To note attendances, including Officers, and any apologies for absence.

Apologies for absence were received from Councillor Western, Councillor Mrs.Haddad and Heather Fairfield from Trafford HealthWatch.

To note that Councillor Dr. Karen Barclay and Councillor Sophie Taylor were appointed as Chairman and Vice-Chairman respectively for the Municipal Year 2019/20 by Full Council at its annual meeting on 22^nd May 2019

RESOLVED that the appointment at Annual Council of Councillors Dr. Barclay and Taylor to Chairman and Vice-Chairman of the Health Scrutiny Committee for Municipal Year 2019/20 be noted.

To note the membership of the Committee for the Municipal Year 2019/20, as determined by Full Council at its annual meeting on 22^nd May 2019

RESOLVED that the membership of the Health Scrutiny Committee for Municipal Year 2019/20 as determined by Full Council at its Annual Meeting on 22^nd May 2019 be noted.

To note the terms of reference for the Committee for the Municipal Year 2019/20, as determined by Full Council at its annual meeting on 22^nd May 2019

RESOLVED that the Terms of Reference of the Health Scrutiny Committee for Municipal Year 2019/20, as determined by Full Council at its annual Meeting on 22^nd May 2019 be noted.

A maximum of 15 minutes will be allocated to public questions submitted in writing to Democratic Services (democratic.services@trafford.gov.uk) by 4 p.m. on the working day prior to the meeting. Questions must be relevant to items appearing on the agenda and will be submitted at the meeting in the order in which they were received.

There were no public questions received.

To receive and, if so determined, to agree as a correct record the Minutes of the meeting held on 7^th March 2019

RESOLVED that the minutes of the Health Scrutiny Committee meeting held on 7^th March 2019 be approved as a correct record.

Members to give notice of any interest and the nature of that interest relating to any item on the agenda in accordance with the adopted Code of Conduct.

Councillor Akinola declared a personal interest at Items 10 and 13 by virtue of her employment as an adult social care contractor.

Councillor Dr. Carr and Councillor Taylor declared a personal interest at most items of today’s agenda by virtue of their employment with the NHS.

Councillor Lloyd declared a personal interest at most items on today’s agenda by virtue of her previous position as a Cabinet Member for Health and Wellbeing during Municipal Year 2018/19.

Any other item or items (not likely to disclose "exempt information") which, by reason of special circumstances (to be specified), the Chairman of the meeting is of the opinion should be considered at this meeting as a matter of urgency.

There were no items of urgent business received.

The Committee gave consideration to a progress report of the Deputy Programme Director, Single Hospital Service, which informed of the latest position on the planned acquisition by Manchester University NHS Foundation Trust (MFT) of North Manchester General Hospital (NMGH). This was one of the two projects outlined in the report which aimed to deliver the Single Hospital Service Programme.

No representatives from the organisations involved with the Single Hospital Service Programme could attend today’s meeting to present the report.

Members requested to see evidence of the benefits for patients of the merger of the two hospitals. Members also enquired about the outcome of the meeting that took place on 21^st June 2019 between NHS Improvement Executive and MUF Executive to determine whether the acquisition of North Manchester General Hospital could move on to Business Stage Case. The Committee requested to see the video about the merger produced by MUF for residents.

RESOLVED:

1.    That the report be noted;

2.    That the following information be provided to the Committee:

a.    Evidence of benefits for patients of the merger of Central Manchester University Hospitals NHS Foundation Trust and University Hospital of South Manchester NHS Foundation Trust

b.    Outcome of the meeting that took place on 21^st June 2019 between NHS Improvement Executive and MUF Executive to determine whether the acquisition of North Manchester General Hospital could move on to Business Stage Case;

c.    Link to the video produced by MUF about the merger.

The Committee considered a report of the Interim Statutory Director of Adult’s Services which outlined the progress against the action plan developed to address the issues identified by the CQC inspection of the health and social care system in Trafford in 2017 and the outcome of the CQC review in 2018.

The author of the report, accompanied by the Corporate Director of Commissioning, the Trafford Integrated Network Director and the Director of All Age Commissioning, was in attendance to present the information and to address the enquiries of the Committee.

The result of the CQC inspection in 2017 had highlighted that health and social care organisations in Trafford had to work as a system to address issues such as delayed transfers of care from hospital to the community. Consequently, a number of measures had been put in place to address the CQC recommendations.

The Urgent Care Control Room was introduced to prevent delays in hospital discharges via the coordination between activities in the four hospital sites and resources in the community. Discharge pathways were revised, early discharge planning was put in place and work with the Third Sector was extended to support hospital discharge and avoid unnecessary admissions. An Enhanced Home Care Team and an extended Reablement Service were in operation to support people to remain independent. These and other actions, detailed in the report, contributed to improvements to the delayed transfer of care and this was reflected in the CQC review in 2018. Therefore, it was proposed to close the action plan started in 2017 to move to the next phase which would focus on hospital admission prevention.

Members sought and received clarification on a number of points concerning support for advanced care planning in the community and frailty screening, progress with integrated response to support people in their homes, appointment of a Community Flow Lead to address capacity and coordination in hospital discharges, measures to mitigate waiting times for Community Reablement, provision of Extra Care apartments at Limelight, current performance on delayed transfers of care against other Local Authorities in England, resources to fund implemented measures and development of a differently skilled workforce to provide a wider range of support in people’s homes.

RESOLVED:

1.    That the progress made to date and the closure of CQC Action Plan be noted;

2.    That the new targets for length of hospital stay be noted;

3.    That an update be presented in six months on admission avoidance and intermediate care.

RESOLVED that Trafford Strategic Safeguarding Board’s annual report for 2018/19 be brought to a meeting of the Health Scrutiny Committee following the Board’s approval in October 2019.

RESOLVED that the overview of the performance of the North West Ambulance Service NHS Trust against national standards and the update on activities undertaken in Trafford be noted. 

The Committee considered a report of the Director of All Age Commissioning which provided an update in respect of the improvement work being undertaken in residential and nursing care.

The author of the report, accompanied by the Interim Statutory Director of Adult’s Services and the Corporate Director of Commissioning, was in attendance to present the information and to address the enquiries of the Committee.

It was reported that the result of the latest Care Quality Commission (CQC) inspection in April 2019 showed that the quality of care and nursing homes in Trafford had improved by 18% in the last 12 months. Homes rated “good/outstanding” were 77.22% of the total inspected homes and the first “outstanding” home status had been achieved. The analysis of the North West Association of Directors of Adults Social Services North West Branch showed that the percentage of care homes in Trafford rated “good/outstanding” reduced with the increase in the number of beds. This data was significant to plan commissioning activities. Future initiatives contemplated developing links between residents and young people in local schools and investment in training and development to support members of staff with projects to improve residents’ oral health and communication and consistency in the transition between community care and hospital. Further initiatives to improve the quality of care were highlighted.

The Committee sought clarification on the number of care and nursing homes in Trafford “requiring improvement”. It was explained that, last year, five homes rated “inadequate” had been closed, consequently, 150 beds had been lost. This year, two establishments were rated “inadequate” and those “requiring improvement” had action plans in place. Members also enquired about the percentage of residential and nursing homes with a charitable or private status. The Committee discussed the process to determine the hourly rate for care workers and it was explained that providers set the hourly rate independently from the annual increase that the Council paid in line with inflation. It was explained that contingency plans were in place for continuity of care. Members also queried the rational for the self-assessment tool for care homes and it was explained that the data obtained was utilised with other processes, such as safeguarding and site visits, to ensure quality of care. 

RESOLVED:

1.    That the progress made to date be noted;

2.    An update be requested at six monthly intervals on quality within the market.

The Committee considered a report of the Interim Director of Public Health which gave an overview of the Health and Wellbeing Board and the three life course boards: the Start Well Board, the Live Well Board and the Age Well Board.

The Consultant in Public Health and the Public Health Project Support Officer attended the meeting to present the information and to address the enquiries of the Committee.

It was reported that the Health and Wellbeing Board had been in place since 2013. Its function was to develop a share understanding of local needs through the Joint Strategic Needs Assessment (JSNA), to support the development of strategies to improve health and wellbeing of local population and to foster partnership working.

On the basis of the data gathered by the JSNA, five priorities were identified for Trafford for 2019-25. These were: reducing the number of people who smoked or used tobacco, reducing physical inactivity, reducing harm from alcohol, reducing the impact of mental illness, improving cancer prevention and screening.

The remit of each of the life course boards was outlined. Each of them reported to the Health and Wellbeing Board. The Mental Health Partnership sat alongside these three boards and it was in the process of developing a mental health strategy for Trafford.

It was explained that the Age Well Plan for Trafford was developed following Greater Manchester being named as the first age-friendly city region in the UK in March 2018. The plan was submitted to Greater Manchester Combined Authority in March 2019 and Trafford itself was named as an age-friendly community by the UK Centre for Ageing Better in May 2019.

Members queried the efficacy of current measures to reduce health inequalities, considering that resources such as Sure Start Centres and Children Centres were no longer in operation. It was explained that the structure in place focused on key issues such as better start in life and education; through tools such as screening work in the community, it was possible to identify groups that required intervention. It was noted that, although the national context was difficult, different initiatives in the community were ongoing to address long term goals through a collective approach.

Members sought and received clarification on the Poverty Strategy which was being developed; a workshop, led by Public Health and attended by several partners, had taken place. The draft strategy would be brought to the Health and Wellbeing Board in March 2020. Members asked for the draft to be brought to this Committee after endorsement by the Health and Wellbeing Board. Members also requested to be involved with Neighbourhood plans which looked at aspects of JSNA and their links with communities and GPs in specific areas of Trafford. Members also queried whether, within the Start Well Board’s work plan, communication skills were included in the school readiness plans. It was explained that there were place based plans and speech and language were prioritised.

RESOLVED

1.    That the report be noted;

2.    That the Poverty Strategy be shared  ...  view the full minutes text for item 14.

RESOLVED that HealthWatch Trafford’s End of Year Performance and Impact report 2018/19 be noted.

The members were presented with a draft work programme for 2019/20. This document was prepared on the basis of the work that had been carried out by the Committee during the previous municipal year.

Members noted the document and agreed that a further discussion was necessary to ensure that the work plan for 2019/20 reflected the Council’s new corporate priorities outlined in the new Corporate Plan, as well as the five health and wellbeing priority topics identified via Trafford’s Joint Strategic Needs Assessment. Members agreed to delegate the development of the work programme to the Chair and Vice-Chair of the Committee. Therefore, a revised work programme for 2019/20 would be presented at the next meeting of the Committee in September 2019.

The Chairman informed the Committee that an extraordinary meeting would take place on Wednesday 24^th July 2019 to scrutinise the matters concerning the Altrincham Hub development.

RESOLVED:

1.    That the Chair and Vice-Chair of the Health Scrutiny Committee meet to develop the work programme for 2019/20; this would be brought to the meeting in September 2019 for approval;

2.    That it be noted that an extraordinary meeting of the Health Scrutiny Committee take place on Wednesday 24^th July 2019 to scrutinise the matters concerning the Altrincham Hub development.