Apologies were received from Cllr RL Mayo.

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

Cllr CR Butler substituted for Cllr RL Mayo.

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 16 November 2017.

RESOLVED:

That the minutes of the meeting held on 16 November 2017 be confirmed as a correct record and signed by the chairman.

To receive questions from members of the public.

Deadline for receipt of questions is 5pm on Monday 22 January 2018.

Accepted questions will be published as a supplement prior the meeting.

There is guidance on how to submit a question to the committee on the council’s website at: https://www.herefordshire.gov.uk/getinvolved

Please submit questions to: councillorservices@herefordshire.gov.uk

There were no questions from members of the public.

To receive questions from councillors.

Deadline for receipt of questions is 5pm on Monday 22 January 2018.

Accepted questions will be published as a supplement prior the meeting.

Please submit questions to: councillorservices@herefordshire.gov.uk

One question was received and is provided, with the answer, in appendix 1 of the minutes.

To consider further information on the proposed closure of the Hillside Centre facility.

A presentation was given by the managing director, Wye Valley NHS Trust (WVT) and the director of operations, NHS Herefordshire Clinical Commissioning Group (the CCG). 

It was explained that some of the information provided had already been shared and it was intended to give more detail and update the committee since the meeting in November. Members were reminded that officers had also attended the meeting in August 2017 and talked through the process, and had taken members’ advice on the engagement process from that meeting.

In the presentation, the following key points were made:

·         There was a strong body of evidence to support not keeping people in a bedded environment, which included the degenerative impact, and to provide reablement

·         In terms of metrics, WVT performance compared well with other areas and as provision of care shifted it was expected to see improvement

·         The early supported discharge (ESD) team had transitioned care from other sites as well as the Hillside annexe and was providing high quality community-based reablement including dedicated stroke reablement in order to provide better outcomes. It was important to recognise this if performance were to be improved in addressing length of hospital stays and increasing the number of people who had access to care at home

·         6 additional staff had been recruited with a further 4 sought in the new financial year and there was confidence over capacity to meet the change in service. Double running of provision was in operation during February whilst stepping down the number of people at Hillside for the transition to be effective from 24 February 

·         There was close working between the health and social care teams to support the transition

The assistant director, operations and support, explained that around £1.2m had been spent on reablement and rapid response services, leading to the council forming the home first service. Investment would increase to £1.5m next year. Where previously around 300 people would have been in receipt of this service, it was expected to increase to around 1000. It was anticipated that this number could grow further as the new service became established.

A member asked what was included in reablement and rehabilitation and whether this included soft exercise. The managing director, WVT, confirmed that the increase in reablement staff included additional physiotherapy input.

Responding to a member’s concern over contingency plans in the event that the additional workforce could not be recruited, it was further clarified that there were staff in place. The assistant director added that 6 of the 11 posts in the adults and wellbeing team were being filled with 4 being recruited, and this would be an ongoing recruitment drive.

The member asked whether any staff from Hillside had joined the home first team, or if they had been redeployed elsewhere.

The WVT managing director explained that staff had a choice of vacant posts in the trust and that they were avoiding redundancies. It was not certain whether there had been any resignations as a result of the changes.

A  ...  view the full minutes text for item 32.

To receive an update on both the commissioning and the work of Healthwatch Herefordshire, and to consider areas that Healthwatch has raised for inclusion in the committee’s work programme for further scrutiny.

The director for adults and wellbeing introduced the item. In setting some context, he explained that Healthwatch was commissioned by the council and, through the Health and Social Care Act 2012, was the third iteration of arrangements since Community Health Councils were abolished in 2003 that had been established formally to provide a function for public involvement in health.

There had been long standing arrangements in place for such a function through the establishment of community health councils in 1974. Councils were required to commission Healthwatch services from a third sector body, through non-ring fenced funding. The commissioning relationship was complex as it was established on behalf of the system but also the council was subject to review by Healthwatch, and so it was important to maintain the right balance between being an effective commissioner and not disabling Healthwatch’s role to hold the council to account. The new arrangements represented a significant step forward in fulfilling this role.

The chair of Healthwatch provided some background to the current arrangement, and explained that the previous iteration of Healthwatch was formed as a subcommittee through Herefordshire Voluntary Organisations Support Service (HVOSS) but was now recommissioned as a standalone organisation. It was an established company, with a new board of directors and a developing team led by a new chief officer. Further appointments to engagement and communication roles were underway.   There was still work to do in continuing to improve the performance of the organisation from these good foundations and in continuing to monitor health and care provision. Accountability was established through the formal contract with the council and in the relationship with the public as users of health and social care, in taking their views and helping them to understand what is happening within local services. It was a challenge to maximise engagement but Healthwatch continued to make progress, supported by a valued volunteer network and an established stakeholder group. The Healthwatch chair acknowledged the significant role of volunteers including two who had been co-opted to the board. The Healthwatch chair also acknowledged the support that had been provided by Healthwatch Worcestershire to help establish Healthwatch Herefordshire so that it was able to become a standalone organisation. 

The chief officer of Healthwatch gave an account of the work of Healthwatch over the past year, which commenced with asking the public what they thought Healthwatch should focus on. This had identified: GP access; public health and prevention; palliative care; complex conditions; adults social care pathway; and accident and emergency services.

The resulting plan was to focus on two areas at a time, making use of groups and gathering feedback and information, which had led to further emerging issues to be addressed at the same time as the key priorities.

The key point this year would be to evaluate what contact was the most effective and to develop relationships with key organisations to ensure ongoing dialogue to inform the work. An example included working with the CCG about public concerns over Hillside. Positive and  ...  view the full minutes text for item 33.

To consider the committee’s work programme for January to May 2018.

Members were reminded of the workshop that was scheduled for 7 March which would cover public health, how it operates and what the strategies achieve. It was noted that the new director of public health would be in post by then.

A councillor had expressed concern regarding contract management for home care and it was agreed that this be included in the work programme. It was noted that there was a new framework for home care agencies to go through a single contract and quality management process. It was intended that the framework would be an interim step pending development of a new market strategy and which would need to be revisited for new contracts to ensure stability in the market.

With regard to scrutiny of learning disability services, it was noted that the learning disability strategy was under development and that this would embrace all age groups. Members agreed that this might be an opportunity for the committee to work in tandem with the children and young people scrutiny committee to look at the strategy in entirety and officers would make appropriate arrangements for this.

A member pointed out some clashing of timings with CCG meetings and it was agreed to look at this.

RESOLVED

That the updated work programme be agreed subject to the amendments noted.