To receive apologies for absence.

Apologies were received from GA Vaughan-Powell and PJ Watts.

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

Councillor P McCaull substituted for Councillor GA Vaughan-Powell.

To receive any declarations of interest by Members in respect of items on the Agenda.

There were no declarations of interest.

To approve and sign the Minutes of the meeting held on 7 June 2013.

The Minutes of the meeting held on the 7 June 2013 were approved as a correct record.

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.

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). 

None.

To receive an update report on progress related to the recruitment and retention strategy in Children’s Social Care and the multi-agency Children’s Services workforce commissioning analysis.

The Committee received a report on the Children’s Services Workforce.  The Interim Strategic HR Business Partner highlighted the following areas:

·         that the Council struggled with acquiring a skilled workforce. The Ofsted inspection undertaken in September 2012 had made a number of recommendations one of which required the Authority to ensure that first line managers had sufficient skills, knowledge and experience to effectively undertake their role. As a result, Institute of Leadership and Management (ILM) training would be provided for all first line managers, and a recruitment strategy would be in place in order to help to ensure the recruitment of high calibre managers. 

·         That there would be a review of social workers responsibilities and workloads to ensure staff have a manageable range of work and a caseload consistent with their level of experience and competence. 

·         From July 2013, the Multi Agency Safeguarding Hub would operate and would combine elements of the current FAST Service with Police, Health, Education and Women’s Aid in improving information sharing and decision making arrangements with respect to new contacts to Children’s Social Care.

In the ensuing discussion, the following points were made:

·         That it was important that the Service should concentrate on growing its own Social Workers locally as it was challenging to recruit staff, as people were not prepared to commute for more than an hour.

·         That eight social workers had been newly recruited, and there would be an assessment day on the 22^nd July.  The Council was working with a national recruitment company on order to recruit senior staff.

RESOLVED: That the committee should receive an updated report within 6 months.

To seek the view of the Committee on the current arrangements for the Adult Social Care business change programme, its governance and to endorse:-

·         the proposed approach for the Next Stage Integration Project for Wye Valley NHS Trust and Herefordshire council’s adult social care service and

·         the open book review process that has been undertaken in relation to Herefordshire’s residential & nursing care banded rates of payment.

The report is also to seek guidance from the committee on the key areas of the programme in which it would like to focus on during 2013/14

The Committee received a report on the current arrangements for the Adult Social Care business change programme.

The Interim Transformation Manager highlighted the following areas:

·         That meeting the needs of an aging population whilst improving outcomes and staying within reduced public sector budgets was a national issue.  The programme before the Committee had two stages.  The first of these was to regain control of finance and governance of the Adult Social Care system, the second was to redesign the adult social care system in Herefordshire. 

·         That the Council commissioned Wye Valley NHS Trust (WVT) and 2gether NHS Foundation Trust (2gether) to manage and provide a range of adult social care services on its behalf. Staff within adult social care were currently seconded from the Council to both organisations. Commissioning arrangements had to be reviewed as existing arrangements would cease when the current Section 75 agreements come to an end in September 2013 (WVT) and March 2014 (2gether). The Council also had to take account of the Care and Support Bill, the financial outlook and future transformation requirements.

·         Herefordshire had been slower than other councils in transforming services to date, and this, combined with the growth in older people meant there was a savings plan (within ASC alone) of £7.078m to ensure a balanced budget of £48.797m in 2013/14, of which  £3.9m was not yet assured.

·         £1m of savings would be delivered by the Next Stage Integration project in 2013/14.

·         The Next Stage Integration project would be supported by the Open Book Review into Residential & Nursing Care which was designed to ensure that there was a fair and transparent approach to the charging for residential & nursing care provision in Herefordshire. This would mean balancing considerations of the providers’ actual costs with the desire of the Council to obtain best value through a pricing structure which is fair to providers and customers as well as the Council. This structure would be one which was likely to ensure a reasonably stable and competitive market for services and deliver an appropriate quality of care.

In the ensuing discussion the following points were made:

That there was a risk register as part of the project.  The largest risk was that a significant part of the necessary savings of £7.078m would not be achieved.  There were also risks around embracing change, and the discharge of patients from hospital.  Both of these were being worked on with the Herefordshire Clinical Commissioning Group.

In reply to a question, the Director for People's Servicessaid that should the Service fail to achieve its budget, then vulnerable patients would be put at risk.  Work was underway with the hospital as a health and care system to review the Urgent Care pathway.  The principal concern was around the broad County services, not those provided by the hospital. Attention was being given to the discharge of patients, and an assessment would be undertaken of the Occupational Therapist Service. The Care Bill made it clear that people would be encouraged to take increased  ...  view the full minutes text for item 60.

The Committee received a report on the Herefordshire Clinical Commissioning Groups Adult Urgent Care engagement and communication plans.  The Executive Lead Nurse, Herefordshire Clinical Commissioning Group (HCCG) highlighted the following themes:

HCCG wanted to introduce a model of adult urgent care service that was simple to understand, to access and to navigate, and to provide local care with options for self-care of long term conditions.

A key element was to ensure we embed people’s views of what matters into the strategy. It was important that the local community of Herefordshire and wider stakeholders were well informed about the opportunities for involvement in the process. Working with HealthWatch during September 2013 six engagement events would be held in the City and Market Towns, led by one of the HCCG GP members.

In the ensuing discussion, the following points were made:

·         that NHS Direct had taken over the 111 telephone service, and that the HCCG were working closely with them to deliver a localised service.

·         That the public meetings would be open to all, and the HCCG would encourage as many stakeholders to attend as was possible.

·         That the HCCG were still considering a triage system at the hospital, but there was a differing amount of research as to the effectiveness of such a system.  The CCG was also limited as to what it could do to the fabric of the hospital.  If it were possible to integrate GP’s in A&E, then it could well be the best available option.

RESOLVED: That a further update report should be provided to the Committee in four months.

To note the Committee’s Work Programme.

The Committee noted its Work Programme.