Agenda and minutes

Health and Wellbeing Overview and Scrutiny Committee - Thursday, 5th September, 2019 7.00 pm

Venue: Committee Room 1, Civic Offices, New Road, Grays, Essex, RM17 6SL. View directions

Contact: Jenny Shade, Senior Democratic Services Officer  Email:

No. Item


Minutes pdf icon PDF 88 KB

To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 13 June 2019.


Councillor Muldowney requested that the comments made on page 11, paragraph 6 of the agenda to be amended to read:


Councillor Muldowney referred back to Dr Google and stated her concerns based on the reading of the subject and Officers saying that there had been varying results from the trials they were doing around digital about how much better some of these APPS are at the moment. Councillor Muldowney stated that personally she thought the one that had been taken on board nationally probably should not had been rolled out yet to live patients and should still be in beta testing as she did not think it had been properly developed enough. So this was her concern at this level that we are not falsely reassuring people who may have something more serious but would not necessarily get picked up. Councillor Muldowney stated that this was one of the concerns but also the accuracy and the actual fit for purpose of whatever we are using I just want to make sure that it was really robust.


Following this amendment, the Minutes of the Health and Wellbeing Overview and Scrutiny Committee held on the 13 June 2019 were approved as a correct record.


Urgent Items

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.


No urgent items were raised.


Declarations of Interests


No interests were declared.




Kim James, Healthwatch, updated Members on a piece of work that would be commencing in October which would focus on dementia care within residential homes, nursing homes and into specialist wards in hospitals and will end with an event in February 2020 for the Dignity in Care Week. Healthwatch would be interested to hear any feedback or views of Members. Mandy Ansell requested that Healthwatch linked in with the Nursing and Quality Teams at the Clinical Care Commissioning and the Chair stated she looked forward to hearing an update at a future committee.



The Chair announced that the order of the agenda would be changed to hear Item 11 first.


Reduction of Thurrock Clinical Commissioning Group Budget 2019-20 and wider NHS England proposals to merge five Clinical Commissioning Groups across the Mid and South Essex STP geographical footprint pdf icon PDF 154 KB

Additional documents:


The Chair welcomed Wayne Bartlett-Syree, Director of Strategic Transformation/Locality Director, NHS England, to the meeting and explained how difficult it had been to get someone from NHS England to attend this evening. The items discussed under this item would be:


           £490K funding taken from Thurrock Clinical Commissioning Group to Cambridgeshire and Peterborough STP

           The proposal for a single Clinical Commissioning Group Accountable Officer

           The merger of the five Clinical Commissioning Groups


Wayne Bartlett-Syree introduced himself and provided Members with an overview of his broad background.


Wayne Bartlett-Syree stated that money was interesting in the NHS and had always been a significant challenge and recognised and had sympathy for local authorities on the challenges that they faced. How monies worked in the NHS was that it would be passed from Government through the Treasury to the Department of Health and Social Care and onto Clinical Commissioning Groups. The majority of that money would go to NHS England who had a strategic responsibility to balance their books which meant that commissioners and providers across the country had to be in a position where the money balanced but the accountability would sit with the Secretary of State and also Simon Stevens now the Joint Chief Executive between NHS and NHSE. There were Trusts and Clinical Commissioning Groups that run surpluses and deficits and what the National Director of Finance would like at the end of the year for deficits and surpluses all to total back to a net zero position but as years had gone by this had become increasingly more challenging where money had been asked from systems or monies been moved from systems to ensure that net zero. For 2019/20, rather than this to take place at national level, regions were asked to balance within NHS England. Currently within the East of England there was a significant gap when coming to the planning element and that gap existed in Cambridgeshire and Peterborough of around £70 million. The approach taken in the East of England was that a contingency reserve could be deployed, this would be a large ask for Cambridgeshire and Peterborough in regard to their savings plan. The said ask for the five STPs with a contribution of £5m each into that deficit in order to balance the books.


Councillor Rigby arrived into the Committee Room at 7.13pm.


Wayne Bartlett-Syree moved onto the mergers of the Clinical Commissioning Group that the long term plan set out the commitment to ICSs over the next four years and the move would mean that each ICS would be covered by one Clinical Commissioning Group. That all regions had written out to their Clinical Commissioning Groups in line with the long term plan. That the first draft is expected by September 2019 asking about each Clinical Commissioning Group were thinking on this and what their expected timelines would be for this merger. Some Clinical Commissioning Groups were further on and looking to merge, some had merged and some were yet to  ...  view the full minutes text for item 13.


2018/19 Annual Complaints and Representations Report - Adult Social Care pdf icon PDF 63 KB

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Roger Harris, Corporate Director of Adults, Housing and Health, presented the report on the operation of the Adult Social Care Complaints Procedure covering the period 1 April 2018 to the 31 March 2019 and updated Members on the representations included in this statutory annual report. Roger Harris referred Members to the Appendix which summarised the representations received for this period.


The Chair noted the consistency of representations when compared to those from 2017/18.


Ian Evans, Thurrock Coalition, questioned how learning and outcomes were cascaded and embedded. Roger Harris stated it depended on the nature of the complaint and that the appropriate action would be taken with complaints being taken very seriously.


Councillor Muldowney congratulated Officers on the larger number of compliments compared to the number of complaints. Roger Harris welcomed the compliments but stated he had concerns that residents still felt that services would be taken away if they made complaints. That residents should be encouraged to put their concerns forward even if these were anonymous or through a third-party.


Kim James stated that Healthwatch receive calls about services but those residents are reluctant to make an official complaint as they were afraid they would lose their services. That Healthwatch did monitor and look for any trends in services and support those in need of help and that regularly meetings are held with Roger Harris.


The Chair stated that it was sad to hear that residents were too nervous to share their concerns and questioned whether concerns received could be unofficially tracked and could monitor those pre-complaints and provide a more realistic figure. Roger Harris stated that concerns raised are registered but not as a formal complaints process.




That the Health and Wellbeing Overview and Scrutiny Committee considered and noted the report.


Whole Systems Obesity Strategy Delivery and Outcomes Framework pdf icon PDF 249 KB

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Helen Forster, Strategic Lead Place Environment and Community, presented the report to Members and explained that the Whole Obesity Strategy had been developed as the driver for preventing and reducing obesity in Thurrock. The Delivery Framework which accompanied the strategy would continue to be developed as a result of a number of engagement activities and in collaboration with a range of key stakeholders and detailed the specific actions that set out how the strategy could be achieved. Helen Forster stated that a lot of work was already going on and this was an exciting time to embrace the further recommendations with Members being reminded that the Delivery Framework was a dynamic document and would evolve.  She welcomed comments and questions.


The Chair thanked Public Health for another excellent report.


Councillor Ralph asked who the community champions were. Helen Forster stated there were a number of people who attended and were invited to the ‘Citizens Panel’ which included Kristina Jackson from Thurrock CVS, Residents and Sericc to name a few.  Helen was happy to discuss the ‘Citizens Panel’ membership outside of the meeting.


Councillor Ralph stated the report detailed lots of activities but did not focus on what was already there in the borough and what green spaces were already being used. Helen Forster thanked Councillor Ralph for his comment and agreed that a lot of work had been undertaken and the work would continue to grow.  She emphasised again the delivery framework was a working document and welcomed further input from members going forward.


Councillor Muldowney questioned the two figures for overweight and obese adults in paragraph 2.3 of the report compared to the figure shown in Figure 1 of 4.1. Helen Forster stated they were both correct as there had been a change in the way the data was recorded.


The Chair questioned whether it was the level of BMI that identified obesity. Ian Wake, Director of Public Health, stated it was the measure in identifying people who are overweight and obese.


Councillor Ralph stated had consideration had taken place to reduce the number of take away shops in the borough. Helen Forster stated that the Public Health team were working with Planning and Regeneration about how to tackle this issue and further consideration on this would be featured throughout the delivery framework.


Kim James, Healthwatch, stated that the exercise referral programme for those residents with mental health concerns or a long term condition required a form to be signed by their general practitioner before they were allowed to use a gym. Unfortunately some general practitioners were charging for this letter, some up to £80, and questioned was it not for general practitioners to support their patients and not to make money.


The Chair questioned what could be done about this. Rahul Chaudhari, Director of Primary Care, stated that general practitioners need to take responsibility for their patients otherwise those patients would be returning back to their general practitioner with health issues. Contact would be made with the general  ...  view the full minutes text for item 15.


24-7 Mental Health Emergency Response and Crisis Care Service pdf icon PDF 105 KB

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Mark Tebbs, Director Mental Health Commissioning, Mid and South Essex Sustainability and Transformation Plan provided Members with a progress update on the third phase of the Mid and South Essex Sustainability and Transformation Plan Urgent and Emergency Care Mental Health programme. Members were referred to Appendix 1, the 24/7 Mental Health Emergency Response and Crisis Care where Mark Tebbs took Members through the response pathway, the project implementation structure and the key milestone with the go live date of the service being 1 April 2020.


Nigel Leonard, Executive Director of Strategy & Transformation, Essex Partnership University NHS, stated that this was an exciting project working with the Clinical Commissioning Group with the models being driven by clinicians, primary care and the trust. Members were reassured that job vacancies were being advertised imminently and any financial risk cost by staffing starting early would be met. Recruitment remained a challenge with a strategy in place which would entail working alongside universities.


Councillor Ralph commended Officers on the report and stated that the street triage was brilliant but questioned whether the service was available to different age ranges. Mark Tebbs clarified there is separate work being undertaken to develop a 24/7 crisis offer for Children and Young People. Jane Itangata, Associate Director Mental Health Commissioning, stated that work had been undertaken with Children Services to ensure the interface worked.


Councillor Ralph questioned whether the street triage was easily accessible to the Police. Mark Tebbs asked for details of the issues raised by Councillor Ralph. Mark Tebbs stated that he shared the same aspirations that crisis care needs to be easily available to take pressure off the accident and emergency assessment service. He confirmed that the crisis café will also provide a service for high intensity users so that they can be supported in a pro-active way and would provide follow ups.


Councillor Muldowney thanked Officers for the report and the fantastic service and although the service had been delayed due to funding reduction it was great that it was now going ahead. Councillor Muldowney questioned whether there had been any aspirations to increase the hours over time. Jane Itangata stated that the home treatment service will change from 8.00am to 8.00pm to a 24/7 response service.


The Chair echoed Members comments with the service being needed for some time and work towards this has been undergoing for some time. The Chair spoke highly of the positives of this report and thanked all those that had been involved.




That the Health and Wellbeing Overview and Scrutiny Committee noted the progress made in the development of a responsive 24-7 Mental Health Emergency Response and Crisis Care service that will be available via 111 to anyone in a mental health crisis.


Primary Care Networks pdf icon PDF 201 KB

Additional documents:


Rahul Chaudhari, Director of Primary Care, Clinical Commissioning Group, provided Members with an update on the Primary Care Networks and how these were impacting on Thurrock. That the report was a good initiative with the change being welcomed amongst general practices. The update included how the networks would help address workforce shortages in general practices and focus on improving primary and community services to get residents healthy and to look at the proposals on the range of clinical priorities. Rahul Chaudhari updated Members on the additional roles under the Primary Care Networks and the financial entitlements and how funding would be allocated to support the employment of additional staff. The Thurrock Primary Care Network profile was explained against the requirements for the Stanford Le Hope and Corringham, Tilbury and Chadwell, Grays and Aveley, South Ockendon and Purfleet Primary Care Networks.


The Chair thanked Rahul Chaudhari for the report and how important it was that the report was brought back to committee with the focus on Thurrock. The Chair requested that an update report be brought back to committee in March 2020 which would allow time for this transformative service to have ran.


Councillor Muldowney thanked Rahul Chaudhari for the report, for his enthusiasm and that the local detail helped.


Councillor Muldowney had concerns on artificial intelligence and requested more detail. Rahul Chaudhari stated that e-consult shared the same concerns and that IT should be used to better effect. With every Clinical Commissioning Group using e-consult triage service to enter details to navigate to the right person or outside practices. That one single product should be available for all Clinical Commissioning Groups to use and for development to find what this produce should look like and then carry out impact assessments.


Councillor Muldowney requested some information on how the Primary Care Network in Chadwell and Tilbury had been performing. Rahul Chaudhari stated that the centre had only been seeing patients on a daily basis for the last three to four months and requested more time to evaluate the effectiveness and would provide further information following that evaluation.


Councillor Ralph asked if two health centres in Tilbury and Chadwell would both be expected to open 24/7. Rahul Chaudhari stated that not both would need to be open 24/7 as long patients had access. With patients being able to access any Primary Care Network but funding would follow with that patient.




That the Health and Wellbeing Overview and Scrutiny Committee noted the update.


Mid & South Essex Health & Care Partnership Update pdf icon PDF 108 KB


Roger Harris, Corporate Director of Adults, Housing and Health, provided Members with an update on the work of the Mid and South Essex Sustainability and Transformation Plan. That following the decision of the referral to the Secretary of State of Health and Social Care the concerns relating to the proposal to close Orsett Hospital and the movement of services to the planned Integrated Medical Centres. Following the advice from the Independent Reconfiguration Panel to the Secretary of State it had now been concluded that in relation to services at Orsett Hospital until new services are in place, the proposals should proceed.


Mandy Ansell, Accountable Officer, Clinical Commissioning Group, stated that the Peoples Panel was still on going and that a meeting had been arranged for next week to meet with the new independent chair of the Mid and South Essex Sustainability and Transformation Partnership, Michael Thorn..


Kim James, Healthwatch, stated the Peoples Panel had now reconvened with Tom Abell the Deputy Chief Executive and Chief Transformation Officer, Basildon & Thurrock Hospital Trust attending their meeting. That the Peoples Panel had requested a list of all services in Orsett Hospital and who provided those services. That “champions” were being sought in those areas so they could provide a patient experience/blog to residents. That Ian Wake, Director of Public Health, would be invited to the Peoples Panel to talk about the future plans of the Integrated Medical Centres.


The Chair stated it was still important to scrutinise the decisions being made for Orsett Hospital and the Orsett Hospital Task and Finish Group would going forward ensure services are managed better. The Chair agreed that the understandings from the feedback provided from the Peoples Panel was important and requested that the item be monitored and progress on the Integrated Medical Centres be brought back.




That the Health and Wellbeing Overview and Scrutiny Committee noted the report.


Work Programme pdf icon PDF 56 KB


Members agreed to add the following items onto the work programme for 2019/20 municipal year.


·         Update on the Library Peer Review be added to the 7 November 2019 committee.

·         Whole Obesity Strategy be brought back to the 5 March 2020 committee.

·         Primary Care Networks be brought back to the 5 March 2020 committee.