Agenda and draft minutes

Members are asked to declare any interest and the nature of that interest which they may have in any of the items under consideration at this meeting.

Councillor Roberts declared an ongoing interest as:

· Chair of Food Aid Far Cotton

· A board member of Food Aid Alliance West

· A board member for the Community Training Partnership contract to be delivered by the Community Law Service.

To confirm the Minutes of the meeting of the Committee held on 27 June 2023.

RESOLVED: That the Adult Social Care and Health Overview and Scrutiny Committee agreed the final minutes of the former People Overview and Scrutiny Committee of the meeting on 27 June 2023 as an accurate record.

The committee to receive a presentation on transformation progress from the Chief Executive and Chief Operating Officer of the NHS Northamptonshire Integrated Care Board.

The Chair welcomed the Chief Executive and colleagues from Northamptonshire Healthcare NHS Foundation Trust (NHFT) and Northamptonshire Integrated Care Board (ICB) to the meeting. The Chief Executive ICB, Toby Sanders introduced himself and colleagues David Maher Managing Director NHFT, Anne Rackham Interim Chief Operating Officer NHFT, and Giles West Associate Director for Urgent and Emergency Care ICB.

The Chief Executive ICB expressed a commitment to collaborative working with scrutiny and shared that the presentation on Step-up and Step-down Community Transformation which signalled the start of community work taking place across the county in different care settings and various programmes such as the Age Well and iCAN Programme. Colleagues from NHFT and ICB delivered the presentation which detailed the progress and planned development of Pathway 2 provision in Northamptonshire.

Members listened and observed the presentation and following a discussion made the following points:

Members questioned the distribution of beds in West Northamptonshire compared to North Northamptonshire and made the observation that there were more beds in North Northamptonshire and asked if there would be an equal distribution following the transformation work. The Interim Chief Operating Officer NHFT explained that through urgent care planning NHFT have looked at geographical areas and beds required. In the future with changing the estate and changing the number of beds available there would be a much more even distribution.

Members raised the issue of cross-border areas, such as residents bordering Oxfordshire and the role of palliative care and hospices in this area. They felt that if residents currently able to go to the hospice at Adderbury were prevented access in the future then this would cause problems for the rural area. Members stressed that another hospice was needed in the rural South Northants area. The Managing Director reassured councillors that a review of palliative care was currently being done and feedback following the review could be presented back to the committee.

Members asked if Daventry could be added to the map in the presentation. They also expressed concern regarding the average figure of 100 people being admitted to hospital each day and asked if there was any data showing the reasoning for their admittance. The Associate Director for Urgent and Emergency Care ICB responded that this figure was a success for Northamptonshire as this was historically higher, but due to the success of the transformation programmes, numbers have been kept down and early intervention and other preventative methods in the future could help reduce numbers even further. He continued that upskilling reablement staff and purchasing raiser chairs were other ways that they were improving care quality. In terms of the question regarding data collection, they were continuing to collect intelligence but there wasn’t enough information relating to sudden spikes in illness (e.g., respiratory related illness during the heatwave) but they were continuing to collect data over time.

Members asked if the two local authorities in West Northamptonshire had affected the delivery of ICB with varying approaches to adult social care and health. The Interim Chief Operating  ...  view the full minutes text for item 11.

The committee to receive a presentation on Performance Measures from the Executive Director of People Services.

The Executive Director People Services introduced the presentation and explained that following the previous meeting, members had requested an item on performance and key performance indicators and going forward this would be a standard item on the agenda for scrutiny to review at their agenda planning meeting and consider opportunities for further scrutiny work to be brought to the committee. This would give scrutiny an opportunity for greater pre-decision scrutiny. The Executive Director People Services added that scrutiny could also engage with the corporate scorecard that was regularly presented to Cabinet on performance.

The Executive Director People Services delivered the presentation on Performance Measures 2023-24 and explained that changes implemented by government had reflected the changes in data collection frameworks and inspection criteria going forward. The presentation indicated the metrics that had been removed and added as a result of the changing national context.

Members thanked the Executive Director People Services for providing the information that scrutiny requested and expressed that it was important for scrutiny to be able to use this information to inform their approach. They expressed concern relating to the rate of elderly falls receiving emergency care and requested more information on this and how it corresponded to residents looking for exterior adaptations to their home such as outdoor steps and railings.

The Cabinet Member for Adult Care, Wellbeing and Health Integration supported the Executive Director of People Services in the direction of travel for monitoring performance and welcomed the challenge from scrutiny and open discussion leading up to the CQC inspection and in the future.

RESOLVED: That the committee received an informative presentation relating to the Performance Measures from the Executive Director People Services and agreed to add this as a standing item to the future agenda planning meetings to inform opportunities for future scrutiny work.

The committee to receive a presentation from the Executive Director of People Services and Assistant Director for Commissioning & Partnerships.

The Executive Director People Services delivered the presentation on Carers which detailed the current carer support provider model, and the council were currently looking at how we commission work going forward. The current model is commissioned by NNC and ICB on behalf of WNC on a two year contract from October 2022-2024. He explained the council would be going out to tender procurement next year for a solution going forward and would offer out to other organisations through the procurement process.

Members thanked the Executive Director People Services for the comprehensive presentation asked if the work would correlate with the estates exercise being undertaken by NHFT and ICB and look at the respite offer. The Assistant Director for Commissioning & Partnerships explained the offer was around going into people’s homes rather than offering building and traditional respite services.

Members discussed the issue of communication with carers and making sure the council is reaching people and how we can improve our working relationship with ICB. The Executive Director People Services explained the starting point for communication was the council’s website, and he had flagged a number of documents out of date to be removed and the need for the website to reflect what is available. He was currently working to redevelop the website to become more user friendly. He encouraged councillors to promote what was on offer within their wards too, as navigators within WNC to signpost residents to what help and support is available for them.

Members discussed the role of the LAPs and the need to get the right structure and people involved to deliver benefits for people in the area.

The Executive Director of People Services explained this would be the responsibility of the project leads to promote attendance and hold people to account for non-attendance. He felt that with the new contract, there would be an opportunity for better data reporting as historically data was too generic in local area profiles and did not reflect the diversity in community they supported.

Members asked what the position was for young people caring for parents. The Executive Director People Services explained that Northamptonshire Carers was commissioned to support young carers.  Adult social care was responsible for supporting a young person who was a carer in this capacity; children’s social was responsible for supporting them as young person.

The Chair invited the Assistant Director for Commissioning & Partnerships to deliver a supplementary presentation on the Quality in Care Homes which profiled the care homes in West Northamptonshire and their rating on a scale of inadequate, requires improvement, good and outstanding.

Members thanked the Assistant Director for Commissioning & Partnerships for the informative presentation and the representation of data. Members discussed the issue of staffing and the impact of Covid-19. The Assistant Director for Commissioning & Partnerships shared that it remained a big concern on the clinical side and explained that a workforce strategy was underway to look at how retainment of staff could be improved.

Members asked for assurance relating to complaints from care  ...  view the full minutes text for item 13.

The committee to receive a verbal update from the Executive Director of People Services.

The Executive Director People Services delivered a verbal update on the recruitment of coordinators to the LAPs and explained that the council had sourced funding from the public health reserve with the condition to support and recruit 5 LAP project leads. He advised scrutiny that they had successfully recruited to 4 positions in Northampton and the Executive Director People Services would circulate their information to scrutiny outside of the meeting. He felt positively that this would allow for more information to be received on the progress of the LAPs and contribute to their success.

Members commented that low attendance from some partners at LAP meetings could still hamper their effectiveness. The Cabinet Member for Adult Care, Wellbeing and Health Integration emphasised that all partners had committed to participate and should be held to account if not doing so.

RESOLVED: That the committee received the verbal update on the recruitment of coordinators to the LAPs and would receive information relating to the coordinators and positions in Northampton outside of the meeting.

To consider and approve the final report from the scrutiny review.

The Chair expressed that she was impressed with the final report and thoroughly agreed with recommendations contained in the report. The Chair suggested that the recommendation relating to LAPs and GP response can be picked up as part of the standing item on the LAPs in the work programme.

The Chair of the iCAN task and finish panel thanked members of the panel and the Assistant Manager Democratic Services for their hard work and putting together the report. She expressed concern regarding the last recommendation relating to finance and the panel strongly felt information was not provided as the programme was designed with the aim to provide financial savings.

The Chair thanked the Chair of the iCAN scrutiny panel and welcomed the outcomes from the report and suggested that the last recommendation be passed onto Corporate Overview and Scrutiny committee for consideration as their remit sits within financial scrutiny or the Overview and Scrutiny Triangulation Group for consideration.

RESOLVED: That the committee agreed the report from the former People Overview and Scrutiny Committee Review of Integrated Care across Northamptonshire (iCAN) subject to the amendment of recommendation K to read:

K) The Overview and Scrutiny Triangulation Group to recommend that the appropriate Overview and Scrutiny committee(s) receivea report to a future meeting confirming:

 • The total financial cost to West Northamptonshire Council of the iCAN programme to the end of 2022/23, including the cost of the system transformation partner

 • The positive outcomes directly resulting from the iCAN programme delivered to the end of 2022/23.

The Chair welcomed Councillors Jonathan Harris and Rosie Humphreys for attending the committee to comment on the proposal for a task and finish group. Councillor Harris and Humphreys thanked the Chair for allowing the motion to come to the committee at the earliest opportunity.

Councillor Harris addressed the committee and shared that unpaid carers was an emergent theme coming through from the LAPs and an area of focus that hasn’t always had the attention it needs. The Carer’s Leave Act 2023 is one of the motivating factors for putting the proposal forward to scrutiny as statistics showed that nationally 2 million people will be impacted by the Act. Another statistic showed that 600 people a day leave their career to become a carer and the University of Sheffield found that unpaid carers save the government billions of pounds. He urged scrutiny to form a task and finish group with the outline set out in the proposal and encourage carers to come forward to inform the task and finish group and the need to use their own experience to inform how best they could be supported.

The committee discussed involvement in a scrutiny review and a draft scrutiny review proposal form produced for consideration.  The Assistant Manager Democratic Services explained that scrutiny could gather interest from the committee first and extend to non-executive members to form the task and finish group. The draft proposal included a focus on ensuring the council’s preparedness for the new legislation and the development of a new council Carers Strategy, as discussed at the agenda planning meeting. The committee should consider arrangements for finalising the plan for the scrutiny review if it was not in a position to do this at the current meeting.

Members discussed the membership of the task and finish panel and agreed that 7 members should form the group in total with one of the proposers of the motion to join the group along with 6 other members, who would come from committee members first and then other non-executive councillors.

RESOLVED: That the committee:

a)    Agreed to form a task and finish panel on unpaid carers and how WNC supports carers and to assist with the development of the carers strategy.

b)   Agreed that the Chair and Vice-Chair would agree the final plan for the scrutiny review of support for unpaid carers to enable this to be done ahead of the next committee meeting.

To review and approve the Committee Work Programme for 2023/24.

The Chair asked members to review the committee work programme and consider the topics for scrutiny and agree any items arising from the meeting to the work programme.

Members agreed to add the proposal for a task and finish group on unpaid carers and how WNC supports carers and assist with the development of the carers strategy to the work programme. In addition, members wished to add the review on palliative care that arose from the presentation on step-up and step-down community transformation.

RESOLVED: That the committee reviewed the work programme for 2023/24 and agreed to add the following items:

§  A proposal for a task and finish panel on unpaid carers and how WNC supports carers and to assist with the development of the carers strategy

§  A review of palliative care from the NHFT and ICB to be brought to a future meeting of the Adult Social Care and Health Overview and Scrutiny Committee.

The Chair to advise whether they have agreed to any items of urgent business being admitted to the agenda.

There were no items of urgent business.