Meeting documents

Also present at the invitation of the Chairman

Mr Simon Cox (Chief Officer, Scarborough and Ryedale Clinical Commissioning Group) – for Items 4&5

Dr Phil Garnett (Clinical Chair, Scarborough and Ryedale Clinical Commissioning Group) – for Items 4&5

Mr Andy Hudson (Lay Member and Lead for Patient and Public Engagement, Scarborough and Ryedale Clinical Commissioning Group) – for Items 4&5

Members are reminded of the need to consider whether they have a personal or prejudicial interest to declare in any of the items on this agenda.  If so, the nature of the interest must be declared at the start or as soon as the interest becomes apparent, of the meeting.  In addition, the attached form must be completed and passed to the Committee Administrator.  The Officers will be pleased to advise, if necessary, and any request for assistance should be made, in the first instance, to the Committee Administrator whose name appears at the end of this agenda.  Ideally, such advice should be sought before the day of the meeting so that time is available to consider any uncertainty that might arise.

Councillor Evans declared a personal interest in agenda item 8, Work Programme 2012/13, in respect of the review proposal about the Council's Grants Allocation Policy, since his wife was a trustee of a local voluntary organisation.

To approve as a correct record and sign the Minutes of the meeting held on 24 October 2012.  (Minutes attached).

RESOLVED that the minutes of the meeting held on 24 October 2012 be approved as a correct record and signed by the Chairman.

Public questions of which due notice has been given and which are relevant to the business of the Scrutiny Committee.

The Chairman reported that no public questions had been submitted.

To receive a briefing by Simon Cox, Locality Director, North Yorkshire and York Primary Care Trust (Scarborough and Ryedale)

Mr Cox and Dr Garnett (see below) have also been asked to brief Members about the Primary Care Trust’s developing strategy with the support of KPMG to move the local healthcare economy to clinical and financial sustainability, in particular with reference to services at Scarborough General Hospital.

The Committee considered a verbal report by Simon Cox, Chief Officer of Scarborough and Ryedale Clinical Commissioning Group (SRCCG) on the financial position of the Primary Care Trust, its developing strategy with the support of KPMG to move the local healthcare economy to clinical and financial sustainability, and the implications for the new SRCCG.  Mr Cox advised that the PCT Cluster Board had considered the KPMG report at its meeting the previous day.  This high level, strategic report was short on specifics but confirmed the wider objective to shift more care towards community settings.  However, in respect of Scarborough Hospital, the two options of the cessation of overnight A&E services and the downgrading of maternity services had both been discounted.  In relation to the PCT’s forecast end of year deficit of £19M, this figure had now been revised down to £15M, or perhaps even less.  This translated to a £2.25M deficit for SRCCG which when added to efficiencies, amounted to £4.25M savings required in 2013/14 from a total budget of £145M.  The SRCCG planned to be in financial balance by the end of 2013/14, as part of a four year savings plan – many of these savings would have to come from hospital services.  In reply to Members’ questions, Mr Cox commented that he believed A&E and maternity services should remain at Scarborough Hospital, but clinical imperatives would continue to drive the evolution of services and care pathways; for example, patients suffering from heart attacks were now either stabilised at Scarborough Hospital or sent directly to specialist centres in Hull or South Tees.  This may well entail greater usage of services such as the air ambulance.  Dr Garnett then provided further clinical background in that the initial ECG examination would determine the appropriate care pathway: whether directly to a specialist centre, or to Scarborough Hospital for stabilisation first.  He believed a key element of clinical commissioning was to identify the best clinical outcome for patients, and then configure services accordingly.  In respect of the SRCCG’s budget, Dr Garnett commented that the new structure put an end to the historical underfunding of local commissioning.  Although he accepted that a weakness of the funding formula was that it did not take into account rurality, the new SRCCG was now located in the top quartile of CCG funding in the country, higher per capita than Hull, reflecting the high levels of deprivation in the area.  Dr Garnett believed that through the new arrangements, the CCG would address the deficit and improve services at the same time.  Mr Cox accepted the Chairman’s offer of support to the new CCG, hoping to build on the PCT’s existing positive working relationship with the Borough Council, through such initiatives as the Wellbeing Pilot for elderly people.  He acknowledged that historically the PCT had not been the best communicator, but the CCG put patient and public involvement at the heart of its work.  Andy Hudson, Lay Member for Patient and Public Involvement  ...  view the full minutes text for item 4.

To receive a briefing by Dr Phil Garnett, Chair of Scarborough and Ryedale Clinical Commissioning Group and Andrew Hudson, Lay Member for Patient and Public Involvement, Scarborough and Ryedale Clinical Commissioning Group

This item was considered in conjunction with the item above.

To consider a report by the Head of Regeneration and Planning (Reference 13/57 attached)

The Committee considered a report by the Head of Regeneration and Planning (Reference 13/57) outlining progress with the Council’s Alcohol Harm Reduction Strategy, accompanied by a presentation by the Community Partnerships Manager, Jo Ireland.  Members were reminded that the Strategy, now a year in, was focused on four priorities: leadership and coordination; treatment and interventions; young people; and management of the town centres and night time economy.  Without underestimating the challenges ahead, there was considerable progress to report, namely: the strategic recognition of the issue in the Joint Strategic Needs Assessment and the Joint Health and Wellbeing Strategy; the establishment of the Local Substance and Misuse Partnership in July 2012 to drive delivery of the strategy, promote integration and influence commissioning; and examples of new initiatives, new ways of working and more integrated and outcome focused services.  Particular reference was made to improved data sharing between agencies; the redesign and retender of Young People’s Services; the Changing Lives project; the new A&E Alcohol Worker; the Street Safe and Aftermath initiatives which deal more with the consequences of alcohol abuse; and the presence in Scarborough and Whitby town centres achieved through the night marshals and Street Angels.  However, the report and presentation also highlighted two specific areas of concern: the lack of local provision of Alcohol Treatment Requirements for male offenders and the failure to secure continued funding for the project giving support for carers of people with drug and alcohol misuse problems which had been operating in the Borough during the previous three years.  Members then discussed the report and presentation and asked the officers questions.  In respect of the carers project, Ms Ireland noted that there was an exit strategy in place for those currently receiving support, and there would be residual benefits from the project in terms of increased levels of awareness and expertise in the host organisations.  However, a challenge remained of how to secure sustainable funding for this and similar projects.  Strategic Director, Hilary Jones gave the example of the Changing Lives initiative, which although a pilot project, would, if successful, build the case for mainstreaming the participant organisations’ budgets to establish a new model of service delivery.  Another example, the A&E Alcohol Worker, enabled the collection of important data which helped agencies understand the extent and nature of this issue and the effectiveness of this intervention in preventing later problems.  The Safer Communities Manager and Safeguarding Officer, Sandra Rees, acknowledged that more data was required around the method of A&E admission, whether by ambulance or other means, for which the support of Yorkshire Ambulance Service was being sought.  Ms Rees felt the Safer Communities Partnership could replicate the success of such initiatives as the Colchester SOS Booze Bus, especially since the Kingdom Faith Church – the main organisation behind Street Angels – now had a base in Scarborough town centre.  In respect of the current Home Office consultation on measures in the Government’s Alcohol Strategy designed to tackle the problems associated with  ...  view the full minutes text for item 6.

To consider a report by the Head of Regeneration and Planning (Reference 13/58 attached)

The Committee considered a report by the Head of Regeneration and Planning (Reference 13/58) in respect of the national campaign to reduce and end loneliness, and its implications for the Borough.  Members were advised that thrust of the campaign backed by a coalition of organisations was to raise awareness and obtain strategic recognition of an issue which had a considerable impact on public health, equivalent to smoking and worse than obesity.  The report pointed out that loneliness was a subjective state and did not necessarily equate to isolation, although social loneliness was defined as an absence of a social network consisting of a broad group of friends, neighbours and colleagues.  Positively, in North Yorkshire, the matter was recognised as a strategic health issue in both the Joint Strategic Needs Assessment and the Joint Health and Wellbeing Strategy with ‘reducing social isolation’ and ‘good mental health’ as key objectives within the JHWBS.  There were two very active Older People’s Forums in the Borough.  As part of the North Yorkshire Older People’s Board, a task group had been set up, consisting of representatives from the Older People’s Forums, to look into this issue, and would be reporting in due course.  The Borough’s Local Health Partnership was aware of the significance of loneliness and its effects, which needed to be understood properly when making decisions around commissioning and decommissioning services.  Members then discussed the report and asked officers questions.  There was concern about those lonely people who slipped through the net and how the Council and its partners could prevent this happening.  The Community Partnerships Manager, Jo Ireland cited the important role and contribution of the voluntary sector in providing support.  There was also discussion about the opportunities to bring older and young people together.  The example of the Growing IT intergenerational project in East Whitby was cited which involved the older and younger generations sharing their different skills with each other.  The Suffolk Rural Coffee Caravan, which featured as a case study in the report and distributed information and organised community events, was suggested as an idea which could bring much benefit to the Borough.  Strategic Director, Hilary Jones, also highlighted the need to raise awareness among the Council’s frontline staff to help identify lonely and vulnerable residents.  Members echoed Ms Ireland’s comments about the role of the voluntary sector and suggested that a summit be held to bring together a wide range of organisations with a focus on tackling this issue.  As a first step, Ms Ireland suggested that the North Yorkshire Older People’s Task Group’s report be brought to the Committee, to consider how its recommendations could be translated into local action.

RESOLVED that:

(i)                 the report be received; and

(ii)               a further report be submitted to the Committee after the North Yorkshire Older People’s Task Group’s report had been published to consider its findings and recommendations.

To consider a report by the Head of Legal and Support Services (Reference 13/37 attached)

The Committee considered a report by the Head of Legal and Support Services (Reference 13/37) to assist Members in planning the Committee’s work for 2012/13.  The Strategic Director, Hilary Jones advised that the day before, the Cabinet had agreed that the budget for Area Committee grants be considered as part of a wider scrutiny review of the Council's Grants Allocation Policy, also encompassing Housing, Voluntary Sector and Community Revenue Grants, the findings of which would feed into the Cabinet's mid year budget report in July.  In 2012/13, funding for the three types of grants above had been amalgamated into one budget cost centre.  Applications were considered and approved in a single annual report to the Cabinet, and grants above a certain threshold were subject to a service level agreement between the organisation and the Council.  The review of the wider policy would be undertaken by a joint scrutiny task group drawing members from both this Committee and the Safer and Stronger Communities Scrutiny Committee.  Councillor Billing suggested that the Committee consider the issue of the effect of the recent inclement weather on admissions at Scarborough Hospital, in particular the rise in pedestrian injuries caused by falls and the extent of ambulance transfers from Whitby.  The Overview and Scrutiny Manager suggested that as a first step the Chairman write to York Teaching Hospital Foundation Trust to request the figures with a breakdown and analysis.  Once received, the Committee could then consider what further action it wished to take.  With reference to the Work Programme report, the Overview and Scrutiny Manager advised that following a request by the Chairman, the issue of cancer in children had been added to the agenda of the next meeting.  This was in light of a recent national e-petition which had been circulated to Members and the work of Ellie’s Fund, a local charity which campaigned to raise awareness about the condition and provided support to families who have children with cancer in the Borough and wider region.  A mere 0.7% of cancer research was spent on brain cancer, yet brain tumours killed more people under 40 including children than any other cancer.  Ellie’s mother, Heather Othick had been invited to address the Committee about the Fund’s work, aspirations and campaigns.

RESOLVED that:

(i)                 the report be received;

(ii)               Councillors Jeffels and Mrs Turner be nominated as the Committee’s two representatives on the Grants Allocation Task Group, and a further two nominations be sought from the Safer and Stronger Communities Scrutiny Committee; and

(iii)             the Chairman, on behalf of the Committee, write to York Teaching Hospital Foundation Trust to request the data in respect of the impact of wintry weather on hospital admissions at Scarborough Hospital.