To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 13 January 2015.

The Minutes of the Health and Wellbeing Overview and Scrutiny Committee, held on 13 January 2015, were approved as a correct record.

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972.

There were no urgent items of business.

Councillor Gupta declared a non-pecuniary interest in respect of Agenda Item 6, Adult Social Care Local Account 2014, as he was a carer.

Councillor Curtis declared a non-pecuniary interest in respect of Agenda Item 6, Adult Social Care Local Account 2014, as his daughter was employed in Adult Social Care.

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

The Chief Operating Officer of Healthwatch Thurrock provided an update to the Committee on the following key points:

·         That there had recently been a number of changes to the HealthWatch project in Thurrock, and the board was now overseen by Thurrock CVS with a new advisory Committee to be created to support the CVS Board.

·         That a number of concerns had been raised from a recent preliminarily information gathering exercise by the Care Quality Commission (CQC) in preparation of its inspection of GP’s surgeries. It was explained that the findings had been misreported in the press and clarified that this had been an information gathering exercise and not the inspection itself.

·         In response an event was scheduled for 23 February 2015, and the CQC Area Inspector for Primary Care invited to attend, to explain how the inspection will take place, what the findings could be, how this would be reported and what this meant for individual GP’s and patients of the surgeries. NHS England were also due to attend the event to explain what would happen if there were any difficult findings.

·         That concerns had also been raised about the proposed changes to the Walk-In centre, and a petition was currently underway, however this was not being led by HealthWatch.

Councillor Gupta questioned how many GP’s surgeries would be inspected, to which the Chief Operating Officer of Healthwatch explained that approximately 25% of Thurrock surgeries would be inspected which was due to start in July 2015. Members were advised that preliminarily work had begun and patient participation groups had been contacted.

The Chair proposed that item 7, ‘Air Quality, Regeneration and Health’ be brought forward on the agenda for discussion, to which Members agreed.

The Interim Consultant for Public Health provided a detailed introduction and presentation of the report, which provided an overview of the multiple sources and types of air pollution, in addition to the associated acute and chronic health effects from exposure.

A Member observed that air pollution had been an issue for some time and felt that it was difficult to implement a solution. He felt that schools had improved numbers of children walking or cycling to school, but that it was difficult to measure any significant impact of Public Health or Local Authority initiatives.

In response it was explained that air pollution had been prioritised in recent years and the Public Health Framework and Indicators had improved, however it was thought further work was required to join up action undertaken across Local Authorities.

Councillor Key questioned the Interim Consultant for Public Health and received responses on the following matters:

·         Whether the type of particulate matter was more important that the mass or level of matter.

It was explained a number of variables affected health of individuals and communities, and that length and the volume of exposure were particularly important.

·         In reference to the opportunities to increase impact for health, he observed that Thurrock had high levels of exposure due to the fact that the Borough had the biggest economy in East Anglia and Essex. However he recognised that most of the opportunities identified targeted individual people rather than businesses and questioned whether these were aimed at the wrong target audience.

Officers agreed that a balance needed to be achieved with Thurrock’s growing economy. The Director of Adults, Health and Commissioning explained that a link needed to be established with the planning process, business board and local employers to both attract businesses and control emissions in the Borough.

·         He asked whether any schools were located within Air Quality Management Areas (AQMA).

The Committee were advised that there were a number of Air Quality Management Areas in Thurrock, which did encompass some schools.

·         If particulate matter pollution was easily measurable as a Key Performance Indicator (KPI).

Members were advised that there was an indicator for particulate matter and so it was easily measurable.

Councillor Snell questioned whether it was counter-productive to slow traffic down in attempt to reduce pollution, as it would make journeys slower and longer. In response it was explained that slow and steady journeys through traffic calming measures were better in order to reduce pollution levels.

Councillor Brookes asked whether it was possible to measure and compare pollution in different parts of the Borough, to which it was explained that officers continued to monitor pollution across the Borough.

A brief discussion took place in response to Members concerns about health inequalities between different wards in the Borough due to varying pollution exposure levels. Officers explained that Thurrock was doing good work but it was proposed an officer working group be established to examine where the local authority should concentrate its efforts in order to achieve the greatest impact.

The  ...  view the full minutes text for item 37.

The Director of Adults, Health and Commissioning introduced the report which outlined the performance of Adult Social Care and the progress that had been made in delivering the key priorities and actions from the 2012/13 local account. The following key facts and figures were highlighted:

·         The net budget of Adult Social Care was £43.7 million but the gross was in excess of £50 million. The difference was accounted for by fees and charges and NHS contributions to Adult Social Care.

·         That over 2000 adults and older people received Adult Social Care services.

·         Over 1030 people received a personal budget or direct payment.

·         The service was focussed on prevention and supporting communities, through the work of Local Area Coordinators, Extra Care Housing and the Telecare Service over 250 people had been enabled to live independently.

·         That the £43.7 million Adult Social Care budget was approximately 20% of the overall total budget of the Council, which meant that Thurrock was a low spend authority as the National Average was 26%.

·         That the legislation had changed, with the introduction of the Care Act 2014, Duty to Promote Wellbeing, and further changes to Adult Social Care funding were expected for April 2016.

The Director of Adults, Health and Commissioning explained that a new system called Quickheart had been introduced, and it was expected that a demonstration would be provided to the Committee in the new municipal year.

Members asked how recent budget cuts had impacted on the service, in recognition of the fact that Thurrock’s budget was smaller every year and was already less than that of the national average. In response the Director of Adults, Health and Commissioning advised that:

·         Income had been increased and full-cost recovery obtained to maintain services, such as the increase in the cost of homecare from £10.50 a day to full cost-recovery of £13.00 per hour.

·         The service had been successful in securing money from the NHS so that service levels did not have to be reduced.

·         Eligibility Criteria had been re-examined so that care was now delivered to only those with substantial or critical care needs.

In addition, the Director of Adults, Health and Commissioning advised some packages of care were no longer affordable, and although there was no easy answer, the service examined every opportunity for external funding sources.  He proposed that a further report be referred back to the Committee to examine how this could be improved in future.

There was a brief discussion on the importance of intervention to prevent cases from escalating, which in turn saved the service considerable money. The Director of Public Health added that the Public Health Report would detail further information about primary prevention.

Councillor Snell observed that the Key Performance Indicator (KPI) for the percentage of people who used the service who had control over their daily life had been interchangeable over the reporting period, and question why this was. In response the Director of Adults, Health and Commissioning explained that a third of service users were sampled  ...  view the full minutes text for item 38.

The Director of Adults, Health and Commissioning informed Members that the Annual Public Health Report should be referred to Committee in March. He advised that he would liaise with Democratic Services and the Chair and Vice-Chair of the Committee regarding other items for inclusion on the agenda.

RESOLVED: That the Annual Public Health Report be added to the work programme for 31 March 2015.