Agenda and minutes

At this point Members are asked to declare any personal or prejudicial interests they may have in the business on this agenda. A list of general personal interests previously declared are attached.

Members were invited to declare at this point in the meeting any personal or prejudicial interests they might have in the business on the agenda. Other than the standing interests no further interests were declared.

To approve and sign the minutes of meetings of the Committee held on 7 and 20 July 2010.

Arising out of consideration of the minutes of the Committee’s  meeting on 20 July the Chair requested an update in relation to agenda item 14 – Joint Vision for Older People’s Health and Social Care in York.

Officers confirmed that the Executive Member for Health and Adult Social Services had taken the Committee’s comments into consideration at his Decision Session on 27 July. It was reported that he had agreed to amend the language and some of the wording in paragraph 8.6. Officers confirmed that they would circulate copies of the finalised report to Members by email. ^1. 

RESOLVED:             That the minutes of meetings of the Committee held on 7 and 20 July 2010 be approved and signed by the Chair as correct records.

At this point in the meeting, members of the public who have registered their wish to speak regarding an item on the agenda or an issue within the Committee’s remit can do so. The deadline for registering is 5:00 pm on Tuesday 21 September 2010.

It was reported that there had been one registration to speak at the meeting under the Council’s Public Participation Scheme. Details of the speaker are set out under the individual agenda item.

The Director of Standards and Compliance, the Locality Manager for York and the Service and Quality Improvement Manager for North Yorkshire will be in attendance at the meeting to give a presentation on YAS’s forthcoming priorities, challenges and successes. This will include an update on Accident & Emergency operations, an update on the Patient Transport Services and information on quality improvement (measuring patient safety, clinical effectiveness and patient experience).

The Committee received a presentation from representatives of the Yorkshire Ambulance Service on their forthcoming priorities, challenges and successes.

The Director of Standards and Compliance, presented an update on Accident and Emergency response standards and referred to recent improvements. He also reported on improvements in the patient transport service and clinical quality to meet the Care Quality Commission standards. In respect of national standards he stated that the Service was leading the way for safeguarding in ambulance services and were best in the country for infection prevention and control.

The Service and Quality Improvement Manager explained how this reflected locally. She confirmed that demand was increasing, NHS North Yorkshire and York had anticipated in the region of 33,508 calls being made to the service but the actual number had been 35,540 a variance of 6.1%.

The Locality Manager for York for the Yorkshire Ambulance Service (YAS) reported details of recent success and achievements in the service, which included:

• A Controlled Drugs role out on 5 July 2010
• The roll out of airwaves digital radio in February 2010
• Purchase of 3 new ambulances in the York area with LifePak 15 defibrillators
• New York Ambulance Station
• The introduction of falls and diabetic care pathways

Members questioned a number of points arising from the presentation including:

• In relation to clinical standards mention was made of liaison with the PCT. What sort of liaison would be undertaken when there was no longer a PCT? YAS representatives reported that this had been flagged as a potential danger.
• Care pathways for patients and their identification to avoid any unnecessary distress for the patient or their families
• Concern that any under performance in the rural areas of North Yorkshire would not be improved at the expense of urban areas such as York.

The Chair thanked the representatives of the Ambulance Service for their attendance and informative presentation.

RESOLVED:             That the six month update be received and noted.

REASON:                  To update the Committee on the work of the Yorkshire Ambulance Service.

This report asks Members to consider information requested at a previous meeting and to make a decision on whether to progress this topic to review.

Consideration was given to a report, which set out details of information requested at a previous meeting. This related to services provided to new mothers and newborn children, work undertaken by health visitors and at Children’s Centres and the numbers accessing these services.

The Committee were reminded that this scrutiny topic had been submitted by Cllr Wiseman and questioned whether the way health visitors currently worked in York allowed them to offer a full and effective service to mothers and their babies from birth to six months.

Members were asked to consider whether the information received to date indicated any gaps in service provision. Members were also reminded that NHS North Yorkshire and York were currently undertaking a review of this service themselves.

Representatives from NHS North Yorkshire and York were in attendance at the meeting to present the answers to the specific questions requested by Members at their last meeting and to answer any further questions. They also circulated a copy of the Personal Child Health Record known as the ‘red book’ which was handed to new mothers whilst still in hospital and which would hold all the child’s health records.

Members further questioned the representatives in relation to a number of points including:

• If the new mother did not attend the 6-8 week Universal check, was this followed up and when was the next statutory check
• Was any additional support offered to single parents
• Further details in relation to drop in centres in rural wards and whether the time allocation was sufficient
• Confirmation that the concerns of any health professional would be passed onto other agencies

Following further discussion Members thanked the representatives for their attendance and comprehensive information and comments. They confirmed that following the additional information received that they would not be pursuing this review.

RESOLVED:             That the scrutiny topic on post-maternity services not be progressed to review for the reasons set out above.

REASON:                  To address the registered scrutiny topic.

This report analyses the latest performance for 2010/11 and forecasts the outturn position by reference to the service plan, the budget and the performance indicators for all of the relevant services falling under the responsibility of the Director of Adults Children and Education.

Consideration was given to a report which detailed the latest performance for 2010/11 and forecast the outturn position by reference to the service plan, the budget and the performance indicators for all of the relevant services falling under the responsibility of the Director of Adults Children and Education.

The report highlighted early financial pressures of £1,349k in respect of take up of direct payments, which it was reported were likely to increase with the personalisation of services. It also arose from a higher number of referrals for Independent Residential and Nursing Care and agency staff costs.

Members questioned the percentage of the budget involved in the use of agency staff in Elderly Persons Homes.

Officers confirmed that they would continue to track progress in all areas but that there were still significant pressures although this was only the first financial monitor of the year.

RESOLVED:             That the first quarter monitoring report in respect of Adult Social Services be received and noted.

REASON:                  To update the Committee on the latest financial and performance position for 2010/11.

This report presents Members with the final report arising from the Childhood Obesity Scrutiny Review.

The Committee considered the final report of the Childhood Obesity Scrutiny Review, which had looked to address whether current service provision was effectively reducing childhood obesity in the city.

The Scrutiny Officer presented the report, which recommended that a dedicated lead officer based within the City of York Council would be responsible for promoting and leading on the childhood obesity agenda. The Committee were asked to reconsider the Task Group’s recommendation in the light of the implications contained within the final report. 

Members felt that the recommendation should stand if the Task Group and the Scrutiny Committee were serious about reducing childhood obesity within the city.

The Health Improvement Manager at NHS North Yorkshire and York was in attendance at the meeting and, congratulated the Task Group on their comprehensive review which had involved a number of stakeholders. He confirmed that when the Task Group’s work had commenced the Healthy City Board and  various stakeholders had undertaken part of the role proposed for the dedicated officer. He stated that his work also involved parts of this role. He went onto report a number of interim figures from the National Child Measurement Programme, although not yet validated, which showed an encouraging downward trend in childhood obesity figures.

Following further discussion it was

RESOLVED:    i) That the final report and recommendation arising from the childhood obesity scrutiny review be approved as submitted to the Health and Overview and Scrutiny Committee for consideration by the Executive subject to the following amendment:

In paragraph 89 delete the words ‘eating the wrong foods’ and replace with ‘eating too much energy’.

ii)   That the Health Overview and Scrutiny Committee be informed of the Executive’s decision. ^1.

REASON:      To address the concerns set out within the original topic registration form.

This report presents Members with an early draft report to the Executive in relation to the Government White Paper ‘Equity and Excellence: Liberating the NHS’. The report also includes an early draft of the proposed Council response to the consultation.

The Committee considered an early draft of a report to the Executive on 5 October in relation to the Government Health White Paper ‘Equity and Excellence: Liberating the NHS’. In particular those items that had most impact for the Local Authority.  The report also included an early draft of the council response to the consultation.

John Yates spoke on behalf of the Older People’s Assembly. He stated that he had examined the White Paper but had found it difficult to ascertain how the public could get involved, as the proposals appeared to have a massive affect on the way services would be delivered in future. He stated that much of the information was not in an easily understood format and that the involvement of patients and the public had been understated. He stated that the proposals once again appeared to adopt the old top down approach.

Officers reported the views of the Healthy City Board on the proposals for member’s information.

Members confirmed their general support for the Healthy City Board’s consultation responses proposals but also expressed a number of concerns including:

• That the White Paper appeared to have been written from an urban rather than a rural perspective.
• It appeared that General Practitioners surgeries could be members of more than one consortia, which could then be covered by different Health Trusts and therefore not relate to local authority boundaries or health provider catchment areas.
• There could be conflicts of interest if the role and powers of the Scrutiny Committee were brought within the remit of the Health and Wellbeing Board.
• Concerns about the membership and size of the Health and Wellbeing Board and whether the Leader or Elected Mayor would be the most appropriate representative in relation to political balance.
• Serious concerns that both the cost of the proposals and their implementation could add up to more than existing services.

Officers thanked the Committee for their comments, which would be incorporated in the report to the Executive for consideration at their meeting on 5 October 2010.

RESOLVED:             That subject to the inclusion of the Committee’s comments as outlined above in the final report to the Executive the Committee note the report and draft response at Annex B to the White Paper.

REASON:                  To give voice to the Health Overview and Scrutiny Committee’s views on the White Paper and associated consultation documents.

[As amended by the Health Overview and Scrutiny Committee at their meeting held on 3 November 2010.]

Members are asked to review the Committee’s work plan for 2010/11. Extracts from the Forward Plan are included for Members’ information.

Consideration was given to the Committee’s work plan for 2010/11 together with relevant extracts from the Forward Plan.

The Scrutiny Officer updated Members on the Executives consideration of the Joint Strategic Needs Assessment for York the previous day. It was agreed that copies of the report would be sent to Members for their information. ¹.

RESOLVED:             That the work plan be approved.

REASON:                  In order to progress the work of the committee.