Agenda and minutes

Apologies for absence from the meeting had been received Councillors Drew, O’Donnell and Rolfe (replaced by Councillor Roodhouse), from Councillor Clifton and Vicky Castree (Coventry City Council) and from Phil Johns and Rose Uwins (CWCCG).

Councillor Jerry Roodhouse declared an interest as a Director of HWW.

The Chair welcomed everyone to the meeting, especially new members to the Committee. She outlined the purpose and remit of this committee, the breadth of services covered, and this first meeting would provide context for newer members. The Chair explained the additional arrangements for this face to face meeting and the possibility of providing additional information to members away from the formal meetings using virtual meeting technology.

To receive the Minutes of the meetings held on 17 February and 25 May 2021.

The Minutes of the meetings held on 17 February and 25 May 2021 were accepted as true records and signed by the Chair.

None.

Up to 30 minutes of the meeting is available for members of the Committee to put questions to the Portfolio Holder: Councillor Margaret Bell (Adult Social Care and Health) on any matters relevant to the remit of this Committee.

None.

Members of the Committee are invited to give notice of questions to NHS commissioners and service providers at least 10 working days before each meeting. A list of the questions and issues raised will be provided to members.

None.

An introductory presentation to explain the remit of the committee, its roles, how it works and degrees of influence. To include the services the county council commissions and those provided through Social Care and Public Health.

The Committee received an introductory presentation. The slides had been circulated ahead of the meeting. Nigel Minns, Strategic Director for People Group opened, giving an overview of the Committee, its role and the service areas it reviewed and scrutinised, including the specific role in relation to health scrutiny. Slides included:

• The Committee’s role
• Specific health scrutiny powers
• The bodies and providers involved
•  Substantial changes in health services

Next an outline was given on the People Directorate, covering its aim, vision and roles in commissioning services and providing them. This included a structure chart showing key officers. It was followed by further detail from each of the Assistant Directors.

Shade Agboola, Director of Public Health (DPH) covered the following areas:

• What is Public health?
• A brief history on the function
• Mandated responsibilities
• Non-mandated functions
• Funding
• The role of the Director of Public Health
• A structure chart showing the key personnel
• Current priorities
• An offer to circulate the previous statutory DPH annual report

Pete Sidgwick, Assistant Director for Adult Social Care gave an overview of Adult Social Care delivery. This covered the following areas:

• An overview of Adult Social Care
• Legislative changes introduced by the Care Act 2014, the Mental Capacity Act 2005 and the implications for the Council
• How we support individuals
• A graphic showing key data for the service
• A structure chart showing the key personnel
• Finances
• Key metrics

Becky Hale concluded with an overview of People Strategy and Commissioning, which covered the following areas:

• An overview of the key roles of this function.
• The structure of the three service areas Health, well-being and self-care, integrated and targeted support and all age specialist provision
• The key functions to analyse, plan, do and review
• Partnership working
• Commissioning principles
• Examples of services commissioned
• Extracts from the commissioning plan for the period 2020-22 with slides showing examples of the areas of work against analyse, plan, do and review

The Chair thanked officers for the comprehensive presentation and spoke of the scale of expenditure involved. She used the example of the consultation undertaken for the Coventry and Warwickshire stroke service redesign to demonstrate the committee’s influence, speaking of the good dialogue with NHS colleagues in considering this reconfiguration. She invited questions and comments from the committee:

• Councillor Pam Redford raised the closure of the clinics where people could undertake lateral flow tests and asked if the service could be retained. Shade Agboola responded. With the move to home testing, there had been a significant reduction in footfall at the sites and their continuation could not be justified. Covid was likely to remain into the future. The testing arrangements were dynamic, with a current focus on certain key groups. One site would be retained in Nuneaton and discussions were ongoing so some additional fixed sites may be required, but for now they had been closed.
• Councillor John Holland praised the clear presentation. He sought further information regarding enquiries when members were notified of people needing support. There were concerns about when issues should be  ...  view the full minutes text for item 5.

To complement the above item, this is a high-level presentation by the Coventry and Warwickshire Clinical Commissioning Group (CCG) on the NHS services commissioned and provided in Warwickshire.

Dr Sarah Raistrick, Chair of the Coventry and Warwickshire Clinical Commissioning Group (CWCCG) was welcomed to the meeting. She gave a presentation explaining the roles of the NHS and services delivered in Coventry and Warwickshire. The presentation covered the following areas:

• Integrated Care in Coventry and Warwickshire
• Health and care services
• Our role as a clinical commissioner – plan, determine & prioritise, purchase and monitor
• Coventry and Warwickshire Health System
• What happens at place and system, a graphic on primary care networks, place and system
• How we can work together – the ways the committee could receive information to undertake its scrutiny role
• The next steps for health and care in Coventry and Warwickshire
• Why become an ICS?
• Our Vision
• What does this mean for clinical commissioning?
• Next steps for ICS

The Chair thanked Sarah Raistrick for the comprehensive presentation and noted that the ICS would feature on the committee’s future work programme. She invited questions and comments from the committee:

• Concerns were raised about GP service delivery. Councillor Redford had received complaints about the lack of face to face services, telephone waiting times and the amount of personal information being required by receptionists. There had been an increase in demand for GP services, challenges in getting appointments, frustration and it was especially so for those with mental health conditions. An assurance was sought on service resumption.
• The Chair added that a revisit of the focused task and finish group (TFG) on GP Services would be proposed under the work programme.
• Sarah Raistrick acknowledged these points which were raised to varying degrees across the area. She explained that the information being sought by receptionists was to ensure each patient was referred to the correct part of the practice, as not all required the GP to respond.
• In terms of the ‘return to normal’, there was a push under the NHS long term plan to offer digital and remote services using technology. This approach was preferred by some patients. Others preferred face to face appointments and the CCG was working with GPs to ensure capacity to offer this.
• An apology was provided on the example of a patient having to call over 200 times to join a call queue, which was not acceptable. The CCG would like to work with the committee and the public on finding solutions to such issues, to make suggestions to those providing the services. GPs were working very hard, with increasing requests for appointments. A range of other clinical staff were collocated at practices to assist. Another area discussed was liaison with patients via participation groups and Healthwatch.
• Councillor Matecki asked about contact information for NHS services and the process for escalation of queries to enable councillors to assist. Sarah Raistrick offered to work with Nigel Minns on a combined NHS/council contact list. 
• Chris Bain of HWW also offered to be a conduit for councillor enquiries, referring to the recent briefing note he’d supplied. He was pleased to see that ICS would have statutory powers, unlike the  ...  view the full minutes text for item 6.

The Council Plan Year End Performance Report was considered and approved by Cabinet on 17th June. This report provides the Committee with information relevant to its remit. It will be accompanied by a presentation.

The Council plan year end performance report for the period 1 April 2020 to 31 March 2021 was considered and approved by Cabinet on 17June. A tailored report for the areas within the committee’s remit was provided which reported an overview of progress of the key elements of the council plan, specifically in relation to performance against key business measures (KBMs), strategic risks and workforce management. It included a financial monitoring report for the period covering both the revenue and capital

budgets, reserves and delivery of the savings plan.

The report was accompanied by a presentation from Nigel Minns which covered the following areas:

• Introduction
• Context and Performance
• The two high level outcomes
  • Warwickshire’s communities and individuals are supported to be safe, healthy and independent; and,
  • Warwickshire’s economy is vibrant and supported by the right jobs, training, skills and infrastructure.
• Of the 83% (ten) KBMs which were ‘on track’, there were four of note for which detailed slides showed performance and a narrative, including direction of travel
• There were two KBM’s which were not on track at year end of which one required highlighting on people with a learning disability or autism in inpatient care.
• Finances – revenue, savings and capital

The Chair thanked officers for the presentation and invited questions and comments from the committee:

• Councillor Matecki asked if targets were achieved or exceeded, whether they were refreshed to make them more stretching. Targets were set to stretch but be achievable. They were not adjusted in year, but a focus was maintained, and endeavours were made to exceed the targets.
• Councillor Humphreys spoke of the increase in domestic abuse cases, asking how services had coped. She questioned if there was a role for local councillors in providing ongoing support.  Becky Hale gave an outline of the joint work across partners, including the Police, Refuge and the Council. This included targeted activity, campaigns and communications work on domestic abuse services. There was new domestic abuse legislation and a lot of work was taking place within the Council and with partners to meet its requirements. This would be a useful area for the committee to consider. Warwickshire had been recognised as an example of good practice for its work on collaboration. The Chair agreed this could be added to the work programme and there would be a key focus on the ICS too.
• The Chair encouraged people who were experiencing domestic abuse to call the national domestic abuse helpline on 0808 200 0247, also the website www.uksaysnomore.org which was partnering with pharmacists to use their consulting room as a safe space to report domestic violence. A further national resource was www.nationaldahelpline.org.uk

·       In Warwickshire, Refuge had a domestic violence service helpline on 0800 408 1552 (Monday-Friday 8:30am-8:30pm; Saturday 10am-4pm). It included an out of hours voicemail and they would respond. Contact could be made by email DVSW@refuge.org.uk. Finally, in an emergency, people should call 999.

Resolved

That the Committee notes the presentation and comments on the progress of the delivery  ...  view the full minutes text for item 7.

To review the Committee’s work programme for 2021/22.

It was reported that each overview and scrutiny committee set a work programme of areas for consideration. A draft work programme was discussed by the committee’s Chair, Vice Chair and representatives of other groups (spokespeople) on 7 June. The outcome from that discussion was submitted. The Chair provided context that the work programme would include some significant pieces of work. The committee reviewed its draft work programme, with the following points being raised:

• The Chair referred to the previous task and finish group (TFG) on GP services, which would be revisited.  For the benefit of new members, the previous review report would be circulated. Members wishing to participate in the TFG were asked to contact Paul Spencer in Democratic Services.
• Councillor Mills asked that the contact information provided under the previous item be circulated to members.
• In response to a question from Councillor Cooke, an outline was provided on the function of the Chair and party spokespeople meetings.  It was emphasised that those meetings and the scrutiny function were not political.
• The Chair highlighted the proposal to include menopause services on the work programme. This was supported and a date for its consideration would be agreed. Similarly, the topic of domestic abuse services would be included on the work programme.
• Reference was made to the briefing notes circulated and those proposed in the near future.

Resolved

That the Committee approves its draft work programme as submitted.