Apologies for absence were received from Councillors PL Bettington, RC Hunt and SJ Robertson.

To receive details of any Member nominated to attend the meeting in place of a Member of the Committee.

Councillor PJ Edwards for Councillor SJ Robertson and Councillor J Hope for Councillor PL Bettington.

Agenda Item 11. Task and Finish Group Reports - Executive Responses.

Councillor PGH Cutter, Personal, as Chairman of the Planning Committee.

Agenda Item 11. Task and Finish Group Reports - Executive Responses.

Councillor PJ Edwards, Personal, Member of the Management Steering Group for Belmont Country Park.

To approve and sign the Minutes of the meeting held on 8 June 2012.

RESOLVED:  That the Minutes of the Meeting held on 8 June 2012 be confirmed as a correct record and signed by the Chairman.

To consider suggestions from members of the public on issues the Committee could scrutinise in the future.

(There will be no discussion of the issue at the time when the matter is raised.  Consideration will be given to whether it should form part of the Committee’s work programme when compared with other competing priorities.)

There were no suggestions for future scrutiny.

To note questions received from the public and the items to which they relate.

(Questions are welcomed for consideration at a Scrutiny Committee meeting so long as the question is directly related to an item listed on the agenda.  If you have a question you would like to ask then please submit it no later than two working days before the meeting to the Committee Officer.  This will help to ensure that an answer can be provided at the meeting). 

The Committee noted that a number of questions had been submitted by the public, mainly relating to Agenda Item 9.   These were circulated at the meeting together with written answers, where available.  It was noted that the full schedule of questions and answers would be forwarded to the members and contributors in due course.

The Chairman thanked the contributors for submitting their questions. 

To consider the future of healthcare in Herefordshire as part of a discussion with the Wye Valley NHS Trust, the Herefordshire Clinical Commissioning Group and the West Mercia PCT Cluster.

The Committee considered the future of healthcare in Herefordshire as part of a discussion with the Wye Valley NHS Trust, the Herefordshire Clinical Commissioning Group (HCCG) and the West Mercia PCT Cluster.  The Chairman welcomed Ms C Gritzner, Chief Operating Officer Designate and Interim Accountable Officer, HCCG, Mr P Maubach, Director of Commissioning Developments West Mercia PCT Cluster and Mr H Oddy, Acting Chief Executive, Wye Valley NHS Trust.

Ms Gritzner provided a presentation, and highlighted the following areas:

·         That the Governance structure for the HCCG as outlined for the Committee in the presentation had been agreed, and the organisational structure had been sent out for consultation with staff.  A report would be submitted to the Board in August. 

·         That the HCCG had slipped from Wave 2 into Wave 3 of the authorisation application process, the legal process through which CCGs were approved as the new local statutory NHS commissioning bodies.  The application would be submitted in September and assessed by an independent panel from outside the region.

·         That the objectives, vision and plan of HCCG had been endorsed by the Health and Wellbeing Board, and the Joint Strategic Needs Assessment had been embedded into the planning process.

Mr Maubach provided a presentation on the structure of the National Commissioning Board (NCB).  He said that there would be 8 local area teams within the Midlands and East Cluster, and they would have the same core functions around CCG development, emergency planning, quality and safety and system oversight.  All Teams would have responsibility for GP, dental, pharmacy and optical services. Local Authority Directors were currently being recruited.  There would be a West Midlands Cluster of 4 PCTs, and transitional risks as the present Cluster was split in two. 

·         In answer to a question, he said that the NCB would have responsibility for 20% of the commissioning spend, whilst the CCGs would be responsible for a total of 80% of spend.  The local Health and Wellbeing Boards and Councils would be expected to assume the bulk of local arrangements.

·         In reply to a question regarding the top down nature of the governance structure, he said that it would be necessary to secure resources in order to ensure service delivery, and that the sustainable nature of services would need to be addressed.  There would be a more top down approach should the local systems not prove to be sustainable, but the onus was on local determination.

·         In response to concerns that the organisational structure was too top heavy and therefore costly, Mr Maubach said that the logistical structure of the NHS Midlands and East Clinical Commissioning Board had been based on the number of CCGs and Health and Wellbeing Boards that would be under its control in order to provide each region with a consistent number of organisations to work with.  The structure had been designed to reduce bureaucracy, and was working with substantially reduced management overheads.  Ms Gritzner added that the Commissioning Support Organisation (CSO) that had been appointed by  ...  view the full minutes text for item 15.

To consider the findings arising from the Task & Finish Review into the Wye Valley NHS Trust (Stroke & Trauma Services and the delayed transfer of care).

The Committee considered the findings arising from the Task & Finish Review into the Wye Valley NHS Trust (Stroke & Trauma Services and delayed transfer of care).

The Vice-Chairman reported that the Group had concluded that the potential benefit of the further integration of the Adaptions Team into the Total Patient Care Pathway should be supported, as this was a logical adjunct to the Integrated Care Pathway. 

The Group also recommended that the rationale for the Wye Valley NHS Trust’s bid to the West Mercia PCT Cluster for funding from the Strategic Health Authority’s Reserve Fund to invest in further work to improve the flow from acute care to home care be supported.

RESOLVED: That the report be noted and referred to the Wye Valley NHS Trust.

To consider how and when the Committee wishes to be consulted in respect of the programmes for adopting the Local Development Framework and Local Transport Plan as set out in the attached draft report to Cabinet on 12 July 2012.

The Committee considered a report outlining how and when it should be consulted in respect of the programmes for adopting the Local Development Framework (LDF) and Local Transport Plan (LTP) as set out in the report to Cabinet of 12 July 2012.  It was noted that a number of public questions had been received for this item, and would be submitted to Officers for a written response.

The Head of Transportation and Access and the Head of Strategic Planning and Regeneration presented the report and outlined the respective timetables for consultation on the LTP and LDF.  In view of the timetable changes proposed, work should proceed on an LTP covering the period to 2014/15 with key long term linkages between the two strategies being maintained.

During the discussion, the following principal points were raised:

·         That whilst the possibility of an Eastern Link Road had been raised to link Holme Lacey Road and Ledbury Road, the feasibility study had yet to be completed

·         That whilst there were differences of opinion regarding the summary of results of the Revised Preferred Option consultation undertaken in the Autumn of 2011, the results were a matter of public record as part of the consultation process.

·         That the LTP and LDF were of such weight, that a broader discussion was required, perhaps as a series of one off meetings that would allow for a wide ranging discussion of the issues.

·         A Member suggested that the Committee should be advised when each area of evidence was nearing completion and should then be briefed on its contents.  He asked that non-technical summaries to help explain the evidence base should also be produced as a matter of course in order to help the Committee ensure that the evidence base was adequate.  The evidence base should include a refreshed Community Strategy, as the LDF was required to have this as part of the National Planning Policy Framework (NPFF).

·         He went on to say that under the NPFF, paragraph 49 of the report would allow any developers to put forward plans for development on greenfield rather than brownfield sites.  He suggested that identified brownfield sites should be given development priority over greenfield sites for the first five years of the land bank.  This would provide protection for the first five years in order to allow greenfield sites to be identified in an appropriate manner.

RESOLVED:

That Cabinet be recommended that:

a)    subject to outstanding issues being resolved, the proposed scale and distribution of development and strategic housing, employment and infrastructure proposals, as set out in paragraph 49 of the Draft report to Cabinet of the 12 July 2012, should form the basis of the consultation process.

b)    as a result of the possibility that a Western Relief Road should not come to fruition for planning or cost reasons, it would be inappropriate to approve large scale developments for inclusion within the draft Core Strategy until the necessary infrastructure had been similarly approved;

c)    under Paragraph 18 of the Draft report to  ...  view the full minutes text for item 17.

To note the Cabinet Member Report on the final draft of the Strategic Delivery Plan for Transforming Adult Services 2012-15.

The Committee noted the final draft of the Strategic Delivery Plan for Transforming Adult Services 2012-2015.  The Cabinet Support Member (Adult Social Care) introduced the report and highlighted the following principal areas:

a)    That the Strategic Delivery Plan had been developed to take account of national policy direction, the demographic profile of Herefordshire and to build on the vision of encouraging people to take responsibility for their own lives and access formal health and social care services only when necessary.  It provided a single document setting out the overall approach for adults over the next three years and contributed to the Joint Delivery Plan, the strategic aims of the council and its partners, and was a key part of achieving a balanced budget position.

b)    All Councils and Health communities were facing significant challenges due to reduced budgets and increased demographics. There was a need to have sustainable systems and services and which offered value for money.  This was a national as well as local issue and the strategic delivery plan set out a transformation programme over three years;

c)    Various Council services, NHS Herefordshire, Herefordshire Clinical Commissioning Group, Wye Valley NHS Trust and 2gether Foundation Trust had been involved in the development of the plan, which had been approved by the Health and Wellbeing Board.

In the ensuing discussion the following principal points were made:

·         The Assistant Director People's Services Commissioning said that an Adult Social Care Forum would be set up for the Health and Wellbeing Board, and that a progress report on the Delivery Plan would be provided to Cabinet on an annual basis.  It was important that the Plan was delivered though the Localities, and their active engagement was being sought.

·         The Cabinet Support Member said that whilst the Locality System was not perfect, he had visited three Locality Teams, and had been impressed by the commitment they had shown.  Problems that had existed between the Panel and the Locality Teams were being worked through.

·         The Assistant Director People's Services Commissioning said that the initial issues that had faced the Service with the introduction of the Frameworki software were being sorted out, and the process was being slimmed down.  The Agresso software had been introduced in April 2011, and work was in hand to further reduce the complexity of the system.

·         A Member said that the needs of full time carers should be focussed on.  He expressed concern at the cost of the service, and suggested that greater efficiencies should be possible using technology based care.

·         A Member asked how this Plan would help to deliver the £8m of savings that were required, and asked that a report be provided that gave clarity to the performance and progress of the transformation programme.

RESOLVED:

That:

a)    as part of the Delivery Plan there should be sufficient support for full time carers in order to ensure that they were in a position to continue their caring role effectively;

b)    a report be brought to the next meeting on  ...  view the full minutes text for item 18.

To note the Executive responses to the Reports from the following Task & Finish Review Groups:

Adult Safeguarding in Herefordshire

Planning System Review – Development Control and the Operation of the Constitution

Council Procurement Policy and Local Business and Local Employment

Income and Charging

Tourist and Temporary Event Signage

The Committee noted a report to consider the Executive’s response to the recommendations made to it in the following Task and Finish Group Scrutiny Reviews: Adult Safeguarding in Herefordshire, Planning System Review – Development Control and the Operation of the Constitution, Council Procurement Policy and Local Business and Local Employment, Income and Charging and Tourist and Temporary Event Signage. 

RESOLVED: 

That:

(a)       the Executive’s response to the findings of the reviews be noted; and;

(b)     a further report on progress in response to the Review be made after six months with consideration then being given to the need for any further reports to be made.

To consider the Committee’s Work Programme.

The Committee considered its Work Programme.  During the discussion, the following points were made:

·         That, in future, the Clinical Commissioning Group, the West Mercia Cluster and the Wye Valley NHS Trust should be invited to attend the Committee at the same time to ensure that common issues were debated and each would have a chance to respond to matters of concern.

·         That the Review of GPs and Out of Hours Services should be undertaken during Autumn 2012.

·         Information was sought regarding the latest position concerning:

o   The development of Park and Ride sites particularly as the new Local Transport Plan had been delayed.

o   Any current developments concerning cycle way routes – particularly in view of the ‘Destination Hereford’ package of integrated transport improvements.

o   The position regarding the Connect2 Greenway project. How the Greenway is to integrate with the Enterprise Zone.  Will there be a car park or a Park and Ride site at the Zone end of the route and was this in the original design.

The Committee agreed that the above information be provided in a briefing note to the Committee.

• Following the increase in academies and various education based services being commissioned through service level agreements, questions were asked regarding the level of activity within the education section of the People’s Services Directorate.  The Committee agreed that the above information be provided in a briefing note to the Committee.

• The Committee agreed that consideration of the Root & Branch reviews needed to be scheduled appropriately into the work programme.

• As requested earlier in Minute No.18, a report should be scheduled into the work programme regarding the progress and benefits accrued following the integration of the Frameworki and Agresso software systems.

• The Committee noted that the Vice-Chairman was to attend a meeting to discuss Healthwatch and he would be focusing on the Centre for Public Scrutiny’s ’10 Questions to Ask’. If there were any issues of concern, these would be reported back to Committee.

RESOLVED: That the two briefing notes be requested and the work programme be amended to reflect the above.