To receive apologies for absence.

Apologies were received from Councillors CR Butler and PE Crockett.

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

Councillor WLS Bowen substituted for Councillor PE Crockett.

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

None.

To approve and sign the minutes of the meeting held on 6 July 2016.

RESOLVED

That the minutes of the meeting of 6 July 2016 be agreed as a correct record of the meeting and signed by the chairman.

Referring to the matter of speech and language therapy (SALT) provision and the committee’s recommendation to expedite a review of the same (Item 87, 6 July 2016), the director for children’s wellbeing confirmed that this area was the responsibility of the clinical commissioning group (CCG). The CCG had been made aware of the recommendation and were to undertake a review of SALT and occupational therapy services for children and young people. Advice regarding a timeframe for this review was awaited.

Members commented that this review was needed without delay.

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.)

None.

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.

The programme director for One Herefordshire presented a briefing on One Herefordshire and the NHS sustainability and transformation plan (STP) to provide context and progress to date.   The main points of which were:

• Development of the STP commenced in December 2015, with a local footprint of Herefordshire and Worcestershire.  Underpinning the STP was the imperative to maximise outcomes through the triple aim of improved health and wellbeing, care and quality, and finance and efficiency.
• STP leadership and governance arrangements were established in March 2016, with proposals being developed in readiness for submission of the final plan to NHS England on 21 October 2016.
• There were differences across the footprint, including mortality and expected outcomes for children, and public health priorities were key in supporting service redesign.
• There was an anticipated shortfall of £84m against a forecast budget of £1.4bn available to NHS commissioners for 2020-21, so providers would have to make efficiency savings year on year. This would require wide engagement and evidence of best practice.  
• Emerging priorities were defined as cancer, stroke, maternity, mental health and wellbeing, frailty and dementia, and acute services.
• The plan would address changing ways of working, focusing on the workforce, digital technology, estates, personal care planning, public and patient involvement, leadership and decision making.
• In terms of engagement, subsequent detailed plans would be co-produced with local communities to look at the specifics, and would be subject to scrutiny review 
• One Herefordshire provided a specific medium within the county for partners to work together to focus on prevention and ensuring resilient communities. This sought to recognise interdependence across wider public services to achieve common aims, provide a cohesive service and support delivery of the STP.   
• New models of delivery and care were being explored, with closer organisational alliances, whilst recognising the complexities of governance and cross working. The alliance approach was based on a memorandum of understanding to support improved outcomes.

The director for adults and wellbeing made the point that it was important to address any tensions in the system and members’ views were sought in respect of three particular areas:

• Firstly, the triple aim model was based on sustainability, which encompassed areas that drove the broader wellbeing of the population, such as economic development, education and housing, which in turn enabled the delivery of quality health and social care services.  There were finite time and financial resources to achieve this which caused tension and so system change was the only option.
• There was a second tension about connecting appropriately with the public on significant levels of change. Timing and level of detail of this was key. It was important to consider whether to provide a high level of detail on a finished product or whether to involve the public in designing the services in order to develop a more owned and realistic solution.  The latter would take longer to achieve and there is a deadline to submit the plan in October, with contracts then signed by 23 December, giving little time for meaningful  ...  view the full minutes text for item 97.