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.

Councillor Adrian Hutton declared a personal interest in Item 9 ‘Green and Blue Infrastructure Strategy’, the nature of the interest that he was the Chairman of Blackpool Coastal Housing Limited Board.

To agree the minutes of the last meeting held on 10 October 2018 as a true and correct record.

The Committee agreed that the minutes of the meeting held on 10 October 2018, be signed by the Chairman as a true and correct record.

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

There were no applications by members of the public to speak on this occasion.

To consider the content of the Council’s Forward Plan, December 2019 – March 2019, relating to the portfolio of the Cabinet Secretary.

The Committee noted that the item contained within the Forward Plan, Green and Blue Infrastructure Strategy was an item on the meeting agenda and deferred consideration of the subject until that time.

To provide an update to the Committee on extended access GP appointments.

Ms Michelle Ashton, Blackpool Clinical Commissioning Group (CCG) provided an update to the Committee on extended access GP appointments. She advised that CCGs were required to provide extended access to GP services including at evenings and weekends for 100% of their population. GP practices in Blackpool had unanimously agreed to provide the service through centres at Whitegate Drive, Freckleton and Fleetwood to serve the residents from across Blackpool, Wyre and Fylde.

It was noted that despite publicity and marketing designed to raise awareness of the availability of extended access appointments, the service was underutilised. There were also a significant number of appointments booked which patients failed to attend. A review had been undertaken to identify ways in which to improve communication of the appointments and recommendations had included providing a direct link from NHS 111 to extended access appointments, whereby the phone call to NHS 111 would result in a patient being booked into an extended access appointment when appropriate.

The Chairman referred to a recent article in the local press which had claimed that 31,026 Blackpool residents had no access to extended access appointments. Ms Ashton advised that that had previously been the case, however, the service was now available to 100% of residents.

Members discussed the booking of standard GP appointments in detail and noted that when attempting to book an appointment either by telephone to the GP practice or by using the Patient Access application there was no signposting to the extended access service when no standard appointments were available. Mr David Bonson, Chief Executive, Blackpool CCG advised that a number of sources had indicated that extended access appointments were not being offered automatically despite communication and guidance issued. Upon consideration of the information presented, the Committee suggested that a mystery shopper exercise be undertaken to understand the extent to which appointments were offered.

In response to a question, it was reported that the extended access appointments in Freckleton and Fleetwood were utilised more than at Whitegate Drive. Mr Bonson advised that the reasons for the better take-up were unknown, however, it was noted that Freckleton and Fleetwood were both GP practices, whilst Whitegate Drive was not. It was acknowledge there could be an element of patient choice and their desire to see their own GP. Ms Ashton added that Blackpool CCG worked closely with Fylde and Wyre CCG and the same level of communication regarding extended access appointments had been provided by both CCGs.

Members raised concerns regarding the number of ‘did not attends’ and also the cost of providing extended access appointments that were not used and queried what measures could be put to explain the importance of attending appointments or cancelling them in good time.

The Committee agreed:

1.      That the CCG be requested to investigate ways in which to improve signposting to extended access appointments through the Patient Access App and by GP practice receptionists and to report back to the Committee with the outcomes in July 2019.

2.      That the CCG be  ...  view the full minutes text for item 5.

To consider the mid-year performance of the Blackpool Clinical Commissioning Group (April 2018 – September 2018).

Ms Kate Newton, Performance and Quality Manager, Blackpool Clinical Commissioning Group (CCG) presented the mid-year performance of the Blackpool CCG from April 2018 to September 2018 to the Committee highlighting that a number of indicators had been negatively impacted by a shortage in consultant radiographers.

Mr David Bonson, Chief Operating Officer, Blackpool CCG added that the impact of Winter 2017/2018 could be seen in the performance reporting for the first two quarters of 2018/2019, and that it had taken services longer than expected to recover. He added that performance had been improving since September 2018 and that Accident and Emergency performance was currently 90%. A new winter plan had been developed and it was considered that its implementation was already having a positive effect on performance.

The Committee discussed the recruitment and retention of staff, especially those in niche areas such as consultant radiographers for breast cancer. It was noted that the performance of the indicator ‘patients seen within two weeks of a GP referral for breast cancer symptoms’ was 25.18%..

Members were extremely concerned with the poor performance for referrals for breast cancer and considered the level of performance to be unacceptable. In response, Mr Bonson advised that In order to see patients more quickly support had been sought from other CCGs within Lancashire, however, no consultants had been willing to travel to Blackpool to provide a service and the only appointments offered to Blackpool residents were in Burnley. He added that a locum radiographer had subsequently been appointed in Blackpool and it was expected that the performance of related indicators would improve.

Members further queried if transport had been offered to take patients to Burnley to increase the likelihood of them accepting an appointment so far away. The CCG representatives at the meeting were unsure if had transport had been offered and agreed to investigate the matter following the meeting.

Further concern was raised with regard to succession planning. It was noted that a number of services were provided by specialists and were reliant on individuals and small teams. Mr Bonson advised that a regional approach must be taken to ensure the ongoing provision of such specialist services. It was requested that the CCG report back to the Committee in July 2019 looking at the main areas of concern with succession planning and an approach to be taken.

With regards to the Winter Plan for 2018/2019, Mr Bonson advised that a more robust approach had been taken than in previous years and programmes put in place would be managed and monitored extremely closely. He added that the plans put in place would also ensure that services would be more capable of dealing with the extra pressures and reacting accordingly.

The Committee went on to consider the number of patients waiting for more than 12 hours in Accident and Emergency and noted the large proportion of patients that were mental health patients. Ms Newton advised that the figures also included patients arriving at Accident and Emergency intoxicated with alcohol  ...  view the full minutes text for item 6.

To receive and consider the annual report of the Blackpool Safeguarding Adult Board.

Ms Sarah Rahmat, Business Development Manager, Blackpool Safeguarding Adult Board presented the Annual Report of the Blackpool Safeguarding Adult Board  (BSAB) 2017/2018 and highlighted that a new system of robust quality assurance had been put in place over the course of the year in order to assure partners and demonstrate improvement. She also highlighted that the Board was working more closely with Healthwatch and seeking the input and testimony of service users to compliment the statistical data already being captured.

Members noted the annual report and queried the number of referrals received for Serious Adult Reviews (SARs). Ms Rahmat advised that referrals for SARs were subject to strict criteria set out by the Care Act 2014. In response to further questioning, Ms Karen Smith, Director of Adult Services advised the criteria was designed to address partnership working to identify any potential learning and that in Blackpool partners generally worked well together resulting in fewer reviews despite complex safeguarding issues.

The Committee raised concerns regarding the attendance of partners at some of the BSAB meetings highlighting areas of extremely low attendance. In response, Ms Rahmat reported that a key objective of the Independent Chair for 2017/2018 had been to improve attendance and ensure that partners understood their safeguarding responsibilities. The number of meetings had been reduced to encourage partners to attend. Members of the Committee expressed the opinion that a target of 75% attendance was not high enough and that the BSAB be requested to consider increasing expected attendance at meetings to 100%.

The Committee went on to discuss the measures put in place to support adults that had been assessed to have capacity but continued to make decisions that might be considered to not be in their best interest. Ms Smith advised that services must abide by the Care Act, however, if it was considered that the individual’s actions would put them at serious risk of harm then action would be taken.

It was noted that Lancashire Care Foundation Trust (LCFT) was a key partner and had recently been deemed as ‘not safe’ by the most recent Care Quality Commission (CQC) inspection. The Chairman sought assurance that the BSAB was taking action to address the concerns raised. In response, Ms Rahmat advised that the Board regularly quality assured all partners and received regular updates from LCFT on the improvement plan put in place to address the concerns raised by the CQC inspection.

Concern was also raised regarding the closure of the domestic abuse Facebook campaign as it had been recognised to be working. It was reported that the campaign had been time limited and therefore removed once the period had ended. In response, the Committee considered that the end of a set time period was not a good reason to end a campaign that was having an impact and requested that its reinstatement be considered.

The Committee agreed:

1.      To request that that the BSAB consider increasing expected attendance at meetings to 100%.

2.      To request through Karen Smith, Director  ...  view the full minutes text for item 7.

The report provides an update on the current status and developments in Adult Services.

The Committee considered the Adult Services Update Report presented by Ms Karen Smith, Director of Adult Services and noted that the Care at Home procurement process had been completed and the successful tender would be announced following the 10 day period allowed under procurement rules for the decision to be challenged. Members also noted the continued outstanding performance of the service in dealing with the high volume of Deprivation of Liberty Safeguards (DoLS).

Ms Smith referenced the Winter Plan 2018/2019 and reported that she concerned the concerns raised by the Committee in relation to the robustness of the Plan in previous years. She added that the recent programmes put in place were more demonstrable than in previous years and that services were in a better position to respond to challenges.

The Committee highlighted the work of the Resilient Communities and Children’s Scrutiny Committee in relation to the development of a dashboard to allow Members to easily process data. It was agreed that a similar workshop be held with Adult Services in order to develop a dashboard of key facts and figures. The dashboard would allow for Members to have more input into the content of reports presented to future meetings.

The performance in relation to Carers Direct Payments was discussed. It was reported that such payments were designed to help a carer alleviate a particular difficultly they were having that directly related to their caring responsibilities. An example was given of a washing machine breaking which was needed to wash bedsheets. Rather than administering the scheme directly, the funding scheme was operated the Carers Centre. The Council could therefore not include the payments made by the Carers Centre in the performance data as it was not making the payments directly. Ms Smith advised that despite that fact, it was considered that the Carers Centre was the right avenue for offering the funding.

Members went on to consider the delayed transfers of care attributed to both the NHS and Adult Social Services and noted that they were generally the most complex cases. It was noted that delays due to the NHS and Adult Social Care separately were similar in number to other authorities, however, those caused by both organisations together were above average. Ms Smith highlighted that the reasons for the difference were being investigated but were not yet known. She added that the delays caused by Adult Social Care had been improved and there was now more control in the system.

The Committee considered the reasons around potential delays further and queried the strength of the links between the hospital and Adult Social Care. In response, Ms Smith advised that there remained difficulties in accessing information relating to discharges and the sharing of clinical information. She advised that the working relationship with the staff in the hospital was of key importance and assured the Committee that it was an area of focus for services. She added that services were being open and honest with each other in order  ...  view the full minutes text for item 8.

To inform and seek support from scrutiny on the production of a Green and Blue Infrastructure (GBI) Strategy.

Mr John Hawkin, Chief Operating Offer, Community and Environmental Services introduced the Draft Green and Blue Infrastructure Strategy and invited questions from the Committee.

Members noted the ongoing large developments currently taking place in the town centre including the conference centre and the imminent announcement regarding the Central Leisure Quarter. It was queried how the Council would ensure that the Green and Blue Infrastructure Strategy was reflected in the ongoing developments. In response, Mr Hawkin advised that the benefits of an attractive public realm were well known both on the health and wellbeing of residents and visitors and also on the economy and the length of time people would dwell in a space. He added that a key aim of the Strategy was to give planning developers a tool to set out the town’s vision. It was further noted that the Strategy would promote the receipt of commuted sums from developers.

The train station was identified as a key route into the town centre severely lacking green space. It was noted that Network Rail would also be a key partner in implementing the Strategy. Mr Hawkin agreed that all key gateways into the town should be revisited in light of the Strategy.

The Committee went on to consider the offer to employees in relation to volunteering opportunities and the Chairman cited the three days paid leave offered to civil servants to undertake volunteer work. Mr Hawkin advised that there was no current paid leave incentive to staff to volunteer and highlighted that 20% of all scores given during procurement related to social value added. Members also noted the volunteering opportunities offered by Blackpool Coastal Housing and the assistance to be provided to business to introduce greenery into the space they had available.

In response to questions, Mr Hawkin advised that further thought was required in order to ensure that socially isolated people could be encouraged to become involved in implementing the Green and Blue Infrastructure Strategy. He added that plans were in place to extend ‘Friends’ groups, involve young rangers and their families and to link together parks and transport offers.

The Committee agreed to establish a task and finish group to further contribute to the Strategy with the other two Scrutiny Committee and nominated Councillors Callow, Mrs Callow, Humphreys and Hutton to participate in the review.

The Committee to consider the Workplan, together with any suggestions that Members may wish to make for scrutiny review.

The Committee noted its workplan for the remainder of the 2018/2019 Municipal Year.

To note the date and time of the next ordinary meeting as Wednesday, 7 February 2019, commencing at 6.00pm.

An additional special meeting of the Committee will be held on Thursday, 24 January 2019, commencing at 5.00pm.

The date and time of the special Committee meeting established to consider Lancashire Care Foundation Trust improvement was noted as 25 January 2018, commencing at 5.00pm.