Apologies were received for Councillor Rigby, Nicola Cranch and Portfolio Holder- Councillor Hooper.

To approve the minutes of the People Overview and Scrutiny Committee held on the 15 October 2024.

Minutes were approved subject to one amendment. It was requested to add Q2 forecast report was requested to the minutes.

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.

The Chair briefly raised several urgent items of business. Including the delays associated with the transfer of Hassenbrook and Gable Hall to the Mossbourne Federation.

It was raised that parents are still waiting for this transfer to be complete and struggle to get a response from the Federation. The communication is lacking, and the processes are not transparent.

The Executive Director for Childrens Services read a statement from the Federation.

‘Mossbourne Federation is currently working closely with the three ORTU academies. The delay to the formal transfer date has been due to the time it has taken to conclude an external financial audit of the ORTU accounts and to finalise the new Funding Agreement, which the trust must enter as part of the transfer process. The previous Interim CEO of Ortu left at the end of last term. To bridge the gap, the Ortu Federation Board appointed the current CEO of Mossbourne as the interim CEO of the ORTU Federation on 27 August 2024. Mossbourne has also brought in additional senior leadership capacity from within their trust to work across all three ORTU academies, in order to deliver the much-needed School Improvement support, particularly at Hassenbrook and Gable Hall. Mossbourne has invested significant resources into this transfer and remain committed to conclude the formal transfer for 1 January 2025.’

The Chair also raised concerns that were brought up by Healthwatch at the recent Health and Wellbeing Board (HWB) regarding hospital discharges from Basildon Hospital. The Chief Operating Officer (COO) of Health Watch added that patients were being missed due to poor communication and community nurses were not routinely following up all patients. Staff who work in the discharge pathways also raised concerns about patients being missed. The report that went to the HWB was accepted, as it included people and staff lived experiences. It was confirmed that a plan and recommendations were agreed, however unfortunately this is no longer happening. Instead, the Integrated Care Board (ICB) have put a questionnaire in place. The questionnaire is online and has 34 questions in total. This is concerning as the questionnaire will not reaching the right people. People who are more able bodied and have good digital literacy will be able to complete this questionnaire, however those who are elderly may not know where or how to access this.

Members were also informed that Healthwatch are no longer commissioned to do this piece of work. Despite this, they aim to continue this via another project that will include welfare calls to those discharged patients who are most vulnerable. The service has increased and will run from 8am-8pm. Every patient who has been discharged will be included, however the elderly will be prioritised followed by those who have had hip replacements and new mothers.

The Chair suggested it is added to the work programme and members suggested the Chair write a letter to the ICB regarding concerns. The progress will be reported to the Committee in the new municipal year.

A brief verbal  ...  view the full minutes text for item 29.

There were no declarations of interest.

The Executive Director of Childrens Services advised the committee that the Inspection of Local Authority Children’s Services was rated recently rated ‘Outstanding’. The inspection took place between 9 -20 September 2024. It was a robust review with five inspectors who spent time with Social Workers, children, young people, and families. The areas for review included impact of leaders, experience and progress of children who need protection, experience of young people who need care, experience and progress care leavers, and overall effectiveness. Thurrock was rated Outstanding in all areas, with no follow up actions.

The Chair, Portfolio holder for Childrens Services and Members passed on their congratulations to the team.

Recommendations

1.1 That the Committee note Thurrock’s outcome from the Ofsted ILACS and offer their unanimous thanks to all officers and elected members of the council involved in achieving the Outstanding rating.

Recommendations approved.

The Interim Executive Director of Adults and Health presented the item to the committee. Advising that Thurrock are working in partnership with NHS colleagues. Stating that he is new to the role but has some observations including the lack of GPs to cover the population, the uncertainty around the future of Orsett Hospital, the development of the new diagnostic centre, the opening of the Corringham Integrated Medical and Well-Being Centre (IMWCs) as one of the four that were intended and the other three have not been able to progressed. Adding that some progress has been made and one of the four IMWC’s have progressed to deliver the locality teams and proposals have been brought forward for South Ockendon, Tilbury and Grays.

Chief Executive of the Integrated Care Board (ICB) added that they recognise there is significant work to do within general practices within Thurrock. Advising that some of the causes are due to restrictions on capital in recent years. The committee were advised that the NHS allocate 2 million on general practice. This is not sufficient to make strategic investments. It was confirmed that there is a cap on rental reimbursement and the cost of inflation since COVID have increased significantly. They continue to work across the NHS to deliver a strategy that will review all assets in mid-south Essex.

The Chief Executive of the ICB advised the committee that a group has convened to review options to capitalise on from existing estates. Opportunities in primary care have been progressing and opportunities are coming up in Tilbury. They have identified sites and will present a business case. In addition to this there may be able to apply for section.106 for funding from existing routes.

Members queried the cost of re-designing and scoping and what lessons were learned surrounding the delays in the past five years. The Chief Executive of ICB advised he is unaware of the specific numbers but will find out and relay back to the committee. It was confirmed that that the lessons learned were to make sure a good funding route was accessible early in the year, before commit to something that were not confident about. Along with early checks on any future developments. The Associate Director System Programmes added that currently there is no additional costs at this time.

Members queried if there are any concrete timelines of when the IMWC will be completed. The Associate Director System Programmes advised that firm proposals will be completed in two to three months with cosmetic refurbishments to the site to be completed and ready to move in by the end of the financial year.

Members queried what measures have been put in place to ensure they have appropriate funding for projects going forward. The Chief Executive of ICB advised that part of the infrastructure has been developed to review what is affordable over the next three to five years. ICB have a decision-making process group and any proposals will include if it is feasible and affordable and  ...  view the full minutes text for item 32.

The Director of Strategy and Innovation, Mid-South, and Essex Foundation Trust presented the report to the Committee. Advising that the merge started in February 2020 and during that time they were in the first few weeks of the pandemic. Therefore, review of the short-term strategy was required.

The Board have agreed to look at a longer-term plan for the future direction of travel and research has been carried out with staff and communities’ voices included. They have also included the research and outcomes from Healthwatch. This has allowed them to identify four key priority areas. They aim to focus on the community and review the holistic plan and then move on to prevention. Focusing on local communities that can offer the right services and high performing services with improved outcomes.

Members queried the staff engagement as there was no evidence of this provided in the report and wondered what the figures/percentages were of staff that participated in the survey. It was confirmed that they have built on the Healthwatch data to collate their key points and the engagement is consistent, it’s not one survey as it is continuous. In addition to this they spoke with governors who have connections with the community and asked different sets of questions that were consistently developed on. Along with gathering feedback from staff and patients and using every opportunity to bring it all together. The Healthwatch Chief Operating Officer added they have engaged with the Trust and sent over several reports and they continue to actively engage. 

Members queried whether any of the feedback from the consultation surprised them. The Committee were advised that they were partially surprised by some of the feedback however there were conversations that were being had for some time.

Members queried what the operational and financial challenges were. It was confirmed that more partnership work was needed to work closely with local communities. Patients are first and pay a key role in community care. As well as having conversations at strategic and local levels. They also need to empower and help staff to do this.

Members queried when will things be actioned. It was confirmed that the team are implementing changes now and looking at ways to make things more sustainable. Ten years is the timeframe required to achieve everything in the strategy.

The Chair welcomed the report and thanked NHS colleagues for attending the meeting. The Chair reiterated the concerns from members and asked that our NHS colleagues return to committee in six months with a report more focused on Thurrock.

Members noted the report.

The Chief Executive of Integrated Care Board (ICB) presented the briefing note to the Committee. Advising that they recognise there has been a shortage of GP’s. The Committee were advised that the foundations are coming into place and learning operations within the patch. Despite this there is more work to be done.

The Director of Primary Care, Mid and South Essex ICB advised that the ICB have tried to act quickly and have focused on trainee GPs in practices who will eventually be fully qualified. Advising the committee that when GPs are trained many will stay in the area. It was confirmed that they are seeing an upward trend in the program. The Fellowship program is unique to Thurrock as it includes an enhanced offer that is only available in Thurrock. It was confirmed however there have been funding challenges which has put this on hold. The ICB will review how to get local funding to make the Fellowship programme available again.

In addition to this they are creating new roles to general practice that support the primary care force. They provide a function however they are not a replacement. Members were advised they will revisit the fellowship in the new financial year.

Members queried the use of language in the media regarding the GP shortages. The media used the terminology ‘physician’ members sought clarity on whether these are these doctors. It was confirmed they are trainees taking out health checks, not replacements for GPs.

The Vice-Chair advised that previously GPs were not attracted to Thurrock and what they were doing to address this. It was confirmed they were looking at the training route rather than competitive pay. The Vice-Chair queried out of the 12 GP fellowships how many were still in post. It was confirmed that 5 GPs were still in post.

Members questioned how long trainees stay in post. It was confirmed that the fellowship is two years. The Trainee scheme lasts for three years, then practice train them to retain staff.

Members queried whether they attract potential trainees from London hospitals It was confirmed that they have been boosted by Anglia Ruskin University to recruit trainees. In addition to this they link in with schemes in London and beyond. They have a good network that exists in terms of recruitment.

Member queried whether things were improving in terms of increasing the amount of GP Surgeries. It was confirmed thatgeneral practices are facing challenges as is the NHS. Unless they can see a sustainable amount of income they can’t commit long term. It is a challenging position, and they are working alongside practices to improve and provide confidence.

The Chair stated there is a considerable opportunity to make use of s106 funding and NHS colleagues should be more adventurous, think outside the box and be more cohesive. Advising there is an opportunity to look at Thurrock as a place of opportunity.

The Overview and Scrutiny Officer advised that the CQC inspectionwould be removed from the December Work Programme. This was confirmed by the Interim Executive Director for Adults and Health that CQC inspection adult social care report has not commenced as the inspection has not been carried out. Members were advised that a self-assessment is being carried out in preparation for the inspection and it will most likely happen early summer.

Members stated that Youth Cabinet used to be a standing item on the agenda. The Chair agreed this should be added to the work programme.

Thurrock Coalition Manager advised that they reconvened in July. Autism was brought up in the reviewing strategy and an update on this will come to the committee.