Councillor Waller welcomed everyone to the meeting.  She informed attendees that as Chair she would reorganise that evening’s agenda as an Officer needed to attend another meeting later that evening.  She also advised that she had received apologies from Lakeside Healthcare Stamford who could not attend the meeting due to an imminent CQC inspection. However, they had confirmed that they would be attending the next scrutiny committee meeting at the end of March.  

Apologies were received from Councillor Bool, Councillor Fox, Mark Powell and Fiona Myers

To confirm the record of the meeting of the Adults and Health Scrutiny Committee held on the 9^th December 2021 and Special Joint Scrutiny Committee held on the 26^th January 2022.

The minutes of the meeting held on the 9^th December 2021 were approved as an accurate record.

ACTIONS

Action 1

Dr Janet Underwood requested that the last sentence under Item 8 in the previous minutes be amended to read: It was agreed that Janet would expand on the matter via email with John Morley but that she would not reveal specific details which could reveal identities etc and breach rules of

Confidentiality

The Scrutiny Officer confirmed action completed.

Action 2

It was agreed that Viv Robbins would contact Councillor Waller with the data regarding item 2.4 Overview of Health – Children and why Rutland secondary school children were worse than the national average.

The Public Health Consultant confirmed action completed.

Action 3

Redacted correspondence with Lakeside Healthcare Stamford to be circulated with the minutes

The Scrutiny Officer confirmed action completed.

Action 4

Appointment of a new Vice Chair to be added to the agenda for the meeting after the budget meeting in January.

The Scrutiny Officer confirmed the item was on the agenda.

The minutes of the Special Joint Scrutiny Committee meeting held on the 26^th January 2022 were approved as an accurate record.  There were no actions from this meeting.

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.

Dr Underwood declared a non-pecuniary interest in agenda item 10 – Joint Health and Wellbeing Strategy as she was a member of the Rutland Health and Wellbeing Board and also a registered patient at Oakham Medical Practice.

Councillors Cross and Powell declared a non-pecuniary interest in agenda item 10 as they were registered patients at Oakham Medical Practice.

To receive Report No. 28/2022 from Viv Robbins, Consultant in Public Health

Report No. 28/2022 was received from Viv Robbins, Consultant in Public Health.  During the discussion, the following points were noted:

·       The revised Public Health Team for Rutland was as follows:

1.    Director of Public Health (0.2 whole time equivalent [WTE])

2.    Consultant in Public Health (0.4WTE)

3.    Strategic Leads for Rutland and Rutland Commissioning (1.8WTE)

4.    Public Health Analyst (0.2WTE)

5.    Additional support from within RCC including Sandra Taylor as the Health and Wellbeing Integration Lead.

·       The Public Health Team had expanded through the Public Health Consultant, additional Strategic Lead and Health and Wellbeing Integration Lead posts.

·       A clear strategic direction and future objectives were being worked on and these would link in with the development of the Rutland Joint Health and Wellbeing Strategy.

·       Rutland County Council would now receive 2 days per week of dedicated Public Health Consultant time and the capacity of the Strategic Leads had doubled. 

·       The Public Health Team was working closely with Adult Services to continue to provide an innovative and dynamic service to the community. 

·       Councillor Waller requested that more details be provided as to why people were not engaging with a healthy lifestyle and what the barriers the public were experiencing in trying to gain good health. These pieces of work would be picked up by the team through actions in the Joint Health and Wellbeing Strategy.

RESOLVED

That the Committee:

·       NOTED the content of the paper and revised public health offer for Rutland.

·       PROVIDED recommendations for priority public health areas to focus on over the next year.

To receive any petitions, deputations and questions received from Members of the Public in accordance with the provisions of Procedure Rule 216.

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.

The Scrutiny Officer confirmed that a deputation and a question submitted at short notice had been received.

Councillor Waller notified all attendees of the process regarding petitions, deputations and questions as detailed in Procedure Rule 28 of the Council’s constitution.

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Mr Ramsay Ross joined the meeting at 19:19

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Mr Ramsay Ross, on behalf of the Rutland Health & Social Care Policy Consortium, addressed the Chair and the Committee with his deputation regarding the Joint Health and Wellbeing Strategy.

The Committee thanked Mr Ross for his important and interesting deputation.

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Mr Ramsay Ross left the meeting and Mr Andrew Nebel joined the meeting at 19:26

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Mr Andrew Nebel, as Co-Chair of the Empingham Medical Centre Patient Participation Group and as a Ryhall Parish Councillor addressed the Chair and the Committee with his question regarding the Joint Health and Wellbeing Strategy.

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Mr Andrew Nebel left the meeting at 19:28

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To consider any questions with notice from Members received in accordance with the provisions of Procedure Rule No 218 and No 218A.

There were no questions with notice from members

To consider any Notices of Motion from Members submitted in accordance with the provisions of Procedure Rule No 219.

There were no notices of motion from members

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

There was no call in

To elect a new Vice Chair following the appointment of Councillor Waller as the new Chair.

·       Following the appointment of Councillor Harvey to Cabinet and the promotion of Councillor Waller to Chair, the post of Vice Chair was now vacant. 

·       Councillor Waller requested nominations for the post of Vice Chair.

·       Councillor Cross proposed Councillor Powell.  This was seconded by Councillor Toseland. 

RESOLVED

That the Committee:

a)    APPOINTED Councillor R Powell as the Vice-Chair of the Adults and Health Scrutiny Committee.

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The Deputy Director of Integration and Transformation left the meeting at 19:24

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To receive Report No. 41/2022 regarding the Rutland Health and Wellbeing Strategy (Place Based Delivery Plan) from Councillor S Harvey, Portfolio Holder for Health, Wellbeing and Adult Care.

Report No. 41/2022 was received from Councillor S Harvey, Portfolio Holder for Health, Wellbeing and Adult Care regarding the Rutland Joint Health and Wellbeing Strategy (Place Based Delivery Plan).  During the discussion, the following points were noted:

·       The strategy is a complex document but an easy-read version would be produced for ease of reading by the public.

·       The delivery plan was outlined in seven sections and these linked in with existing work streams/priorities in the Strategy.

·       A matrix would be incorporated so that the delivery plan could be monitored on a regular basis.

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The Deputy Director of Integration and Transformation re-joined the meeting at 19:35

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·       It was confirmed that 4 non-executive directors had been appointed to the Integrated Care System (ICS) with David Sissling appointed as the independent chair of the ICS for Leicester, Leicestershire and Rutland. 

·       Work was ongoing in defining the roles of the ICS and the ICB but one of the non-executive directors would be a member of RCC as the Rutland representative but no further details were currently available.

·       Membership of the Integrated Care Partnership (ICP) was currently being defined but it would have significant representation from Rutland including lead members and directors.

·       Active engagement was ongoing with all partners to ensure flexible cross border working, which was an important major factor to Rutland County Council.

·       An initial outcomes report had been produced but not in time for discussion at this meeting.  However, it would be reported to the Rutland Health and Wellbeing Board on the 22 February 2022 and it was agreed that the outcomes report would be published with the minutes of this meeting.

ACTION: Jane Narey

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The Head of Transformation and Integration joined the meeting at 19:38

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·       It was reported that Rutland Memorial Hospital (RMH), as a cottage hospital, was indispensable as the bigger hospitals must discharge patients as soon as possible so relied on cottage hospitals to be able to do this.

·       It was confirmed that the Joint Strategic Needs Assessment (JSNA) was a separate piece of work to this strategy but that it would feed into the strategy following an update of census data, which was expected to be published within the next few months.

·       Dr Underwood confirmed that Healthwatch Rutland, Leicester and Leicestershire had regular meetings with Andy Williams, Chief Executive, LLR CCGs and he had confirmed that each Healthwatch Chair would have a non-voting seat on the ICB and ICP.

·       Councillor Waller requested that the sponsor report be six monthly instead of annually. 

RESOLVED

That the Committee:

·       REVIEWED and provided feedback on the draft Rutland Joint Health and Wellbeing Strategy Delivery Plan.

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The Head of Transformation and Integration, the Public Health Consultant and the Health and Wellbeing Integration Lead left the meeting at 20:18

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To receive Report No. 29/2022 from Councillor Paul Ainsley, Chair of the Primary Care Task & Finish Group

Report No. 29/2022 was received from Councillor Paul Ainsley, Chair of the Primary Care Task & Finish Group.  During the discussion, the following points were noted:

·       Over 900 responses were received as part of the patient survey which had been undertaken via leaflet distribution, face-to-face meetings and telephone conversations as well as online.

·       The Task and Finish Group was still collating information for publication in the final report.

·       The final report would detail recommendations and proposed actions for each committee before being presented to the Rutland Health and Wellbeing Board and Council. 

·       The feedback from patients differed between the various medical practices and had been very informative.

·       The preliminary report had been distributed to the medical practices, the ICS and the LLR CCG.

·       The Committee thanked the 900+ members of the public for completing the survey and giving a comprehensive view of the community feeling regarding accessing primary care services.

·       Councillor Ainsley confirmed that no demographic information had been taken regarding the survey participants so no analysis could be done regarding how different age groups etc accessed the primary care services and no information had been gathered regarding the Winter Access Fund. 

To consider the current Forward Plan and identify any relevant items for inclusion in the Adults and Health Scrutiny Committee Annual Work Plan, or to request further information.

The Forward Plan is available on the website at:

https://rutlandcounty.moderngov.co.uk/mgListPlans.aspx?RPId=133&RD=0

·       Councillor Harvey read out a written statement as follows:

Following on from the decision by ‘My Dentist’ to reduce the NHS list of two of their dentists, we have received correspondence from residents and Councillors regarding the ability to access NHS Dentistry in Rutland.

We were already aware of problems and this had been heard by the LLR Joint Health Scrutiny Committee in November 2021

Healthwatch Rutland are currently asking residents for their experience of accessing Dentistry.  I ask that the survey is shared widely so we can gain the experience of as many residents as possible: Healthwatch Dental Survey

Please find below a detailed response from NHS England, Primary Care Dental Lead, who commission dentistry services in Rutland:

‘At the onset of the Covid-19 pandemic, NHS Dental Services were suspended in March 2020. Although face-to-face services have resumed, NHS dental practices are working at a much lower capacity, as they are following social distancing and hygiene rules as per the national guidelines set by Public Health England, to ensure the safety of both our clinical colleagues and patients. As a result, patients may experience a delay in accessing routine NHS appointments.

Practices are being asked to see all regular and non-regular patients (historically referred to as registered patients), where they can accommodate. There are limited routine appointments available as this is dependent on the capacity of each practice, following treating any urgent patients. This can mean that even patients who (before the pandemic) would regularly attend a dental practice, are currently only able to be seen in practice if they meet the criteria for safely accessing an urgent face to face appointment. If a patient is deemed not urgent then they may wish to enquire about joining a local practice’s waiting list for routine care.

There is no patient registration process for dental practices, therefore any patient can ring any practice at any time. For assistance with locating an NHS dental provider, patients can visit https://www.nhs.uk/service-search/find-a-dentist or can contact the NHS England Customer Contact Centre on 0300 311 22 33. We appreciate that some practices may be listed as not accepting new NHS patients, however, may still be able to help by providing urgent care, self-care advice and signposting to another relevant service if necessary.

If a patient requires urgent general dental care, they are advised to call a local NHS dental practice, where the clinician will then assess if the patient requires an urgent face to face appointment and will endeavour to accommodate by offering the next available urgent slot. If they are unable to offer an appointment suitable to their needs, but the patient requires intervention, the patient could be referred to an Urgent Dental Care (UDC) centre where they will be contacted to arrange a convenient appointment. A COVID-19 assessment for the patient will also be undertaken at this time to ensure that the patient attends the appropriate clinic requiring the relevant level of protection.’

It is worth reiterating the comments regarding registration for dentistry as  ...  view the full minutes text for item 12.

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

There was no urgent business

Thursday, 31^st March 2022 at 7 pm via Zoom

Proposed Agenda Items   

1.     Public Health and CCG Performance Data

2.     Dentistry Update

3.     Adult Services Performance Data and Risk Register

To review current performance data; ensure that it matches the current identified risks and to identify possible priorities for 2022/23

4.     Primary Care T&F Group: Final Report

Thursday, 31st March 2022 at 7 pm via Zoom

Proposed Agenda Items

1.    Lakeside Healthcare Stamford

2.    Dentistry in Rutland: Update

3.    Primary Care T&F Group: Final Report

4.    Adult Services Performance Data and Risk Register – for information only

5.    Public Health and CCG Performance Data – for information only

SUMMARY OF ACTIONS