Agenda and minutes

To agree the minutes of the last meeting held on 14 December 2016 as a true and correct record.

The Committee agreed that the minutes of the Scrutiny Committee meeting held on 14 December 2016 be signed by the Chairman as a correct record.

To consider any applications from members of the public to speak at the meeting.

The Chairman welcomed the attendance from young people and representatives of the Blackpool Youth Council, the HeadStart resilience support programme and the UR Potential youth support group. The Committee noted that there were no formal applications to speak by members of the public on this occasion. However, the Chairman explained that, after each report item had been presented and Committee Members had asked questions, there would be an opportunity for any of the young people present to put forward questions and suggestions.

To present performance against the Council Plan 2015-20 for the period 1 October 2016 - 31 December 2016.

Ms Valerie Watson, Delivery Development Officer, Blackpool Council reported on the ‘direction of travel’ for key performance indicators relating to health services. Five of the eight indicators were reported annually at the end of each year (quarter four, January-March) covering smoking, obesity and healthcheck targets. The indicators would be discussed at the July 2017 meeting. Performance for quarter three, October-December 2016, related to three groups (opiate drug users, non-opiate drug users and alcohol users) and the percentages of those substance users successfully completing treatment. For drug users, recovery meant not re-presenting within six months.

Alcohol misuse - recovery rates

Alcohol users had been highlighted as an ‘exception’ with a shortfall in performance requiring more detailed reporting. The Chairman noted that the percentage of alcohol users successfully completing treatment had dropped for each of the last three quarters and was currently 36.7%, well below the quarter four or end-year target  of 60% of people recovering.

Dr Arif Rajpura, Director of Public Health, Blackpool Council explained that the support service, Horizon (commissioned by the Council), for people trying to recover from substance misuse, including alcohol, had been reviewed. Staff had previously focused mainly on providing narrow drug advice and support to people but a requirement had been identified for a more integrated and holistic service, involving specialist staff with alcohol expertise. The service would increase recovery by focusing on people’s immediate situation and their wider longer-term needs such as mental health support, housing opportunities and building skills for potential employment. Innovative approaches would be pursued including community-based working with GPs. The new service, continuing under the Horizon brand, would start on 1 April 2017 and he believed would help increase recovery rates across all areas.

NHS healthchecks

The Chairman referred to the annual target for numbers of people aged 40-74 years old taking NHS healthchecks. He noted that the percentage of healthchecks had dropped substantially from over 76% in 2013-2014 to 52% in 2015-2016. The current target was for an improvement on 2015-2016.

Dr Rajpura explained that Blackpool had previously had the best healthcheck rates in the country so the decline was being investigated and would be reported to the next meeting. Double-counting of healthchecks may have occurred so data accuracy needed to be verified and made more robust. Also people who were more willing had undertaken earlier healthchecks but ‘harder to reach’ people now needed to be encouraged. He added that the quality of healthchecks was paramount as people in the 40-74 age range were at increased risk and prone to higher blood pressure and conditions such as diabetes and heart disease. Early effective intervention was key to preventing worsening health so robust healthchecks were needed and payment would be levered to ensure quality information was being secured. He hoped that the percentage of healthchecks would increase to over 75% again. 

Drug misuse - recovery rates

The Chairman referred to the 8% target for opiate drug users to sustain recovery (not requiring further treatment within six months of successfully completing  ...  view the full minutes text for item 4.

To provide an update to members on the areas of the Lancashire Care Quality Commission (CQC) action plan for Looked After Children (local authority care) that are relevant locally, and provide assurance on the current provision for the health needs of Looked After Children in Blackpool.

Hazel Gregory, Head of Safeguarding, Blackpool Teaching Hospitals NHS Foundation Trust and Kelly Gorrie, Named Nurse Looked After Children, Blackpool Teaching Hospitals NHS Foundation Trust presented a report on the health needs of children in Blackpool Council’s care (‘looked after children’).

Care Quality Commission - ‘Not Seen, Not Heard’

Ms Gregory explained that the Care Quality Commission had produced a report in July 2016 entitled ‘Not Seen, Not Heard’. The report had followed a review of how the health and safeguarding needs of ‘looked after children’ were being met across Lancashire. The review had not included Blackpool but the Commission’s recommendations had led to a Lancashire Improvement Plan which contained some aspects relevant locally. The Teaching Hospitals did provide services across Lancashire and locally for people resident in Lancashire but not Blackpool.

Ms Gorrie explained that they were ‘frontline’ issues with high numbers of ‘looked after children’ (1295) across Lancashire including over 500 in Blackpool. There were a number of homes with children being placed there, in partially independent placements or in short break placements. She cited the speed and challenge of placement turnover with six new placements in December 2016.

Ms Gorrie explained that the Care Quality Commission had made four key recommendations: ensuring that young people had a ‘voice’; outcomes-focused care; identifying young people at risk of harm; and access to emotional / mental health support. In particular, for outcomes, the Commission recommended use of the ‘so what’ approach, i.e. the impact of work and decisions needed to be effective otherwise reviewed. The recommendations had generated a number of actions.

Current service provision and outcomes in Blackpool

Ms Gorrie referred to the actions table within the report which displayed the current service provision for each action and also the outcomes that had been achieved.

Health assessments

The Chairman noted that the outcomes were stated as improvements and enquired what evidence there was to demonstrate improvement. Ms Gorrie referred, in particular, to 100% of health assessments being quality assured. Assessments not meeting quality standards were returned to practitioners).

Ms Gregory added that initial health assessments needed to be completed within 28 days (20 working days) of the Hospital Trust being notified of a new child in care. There were sometimes delays due to not being notified by the care authority (council) of a new child. However, even though there were nearly 1,300 ‘looked after children’ across Lancashire, the Hospital Trust had a robust tracking and monitoring system.  The Trust was aware if a child had failed to attend an appointment, the reasons for non-attendance and would ensure that they were seen within another week. She added that there were regular tracking meetings with the local authority.

Involving ‘looked after children’

The Chairman noted the range of current provision in place and enquired what improvements to the service were being proposed and what happened when a child complained about the service. Ms Gorrie explained formal complaints processes would be discussed with a child and relevant other parties would be made  ...  view the full minutes text for item 5.

To provide a summary of the Transformational Planning Programme across Lancashire for Children and Young People’s Emotional Health and Wellbeing and progress to date in Blackpool, challenges, opportunities, next steps and involvement of children and young people.

The Committee agreed to defer this item to the next meeting on 26 April 2017 due to personal circumstances of the lead officer and as no replacement had been available at short notice.

To present an update on work to promote healthier weight and good oral health amongst children in Blackpool.

Dr Arif Rajpura, Director of Public Health, Blackpool Council presented a report on the linked issues of young people’s healthy weight and oral health. He emphasised that these were serious issues in Blackpool and needed joined-up, long-term effort from all services.

Healthy Weight

Lynn Donkin, Consultant in Public Health, Blackpool Council explained that having a healthy weight protected people from a number of serious health conditions. Wider impacts included economic loss to businesses and increased financial pressures on the NHS for what was one of the health sector’s biggest challenges.

National strategy

She added that Government had agreed a national strategy imposing a financial levy on high sugar content products, principally soft drinks. National objectives included reducing sugar in food products, promoting healthier food in the public sector, minimum healthy food standards in schools and a voluntary healthy food ratings scheme in schools. Increasing physical activity in schools was the other strand.

Scale of challenges in Blackpool

Lynn Donkin explained that Blackpool had amongst the highest rates nationally for being overweight (obese). Figures for being overweight included over 1 in 4 (26.5%) of 4-5 year olds, over 1 in 3 (40%) of 10-11 year olds and 3 in 4 (74.5%) of adults. 40% of children moving from primary to secondary school were overweight and 84,000 adults (out of 140,000) were overweight. There was no simple solution and there were other impacts, e.g. on oral health with dental decay.

Food intake and calories

She explained that people were eating too much in terms of high calorie intake and needed to be encouraged to reduce calories and promote healthier food options. Modern lifestyles often equated to sedentary movement which heightened weight pressures.

Blackpool strategy

A Healthy Weight Strategy had been approved in 2016 by the Health and Wellbeing Board and had five key elements: increasing knowledge, skills and healthier food choices; reducing sugar; local environments offering healthier foods and physical activity; weight support services for young people; and focusing on young people.

Progress

Lynn Donkin referred to achievements.

Blackpool had become the first council in the country to create a Local Authority Declaration on Healthy Weight to support employees and residents. The Health and Wellbeing Board had suggested that other partner organisations needed to sign up so a Healthy Weight Summit was held in February 2017 resulting in another twenty local organisations adapting the Declaration. 

‘Give up Loving Pop’ (GULP) was a campaign to encourage young people to give up fizzy drinks for one month. This had gained national recognition. Further work would build on this success including featuring in the ‘Fit2go’ programme targeting younger children.

Physical activity

The Chairman made reference to a national initiative, the ‘Daily Mile’, which had had spread across the UK. This was a simple initiative promoting school classes to walk a mile as a group exercise during school time. Wider benefits included higher classroom performance.

Lynn Donkin referred to a similar initiative, the Living Streets ‘Walk to School’ project, led by a national charity (Living Streets)  ...  view the full minutes text for item 7.

To review the Health Scrutiny Committee’s Workplan for 2016-2017.

The Chairman referred to the Health Scrutiny Workplan for 2016-2017 and progress with the implementation of recommendations.

The Committee agreed:

1. To approve the Scrutiny Workplan subject to Transformation Plan progress being considered at the April 2017 meeting, addition of an explanatory report on NHS Healthchecks (people aged 40-74 years old) as part of the regular performance indicators report and a ‘Daily Mile’ progress report (whether the initiative would be progressed locally) to the July 2017 meeting
2. To comment by email on annual Quality Accounts submitted by NHS trusts and for final responses to be approved by the Chairman.
3. To note the ‘Implementation of Recommendations’ table.

To note the date and time of the next meeting as Wednesday, 26 April 2017

commencing at 6pm in Committee Room A.

The Committee noted the date and time of the next meeting as Wednesday 26 April 2017 commencing at 6pm in Blackpool Carers’ Centre, Beaverbrooks House, Blackpool (venue subject to confirmation).