No apologies were received.

To confirm the record of the meeting of the Adults & Health Scrutiny Panel held on 8 February 2018 (previously circulated).

The minutes of the meeting of the Adults and Health Scrutiny Panel held on 8 February 2018, copies of which had been previously circulated, were confirmed as a correct record and signed by the Chairman.

In accordance with the Regulations, Members are invited to declare any personal or prejudicial interests they may have and the nature of those interests in respect of items on this Agenda and/or indicate if Section 106 of the Local Government Finance Act 1992 applies to them.

No declarations of interest were received.

To receive any petitions, deputations and questions received from Members of the Public in accordance with the provisions of Procedure Rule 217.

The total time allowed for this item shall be 30 minutes.  Petitions, declarations and questions shall be dealt with in the order in which they are received.  Questions may also be submitted at short notice by giving a written copy to the Committee Administrator 15 minutes before the start of the meeting.

The total time allowed for questions at short notice is 15 minutes out of the total time of 30 minutes.  Any petitions, deputations and questions that have been submitted with prior formal notice will take precedence over questions submitted at short notice.  Any questions that are not considered within the time limit shall receive a written response after the meeting and be the subject of a report to the next meeting.

No petitions, deputations or questions from members of the public had been received.

To consider any questions with notice from Members received in accordance with the provisions of Procedure Rule No 219 and No 219A.

No questions were received from Members.

To consider any Notices of Motion from Members submitted in accordance with the provisions of Procedure Rule No 220.

No notices of motion were received from Members.

To consider any matter referred to the Panel for a decision in relation to call in of a decision in accordance with Procedure Rule 206.

No matter was referred to the Panel for a decision in relation to a call-in of a decision in accordance with Procedure Rule 206.

To receive a presentation from University Hospitals of Leicester NHS Trust.

A presentation (appended to the minutes) was received from University Hospitals Leicester.  The presentation was provided by Paul Traynor – Chief Financial Officer; Nicky Topham – Reconfiguration Programme Director; John Jameson – Deputy Medical Director and Rakesh Vaja – Head of Service Critical Care.

The purpose of the presentation was to provide members with information and background regarding the plan for the relocation of Intensive Care capacity and associated specialties from the Leicester General site.

During discussion the following points were noted:

i.      The current situation was not sustainable due to the lack of a suitably qualified clinicians to maintain safe Level 3 Intensive Care Unit (ICU) services across the three sites and the fact that the Leicester General did not treat a sufficient number of critically unwell patients to safely maintain Level 3 ICU services;

ii.     The £31 million investment was designated to this project only and was not reliant on or connected with other proposals for sustainability through the Sustainability and Transformation Plan;

iii.    It was confirmed that clinicians advised the project team, members were reassured that Doctors and Consultants working within the system were involved in developing proposals.  The Chief Finance Officer was also important to maintain oversight of budgets and the capital programme;

iv.   Members asked for reassurance that this would not lead to further reduction in services at the General, especially as many Rutland Residents already opted to go to Peterborough Hospital as it was easier to access.  It was confirmed that this business case stood alone, but that there may be other projects and schemes to centralise services in order to ensure future sustainability; and

v.     Leicester General was still a teaching hospital, but the full range of intensive care teaching could no longer be achieved at the General.

AGREED:

The Panel endorsed the plan to consolidate ICU at the Royal and Glenfield.

To receive a presentation from Mr M Andrews (Deputy Director for People)

A presentation (appended to the minutes) was received from Mr Mark Andrews, Deputy Director for People, the purpose of which was to brief Members on a holistic homecare model that was being trialled in Rutland.

The Chairman welcomed the following attendees to the meeting:

• Janet Musson – Service User
• Tammy Thurley - Community Support Services Team Manager
• Joanne Carter - MICARE Community Support Coordinator
• Carol Taggart - MICARE Community Support Worker
• Tracey Taylor - MICARE Community Support Worker
• Gaynor Poole - MICARE Community Support Worker
• Liz Perkins - MICARE Community Support Worker
• Tracey Gilbert – Community Support Services Manager

Ms Musson was invited to share her experience of the service with the Panel.  Ms Musson noted the following:

• She had been receiving 30 hours of care on her return home from residential care. Ms Musson was discharged from hospital into residential care  after a fall;
• The Support Workers had helped her to improve her mobility and confidence and her care package had reduced to 2 hours per week as a result; she has also had her driving license re-issued.
• The Support Workers had also helped her with moving house, and confidence to use the stairs so she could sleep upstairs again.

During discussion the following points were noted:

1. The model had been very successful for complex cases, but would need to be tested for low level care and may need adapting;
2. Care was person centred and flexible, allowing the support worker to form a relationship and use their judgment, taking into account the feelings and preferences of the Service User.  This takes a specific type of person and recruitment could be difficult;
3. The deadline for recommissioning homecare had been pushed back to allow for further work and evidence to be developed;
4. Support workers discussed the needs of the service user with them and designed a support plan around those needs.  The service user was more important than timescales, so support workers could have a chat and a cup of tea with the service user before assisting with tasks.  They were able to spend less time on one visit if appropriate and more time on another to suit the service user;
5. Support Workers felt that they were able to get to know the service users and were trusted to work flexibly in the best interests of the service user, this led to a feeling of achievement when the outcomes were good and greater job satisfaction;
6. Members observed that the staff were committed and engaged and that as the service was developed their input should be sought;
7. Growing the service would be complex, particularly as it had been trialled in Oakham which brought economies in terms of travelling costs and time, but also in terms of changing the organisational culture to accept a different way of working;
8. Members noted that the service must bring a great sense of relief not only to service users, but to their families who must be reassured by the focus on the emotional, physical and social well-being  ...  view the full minutes text for item 726.

To receive Report No. 62/2018 from the Director for People

Report No. 62/2018 from the Director for People was received.

Mr A Walters, Portfolio Holder for Adult Social Care and Health and Mr M Andrews, Deputy Director for People, introduced the report, the purpose of which was to seek comments from the Panel on the draft Leicester, Leicestershire and Rutland (LLR) Dementia Strategy.

Mr Walters highlighted section 2.4 of the report and the focus on the provision of the Admiral Nurse.

Mr Andrews introduced the Admiral Nurse, Angela Moore, to the Panel.

During discussion the following points were noted:

i.      There were currently only 227 Admiral Nurses working in the UK compared to 1000’s of MacMillan Nurses.  Currently only two Local Authorities employed Admiral Nurses and Rutland was one of these;

ii.    Admiral Nurses provide support and education to people with dementia and their families.  This support continued from diagnosis to end of life;

iii.   Mrs Moore confirmed that she had already started to make contacts with groups and organisations within Rutland and had been reassured by the willingness to work together for the benefit of Rutland residents suffering from dementia;

iv.   The table on page 14 of the agenda pack illustrated that East Leics and Rutland had a lower diagnosis rate than Leicester City and West Leics, but a higher percentage of population of people aged over 65 living with dementia.  If diagnosis rates were higher, this percentage figure would also increase;

v.    Diagnosis was an issue in that there had been a period of where it was seen as unnecessary to diagnose people who were already living in care homes.  People also found it difficult to admit that they had a problem until symptoms became more acute;

vi.   Section 6 of the Strategy would be amended to reflect that there was not an Admiral Nurse in the period 2011 – 2014;

vii.  Rutland residents have access to the Dementia Support Service;

viii.Should members have safeguarding concerns regarding residents that may be people with dementia they should contact the Duty Desk;

ix.   Mrs Moore acknowledged the problems with early diagnosis and people accepting that they had a problem and highlighted how raising awareness, education and training were key in order for family, friends and health professionals to recognise symptoms early so that a person could be supported appropriately;

x.    Rutland had already started work on implementing the strategy;

xi.   The number of new retirement developments in Rutland was increasing as there was demand for this provision, additional numbers of older people in Rutland could lead to a greater demand on services.  There were issues with classification of these developments which could result in limited Community Infrastructure Levy contributions, but there was the opportunity to negotiate with developers to secure facilities which would benefit people suffering from dementia and other conditions.

AGREED:

1)    The panel provided comments and feedback on the Dementia Strategy as noted above;

2)    The panel NOTED the LLR Dementia Strategy 2018-2021.

To receive Report No. 65/2018 from the Director for People

Report No. 65/2018 was received from the Director for People.

Ms K Kibblewhite, Head of Commissioning,  introduced the report, the purpose of which was to outline proposals to bring together funding from Public Health Grant and Better Care Fund to establish a grant scheme to boost local community activity in relation to health and wellbeing.

During discussion the following points were noted:

1. Public Health Reserves had been inherited when the Public Health responsibility had transferred to the local authority from the (then) Primary Care Trusts.  Public Health England had now indicated that unless funds could be spent this financial year in line with the health and wellbeing strategy then they would ask for reserves to be returned.  Some of the reserves were already being spent on Public Health activity, this proposal would reduce the reserves further;
2. The preferred option was to devolve the scheme to the Rutland Access Partnership (RAP), however Members were concerned that RAP had not established links with Parish Councils as reported;
3. There would be a separate award panel that would make the final decision on award of grants.  This panel would be independent of RAP.  This would be clarified in further reports;
4. Option 2 had been discounted as very few Parish Councils had the power of competence to hold funds on behalf of another organisation;
5. The total fund for this scheme from the Better Care Fund Programme and Public Health reserves was approximately £100k;
6. The Public Health Grant was unlikely to continue in the long term and any funds received are ring-fenced;
7. Grants from this scheme would be used to encourage existing organisations to think differently and use their existing infrastructure to expand the ways in which they can work to benefit the community, or as a seeding grant for new schemes; and
8. The panel requested more information on criteria, levels of award and the assessment panel.

AGREED:

1)    The Panel ENDORSED the use of the Public Health Grant and Better Care Fund Programme funding to establish a Healthy Rutland Small Grants Scheme to improve the health and wellbeing within local communities as set out in Section 3 of Report 65/2018; and

2)    The Panel RECOMMENDED TO CABINET the proposed option for managing the scheme, subject to a further report on criteria; levels of funding; and the composition of the assessment panel being presented to the Adults and Health Scrutiny Panel at a later date.

The Chairman of Adults and Health Scrutiny Panel to give a verbal update

Mrs Stephenson provided a verbal update on the Mental Health Task and Finish Group noting that the group were on target to achieve the deadlines set out in their terms of reference.  The Group were due to meet with East Leicestershire, Leicester and Rutland Clinical Commissioning Board on Tuesday 10 April and had arranged for an afternoon of evidence sessions with key stakeholders on 1 May 2018.

To receive Report No. 12/2018 from the Chief Executive

(Report circulated under separate cover)

Report No. 12/2018 was received from the Chief Executive, for information only.

The Panel NOTED the Report.

To receive Report No. 32/2018 from the Director for Resources

(Report circulated under separate cover)

Report No. 32/2018 was received from the Director for Resources, for information only.

The Panel NOTED the Report.

To consider Scrutiny issues to review. 

Copies of the Forward Plan will be available at the meeting.

·         Mrs Stephenson noted that the panel had been expecting an update on the Sustainability and Transformation Plan from the CCG, but that this had been cancelled as the information was not yet ready for publication.  Mrs Stephenson had received an email from the CCG outlining the situation which would be shared with Members, but was minded to write to the CCG to express the concerns of the panel regarding the delay in the availability of any further information.

·         Miss Waller requested that East Midlands Ambulance Service be invited to an Adults and Health Scrutiny Panel meeting in the new Municipal year.

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In accordance with Procedure Rule 229 of the Rutland County Council the Panel AGREED to extend the meeting by 15 minutes.

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To receive any other items of urgent business which have been previously notified to the person presiding.

The Chairman had been advised of the following item of urgent business:

Mrs Burkitt requested clarification on the award of the Healthwatch contract.

Mr Walters, Portfolio Holder for Adult Social Care and Health, confirmed that the decision had been taken to recommission the service.  The existing provider had not scored the most points in the procurement process and therefore had not won the contract. 

Mr Andrews, Deputy Director for People, confirmed that there was some confusion as Healthwatch Rutland had been the name of the Community Interest Company providing Healthwatch as well as the name of the service. The new provider was also a Community Interest Company and the service, which was Healthwatch Rutland, would continue to be Rutland based.

Mrs Stephenson confirmed that once the new provider had time to establish itself, they would be invited to report to the Adults and Health Scrutiny Panel.

Thursday 26 April 2018 at 7 pm (Special Meeting)

Proposed agenda items:  

Proposed Closure of Ketton Surgery

Thursday 26 April 2018 – Special meeting on Proposed Closure of Ketton Surgery.