To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 2 September 2014 and note the minutes of the Meeting of the Chairs and Vice-Chairs of Overview and Scrutiny held on 27 October 2014

The Minutes of the Health and Well-being Overview and Scrutiny Committee, held on 2 September 2014, were approved as a correct record.

The Minutes of the Meeting of the Chairs and Vice-Chairs of Overview and Scrutiny held on 27 October 2014 were noted.

Councillor Gupta declared a non-pecuniary interest by virtue that he worked with and represented seven voluntary organisations that may be effected by the health services.

Councillor Curtis declared a non-pecuniary interest in relation to item 5 by virtue that his wife is a director of HealthWatch.

The Committee had received a request from the CCG to decide whether revised criteria for weight management services at Tier 3 should be changed without need for public consultation. Officers from Public Health explained that there were four levels of treatment for obesity and tier 3 related to surgery and other medical interventions. Officers felt that more consideration needed to be made on this item before a decision was made and that an options report could be brought back to January’s meeting.

RESOLVED:  That a report on this particular issue of weight management be brought back to the committee in January.

This item is reserved to discuss any issues raised by the HealthWatch co-opted member or designated representative.

Mr Evans used this item to highlight that HealthWatch were planning a major public event relating to Dignity in Care in February and that Christine Ludlow had been appointed as the new chair of HealthWatch.

Since 1st April 2013, Health and Wellbeing Boards have had the statutory responsibility for producing a pharmaceutical needs assessment (PNA) which NHS England (Area Teams) use to determine whether new pharmacies or services provided by pharmacies are required in an area. The Thurrock PNA was produced in consultation with members of the public, pharmacies themselves and other key partners.

The Committee generally agreed that pharmacies should be given the opportunity to provide more community services to ease pressure off hospitals and GP surgeries. Councillor Gupta did highlight that more GPs and better quality GP surgeries were also needed to take the pressure off of A&E and other hospital services.

The Committee discussed various issues relating to the PNA and learnt that all pharmacies should have wheelchair access and that this needed to be achieved within a five year period.  A number of pharmacies are still working to improve wheelchair access and it was expected that all pharmacies would be compliant within the coming year. Any complaints relating to wheelchair users being unable to access pharmacies would go through NHS England and officers had not been made aware of any. Officers noted that signposting was key for those pharmacies that were not as yet compliant so that wheelchair users could find the nearest accessible community pharmacy.

In relation to the specific needs of Black, Asian and Minority Ethnic (BAME) communities, officers stated that there had been no complaints relating to pharmacies, and BAME groups had been included in the consultation on the PNA. During the conversation it was confirmed that Thurrock had five pharmacies that opened one hundred hours a week, most of which were located in supermarkets. The Committee also noted that there were no actual Dispensing Appliance Contractors (who supply appliances such as stoma bags and incontinence aids) in Thurrock, although these services can be accessed outside the borough.

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In response to a question on the previous PNA covering Thurrock, officers stated that the current Thurrock PNA had largely been rewritten on this occasion because guidance had changed so significantly. They added that the accuracy of the Assessment had been reviewed by the Essex Local Pharmaceutical Committee (LPC), which represented all Thurrock community pharmacists.

The Committee, through questioning, also recognised that pharmacies had a role to play in managing obesity and reducing teenage pregnancies.

RESOLVED:  That the report be noted.

The Better Care Fund was a central government initiative to integrate health and social services to provide a more efficient and ultimately better care package for residents.  Thurrock was able to call upon £18 million of funding to provide these services but needed to produce a Better Care Fund Plan to outline how the services would achieve a number of national goals. The key goal was to reduce hospital admissions of people over 65.

The Council had submitted a number of drafts of their plan and had been registered as ‘Approved subject to conditions’. Therefore, they were required to re-submit to gain fully approved status. Officers stated that the process for gaining approval had been very challenging and many councils were facing similar issues. One of the key challenges was to get health service providers to subscribe to the government’s goals of reducing hospital admissions for over 65s by the published amount. A draft had just been re-submitted and officers were hopeful of being approved before Christmas. The Government wanted all councils to be approved before April 2015.

Officers clarified that the drafting and approval process did not eat into any of the potential £18 million funding and the council budgets that were already tied in with these services would continue to be used but with more efficiency and better outcomes.

The Committee discussed a number of financial points and clarified that the funding would sit with the CCG but would only be released if the aims were met. Therefore, there would be no situation whereby the Council or the CCG owed money back to government. It was also clarified that the services identified for integration were operational ones and therefore there was less chance of disagreements over whose budget should be spent on certain services, social or health.

RESOLVED: That the comments above be noted by officers and the report is noted by the committee.

RESOLVED: That the work programme be noted.