To receive apologies for absence.

Apologies for absence were received from Cllr Pauline Crockett.

To receive details of any councillor nominated to attend the meeting in place of a member of the committee.

Cllr Elizabeth Foxton was present as the named substitute for Cllr Pauline Crockett.

To receive declarations of interest in respect of items on the agenda.

No declarations of interest were made.

To receive the minutes of the meeting held on Thursday 3 October 2024.

The minutes of the previous meeting were received.

Resolved: That the minutes of the meeting held on 3 October 2024 be confirmed as a correct record.

To receive any written questions from members of the public.

No questions had been received from members of the public.

To receive any written questions from members of the council.

No questions had been received from councillors.

To examine Hereford’s oral health outcomes and the work being undertaken to improve the oral health of the local population.

The committee considered a report on Dental Services in Herefordshire by NHS ICB colleagues.

The principal points of the discussion are summarised below:

1. The Director of Delegated Commissioning (NHS Herefordshire and Worcestershire ICB) introduced the report and welcomed the opportunity to update the committee on progress on dental services in Herefordshire. The committee was advised that since 2022, NHS England has delegated the responsibility for the commissioning and purchasing of dental services to the Integrated Care Board (ICB). The ICB took this on in 2023. As part of the process at looking at improvements to dental services in Herefordshire, the ICB have developed a ‘Dental Recovery Plan’ which is aimed to ensure that the populations across both Herefordshire and Worcestershire have access to sustainable NHS dental prevention, care and treatment. It was recognised that the national contract for dentistry is not attractive to the profession and the ICB is tackling two key issues which challenge access to NHS dentistry – the national dental contract; and workforce. 

2. In response to a question about where new NHS dentists are being supervised, the Director of Delegated Commissioning (NHS Herefordshire and Worcestershire ICB) noted that a dental training school has been introduced locally which will support training and fast-tracking dentists that will be brought to the area.

3. The Head of Delegated Commissiong (NHS Herefordshire and Worcestershire ICB) added that the training school taps into some of the overseas dentists who are brought to the local area. They are fully qualified from their country of origin but NHS regulations in the UK require a period of mentoring before they can become a fully qualified NHS dentist. It is hoped that this scheme will help attract dentists into the local area. Some of the incentives that are being put in place incentivises them to stay for a minimum of three years and it is hoped that they will want to continue working in the area.

4. In response to a question about the contract hand-backs referenced in the report, the Director of Delegated Commissioning (NHS Herefordshire and Worcestershire ICB) commented that they are the hand-backs that were in place just prior to the ICB becoming the responsible commissioner between October 2022 - March 2023. As part of the assessment of dental service need, the ICB has undertaken an oral health needs assessment to identify across the 176 wards within Herefordshire and Worcestershire where the areas of greatest need are. The Dental Services Equity Audit looked at areas of deprivation, the number of children with decayed, missing and filled teeth (DMFT). The ICB have looked at how many units of dental activity (UDA) have been commissioned across Herefordshire and how many are needed to be commissioned to get back to the pre-covid level of 55% of the population having access to NHS dentistry. Two new dental practices being commissioned in Hereford city which was located as an area of high need.

5. The Head of Delegated Commissioning (NHS Herefordshire and Worcestershire ICB) highlighted findings from the Dental Services Equity  ...  view the full minutes text for item 27.

To scrutinise preparation for an anticipated assurance visit from the Care Quality Commission (CQC).

The committee considered a report on the Care Quality Commission (CQC) Assurance Visit Preparation. The Vice-Chairperson introduced the officers to present the council’s report.

A short presentation on the CQC Assurance visit preparation was delivered.

The principal points of the subsequent discussion are summarised below:

1. In response to a question on the type of cases that will be presented to the CQC, the Head of Service Transformation & Improvement explained that the cases presented to the CQC will include a combination of individuals receiving care and support through the local authority, as well as unpaid carers. A total of fifty individual cases are available to be put forward.

2. The Corporate Director Community Wellbeing clarified that in terms of the cases, the CQC stipulate that they want cases of older people and those with learning disabilities. Therefore, there must be a broad range across the piece and a certain number of cases must be picked from certain criteria.

3. In response to a question as to whether specific areas of assessment will be looked at by the CQC, the Head of Service Transformation & Improvement confirmed that the notice of assessment will land with the Corporate Director and will be asked to upload the range of information within the first three weeks. The next part of the process will involve a team at the CQC will look through all the information uploaded and will talk to partners, carers, and individuals and all of the discussions will help establish key lines of enquiry.

4. The Corporate Director Community Wellbeing added that apart from the four themes of the assessment framework, there are no key lines identified in the initial notice by the CQC. The information in terms of performance indicators will start to hone where they may want to focus their attention to in terms of the four areas.

5. In response to a question about cases that are less usual, the Service Director Adult Social Care & Housing noted that the CQC will be looking at people’s experiences and when they access the fifty cases, they will be able to ask questions about people’s experiences and will be in terms of equality, diversity and inclusion in the broader sense and staff experience as to communicating with people from different backgrounds and differing needs.

6. The Corporate Director of Community Wellbeing noted that some cases involve working with individuals who are less usual. The case tracker will capture the diversity of these cases and the wide range of experiences of the individuals they support.

7. In response to a question about the type of questions that may be asked, the Corporate Director of Community Wellbeing explained that officers have a good understanding of the types of questions likely to arise. Additionally, mock interviews have been conducted using a prepared set of questions to ensure readiness and confidence when talking about the work that staff have been doing.

8. In response to a question about whether the CQC speak to external providers, the Corporate Director of Community Wellbeing noted that a list  ...  view the full minutes text for item 28.

To consider the work programme for Herefordshire Council’s Health, Care and Wellbeing Scrutiny Committee for the municipal year 2024/25.

The Statutory Scrutiny Officer noted the draft work programme for the Health, Care, and Wellbeing Scrutiny Committee for the municipal year 2024/25.

The Vice-Chairperson recommended that it might be useful to wait until the JSNA report is published and whether there are any items that the committee may want to look at that time. 

The Statutory Scrutiny Officer suggested that the committee should stay informed about the progress of dental services in Herefordshire. It was subsequently confirmed that this topic would be included in the draft work programme for the committee's approval at its next meeting.

The committee unanimously agreed the draft work programme for Health, Care, and Wellbeing Scrutiny Committee as contained in appendix 1.

Resolved that:

The committee agree the draft work programme for Health, Care, and Wellbeing Scrutiny Committee contained in the work programme report attached as appendix 1, which will be subject to monthly review, as the basis of their primary focus for the remainder of the municipal year.

Date of the next scheduled meeting: Monday 17 February 2025, 2.00 pm

The next scheduled meeting in public was confirmed as Monday 17 February 2025, 2.00 pm.