Agenda and minutes
Health, Housing and Adult Services Overview and Scrutiny Committee
Tuesday, 13 March 2012 7:00 pm
Venue: Salon - York House. View directions
Contact: Louise Hall
To receive any apologies for absence.
Apologies were received from Councillors Blakemore and Bouchier and Co-opted member Martyn Kingsford
DECLARATIONS OF INTEREST
To receive any declarations of interest from members of the committee pertaining to items on the agenda.
Co-optee Margaret Dangoor declared a personal interest in items relating to Adult Social Care by virtue of her role as a carer.
To receive the minutes of the last meeting held on 31st January 2012 and approve for signing by the Chairman.
The minutes of the meeting held on 31st January 2012 were agreed as a correct record and the Chairman authorised to sign them.
REPRESENTATIONS BY MEMBERS OF THE PUBLIC (IF ANY)
Any member of the public registered to speak will be asked to make their representation at the beginning of the relevant agenda item.
No representations from members of the public had been received.
EXECUTIVE DECISIONS CALLED IN
To receive a report on a proposed Cabinet Member Decision called in by two members of the Committee.
To receive a report on a proposed Cabinet Member Decision called in by two members of the Committee. The decision relates to proposed Fees and Charges within Adult and Community Services for 2012/13.
Having called in the decision and having declared a personal interest owing to this fact Councillor Jones resigned the Chair for the duration of the item. Vice Chairman, Councillor Butler, took the Chair.
The Committee received a report of the Cabinet Member for Adult Services, Health and Housing the purpose of which was to introduce for the committee the Call-in of a Cabinet Member Decision and to explain the reasons for the decision in light of this.
The decision called in was the ‘Annual Review of Fees and Charges’. The Committee Manager explained the procedural details of the Call-in. The Committee was informed that, although having been previously considered by the Committee, and therefore requiring a majority of the committee to call the decision in as per the council’s constitution, the call-in had been allowed with just two supporting members. The decision to allow this was taken by the Cabinet Member for Adult Services, Health and Housing in order to facilitate the fullest discussion and consultation.
Councillor Jaeger and Councillor Jones, having called in the decision, addressed the Committee to explain the reasons why.
Councillor Jaeger raised the following points:
(i) That the budget debate that had taken place since the Committee had first considered the fees and charges report in January, altered the context of the decision sufficiently that it should be discussed again in light of other budgetary and policy decisions.
(ii) In particular, the decision that parking charges be frozen, benefiting all motorists but maintaining a new charge on Blue Badges, was considered to be unfair and targeted the most vulnerable.
(iii) That the financial implications of the decision to introduce or raise charges had not been fully explained. Percentage increases were not translated to income generated and this would have helped the Committee to put the decisions into context. This should be included in all future reports to the committee.
(iv) That information on who charges would affect, and by how much, had not been received by the Committee previously and again this would aid effective scrutiny.
Councillor Jones raised the following additional points:
(i) That further clarification of various facts was needed and that this call in was aimed at facilitating this as much as questioning the Blue Badge charges.
(ii) That more information about the people likely to be affected by changes would be welcomed.
Councillor Urquhart addressed the committee, in order to explain the reason for the decision. In particular she referred to the following:
(i) That the Administration’s policy had been clear – that the greatest number of residents be helped at the lowest cost. This was the motivation behind the freeze on council tax. Fees and Charges were considered after and outside of this decision.
(ii) The increases in fees and charges had occurred where they are necessary and fair, and increases applied were considered reasonable. In this respect, introducing a charge on Blue Badges which would never more than meet the administrative costs of issue, was considered ... view the full minutes text for item 132a
To receive a paper of Hounslow and Richmond Community Healthcare NHS Trust detailing the timetable and process to secure Foundation Trust status and seeking feedback from the Committee on its overall proposals, strategic objectives and service development priorities.
Councillor Jones resumed Chairmanship of the Committee.
The Committee received a report of the Hounslow and Richmond Community Healthcare NHS Trust (HRCH) regarding the obligation for them to become a Foundation Trust and the work being undertaken to achieve this.
Richard Tyler, Chief Executive of HRCH and Steve Swords Chairman of HRCH were in attendance to make a presentation to the committee. The presentation referred, in particular, to the following:
(i) The benefits of Foundation Trust authorisation
(ii) Governance arrangements in place and the 5 year business plan currently being produced
(iii) The process and timeline for the application, of which the consultation at hand was part
(iv) HRCH vision, strategic objectives and service development plans
(v) Engagement strategy
The Committee discussed the information in the report and that received in the presentation; the following themes were explored and in response to comments made and questions raised the following additional information was received from the officers in attendance:
(i) That HRCH was the Trust under which responsibility for Teddington Memorial Hospital would fall. The transfer of the hospital to the HRCH FT was part of the application and therefore subject to the risk assessment and rigour that all aspects of the application would be.
(ii) That the Chief Executive and Chairman were aware of the strength of feeling in the community relating to Teddington Memorial Hospital, but that Government regulation was clear on the matter of hospital transfer to Foundation Trusts and that should the application be successful the transfer would go ahead. They acknowledged that they had not been present at recent meetings organised to discuss the transfer but also reported that they had not received an invite.
(iii) That the Trust had every intention of continuing services at the Teddington Memorial hospital.
(iv) That the Integrated Business Plan (IBP) document was currently being signed of by various stages of the NHS process. On completion of this process there would be a comprehensive stakeholder consultation of which the Committee would be part
(v) HRCH confirmed that officers were happy to continue to attend the committee until that point to ensure that scrutiny was maintained.
(vi) That the application would show how the Trust proposed to deal with the different requirements of the populations using its services, including those people who lived outside of the Borough. Early intervention and preventative work on which there was currently a common emphasis in health care required a thorough knowledge of the people using or likely to use services.
(vii)That ‘Whitton Corner’ would not transfer to the Foundation Trust should it be established. This was related to the rules of the Department of Health and the consideration that this establishment was deemed to deliver primary care as opposed to community services.
(viii) That the Whitton ‘poly-clinic’ had been built to partly provide walk-in services and this may no longer be the case. HRCH confirmed that it need not be so, they would deliver what commissioners wished to commission.
It was RESOLVED ... view the full minutes text for item 133.
CHANGES TO LOCAL HEALTH SERVICES - VERBAL UPDATE
To receive a verbal update from the Director of Adult and Community Services, the managing Director of NHS South West London Richmond Branch and the Director of Public Health for Richmond on the latest changes to local health services.
Cathy Kerr, Director of Adult and Community Services, Dominic Wright, Managing Director at NHS Richmond and Dr Marilyn Plant Chair of NHS Richmond Professional Executive Committee were in attendance to address the Committee. They reported recent changes to local health services and in particular they drew the attention of the committee to the following information:
Dominic Wright addressed the Committee:
(i) Co-location collaboration with HRCH and Whitton was underway to facilitate the changes in this area including the FT status the committee heard about under the previous item
(ii) Financially the PCT had been successful in 2011/12 and it was expected that there would be a surplus which would be banked for use in next? financial year.
(iii) That this healthy surplus had necessitated a relocation of funds to Croydon PCT from Richmond NHS and all other SW London Boroughs had also contributed. In addition an amount had been received by Croydon from NHS London. Some of these monies would be recouped.
(iv) That a Service Level Agreement had been produced and it was hoped that this would be used when the Clinical Commissioning Groups took over next year to formalise service delivery between the Local Authority and the NHS. Dominic to check
(v) To further cement work towards co-location and collaboration work, the NHS had secured office space within the LBRuT Civic Centre offices, it was hoped that this would further integrate health and social care in the Borough.
(vi) That the Whitton facility would open in May and would house, 2 GP’s, a dentist, and aspects of integrated health & social care provision. The facility would be a poly-clinic in all but name.
The Committee discussed the information received and in response to comments made and questions raised the committee received the following information from officers in attendance:
(i) That rental charges on pfi financed buildings were high but that this was not now able to be changed. These charges would be paid by those who were entrusted with the Whitton Facility and would be expected to do so without compromising patient services.
(ii) That it was not able to be guaranteed that any particular group of people would use the services offered. The way in which this would be resolved would be to ensure a thorough knowledge of the population and tailor services appropriately.
(iii) That careful discussions continued with HRCH about the kind of contract that would be utilised to formalise their provision of services at Whitton. These were loosely based around the pros and cons of ‘Block’ contracts versus ‘Pay As You Use’ contracts.
Dr Marilyn Plant provided an update for the committee on the progress made towards the Clinical Commissioning Group. She explained that:
(i) The CCG was now established as a ‘Shadow Group’ and that it was required to act in this way for a year. The process was very rigorous but Richmond was well placed to meet the tests it would encounter thanks to the early planning and joint working that had ... view the full minutes text for item 134.
To receive a report of the Director of Public Health, NHS Richmond and London Borough of Richmond providing an overview of new public health roles and responsibilities for LBRuT, and outlining a transition plan for these roles, the report seeks input from scrutiny before it is received by Cabinet later this month.
The Committee received a report of the Director of Public Health the purpose of which was to provide an overview of the new public health roles and responsibilities for LBRuT and to outline a transition plan for the formal shift from NHS Richmond public health functions to LBRuT by April 2013. The report would proceed for consideration by cabinet later in the month.
Dagmar Zeuner, Director of Public Health for Richmond was in attendance to speak to the report and she introduced it for the Committee, in particular she referred to the following:
(i) The new responsibilities, namely:
· Commissioning responsibilities
· Commissioning support to the NHS
· Assurance of effective health protection arrangements
· Public Health Outcomes framework
(ii) The difference between the services that would be discretionary, delivered in line with local needs, and the services that would be mandatory. Those services that were a local choice function would be based on the joint strategic needs assessment , including the voice of local residents. It was important to assess how this would affect the way in which the council including scrutiny work at present.
(iii) That the transitioning approach taken by Richmond was in accordance with the National Guidance issued.
In response to a question raised the Director of Public health explained that the Olympics would impact on the role of the council and NHS in terms of public health mainly through the responsibility of public health for emergency planning as well as legacy planning.
It was RESOLVED that the report be NOTED.
To receive a report of the head of Democratic Services making suggestions which seek to address the heavy workload recently experienced by the Health, Housing and Adult Services Overview and Scrutiny Committee and seeking approval for additional alternative working methods.
The Committee received a report of the Head of Democratic Services which sought solutions to the heavy workload of the Committee experienced in the last year through additional and alternative working methods detailed in the report. In addition the Committee was asked to consider the work programme for the future and issues which it might want to consider.
The Senior Democratic Services Officer and Scrutiny Officer were in attendance to speak to the report and the jointly introduced the report, in particular they drew the attention of the committee to the following:
(i) The types of scrutiny review that might be implemented, omitted in error from the report at (ix). These were:
· In-depth Reviews This is what is currently undertaken in the London Borough of Richmond upon Thames. This type of review run for 6 months and is very detailed.
· Light-touch Review: –This type of review looks at an issue in some depth but not in as much detail as in-depth review. It tends to run for 3 months,
· Challenge Session:If Scrutiny Leads want to look at an issue quickly but want to ensure there is some detailed evidence gathered, they can call for a Challenge Session. In these meetings scrutiny will hear from relevant stakeholders, residents, senior officers and other Councillors, to gather evidence on the issue. Then, like a scrutiny review, a report with recommendations will be created for agreement by the Overview and Scrutiny Committee and Cabinet. There tends to be only one meeting and this piece of work runs for a considerably shorter period of time than both an in-depth and a light-touch review.
· Or a combination of these methods.
(ii) The additional measures that might be taken to reduce agenda length at full committee, such as Member portfolios.
The Committee discussed the report and in response to comments made and questions raised the Committee received the following further information from officers:
(i) That it was best practice to have a maximum of 3 substantive items on the agenda for any one committee meeting.
(ii) That the scheduled briefings referred to in the report were suggested in order that members had potential dates diaried in order to encourage better attendance. They would not be used unless necessary.
(iii) That the length of the meetings could be reduced whist maintaining and improving the scrutiny work undertaken.
The Committee continued to discuss the content of the Work Programme and particularly highlighted the need for a standing item on SWL and St Georges Mental Health Trust. The Committee also felt that the work programme should be allotted more time on the agenda in order to give it a more full consideration. The Committee also heard that the NHS Trust Key Accounts were to be released for consultation in the near future and must be consulted upon before April 30. As no meetings of the Committee were scheduled before that date and in line with the new working practices listed in the report the Committee suggested setting ... view the full minutes text for item 136.
To receive a report of the Assistant Director Commissioning, Corporate Policy and Strategy giving details of the Council’s forward procurement activity for the next three years and seeking to identify any specific procurement it would wish to scrutinise over the course of the period detailed.
The Committee received a report of the Assistant Director, Commissioning Corporate Policy and Strategy the purpose of which was to provide an opportunity for the Committee to review the three year rolling procurement plan and seek to identify particular procurement activities to be scrutinised as part of the committee’s work programme and to facilitate the agreement of a cross cutting work plan for all committees.
The Assistant Director, Commissioning Corporate Policy and Strategy and the Acting Head of Contracting and Procurement were in attendance to speak to the report and they introduced the report to the committee. In particular they drew the attention of the committee to the following information:
(i) That this process being undertaken would be undertaken with each Overview and Scrutiny Committee and on completion of this round of consultation a meeting of the chairs and vice chairs would take place in order that a co-ordinated approach to scrutiny could be agreed and maintained.
(ii) That it was important to take this kind of approach in order that scrutiny could have the most impact on policy.
(iii) That 2 or 3 procurement activities would be an optimum number for consideration by the Committee and it that it was hoped that these could be agreed at the meeting.
The Committee discussed the report and the information received from officers and in response to comments made and questions raised, the committee heard the following additional information from officers and discussed the following themes:
(i) That the information contained within the report did not contain live procurements but that this information could be shared with the committee if it was requested.
(ii) Members felt that live information would be useful in order to create a context for issues, officers agreed but reminded the committee that some of these procurements would be in the later stages and could not be easily influenced at this point. It was requested that in particular this information include voluntary sector tenders and procurements such as meals on wheels.
(iii) That end dates of live contracts should be included in information received by the committee.
(iv) That the list of procurements should only include or particularly highlight those which fell within the remit of the committee.
(v) That those procurements related to the Supporting people Programme were of particular interest to the committee but that a further breakdown of what these were was needed . It was noted that the Committee had already scrutinised the Supporting People review
(vi) In addition Residential Care procurement was suggested; officers warned that the impact of scrutiny in this area would be limited as this was a procurement of an existing service where no significant policy change was planned
(vii)Mental health procurement was also put forward by a member of the committee as an area of future interest.
(viii) It was commented that under new commissioning arrangements scrutiny would need to adapt in order to successfully scrutinise health and adult services in the borough.
(ix) It was suggested that ... view the full minutes text for item 137.
To receive a report of theAssistant Director Commissioning Corporate Strategy & Policy and the Assistant Director Community Operations containing the draft Cabinet Paper on the Homelessness Strategy to be considered by cabinet on 15th March Cabinet. It also includes the latest version of the strategy and an action plan for 2012/13.
The Committee received a joint report of the Assistant Director Commissioning Corporate Strategy and Policy and the Assistant Director Community Operations which included the Homelessness Strategy and draft report on the same matter to be considered later in the month by Cabinet.
Both of the Assistant Directors were in attendance to speak to the report and they briefly introduced it for the Committee and reported the key changes in the document since the Committee had last considered it in January 2012.
The report sought any views of the committee that it wished to be verbally reported at the cabinet meeting on the 15th march.
The Committee discussed the report and the draft Strategy.
A substitute Committee member raised a concern that the Homelessness task group had witnesses unquestioned, namely SPEAR and suggested that the Task group be reformed. On discussion with officers and in light of the Work programme previously approved under item 9 it was agreed that reforming the task group without a clear remit would not provide the best solution and that it might be possible to establish a ‘challenge session’ to report back findings from any interview conducted to the Committee.
It was RESOLVED
1. That the necessity and purpose of a challenge session be investigated by the Scrutiny officer in liaison with relevant Councillors and SPEAR
2. That the draft strategy be NOTED and no comments be relayed to cabinet.
To receive a report of the Cabinet Member for Adult Services, Health and Housing in to satisfy the request of the Committee to receive regular detailed updates were in response to the Homelessness Task Group report. The report covers recent patterns in homelessness, latest developments in the New Affordable housing model, and further news on policy changes.
The Committee received a report, the purpose of which was to provide information for the Committee on recent patterns in homelessness, the latest developments in the New Affordable Housing model and policy changes. This report was brought before the Committee in response to a resolution at the meeting of 31 January 2012
The Assistant Director Community Service Operations was present to talk to the item and he briefly introduced the key themes for the Committee, in particular he referred to the following:
(i) That there had been an increase in the number of homeless people for whom a duty had been accepted.
(ii) That there had been an increase in the number of people in temporary accommodation.
(iii) That people facing housing benefits cuts were being sought out and offered advice on future changes. Some people had voluntarily stopped receiving benefits for a week in order to reapply and as a result extend the transitional relief period allowed by the Government to the end of December 2012.
The Item was discussed and the following further information was reported by the Assistant Director in response to questions from the Committee:
(i) That turning down a new higher rent property offered would not automatically deny the applicant further offers. Each case would be judged on its merits and a decision made as to whether refusal was reasonable or not.
(ii) That the reasons for homelessness of those people under the category ‘Parents unwilling / unable to accommodate’ were varied and could include a number of the factors identified in the Priority Need Reason table included in the report, but many would have children or be pregnant themselves.
(iii) That the changes to tax credit had not been considered in the same way as the changes to housing benefit. Officers do not have access to this information and therefore the effect of these changes on homelessness in the Borough was not yet known. It was not envisaged that the effects on homelessness would be drastic.
(iv) Correction: Paragraph 16. Table title should read ‘weekly amount’, not ‘monthly amount’ as printed.
(v) That any person identified as likely to receive a £20 per week or higher cut to benefits received was being contacted by one of two dedicated workers. This preventative work was considered to be satisfactory to prepare the council for the scheduled changes and mitigate the most serious risks. Should any of those people identified then become homeless despite preventative action having been taken, those people who were not classed amongst the very vulnerable were unlikely to be rehoused. These people were not elderly, or part of a family with young children or disabled. Should they become homeless the council would offer advice and guidance, and in particular attempt to assist in identifying suitable private accommodation. It was envisaged that this might be difficult to find in the borough, due to the Housing Benefit cuts and therefore a private tenancy outside of the borough may be identified. The council would not ... view the full minutes text for item 138b
TOBACCO CONTROL TASK GROUP - VERBAL UPDATE
To receive a verbal update from Councillor Jones and Scrutiny officer on the work and progress of the Tobacco Control Task group.
The Committee received a verbal report from the Chairman of the Committee regarding the Tobacco Control group of which she was a member. Councillor Jones reported that the scoping meeting had been successful and the terms of reference were agreed by the Committee at its meeting in January. Since then the Task group had met with a Youth Worker and the Director of Public Health amongst other witnesses and planned to invite more stakeholders and interested parties to it’s next meeting. It had also enlisted the help of the Youth Council who would be undertaking peer research to feed in to the Groups work.
It was RESOLVED that the information received be NOTED.
To receive a report of the Director of Adult and Community Services providing an update on performance in relation to projects and indicators that monitor the council priorities for Adult Social Care and Housing.
[This is a nil return report]
The Committee received a nil report of the Director of Adult and Community Services regarding performance in relation to projects and indicators.
There were no outstanding indicators or projects that met the requirements of reporting to the Committee for underperformance.
It was RESOLVED that the report be NOTED.