Agenda and minutes

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No. Item

County Councillors Alan Schofield and Julia Berry replaced County Councillors Peter Britcliffe and Mohammed Iqbal respectively, for this meeting only.





Apologies were received from District Councillors Gail Hodson (West Lancashire) and Gina Dowding (Lancaster)



Constitution: Chair and Deputy Chair; Membership; Terms of Reference of the Health Scrutiny Committee and its Steering Group pdf icon PDF 129 KB

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Resolved: That the appointment of Chair and Deputy Chair; the membership of the committee and the terms of reference, as presented, be noted.



Disclosure of Pecuniary and Non-Pecuniary Interests

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.




Minutes of the Meeting Held on 30 June 2020 pdf icon PDF 220 KB


Resolved: That the minutes from the meeting held on 30 June 2020, be confirmed as an accurate record.



NHS 111 First pdf icon PDF 21 KB

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The Chair welcomed Dr Amanda Doyle, GP and Integrated Care Strategy lead for Lancashire and South Cumbria and Jackie Bell, Head of Service for 111, North West Ambulance Service NHS Trust. A report outlining the process and implementation of the new NHS 111 First initiative was presented


The following points were highlighted:


·  The new appointment system for those who would normally self-present at A&E supported social distancing and aimed to reduce overcrowding, waiting times and subsequently COVID-19 infection rates. The new system would support a better flow of work, made best use of available technology and should improve clinical outcomes, as all attendees will have had a remote assessment prior to their A&E appointment. The clinician carrying out the assessment would book the most appropriate appointment depending on the issue and the service user would not be required to re-dial another service. It was emphasised that the new way of working was not for urgent 999 calls and life threatening situations. A&E self-admissions represented approximately 60% of the A&E intake.


·  The new system had been launched in Blackpool and Warrington with Royal Blackburn to follow in October. These initial launches were to assess effectiveness and outcomes, to make any necessary amendments prior to the national campaign launch which would communicate the new process of ringing 111. By the end of November all A&E departments would be live with the system. Feedback so far from patients and staff had been very positive and hospitals were keen to launch the programme to prepare for winter.


·  The aim was for 20% of self-referrers to access 111 First, however initial monitoring indicated that the uptake would be higher. Therefore it would be a significant challenge to ensure the recruitment of health advisers and assessment clinicians was sufficient to support demand. Recruitment for health advisers was on schedule.


·  The clinical assessments would be at a local level to ensure the most appropriate services for the area were signposted.


In response to questions from members the following information was clarified:


·  There had been a significant and sustained pressure on the 111 service, related to calls about access to testing rather than in relation 111 First. The messages on testing websites were being changed to reduce these calls. Blackpool had been identified for an initial launch as an area that made low numbers of calls to 111 but had high presentations at A&E.


·  Staff with experience of 111 First and all patients ringing 111 who were subsequently booked in to a service were being surveyed. Once more sites were live the feedback results would provide a more robust and effective base for sound evaluation.


·  As a national programme, the service would be centrally funded. Additional capital funding to house additional staff resource would also be required. It was anticipated that the programme would eventually yield savings once firmly established.


·  Staff numbers would be increased for the additional calls and work was underway with the estates team to undertake rapid expansion  ...  view the full minutes text for item 5.


Lancashire County Council Adult social care - winter preparations pdf icon PDF 41 KB

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The Chair welcomed Sue Lott, Head of Service Adult Social Care Health, Sumaiya Sufi, Quality Improvement and Safety Specialist and Abdul Razaq, Consultant in Public Health to the meeting. The Lancashire County Council staff were invited to present a report detailing the support that had been provided to adult social care providers and the Adult Social Care Winter Plan.  Lynsey Davies-Coward from Willowbrook Homecare and Martin Layton from Caritas Care were also in attendance to provide feedback to the committee on their experience of county council support during the initial stages of the pandemic.


The following information was highlighted with regard to support provided to adult social care providers:


·  Support had been given to (in the region of) 600 adult social care providers including care homes, home care agencies and supported living providers. The support included welfare calls to check they had the information required, along with sufficient food and medication supplies. Providers were also offered access to a financial assistance scheme for COVID-19 related costs. In addition, a not for profit organisation was commissioned to offer a package of emotional and wellbeing support.


·  As the information, advice and guidance from central government was changing rapidly, it had been necessary to provide regular timely communication and this was disseminated via a weekly webinar, attended by the council's infection control team and a newsletter. Bespoke webinars responding to requests from providers were also arranged. All information and webinars were uploaded to a custom-made website, along with education tools to enable providers to train staff. This support continued to help providers manage new outbreaks.


·  Challenges faced included courier collection of tests and delays receiving test results and this had been escalated to establish a resolution. Repeat testing was in place – weekly for staff and every 28 days for residents.


·  A council managed temporary staffing agency was available for providers encountering staff shortages due to self-isolating and sickness absence.


·  The council also sourced personal protective equipment when needed and the service had received feedback stating that this support had helped providers to manage the pandemic and remain confident that provision of services could continue. The team continued to work with the Lancashire Resilience Forum to ensure personal protective equipment needs could be met.


·  As lockdown restrictions eased, some care homes had been reluctant to change the constraints in place regarding visiting. Lancashire County Council had worked with care homes to provide guidance and resources regarding how to make visiting safe to support infection control.


The private social care providers in attendance made the following comments:


·  Lancashire County Council had been instrumental in allowing providers to sustain vital services during this challenging time. Particularly in the areas of training, personal protective equipment provision, communication and financial support.


·  Government guidance had centred on care homes, therefore the Lancashire County Council portal had been an invaluable single point of access for providers of domiciliary care. It was emphasised that multi-disciplinary teams were available to support outbreaks in assisted living settings. In addition, domiciliary care providers  ...  view the full minutes text for item 6.


Report of the Health Scrutiny Steering Group pdf icon PDF 261 KB


The committee considered a report providing an overview of matters considered by the Health Scrutiny Steering Group at its meetings on 22 June and 15 July 2020.


Councillor Margaret France expressed that as a member of the Council of Governors for the Lancashire Teaching Hospitals NHS Foundation Trust and a member of the Our Health Our Care Stakeholder Reference Panel, there may be a conflict of interest if she were to be confirmed as a member of the proposed task and finish group to consider forthcoming proposals from the local NHS on the future of Chorley and South Ribble A&E. It was explained that Chorley Council's nominated substitute member for Councillor France could take up the seat instead or alternatively for the county council to write to Chorley Council to nominate a replacement member. Resolved That:


1)  The report of the Steering Group, as presented, be received.


2)  The establishment of a task and finish group consisting of seven county councillors and the two co-opted members from Chorley Council and South Ribble Council to review the forthcoming proposals from the Our Health Our Care programme on the future of Chorley and South Ribble A&E, be agreed.



Overview and Scrutiny Work Programme 2020/21 pdf icon PDF 38 KB

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Josh Mynott, Democratic & Member Services Manager, Legal, Governance & Registrars was welcomed to the meeting. Josh Mynott emphasised the importance of focussed and targeted work planning to improve outcomes and robust scrutiny and how this could be achieved by developing specific and detailed lines of questioning.


Members reviewed the topics listed for consideration by the Health Scrutiny Committee on the single combined work programme for all Lancashire County Council scrutiny committees.


Members requested that the following topics be included on the Health Scrutiny Committee workplan:


·  An update on NHS 111 First in March 2021.


·  A report from the Our Health Our Care task and finish group prior to May 2021.


·  An update on Commissioning Reform in Lancashire and South Cumbria..


·  It was confirmed that an update on suicide prevention in Lancashire would be brought to the November meeting. It was requested that this include information on resourcing and the appointment of district mental health and suicide prevention champions.


Resolved: That the items listed for the Health Scrutiny Committee on the single combined work programme be agreed subject to the inclusion of the matters requested and listed in the minutes above.



Urgent Business

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.



There were no items of urgent business.



Date of Next Meeting

The next meeting of the Health Scrutiny Committee will be held virtually on Tuesday 3 November 2020 at 10.30am.


The next meeting of the Health Scrutiny Committee will be held on Tuesday 3 November 2020 at 10.30am by means of a virtual meeting.