Members will be asked to make any declarations of interest in respect of items on this agenda.

There were no declarations of interest in accordance with the code of conduct.

To agree the minutes of the following meetings Your Plymouth on 14 December 2015, Ambitious Plymouth on 1 February 2016, Caring Plymouth on 17 March 2016 and Wellbeing Overview and Scrutiny on 20 July 2016

The minutes of the meetings of;

a)    Your Plymouth on 14 December 2016

b)    Ambitious Plymouth on 1 February 2016

c)    Caring Plymouth on 17 March 2016

Were agreed as a true and accurate record.

The minutes of the meeting of the Wellbeing Overview and Scrutiny Committee of 20 July 2016 were agreed as an accurate record, however, Cllr McDonald queried whether a request she had made regarding the redistribution of non-domestic rates had been responded to. It was agreed that the webcast for the previous meeting would be checked.  

To receive reports which, in the opinion of the Chair, should be brought forwardfor Urgent consideration.

Following discussions around the Sustainable Transformation Plan and proposed new models of care, Chair and Vice Chair had been in discussion with colleagues in Devon and Torbay and would report their findings back to the Committee towards the end of the year.

Chair had proposed a Select Committee Review into GP services in Plymouth. Membership was confirmed and the meeting would take place on 6 October 2016.

The Committee will be asked to consider and approve the Work Programme and give consideration to the prioritising tool attached.

The Select Committee review on 6 October was added to the work programme.

The Wellbeing Overview and Scrutiny Committee will monitor the progress of its previous decisions.

The decision had been made to combine the tracking of decisions from both scrutiny committees so that each knows the issues the other is considering and any crossover can be identified. Those items that were greyed out were considered complete.

Members of both committees would receive an updated version of the risk register with larger print in due course.

The Committee will receive a report on the Integrated Fund.

The Committee received the Integrated Fund Monitoring Report, introduced by Councillor Mrs Bowyer and presented by David Northey(Plymouth City Council), Carole Burgoyne (Plymouth City Council), Craig McArdle (Plymouth City Council) and Jerry Clough(New Devon CCG) (as attached);

The Committee heard that;

a)    NHS finances were under pressure in all areas. The intent of the integrated fund was to encourage greater collaboration between NHS organisations by setting a control total across all of those organisations rather than a total for each individual organisation. The CCG was working with all of its providers on a joint forecast outturn position;

b)    the decision nationally to change the funding rate for free nursing care had increased cost pressures, there were a number of other cost pressures that could emerge, mitigating actions were in place to offset these pressures;

c)    the system control total for the CCG was not yet set. Although this was an irritant it was not having any detrimental operational effect. The issue was between NHS England and NHS Improvement who needed to agree how the control total was apportioned between them;

d)    a break even position was forecast for the end of the year;

e)    savings of around £25 million were required to be made this year;

f)     there was continued overheating in Children’s placements and adult social care. The department needed to deliver savings of £9.2 million while managing budget pressures of £1.6 million. It was expected that these savings that these savings would be achieved and that the budget pressures were manageable;

g)    it was hard to forecast the volume of pressure on the service but more sophisticated modelling meant this was improving. A number of initiatives were underway to offset the cost pressures of increasing volumes of work and being a part of the Integrated Fund assisted in meeting demand.

In response to questioning the Committee heard that;

a)    payments for commissioned services would not be capped if they are over performing although the rate of pay for visits may change depending on the level of over performance;

b)    the cost of home to school transport had increased following re-tendering but the department was confident that it was able to cover the increased cost pressure that resulted. This service was under constant review;

c)    the £5 million contingency fund held by the CCG had been used up relieving the pressure caused by the new expectation to provide free nursing care. There was no further contingency available to offset additional pressures should they arise this financial year;

d)    it was difficult to pinpoint the reasons that use of minor injuries services was rising. One reason could be pressure on primary care but this would not be the only reason.

The Committee agreed the following recommendations;

a)    a briefing and training session for members of the committee on NHS financing would be provided;

b)    a briefing on guardianship would be provided for members of the committee via email;

c)    figures for the full year cost of the school transport service  ...  view the full minutes text for item 14.

The Committee will receive a report in respect of the Integrated Commissioning Scorecard.

The Committee received the Integrated Commissioning Scorecard (as attached) introduced by Councillor Mrs Bowyer and presented by Craig McArdle (Plymouth City Council), Rob Sowden(Plymouth City Council) , Dave Spencer(NEW Devon CCG), Jerry Clough (NEW Devon CCG) and  Ruth Harrell (Plymouth City Council).

In response to questioning the Committee heard that;

a)    the purpose of the drive to increase the diagnoses rate for dementia was to meet the expected level of prevalence for a population;

b)    a comprehensive programme of sexual health education formed part of the core work of Public Health to aid in the prevention and detection of sexually transmitted diseases;

c)    a range of measures were underway to reduce referral to treatment waiting times including the use of private sector capacity and improving test reporting;

d)    campaigns to increase carer’s awareness of how to access services were ongoing and their efficacy was being tracked through the Carer’s Strategic Partnership Board. Carers surveys were carried out every 2 years. The next cohort of carers were currently being identified and would be surveyed at the end of the year, the results of that survey would be ready next spring;

e)    the befriending service within the city had been strengthened to try to combat social isolation. It was impossible to say how much of a factor social isolation was in the reported low happiness scores for the Poulation in Plymouth;

f)     the information in relation to low happiness was collected nationally, however, there was locally collected data which enabled targeted projects such as Thrive Plymouth;

g)    alcohol related admissions have fallen in line with a national trend and as a result of an effort to improve joined up working across a number of disciplines;

h)    the integrated approach has enabled issues to be highlighted that may otherwise not have been apparent.

The Committee agreed the following recommendation;

• national indicators relating to the happiness score would be removed from the data  a local mechanism for providing that data would be developed.

The Committee will receive a report in respect of the Welcoming City Action Plan.

The Committee received the Welcoming City Action Plan (as attached) presented by Councillor Downie, Superintendent David Thorne (Devon and Cornwall Police), Peter Aley (Plymouth City Council)

In response to questioning the Committee heard that;

a)    a number of indicators had been identified to monitor the success of the plan however it was felt that the qualitative data was also very important;

a)    the intention of the plan was to encourage more collaborative working between organisations and the community. A lot of strong links were being established with previously hard to reach groups. A high degree of collaboration would also mean effective use of resources.  A new Community Connections Service had been set up to work closely with neighbourhood police, schools and social inclusion and aid integration;

b)    small community grants were now reaching a broader range of communities. A list of grants made would be made available on the Plymouth City Council website;

c)    a peer review would be one of the methods used to measure success. Voluntary sector coordinators would be invited to form part of the working group.

The Committee agreed the following recommendations;

a)    to receive an update on the action plan post February 2017;

b)    members would be provided with a list of small budgets issued to diverse groups via email;

c)    members would be provided with guidance on the “Members Room” for the third party reporting of hate crime.

The Committee will receive a report in relation to Special Educational Needs and Disability and the progress towards the ambition set out in the Integrated Children and Young People’s Commissioning Strategy.

The Committee received a report on Special Educational Needs and Disability (as attached) introduced by Councillor Mrs Beer and presented by Jo Siney (Plymouth City Council), Carole Burgoyne (Plymouth City Council) and Craig McArdle (Plymouth City Council);

In response to questioning the committee heard that;

a)    the intention was to work towards a single delivery service by integrating commissioning and delivery;

b)    the NEW Devon CCG had aligned their contracts to expire simultaneously in March 2017, allowing a full strategic review of review of future commissioning for the SEND services;

c)    a technical working group was working to redesign areas of SEND provision in particular speech and language;

d)    post 16 SEND provision remained a priority as it had been for the past 10 years, working to raise aspiration in young people with SEND to maximise independence and promote employability.

e)    focussed work with Livewell Southwest around commissioning for the  CAHMS service was ongoing. Funding had been received from the National CAHMS Enhancement as well as funding commitments that had been received from local schools. As of this September the CAHMS offer would be greatly enhanced with 500 additional counselling sessions available to schools, additional counselling for staff at The Zone, an online counselling scheme and an additional 26 workers across the CAHMS Service. This improved offer was made possible by the new integrated approach.

The Committee agreed the following recommendation;

a)    the Committee would receive an update on SEND services at the end of the municipal year.