Agenda item

The Panel received presentations from the Director of Adult Social Care, Assistant Director of Public Health and the Chair of Slough Clinical Commissioning Group (CCG) introducing the key themes and issues relating to the remit of the Panel.

(Councillor Qaseem joined the meeting)

Adult Social Care

The key points noted are summarised as follows:

·  The legislative framework for adult social care was set out in the Care Act 2014.  Services were undergoing a period of significant change and aimed to support people to maintain their ‘independence, dignity and control’.

·  Adult social care budgets had reduced by 31% in real terms nationally in the past five years and in Slough the net budget for 2016-17 was £31m, down from £40m in 2013-14.  A major Reform Programme was in place which included planned savings of £7.8m between 2015 to 2020.

·  Spending patterns were changing with a shift from supporting people in care homes towards more support for care at home.  Despite the funding pressures, all but one key performance indicator was improving.

·  Future strategy aimed to prevent, support and delay the need for social care services; help support people to live at home; make safeguarding personal and integrate support with the NHS and other partners.

In response to a question it was noted that it was generally more cost effective to support people at home rather than in a care home setting, although costs were rising partly due to the increasingly complex needs of many people.  Most care home provision was through spot purchase with only one block contract at present.  The Council was commended on the quality of its reablement service and it was recognised to be performing well.  Direct payments were increasing from around 20% a few years ago to a target of 40% in the next two years.  A Member asked about the linkages with other services, particularly housing, to ensure people receiving care at home were fully supported.  It was responded that a new housing strategy was being developed and this had recently being considered by the Health Priority Delivery Group to identify the important linkages between social care and housing.  A number of practical steps had already been taken to improve engagement and it was recognised that further progress was required to provide people with the support that fully met their wider needs.

The Panel discussed the integration between health and social care services and noted the significant changes underway as part of the transformation programme.  Members recognised the importance of working closely with the NHS and other partners to improve services and meet the financial challenges facing social care.

Public health

The key points noted are summarised as follows:

·  The scope of public health services was detailed and aimed to extend healthy life expectancy and reduce premature death.  The Public Health Team sought to work with Council departments and partners to address the determinants of health such as education, housing employment etc.

·  Significant public health data was available to Members, including ward profiles and emerging trends from www.phoutcomes.info.

·  The Strategic Director of Public Health, based in Bracknell, was a shared service arrangement across Berkshire with local teams in each authority.

·  The Public Health Grant from the Government had been subject to a significant in year cut last year and was set to reduce for the next two years.

·  Performance indicators were closely monitored and the Panel noted the successes made on a number of key local priorities e.g. to tackle childhood obesity, flu immunisation and CAMHS services.

Members welcomed the range of programmes and activities underway and offered their support in championing and promoting such initiatives.  It was agreed to give further consideration to how this could best be achieved.  The Panel also commended the Public Health Team for the numerous ways in which they had engaged Slough Youth Parliament and it was suggested that they be involved with the Panel on relevant areas of scrutiny in the future.

A Member asked what was being done to identify and adopt innovative practices in areas such as mental health services.  A significant amount of work had been done on providing mental health ‘first aid’ training for 400 people and local CAMHS services were considered innovative.  In response to a question about the wards in Slough with the highest levels of admissions it was noted that there were particular challenges in Chalvey and activity was underway there to promote physical activity and prevent conditions such as diabetes.

NHS/CCG services

The key points noted are summarised as follows:

·  Slough CCG sought to work with providers, the Council and other CCGs to improve the health of the local population and improve the outcomes for patients.  For an overview of how the NHS worked, Members were encouraged to view a video put together by the Kings Fund and it was agreed to circulate the web link.

·  Of the overall NHS budget of £120bn, £72bn was provided to the 209 CCGs to purchase routine and planned services, urgent and emergency care, elective (planned) hospital care, community health services, maternity and mental health.

·  The NHS Five-Year Forward View set the future national direction for the service which included more out-of-hospital care, new models of service delivery and increased investment in primary care.

·  The CCG Assurance Process had now changed to the Improvement and Assessment Framework focusing on Better Health, Better Care, Sustainability and Leadership to deliver the Forward View.

The Panel asked a number of questions about the likely impact of the increased GP investment and co-commissioning arrangement for services in Slough and the wider engagement with the wellbeing agenda locally.  It was responded that the additional resources were required to meet rising demand and that services were being changed to help patients navigate through the health system and address the needs of people with complex and long term conditions.  This included the roll out of activity piloted through the Prime Ministers Challenge Fund for a ‘seven day NHS’ and to provide longer GP appointments for people with complex conditions.  The local partnership arrangements of the Slough Wellbeing Board and Health Priority Delivery Group were also explained.

At the conclusion of the discussion the Panel noted the information provided and thanked Alan Sinclair, Angela Snowling and Dr O’Donnell for their presentations.  The overview was considered to be helpful background and would be used to shape the Panel’s Work Programme for the year ahead.

Resolved –  That the presentations to introduce the Health Scrutiny agenda be noted.