DONCASTER METROPOLITAN BOROUGH C

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					                   DONCASTER METROPOLITAN BOROUGH COUNCIL

                  HEALTHIER COMMUNITIES AND VULNERABLE PEOPLE
                          OVERVIEW AND SCRUTINY PANEL

                                   21ST JANUARY, 2009

      A MEETING of the HEALTHIER COMMUNITIES AND VULNERABLE
      PEOPLE OVERVIEW AND SCRUTINY PANEL was held at the MANSION
      HOUSE, DONCASTER on WEDNESDAY 21ST JANUARY, 2009 at 2.00 p.m.

      PRESENT

                              Chair - Councillor John Mounsey
                            Vice Chair - Councillor Norah Troops

      Councillors Jill Arkley-Jevons, Joe Blackham, Elsie Butler, John McHale,
      Georgina Mullis, Sue Phillips, Margaret Pinkney, Cynthia Ransome and Beryl
      Roberts.

      Invitees:

      Mr. A. Drakeley, Head of Strategic Partnerships (NHS Doncaster).

      Also In Attendance:

      Councillor Martin Williams – Cabinet Member for Adult Social Care
      Sheena Powell, Director of Finance, (NHS Doncaster)
      Julie Warren, Deputy Director of Strategic Development and Commissioning,
      (NHS Doncaster)
      Tony Baxter, Director of Public Health, (NHS Doncaster)
      John Plant - Doncaster LINk
      Councillors Marilyn Green, Stuart Hardy and Tony Sockett - Ward Councillors
      for Bentley Ward

      APOLOGIES

      Apologies for absence were received from Councillor Pat Porritt.

                                                                         ACTION
39.   DECLARATIONS OF PERSONAL AND PREJUDICAL INTEREST,
      IF ANY

      There were no declarations made at the meeting.

40.   MINUTES OF THE MEETING HELD ON 3RD DECEMBER, 2008

              RESOLVED that the Minutes of the meeting held on 3 rd      All to note
              December, 2008, be approved as a correct record and
              signed by the Chair.
41.   PUBLIC STATEMENTS

      There were no public statements made at the meeting.

      In accordance with Council Procedure Rule 28.6 (b) the Chair
      agreed that Councillor Marilyn Green would speak on Agenda Item
      10 following the Officer’s presentation. In addition, it was agreed
      that Councillors Marilyn Green, Stuart Hardy and Tony Sockett be
      allowed to contribute to the discussion as Ward Councillors for
      Bentley Ward.

42.   HEALTHIER COMMUNITIES AND VULNERABLE PEOPLE
      OVERVIEW AND SCRUTINY PANEL 2008/09 WORK PLAN
      UPDATE

      Alison Jordan, Scrutiny Consultant, presented a report which
      outlined the progress made to date on the Panel’s Work Plan,
      together with key activities and developments that had taken place
      since the last meeting of the Panel held on 3 rd December, 2008.

      The Scrutiny Consultant, confirmed that all items in the Work Plan
      (attached at Appendix A of the report) had been considered on the
      planned dates and drew Members’ attention to a letter at Appendix
      B of the report for which a response from the Mayor was awaited.

      The Scrutiny Consultant also sought volunteers for the Joint South
      Yorkshire Health Scrutiny Panel. The following Members
      expressed an interest to attend meetings on Monday 2 nd March,
      2008 and Tuesday 17th March, 2008, subject to their availability:

            Councillor Cynthia Ransome
            Councillor Beryl Roberts
            Councillor Georgina Mullis
            Councillor Margaret Pinkney

             RESOLVED that

             (1) the Panel note the progress made against the Work            All to note
                 Plan;

             (2) the Panel note the letter and responses from Mayor           All to note
                 Martin Winter, and

             (3) the expressions of interest for participation on the Joint   Scrutiny
                 South Yorkshire Health Scrutiny Panel, be noted.             Consultant
43.   DONCASTER DIRECTOR OF PUBLIC HEALTH ANNUAL
      REPORT 2008

      Tony Baxter, Director of Public Health, NHS Doncaster outlined
      the contribution this report would make towards identifying public
      health priorities and planning services for local populations using
      the following key categories:

      The Summer Floods 2007
      It was explained that the impact of the floods on the health of local
      residents was significant particularly with regards to mental health.
      The Joint Public Health Team had been working with the NHS and
      GPs to analyse the response to the disaster with the view to
      making future improvements.

      Joint Strategic Needs Assessment (JSNA)
      It was explained that the purpose of the JSNA was to establish a
      process for reducing health inequality and for improving access to
      services. The key issues that emerged from Doncaster’s first
      JSNA were:

            Infant Mortality
            Breastfeeding
            Childhood Obesity
            Drugs Misuse
            Alcohol Misuse
            Circulatory Disease Mortality
            Cancer Mortality
            Dementia
            Respiratory Disease

      Progress Report on last year’s recommendations
      Progress made since 2007 on the following key recommendations
      was summarised:

            Reducing health inequalities
            Improving health
            Protecting health
            Working together for a sustainable future

      It was explained that a key overall aim would be to achieve a 10%
      reduction in the difference between Doncaster’s average and the
      national average life expectancy.

      Challenges and recommendations 2008
      Key 2008 challenges and recommendations were identified and
      categorised using the four key 2007 recommendations listed
      above.
The Director of Public Health explained that a local Health
Protection Strategy had been developed and that it was hoped that
a Partnership Framework for corporate social responsibility would
be implemented. Any recommendations from this would be
managed by the Local Partnership Board

The Chair requested Members’ comments regarding whether they
felt the key priorities identified were accurate. Members were of
the opinion that teenage pregnancy and sexual health were still
key issues in the Borough. The Director of Public Health accepted
that these issues were still important ones and were being
addressed through other projects. Furthermore, he explained that
they had spearheaded a target of a 50% reduction in teenage
pregnancy by 2011; already the rate of reduction was 28%.

Members were concerned about the levels of drug and alcohol
abuse in the Borough and in particular amongst parents. The
Scrutiny Consultant confirmed that the Drug and Alcohol Strategy
would shortly be considered by the Schools Children and Young
People Overview and Scrutiny Panel. It was also explained to
Members that there would be a forthcoming Scrutiny Review for
which expressions of interest would shortly be sought. In addition
the Director of Adult Services confirmed that the wider Drug and
Alcohol Agenda would be considered by Safer Doncaster.

Members also raised concern with regards to Licensed premises
selling alcohol to underage or already intoxicated customers. The
Assistant Director of Neighbourhoods explained that Test
Purchase operations had identified premises not complying with
the law and a Member of the Licensing Committee reassured the
Panel that offenders were regularly refused License renewals.

The Panel were happy with the progress made and felt that the
four identified priorities were accurate.

      RESOLVED that

      (1) the Panel noted the Director of Public Health’s Annual     All to note
          Report; and

      (2) the Panel’s comments on the priorities and challenges      Scrutiny
          outlined in the report be noted; and                       Consultant

      (3) the Panel’s agreement with the recommendations             Scrutiny
          outlined in the report be noted.                           Consultant
44.   NHS DONCASTER COMMISSIONING PROSPECTUS FOR
      2009/2010

      Julie Warren, Deputy Director of Strategic Development and
      Commissioning for NHS Doncaster gave a presentation that
      outlined the content of their third Annual Commissioning
      Prospectus. The Prospectus identified the following key issues:

            Alcohol
            Childhood Obesity
            Infant Mortality
            Life Expectancy
            Breast Feeding
            CVD Mortality
            Drugs Misuse
            Health Inequalities
            Cancer Mortality Rate
            Dementia / End of Life

      The Panel’s attention was directed to 16 Spotlight initiatives that
      were informed by the Local Area Agreement (LAA), Joint Strategic
      Needs Assessment (JSNA) and local intelligence. Details of how
      these goals were to be achieved were split in to four themes.

            Children & Young People
            Adults
            Older People
            Vulnerable People

      Members were concerned that the initiative to reduce childhood
      obesity by 1% did not initially appear to be a challenging one. The
      Deputy Director of Strategic Development and Commissioning and
      the Director of Public Health explained that, at present, the rate of
      childhood obesity was rising so such an aim would not only stop
      this rise but also reverse it.

      Members felt strongly that educating parents and children in the
      importance of healthy eating was key to addressing obesity
      problems. The Deputy Director added that each of the 16
      initiatives would be linked to a range of activities designed to both
      prevent and treat the issue.

      The Chair sought clarification as to what effect introducing healthy
      school meals had had in the area. The Director of Public Health
      explained that school intervention needed to be combined with
      changing attitudes and practices at home in order to be effective.

      Members asked about Occupational Therapy improvements in
      relation to joint commissioning and why there was no reference to
      Doncaster MBC. The Director of Adult Services confirmed that
      extensive joint work in relation to this is taking place.

      Members suggested some technical and grammatical
      amendments to the document which included clarification that
      there were 7 existing and 4 further planned primary care facilities
      created in partnership with Doncaster Community Solutions
      (LiftCo) Ltd.

          RESOLVED that

         (1) the Panel noted the content of the NHS Doncaster               All to note
             Commissioning Prospectus 2009/2010; and

         (2) the Panel’s comments be noted.                                 Scrutiny
                                                                            Consultant
45.   PERFORMANCE JUDGEMENT AND RATINGS FOR ADULT
      SOCIAL CARE 2008

      Joan Beck, Director of Adult Services presented a report which
      drew the Panel’s attention to the outcome of the Commission for
      Social Care Inspection (CSCI) 2008. It was explained that for the
      previous 2 years the service had received a 1 star rating and
      priority for improvement status. For 2008 the CSCI rated the
      service as ‘Good’ in terms of delivery of outcomes and ‘Promising’
      in terms of prospects for improvement.

      The Director of Adult Services went on to explain that this had
      been achieved through meeting with and accepting the
      recommendations of the Department of Health which included
      accepting a Mentor, carrying out consultancy work and undertaking
      regular meetings with CSCI. She added that the inspection
      process would be different in future, as the CSCI, Health Care
      Commission and Mental Health Act Commission would be merging
      their inspection processes.

      The Director of Adult Services drew the Panel’s attention to the
      CSCI’s specific areas of judgement in Appendix A of the report and
      the ‘easy-read’ version in Appendix B of the report indicating that
      the service was perceived as ‘Adequate’ in three areas, ‘Good’ in
      four and ‘Promising’ in one with one area described as ‘Uncertain’.
      A copy of the easy-read version would be sent to all Members with Director of Adult
      a covering letter from the Director of Adult Services.              Services

      The Chair congratulated the Director and asked her to pass on the
      Panel’s thanks to her team.

      A Member was disappointed that while the outcomes referred to
      improvements in areas such as quality of life, choice & control and
      dignity & respect, each area had received a grade of ‘Adequate’
      both last year and this year. The Director explained that, although
      significant improvements had been made in these areas, they
      were not sufficient on this occasion to raise the grade to ‘Good’.
      Furthermore, the Director explained that they had acted on all
      advice received from the Improvement and Development Agency
      (IDeA), that the service knew there were still improvements to be
      made and, while celebrating this success, they would not become
      complacent.

      At the request of Members, the Director of Adult Services clarified
      that CSCI had 3 main areas of inspection responsibility:

            Care homes (announced and unannounced visits)
            Themed inspections
            Further inspection work and information gathering (which
             informed the star rating and Annual Performance
             Assessment)

      She added that the CSCI monitored press reports that related to
      the service and relied on intelligence from bodies like the
      Department for Children, Schools and Families (DCSF) and the
      Audit Commission. The Authority provided the CSCI with
      Performance Indicators (which must be thoroughly backed up by
      evidence) and engaged in regular meetings and a comprehensive
      1-day face-to-face interview with Senior Departmental Officers.
      Furthermore, she clarified that all individual judgements on care
      homes were publicly available on the CSCI’s website if Members
      wished to access them.

      Members requested that a CSCI representative be invited to
      address the Panel to explain the mechanics of the inspection
      process. The Director suggested that July might be a more
      appropriate time for such a visit as the CSCI would have become
      the Care Quality Commission by then and would have more
      information regarding the new inspection regime.

          RESOLVED that
                                                                            All to note
         (1) the Panel noted the outcome of the Performance
             Judgement and Ratings; and                                     Scrutiny
                                                                            Consultant /
        (2) a representative from CSCI be invited to the Panel’s July       Director of Adult
            meeting to explain the mechanics of the inspection process.     Services
46.   NHS LIFT (LOCAL IMPROVEMENT FINANCE TRUST)
      SCHEMES – COST/BENEFIT ANALYSIS

      Pat Higgs, Assistant Director of Neighbourhoods presented a
      report that gave Members the opportunity to consider the
      background to the NHS LIFT scheme and explained that LiftCo
      was the generic term for the joint venture company which was set
up on each local LIFT scheme; in Doncaster this was Doncaster
Community Solutions (LiftCo) Ltd.

The report was specifically being presented at this meeting in view
of current proposals relating to a new scheme in Bentley, which
local Ward Councillors felt was an opportunity to co-locate a range
of Council services.

It was explained that the scheme was designed to deliver property-
related investment services and facilities to end-users over a 25-
year period. Buildings would be bespoke, designed to suit tenants
specific requirements, and give tenants the opportunity to include
varying levels of maintenance and repair in their leases.

The Assistant Director of Neighbourhoods confirmed that
Doncaster had elected not to include an exclusivity clause in their
legal documentation meaning that the Council would not have to
offer any capital build projects to Doncaster Community Solutions
(LiftCo) Ltd. for first refusal, whereas the PCT did have to.

The presentation went on to address the following issues:

Current Schemes and Running Costs
Members’ attention was drawn to the running costs of three similar
buildings in which the Council occupied space as a tenant. The
cost per square metre was provided for the Martin Well Centre in
Edlington as an example.

Costs / Benefits
It was clarified that a base lease payment would be fixed and
would only vary subject to annual inflationary indexation. This
would give tenants fixed payments for the term of the lease.

Customers / Tenants
The Assistant Director explained that co-location could offer a
single point of access for Health and Social Care Services and
other community facilities (e.g. libraries) and improved information
sharing across organisations. It would also signal regeneration of
the area the building was located in.

Tranche 2
Doncaster Community Solutions (LiftCo) Ltd. were currently
developing the next phase of schemes in Bentley, Mexborough,
Conisborough and the Town Centre. It was explained that the
Bentley scheme offered the potential for the Police (subject to
discussion and their agreement), Neighbourhood, Adult Services
and Children’s Teams to co-locate.

Using the closest appropriate comparison, the report provided
estimated costs for Service Charge levels and included costs for
alternative options such as renting existing suitable buildings or
facilities remaining in current buildings. It also recommended that
a complete Estates Strategy be drawn up to ensure any
development addressed the needs of the Community,
Neighbourhood, the Authority and its partners.

In conclusion, the Assistant Director of Neighbourhoods asked
Members to be mindful that many prices quoted were estimates in
view of their being few or no suitable site for comparison.

Councillor Green spoke in support of the scheme and was of the
opinion that it would provide Bentley Ward with service provision
comparable to that of other Wards. Councillor Green held the view
that the area was a deprived one that experienced a range of
social problems and such a project would provide a definite
regenerative benefit. Councillor Green was firmly of the opinion
that, whilst she recognised the cost involved, Doncaster MBC
should co-locate its services in the LIFT building. She felt the
benefits of doing this had not been fully explored.

Other Bentley Ward Councillors expressed agreement with
Councillor Green and asked the Panel to endorse the possibility of
the full installation of the programme.

The Panel were also of the view that such programmes offered a
real benefit to the community including improved use of services
by residents, reduced Anti-Social Behaviour, better information
sharing and improved community relationships. Some Members
outlined the benefits that had been brought to Edlington and how
the co-location of services there had contributed to regenerating
the local area.

At the request of the Panel, the Director of Finance at NHS
Doncaster confirmed that membership of Doncaster Community
Solutions (LiftCo) Ltd. Board comprised of the Community Health
Partnership, NHS Doncaster and the Council. Members were
concerned to hear that there were no Elected Members sitting on
the Board.

       RESOLVED that

      (1) the Panel noted the content of the report; and              All to note

      (2) the Panel recommend that the Council participate fully in   Scrutiny Officer
          all LIFT projects and work in conjunction with LIFTCo to
          ensure that all Doncaster MBC teams in those particular
          areas are co-located on those sites; and

      (3) the Panel recommend that the possibility of an elected      Scrutiny Officer
          Member being appointed to LiftCo Doncaster Community
              Solutions (LiftCo) Ltd. Board be considered; and

           (4) support be given to the establishment of a Joint Estates   All to note
               Strategy in conjunction with DMBC, South Yorkshire
               Police, NHS Doncaster and other partners.

47.   DATE OF NEXT MEETING

      RESOLVED that the next meeting of the Healthier Communities
      and Vulnerable People Overview and Scrutiny Panel be held on
      Wednesday 17th February, 2009 at 2.00 p.m. at the Mansion
      House.

				
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