Agenda and draft minutes

Apologies for absence had been received from Councillors Jo Barker (Chair), Andy Jenns, Chris Mills (replaced by Councillor Dave Humphreys) and Sandra Smith (North Warwickshire Borough Council). Officer apologies were received from Nigel Minns (Executive Director for People) and Dr Shade Agboola (Director of Public Health).

Councillor Humphreys declared an interest as Chair of the Children and Young People’s OSC.

The Chair was mindful it was a full agenda and he urged brevity from those presenting, to allow time for questions. Everyone was welcomed to the meeting, especially Councillor David Johnston, the new representative for Stratford-upon-Avon DC. It was proposed to hold a presentation on the performance management Power BI platform. This would take place for members of the Committee at 9.30am on 15 November.

To receive the Minutes of the committee meeting held on 28 June 2023.

The minutes of the Committee meeting held on 28 June 2023 were approved as a correct record 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.

Councillor Colin Cape (NBBC) had given notice of the following questions:

·       How many veterans are registered with GPs in the region (what percentage of the population is this)?

·       What is done to flag them as such in order to follow the directives of the AFC (Armed Forces Covenant) for health?

·       What trends or variance if any appear in their health needs?

The questions had been provided to Rose Uwins of the C&W ICB who would arrange for a written response to be provided. This would be circulated to the Committee when it was received.

The Integrated Care Board (ICB) and the County Council (Infrastructure Planning) to provide a joint presentation. The focus for this item is NHS estates and the use of developer contributions, the identification of areas where there are perceived challenges, an update on the key projects being progressed and an overview of each of these projects.

The Committee received a joint presentation from the Integrated Care Board (ICB) and the County Council. The presenters were Simon Doble of the C&W ICB and Janet Neale from WCC’s Infrastructure Team. Tim Sacks (ICB) was also present to respond to questions. In opening the item, the Chair mentioned that the focus was on estates aspects rather than access issues. Janet Neale commenced the presentation covering the following areas:

• The Local Plan process, with an outline of the key stages leading to formal adoption of the Local Plan. There was a clear need for both WCC and the ICB to be very involved in this process.
• Section 106 (S106). This was a legal agreement between local authorities and landowners/developers detailing obligations required as a result of a planning application. Effectively it was a charge against the land.
• Community Infrastructure Levy (CIL). A tax on net new floor space set locally and paid to the district or borough council. The requirements around levying and use of CIL were outlined. In Warwickshire to date, only the Stratford and Warwick Districts had adopted CIL, with Rugby Borough pursuing the use of CIL currently.
• Further slides showed the pros and cons of the S106 and CIL approaches.
• The proposal to introduce a new mandatory Infrastructure Levy, set locally (similar to CIL). This would be based on the assessed uplift value of the land, as a result of development. This approach had attracted strong challenge during the consultation process by a wide range of organisations.

Simon Doble then spoke to the NHS aspects:

• Primary Care Estate Context. This included the transfer from the former Clinical Commissioning Groups (CCGs), frustrations for general practice and responding to known population growth with limited funding.
• Primary Care Estate Environment. This confirmed there was no new funding, a historic lack of investment, before raising the challenges from existing funding streams, build costs, workforce aspects and ownership of premises.
• The current picture. A slide giving an understanding of the ICB’s position, the baseline and portfolio of the ICB estate. It detailed the current and projected population and the known shortage of rooms for patient appointments. 

• Growth areas and priorities for further work.
• Opportunities, including a collaborative working approach.

Questions and comments were invited with responses provided as indicated:

• The Stratford and Warwick District Councils were producing a joint Local Plan for the South of Warwickshire. Such plans included a ‘target’ number of new dwellings, and one consideration was whether to extend existing settlements, or development of new settlements. It was questioned from a health perspective which option would be easier to plan more reliable services for.
• Tim Sacks replied that there were challenges both in terms of buildings and workforce with a need to increase both, to improve access to services. The S106 funding received was not sufficient to build new premises. Options were expansion of existing premises within the funds available, or providing a new premises which was reliant on an external funding contribution to make up the shortfall,  ...  view the full minutes text for item 5.

The Coventry and Warwickshire Integrated Care System is developing a joint all age strategy for Palliative and End of Life Care, on which the Committee’s feedback is sought.

The Committee received a report and presentation on the draft Coventry and Warwickshire Palliative and End of Life Care (PEoLC) Strategy, on which the Committee’s feedback and support was sought. The item was introduced by Jamie Soden, Deputy Chief Nurse with a presentation from Kathryn Drysdale. They were supported by Kate Hoddell of the ICB and Katie Herbert (WCC and SWFT).

The presentation by Kathryn Drysdale covered the following areas:

• What is Palliative and End of Life Care?This was an all-age strategy for Coventry and Warwickshire.
• There had been extensive collaboration across the local NHS system and with relevant partners in all sectors, to understand current challenges and work together to make improvements.
• An outline of the approach undertaken through an overarching partnership board, with four place-based groups feeding in local information.
• The aim and vision of the strategy, to provide a delivery plan and to raise the profile of this service area.
• The Strategy would cover a five-year period commencing in January 2024. Detail was provided on the communication plan, the two-year delivery plan, equalities aspects and areas of focus based on need. This included a focus on underserved communities, building relationships with communities and co-production. 
• Our Priorities: What we want to do.
  • Providing information - a focus on identification, early intervention and support.
  • Access to timely PEoLC and support throughout for all diverse communities.
  • Support for people diagnosed with life limiting conditions and those who matter to them.
  • Improve the quality of personalised care and support planning, through education and training for all.
  • Deliver a sustainable system of integrated care.
• The National Framework and the six ambitions for PEoLC. These were: being seen as an individual, getting fair access to care, maximising comfort and wellbeing, coordinated care, all staff being prepared to care and community support.
• How the strategy was developed. A slide showing the co-production, the engagement with stakeholders, along with meetings, surveys, and group discussions. Data was provided on the engagement undertaken, raising the profile and importance of EoLC.
• Health Inequalities in Coventry and Warwickshire. Some communities had poorer access to information, services and planning for EoLC. Details were provided of the specific groups affected particularly young carers, veterans and South Asian women.  
• Population Health Management. A need to understand the current system, the population, socio-economic and demographic factors both now and in the future. This would help to determine workforce requirements, given the known challenges currently.
• How we will deliver improvement. A need for seamless care across settings, clear referral pathways, pro-active personalised care, collaboration and clear communication.
• Programmes through which we will work. This included care collaboratives, a community integrator model, the Warwickshire Community Recovery Service and a review of the continuing health care fast track system.
• Delivery Plan for the period January 2024 – December 2026. This included areas of focus for each of the five priority areas reported above.
• Remaining timeline for the strategy.

The following areas were discussed:

• A member noted the passing reference to veterans. It would have been helpful  ...  view the full minutes text for item 6.

This item is being submitted to all the Overview and Scrutiny Committees in September as part of the public and stakeholder engagement programme for the strategy, before its final consideration by Cabinet.

This item was introduced by Steve Smith, Director of the Commissioning Support Unit. From October he would join the Communities Directorate and his role would include both Climate Change and Strategic Infrastructure. The draft Sustainable Futures Strategy was being submitted to all the Overview and Scrutiny Committees as part of a detailed engagement process, before its final consideration by Cabinet in November. Key information was provided in the covering report, which outlined the features of the strategy and the use of expert panels. A copy of the draft strategy, the action plan and an update on projects were provided as appendices.

Questions were submitted and discussion took place on the following areas:

• It was questioned if recent changes in national policy on timescales would impact on the council’s targets and trajectory for 2030 and 2050. Steve Smith agreed this was a dynamic situation, but the targets remained unchanged. However, the route to these targets may change with the recent announcements. There would be regular updates to Cabinet and the scrutiny committees to show the progress being made. The key issue was access to funding, most of which was small external grant sources. 
• Consent had just been given to open the Rosebank oil field near Shetland for another 40 years. Given the carbon emissions this would cause, it was questioned if this would outweigh local endeavours. Steve Smith replied that the Council could control its own consumption. It knew the carbon tonnages associated with building use, transport, fleet operations and street lighting. There was a lot of expectation at the contribution small and medium enterprises could provide too. Also, a need to be aware of current impacts from climate change, those for public health and flooding aspects too.

In closing the item, the Chair suggested that any further comments be submitted direct to Steve Smith.

For the Committee to consider and comment on the Quarter 1 Integrated Performance Report (period covering April - June 2023).

The Committee received the Integrated Performance Report, which gave a retrospective summary of the Council’s performance at the end of Quarter 1 (April - June 2023) against the strategic priorities and areas of focus set out in the Council Plan 2022-2027. Key sections of the report focussed on:

·   Performance against the Performance Management Framework

·   Progress on the Integrated Delivery Plan

·   Management of Finance

·   Management of Risk

There were no questions submitted by members.

For the Committee to review and update its work programme.

The Committee reviewed its work programme. Prior to the next meeting on 15 November, a briefing session would take place on performance and the Power BI platform. At the recent Chair and Spokesperson meeting, discussion took place about development of the Adult Social Care Strategy and planned engagement. It was agreed to add this to the Committee’s agenda in November.