adult Social Care and Health work programme for consideration. The Chair advised that he would be consulting with the Vice Chair to refine the programme and requested Members to inform him of any further items for inclusion.

RESOLVED that a revised draft work programme be submitted to the next Board meeting for consideration and approval.

Th Board considered the latest Key Decisions document which set out the Authority’s Key Decisions scheduled to be taken from 23 June 2023.

RSOLVED that the Key Decisions document be noted.