Apologies for absence were received from Councillor Roy Aldcroft.

None declared.

To confirm the minutes of the meeting held on 12 July 2021 as a correct record TO FOLLOW

Councillor Heather Kidd reported that she had been present at the previous meeting but was not recorded as being present in the Minutes.

RESOLVED:

That subject to Councillor Kidd’s name being added to the list of these present, the Minutes of the Health and Adult Social Care Overview and Scrutiny Committee meeting held on 14 June 2021 be approved as a correct record.

To receive any questions or petitions from the public, notice of which has been given in accordance with Procedure Rule 14.  The deadline for this meeting is 10.00 am on Thursday 9 September 2021

None received.

To receive questions of which members of the council have given notice.  Deadline for notification is 5.00 pm on Wednesday 7 September 2021

Questions from Councillor David Vasmer in relation to whether the policy of investigating patient needs for support after release from hospital be extended to day-care patients?

A copy of the questions and the response provided would be circulated to Members of the Committee and are attached to the signed minutes and available on the Committee’s pages on the Shropshire Council website.

The Scrutiny Officer reported that an additional question had been received from Councillor Halliday, however it wasn’t received in time to process and so would be carried forward to the next meeting.

To scrutinise the impact of the change in developing 111 non-emergency services in Shropshire, a report will follow

Sharon Clennell, Head of Urgent Care, CCG presented the report providing an update on the impact of the change in developing 111 non-emergency services in Shropshire.  Craig Lovett, Head of Information, CCG provided an update on performance.

The Head of Urgent Care, CCG provided an update on the next steps.

In response to questions and comments from Members, the following points were made:

·         The difference between Emergency Departments (ED) and Minor Injuries Units (MIU) was that an ED was for life threatening and critical conditions, MIU was for non-life threatening injuries, such as soft tissue and sprains.

·         Issues for individuals living on the border of Wales were highlighted, including that not all areas within Shropshire had a Shropshire postcode and the Head of Urgent Care agreed to investigate issues referred to and report back to the individual Councillor who raised them.

·         Rural demand on ambulance service would be examined and the reasons why they may choose to use the 111 Service.

·         The one appointment per 500 registered patients was a national directive, but actually there were issues around population density and the fact that need may actually be higher in rural areas, where residents may be more likely to be elderly and more dependent on ambulance for example.  Need is very different when taking into account the age profile of an area. The Head of Urgent Care stated that she would take this point away to regional commissioners. 

·         The Trust had recently appointed two Population Health Manager Analysts, who will work collaboratively to try and form a better understanding of services and trends and services that are available including looking at health inequalities. 

·         With regards to soft tissue injury/wound groupings, they do appear on the NHS111 system, however with this type of injury patients were naturally likely to want to present and get more urgent care access, which would include access to an ED.  Looking at patient behaviour around soft tissue injuries would be a primary focus area including what could be delivered elsewhere.  Soft tissue injuries was an area that they were hoping to improve.

·         On both sides of the county there were frequent users and a monthly report is produced which outlines the top 100 attenders.  There is work ongoing to try and identify the reasons for frequent service users and where did they need support, it is dependent on engagement from service users.  The High Intensity Service User Programme reviews ED attendance, those associated with short hospital stays and also increased use of the ambulance service.  

The Chairman thanked Sharon and Craig for their informative update.

To scrutinise Shropshire’s Council’s role in providing supported housing and maximising independent living

The Director of Adult Services introduced herself to the Committee commenting that Members had received two informative briefings on the subject of Independent Living and feedback received had been positive.  In relation to assisted technology, the results had been very positive.  Some clients had changed the way they communicate using the technology, giving them greater independence.  The Director reported that the team were now starting to talk to care providers and reaching out to them to and asked them to consider whether they can make adjustments to their visits given that the assisted technology has meant that individuals are more independent, and care could be reduced.  Hopefully more data around this will be available to the Committee in six months time.  Flexible Contract Arrangements were also outlined and the positive changes and new applications from providers, this was bringing.  The Director handed over to Michelle Davies, Adult Services and Stephanie Kelly, Team Manager, Care Management and invited questions from the Committee.

In response to questions and comments from Members, the following points were made:

·         With regards to assisted technology, it was confirmed that internet connectivity was very important and the Committee were reassured that lots of the prompts and verbal and visual reminders worked offline and did not require an internet connection, however it was an important issue as service users also used the technology to keep in touch with family, friends and to do research to enable them to do the things that they enjoy doing.

·         With regards to rates of pay for carers, it was reported that Shropshire was one of the highest payers in a rural county of hourly rates to providers and the Council made sure that what was paid to providers allowed them to passport that rate to their staff, although this could not be enforced.  A report back on staff pay was requested.

·         A varied age group were accessing the technology. 

Stephanie Kelly, Team Manager for the Occupational Therapy Team, Children and Adults joined the meeting to provide an update on the OT role and the follow on to get adaptations into users homes and to ultimately reduce care costs.

The Chairman thanked the Team for their informative update. 

To consider proposals for the Committee’s work programme.

The Scrutiny Officer presented the report detailing the Committee’s Work Programme for the municipal year 2021/22.

The Scrutiny Officer reported that he would write to the CCG to get a response for the Committee on some of the topics that were raised that could not be answered at the time.

The Scrutiny Officer suggested an informal virtual planning meeting to discuss the topic of GP practices and the Shrewsbury Super Hub to include closures and mergers.

The suggestion was put forward that at some point in the future the Governments plans for Adult Social Care would need to be discussed.  

RESOLVED:

That the proposed committee work programme attached as appendix 1 be agreed.