Agenda and minutes

County Councillor Dr Erica Lewis replaced County Councillor Kim Snape and County Councillor Nweeda Khan replaced County Councillor Mohammed Iqbal MBE for this meeting only.

Apologies were received from Councillor Alex Hilton representing Chorley Council.

County Councillor Joan Burrows, County Councillor Lizzi Collinge, County Councillor Stuart C Morris, County Councillor Lian Pate, Councillor Barbara Ashworth, Councillor Saeed Chaudhary, Councillor Gina Dowding, Councillor Sue Gregson, Councillor Jenny Molineux, and Councillor Julie Robinson representing Wyre Council attended virtually on Microsoft Teams.

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.

County Councillor Mein declared a non-pecuniary interest in agenda item 5, as a previous board member of Community Gateway and was involved in decision-making.

County Councillor Lewis declared a non-pecuniary interest in agenda item 5, as a district councillor for the John O'Gaunt ward in Lancaster where an extra-care scheme was being built and under employment of Cumbria University, whose land was being built on.

Resolved: That the minutes from the meetings held on 2 and 16 November were confirmed as an accurate record.

Aaron Cummins, Senior Responsible Officer for the stroke programme and
Chief Executive of Morecambe Bay Hospitals, Cath Curley, Clinical Director of the Integrated Stroke and Neuro Delivery Network (ISNDN) and Stroke Consultant Nurse, Elaine Day, Manager of the Lancashire and South Cumbria ISNDN, Anthony Gardner, Director of Planning and Performance, Hayley Michell, Interim Stroke Programme Director, Sharon Walkden, Project Manager, Stroke Programme, and Phil Woodford, Chair of the Patient and Carer Stroke and Neuro Assurance Group attended to present the report and answer queries from the committee.

Comments and queries from the committee were as follows:

·  In response to member's concerns about lessons learned it was noted that the model was adopted by Manchester and London a few years ago and national data from the Sentinel Stroke National Audit Programme (SSNAP) for those areas helped to identify key outcomes.  A key outcome at specialist centres was that staff became experts as they saw more patients and had more experience with procedures. The Lancashire stroke team learnt that on those sites where there was not a front-door team, there was a requirement to have an established team within the hospital to take calls from the ambulance, A&E or from the wards to attend to the patient straight away, diagnose the urgency and identify next steps. Other lessons learnt from the Manchester and London models was a requirement to up-resource community teams.

·  To ensure the 24/7 service, staff were recruited as part of a three-year investment plan and workforce plan. The local NHS worked with the local universities and set up different courses along the pathway. The stroke centres have been considered good places to work, therefore recruitment was successful, new unblended roles were introduced, and services were future proofed. Succession plans were put in place for the staff already in place and this supported retainment. Digital services also supported staff to do their jobs more efficiently, they did not need to be onsite to access test results. 

·  The team visited individual hospitals for thoughts and feelings of the staff and to gather if there was any resistance to change. This was followed up with regular workshops, where staff contributed to the case for change, so that there would be no surprises with the new model of care.

·  It was clarified that the hospitals would not lose their acute stroke units, but would be strengthened, with staff supported in their training and development.

·  It was confirmed that there had not been any involvement with Trade Unions or professional bodies, as it had been perceived from staff that there was no need. However, they were aware of a forum which they could attend. Further information on trade union and professional body engagement could be provided to the committee.

·  It was noted that the local NHS had a strong relationship with UCLAN, courses were also available in Manchester and Liverpool, and it was expected that where students train, they would stay to work close-by. There was a phased approach across the region due  ...  view the full minutes text for item 4.

The Chair welcomed Sarah McCarthy, Policy, Information and Commissioning Senior Manager (Age Well), Dawn Astin, Service Manager (Housing Specialist PLOT), and Mike Alsop, Policy, Information and Commissioning Senior Manager (Age Well) from Lancashire County Council who presented an update about progress on the implementation of the Housing with Care and Support Strategy 2018-2025, which set out the county council's vision for extra care housing for older people and apartment developments for working age adults with disabilities. Officers were joined by
Diane Emmison, Supported Housing Manager from the Regenda Group, Katie Stanley, Scheme Manager at Lighthouse View in Fleetwood, and tenants.

Comments and queries from the committee were as follows:

·  It was clarified that for supported living schemes, different housing benefit opportunities covered the costs of rent for tenants which was managed by the district councils, although officers were aware of residents that worked and volunteered. The package of support was met by Lancashire County Council, each individual was financially assessed, and contributions were made depending on their income. On average, most apartment schemes were
£200-250 per week for rent, which was consistent with specialist accommodation, however, it was noted that this type of accommodation was at a higher level of rent than other sectors. Officers were in conversation with providers regarding the national issue of the rising cost of development and ensured that new schemes were affordable. 

·  Supported living schemes on average were 45-50 square feet, this was deemed to be more spacious and larger than previous options. Extra care schemes were also larger, some were two bedrooms apartments. Upkeep of the apartments were quality monitored and there was a ten year forward plan for replacements to maintain service standards.

·  In terms of service user allocation into extra care schemes, there were three priority groups:

1.  Who otherwise would have been in residential care;

2.  Eligible for care in terms of the Care Act, with either a commissioned care package or they opted for informal care; and

3.  Did not have an eligible need under the Care Act but would benefit from living in an extra care environment.

On the referral pathway, the decision was determined by a panel which consisted of the landlord, care provider, and social care representatives. Only need was considered, direct payments and funding were not taken into account. There was a waiting list, and this was referred to when there was a vacancy. Not all settings are suitable for individuals and in some circumstances, schemes were developed to meet needs.

·  It was explained that once all existing schemes had been developed and established, the officers would then look at demand with the district councils to see what next steps were needed for each district.

·  It was identified that there was a shortage of accessible accommodation, therefore officers were working with Adult Social Care and district councils to undertake a needs assessment.

·  There was no intention to retire anymore social care settings, although some residents may have been move into the schemes if  ...  view the full minutes text for item 5.

The committee considered a report containing an overview of matters presented and considered by the Health Scrutiny Steering Group at its meetings held on 10 November, 1 December 2021, and 5 January 2022. No queries were raised by the committee.

Resolved: That the report of the Health Scrutiny Steering Group, as presented, be received.

The committee considered a report which provided information on the work programme for the Health Scrutiny Committee.

The topics included in the work programme were identified at the work planning workshop held on 29 June 2021.

Resolved: That, the Health Scrutiny Committee Work Programme 2021/22 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 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.

The next meeting of the Health Scrutiny Committee will be held on Tuesday 22 March 2022 at 10.30am, County Hall, Preston.

It was noted the next meeting of the Health Scrutiny Committee was scheduled to be held on 22 March 2022 at 10:30am in County Hall, Preston.