Agenda and minutes

Members are asked to declare any interests in the items under consideration and in

doing so state:

(1) the type of interest concerned either a

(a) personal interest

(b) prejudicial interest

(c) disclosable pecuniary interest (DPI)

and

(2) the nature of the interest concerned

If any member requires advice on declarations of interests, they are advised to contact the Head of Democratic Governance in advance of the meeting.

There were no declarations of interest on this occasion.

To agree the minutes of the last meeting held on 14 March 2018 as an accurate record.

The Committee agreed that the minutes of the Adult Social Care and Health Scrutiny Committee meeting held on 14 March 2018 be signed by the Chairman as a correct record.

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

The Committee noted that there were no applications to speak by members of the public on this occasion.

To present a comprehensive update on progress tackling childhood and adult obesity.

Ms Nicky Dennison, Senior Public Health Practitioner presented a report on progress towards tackling childhood and adult obesity. Also in attendance was Dr Arif Rajpura, Director of Public Health.

She explained that the Council’s Healthy Weight Strategy which had five local action themes: people better informed to make their own good health choices; focusing on young people; good weight management services; reducing sugar intake; and improving local environments to encourage health eating and exercise.

Ms Dennison referred to the Local Authority Health Weight Declaration, a national initiative, which the Council signed in 2016. There were a range of commitments progressing well. Councillor Cain, as the Chairman of the Blackpool Health and Wellbeing Board and Cabinet Secretary for Resilient Communities, had encouraged the work to be promoted further so four healthy weight summits had been held over the last year involving local businesses, schools and other public/voluntary sector partners.

She added that an annual Healthy Choice Award event had first taken place in 2017 with food outlets and other organisations helped to make simple changes to create healthier menus, e.g. more low fat condiments, smaller portions. One hundred businesses had been successful with this initiative including ethnic restaurants and the initiative had been spreading into children’s centres and schools. Good hot/cold food and packed lunches were being promoted. St Johns Primary School was leading on a pilot that, following feedback from parents, would be rolled out further and St Georges School was promoting cookery skills. The healthy weight pilot had also proved successful so had been extended to 2019.

Ms Dennison reported that two successful Give Up Loving Pop (GULP) events had been held where whole classes were encouraged to stop drinking fizzy drinks for at least 28 days with an associated competition for classes to take part in. This would be extended to more year groups.  Another benefit had been that children involved with the campaign had now started to check the nutritional information on products.

Other proactive work included providing planning policy with evidence of the impact of fast food outlets so their numbers could be controlled.

She referred to effective work being pursued through the Head Start Programme (emotional resilience for 10-15 year olds), e.g. using social media to get good health messages out.  Early years (0-4 year olds) work was also being developed with the Better Start Programme (good nutrition focus) and the ‘Food Active’ organisation across the north-west.

The Chairman noted the Local Authority Declaration, summits and anecdotal feedback but enquired what empirical evidence there was to confirm that effective progress was being made. Ms Dennison explained that it was difficult to directly correlate interventions with outcomes but Blackpool figures from the National Child Measurement Programme indicated an improving trend over the last two years for healthy weight outcomes. However, those figures would need to be sustained before robust outcomes could be confirmed. She added that an evaluation of the Declaration would take place with Food Active.

Dr Arif Rajpura agreed that this was interim progress  ...  view the full minutes text for item 4.

To present progress made and plans for improving mental health service provision.

Ms Helen Lammond-Smith, Head of Commissioning, Blackpool Clinical Commissioning Group and Blackpool Council presented progress made and plans for improving mental health service provision.

Also present was Ms Elaine Walker, Emotional Health and Wellbeing Manager, Blackpool Teaching Hospitals and Ms Michelle Sowden, Head of Mental Health and Learning Disability Services, Blackpool Teaching Hospitals.

Representatives were present from Rethink (national mental health support charity) and the Blackpool Carers’ Centre and Sergeant Peter Hannon, Lancashire Constabulary whose role incorporated mental health liaison within Blackpool.

Ms Lammond-Smith reported that three broad elements were being presented. There was a full review of current mental health service provision and proposed mental health integration of primary care (New Models of Care) across the Fylde Coast area as part of the ‘Vanguard’ programme linking in with community/ neighbourhood hubs.

The two parallel elements were the children and young people’s mental health provision developments and a directory of Fylde Coast mental health services (part of Vanguard) aimed at GPs and other professionals / the voluntary sector.

She explained that the main areas of primary and community integration being considered included Improving Access to Psychological Therapies (IAPT) which recognised that many people had long-term physical conditions and developing a pool of ‘connecting people’ trainers (bringing public and professionals closer together). There were a number of challenges including accommodation with a shortage of beds.

A wide range of work was being pursued including creating multi-disciplinary teams for a genuinely ‘single point of access’, home treatment, investing in crisis support services and developing ‘Core 24’ support (24 hours per day, seven days per week). The work would help create better pathways of support including access to beds.

The Chairman cited an example of a patient from over one year previously being given medication for depression but then told there would be a wait of over one year for any further treatment. Members felt that waiting times for Child and Adolescent Mental Health Services (CAMHS) were also too long. Members were informed that Blackpool services were currently performing well with 100% of people being assessed within target time (twelve weeks for CAMHS) and next stage targets had also been met. There was also support through YouTherapy and ‘walk-in’ options. The Transformation Plan for Children and Young People’s Emotional Health and Wellbeing Members was developing the support options.

Members emphasised that it was important that young people were aware of the support available. They were concerned that the directory of mental health services was too complex to follow. It was explained that it was a comprehensive directory which had been developed after consultation with stakeholders who had given positive feedback. Target users of the directory found printed versions useful. The directory linked in with the recently launched public ‘For your information’ directory of wider public and community services/groups. The directory would evolve with feedback. The Rethink representative added that he had found the directory a good approach and that it would help him better support and signpost his members.

Ms Walker reported that  ...  view the full minutes text for item 5.

To provide an update in respect of the completed Domestic Abuse Needs Assessment 2018; and progress with delivering the Blackpool Domestic Abuse and Interpersonal Violence (DAIV) Partnership’s Action Plan.

Mr Tony Morrissey, Head of Safeguarding /Principal Social Worker, Blackpool Council and Chair of the Blackpool Domestic Abuse and Interpersonal Violence Partnership Sub-Group presented an update on the completed Blackpool Domestic Abuse Needs Assessment and progress being made with delivering the Blackpool Domestic Abuse and Interpersonal Violence (DAIV)’s Action Plan.

The Chairman enquired why funding for domestic abuse services was ‘fragmented and insecure’ impacting upon the planning and effective delivery of services. Mr Morrissey explained that poor funding arrangements were a national issue. Some funding came from government, some was ring-fenced but there was no long-term sustained budget. He was aiming to promote the need for a pooled budget from across the Blackpool Domestic Abuse and Interpersonal Violence Partnership. This would provide better value and promote more effective commissioning of services including better support for domestic abuse refuges.

The Chairman also enquired why there were year-on-year increases in police call-outs for domestic abuse incidents. Mr Morrissey informed Members that Blackpool had a holistic partnership approach working with victims, families and perpetrators. There were a number of resources and programmes, e.g. Inner Strength Programme which provided a route for perpetrators to move away from patterns of violence andworking with schools to get across messages of health relationships including that domestic abuse was not acceptable or normal. Domestic abuse work was being taken forward as a public health issue, e.g. domestic abuse needs were evidenced within the Public Health Joint Strategic Needs Assessment (JSNA). He emphasised that preventing domestic abuse was paramount.

Mr Morrissey added that Blackpool was good at raising awareness of issues and tackling perpetrators.  However, it was important to use evidence to evaluate the effectiveness of work, i.e. not to continue with approaches that were not having the right impact and outcomes sought to reduce domestic abuse. A university had been commissioned to undertake evaluation of work.

The Committee enquired how the effectiveness of the Troubled Families Programme was measured. Members were informed that the Programme came within government ‘payment by results’ criteria which covered more than domestic abuse work such as anti-social behaviour, employment opportunities and improving self-esteem. The Council’s Families in Need Service led on the Programme offering a range of support including early help. He added that demand was high within Children’s Services although causes and effective actions had been improved making some impact,

In response to a query about whether same sex abuse was an issue, refuge space for men and also keeping perpetrators away, Mr Morrissey explained that abusers and victims came from all groups and backgrounds.  He added that male victims could be unwilling to come forward so it was important to offer a good range of support services for all victims. The police did have powers to tackle perpetrators.

Members expressed concern that the number of repeat cases discussed at Multi-Agency Risk Assessment Conferences (MARAC) had dropped to 74 in 2015-2016 from 153 in 2014-2015 but had then risen again to 153 in 2016-2017. Mr Morrissey explained that these were  ...  view the full minutes text for item 6.

To present progress on health and social care integration including Enhanced Primary Care and neighbourhoods work and planning for 2018-2019.

Mr David Bonson, Chief Operating Officer, Blackpool Clinical Commissioning Group, presented an update on health and social care integration in Blackpool (as part of the wider Fylde Coast local delivery partnership) including Enhanced Primary Care and neighbourhoods work and planning for 2018-2019.

Also present were Mr Roy Fisher, Chairman, Blackpool Clinical Commissioning Group; Ms Jeannie Harrop, Senior Commissioning Manager; and Ms Kate Dalton, Team Leader, Blackpool Clinical Commissioning Group.

Members had considered integration first in November 2016 in the early stages of development and received a further update in September 2017. They had felt that there was not sufficient detail of local work within the original Sustainability and Transformation Plan (STP) for Lancashire and South Cumbria nor financial costings.

There had also been concerns whether sufficient transformation progress was being made in good enough time to deliver the five-year plan to better manage integrated care for people’s health and wellbeing and reduce service demand / cost pressures.

Members commented that the various changes referred to within the report were not easy to follow. Mr Bonson explained that the local delivery arm for pursuing transformation was the new Fylde Coast Integrated Care Partnership (ICP). This comprised of Blackpool Clinical Commissioning Group, Fylde and Wyre Clinical Commissioning Group and Blackpool Teaching Hospitals Trust working together to deliver shared plans as part of the wider Lancashire and South Cumbria Integrated Care System (ICS) which took forward Sustainability and Transformation Planning.

Mr Fisher explained that the Lancashire and South Cumbria finance lead, Mr Gary Raphael had become unavailable for the meeting but had suggested that a dedicated meeting be held on the wider sub-regional picture (i.e. Integrated Care System / Sustainability and Transformation Planning) allowing current focus to be on local delivery through the Integrated Care Partnership. Ms Amanda Doyle, Chief Clinical Officer, Blackpool Clinical Commissioning Group would also be requested to attend.

The Chairman referred to winter planning and the stated potential for an additional ninety beds. He also queried transformation progress, after three years planning, with reducing the number of unnecessary admissions to hospital, which was estimated to be around 25% and bed blockages/shortages particularly this winter. Members re-iterated previous concerns about delayed discharges from care.

Mr Bonson explained that provision was based on 2017-2018 outturns when extra beds had been taken from elective care wards following a bad winter with subsequent impact throughout the year. The ninety beds would be provision for unscheduled care. Bed availability would be managed through reducing unnecessary admissions, reduced length of stays (higher than the national average so a priority), improved discharges of patients (with effective case management) and better planning of elective care. Improving patient flow was central to all work. High priority areas, including elective cancer treatment, would not be impacted, i.e. would not be targeted for beds.

Mr Fisher explained that not all services had been commissioned through the sub-regional Sustainability and Transformation Planning. Most services (70%) were commissioned locally through the Fylde Coast Integrated Care Partnership. He added that innovative work was  ...  view the full minutes text for item 7.

To consider the Adult Social Care and Health Scrutiny Committee Workplan 2017-2018, together with any suggestions that Members may wish to make for scrutiny review topics.

The Committee agreed:

1.       To approve the Scrutiny Workplan subject to receiving a further report on health and social care integration, focusing on the Lancashire and South Cumbria Integrated Care System / Sustainability and Transformation Planning.

2.       To note the ‘Implementation of Recommendations’ table.

To note the date and time of the next meeting as Wednesday, 4 July 2018 commencing at 6pm in Committee Room A, Blackpool Town Hall.

The Committee noted the date and time of the next meeting as Wednesday 4 July 2018 commencing at 6pm in Committee Room A, Blackpool Town Hall subject to confirmation at Annual Council.