Agenda and minutes

There were no declarations of interest made by Members.

We confirmed and signed the minutes of the meeting held on Tuesday 13^th October 2015.

·         A Performance Update on Health Developments in Monmouthshire (presentation to follow)

·         Discussion on ‘Dying Matters’ as a possible future area for scrutiny work with the Aneurin Bevan University Health Board (verbal)

·         Scrutiny of an Evaluation of the Choose Wisely Programme (to follow)

We welcomed representatives from the ABUHB:

G. Evans                     Director of Workforce

B. Bolt                         Deputy Chief Operating Officer

P. Buss                        Medical Director

D. Jenkins                   Chair of ABUHB

J. Paget                       Chief Executive

A. Davies                    Director of Planning and Performance

A. Brace                      Deputy Chief Executive and Finance Director

We received a presentation from the Chief Executive in order for Members to scrutinise, with ABUHB, the following areas:

·         A Performance Update on Health Developments in Monmouthshire.

·         Discussion on ‘Dying Matters’ as a possible future area for scrutiny work with the Aneurin Bevan University Health Board.

·         Scrutiny of an Evaluation of the Choose Wisely Programme.

Following the initial presentation on Health Developments in Monmouthshire, Members were invited to comment and discuss.  In doing so the following points were noted:

Members sought clarification on the review on the GP out of hours scheme.  In response we were advised that a challenge to the Health Board had been recruiting GPs to the out of hours service.  The service relied on being able to recruit salaried GPs or Sessional GPs, which had become increasingly difficult over the past 12 to 18 months.  In order to address the issue the Health Board had recruited more nurses to work alongside GPs and increased payment rates for GPs, which had not been particularly effective.  A complete route and branch review of the service had been conducted, which would have been carried out with the introduction of a new telephone number, the 111 service, to ABUHB in 2017. The review had looked at the number of calls coming in, the types of calls, if a different response could be provided.  The Health Board were focussing on a primary care approach to the out of hours service.  It was noted that the service was not being reduced, but enhanced.

Members referred to problems with car parking facilities at Neville Hall hospital.  In response we heard that a meeting had been attended which confirmed that planning permission had been applied for to extend the facility, but had been appealed against by National Resource Wales.  The Health Board confirmed they were committed to resolving car parking issues at both Neville Hall and Royal Gwent Hospitals.

A Member questioned the Health Boards policy surrounding smoking electronic cigarettes and it was confirmed that their smoking policy covered the ban of all types of cigarettes.

A Member raised concerns surrounding the role of the Community Health Council for the future. It was a concern that the future service may be more in-house.  The Chair of ABUHB expressed that there was a good relationship with the CHC and the CHC provided a much better informed service.  As far as the Health Board were concerned, the work of the CHC in Gwent was greatly valued, as was the support.  

A Member questioned if the scrutiny process was a hindrance to progress.  The Chief Executive of ABUHB considered the scrutiny process important and useful to test out views and plans.  It was thought to be essential that plans were tested through  ...  view the full minutes text for item 3.

Context:

We received a report in order to present quarter 2 performance data for the Improvement Objective and Outcome Agreement objectives which were under the remit of Adults Select Committee:

·         Improvement Objective 2 “We will safeguard people, whether young or old, while reducing people’s dependence on social care”.

·         Outcome agreement theme “Ensuring people receive the help they need to live fulfilled lives”.

Key Issues:

The Outcome Agreement and the Improvement Objectives have a different focus:

·         Improvement Objectives were set annually by the council to deliver on priorities.  Despite objectives being focused on the long term the specific activities that support them were particularly focussed for the year ahead

·         The Outcome Agreement is an agreement with the Welsh Government for a three year period, where the council needs to deliver on performance activity and associated targets that contribute to the Programme for Government. The

current agreement covers the period from 2013 to 2016. The council has previously been awarded full payment each year.

In the summer of 2015 the Welsh Government announced the final year of funding for performance in 2015-16 would no longer be attached to performance in the

Outcome Agreement and would be rolled directly into the Revenue Support Grant for

2016-17.  This means that payment for performance against the targets in the agreement for 2015-16, being discussed by members today, is assured. However given the importance placed on the agreement as part of the council’s performance framework to contribute to delivering the outcomes set it is important to continue to monitor performance against the agreement for its final year.

Member Scrutiny:

A Member commented that Children’s Services were behind target, which could be attributed to staffing issues and an outcome of inspection reports.  It was questioned if officers expected this to improve.  We heard that last year had shown incredibly good performance in Children’s Services.  There had been a difficult start to this year with staffing issues and agencies workers causing added pressures.  Staff were now looking closely at the measures, with frequent discussions with the leadership team being fed through to the Directorate Management Team on a monthly basis. 

A report regarding Children’s Services Performance Indicators would be brought to Joint Select Committee which would try to address all the issues in one coherent plan.

Members raised a concern surrounding Community Coordination and the decision not to roll out across the whole county without pilot work.  On the face of it there was a different feel to the services and way of working in Abergavenny and Caldicot to Chepstow and Monmouth.  It was questioned if the evaluation proved that it was not as effective as expected what would be the course of action. 

The Chief Officer for Social Care and Health explained that in terms of taking forward local area community coordination in those two area, it would be evaluated against the original criteria and business case.  It was important to get the hard evidence of what this has told us.  In terms of the future direction  ...  view the full minutes text for item 4.

Context:

We received a report from the Finance Manager to provide Adults Select Committee Members with information on the forecast revenue outturn position of the Authority at the end of reporting period 2 which represents month 6 financial information for the 2015/16 financial year.

The report would also be considered by Select Committees as part of their responsibility to:

·         Assess whether effective budget monitoring is taking place,

·         Monitor the extent to which budgets are spent in accordance with agreed budget and policy framework,

·         Challenge the reasonableness of projected over or underspends, and

·         Monitor the achievement of predicted efficiency gains or progress in relation to savings proposals.

Member Scrutiny:

Members expressed thanks to all involved and the efforts made to the positive outcome, especially in the challenging position of the Authority.  The Chief Officer and Finance Manager were asked to convey the message to staff involved.

We were informed there were no particular areas of concern going forward but it was recognised that it would remain challenging.

We received the work programme from the Scrutiny Manager, in doing so we noted that:

·         Joint meeting to be held on 16^th December 2015 with Children and Young People Select Committee.

·         19^th January 2016 meeting to cover the Raglan Project and the Social Care and Wellbeing Act.

·         A special joint meeting with Children and Young People Select to be held – no confirmed date.