Agenda and minutes

Apologies for absence were received from County Councillor Borrow.

Members are asked to consider any Pecuniary and Non-Pecuniary Interests they may have to disclose to the meeting in relation to matters under consideration on the Agenda.

None.

Resolved: - That the minutes of the meeting held on 8 June 2015 be agreed as a true and accurate record and be signed by the Chair.

Aiden Kirkpatrick, Consultant in Public Health, and Lee Girvan, Public Health Specialist (Wellbeing, Prevention and Early Help), attended and presented a report giving an update on the performance of the NHS Health Checks programme in Lancashire in 2014/15 and described improvement initiatives that are taking place.

It was reported that the NHS Health Checks programme is a national mandated service which is aimed at detecting people at risk of developing heart disease, stroke, diabetes, kidney disease and certain types of dementia, in order to help prevent these conditions occurring or to provide early diagnosis and treatment. People who are aged between 40 and 74 years who do not already have a diagnosed condition, are eligible to receive an NHS Health Check every 5 years. The national ambition is that 20% of the eligible population are invited each year (i.e. 100% invited every 5 years) and that 75% of those invited take up the offer.

The main vehicle for delivery of NHS Health Checks in 2014/15 was via GP practices which are commissioned to provide the services for their eligible patients and are paid on a tariff basis for each NHS Health Check carried out. Currently 96% of practices are signed up to deliver NHS Health Checks across the authority. This is an improvement since the November 2013 report where only 72% of practices were signed up.

Data from Lancashire GP practices indicated that 9.29% of the eligible individuals received an NHS Health Check compared with the national average of 9.61%.

It was reported that in an attempt to widen the reach of NHS Health Checks in Lancashire, a number of initiatives have commenced this year including the delivery of NHS Health Checks in community and workplace settings by Wellness International which commenced in April 2015. The delivery plan for this element of work allows for an additional 20,000 NHS Health Checks across Lancashire per annum. Also it is believed that Lancashire is the first authority to deliver NHS Health Checks within prisons, substance misuse services and Healthy Living Pharmacies, which aim to further improve the volume and quality of Health Checks over the forthcoming year.

An analysis of NHS Health Checks performance over the last three years was presented in Appendix 'A' to the report.

Resolved: - That:

(i)  The report now presented be noted:

(ii)  The actions outlined in the report be approved.

Bob Stott, Director for Universal and Early Support Services, and Barbara Bath, Head of Service Adoption, Fostering and Residential Youth Offending attended and presented a report giving the latest Adoption Scorecard published by the Department for Education (DfE) in December 2014, covering the period April 2011 to March 2014

It was reported that Lancashire's adoption performance has been mixed compared with the last published scorecard which covered the period April 2010 to March 2013. The scorecard looks at three key indicators and aggregates performance across a three-year bracket.

The latest Lancashire Adoption Scorecard analysis for 2011-14 and recent 2014/15 performance was presented in Appendix 'A'.

It was noted that more Lancashire children than ever were adopted in the last financial year. 121 children received an adoption order in 2014/15, over 50% more than in 2013/14 (83) which was a further increase on 2012/13 performance of 75.

It was reported that Dr Carol Homden from the national Adoption Leadership Board and the DfE had visited Lancashire. Dr Homden reported favourably on the narrative put forward by the authority in getting 'behind the data' and the progress being achieved by the authority at both a region adoption conference and at the North West Adoption Leadership Board. Dr Homden and the DfE were impressed with Lancashire's multiple approaches to securing adoptive placements for some of the more difficult to place children. Dr Homden has suggested that as the authority with the largest number of adopters, Lancashire would be a logical addition to the board.

Resolved: - That the report now presented be noted.

Tony Pounder, Director Adult Services, and Nick Clifton, Team Manager DoLS, Safeguarding Adults, attended and presented a report setting out an overview of the current situation regarding the DoLS and the legal requirements of the Local Authority in this process and with respect to Court of Protection applications.

The report outlined the pressures being faced since the Supreme Court ruling of March 2014 (known as the Cheshire West ruling) which dramatically increased the number of people who now come within the remit of Deprivation of Liberty legislation. The financial pressures on Lancashire as a result of this ruling are still being assessed but they will be significant and ongoing.

It was reported that the numbers of applications had risen from around 350 in 2013/14 to over 3,000 in 2014/15 when the impact of the Supreme Court ruling began to take effect. The process for DoLS is complex and specialist knowledge and skills are required.

Nationally the consensus is that local authorities will face severe financial burden as a result of the increased activity, which is likely to continue to increase over coming years.

It was noted that the Government had asked the Law Commission to design a new scheme amid concerns that the current system was not fit for purpose and was failing to cope with a tenfold rise in deprivation of liberty cases. The Law Commission published its proposals on 7^th July 2015 which are open to consultation, with final proposals being presented to Government at the end of 2016.

It was reported that in March 2015, the Minister for Care and Support announced an additional £25m would be made available to local authorities for DoLS, with the County Council being awarded £588,603. The grant is designed to help address the significant increase in DoLS applications resulting from the Supreme Court ruling and to improve staff and partner understanding of the DoLS and the wider Mental Capacity Act.

Resolved: - That the report now presented be noted.

Kate Lee, Head of Exchequer Services attended and presented a report giving an update on the Debt Management Recovery Plan.

An update was presented on the Debt Management Performance Indicator Recovery Plan:

·  A new Income and Debt Management Policy, Processes and Responsibilities document was approved by the Deputy Leader with effect from 1^st April 2015. The document has been shared and publicised with key stakeholders involved in ensuring its successful implementation.

·  A new charging policy for care will be developed as part of the County Council's timetable for the implementation of the Care Act and will include consideration of the avenues available for limiting the incidence of debt and preventing payment arrears from escalating.

·  The new Accounts Receivable IT system went live on 21st July 2015. It is anticipated that the automated system for sending out reminders, statement and letters, combined with the improved classification of debtors using the newly developed debt strategies, should enable the Authority to recover debts more promptly which subsequently will improve the probability of collection.

·  A key factor in the collection of care debt is the take up of direct debits. A full review of the Direct Debit process has recently commenced and is part of a larger project looking into methods of payment in and out of the County Council.

·  The speed of financial assessments is another key factor in ensuring that clients are aware of care costs as early as possible and that they are charged accordingly. A process review within the service area will commence once the IT system is implemented.

·  Paperless direct debits are currently under development and will be progressed in conjunction with the payments and income methods project detailed above.

·  The implementation of the new debt strategies will result in an increased and automated referral to Legal Services for appropriate cases.

An update was given on additional action points to support the Recovery Plan:

·  The Debt Management Board has continued to meet on a fortnightly basis to ensure that key milestones are achieved.

·  Additional resources have been allocated to the Debt Management Team to complete a "cleanse and migrate" process prior to moving existing debt information from the current Accounts Receivable system to the newly implemented system.

·  The Income and Debt Management Policy, Processes and Responsibilities highlights the importance of Budget Holders/Heads of Service as key stakeholders, accountable for debt recovery in their service area. Heads of Service have a copy of the Policy document and have received follow up mandatory training. Budget holders will be provided with reports that provide clear information on their outstanding debt position.

Additional information was provided as Appendix 'B' on the current position of key performance indicators in relation to debt management including:

·  Outstanding Debt Balance Analysis

·  Outstanding Debts over 180 days (6 months)

·  Bad Debt Provision Analysis

Resolved: - That the report now presented be noted.

Deborah Barrow, Head of Service Human Resources attended and presented a report setting out details of the County Council's performance against key metrics regarding workforce information for both the 4^th quarter in 2014/15 and the final year outturn for 2014/15.

It was reported that the Corporate Human resources key metrics regularly monitor and report against workforce data, including: sickness absence, the numbers of starters and leavers, reasons for leaving, redeployment activity, vacancy numbers, recruitment costs, new starts onto employment programmes and ex service personnel mentoring in schools. This data was circulated at the meeting as Appendix 'A'.

Highlights reported for the 4^th quarter of 2014/15 included:

-  The number of FTE days lost per employee due to sickness absence was 2.51 against a Q4 target of 2.43 days.

-  The number of starters increased by 1.45% in Q4 of 2014/15 compared with Q4 of 2013/14.

-  The number of leavers was down by 29% in Q4 of 2014/15 compared with Q4 of 2013/14.

-  Turnover increased from 9% in Q3 to 28% in Q4 of 2014/15.

-  The number of recruitment adverts remained the same in Q4 of 2014/15 compared with 2013/14.

It was reported that in Q4 of 2014/15 the top three reasons for absence across all service areas were mental health at 25%, respiratory at 12.5% and musculoskeletal at 11.8%.

Highlights reported for the full year 2014/15 included:

-  The number of FTE days lost per employee due to sickness absence was 8.41 against a target of 8 days, a variance of +5.1%.

-  Employee turnover was 17%.

-  The number of starters in the full year was down 17% from 2013/14.

-  The number of leavers in the full year was down 27% from 2013/14.

-  Voluntary redundancies accounted for 24% of all leavers. This is down 19% from 2013/14.

-  Recruitment advertising spend continues to reduce year on year and is down by £17.4k in 2014/15.

-  The Employment and Support Team met the target to deliver 1,000 new starts onto employment programmes for 2014/15.

It was suggested that the failure to achieve the target number of FTE days lost per employee due to sickness absence for Q4 and the full year 2014/15 may be related to the County Council's ongoing transformation process.

It was reported that for the full year 2014/15, the top three reasons for absence across all service areas were mental health at 25%, musculoskeletal at 12.7% and medical at 12.6%.

Resolved: - That the report now presented be noted.

An item of Urgent Business may only be considered under this heading where, by reason of special circumstances to be recorded in the minutes, the Chairman of the meeting is of the opinion that the item should be considered at the meeting as a matter of urgency.  Wherever possible, the Chief Executive should be given advance warning of any Members' intention to raise a matter under this heading.

There was no urgent business to be considered.

The next meeting of the Cabinet Committee on Performance Improvement would be held on Monday 5 October 2015 at 2.00pm in Cabinet Room 'B' – The Diamond Jubilee Room, County Hall.

The Cabinet Committee noted that the next meeting would be held on Monday 5 October 2015 at 2.00pm in Cabinet Room 'B' – The Diamond Jubilee Room, County Hall.