Agenda, decisions and minutes

Personal interest declared by Councillors David Mackie and Hilary McGuill.

Councillors David Mackie and Hilary McGuill both declared a personal interest in relation to Agenda Items 4 and 5 as members of the Community Health Council.

To confirm as a correct record the minutes of the meetings held on 12 June and 3 July 2014.

That both sets of minutes be approved as a correct record and signed by the Chair.

The minutes of the meetings held on 12 June and 3 July 2014 had been circulated with the agenda.

RESOLVED:

That both sets of minutes be approved as a correct record and signed by the Chair.

(a)       That the commitment across Health & Social Care organisations to deliver integrated support to those individuals living with Dementia and the joined-up approach to service improvements in the future be noted;

(b)       That the development of an ‘Integrated Dementia Action Plan’ and its implementation over the next three years be noted, recognising that it is ‘work in progress’ requiring further agreements in terms of performance measurement and monitoring arrangements;

(c)        That Members seek regular progress reports through the regular quarterly monthly reports; and

(d)       That awareness of issues such as Dementia be encouraged across all the Council’s services.

The Chief Officer (Social Services) presented a report on the strategic approach being taken by Social Services in Flintshire and its partners within the Betsi Cadwaladr University Health Board (BCUHB) to deliver integrated health and social care services to individuals living with Dementia, their families and carers.  He said that the content of the integrated Health and Social Care Dementia Action Plan, which was attached to the report, went beyond the recommendations from the Care & Social Services Inspectorate Wales (CSSIW) inspection earlier in the year to deliver improved outcomes for those affected by Dementia.

The Commission Manager explained that the comprehensive Action Plan would be rolled out over the next three years and contained seven themes which linked with work already progressed on the Council’s Commissioning Strategy for Dementia.  The three recommendations arising from the CSSIW inspection were being addressed through the co-location of Health and Social Care teams, more effective use of Memory Services and the provision of EMI placements.  Reference was made to the extra care facilities in the county together with a range of service provision aimed at helping people to remain living in their own homes.  The Commission Manager outlined work with the North East Wales Carers Information Service (NEWCIS) and Dynamic Care on improved education and management of Dementia where 20 people had already signed up to take part on an e-learning rolling programme.

Mr Sean Page, Consultant Nurse (Dementia) of BCUHB said that good work on Dementia Services in social care had been acknowledged but that there was a need to move to partnership working with a shared philosophy.  The Flynn/Eley review had reported mixed results on integrated Health and Social Care systems across North Wales, with Flintshire recognised as an area where excellent progress had been made.  Mr Page outlined work in a number of areas such as the potential rollout of the ‘Dementia Red’ (Respect, Empathy, Dignity) model across North Wales following a pilot in Denbighshire and the identification of Dementia Champions.  On Memory Services, he was pleased to report that waiting times had been significantly reduced over the past year following improvements to the process and recruitment of additional staff.  Further improvements were being sought through plans to seek accreditation to work to nationally agreed standards; the first in Wales to do so.  In addition, the ‘Butterfly’ scheme had been implemented in community hospitals in Flintshire as a means of helping those with Dementia to communicate and access care.

On request from Councillor Andy Dunbobbin, the Commission Manager agreed to provide specific dates aligned to actions within the Action Plan.

Councillor David Mackie fully supported the joint approach being taken by Health and Social Care on Dementia and thanked all those involved.

Councillor Hilary McGuill welcomed the introduction of an e-learning programme for families of those with Dementia and asked how information could be obtained.  The Commission Manager said that details were available from NEWCIS on Dynamic Care and would circulate an email to the Committee.  On the Dementia  ...  view the full minutes text for item 17.

To receive a verbal update on outstanding issues following the meeting on 12 June 2014.

That the information be noted.

Mrs Lynne Joannou, Assistant Director Primary Care Support at Betsi Cadwaladr University Health Board (BCUHB) was in attendance to provide an update, following discussion at the meeting on 12 June 2014.  She advised that there were currently 114 GP surgeries across North Wales, including 23 between the three localities in Flintshire, and that despite media reports of difficulties with GP recruitment in some areas of the country, this was not the case in Flintshire.  She went on to advise that around 60% of residents in Flintshire and Wrexham were accessing NHS Dentists including some patients engaged with services across the border in England.

Mrs Joannou referred to the allocation of funding for GP and Dentist services across North Wales and the potential for this to be allocated on an area basis as a result of negotiations around a change in BCUHB management structure.  She spoke about the need for a different approach to the delivery of Primary Care services due to a national shortage of GPs and changes in the way that many GPs wished to work.  A move to a different model of working in terms of exploring the expertise/up-skilling of other clinical staff, Nurse Practitioners and use of pharmacists would help to maximise GPs’ time.  The introduction of the new GMS contract meant that GP practices determined their own arrangements and resources and there was no central list of GP vacancies.

In response to queries from Councillor Hilary McGuill, Mrs Joannou provided explanation on the annual monitoring of the Quality and Outcomes Assurance Framework (QOF) process and the provision of Orthodontist Chairs located in Shotton and Mold, with the contract for the latter coming to an end.  As part of the tender process, increased activity was identified in east Flintshire and Wrexham with new contracts starting from 1 October 2014.  She agreed to provide the Committee with figures on waiting times of the four Orthodontist practices across North Wales and would confirm the average age of GPs in Flintshire, which Councillor McGuill thought to be around 65.  The recruitment of new GPs would be addressed through joint working with nursing colleagues and other professionals.  She went on to provide explanation on contractual requirements for accessing GP practices, adding that most opening hours were between 8am and 6.30pm.  Those operating with two or more full-time GPs were not permitted to close early during the week and should be reported to the Health Board as this could potentially constitute a breach of contract.

Mrs Joannou agreed to follow up concerns raised about the opening hours of two local GP practices.

Councillor Marion Bateman commented on the possibility of GP surgeries located at some supermarkets.  Mrs Joannou said that this was not presently under consideration in Wales to her knowledge and that a lack of additional funding meant that new surgeries would need to be financed from transferred funding or the closure of another surgery.  Councillor Bateman asked if some GPs were directly employed and whether they could be  ...  view the full minutes text for item 18.

(a)       That the report be noted; and

(b)       That feedback be provided to the Corporate Resources Overview & Scrutiny Committee who are responsible for the overview and monitoring of performance.

The Chief Officer (Social Services) introduced the report for the Committee to note and consider elements of the 2014/15 Improvement Plan Monitoring Report relevant to the Committee for the period April to July 2014.

Councillor Hilary McGuill commented on the differing performance in the delivery of Disabled Facilities Grant (DFG) major adaptations between Council and privately owned properties.  The Chief Officer (Social Services) explained that waiting times had been significantly improved through the Occupational Therapy referral process for assessments and that a reduction in staffing within Housing Regeneration & Strategy had recently been addressed with permission to recruit to a vacant post.

The Housing Regeneration & Strategy Manager gave assurance that the same approach in terms of staffing resources and target timescales was taken for adaptations to both sets of property types.  However, the Council had previously taken the decision not to ask its tenants to submit a full DFG application for adaptations, whereas more major works in private properties were required to do so by the legislation in place. This could have a positive impact on timescales in Council owned stock.  In addition, DFG works at Council properties tended to be less complex, as the Council was pursuing relocation options for those tenants with the most complex needs, rather than adapting their existing dwelling.  The staffing issues had contributed to a dip in performance, however with the additional member of staff in place, figures were expected to show improvement after the next quarter.

In response to a further comment, the Housing Regeneration & Strategy Manager stressed that the Housing Revenue Account (HRA) was a ringfenced budget and that additional resources were not being transferred to Council housing budgets at the expense of owner occupiers and private tenants.  Therefore with the resolution of the staffing issue, timescales were anticipated to improve.

Concerning a query from Councillor Andy Dunbobbin on the completion of DFG work for young people, it was explained that delays to the process could occur due to the constantly changing needs of a particular client, which occurred most frequently with young children as their future development could be unclear.  The result was that, in some cases, longer delays occurred where there were complex needs or the child was subject to hospital stays.

The Housing Regeneration & Strategy Manager responded to a question from Councillor Marion Bateman on legislation governing Council properties which had been adapted for disabled residents.

Following remarks made by Councillor Stella Jones on the tendering process, the Housing Regeneration & Strategy Manager explained proposed changes to the Procurement Strategy which would involve widening the opportunities for those on the approved contractor list issuing all tender opportunities by public notice, which would add a greater level of competition.  Councillor Jones suggested that tender prices submitted could be audited to ensure value for money.  The Chair asked the Facilitator to pass this suggestion to the Housing Overview & Scrutiny Committee.

RESOLVED:

(a)       That the report be noted; and

(b)       That feedback be provided to the Corporate Resources Overview & Scrutiny Committee who are  ...  view the full minutes text for item 19.

That the information be noted.

Councillor Hilary McGuill reported positively on her visits to Rowley’s Kitchen, Estuary Crafts and Growing Places but suggested that changes to the latter could improve the clients’ experience.

Councillor Brian Lloyd reported on his visit to Abbey Metals in Flint where he had been particularly impressed with the facilities in the engineering section.

Following a suggestion by Councillor McGuill, the Facilitator agreed to include the Old Brewery in Shotton on the list of rota visits.

RESOLVED:

That the information be noted.

(a)       That the Forward Work Programme be updated accordingly; and

(b)       That it be recommended to Council that the DVD of experiences of young people in care be shown at full Council.

The Environment and Social Care Overview & Scrutiny Facilitator introduced a report to enable the Committee to consider the Forward Work Programme following the planning session held in July 2014.

The Facilitator suggested that a report on the Single Point of Access be included in items for the meeting on 13 November 2014 and that an invitation be extended to colleagues at the Ambulance Trust to attend the meeting on 18 December 2014 where representatives from the Betsi Cadwaladr University Health Board would be in attendance.

Councillor Peter Curtis asked if representatives of the ‘Community First Responders’ could also be invited to provide information and raise awareness of their important role in supporting the Ambulance Service.

All of the above suggestions were supported by the Committee, together with the proposal for the DVD of experiences of young people in care to be shown to all Members at full Council.

RESOLVED:

(a)       That the Forward Work Programme be updated accordingly; and

(b)       That it be recommended to Council that the DVD of experiences of young people in care be shown at full Council.

That the contents of the report be noted and the ongoing work being undertaken by the Childcare Development Group in working towards addressing the recommendations in the audit of sufficiency be supported.

A report on the findings of the Flintshire Childcare Sufficiency Assessment for 2014-2017 was received for information.

Councillor Marion Bateman referred to geographical gaps identified in the report and queried provision of new childcare daycare places for Northop and Sychdyn.  The Children’s Partnership Co-ordinator explained that when compiling the data, there may have been no full-time daycare places in those particular areas, however this may have changed.  She agreed to discuss separately with Councillor Bateman in more detail.

Councillor Stella Jones queried provision in Hope.  The Children’s Partnership Co-ordinator said that the areas indicated in the report may have been based on wider areas than wards, but would discuss further outside the meeting.

RESOLVED:

That the contents of the report be noted and the ongoing work being undertaken by the Childcare Development Group in working towards addressing the recommendations in the audit of sufficiency be supported.

There were no members of the press or public in attendance.