Health & Adult Services Overview / Scrutiny

Committee Minutes

Thu Oct 16 2008

Related Documents:
agenda for these minutes

Present: -

Devon County Council

Councillors Barker (Chairman), Clatworthy, Croad, Ford, Hook, Leadbetter, McInnes, Newcombe, Turner and Wragg

District Councils

Councillors Cook (Teignbridge), Daniel (North Devon), Drew (East Devon), Newton (Exeter), Squires (Mid Devon) and Symons (Torridge)

Devon Association of Parish Councils

Councillors Hawes and Roach

Apologies for Absence: -

Councillors Fry, Hosking, Jenkins, Tucker and Westlake (DCC), Sanders (West Devon) and Squire (South Hams).

*103 Welcome

The Chairman welcomed:

Councillor Laura Newton (Exeter City Council) to her first meeting of the Committee;

Councillor Eric Parkin, Chairman of Cornwall County Council s Health and Adult Social Care Overview and Scrutiny Committee who was attending the meeting as an observer.

*104 Minutes

RESOLVED that the Minutes of the meeting held on 31 July 2008 be signed as a correct record.

*105 Urgent Business:

(Items taken under Section 100B(4) of the Local Government Act, 1972)

The Chairman had decided that the Committee should take these items as a matter of urgency because of the need for the matters involved to be raised as soon as possible.

(a) Non-Urgent Patient Transport Services (PTS)

The Chairman reported that the Chief Executive of the Northern Devon Healthcare Trust had indicated that the South Western Ambulance Service NHS Trust would be withdrawing from provision of PTS in North Devon from the end of November 2008 due to funding constraints. The matter could be discussed in the context of the further report on PTS in Devon that was due to be submitted to the Committee s next meeting in January 2009.

(b) Task Group Report on the Transfer of Services from DCC to Shaw Healthcare

The Chairman reported that the Task Group was due to meet on 20 October 2008 to discuss its draft interim report. The report would be circulated to Committee members when agreed and it would be submitted to the next meeting.

*106 The Way Ahead: Five Years of Improvement

The Committee considered a report by Mrs Jenny McNeill, Assistant Director of Strategic Development, Devon PCT introducing the updated draft Strategic Framework for Health and Social Care in Devon.

Mrs McNeill indicated that, in response to feedback received, the revised Framework:

included new Care sections on Carers and Learning Disability;

signalled an intention to focus more closely on rural issues;

placed a stronger emphasis on engagement and partnership working.

She indicated that the strategic plan for delivering The Way Ahead was nearing completion. The plan would provide greater demographic and health detail; give more information on the actions and how they would be achieved; and describe steps to success in the delivery of the plan. It would include a performance framework which brought together and mapped all indicators being measured for health and social care in Devon. This single performance monitoring framework aligned with the aims and objectives of The Way Ahead would achieve better co-ordination of performance information and improve transparency of performance feedback. Mrs McNeill regarded the plan as a living document that would be regularly updated.

Mrs McNeill and Mr T Golby, Assistant Director, Finance and Business Support, Adult and Community Services responded to queries, comments and concerns from members on matters including:

the ability of The Way Ahead to respond to demographic changes/liaison with planning authorities about future housing development;

communication with the public on service changes;

performance monitoring of LAA and other targets/use of DCC system;

support for carers (general and in relation to patient transport);

support for dementia sufferers;

loss of GP practice pharmacies.

It was MOVED by Councillor Barker, SECONDED by Councillor Newcombe and

RESOLVED that the report be noted.

*107 Adult and Community Services (ACS) Modernisation Programme - Progress Update

(Councillor Ford declared a personal interest in this item by virtue of his father receiving home care and being involved in the direct payments Scheme)

The Committee considered a report by the Executive Director of Adult and Community Services outlining progress on the ACS modernisation programme.

The report covered developments on:

the revision of the Direct Payments scheme;

Rapid Equipment and Minor Adaptations Service (REMAS);


CareDirect Plus;

the transfer of older people s residential care services to Shaw Healthcare.

The Executive Director of Adult and Community Services reported orally on developments relating to domiciliary care (a copy of a report to the meeting of the Executive on 14 October 2008 was circulated with the agenda for information). Following consultations, the Executive had decided to proceed with the ongoing development and redesign of the current ACS domiciliary care service to provide a specialist joint health and social care home support service. This would ensure consistent service delivery across the whole of Devon and alignment with other home support services provided by the Devon PCT and the Northern Devon Healthcare NHS Trust.

Mr Johnstone referred to important issues still outstanding in the negotiations with Shaw Healthcare and to the anticipated timing of the completion of the transfer. It was crucial to achieve a deliverable contract.

Mr Johnstone responded to queries, comments and concerns from members on matters including: management of direct payments; safeguards for vulnerable/inarticulate clients with telephone-based assessments; local contact points; options for the future provision of domiciliary care services, possible involvement of small independent contractors and consultations; recruitment/retention of care staff; rurality issues; and the local impact of the transfer to Shaw Healthcare and development plan proposals.

Mr Johnstone undertook to provide:

further information on the background to the proposed outsourcing of the management of direct payments and the options available;

performance data on CareDirect Plus and arrange for a presentation to members on the service;

a list of Cluster Managers throughout Devon whom members could contact with local issues or concerns and look into ways of improving communication with District Councillors.

It was MOVED by Councillor Barker, SECONDED by Councillor Newcombe and

RESOLVED that the progress made on the modernisation of the care management processes be noted.

*108 The Transition from Residential to Community Care - Implementation of Recommendations of the Mental Health Review Task Group/Places of Safety (Min. *86/13 March 2008)

(Councillor Symons declared a personal interest in this item by virtue of being a public governor of the Devon Partnership NHS Trust)

The Committee received a presentation on the Vision for Adult Mental Health Services in Devon and Torbay as a means of reviewing progress on the implementation of the recommendations of the Mental Health Review Task Group. The Task Group had been formed to review issues arising from the transition of mental health services from residential to community-based care.

The presentation was made by the following:

Mr Ian Pearson, Joint Commissioning Manager - Adult Mental Health, Devon PCT;

Mr John Horrocks, Primary Care and Commissioning Lead, Devon PCT;

Mr Iain Tulley, Chief Executive, Devon Partnership NHS Trust (DPT);

Alison Moores, General Manager, Community Care Trust South Devon Ltd;

Julia Moore, Mental Health Policy Officer, Devon and Cornwall Constabulary.

Copies of the Report of the Mental Health Review Task Group - February 2008 and a hard copy of a PowerPoint version of the presentation were circulated with the agenda as background information.

The presentation provided information on:

the Vision for Adult Mental Health Services which was to create a comprehensive and cohesive mental health system founded on the promotion of good mental health and well-being for the local population. Services would be delivered increasingly within mainstream primary and community settings. People who needed services to be delivered in specialist facilities would be enabled to maintain and regain their health, well-being and support networks. The services would be based on the principles of recovery, self help, early intervention, and mainstream and social inclusion. The services would be characterised by their quality, convenience and commitment to empower everyone;

the large Number of adults affected by mental health disorders;

Partnerships in Progress - the establishment of networks of professional experts with three core functions: Access and Well-being; Urgent and In-Patient Care; and Recovery and Independence;

Recovery and Other Outcomes and their Measurement;


Other Matters: Urgent Care Service redesign; Crisis Team capacity; 24-hour access to support; alternative Place of Safety; further design priorities; and forecast progress by January 2009.

Alison Moores outlined the role of the community and the third sector in the Recovery phase and the challenges involved.

Julia Moore commented on progress on the development of an information exchange protocol between the mental health services and emergency services.

The Health Service representatives commented on the position regarding the implementation of individual Task Group recommendations, and in particular that for establishing alternative places of safety where persons with mental health problems who were also under the influence of alcohol and/or drugs could be accommodated until they were assessed, instead of being held at a Police Station. The Health Service representatives then responded to queries, comments and concerns from members on matters including:

engagement of, and support for, carers of persons with mental health disorders/carers developing mental health problems;

point of contact for members on mental health issues;

the increasing incidence of dementia;

the importance of supporting prevention of mental health disorders (particularly in young people);

resources for implementing the Vision/ability to respond to changing demands/the need for further investment/joint commissioning with partner agencies/developer contributions through the Community Infrastructure Levy;

the position on recommendation 3 regarding doctors qualified to carry out assessments of persons suspected to be suffering from a mental health disorder (Section 12 qualified doctors) and recommendation 9 regarding the extension of the Psychiatric Liaison Team model to all acute hospitals.

The Chairman indicated that the Task Group would reconvene in January 2009 to consider any changes brought about as a result of the findings of the Review and look at other issues that had arisen. He thanked those involved in the presentation and commended the progress being made towards improving mental health services in Devon.

It was MOVED by Councillor Barker, SECONDED by Councillor Newcombe and

RESOLVED that the progress made on the implementation of the recommendations of the Mental Health Review Task Group be noted and welcomed.

*109 Training Opportunities for Members

The Chief Executive:

drew attention to the availability of funds from the Department of Health for health scrutiny training;

invited suggestions from members regarding areas that they would like to be covered under this scheme with a view to a funding bid being made.

*110 Future Meetings

The Committee noted the following:

Next Meeting:

Thursday 8 January 2009

Subsequent Meetings:

Wednesday 21 January 2009 - Budget Meeting

Thursday 12 March 2009

It was agreed that the start time for all future meetings should revert to 10.30am.

*111 Work Programme

The following proposals were made for addition to the Committee s work programme:

an update on Minor Injuries Units in Devon (including opening hours and staffing);

an update on the proposed centralisation of upper GI cancer surgery in Plymouth;

data on customer satisfaction with care services; and

a list of the performance indicators for Health and Adults Services.


The meeting started at 10.00am and finished at 12.50am

The Minutes of this Committee are published on the County Council's Website at:-

Date Published: Tue Oct 28 2008