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

There were no declarations of interest made by Members in accordance with the Code of Conduct.

To confirm the minutes of the meeting held on 21September 2016.

The minutes of the meeting of 21 September 2016 were agreed as a true and accurate record.

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

There were no items of Chair’s urgent business.

The Committee will receive the Sustainability and Transformation Plan.

The Committee received a presentation on the Sustainability and Transformation Plan (attached), presented by; Phil Hughes (Medical Director and Chair of the Clinical Cabinet for the Sustainable Transformation Plan), Tracey Lee (Chief Executive, Plymouth City Council), Craig McArdle (Director for Integrated Commissioning, NEW Devon CCG and Plymouth City Council), Angela Peddar (Lead Chief Executive of the Sustainability and Transformation Plan and Your Future Care) and Steve Waite (Chief Executive, Livewell Southwest);

In response to questioning the Committee heard that;

a)    the Southwest footprint had been identified as one of 11 sites to pilot the associate nurse programme.  Considerable work was being undertaken to encourage young people to consider a career in healthcare and to advance the careers of those already in the industry to maximise resources;

b)    the Sustainability and Transformation Plan was aimed to support work already going on in the patch. Although change was inevitable it should not destabilise the system. The funding situation was improved by the Integrated Fund;

c)    GP and primary care was a recognised local priority;

d)    the Urgent Care Plan is based around preventing admissions, shortening admissions and preventing elective care patients blocking beds. The Discharge to Assess model was one way to achieve this and needed to be scaled up;

e)    the public have been consulted on individual aspects of the plan but may not have seen it in its current format. None of the proposals within the plan would be new to the public. The intention was for consultation to be more engaging and accessible in future;

f)     although nationally there is no rapid move towards adopting capitation budgets this is being considered locally;

It was agreed that:

1.         That this Panel echoes what was agreed at Full Council for a full written agreement to be built into the STP Operational Plan to achieve resource equity, and for the STP Operational Plan is be considered by this Panel at the appropriate time.

2.         That place based approach to Health and Wellbeing to be accelerated and a capitation from budgets be established

3.         Any changes to Acute Services to be considered by this Panel at the appropriate time.

4.         All Members to receive a presentation on STP.

The Committee will receive the Integrated Commissioning Scorecard.

The Committee receive the Integrated Performance Scorecard (attached) presented by Sarah Lees (Consultant in Public Health, Plymouth City Council), Andrew Loton (Performance and Research Officer, Plymouth City Council), Craig McArdle (Director for Integrated Commissioning, NEW Devon CCG and Plymouth City Council), Rob Sowden (Performance and Research Officer, Plymouth City Council)  and David Spencer (Plymouth Hospitals NHS Trust);

The Panel heard that;

a)    in some areas figures were improving but were still RAG rated red. This was because they were being measured against the England benchmark. For instance the figures for children in care are above the England average but in line with statistical neighbours.

b)    the apparent decline in breast feeding rates could be explained by a change in the way it was reported.

The Panel agreed that Homelessness should be added as an indicator to the Integrated Performance Scorecard and to invite an officer to speak on this item at the next meeting of the Panel.

The Committee will receive the Integrated Fund Monitoring Report.

The Committee received the Integrated Fund Monitoring Report (attached) presented by Ben Chilcott (NHS England), Craig McArdle (Director for Integrated Commissioning, NEW Devon CCG and Plymouth City Council) and David Northey (Head of Integrated Finance);

The Committee heard that;

a)    The budget savings seen in Housing Services had been achieved via transformation. Many of the variable costs associated with homelessness such as B&B or hostel payments sat outside of the Housing Services budget and so those cost savings would stand regardless of the level of homelessness in the city;

b)    Payments for placements caused the greatest pressure on the Children, Young People and Families budget and this continued to be a challenging area.

c)    The NHS and Livewell Southwest were working together to drive down the  cost of expensive packages of care provided outside the city. The intention is to manage these cases in a different way, bringing them closer to home and making services such as mental health care more accessible.

d)    The total budget of the Integrated fund is around £1 billion, of this around £5 million is set aside as a contingency.

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

Ross Jago raised that he had not yet completed minute 14 on page 74 and indicated that he would attend to this as soon as possible.

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

The Chair brought NHS England’s response to the Select Committee Review in to GP Services to the attention of the Committee. The working Group had requested further information from NHS England. The Chair indicated that she would be writing to the Secretary of State and requested that any members who had evidence from constituents that would support the Committee’s position should submit it to her.

Ross Jago highlighted that the following items would be added to the January meeting:

·         Livewell CQC Report

·         Children Social Care Budget

·         Homelessness

·         End of Life Care