Agenda and minutes

County Councillor Christian Wakeford replaced County Councillor keith Iddon, and Councillors Helen Jackson and Melvyn Gardner replaced Councillor Liz McInnes (Rossendale) and Mick Titherington (South Ribble), respectively, for this meeting.

Apologies for absence were presented on behalf of County Councillor Andrea Kay and Councillors Brenda Ackers (Fylde Borough Council), Julie Robinson (Wyre Borough Council) and Betsy Stringer (Burnley Borough Council).

To note the appointment by Full Council on 15 May 2014 of County Councillor Steven Holgate as Chair of the Committee and County Councillor Mohammed Iqbal as Deputy Chair for the following year.

It was reported that Full Council, at its meeting on 15 May 2014, had approved the appointment of County Councillor Steven Holgate as Chair of the Committee and County Councillor Mohammed Iqbal as Deputy Chair for 2014/15.

Resolved:  That the appointment of County Councillor Steven Holgate as Chair of the Committee and County Councillor Mohammed Iqbal as Deputy Chair for 2014/15 be noted.

A report was presented on the Membership and Terms of Reference of the Committee.

It was noted that, not all district council nominees had yet been confirmed and a further update would be reported at the next meeting.

Resolved:  That the Membership and Terms of Reference of the Committee, as now reported, be noted.

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 disclosed

The Minutes of the Health Scrutiny Committee meeting held on the 22 April 2014 were presented and agreed.

Resolved: That the Minutes of the Health Scrutiny Committee held on the 22 April 2014 be confirmed and signed by the Chair.

The report explained that over the next 12 months the Health Scrutiny Committee would look in greater detail at the current and emerging strategies developed to deliver public health services to the residents of Lancashire. As part of that undertaking representatives from Public Health England (PHE) and NHS England had been invited to attend Committee to provide members with information on:

• Their roles and responsibilities
• Priorities
• Partnership working with other organisations to deliver the priorities

The Chair welcomed

• Jane Rossini, Centre Director - Public Health England, Cumbria and Lancashire Centre.
• Jane Cass, Head of Public Health - NHS England – Lancashire Area Team.

Jane Rossini explained that PHE is a national organisation with a local presence and that national and local priorities were similar. She delivered a PowerPoint presentation which briefly set out Public Health England's national priorities for 2013/14 and explained how their agenda was to be delivered locally. It explained their role and how PHE would work with partners. It also listed the main areas of focus for health improvement.

Jane Cass then delivered a presentation which focussed mainly on the commissioning of public health services across Lancashire. It showed which stakeholder organisations NHS England works with and the role that each of the various stakeholders has in improving public health and delivering services.

A copy of both presentations is appended to these minutes.

There then followed a discussion, the main points of which are set out below:

·  It was recognised that Scrutiny could add value to the public health agenda, for example, a recent joint scrutiny report, with which Lancashire councillors had been involved, had made a significant contribution towards understanding the current picture relating to NHS Health Checks.

·  In response to a question how PHE's role would fit with the role of Health and Wellbeing Boards, it was explained that PHE was collecting evidence and examples of good practice, which would be shared with stakeholders as appropriate. It was recognised that there could be a real benefit working alongside partners where it was sensible to do so.

·  It was acknowledged that cervical cytology screening was a significant public health intervention where the target was not currently being met within certain communities. This was an issue that would need to be jointly addressed by a number of partners, including primary care settings where conversations could be had to alleviate concerns, and also local authority public health teams who could play their part in increasing uptake. There was a commitment to delivering on this issue in the coming year.

·  Cervical cytology screening had already saved many lives, however it was acknowledged that more could be done. PHE was looking at a social marketing strategy across all screening programmes.

·  Engaging with young people not in employment, education or training (NEET) was a challenge and it was acknowledged that there was a need to think "more laterally" about how best to capture that group. It was suggested that County Councillor Niki Hennessy as the Lead member for Schools might be  ...  view the full minutes text for item 6.

The report explained that Sir Robert Francis had been commissioned in July 2009, to chair a non-statutory inquiry into the happenings at mid Staffordshire. A recommendation had been made that there needed to be an investigation into the wider system to consider why issues had not been detected earlier and to ensure that the necessary lessons had been learned.

The report of the Mid Staffordshire NHS Foundation Trust Public Inquiry had made290 recommendations, grouped into themes. It was recommended that all commissioning, service provision, regulatory and ancillary organisations in healthcare should consider the findings and recommendations and decide how to apply them to their own work. Further sharing of information across Lancashire County Council was continuing to identify all the relevant work areas, and to consider if there were any further significant actions or opportunities to improve our work.

The report briefly set out the conclusions of the Francis report and the key actions taken by the county council so far.

Dr Sakthi Karunanithi, Director of Public Health, attended to present the report and take questions from the Committee. A brief summary of the main points arising from the discussion is set out below:

·  In response to a question about whether patients, carers, elected members and the public were involved in the monitoring of services in a transparent way, Dr Karunanithi explained that the report now presented was a summary of only what the county council is doing in response to Francis; Healthwatch had an important role to play also. Decisions about the use of county council resources would be led by county councillors and available for the public to view. The Committee was invited to submit suggestions about how they would like elected members to be more involved. Dr Karunanithi acknowledged that the public have much to contribute and he confirmed that more thought would be given about how this could be achieved.

·  The third sector, who it was acknowledged work very closely with local communities and were facing challenges in the current economic climate, had not been directly involved in the drafting of the county council's response to the Francis report, however they were fully engaged in the quality and safety agenda and had an important role to play.

·  Ofsted style ratings were welcomed, but there was some concern that the Care Quality Commission might operate a selective approach to inspections / reports and assurance was sought that a more holistic approach would be taken in future. Dr Karunanithi explained that the county council could not influence the CQC however he was aware that discussions were ongoing about how to measure the organisation within which the relevant service was provided and that a broader view was to be taken about how well led the organisation being inspected was.

·  Regarding opportunities to identify and report concerns about safeguarding issues, for example when carrying out of adaptations in people's homes, Dr Karunanithi acknowledged that safeguarding was an important, multi-agency issue; there was a process in place to trigger actions.  ...  view the full minutes text for item 7.

Appendix A to the report now presented set out a draft work plan for both the Health Scrutiny Committee and its Steering Group, including current Task Group reviews.The topics included had been identified at the work planning workshop that members took part in during April 2014.

It was noted that the Steering Group were to look at access to welfare rights and it was pointed out that there was currently a working group looking at the Care and Urgent Needs Support Scheme, which might overlap with this work.

Wendy Broadley explained that it was intended to invite a range of relevant partners to Committee for each topic in order to give members the opportunity to get a holistic view.

It was requested that speakers be asked to avoid using jargon and to provide practical examples to illustrate policies and strategies, where relevant, to enable members to acquire a clear understanding of the topic being discussed.

Members were invited to feed back any further suggestions.

Resolved: That the report and the comments made be noted.

On 4 April the Steering Group had met with Janice Horrocks, Consultant working with Southport & Ormskirk Hospital Trust and West Lancashire CCG, to receive an overview of the Care Closer to Home Programme. Damien Reed, Deputy CEO/Finance Director had also attended to provide an update on the partnership arrangement with St Helens & Knowsley NHS Trust for pathology services. A summary of the meeting was at Appendix A to the report now presented.

Resolved: That the report be received

The Committee's attention was drawn to forthcoming decisions and decisions recently made by the Cabinet and individual Cabinet Members in areas relevant to the remit of the committee, in order that this could inform possible future areas of work.

Recent and forthcoming decisions taken by Cabinet Members or the Cabinet can be accessed here:

http://council.lancashire.gov.uk/mgDelegatedDecisions.aspx?bcr=1

Resolved: That the report be received.

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 Chair 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 Member’s intention to raise a matter under this heading.

No urgent business was reported.

The next meeting of the Health Scrutiny Committee will be held on Tuesday 22 July 2014 at 10.30am at County Hall, Preston.

Future meetings for 2014/15 are set for Tuesday (unless indicated) and will be held at 10.30 at County Hall, Preston.

2 September 2014

14 October 2014

25 November 2014

13 January 2015

4 March 2015 (Wednesday)

14 April 2015

It was noted that the next meeting of the Committee would be held on Tuesday 22 July 2014 at 10.30am at County Hall, Preston.

2014/15 Timetable of Meetings

It was reported that future meetings had been scheduled for:

2 September 2014

14 October 2014

25 November 2014

13 January 2015

4 March 2015 (Wednesday)

14 April 2015

All meetings would be held at 10.30 am in Cabinet Room C - The Duke of Lancaster Room, County Hall, Preston

Resolved:  That the report be noted.