Hampshire County Council Health and Adult Social Care Select Committee Meeting

Apologies were received from Councillors Burgess, Garton and Andrews.

Members were mindful that where they believed they had a Disclosable Pecuniary Interest in any matter considered at the meeting they must declare that interest at the time of the relevant debate and, having regard to the circumstances described in Part 3, Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter was discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore Members were mindful that where they believed they had a Non-Pecuniary interest in a matter being considered at the meeting they considered whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, considered whether it was appropriate to leave the meeting whilst the matter was discussed, save for exercising any right to speak in accordance with the Code.

The minutes of the previous meeting held on 29 November 2022 were agreed as a correct record and signed by the Chairman.

The Committee did not receive any deputations.

The Chairman drew Members’ attention to the email sent on 10 January regarding the Framework for Assessing Change and requested that all Members ensure that they were familiar with the attached document. The Chairman highlighted that Assessing Change was a statutory responsibility of the Committee and that officers would be able to assist where queries arose.

The Chairman noted the Menopause Workplace Pledge that the County Council had signed up to. In doing so, the Council committed to:

·         recognising that the menopause can be an issue in the workplace and that women need support

·         to talking openly, positively and respectfully about the menopause and 

·         to actively supporting and informing employees affected by the menopause.

The Chairman also noted that he had recently met with Frimley NHS Trust to be briefed on their proposals to redevelop part of the site at Frimley Park Hospital to increase capacity and enhance services currently provided on site.

The Committee considered the report updating on the future introduction of the Care Quality Commission’s (CQC) assessment of local authority social care functions.

RESOLVED:

The Committee noted the report and acknowledged the achievement of staff, alongside the contributions of wider partners, stakeholders, and those accessing health and care services and carers, to achieving the Test and Learn rating of Good.

The Committee considered the report and presentation setting out the proposed revenue budget for 2023/24 for the Adults’ Health and Care Directorate.

Members noted the outcomes of the Local Government Finance Settlement including the difference between the settlement figures and those anticipated within the December 2022 Cabinet report. Members also noted the impact of high inflation in comparison to budgets previous years.

It was confirmed that no new savings had been proposed as part of the budget. Existing savings programmes, namely T21 and SP23, were ongoing with savings expected to be achieved later than originally anticipated not least due to the extremely challenging circumstances within Adult Social Care. Members acknowledged that this reflected the challenges being experienced on a national scale such as an increase in demand and complexity of clients across older and younger adults, workforce challenges, cost of living and inflation.

It was noted that the Public Health grant allocation was expected to be confirmed in March 2023.

In response to Members’ questions, it was confirmed that:

·        The County Council had the ability to increase Council Tax by up to 4.99% without a referendum and that every 1% that wasn’t increased represented a £7.5million impact on the Council’s finances.

·        Savings targets were under continual review and if they are ultimately deemed unachievable then they could be offset with savings needing to be sought elsewhere. It was also noted that recurrent savings needed to be funded from recurrent funding and that reserves could not be utilised in this instance.

·        Budget forecasting within the care sector was always challenging due to the unknown increase, or decrease, in complexity and demand of service users.

·        Workforce pay increases had been factored in to the budget.

·        Hospital discharge services had been funded as a one off source between the NHS and the County Council in 2022/23. This funding was no longer available for 2023/24 and consideration would be given to how these services would be funded and or coordinated with significantly reduced level funding available through specific grants in 2023/24.

The recommendation to support the proposals being put forward to the Executive Lead Member for Adult Social Care and Public Health was put to the vote. The outcome of the vote is below.

For: 10

Abstain: 3

RESOLVED:

That the Committee agree to support the proposals being put forward to the Executive Lead Member for Adult Social Care and Public Health as below:

To approve for submission to the Leader and the Cabinet:

      i.        The revised revenue budget for 2022/23 as set out in Appendix 1.

    ii.        The summary revenue budget for 2023/24 as set out in Appendix 1

   iii.        The proposed fees and charges as set out in Appendix 2.

The Committee considered the report setting out the proposed capital programme for 2023/24 to 225/26 for the Adults’ Health and Care Directorate. In response to a Member question it was noted that an increase in numbers of service users attending the Kershaw Centre was not anticipated but rather an investment into the improvement of facilities.

RESOLVED:

That the Committee agree to support the proposal being put forward to the Executive Lead Member for Adult Social Care and Public Health as below:

To approve for submission to the Leader and the Cabinet the capital programme for 2023/24 to 2025/26 as set out in Appendix 1 and the revised capital programme for 2022/23 as set out in Appendix 2.

a)    Whitehill and Bordon Health Hub update (Hampshire and Isle of Wight Integrated Care Board)

The Committee considered an update from the ICB on progress with developing the Whitehill and Bordon Health Hub. (Since the meeting of HASC on 24 January 2023, Members of HASC have also been sent a link to a publicly available presentation, via the Whitehill and Bordon Town Council website, which includes some further details.)

The purpose-built Health Hub was intended to combine primary care (provided by Badgerswood and Forest GP Surgery) and community health services onto a single site, together with services currently provided at Chase Community Hospital. In presenting, the ICB noted that this was not a merger but rather co-located services. They also confirmed that the IT systems used at the Health Hub would be compatible with one another.

There was discussion regarding the importance of including certain services within the Hub – such as menopause support, women’s health services and linking to preventative health care and health checks. It was anticipated that the planning application for the Health Hub would be submitted in April 2023.

RESOLVED:

i)             That the Committee continue to monitor the progress of the development of the hub and request an update at the June HASC meeting ahead of the planned patient group engagement activity.

b)    Integrated Primary Care Access (Hampshire and Isle of Wight Integrated Care Board)

Members heard that, from October 2022, new arrangements came into place across England for additional primary care capacity outside core hours (8.00am to 6.30pm Monday to Friday excluding public holidays). These were available from 6.30pm to 8.00pm Monday to Friday and 9.00am to 5.00pm on Saturdays. It was noted that the changes were designed to improve access, promote patient choice and support primary care resilience. Members were pleased that more provision, not only to GP appointments but also other healthcare professionals, was being offered and were keen to continue to monitor the progress of the initiative.

In response to Members’ questions it was confirmed that:

·         Some additional analysis of how the new arrangements were working (monitoring figures, numbers of patients seen out of hours) would be provided for the Committee at the June HASC meeting.

·         The IT software tool ‘Apex’ was used by the majority of GP practices and was designed specifically as primary care business intelligence tool to extract and present data.

·         That the online eConsult tool was used differently by different practices. A large number of eConsults being submitted had potential to be unsafe as it was impossible to ascertain the severity of issues without reading each individual submission – it was noted that some practices were receiving unsustainable numbers of forms submitted. Members discussed the importance of utilising pharmacies as a first port of call for non-urgent treatment and suggested that a note be added to the system front page for patients information, advising them to visit their local pharmacy where applicable.

RESOLVED:

i)     That the Committee continue to monitor the item given the importance of enabling access to primary care and request a further update on progress with the new arrangements for providing ‘out of hours’ care at the June HASC meeting.

c)    Andover Community Diagnostic Centre (Hampshire Hospitals NHS Foundation Trust)

Members heard that, Hampshire Hospitals (HHFT) had secured investment of £8.2million to create a Community Diagnostic Centre at Andover War Memorial Hospital and that, as part of HHFT’s on-going investment in Andover it would also provide more modernised facilities for the Minor Injuries Unit and Maternity departments.

The Committee were pleased to hear that the proposals would mean patients had greater access to vital services whilst staying closer to home, speeding up early diagnosis and reducing waiting times.

In response to Members’ questions it was confirmed that the Andover Birthing Unit was for low risk births. Patients requiring more critical care would be best placed in a hospital to receive the appropriate clinical services.

RESOLVED:

j)     That the Committee monitor the progress of the project and request a further update at the June HASC meeting if appropriate.

RESOLVED:

That the Committee’s work programme be approved.