Agenda and draft minutes

Health and Wellbeing Overview and Scrutiny Committee - Thursday, 12th January, 2023 7.00 pm

Venue: Committee Room 2, Civic Offices, New Road, Grays, Essex, RM17 6SL.

Contact: Jenny Shade, Senior Democratic Services Officer  Email: Direct.Democracy@thurrock.gov.uk

Media

Items
No. Item

34.

Minutes pdf icon PDF 147 KB

To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 3 November 2022.

Additional documents:

Minutes:

Minutes of the Health and Wellbeing Overview and Scrutiny Committee held on the 3 November 2022 were approved as a correct record.

35.

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. To agree any relevant briefing notes submitted to the Committee.

Additional documents:

Minutes:

There were no urgent items.

36.

Declarations of Interests

Additional documents:

Minutes:

Councillor Ralph declared a non-pecuniary interest in relation to Item 6 as he was Thurrock Council’s Governor to EPUT.

37.

EPUT pdf icon PDF 3 MB

Additional documents:

Minutes:

The following presentation was presented to Members:

 

(Public Pack)Item 6 - EPUT Presentation Agenda Supplement for Health and Wellbeing Overview and Scrutiny Committee, 12/01/2023 19:00 (thurrock.gov.uk)

 

The chair thanked Rita Thakaria, Alex Green and Paul Scott for being here this evening and presenting to members.

 

Councillor Polley thanked officers for the report and referred to Safety First and some of the successes and investments, she referred to the 32% reduction in fixed ligature incidents in 2021/22 and noted that surely the aim would be 100%. Councillor Polley stated there were no figures from previous years to compare this figure against and requested that some further data be provided. Alex Green offered to provide this information outside the meeting and stated that an extension programme of work was in place across all the inpatient environments and being ligature free was difficult in an environment that changed all the time with the focus on the reducing the risk of ligature altogether and therefore the self-harming behaviour. To try and create more therapeutic environments, patient face to face, engaging in conversations and deescalating situations. Within the national benchmarking and in comparison, with other providers they were doing reasonably well.

 

Councillor Polley also referred to the reduction in the data on prone restraint in the presentation and stated this information should be shared with providers as acute behavioural disorders were not necessarily identified to be as acute as they were. Alex Green stated that a lot of work had been undertaken to reduce the number of primary restraints, stated that “no restraint was a good restraint” and why therapeutic time with patients was so important and agreed to share specific data from performance reports around the different types of restraint.

 

Councillor Pothecary stated it was important to know that the fixed ligature was within the national benchmarking and questioned whether this was the same for absconsions and primary restraint. Alex Green stated she would need to check specifically but these were monitored month by month, but the data would include a number of different types of absconsions.

 

Councillor Pothecary then referred to the Channel 4 Dispatches program and questioned whether those people who had been identified in program had been sacked or whether they were still worked within the mental health service. Alex Green stated this was a small number of staff who had now left the organisation.

 

Councillor Ralph stated he appreciated the report being presented this evening, appreciated the work that was being undertaken and acknowledged the work being undertaken to transform the services but had concerns over the use of the social media by patients which were not giving a true representation of the working being undertaken and questioned whether there were any controls that could be put in place. Paul Scott stated this was a national phenomenon, not unique in Essex, which was quite new as social media had been developed. The approach taken was not to stop them but to try and make sure that person was heard  ...  view the full minutes text for item 37.

38.

Integrated Medical Centres Update pdf icon PDF 354 KB

Additional documents:

Minutes:

The following presentation was presented to members:

 

(Public Pack)Item 7 - IMWC and Primary Care Update Agenda Supplement for Health and Wellbeing Overview and Scrutiny Committee, 12/01/2023 19:00 (thurrock.gov.uk)

 

The chair thanked Tiffany Hemmings for the report and questioned when the cardiac treatment, heart failure services would be rolled out on to the Corringham site to which Rita Thakaria stated that all services allocated to the Corringham IMC were now fully functional and operational from last year but agreed to take this question away and confirm outside the meeting.

 

Councillor Ralph raised the issue of staff parking and roads being blocked locally to which Rita Thakaria agreed that a reminder would be sent to all staff of the allocated parking available to them and would raise at the site’s user group. Within a specific period of the opening of the building, an audit of the travel plan would need to be completed to ensure further checks and challenges could be made and that some time would be spent out in the community to understand the needs of parking, community needs and requirements and needs of the nurses.

 

Councillor Ralph referred to the diagnostic centre at the Grays IMC and stated the presentation had indicated that this centre would be the start of the IMC, the IMC was something that had been planned for a long time, the diagnostic centre was a new add-on to the IMC and had new funding. Tiffany Hemmings stated it had a separate funding pot and was an augmentation, but it would be fully integrated within the IMWC and confirmed that the Orsett diagnostics would move into the CDC.

 

Councillor Ralph also referred to the affordability and questioned whether the NHS were still dedicated and committed to the IMC buildings to which Tiffany Hemmings stated there was a commitment to the vision as specified by local Thurrock residents to deliver the integrated medical and wellbeing centre programme. The ability to fund that vision had been affected by national policy with business cases having had to be taken to the NHSE for approval. There had been no control on that pathway, engagement was being undertaken with NHSE but as this was a national issue there was not enough capital to progress onto so many different projects and programs. Once a response had been received this would be fed back to the committee but at this stage Tiffany Hemmings was unable to promise a favourable response. Councillor Ralph challenged this, but Tiffany Hemmings confirmed that NHSE would need to agree to the business cases before any decisions could be made.

 

Councillor Ralph referred to the closure date of Orsett Hospital and questioned whether we would now be on the verge of saying that Orsett Hospital would never close to which Tiffany Hemmings stated there was a commitment to close Orsett Hospital, with the cost of upgrading Orsett Hospital being prohibitive. Members were informed that Orsett Hospital could not be shut until all services had been successfully moved. Councillor  ...  view the full minutes text for item 38.

39.

Self-Care in the Context of Living with Long Term Conditions - A Joint Strategic Needs Assessment pdf icon PDF 114 KB

Additional documents:

Minutes:

The following presentation was presented to members:

 

(Public Pack)Item 8 - Self Care Joint Strategic Needs Assessment Powerpoint Agenda Supplement for Health and Wellbeing Overview and Scrutiny Committee, 12/01/2023 19:00 (thurrock.gov.uk)

 

Councillor Ralph thanked Jo Broadbent for the very detailed report with a lot of helpful information being provided.

 

Councillor Ralph stated the peer support programme had been a great idea which had brought a lot of value to people with the risk of developing long term conditions such as Diabetes to meet up as a group and being able to speak with peers, this was a great benefit and real positive step forward. Referred to cognitive behaviour therapy in that it seemed to not have a positive impact to heart health and referred to page 94 of the agenda felt there was some contradiction as it stated improved mental health but based on no changes to behaviour but was referring to CBT. Jo Broadbent stated that when looking at the terms of evidence around those interventions and impact on behaviour it would be best to look more broadly at impact on a wider range of conditions and for a greater number of people as this was a single relatively small study. In terms of quantifying the impact, in particular around behaviours, it was difficult to measure but the trial had shown some effectiveness.

 

Councillor Ralph referred to page 112 of the agenda “Develop queries to aid GPs with finding the missing thousands (from disease registers) and patients who are on registers” and questioned how long this had been going on for.  Jo Broadbent stated this was the strategy that had been put in place following the Annual Public Health Report in 2016. This year’s Annual Public Health Report, considered at the last meeting, has shown that the rate of diagnosis of conditions such as blood pressure had increased in the intervening years in Thurrock due to the initiatives that had been put in place. Councillor Ralph referred to the missing thousands and to ensure that money was put in the correct places going forward.

 

Councillor Ralph questioned whether the “Brain in Hand” service was a free APP or something was being charged for to which Jo Broadbent stated she would find out and let members know.

 

Councillor Fish agreed the holistic approach would work best for residents and would definitely agree to the recommendations to which Jo Broadbent agreed this needed to be part of the holistic patient centred approach, which would help residents and would make better use of NHS resources and other services. Councillor Ralph agreed the IMCs should be part of the future plan as they demonstrated how well they worked.

 

Councillor Polley asked for an explanation on what Substantiality Transformation Partnership (STP) was to which Jo Broadbent stated the report had been written some 12 months ago, so now the STP was the Mid and South Essex Integrated Care System, the partnership that included the NHS and councils within Southend, Thurrock, and parts of Essex  ...  view the full minutes text for item 39.

40.

Adult Substance Misuse Needs Assessment pdf icon PDF 105 KB

Additional documents:

Minutes:

At 9.15pm, the chair suspended standing orders for the meeting to continue until 10.00pm.

 

At 9.15pm the meeting was paused and restarted at 9.21pm.

 

The following presentation was presented to members:

 

(Public Pack)Item 9 - Adult Substance Misuse Needs Presentation Agenda Supplement for Health and Wellbeing Overview and Scrutiny Committee, 12/01/2023 19:00 (thurrock.gov.uk)

 

Councillor Ralph thanked officers for the brilliant report and commended them on the details within the report as he had been requesting information and data on this subject, especially around alcohol use within Thurrock, for some time. Noting that alcohol could also play on physical health as well as mental health and how manpower and hours off work were being lost through alcohol misuse and questioned whether the focus was only on those that were known about. Philip Gregory stated the service had an educational element promoting healthy activity, what were safe levels of consumption and treatments, and that would be captured by the current services.

 

Councillor Ralph stated the report had been written with the four integrated medical centres in mind and questioned whether a contingency plan would be in place to ensure this service was rolled out into the PCNs. Phillip Gregory stated the service worked well with the concept of moving this to the IMCs would be to improve the service but would depend on the recommissioning process and would await further updates on the IMCs to understand more on what the plans would be.

 

Councillor Ralph referred to page 181 of the agenda and thanked the Police for the work that they had currently carried out within Thurrock.

 

Councillor Ralph referred to page 103 of the agenda where it had identified that teams needed to work together, recognised how each team worked and how important staff training was. 

 

Councillor Ralph also referred to page 202 of the agenda and questioned whether Thurrock had a lead or joint commissioning across mental health services and local public health, alcohol/drugs/tobacco sectors. Phillip Gregory stated that Thurrock did not have this post in place and was one of the recommendations to approve and look at how this could be implemented. 

 

Councillor Pothecary thanked officers for the thorough and detailed report and questioned when the recommissioning of the service took place what the level of involvement of service users would be with that. Councillor Pothecary also referred to the key findings on the success rate of treatment completions with the target met for opiate treatments but stated there were more inconsistency for successful completion rates for other substance types and questioned why this might be. In response to the second question, Phillip Gregory stated this was down to the complexity of cases. An opiate issue could comfortably be dealt with through a clinical model but with a combination of complex issues, treatment would be more difficult to successfully complete. This issue has been discussed at the performance meetings and Public Health were keen to look at to ensure the best possible outcomes. Regarding the first question, service users’  ...  view the full minutes text for item 40.

41.

Active Travel Needs Assessment pdf icon PDF 96 KB

Additional documents:

Minutes:

The following presentation was presented to members:

 

(Public Pack)Item 10 - Active Travel Needs Assessment Presentation Agenda Supplement for Health and Wellbeing Overview and Scrutiny Committee, 12/01/2023 19:00 (thurrock.gov.uk)

 

The Chair thanked officers for the presentation and report which had demonstrated the good working being undertaken. Councillor Ralph referred to the active travel plan and referred to a previous initiative to extend the footpath from Stanford le Hope to Basildon Hospital along the old A13. He referred to the good cycling network in the borough, referred to the school action plan and how important it was to safeguard children and others by installing zebra crossings outside schools.

 

Councillor Pothecary thanked officers for the report and appreciated the work undertaken and what was trying to be achieved and the borough really needed this type of work to be undertaken. Councillor Pothecary referred to section 5.6 of the report, a statutory duty for local authorities, to have Sustainable Modes of Travel Strategy for schools. However, the latest school sustainable modes of travel strategy for Thurrock, which ran from 2015 to 2018, had not currently been updated due to reallocation of transport funding to other areas and consequently there was no strategic guidance in place. Councillor Pothecary stated that schools were perhaps not being given the strategic guidance they needed. She also referred to the proposed cuts to the school bus from St Cleres School for children in East Tilbury and hoped that work was being undertaken with the education department to say this would just not work. Councillor Sammons also commented on the school bus route and how unacceptable it to would be to expect children to have to walk alongside a busy road or across fields to get to school.

 

Councillor Polley stated the report was not inclusive enough with no reference to reduced mobility users, electronic bikes or scooters and mixed abilities of children. Councillor Polley also stated paths should be implemented where there was a desire to have one, consultation with residents was vital to understand where people choose to walk or cycle, and this report had given her the most concerns this evening.

 

Councillor Piccolo agreed Thurrock had good traffic links between Thurrock and Southend and into London, but Thurrock people required a car to travel to places like Brentwood where there were no easy transport links unless you travelled further out and picked up connections. That those connectivity routes needed to be made more accessible.  

 

Councillor Ralph agreed that working with local schools was a must to understand their needs.

 

Councillor Ralph thanked Members for their contribution this evening and officers for the well-presented reports.

 

RESOLVED

 

That the Committee reviewed the needs assessment and the recommendations contained within the report and provided comment.

42.

Report of the Cabinet Member for Adults and Health pdf icon PDF 280 KB

Additional documents:

Minutes:

This item was deferred to the 9 March 2023 committee at the request of the portfolio holder.

43.

Work Programme pdf icon PDF 78 KB

Additional documents:

Minutes:

Members discussed the work programme and agreed to add an Update from EPUT on the work programme for the next municipal year.