To receive apologies for absence.

Apologies were received from Councillors MT McEvilly, NE Shaw and Cllr D Summers.

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

In accordance with paragraph 4.1.23 of the Council’s Constitution, Councillor AJW Powers attended the meeting as a substitute member for Councillor D Summers and Councillor EJ Swinglehurst as a substitute member for Councillor NE Shaw.

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 24 March 2015.

The Minutes of the Meeting held on the 24 March 2015 were approved and signed 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 from members of the public.

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). 

There were no questions from members of the public.

To hold a public accountability session to discuss the performance of the West Midlands Ambulance Trust.

The Committee received a presentation from Michelle Brotherton, General Manager West Mercia (Herefordshire, Shropshire and Worcestershire) West Midlands Ambulance NHS Foundation Trust.  Following her presentation, the following issues were addressed:

In reply to a Member’s question regarding sickness figures, it was stated that the figure of 4.30% for the year was for the whole of Herefordshire, with a large percentage of sickness attributed to muscular stress or injury. Although no trends were presented it was confirmed that sickness was higher during the winter period.

In reply to a members question as to what measures are in place to reduce sickness levels she replied that a robust sickness management system was in place and that early intervention was seen as important in reducing sickness levels.

 In reply to a Members question regarding the number of ambulances  available, she replied that there were nine available at peak demand times plus  cars at 4 community sub-stations. In addition there were a further two cars that were available at particularly high demand times.  There was also the facility to call on Shropshire and Worcestershire services if required.

 A Member enquired about the availability of flu jabs and it was confirmed that this service is available for staff to access if they wished.

 In answer to a Member question regarding the effects of late responses she confirmed that no details were available but could be provided if required.

 Points were raised regarding response times in given areas. Members felt that there should be more detailed information available as to why different areas/locations had differing performance statistics. It was felt that the report statistics presented did not allow any conclusions to be drawn.

 A Member commented on the excellent feedback regarding Brierley Hill and suggested that the approach taken at Brierley Hill should be more widely adopted. 

 In response to a Members question regarding calls from the Welsh border she confirmed that calls were recorded and shown as a Herefordshire response.

A Member raised the issue of future demographic trends and the resilience of the service to cope.  It was confirmed that although the county picture was continually assessed, resources were finite.

Other points discussed included out of hours provision and provision of defibrillators across the county.   It was confirmed that weekly meetings with the Wye Valley Trust were held and every effort was made to promote and maintain communication lines.

Work was ongoing to ensure defibrillators were widely accessible throughout the community and work was ongoing to make them available at Care Homes, shops and Police and Fire Stations.

Resolved: 

That

a)    data on fatalities as a result of late attendance be made available;

b)    a  progress report  on Access to Mental Health provision be provided; and;

c)    An in depth rationale behind the data presented be provided.

To note the proposed arrangements for the implementation of an Information, advice and signposting Hub (IAS Hub), allied to a new Digital Web system which will also deliver online self assessment and a care and support Emarketplace.

The Committee received a presentation from the Commissioning Lead Officer Integrated Pathways, on the proposed arrangements for the implementation of an Information Advice and Signposting Hub.

During the ensuing discussion the following issues were raised:

• That access to services in rural areas is recognised and innovative ways of enabling are always being considered.

• That although the younger generation access services throughout a variety of mediums there is an ongoing commitment to retain the telephone as a method of contact.

• That there is a recognition that services should be made more accessible i.e. 7 days per week. With a ‘pop up’ service for rural areas envisaged.

• The delivery method was moving to self-assessment with an e-market place signposting to a host of different service providers.

• That an information hub system be implemented by the end of August 2015 with an e-market place launch planned for October/November 2015.

In reply to a Members concern regarding access to services in rural areas. The aim of this initiative is to provide a variety of ways to access services.  It is recognised that GPs are excellent at diagnosis however there can be a lack of knowledge in appropriate signposting and referral to services.  This initiative will assist all stakeholders to access the appropriate services.   It is also recognised that the younger generation access services through a variety of mediums however there is a commitment to retain phone access to services.

Concerns were raised by Members as to how the e-market place would be publicised with the reply given that a marketing plan would be developed with all mediums being considered.

In reply to a question from a Member regarding debt advice and  concerns that any funding allocated to this initiative might impact on funding for the Citizens Advice Bureau (CAB). It was confirmed that any funding allocated to this initiative would be new funding and therefore would not impact on the CAB.

Members requested that provision of this service should be linked to any future digital strategy.

Resolved: That a progress report be presented at the end of the year.

To receive a report on areas of concern to Healthwatch Herefordshire.

The Committee received a report from the Independent Chairman of Healthwatch Herefordshire which outlined areas of concern for Healthwatch.

The Chairman confirmed that a briefing paper will be made available for all Councillors.

In reply to Members comments that Healthwatch was not as well-known as other services, The Independent Chairman confirmed that the profile has been raised through local press and radio together with direct marketing to 60000 residents.  It was accepted, however, that further efforts in this area were required.

The Independent Chairman confirmed that regular meetings were held with both the 2Gether Trust and the Wye Valley Trust. Mr Deneen suggested that members undertake visits to the Wye Valley Trust.

 In response to a Members question regarding the continued Healthwatch monitoring of the Ross On Wye and Leominster minor injuries unit, he went on to say that whilst monitoring would continue, it should be noted that the minor injuries unit contract is up for renewal.

Other points raised were:

• Signing of the military covenant was supported and commended.

• Recognition of the difficulty in GP recruitment for Herefordshire. It was suggested that Dr Harris be invited to the next meeting to outline the strategy for recruitment.

• Mr Deneen  expressed his gratitude for the support received from Members and confirmed that a briefing paper would be made available for the Committee

 The Chairman thanked the Independent Chairman for his report.

To note and comment on the Committee’s Work Programme and allocate activities to task and finish groups, as deemed necessary.

The Committee considered its Work Programme and in the ensuing discussion the following points were raised:

·         Concerns regarding the impact of planned 24hr GP cover and the increased demands on the Health Service Herefordshire particularly in the light of increased housing and it was confirmed this area could be further explored and brought before the Committee.

·         That a Commission for GPs was being led by NHS England.

·         That neither Public Health Performance nor Compliance with Care Act featured in the work programme. The Director of Adults Wellbeing confirmed that these areas could be considered once further guidance has been received.

·         That the impact of Housing and Health Infrastructure should be the subject of a Task and Finish review particularly in view of a proposed University for Herefordshire.

·         The Committee would be focusing on Safeguarding Performance and Child Sexual Exploitation.

·         That 106 agreements should contribute  towards Health Promotion

Resolved: That the Work Programme be noted