Agenda and minutes

Apologies were received from County Councillor Cosima Towneley and Councillors Wayne Blackburn, Colin Hartley and Gail Hodson.

Resolved: That:

1.  The appointment of County Councillors Peter Britcliffe and Stuart Morris as Chair and Deputy Chair of the Committee for the remainder of the 2018/19 municipal year be noted;

2.  The new membership of the Committee following the County Council's Annual Meeting on 24 May 2018 be noted; and

3.  The terms of reference of the Committee 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 were disclosed.

Resolved: That the minutes from the meeting held on 17 April 2018 be confirmed as an accurate record and signed by the Chair.

The Chair welcomed Dr Gerry Skailes, Sarah James, Helen Curtis and Lee Hay to present an update from the Our Health Our Care Programme on the future of acute services in central Lancashire. A copy of the presentation delivered at the meeting is set out in the minutes.

It was explained that the purpose of the report was to provide the Committee with an early opportunity to consider the emerging model of care and agree the next steps and future consultation.

On the case for change, the importance of health and care working in partnership was recognised. The partnership involved the County Council, District Councils, Lancashire Teaching Hospitals Foundation Trust, Lancashire Care Foundation Trust, Chorley and South Ribble Clinical Commissioning Group and Greater Preston Clinical Commission Group developing strategic objectives across three separate workstreams:

1. Acute Sustainability (formerly 'hospital care');
2. Locality Care (out of hospital care); and
3. Prevention, early help and self-care.

It was acknowledged that the third sector was missing from the list of partners, but it was emphasised that voluntary organisations and community groups would form a part of developing an integrated model of care.

The six key drivers for change included:

1.  Changing population demographics;

2.  Health inequalities;

3.  Limited workforce;

4.  Bed occupancy;

5.  Variation in meeting standards; and

6.  Decrease in planned surgery

Prevention and intervention were seen to be of significant importance as part of the model of care. There was a consensus that public information and education regarding these should be included as part of the model of care to enable people to take responsibility for self-management of their care.

It was highlighted that the proposals were not yet final as there were still further enhancements to be made. It was confirmed that officers would be meeting with NHS England and the Clinical Senate in July as part of the assurance process.

Whilst it was hoped that a pre-consultation business case would be completed around September 2018, the Committee noted that the Our Health Our Care programme could not enter any consultation exercise until options were considered deliverable. Members requested further details on engagement information. In addition it was suggested that updates on the programme be presented to the Committee at its meetings scheduled in September and December 2018.

Resolved: That:

1.  The update be noted;

2.  Further updates be presented to the Health Scrutiny Committee at its scheduled meetings in September and November 2018;

3.  The importance of all partners working together on prevention and early intervention form a part of developing the new models of care for acute services in central Lancashire; and

4.  Public information and education be included in the new model of care for acute services in central Lancashire.

The Chair welcomed Zakyeya Atcha, Consultant in Public Health, and Marie Demaine, Senior Public Health Practitioner, to present an overview of the opportunities and challenges with implementing the council's Dementia Strategy.

The prevalence of dementia was highlighted by the fact that one in three people are diagnosed with dementia at end of life. It was said that dementia is not a disease but a collection of symptoms.

A recent report by the National Institute for Health and Care Excellence (NICE - guideline NG97), quoted findings from the Alzheimer's Society that in 2013, the total cost of dementia in the UK was estimated to be £26.3bn. Approximately £4.3bn was attributed to health care and £10.3bn attributed to social care with the remaining £11.6bn in estimated unpaid care contributions.

The committee was informed that the county council's campaign on raising awareness of dementia symptoms and encouraging people to see their GP was highlighted by the Local Government Association (LGA) as an example of good practice by a local authority and was one of a number of case studies presented in the LGA's dementia support guide for councils.

Concerns were raised about the ageing population of Lancashire and the increase in pressure on services provided by the county council. Alongside social isolation, this was recognised as a particular area of concern for the county council.

A number of points were raised by members, a summary of which is set out below:

• The needs of carers should be essential to the strategy. Supporting both physical and emotional and social health needs in carers and people with dementia who may also experience mobility and continence issues from Parkinson's or frailty;
• Whether the council could utilise disability facility grants to support people with dementia;
• Dementia friendly housing and the challenges experienced by people living with dementia highlighting technology as a potential barrier. It was reported that the county council served on the Whyndyke Garden Village Healthy New Town Board which was leading on the Homes for Life Long Living theme.

It was suggested that the Cabinet Member for Health and Wellbeing be invited to a future meeting to present on the development of a housing strategy for the ageing population of Lancashire.

Resolved: That;

1.  The report be noted; and

The Cabinet Member for Health and Wellbeing be invited to a future scheduled meeting of the Health Scrutiny Committee to present on the development of a housing strategy and the ageing population.

The report provided an overview of the matters presented and considered by the Health Scrutiny Steering Group at its meetings held on 11 April, 16 May and 13 June 2018.

Resolved: That the report of the Steering Group be received.

The Work Programmes for both the Health Scrutiny Committee and its Steering Group were presented to the Committee. The topics included were identified by the Steering Group at its meeting held on 16 May 2018.

Resolved: That the report be noted.

The next scheduled meeting of the Health Scrutiny Committee will be held on Tuesday 25 September 2018 at 10.30am at County Hall, Preston.

The next meeting of the Health Scrutiny Committee will be held on Tuesday 25 September 2018 at 10.30am in Cabinet Room C – The Duke of Lancaster Room, County Hall, Preston.