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 15 November 2017 as an accurate record.

The Committee agreed that the minutes of the Adult Social Care and Health Scrutiny Committee meeting held on 15 November 2017 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 provide an update on public mental health and suicide prevention.

Ms Zohra Dempsey, Public Health Practitioner, Blackpool Council presented a progress report on the Public Mental Health Action Plan 2016-2019. She had first presented the Plan to Members at their meeting on 5 July 2017. The Plan focused on using medical practice to promote awareness of issues and good mental health, prevent poor health and suicide, reduce stigma and discrimination and effective care and treatment leading to better quality of life.

A sub-regional plan known as the ‘Suicide Prevention Logic Model’ had been developed by the Lancashire and South Cumbria Sustainability and Transformation Partnership. The focus of the meeting update was on suicide prevention work. This was a significant issue which the Committee had previously highlighted.

Representatives and members of mental health and carers’ support organisations were present from Rethink (national mental health support charity); Blackpool Young Boys and Girls Club (local mental health resilience support); and UR Potential (mental health resilience support for young people).

All three organisations had attended the meeting in July 2017 and had maintained interest in the mental health agenda. The Chairman welcomed input from them during the meeting.

Suicide reduction targets

Members noted that Government had a target to reduce suicides by 10% by 2020. Based on the Blackpool rolling average of 19 suicides per year (2014-2016), this target equated to a reduction down to 17 suicides per year locally. The Chairman referred to Mersey Care NHS Foundation Trust which had set an aspirational target of ‘zero’ suicides and were pioneering nationally on zero suicide work. He also queried accountability for meeting suicide prevention targets.

Ms Dempsey explained that the 10% target had been set by NHS England. The ‘zero’ target was a topical discussion and the viability of this depended on local environments. The Chairman contented that Merseyside and Cheshire contained some deprived areas which arguably mirrored Blackpool issues.

A ‘zero’ suicide target was supported by the representative from Blackpool Young Boys and Girls Club. Members discussed the merits of a ‘zero’ suicide target and recommended that a ‘zero’ suicide target should be adopted. Ms Dempsey agreed that the proposed target would be raised at the Suicide Prevention Oversight Group for Lancashire and South Cumbria.

Suicide profiling

Members noted that there had been 57 deaths in Blackpool during 2014-2016 and that there needed to be effective identification of people who committed suicide. They queried what the demographic breakdown of local suicides was in order to identify focus and better plan actions, in particular the high-risk groups of males aged 25-50 (about 70% of local suicides were males).

Ms Dempsey explained that precise profiling of people committing suicide was complex with challenging issues such as substance misuse involved. She confirmed that all suicides were recorded as such when the Coroner reached a verdict of suicide. She clarified that deaths other than suicides, e.g. caused through non-intended overdoses, were not recorded under the suicide count.

In response to Members’ noting the large number of young male suicides, and the ‘Men in Sheds’ initiative not necessarily  ...  view the full minutes text for item 4.

To consider the mid-year 2017-2018 performance of the Blackpool Clinical Commissioning Group for April 2017 - September 2017.

Mr David Bonson, Chief Operating Officer, Blackpool Clinical Commissioning Group presented the Clinical Commissioning Group’s mid-year performance for 2017-2018 (April 2017 - Septmeber2017). Mr Roy Fisher, Chair, Blackpool Clinical Commissioning Group and Ms Kate Newton, Performance and Quality Manager, Midlands and Lancashire Commissioning Support Unit were also in attendance.

Mr Bonson explained that there were ongoing urgent care and winter pressure issues. These included: a shortage of beds; people waiting inappropriately on trolleys; Accident and Emergency waiting times; ambulance response times; and cancer assessments and treatment time. He added that pressures from earlier in the year and the previous winter were still having a consequential effect throughout the year. These were accumulating in current winter pressures. issues such as flu (38 cases) required isolation reducing space and bed capacity although residents and staff were encouraged to have flu jabs.

Mr Bonson reported various plans were in place with frequent high-level partnership meetings including across Lancashire and South Cumbria. The Chair queried how effective the plans were given the previous year’s winter pressures and current pressures. Assurance was given that lessons were learnt and implemented each year but increasing demand on services created tougher challenges. A ‘whole system’ response and planning was required, e.g. involving North West Ambulance Service and Adult Social Care.

Mr Bonson reported that actions included creating physical facilities (to reduce Accident and Emergency pressures) using GP primary care screening, a dedicated mental health area, a discharge lounge (with social workers) and joined-up staff in the same place.

The Chair referred to local press articles. He acknowledged that figures might not mirror those held by the Clinical Commissioning Group but sought assurance of appropriate action. He cited that Accident and Emergency performance relating to waits being no more than 4 hours had been stated as just over 40% but needed to be 95% (the Government had temporarily relaxed this to 90%).

Mr Bonson explained that the 40% represented cases that genuinely required Accident and Emergency against an overall performance of 84%.  He added that new primary care screening had been developed to re-route people not requiring Accident and Emergency.

Members requested that both targets were shown next time with clear explanations. They also suggested that the screening for genuine Accident and Emergency need should be more effective at source, i.e. avoid emergency ambulances.

The Chair referred to press reports that 1 in 7 trolley waits nationally were from Blackpool. Mr Bonson acknowledged the issue but added that the figure represented a small number of exceptional days. Usually more patients were discharged in the run-up to Christmas which had not happened leading to a shortage of beds thereby placing additional pressure on use of trolleys. Members also noted that trolley delays still involved paperwork (getting prescriptions from on-site chemists). This had been mentioned at the last performance report.  Mr Bonson acknowledged bed numbers had reduced over time and delays were a challenge for patient/bed flow (and could involve Adult Social Care pressures).

Members queried the  ...  view the full minutes text for item 5.

To consider the content of the Council’s Forward Plan, January 2018 - May 2018, relating to Adult Social Care and Health Scrutiny Committee (AHSC) functions.

Members were informed that the Homelessness Strategy was on the Forward Plan. Assurance had been given by the Head of Housing that relevant cross-cutting issues such as mental health and substance abuse were incorporated into current work as the Strategy was developed. The new Strategy needed to incorporate Government legislation, coming into force in April 2018, extending the range of people who would be supported through statutory duties to be found appropriate accommodation. Currently the duty applied to families but was being extended to single people which would put pressure on resources. The Strategy had been developed through consulting key stakeholders and would go through a public consultation exercise before being considered for approval by the Executive in April 2018.

It had been proposed that the Committee would be able to influence work going forward through reviewing the Action Plan at its May 2018 meeting, Members were also informed that Homelessness technically came within the remit of the Tourism, Economy and Resources Committee but had been ‘inherited’ by Adult Social Care and Health through previous consideration.

The Committee agreed that the Tourism, Economy and Resources Committee should be requested to consider the Homelessness Action Plan or the Adult Social Care and Health Scrutiny Committee would consider the item at its May 2018 meeting.

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.

Members were advised that the Work Programme was as presented with a potential further mental health update (with all key services) at the March or May 2018 meeting and the Homelessness Action Plan being considered at the May 2018 meeting unless the Tourism, Economy and Resources Committee considered the item instead.

Members were informed that the Action Tracker, of recommendations previously made by the Committee, had been updated to only show amber and new actions (from the last meeting). They were requested to agree, as complete, those amber actions where other progress / events had taken place superseding the value of further action.

The Committee agreed:

1.      To approve the Scrutiny Workplan 2017-2018, subject to the addition of a mental health update (with all key services) at either the March or May 2018 meetings and the Homelessness Action Plan at the May 2018 meeting unless the Tourism, Economy and Resources Committee considered the item.

2.      To note the ‘Implementation of Recommendations’ table and agree that ‘amber’ actions superseded by other progress / events could be considered as ‘complete’.

To note the date and time of the next meeting as Wednesday, 14 March 2018 commencing at 6pm in Committee Room A, Blackpool Town Hall.

The Committee noted the date and time of the next meeting as Wednesday 14 March 2018 commencing at 6pm in Committee Room A, Blackpool Town Hall.