Agenda and minutes

Apologies were submitted on behalf of Cllr Colin Smith.

Councillor Kate Lymer declared a personal interest by virtue of her mother working in Public Health.

As a visiting Member, Councillor Simon Fawthrop (Executive and Resources PDS Chairman) declared a Disclosable Pecuniary Interest at item 13 (Exempt minutes) and item 16 (Award of ICT Contract) of the agenda by virtue of his employment with British Telecom (BT). The Leader agreed to move item 13 to the end of the meeting and accordingly Cllr Fawthrop vacated the Council Chamber prior to consideration of item 16.

a)  to confirm the minutes of the meetings held on 9^th September 2015 and

17^th September 2015

b)  Matters Arising report

The minutes were confirmed.

In accordance with the Council’s Constitution, questions must be received in writing four working days before the date of the meeting. Therefore please ensure that questions are received by the Democratic Services Team by 5pm on Thursday 8^th October 2015.

Four questions had been received for oral reply. Details of the questions and

replies are at Appendix A.

Report CS15925

Report CS15925 outlined the Public Health commissioning intentions for 2016/17 subject to decisions on corporate savings. The Public Health contracts comprised:

·   Contract Type A: Standard Contracts;

·   Contract Type B: Bromley CCG Community Block Contract with Bromley Healthcare;

·   Contract Type C: Sexual Health Clinical Contracts with acute hospital providers; and

·   Contract Type D: Service Level Agreements with General Practitioners

The framework approach provided flexibility to commissioners particularly in responding to corporate saving decisions. There was no commitment to call off services from appointed providers, all initial framework contracts being awarded for a one year term. The Framework expired at the end of April 2016 with an option to extend for a further two years, this option being recommended.

For category A, substance misuse contracts at £1.6m accounted for much of the proposed 2016/17 contract spend; a further 21 contracts valued at £502k had been called off from the Council’s Public Health Framework (annual value estimated at £800k) in 2015/16.

The category B Community block included the following services managed by the Director of Public Health through a Section 75 agreement with Bromley Clinical Commissioning Group (CCG): 

·  Contraception and Reproductive Health

·  Health Improvement

·  Smoking Cessation

·  School Nursing

·  The National Childhood Measurement Programme

·  Child Healthy Weight Programmes

·  Health Visiting (from October 2015)

The community block contract had been extended by the CCG with Bromley Healthcare to 31st March 2017 and, subject to corporate savings decisions, it was intended to continue the arrangement until then. A joint procurement exercise with the CCG could potentially be taken forward during 2016/17 for the relevant community services.

A recurrent value of the services would amount to £6.8m per annum reflecting the inclusion of Health Visiting under the Public Health remit from October 2015 (the annual value of Health Visiting being £3.8m).

For category C Sexual Health Clinical Contracts it was necessary by regulation to provide open access Genito-Urinary Medicine (GUM) sexual health services and a collaborative commissioning approach with other London Boroughs had resulted in a reduced 2015/16 GUM Tariff and more advantageous terms.

For category D Service Level Agreements with General Practitioners to support the delivery of Sexual Health Services, Substance Misuse Services and NHS Health Checks, all 45 registered GP Practices in the Borough had agreed to deliver one or more elements of the services during 2015/16. The total value of GP SLAs for 2016/17 was estimated at £539,350.

A proposed exemption from the Council’s contract procedure rules would support a continuation of the programmes and enable a new round of SLAs to be established with GP Practices for 2016/17. The substance misuse SLA would however be ceased as the services had been incorporated into a wider substance misuse contract.

Extending the overall Public Health framework for a further two years would not commit L B Bromley to a particular level of expenditure - officers would retain manoeuvrability to adjust expenditure should the need occur. 

Members supported the recommendations.

Subject to corporate savings decisions it was RESOLVED that:

(1)  extension of  ...  view the full minutes text for item 276.

Report CS15926

In line with a national programme to increase diagnosis rates for dementia,  diagnosis rates in the borough for the last 12 months had risen from 47% to 58% due to work by Oxleas and primary care GP Surgeries. Using funds set aside for dementia within the Better Care Fund, the Council and Bromley Clinical Commissioning Group (CCG) proposed commissioning to improve, and provide post diagnosis support where this was lacking.

Only a small number of dementia support services in the community (excluding care home beds) were delivered under contract to the Council; most services were provided on a need basis rather than as a response to dementia diagnosis. Although church and other groups provided some support and services, those with dementia lacked a clear pathway to receive advice, guidance, and practical support.

To help bridge gaps in provision, it was intended to establish a dementia support hub, providing a co-ordinated framework of community services. The hub would provide a central point of access to work directly with integrated care networks (ICNs), building on the work of dementia-specialist organisations in Bromley. The post-diagnosis services would include: (i) dementia advice during a first point of contact for those newly diagnosed; (ii) an expanded coping with caring project to improve the knowledge, skills and understanding of those caring for a person with dementia; (iii) dementia information co-ordination; and (iv) support group provision. Post-diagnosis support would also include current contracted services i.e. support to care homes, dementia skills training in Extra Care Homes and coping with caring.

The post diagnosis service and associated services would be established through competitive tender, an anticipated timescale being outlined in Report CS15926. It was recommended that existing service contracts due to expire within the timeframe be extended to 30th June 2016 to ensure service continuity and inclusion of those services in new contracts from 1st July 2016.

Support for dementia sufferers was a target of the borough’s health and wellbeing strategy; in response to increased diagnosis there was a desire to be more organised in the borough. Tender specifications would also be shared with the Health and Wellbeing Board for scrutiny of the new support.

An estimate of diagnosed dementia in the borough was derived from a national estimate extrapolated to a local level, the diagnosis rate in the borough being expressed as a percentage of the local estimate. The level of residents with diagnosed dementia now stood at 67% of the local estimate.

Members supported the recommendations.

RESOLVED that:

 (1)  the proposed service set out at 3.5 of Report CS15926 be approved;

(2)  the procurement approach set out at 3.6 a) of Report CS15926 be approved; and

(3) the extension of contracts set out at 3.6 b) of Report CS15926 be approved.

Report CS15922

It was proposed to extend existing contracts for respite care so that a framework of providers could be established via open tender.

The framework providers could be approached directly for specific services or via a mini-tender for larger tranches of service. Flexibility could be provided in the level of individual respite and funding.

Members supported the recommendations.

RESOLVED that the commissioning intentions outlined in paragraph 3.4.1 be agreed along with the extension of the following contracts at a cost of £14k in 2015/16 and £166k in 2016/17:

(a)  Bromley and Lewisham Mind contract for respite at home sitting service from 1^st April 2016 to 30^th September 2016;

(b)  Carers Bromley contract for respite at home sitting service from

1^st April 2016 to 30^th September 2016;

(c)  The Heathers contract for residential respite from 1^st July 2016 to 30^th September 2016; and

(d)  BUPA contract for residential respite from 3^rd January 2016 to

30^th September 2016

Report CS15923

Report CS15923 set out options and recommendations for care and support services in extra care housing schemes when current contracts expire.

In line with an earlier decision to market test remaining Direct Care (in-house) Services - including extra care housing - it was proposed to retender care and support at Apsley Court, Durham House, and Norton Court.

For care and support services not provided in-house at Crown Meadow Court, Regency Court, and Sutherland House, initial contracts with Mears Care, Sanctuary Care, and Hanover Housing Association expired in 2016. Although the contracts could be extended, there would be benefits in retendering and reconfiguring the model of care and support. This would also rationalise provision across all the schemes. 

It was intended to contract with a minimum of two providers and a maximum of three providers across the six schemes, delivering cost efficiencies on management overheads and potentially facilitating some staff movement between schemes. There was also scope to organise joint activities between schemes and co-ordinate activity management. The tender would require providers to bid for a mix of the existing in-house and externally managed schemes.

To facilitate the tendering of an integrated service, it was recommended that the current contract with Hanover Housing Association for Crown Meadow Court be extended by one year from 25^th March 2016 until 24^th March 2017. Similarly, to manage the procurement exercise, it was recommended that the contract with Mears Care for care services at Crown Meadow Court be extended to 24^th March 2017 from 25^th March 2016 (maximum period of one year).

Concerning Sutherland House, it was recommended that an early termination of the contract with Hanover Housing Association for housing related support be explored; a new combined care and housing related support service could then be started on 21st August 2016.

A procurement and implementation timetable was outlined and it was recommended that the new contracts be awarded for five years with optional extensions of two years plus a further two years. 

Following a question from the Portfolio Holder for Resources it was clarified that access to extra care services in other boroughs such as L B Enfield was via housing needs; however, the route to extra care services at L B Bromley was through care needs.

As there were now voids in extra care housing, the Portfolio Holder enquired whether it was necessary to have a mixed cohort of service users i.e. those derived from care needs and those from housing needs. It was explained that voids would be filled by the end of November 2015 and the void level would be monitored (the level of supply of extra care housing is continually monitored compared to demand).

The Portfolio Holder for Care Services highlighted the second sentence at paragraph 3.6 of Report CS15923 which stated that: “the recent closure of Lubbock House, which reduced the available units by 30, was designed to improve the void position”. The Portfolio Holder indicated that this was not an  ...  view the full minutes text for item 279.

Report CS15921

Members were updated on service activity and actions following the Supreme Court judgement in March 2014 related to deprivation of liberty for individuals and associated safeguards (DOLS). 

Last March the Government allocated a sum of £127k grant funding to L B Bromley to help meet some of the new cost pressures associated with DOLS.  The 2015/16 budget for DOLS included this sum and a further sum of £628k approved by Members last February to meet additional cost pressures.

Report CS15921 sought approval to draw-down the £127k grant funding so that the Council could continue to meets its statutory obligations and fund additional costs of £130k as set out in the report.

In discussion it was predicted that the level of activity highlighted at paragraph 4.2 of the report could be expected to increase. A recommendation from the Law Commission to pro-actively identify individuals would further exacerbate pressure on the DOLS service. L B Bromley complies with current DOLS guidance in that requests for DOLS assessments are received from providers.

Concerning a 21 day target for meeting DOLS assessments, the position for

L B Bromley would be clarified following the meeting. (Democratic Services Note: subsequent advice indicated that L B Bromley met the target in most cases – however, there might be some cases e.g. when the court is involved or if the issues are particularly complex, where the process required additional time).

RESOLVED that:

(1)  the allocation of £126,982 additional grant funding by Government be noted; and

(2)  the allocation be released from central contingency to the Care Services budget to fund the additional costs of £130k set out in Report CS15921.

Report ED15100

Approval was sought for the release of Government grant funding for the London Regional SEN and Disability (SEND) programme, L B Bromley with

L B Enfield being the SEN and Disability (SEND) Regional Leads for London to build on the Pathfinder Champion work.  

Release of the funding would enable L B Bromley’s SEND role to continue; it would facilitate a peerSEND learning approach, sharing best practice to support statutory compliance and a London-wide implementation of the Special Educational Needs and Disability Reforms 2015/16.

RESOLVED that £61,924 non-ring fenced funding be released for L B Bromley’s continued role in 2015/16 as SEN & Disability (SEND) Regional Lead for London in partnership with L B Enfield.

There were no additional issues to be reported from the Executive and Resources PDS Committee.

The minutes were confirmed.

Report DRR 15/091

As requested at an earlier meeting, further details were provided in relation to Anerley Town Hall to enable a full appraisal of options in relation to the building’s future.

Report ES 15071

A decision was sought on whether to re-tender the graffiti removal contract or extend it beyond March 2017 for a two year period.

Report to follow

Report CSD15118

A report on matters related to the future provision of ICT services for the Council was previously considered by the Executive at their special meeting on 17^th September 2015. Report CSD15118 included an update on outstanding matters in relation to cost comparisons.