To receive apologies for absence.

Apologies for absence had been received from Councillors David Minnery (substituted by Councillor Edward Towers) and Nick Bardsley (substituted by Councillor Claire Wild). It was noted that Councillor Gerald Dakin would be joining remotely but would not be able to participate in any voting.

Members are reminded that they must declare their disclosable pecuniary interests and other registrable or non-registrable interests in any matter being considered at the meeting as set out in Appendix B of the Members’ Code of Conduct and consider if they should leave the room prior to the item being considered. Further advice can be sought from the Monitoring Officer in advance of the meeting

Councillor Tracey Huffer declared an interest as she is a Nurse at a GP Practice.

To confirm the minutes of the Health and Adult Social Care Overview and Scrutiny Committee meeting held on 31^st October 2022 (To follow).

RESOLVED:

That the minutes of the meeting held on 31 October 2022 were confirmed as a correct record.

To receive any questions, statements or petitions from the public, notice of which has been given in accordance with Procedure Rule 14. The deadline for this meeting is 5pm on Tuesday 6^th December 2022.

There were no public questions, statements or petitions received.

To receive any questions of which Members of the Council have given notice. The deadline for this meeting is 5pm on Tuesday 6^th December 2022.

There were no member questions.

Members were advised that the Ockenden Report had been the main focus of the November meeting. A meeting was taking place next week which would cover two items; the first being the Task and Finish report which would be discussed later in the agenda for this meeting, and the second being the Integrated Care Strategy which will be finalised in the spring. Members noted that the January meeting of Joint HOSC would focus on staffing.

Members were advised that following the last meeting, eight questions were sent to the ICB with regards to the Health and Wellbeing Hub; responses of which will be circulated to members. It was suggested that this topic remains as a focus on the work programme going forward.

Member were asked to:

·       Confirm whether they would like to formally ask the ICB to share the legal advice that they have received in relation to engagement and consultation to date regarding the Shrewsbury Health and Wellbeing Hub

·       Confirm whether the HASC require officers to collect and collate evidence relating to the development of the proposals for the Shrewsbury Health and Wellbeing Hub and the related engagement and consultation that will contribute to the decision making when it takes place, based on previously shared timelines in Spring 2023.

Concern was raised that an email had been received from the ICS which implied that decisions had already been made and therefore feedback from members at the last meeting had not been taken into account.

Members confirmed the two proposed recommendations.

To receive the report of the Task and Finish Group. Chair of the Task and Finish Group, Cllr Claire Wild, will deliver the report. Report attached.

Councillor Claire Wild, Chair of the Task and Finish Group for Prevention, Primary Care, Urgent and Emergency Care, and Discharge, presented a report which highlighted the key findings, recommendations to date and future areas of focus for health overview and scrutiny.

The task and finish group, assisted by the Executive Director of Health and the Executive Director or People, scoped their work around three key stages:

· Primary Care and preventing emergency department attendance

· Emergency department attendance and admission to hospital

· Preparing for discharge from hospital and discharge from hospital

It was acknowledged that blame should not be apportioned and that there has to be a whole system approach in improving the current system.

It was felt that there were a lack of hospital beds available, especially in certain parts of the county which delayed admission to hospital. Members acknowledged concerns that there was a disconnect when being discharged from hospital, as patients may be told they can leave, however not all of the actions had been completed, for example they were unable to get their medication, or transport was not available at the time and therefore they were unable to be discharged.

It was agreed that these issues need to be raised with the Joint HOSC and ICS and to work together to look to agree a work programme to find and assess the impact of solutions. Examples to ease the pressure on services included setting up another ward in A&E or having a discharge ward which are currently in operation in other areas.

Members felt that social care staffing shortages were leading to care packages not being delivered and as previously raised, 24/7 care in hospitals, including radiographers and pharmacists, could improve the system to allow treatment to continue in the community and reduce the time taken to discharge patients.

Members agreed that performance data was required to track patients on point of entry at A&E through to discharge to understand the system in more detail. It was noted that a joint commissioning project with the ICS was in progress and that a piece of work was also taking place with Healthwatch Shropshire on patients experiences through A&E. It was hoped that the findings from this would be published in January.

It was stated that GP contracts could be coming to an end in April in community hospitals, which were felt to play a significant part in patient recovery and could ease the pressure on other services. Further information regarding these proposals was requested.

The Executive Director for People advised members that there had been an increased number of discharges despite national challenges around workforce. Shropshire Council was now supporting many more patients at home than ever before and looking at a range of options as to how to support people differently. There was an aspiration for more patients not to have to go to hospital but if they did, to be discharged as soon as possible. It was felt that understanding the scope and expected  ...  view the full minutes text for item 38.

To receive a report sharing the role and purpose of the Market Position Statement and an outline of the emerging intentions.

Presented by Laura Tyler, Head of Housing, Resettlement & Independent Living and Natalie McFall, Assistant Director – Adult Social Care and Housing.(Report to follow)

Laura Tyler, Assistant Director – Joint Commissioning and Deborah Webster, Service Manager Commissioning & Governance, gave a presentation on the Market Position Statement (MPS) for social care for all ages. This was an important document that will signal opportunities within the care and support market of Shropshire by identifying the future demand for care and support to ensure needs can be met now and in the future. A copy of the presentation would be circulated following the meeting.

Members noted the significant increase in costs in care provision as well as workforce pressures.

Members were asked to consider the role of the council, whether the council should buy or commission services, whether resources were being targeted in the right place and what else can the council do to support market development and sustainability.

It was noted that, subject to Cabinet approval, the new MPS would be implemented in April 2023

Members felt that the mapping contained within the presentation showing the places with the highest older populations was quite dramatic when presented in this way; demonstrating the areas in the county which required more focus to ensure needs were being met.

Members expressed concerns regarding rurality in terms of service delivery, including care provision and broadband. It was confirmed that the MPS had a place-based approach and therefore the team were working closely with colleagues in Health and the broadband team to ensure a collaborative response.

A request for a map detailing areas experiencing the shortages of care workers that could be considered alongside the populations maps was made.

Members noted the differing types of support available, such as care in the community. One scheme was “two carers in a car”, however it was felt that this was less feasible in more rural areas due to distance and related time between visits.

Members were advised that despite national workforce pressures, the Council were expanding their in-house care team alongside partners across the county. It was suggested that a Hub be set up in partnership with the University of Chester to train carers and shape the market. This suggestion was acknowledged and members were further advised that the Council had already partnered with the University of Chester and had 15 local apprentices graduating next February; 14 of which had confirmed their intention to work for the council. It was further noted that a retainment payment was available after 2 years of service.

Funding had been made available for work experience placements and further funding options were being looked into, including options for recruiting from overseas. Members felt that it was important that there were opportunities for career progression. It was also suggested that, by partnering with local care homes, these could act as hubs where an outreach team could be based to deliver care in the community. This could involve working alongside the planning team to ensure that care can be delivered in rural areas.

Members requested that the transition between child and adult care should be another focus and that this  ...  view the full minutes text for item 39.

To confirm the topics for the committee’s work programme identified at the work programming session on Friday 24 June 2022 and Wednesday 3 August 2022, and a briefing on the Shropshire Inequalities Plan (21 October 2022), and the agenda for the next meeting(s).

Report attached.

Members agreed the proposed committee work programme topics attached as appendix 1.

It was also agreed that, following discussions earlier in the meeting, an informal session will be held to pick up on aspects of the Market Position Statement.

Further suggestions for items on the work programme included virtual wards, the re-configuration of A&E and the future of community hospitals.

It was confirmed that the Scrutiny Manager would organise a work programming session to look at what outcomes Members wish to achieve for the various items.

Members noted that a new Scrutiny officer, whose primary focus would be HASC/JHOSC, had been recruited.

To note that the next meeting of the Health & Adult Social Care Overview and Scrutiny Committee will be held at 10am on Monday 30^th January 2023.

Members noted that the next meeting of the Health and Adult Social Care Overview and Scrutiny Committee will be held at 10am on Monday 30th January 2023.