Apologies were received from Councillors RC Hunt, PJ Watts and Mr P Sell.

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

None

None.

To approve and sign the Minutes of the meeting held on 28 August 2012

The Minutes of the Meeting held on the 28^th August 2012 were approved.

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.)

A suggestion was received from a member of the public to the following effect:

That if councillors are being directed to make decisions on the basis that officers have failed to comply with National Planning Policy Framework and statutory obligations, what was being done to address the situation?

When will the 5 year housing land supply figures and basis of calculation be available?

What risk does this pose to the reputation of the Council and financial risk arising from possible appeals by developers?

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 updated list of answers to the questions from the public that had been made to the meeting on the 4 July was noted. 

To receive an updated presentation on the progress of the Make Ready Ambulance system and the work of the West Midlands Ambulance Service NHS Trust.

The Committee received a presentation from Mr Peter Murtagh, Commissioning Director, West Midlands Ambulance Service, on the performance of the service of the previous six months.

During his presentation, Mr Murtagh highlighted the following areas:

•        The definition of Make Ready Ambulance services as ‘a quality assurance vehicle and equipment preparation programme designed to improve efficiencies across the whole spectrum of Ambulance Operations’.  It was necessary to undertake this change as the present estate was not fit for purpose and the result was that there was a greater coverage across the whole of the West Midlands.

•        Performance of the service since the introduction of Make Ready had improved and Herefordshire’s Red 8 minute performance since the introduction of Make Ready had been consistently high, at 78.8% with an increase in activity of 24% over the previous year.   Despite this increase, shift overruns had reduced by 4.5% in the first quarter of the year.

•        Infection prevention and control had been improved by the Make Ready system.

•        That Foundation Trust authorisation for the Trust had reached the final stages of the assurance process and it was expected that MONITOR would authorise Foundation status by the 1 December.

In reply to a question, Mr Murtagh said that the spike in activity in August was a mixture of the good weather in that month and calls that would have been more appropriately handled by primary care providers. The heightened levels of calls were continuing into September.   Emergency calls had grown by 5% annually, but many could be better handled by primary care providers such as GPs. Ambulance turnarounds at the hospital were an average of 26 minutes, although there were delays at peak times.  Work was in hand to reduce the longest turnaround times with the aim to ensure that there were no handovers longer than thirty minutes. 

Mr Murtagh replied to a Member by saying that the 111 number would come into effect from April 2013, and non-emergency calls should be encouraged to use this instead of the 999 number.  There was an attempt to identify callers to the 999 number at the moment, and there were a number of inappropriate calls from organisations such as Care Homes.  Work was in hand to provide them with a decision tree to work through before they called an ambulance.

In reply to a further question, Mr Murtagh said that whilst there would never be 100% of paramedics employed on ambulances, the Service would reach its target of 70% by 2014.   There was a 30 week training course at the University of Worcester for paramedics and community paramedics, who were trained to higher level.  The intention was to have one paramedic on every vehicle.  A proportion of staff would remain at Technician level.

In reply to questions over ambulance stations, Mr Murtagh said that the key for the Service was to have frontline staff out in the community, and this was more effectively achieved by using the Make Ready system.  There was a  ...  view the full minutes text for item 35.

To receive a half year review on progress for the ²gether NHS Foundation Trust, which demonstrates trends in delivery and highlights emerging issues.

The Committee received a presentation from the Chief Operating Officer, ²gether NHS Trust. 

In the ensuing discussion, the following points were raised:

·         That progress was being made in addressing the suicide rate amongst those at risk who were known to the mental health services, and the rate had dropped from 33% to 10% in 2011.  There was, however, still a gap of those suicides who were not known to the service.  The Improving Access to Psychological Therapies (IAPT) service had bid for funding for a pilot scheme to allow clinicians to use skype to talk to their patients.  IT equipment would be loaned out to patients.

·         That referrals that were received by the services were prioritised in terms of an assessment of need.  This included referrals from the general public, and any that had been made should have received the appropriate response.  There were six patients known to the service in 2010, and this number had been reduced in 2011 to two.

·         That there were more teams being used to help the crisis management teams at peak times.  There was no additional investment available to provide this support.

·         A Member asked that greater detail be provided for those areas where the outcome was designated as compliant in order to allow the Committee clarity in these matters.

In reply to a question from a Member, the Chief Operating Officer said that the statistics showing that 74% of staff were compliant with mandatory and statutory training requirements was slightly misleading and a result of the known pressure points within the organisation.  The issue was not one of trained staff, but of meeting refresher training targets. The system was being turned around so that all staff would proactively receive refresher training. 

In reply to a series of questions, the Chief Operating Officer said that Children and Mental Health Services (CAMHS) average assessment time had been reduced to one week, and one month for treatment following the initial assessment and that the patient survey was made up of a list of nationally approved questions for which the Trust was expected to provide data.

To consider a report on progress with implementation of the Agresso and Frameworki systems.

The Committee received a report on progress with implementation of the Agresso and Frameworki systems.  The Chief Officer: Finance & Commercial reported that as a result of a comprehensive selection process the Agresso system had been chosen as integrated system, a product widely used in local government and healthcare.  The selection was agreed by the Council, PCT and the Hospital Trust.  However, the partners withdrew from deployment of Agresso at the end of 2011 as a result of external changes.  The current Frameworki case management system went live on the 10^th November 2008 with 700 registered users. Since May 2010 there have been on-going project activities to enable commitment accounting.

In reply to a question from a Member, the Chief Officer: Finance & Commercial said that there were no blockages in the schedule to implement the two systems. Delays were as a result of the technical scale of the task of bringing the two systems together.  It was necessary to ensure that the information for Framworki was up to date and that only live cases were fed into the system, and staff were working in a challenging environment with information from multiple agencies.

In reply to a question, the Chief Officer: Finance & Commercial said that licences for the two systems were purchased in blocks and costs £121k for Agresso and £113k for Frameworki. Further detail would be provided to a later meeting. He went on to say that it was important to acknowledge that the Council had bought the right system when it purchased Frameworki.  The delays that had arisen were largely as a result of human action when dealing with the system.

RESOLVED

That:

a)       the Committee should receive, by December 2012, a detailed report on the proposed management of Agresso and Frameworki with a timeline on integration delivery, milestones on future functionality, major risks, and an examination of the accuracy of the Council’s budget forecasting; and

b)       the Committee should continue to monitor the Agresso and Frameworki integration process on an on-going basis.

To update the Committee in relation to the Streetscene Root and Branch review following the Cabinet’s decision on 12^th July 2012 regarding the services currently included in the Amey Service Delivery Agreement.

The Committee received a report on the Streetscene Root and Branch review following the Cabinet’s decision on 12th July 2012 regarding the services currently included in the Amey Service Delivery Agreement.  The Head of Highways & Community Services reported that there would be a workshop on the 21st September in which the issues in the report could be explored in more detail, and he encouraged Members to attend.  In the ensuing discussion the following areas were highlighted:

• Concern was expressed that packages in Appendix A of the report seemed to be a list of services currently supplied under the Amey contract, and thereby replicated the existing contractual system.  There appeared to have been little consideration to structuring the contracts in a way that would facilitate tendering by small and medium sized enterprises (SMEs).

• That the appendix was a list of the services that had been included in the prior information notice that had been published in the official journal of the European Union on 25th August. This announced Herefordshire Council’s intention to consider a procurement of the services listed and marked the start of market consultations. The consultation would inform the procurement strategy for the services and was a way of managing the procurement process.  The packages had been listed in this form, as the detail of each service listed ran to 50 pages or more.  The intention had been to engage the local supply chain, and Package D of the Appendix, planned for a later stage of the process, and had been put together with local SME firms in mind.  A programme of workshops and seminars had also been built in to and enable tendering from these companies.

In reply to a question from a Member, the Head of Highways & Community Services said that contractual compliance was built into all contracts let by the Council and that if there were substantial under performance then action was taken to remedy the situation.

A Member said that she looked forward to an improved version of the document that laid out the core of the Root and Branch Reviews and provided a clear view of what the vision was into the future.  It was important that there was a clear understanding of where the problem boundaries where drawn within the contracts, and that it was ensured that the right skills were available to allow the Council to be expert in commissioning services and managing contracts. This approach should be extended to providing a clear framework of how tranches of service were dealt with at Parish, Town, City and County Council level.  Greater creativity was required when considering how local suppliers should work with the Council, and broadening the supplier base by using the purchasing power of the County at a local level would provide a structure to enable those suppliers to work with the Council.

A Member pointed out that the Council only employed three qualified contract managers, and said that this area should be improved.  It was important that a capable procurement  ...  view the full minutes text for item 38.

To consider the proposals arising from the recent review of the scrutiny structure.

The Monitoring Officer presented a report on the Review of the Overview and Scrutiny Structure. He reviewed Appendix A of the report, the ‘Update Report on the Overview and Scrutiny Function in Herefordshire Council’ by John Lamb and highlighted its recommendations to the Committee.

In the ensuing discussion the following points were discussed:

·         That the proposed scrutiny Committees would be politically proportional, but that political proportionality was not required for any task and finish group.  The intention would be to fill the Committees with Members who had a genuine interest in the areas to be scrutinised.

·         A Member said that she was disappointed that the Executive would not be prepared to hold a nem com vote at Council to move away from the proportionality position.  She pointed out that the Administration’s majority would mean that all Members of the Conservative Group would have to serve either on Cabinet or Scrutiny.  The proposed Boundary Commission consultation reduction to 54 Councillors would mean that every Member would be deployed in a scrutiny function. The Leader replied that there would be a crossover of membership on the Committees.

·         A Member expressed concern over the operation of the existing Committee structure, and said that he did not believe that it had been working well.  It was important that the Chair of the Overview and Scrutiny Committee should be an opposition member, and not from the ruling group.

·         A Member asked whether there was an appropriate mix of statutory co-optees available to the committees, and questioned which committee co-opted members should serve on.

·         A Member said that he was concerned about the transitional arrangements that would need to be in place once the new scrutiny structure had been approved.  He believed that there was a need to explore the future strategic direction of scrutiny with both Cabinet Members and Group Leaders.  He expressed concern that there was no identifiable budget for scrutiny which could facilitate the committees in their work.

·         In reply to a concern that there was no earmarked funding, the Leader said that there was centralised funding could be made available for scrutiny activity.  He went on to say that there would be a Chairman and Vice Chairman of each Committee and Group Leaders would be asked to put names forward for endorsement. 

RESOLVED: To recommend to the Audit and Corporate Governance Committee that recommendation (e) of the draft Audit and Corporate Governance Report to Council on 28 September 2012 be amended from: the change to two Overview and Scrutiny Committees takes effect from Monday 15 October 2012 to: the change to two Overview and Scrutiny Committees should begin to take effect from Monday 15 October 2012 with the final roll out of the two Committees from 1 January 2013.

To consider the Committee’s Work Programme.

The Committee noted its work programme.

In the ensuing discussion the following points were made:

·         that the Health Scrutiny issues should be split out from the Work Programme.

·         That a briefing paper on the progress of the children in the County to meet national swimming targets be provided to the Committee.

RESOLVED: That the work programme be noted.