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SCRUTINY COMMITTEE (SOCIAL CARE AND HEALTH)

 

Minutes of a meeting held on 5th November, 2012.

 

Present:  Councillor R.J. Bertin (Chairman); Councillor Mrs. M.E.J. Birch (Vice-Chairman); Councillors Ms. R. Birch, K.J. Geary, Dr. I.J. Johnson, A. Parker, Ms. R.F. Probert, J.W. Thomas and S.T. Wiliam.

 

Also present:  Councillor C.P.J. Elmore.

 

Also present for Agenda Item No. 4: Councillors Mrs. P. Drake and Mrs. V.M. Hartrey.

 

 

476     APOLOGY FOR ABSENCE -

 

This was received from Councillor Ms. K. Edmunds.

 

 

477     MR. R. PRESTON –

 

The Chairman referred to the recent death of Mr. R. Preston, husband of Councillor Mrs. A.J. Preston.

 

All Members stood in silent tribute.

 

 

478     DECLARATIONS OF INTEREST -

 

No declarations were received.

 

 

479     MINUTES -

 

RECOMMENDED - T H A T the minutes of the meeting held on 8th October, 2012 be approved as a correct record subject to:

 

-         it being recorded that Councillor S.T. Wiliam had requested the reports subject to Minute Nos. 399 and 400

-         that, whilst considering the Revenue and Capital Monitoring for the period 1st April 2012 to 31st August 2012 and Update on the Social Services Budget Programme, a Member had enquired as to how many Community Care Packages there were.  It was not possible for this information to be provided at the meeting and Members were advised that the information would be provided separately.

 

 

480     TOGETHER FOR HEALTH: SOUTH WALES PROGRAMME –

 

Dr. Sharon Hopkins, Director of Public House, Cardiff and Vale University Health Board, was present for this item.

 

Committee were informed of the current engagement process on the South Wales Programme. 

 

Together for Health: A Five Year Vision for the NHS in Wales had been published by the Minister for Health and Social Services in November 2011 and set out the Welsh Government’s (WG) vision for the NHS in Wales over the next five years.  The document set out that services must change to reduce health inequalities across Wales and to improve the performance of the services.

 

The report recognised that, whilst strong foundations were in place to support change and improvements, there were still tough challenges to be faced. These had been identified as:

 

·         health has improved but not for everyone and the population was ageing

·         health care quality had improved but the NHS could do even better

·         expectations were continually rising

·         medical staffing was becoming a real limitation on the services

·         funding was limited.

 

The priority areas for action had been set out as:

 

·         improving health as well as treating sickness

·         one system for health

·         hospitals for the 21st century as part of a well designed, fully integrated network of care

·         aiming at excellence everywhere

·         absolute transparency on performance

·         a new partnership with the public, making every penny count

·         always with NHS staff.

 

An independent national case for change had been facilitated and was in four parts: summary, access, quality and safety, and the workforce.  This independent research had been commissioned by the LHB Chief Executives in South Wales, and this “case for change” represented the first time that the existing evidence had been brought together in one place to represent the overall picture of the issues that were driving change across the NHS.

 

Some of the main findings of the report showed:

 

·         the current configuration of hospitals did not deliver best outcomes for all patients uniformly across Wales

·         service quality needed to be improved if Wales was to have services comparable to the best healthcare systems in the world

·         unless action was taken quickly, the shortage of medical staff in some services was likely to lead to the unplanned closure, and possible collapse, of these services

·         the increasing specialisation of some types of service meant that centralising expert clinical staff led to better patient outcomes in these specialities

·         the nature of healthcare meant that many hospital services were interdependent and outcomes for patients could be improved if certain types of services were brought together on one site

·         the impact of longer travelling distances as a result of centralisation could be lessened by boosting pre-hospital care, using telemedicine more widely and effectively, and providing better transport links.

 

In early 2012, the five Local Health Boards in South Wales established a Programme Board to consider the process of jointly developing strategic plans for health services in South Wales, i.e. the South Wales Programme, in response to Together for Health: A Five Year Vision for the NHS in Wales.

 

During May and June of 2012, over 300 clinicians and other interested parties from across Mid and South Wales participated in a series of clinical conferences designed to engender debate about the future models of certain clinical services across the region.  The Summits were designed to provide clinicians and other stakeholders with an opportunity to discuss in detail the core services at the heart of the South Wales Programme and begin to crystallise ideas on how best to plan and deliver them in the future.  The Summits had made progress on achieving clinical consensus in some important services areas:

 

·         paediatrics and neonatal care

·         obstetrics

·         trauma services.

 

All Health Boards had been fully involved in the process.

 

The five Health Boards in South Wales had launched a 12 week engagement programme with the public regarding the issues facing some specialist hospital services in the region.

 

Once the engagement process was concluded, the Programme Board would meet to consider the outcome of the engagement process and take forward the next stage of development of plans in January 2013, which were likely to be subject to a formal public consultation process.

 

Cardiff and Vale UHB had already undertaken significant strategic service change since its inception, primarily through proposals which had been consulted and engaged upon in Making a Difference and Making a Difference 2.  The UHB was not therefore proposing any changes to local services through this engagement process.  However, it was necessary to be mindful that service change elsewhere may potentially impact upon those services, and these may become clearer following the engagement process.

 

Discussions ensued on the contents of the presentation and questions were asked as to how the Ambulance Service would cope with any proposals. 

 

In reply, Dr. Hopkins advised that the Cardiff and Vale University Health Board was working closely with ambulance colleagues.  No change was anticipated for acute emergency call-outs and work would be carried out to ensure the protocols were right.  Generally, Dr. Hopkins advised that conveyance times were very workable. 

 

A Member enquired as to the use of clinical networking, and Dr. Hopkins advised that clinical networking would be extensively used. 

 

Dr. Hopkins spoke on 'workforce planning', and advised that this was a UK problem.  The Health Service had not been able to keep up with the specialisms demanded.  Workforce planning for the next 20 years was being prepared at the moment although Dr. Hopkins did not think that this would solve all the problems for the future.  The more specialism that took place, within a myriad of units led to difficulties especially in times of financial constraints. 

 

The Chairman noted that not everything was planned to be located within the University Hospital Wales, and enquired why this was not the case. 

 

Dr. Hopkins advised that it was the intention for the University Hospital Wales to be a Centre of Excellence.  It would not be possible to achieve this and also provide routine care on the same site.  Some of the services may have to be moved out to provide more specialism's on the site. 

 

The Chairman thanked Dr. Hopkins for her informative presentation.

 

 

481     SCRUTINY DECISION TRACKING OF RECOMMENDATIONS (DR) –

 

Members were advised of progress in relation to recommendations made by the Scrutiny Committee for:

 

·         1st Quarter - April to June 2012

·         2nd Quarter - July to September 2012.

 

Following consideration of the report, it was

 

RECOMMENDED - T H A T the following recommendations be deemed completed:

 

18 June 2012

Min. No. 49 - Scrutiny Forward Work Programme 2012/13 (DLPPHS) - Recommended

(2)       That the Director of Legal, Public Protection and Housing Services be notified of the priority topic for review, to be forwarded to the Scrutiny Committee Chairmen and Vice-Chairmen Group by 22nd June, 2012.

Topics agreed by Chairmen and Vice-Chairmen Group - Welfare Reform and Traffic Management in the Vale (Minute (e) refers).

Completed

Min. No. 52 - Consultation on the Social Services (Wales) Bill (DSS) -  Recommended

(2)       That all Members of the Scrutiny Committee (Social Care and Health) receive a presentation on the Social Services (Wales) Bill prior to the next scheduled meeting of the Committee.

Presentation given 16th July, 2012.

Completed

16 July 2012

Min. No. 141 - Closure of Accounts 2011/12 (DSS) - Recommended

(2)       That a further report be brought before the next meeting of the Committee outlining the reasons why the works required for the Day Care Service provision had fallen short of what was expected.

Reported to Scrutiny Committee (Social Care and Health) on 8th October 2012.

Completed

Min. No. 142 - Social Services Budget Programme (DSS) - Recommended

(1)       That Cabinet be recommended to endorse the Programme as outlined in the report.

Cabinet, on 30th July 2012, endorsed the Programme (Min. No. C1790 refers).

Completed

(2)       That Scrutiny Committee continue to receive regular updates on the progress of the Programme in order to be able to exercise proper oversight and scrutiny. 

Cabinet, on 30th July 2012, resolved that the relevant Scrutiny Committee and Cabinet receive monthly updates on the progress of the Programme in order to be able to exercise proper oversight and scrutiny.  (Min. No. C1790 refers).

Added to work programme schedule.

Completed

Min. No. 145 - Contracts with Third Sector Organisations for Providing Social Care Services (DSS) - Recommended

(2)       That a further report be submitted to Scrutiny Committee by the Director of Social Services in six months time.

Added to work programme schedule.

Completed

(3)       That a report be brought before the next meeting of the Committee providing information on contracts between Social Services and the private sector.

Reported to Committee on 8th October 2012 (Min No. 399 refers).

Completed

Min. No. 151 - Scrutiny Committees' Draft Annual Report May 2011 to April 2012 (DLPPHS) - Recommended

(1)       That the Annual Report be approved and referred to Full Council.

On 26th September Full Council received the Annual Report (Min. No. 355 refers).

Completed

(2)       That the £50 cap on charges for non-residential care services, imposed as a result of the provisions of the First Steps Improvement Package guidance, introduced by the Welsh Government be suggested as a topic for review, the reason being that the resultant net reduction in income that the Council has to bear as a result of the above was estimated to be in excess of £1.4 million, and to ensure that the Social Services/ Adult Services Division had in place a coherent strategy for securing financial stability within the resources available.

Topic chosen for review by the Chairmen and Vice-Chairmen Group was “Welfare Reform”.

Completed

3 September 2012

Min. No. 258 - Improvement Plan 2012/13 (MD) – Recommended

That the Improvement Plan for 2012/13 be endorsed and referred to Cabinet and Full Council.

Cabinet on 17th September 2012 endorsed the Plan and referred it to Full Council (Min No. C1827 refers).  Full Council on 26th September 2012, approved the Improvement Plan (Min. No. 361 refers).

Completed

Min. No. 261 - Telecare Services (DSS) - Recommended

(5)       That Committee receive a further progress report in 12 months on the take-up of the service and the impact on the Council’s budget.

Added to work programme schedule.

Completed

Min. No. 262 - Carers Strategies (Wales) Measure 2010: Carers Information and Consultation Strategy for the Vale of Glamorgan and Cardiff (DSS) – Recommended

(2)       That the further examination of the Strategy by officers of the likely costs that might accrue from implementation and of the outcome from an Equality Impact Assessment which would be undertaken by the lead body (the Cardiff and Vale University Health Board) be agreed.

No likely costs to accrue, and an Equality Impact Assessment completed.

Completed

Min. No. 264 - Sickness Absence Update – April 2011 to March 2012 (MD and DSS) – Recommended

(1)       That the report and the reduced levels of sickness absence within the Directorate be noted and that further reports be received in relation to this matter.

Added to work programme schedule.

Completed

(2)       That Cabinet be requested to write to the Welsh Government requesting that the Strategy to reduce unnecessary bureaucracy be accelerated.

Referred to 15th October Cabinet meeting.

Completed

 

 

482     SCRUTINY COMMITTEE WORK PROGRAMME (DR) –

 

The Work Programme contained a list of reports that were scheduled for submission to future meetings of the Scrutiny Committee which would include financial monitoring reports, performance monitoring reports, pre-Cabinet decision scrutiny reports as identified within the Cabinet Forward Work Programme together with reports requested by the Scrutiny Committee itself.  The programme schedule was attached at Appendix 1 to the report.  Members were informed that Scrutiny Committees' Work Programmes were publicised on the Council's website in order to advise members of the public of future items that would be under discussion. 

 

The report also referred to the Local Government (Wales) Measure 2011 which required that forward plans of Scrutiny Committees should be made available in advance of the exercise of functions. 

 

Following consideration of the report, it was

 

RECOMMENDED - T H A T the Work Programme schedule be published as detailed at Appendix 1 to the report.

 

Reason for recommendation

 

To confirm the Committee's Work Programme for the remainder of 2012/13. 

 

 

483     PROPOSED MERGER OF THE VALE OF GLAMORGAN AND CARDIFF LOCAL SAFEGUARDING CHILDREN BOARDS (LSCBS) (DSS) –

 

Committee received a report which sought agreement in principle to the proposed merger of the Vale of Glamorgan LSCB and Cardiff LSCB. 

 

As required by the Children Act 2004, the Vale of Glamorgan LSCB and the Cardiff LSCB were established in October 2006, replacing the Area Child Protection Committee in each local authority. 

 

The objectives of an LSCB were to:

 

·         co-ordinate what is done by each person or body represented on the Board for the purposes of safeguarding and promoting the welfare of children in the area of the authority by which it is established

·         ensure the effectiveness of what is done by each such person or body for those purposes.

 

In the Vale of Glamorgan, constituent agencies of the LSCB included:

 

·         the Vale of Glamorgan Council

·         Cardiff and Vale University Local Health Board

·         Abertawe Bro Morgannwg University Local Health Board

·         South Wales Police

·         the Wales Probation Trust

·         Vale of Glamorgan Youth Offending Service

·         National Public Health Service

·         Children and Family Court Advisory and Support Service (CAFCAS) Cymru

·         NSPCC.

 

In October 2011, the Deputy Minister for Children and Social Services made a written statement announcing that the current configuration of LSCBs on a local authority front should move to a regional grouping based upon the Public Service Delivery model.

 

Exactly one year later, the Deputy Minister made a further written statement that specifically dealt with the safeguarding aspects.  She agreed to ensure more robust funding arrangements for Boards and to undertake further work to understand the advantages of Boards having independent Chairs so that they can make more informed choices in this matter (rather than prescribing a uniform approach through legislation).  The Deputy Minister continued to urge all LSCBs to make significant progress in achieving a regional model, thereby ensuring that all the risks had been properly assessed and discharged before the legislation required the change. 

 

The separate LSCBs in the Vale of Glamorgan and Cardiff had agreed to look at a potential merger, to form a single regional Board. 

 

It was anticipated that considerable benefits could be achieved by merging the LSCBs.  It would help to ensure consistent alignment of policy, process and practice across all the organisations at a regional level assisting professionals to work together more effectively in safeguarding children.  There would be opportunities to avoid duplication and to share resources.  For example, a merger would enable the LSCBs to make better use of the staff who helped to manage the work of the Boards and to secure more consistent levels of support from constituent agencies. 

 

Locally, the Vale of Glamorgan and the Cardiff LSCBs had some of their constituent agencies in common and a number of agencies were represented by the same person on both Boards.  Current arrangements were closely aligned and the Training Sub Group had been a merged operation for some time and this joint work had been very successful. 

 

However, there were major challenges too.  Detailed agreement would be needed in areas such as:

 

·         membership

·         governance and accountability

·         structures

·         staffing

·         funding

·         integrated work plans

·         links to other partnership structures in each local authority area

·         links to any strategic group operating to a South Wales Police boundary

·         performance management, audit and quality assurance

·         citizen engagement - children, young people and others

·         political oversight and scrutiny.

 

Both LSCBs had agreed to consider the possibility of appointing an Independent Chair to chair the LSCB, as was current practice in England.  Perceived benefits of an Independent Chair were that (s)he would:

 

·         be independent of statutory services to the Board could exercise its local challenge function more effectively

·         provide a consistent approach and allocate time to commit to their role without other conflicting demands

·         strengthen the governance and accountability arrangements of the Board

·         ensure the Board operated effectively and exercised its functions as set out in the Children Act and statutory guidance

·         quality assured safeguarding processes

·         provide direction on issues arising from Serious Case Reviews

·         ensure key national, regional and local issues were brought to the attention of the LSCB.

 

Both Boards were confident that the work to resolve outstanding issues could be achieved in time for a merger by April 2013, if this was approved.  The next step would be for each constituent agency to agree a merger in principle so that a detailed work programme could be produced.  In due course, a more detailed proposal would be produced as the basis for a final decision. 

 

A Member expressed the view that a change from Council-based to regional-based may raise concerns involving accountability, and felt that the Committee should receive a great deal more information than was contained in the report.  Changes to the recommendations contained in the report were proposed, but not seconded. 

 

A further Member expressed support for the appointment of Independent Chairs, whereupon it was

 

RECOMMENDED -

 

(1)       T H A T the proposed merger of the two Boards be endorsed in principle.

 

(2)       T H A T the report be referred to Cabinet and that Cabinet be recommended to endorse the principle of the merger.

 

(3)       T H A T Committee receives a further report when detailed proposals concerning arrangements for running a merged LSCB had been developed.

 

(4)       T H A T the principle of an Independent Chairman be endorsed and that Cabinet be informed accordingly.

 

Reasons for decisions

 

(1&2)  To achieve agreement in principle across the two local authority areas so that work can be undertaken to produce detailed proposals regarding arrangements for running a merged LSCB.

 

(3)       To ensure that Elected Members continue to exercise effective oversight of this important change in arrangements for safeguarding children.

 

(4)       In that they may make more informed choices on these matters.

 

 

484     SOCIAL SERVICES CHANGE PLAN 2011 – 2014: PROGRESS REPORT (DSS) –

 

Committee were advised of progress made in delivering the actions set out in the Social Services Change Plan 2011 - 2014. 

 

The Change Plan came into effect in April 2011 and dealt primarily with those issues where a corporate approach across Council Directorates was required to deliver appropriate actions.  The Corporate Management Team sponsored the Change Plan as a key programme of work and there was a formal implementation group comprising officer representatives from across the Council.  Six monthly progress reports were submitted to the Corporate Management Team.  Consideration of these reports by the Scrutiny Committee (Social Care and Health) and then by Cabinet was intended to allow robust monitoring and oversight.

 

A Change Co-ordination Group, which included external regulators, had also been developed to review the progress made with implementing the Plan and the implications for the regulatory programme for Social Services. 

 

The fourth progress report, submitted to Corporate Management Team on 17th October, 2012 was attached to the report at Appendix 2.  It contained a summary report card in respect of the overall programme and project updates for each of the seven priority areas.  The report indicated good overall progress with this long term agenda for change.  It also identified any delays in delivery, and included details of the work being done to complete these actions. 

 

A request was made for a report to be brought before the Committee regarding Sub Reference CPE6 as contained within the Change Plan 'with the Vale Centre for Voluntary Services, encourage the development of Social Enterprises delivering social care services in the Vale of Glamorgan.'

 

RECOMMENDED -

 

(1)       T H A T the progress made in delivering the actions in the Social Services Change Plan 2011-2014 be noted.

 

(2)       T H A T the areas of concern where implementation of particular actions had been delayed, and the work being done to expedite delivery be noted.

 

(3)       T H A T the progress report be referred to Cabinet, with a recommendation that changes to the Plan be endorsed.

 

Reasons for recommendations

 

(1&2)  To provide an update on implementation of the Social Services Change Plan, in accordance with agreed monitoring mechanisms.

 

(3)       To complete the current cycle of monitoring and to ensure robust oversight of a key strategic Plan for the Council.

 

 

485     EXCLUSION OF PRESS AND PUBLIC -

 

RESOLVED - T H A T under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following items of business on the grounds that they involve the likely disclosure of exempt information as defined in Part 4 of Schedule 12A (as amended) of the Act, the relevant paragraphs of the Schedule being referred to in brackets after the minute heading.

 

 

486     UPDATE REPORT ON TY DYFAN: THE FINANCIAL IMPLICATIONS OF THE CURRENT CONTRACT WITH HAFOD CARE IN RESPECT OF TY DYFAN (EXEMPT INFORMATION – PARAGRAPH 14) (DSS) –

 

As requested at a previous meeting, Scrutiny Committee considered an update report on the financial implications of the current contract with Hafod Care in respect of Ty Dyfan.

 

RECOMMENDED - T H A T the contents of the report be noted.

 

Reason for recommendation

 

To ensure effective scrutiny of a key function undertaken by the Council.