Agenda and minutes

Adult Care and Health Policy Development and Scrutiny Committee - Tuesday 5 September 2017 7.00 pm

Venue: Bromley Civic Centre

Contact: Kerry Nicholls  020 8313 4602

Items
No. Item

26.

APOLOGIES FOR ABSENCE AND NOTIFICATION OF SUBSTITUTE MEMBERS

Minutes:

Apologies for absence were received from Councillor Will Harmer and Councillor Keith Onslow attended as his substitute.

 

Apologies for absence were also received from Lynn Sellwood, and Justine Goodbeer.

27.

DECLARATIONS OF INTEREST

Minutes:

Councillor Jefferys declared that he was an observer member of Bromley CCG.

 

28.

QUESTIONS FROM COUNCILLORS AND MEMBERS OF THE PUBLIC ATTENDING THE MEETING

In accordance with the Council’s Constitution, questions to the Care Services Portfolio Holder or to the Chairman of this Committee must be received in writing 4 working days before the date of the meeting.  Therefore please ensure questions are received by the Democratic Services Team by 5.00pm on Wednesday 30th August 2017.

Minutes:

Three questions were received from Mrs Susan Sulis, Secretary, Community Care Protection Group and these are attached at Appendix A.

29.

MINUTES OF THE CARE SERVICES PDS COMMITTEE MEETING HELD ON 4TH JULY 2017 pdf icon PDF 272 KB

Minutes:

RESOLVED that the minutes of the Care Services PDS Committee meeting held on 4th July 2017 be agreed.

 

30.

Matters Arising and Work Programme pdf icon PDF 112 KB

Additional documents:

Minutes:

Report CSD17116

 

The Committee considered its work programme for 2017/18, the schedule of Council Members’ visits and matters arising from previous meetings.  The Committee also considered the PDS Investigation Project Outline for the proposed Dementia Services Task and Finish Group.

 

With regard to matters arising from previous meetings, the Chairman noted that Minute 16A referred to the Chairman, Vice-Chairman,  Portfolio Holder for Care Services, and Executive Assistant holding a series of meetings with the Deputy Chief Executive and Head of ECHS Finance to scrutinise the budget.  The Chairman reported that these meetings had not taken place as following the meeting it had been agreed that the most appropriate timing for these meetings would be during the budget setting process.  The Chairman agreed to provide an update to the Committee concerning any alternative arrangements for budget monitoring that were agreed.

 

In considering the most appropriate mechanism to enable the Committee to review the budget position at future meetings, the Vice-Chairman stressed that a written update was the Committee’s preferred format.  The Chairman explained that Members needed to ensure that they were in a position to adequately question and scrutinise the budget and in order to do this Members needed to be as up-to-date as possible.  It was agreed that this issue would be discussed in greater detail later on in the agenda under the ‘Budget Update’ item. 

 

Members considered the PDS Investigation Project Outline for the Dementia Services Task and Finish Group.  The Chairman provided a brief overview of the history of the working group and suggested that the working group be held in abeyance as it was currently unclear as to what the working group would be seeking to achieve.  As the year progressed the need for the working group could be reviewed if necessary.

 

RESOLVED that:

 

1)  The Care Services work programme for 2017/18, the schedule of Council Members’ visits and matters arising from previous meetings be noted; and,

 

2)  The Dementia Services Task and Finish Group be held in abeyance.

 

31.

UPDATE FROM THE DEPUTY CHIEF EXECUTIVE AND EXECUTIVE DIRECTOR: EDUCATION, CARE AND HEALTH SERVICES (VERBAL UPDATE)

Minutes:

The Deputy Chief Executive and Executive Director: Education, Care and Health Services gave an update to Members on work being undertaken across the Education, Care and Health Services Department.  The Deputy Chief Executive began his update by explaining that for this meeting he would focus on commissioning, programming and adult social care.

 

The Deputy Chief Executive and Executive Director ECHS formally thanked Ms Lorna Blackwood, the previous Director of Commissioning for the work she had undertaken in supporting the Care Services PDS Committee during her service at the London Borough of Bromley.

 

The new Director of Programmes, Mr Paul Feven, was introduced to the Committee.  The Director of Programmes would be heading up the Department’s new Commissioning Division and would oversee the commissioning and contract management framework.

 

The Deputy Chief Executive set out the key developments within commissioning, programming and adult social care which included:

 

·  The transfer of the re-ablement contract which would commence on 1st December 2017.

·  Development of a Commissioning Strategy which would identify the commissioning requirements for future years and ensure that the Council knew and understood the key challenges facing services.

·  Better Care Fund – work to integrate services with Bromley Clinical Commissioning Group (CCG) would begin.

·  Developing the role of the Local Authority in terms of supporting the local care market in order to improve services to residents.

·  Planning for winter – ensuring that robust processes were in place to meet challenges in terms of minimising the length of hospital stays.

·  Direct Payments – ensuring users had the option of co-ordinating their own care.

 

In opening the discussion, the Chairman requested that any future reports presented to the Committee had only a brief overview of processes with a greater focus on outcomes and the ways in which success had been measured.

 

A Member of the Committee stressed the need to ensure that any contracts between the CCG and the Local Authority were drafted with sufficient clarity and that any risks and liabilities were adequately managed.

 

In response to concerns that were expressed surrounding delays in the progress of delivery of the Better Care Fund the Deputy Chief Executive provided assurances that a plan had now been agreed between the Local Authority and the CCG and monitoring had been built into the processes.  Both organisations had agreed on the sense of direction and the need to work together in order to meet the needs of Bromley residents.  Members stressed the need to ensure that pace was injected into the delivery of the Fund.

 

In considering the Commissioning Strategy a Member requested that the Committee be provided with updates regarding developing the relationship with providers.  The Deputy Chief Executive indicated that the work that was being undertaken in relation to supporting and developing the market would be key to this.

 

Turning to the re-ablement service, a Member highlighted that in the past concerns surrounding the number of agency staff employed by contractors had been raised.  It was suggested that the Committee may find it helpful if  ...  view the full minutes text for item 31.

32.

HOLDING THE PORTFOLIO HOLDER AND EXECUTIVE TO ACCOUNT

32a

BUDGET UPDATE (VERBAL UPDATE)

Minutes:

The Deputy Chief Executive provided the Committee with an update on work being undertaken across the Education, Care and Health Services Department to address the budget overspend for Care Services Portfolio for 2017/18.

 

The Deputy Chief Executive reminded the Committee that at its meeting on 4th July 2017, Members were advised that the Care Services Portfolio was overspent by £978,000 and that this was projected to have a full year effect of £3,127,000 unless further management action was taken.  At that time the Committee gave a mandate to Officers to work to bring the overspend down.  The Deputy Chief Executive highlighted that Officers within the Department were working within the context of the pressure of an additional £1.5 million efficiency target and the Head of ECHS Finance confirmed that efficiency savings had been profiled throughout the year.

 

The Deputy Chief Executive explained that regular internal budget meetings were held and an action plan with 14 key actions had been developed in order to manage the overspend.  Time had been spent reviewing processes for areas such has hospital discharge and care pathways.  Two budget meetings had now taken place and at these meetings there had been detailed scrutiny of the budget.  Some progress in terms of reducing the overspend was now being seen. 

 

The Head of ECHS Finance explained that due to the way budget monitoring was now resourced, budget monitoring reports were provided to the Council’s Executive on a quarterly basis, although more regular internal budget monitoring was undertaken within the Department.  Through these budget monitoring process management actions had been put in place and a firmer view of the impact of this action could be made following the next formal budget monitoring report in October 2017.

 

The Deputy Chief Executive highlighted that Care Services were demand-led and that it was impossible to predict what the winter months would bring in terms of the level of demand placed on services.  However, the Deputy Chief Executive confirmed that he now felt far more comfortable with the processes and scrutiny that had now been put in place to manage any budget pressures and that action plan had been put in place to deliver savings of £1.2 million.  In response to a question surrounding one-off Government grants, the Deputy Chief Executive stressed the importance of ensuring that where one-off injections of funding were received from Government the funding was targeted at the intended recipients.

 

A Member expressed concern that it had not been possible for the Committee to have been provided with a headline budget position for July 2017 as Members needed assurances that the overspend was reducing.  The Head of ECHS Finance explained that there was not the resources to undertake full monthly budget monitoring and following a review of the Finance division reporting to PDS Committees and the Council’s Executive was not as regular as in the past.  Current internal processes for budget monitoring included scrutiny of ‘hotspots’ such as adult social care.  The Deputy Chief Executive reported that he  ...  view the full minutes text for item 32a

33.

PRE-DECISION SCRUTINY OF CARE SERVICES PORTFOLIO HOLDER REPORTS

The Care Services Portfolio Holder to present scheduled reports for pre-decision scrutiny on matters where he is minded to make decisions.

 

33a

Capital Programme Monitoring - 1st Quarter 2017/18 pdf icon PDF 179 KB

Additional documents:

Minutes:

Report FSD17069

 

On 19th July 2017, the Council’s Executive received the 1st quarterly capital monitoring report for 2017/18 and agreed a revised Capital Programme for the four year period 2017/18 to 2020/21. 

 

The Committee considered the changes to the Capital Programme for the Care Services Portfolio which included an increase of £1,838,000 in grant funding for Renovation Grants – Disabled Facilities, and the transfer of £2,500,000 from the unallocated balance for Housing Section 106 Funds into Affordable Housing Grants scheme and £4,894,000 of funds for the Site G scheme to the Renewal and Recreation Portfolio.  There was also an increase of £3k in Section 106 receipts from developers (uncommitted balance).  A number of net underspends were re-phased into 2017/18 which totalled £1,655,000.  Schemes totalling £1,410,000 were also re-phased from 2017/18 to 2018/19 to reflect revised estimates of when expenditure on Care Services schemes was likely to be incurred including Social Care Grant and Gateway Review of the Housing IT System.

 

Members were advised that progress on works to replace the water supply at Star Lane Travellers Site was underway with final works specifications being determined with Thames Water.  It was anticipated that the work would be undertaken and completed during Quarters 2 and 3 2017/18.

 

A Member stressed the need to ensure that any Section 106 affordable housing contributions needed to be allocated to affordable housing and not diverted to projects that were unrelated to affordable housing.  The Committee sought assurances that Section 106 affordable housing contributions were used for the purpose of affordable housing and the Head of ECHS Finance agreed that following the meeting he would seek clarification report back to the Committee via email.

 

The Committee also considered the timeline for the roll out of mobile working technology, as there was some confusion as to the cause of any delay the Head of ECHS Finance agreed to investigate the issues and provide clarification to Members following the meeting.

 

RESOLVED that the Portfolio Holder be recommended to confirm the revised Capital Programme agreed by the Council’s Executive on 19th July 2017.

 

33b

Formal Consultation on Outline Service Proposals and Procurement Strategy for Point of Care Testing to Support the NHS Health Checks Programme Part 1 (Public) Report pdf icon PDF 75 KB

Minutes:

Report CS18059a

 

The Committee considered a report outlining the service proposals and procurement strategy for Point of Care Testing services to support the delivery of the NHS Health Check programme following the expiry of the existing contract in March 2018.

 

Point of Care Testing services were used for the cholesterol and HbA1C blood tests which were an integral part of the NHS Health Check programme that aimed to prevent vascular diseases including heart disease, stroke, diabetes and kidney disease, and to raise awareness of dementia.  The current contract for the provision of this service had been ‘called-off’ from the Public Health Framework following approval by the Council’s Executive at its meeting on 12th February 2014, and would expire on 31st March 2018 with no option for a further extension.  The existing provider was the sole provider of Point of Care Testing services appointed to the Public Health Framework Agreement, which was unlikely to be retendered after 31st March 2018 due to the decommissioning and consolidation of a wider range of Public Health services across the Framework.  As the existing provider had been identified as delivering an efficient and high quality service which was trusted by GPs to provide accurate results, it was proposed in the Part 2 (Exempt) Report to maintain the current contractual arrangements and approve a three year exemption from tendering this service.

 

RESOLVED that the Portfolio Holder for Care Services be recommended to note the Part 1 (Public) Report when considering the recommendations in the Part 2 (Exempt) Report to award the contract.

 

33c

Empty Property Funding pdf icon PDF 310 KB

Minutes:

Report CS18050

 

The Committee considered a report seeking approval to change the grant conditions linked to the funding of empty property work with a view to improving uptake by property owners.

 

Two externally-funded Empty Property Officers were employed by the Local Authority to provide advice, general support and financial assistance to owners of long term empty property to support them in bringing their property back into use for social housing.  Since the introduction of the scheme in 2008, 64 properties had been brought back into use across the Borough with an average grant award of £9,800; however the uptake of grants through the scheme had fallen significantly over the past three years as a result of the differing rent levels for social and privately rented accommodation, as well as the long nomination period required for social housing.  There were currently approximately 750 properties across the Borough that had been empty for at least six months.  This impacted on the delivery of the Local Authority’s statutory duty to house vulnerable families and individuals identified as being homeless, as well as the level of New Homes Bonus received by the Local Authority.  To support the continued reduction in long term empty properties and maximise the availability of housing to social housing tenants, it was proposed to increase the maximum Empty Homes Property Grant available to owners, reduce the required nomination period to three years and introduce a ‘buy-out’ option where owners no longer wishing to house tenants nominated by the Local Authority could repay grant funding.

 

A Member noted that the funding criteria had been changed to allow funding for empty properties that had only been empty for one month and suggested that this seemed to be a very short period of time, especially when issues such as the settlement of estates were considered.  The Director of Housing explained that the purpose of this was to attract more landlords and that it would allow earlier approaches to the owners of empty properties.

 

RESOLVED that the Portfolio Holder for Care Services be recommended to:

 

1)  Increase the maximum Empty Homes Property Grant available to owners as set out in Paragraph 5.2 to Report CS18050;

 

2)  Reduce the current required nomination period from five years to three years, and allow additional grant to be offered linked to additional years of nomination rights as detailed in Paragraph 5.3 to Report CS18050; and,

 

3)  Where grant conditions are breached and the owner no longer wishes to house tenants nominated by the Local Authority, that the amount of grant to be repaid be reduced pro rata by each full year that has elapsed since completion of the work.

 

34.

PRE-DECISION SCRUTINY OF EXECUTIVE REPORTS

34a

Public Health Commissioning Intentions 2018/19 pdf icon PDF 343 KB

Additional documents:

Minutes:

Report CS18060

 

The Committee considered a report setting out the Public Health commissioning intentions for 2018/19, and seeking authorisation from the Council’s Executive to continue the existing arrangements for sexual health services covering Genitor-Urinary Medicine for 2018/19.

 

The Local Authority participated in a pan-London collaborative commissioning arrangement for the provision of integrated sexual health services in Genitor-Urinary Medicine (GUM) settings.  This was supported by an annually agreed Memorandum of Understanding and an Inter-Authority Agreement between all participating London local authorities.  A budget of £1.6M per annum was allowed for the provision of services through this collaborative arrangement which had proved to be an effective way to commission sexual health services for Bromley residents and had enabled significant savings to be realised over the past three years with actual spend reducing from £1.64M in 2014/15 to £1.55M in 2016/17.  In addition, a number of new initiatives had been developed including the implementation of the London Integrated Sexual Health Tariff and a forthcoming London-wide online testing service which were expected to generate further efficiencies.  It was therefore proposed that the Council’s Executive give authorisation to continue these arrangements for 2018/19, with delegated authority provided to the Director of Public Health in consultation with the Portfolio Holder for Care Services for subsequent annual renewal for the following two years.

 

The Committee noted that there was an intention to review the existing contract for health support for schools in 2018/19. 

 

Members supported the recommendations in the report, noting that a London-wide approach reflected the flow of patients across the London boroughs.

 

RESOLVED that the Council’s Executive be recommended to:

 

1)  Note the 2018/19 Public Health commissioning intentions summary in Appendix 1 to Report CS1806; and,

 

2)  Note the Council’s current participation in the  pan-London collaborative commissioning arrangements for Sexual Health, approve the continuation of these arrangements for 2018/19 and delegate authority to the Director of Public Health, in consultation with the Portfolio Holder for Care Services for subsequent annual renewal for a period of two years for 2019/20 and 2020/21.

 

34b

Gateway Review of the Public Health Service Level Agreements with General Practices pdf icon PDF 325 KB

Minutes:

Report CS18051

 

The Committee considered a report setting out the findings of a review of the performance of Service Level Agreements with Bromley GP Practices for the delivery of specified Public Health programmes and outlining the 2018/19 commissioning intentions for the NHS Health Check Service and Sexual Health Services.

 

All registered GP Practices in the Borough had signed up via Individual Service Level Agreements to deliver one or more elements of specific Public Health programmes from 2014 to 2018.  44 out of the 45 registered GP Practices provided the mandated NHS Health Check Service and all registered GP Practices provided Sexual Health Services.  Performance by GP Practices varied, however all participating GP Practices had been identified as meeting the required clinical and quality standards specified in the Service Level Agreements and were able to achieve significantly more checks than any previous providers in a community setting.  Due to an overall reduction in the percentage of NHS Health Checks, the need to appoint an alternative provider had been identified and following a pilot project, Bromley GP Alliance had been identified as suitable based on the number of checks undertaken during the pilot project and the provider’s unique ability to establish an Information Sharing Agreement with all participating GP Practices to enable access to patient records.  It was therefore proposed that an exemption from tendering be granted to support the continuation of NHS Health Checks and Sexual Health Services in primary care by enabling the Director of Public Health to establish a new round of Service Level Agreements with GP Practices for three years from 1st April 2018 to 31st March 2021.  It was also proposed that an exemption from tendering be granted to appoint Bromley GP Alliance as an alternative provider of NHS Health Checks through a Service Level Agreement for a period of three years from 1st April 2018 to 31st March 2021.

 

The Committee noted that whilst there were other providers for NHS health checks, it was a statutory requirement that any results from NHS health checks had to be recorded on patient health file held by GPs. There had been issues with the process for ensuring that the test results were appropriately recorded on the files.  In addition to this there were eligibility criteria for testing and GPs held a patient register from which eligible patients were invited for testing.

 

RESOLVED that the Council’s Executive be recommended to:

 

1)  Approve the award of Service Level Agreements to GPs for the provision of NHS Health Checks and Sexual Health Services by granting an exemption from tendering as per Sections 3 and 13 of the Council’s contract procedure rules for a period of three years from 1st April 2018 to 31st March 2021; and,

 

2)  Approve an exemption from tendering under Sections 3 and 13 of the Council’s contract procedure rules and award a contract to Bromley GP Alliance as an Alternative Provider of NHS Health Checks for a period of three years from  ...  view the full minutes text for item 34b

34c

Better Care Funding Update pdf icon PDF 305 KB

Minutes:

Report CS18044

 

The Committee considered a report recommending the reallocation of preventative funds within Better Care Funding for 2017/18.

 

In September 2016, the Local Authority and Bromley Clinical Commissioning Group agreed to jointly commission a range of primary and secondary intervention services funded through the Better Care Fund.  These services were designed to reduce the requirement for unplanned care, prevent or delay the need for long term care packages and to support residents to remain independent for as long as possible.  Following consideration by the Council’s Executive at its meeting on 19th July 2017, a contract to deliver these services was awarded to Bromley Third Sector Enterprise from 1st October 2017.  This represented a slight delay from the originally anticipated start date of 1st April 2017.  It was therefore proposed to utilise the underspend on the 2017/18 allocation from the Better Care Fund to offset cost pressures sustained by the Local Authority and Bromley Clinical Commissioning Group as a result of reduced preventative services in 2017/18, and that this be split in accordance with the financial make-up of primary and secondary intervention services on the basis of 60% to the Local Authority and 40% to Bromley Clinical Commissioning Group.

 

Members stressed the need for assurances to be provided that any funding would be used for the purposes set out in the Better Care Fund.  The Deputy Chief Executive confirmed that services had been in place since 1st April 2017, and that funding would be allocated within the key parameters of the Better Care Fund.

 

The Committee noted that a shrink back to budget should be one of the positive impacts of the Better Care Fund.

 

RESOLVED that the Council’s Executive be recommended to:

 

1)  Approve the reallocation of £825,500 of Better Care Fund originally allocated for preventative services to be split between the Local Authority and the Bromley Clinical Commissioning Group on a 60%/40% split;

 

2)  Approve that the reallocated funding be put against overspends and pressures attributable to not having preventative services in place, and note that the preventative services have now been awarded and will commence from 1st October 2017; and,

 

3)  Note the agreement of Joint Integrated Commissioning Executive to this action on 19th July 2017.

34d

Housing Supply pdf icon PDF 192 KB

Minutes:

Report CS18052

 

The Committee considered a report providing an update on the use of temporary accommodation and housing support to meet current housing need and homelessness pressures across the Borough.  The report also set out key actions being undertaken to mitigate the growing pressures on housing supply and requested approval for Officers to progress a number of schemes to assist in addressing the current pressures

 

In common with all London Boroughs, Bromley had experienced a significant increase in the number of households at risk of homelessness or requiring temporary accommodation in recent years.  This was expected to continue to increase as further welfare reforms were introduced and in light of increased duties that would be placed on all local authorities when the Homelessness Reduction Act 2017 came into force.  To address this, the Local Authority had undertaken a wide range of work including early intervention measures to prevent homelessness and significantly increasing temporary accommodation stocks within Bromley and the surrounding area.  The Local Authority continued to work closely with developers and housing associations to maximise the supply of affordable housing in new development schemes.  A number of housing providers and developers were also committed to working with the Local Authority to bring forward property acquisition and refurbishment schemes, for which ten proposed core principles had been developed to assist in the timely progression of schemes which could then be reported Members for their consideration.

 

The Committee noted the following core principles had been developed to enable proactive engagement with the market:

 

1)  The Council will commit to a nomination agreement for a fixed period on the basis that rents do not exceed Local Housing Allowance levels (plus management allowances for any supported accommodation). The initial rents may need to be subject to annual inflation increase, if required, to meet external funders requirements;

2)  The Council will not be responsible for the collection of rents and the provider will need to make allowances for any bad debt and any reasonable void levels;

3)  In having full nomination rights the Council reserves the right to place residents on behalf of other local authorities or use some of the units for alternative private sector market tenants;

4)  The accommodation must be suitable for meeting the Council’s housing needs and is required to meet Decent Home Standards during the period of the nomination agreement;

5)  The Council will normally seek for the properties to be returned to the Council under its full ownership which may require the final repayment of any external borrowing towards the project;

6)  A Special Purpose Vehicle arrangement will normally be required recognising that the Council will not have direct sole control on the accommodation;

7)  The Council will only work with providers who have experience in property development and management;

8)  Any planned acquisition of property must not be in direct competition with the existing arrangements with More Homes;

9)  The Council would seek alternative management arrangements, in the event that the management of the accommodation failed to meet  ...  view the full minutes text for item 34d

34e

Adult Services Business Case for Mobile Working pdf icon PDF 135 KB

Additional documents:

Minutes:

Report CS18063

 

The Committee considered a report outlining proposals to introduce mobile working across the Adult Social Care service and requesting the Council’s Executive release £200k from the Council’s Technology Fund to provide the additional IT equipment needed to support the implementation of the scheme.

 

Following concerns identified around the continuing high demand for Adult Social Care services, a mini-pilot scheme was undertaken in the Initial Response Service to identify how an increased level of mobile working could benefit the service, staff and service users.  The outcome of the eight week pilot scheme which focused on the Occupational Therapy service demonstrated improved productivity in assessments of 40-50% with a significant uplift in the number of service users assessed each week, both increasing the efficiency of the Occupational Therapy Service and supporting service users to retain their independence.  It had been identified that there were 149 posts with assessing responsibility across the Adult Social Care service that might benefit from increased remote working and realise the associated efficiencies, and that a similar move to remote working had recently been rolled-out across Children’s Social Care.  It was therefore proposed that the Council’s Executive approve the release of £200k from the Local Authority’s Technology Fund to provide additional IT equipment to support the implementation of mobile working across the Adult Social Care service.

 

RESOLVED that the Council’s Executive be recommended to approve the release of £200,000 from the Local Authority’s Technology Fund to provide additional IT equipment to support the implementation of mobile working across the Adult Social Care service, as detailed in Report CS18063.

34f

Discharge to Assess - Support

Item withdrawn.

Minutes:

This report was withdrawn from the agenda, and would be considered at a future meeting of Care Services PDS Committee.

35.

POLICY DEVELOPMENT AND OTHER ITEMS

35a

Public Health Programmes Performance Update 2016/17 pdf icon PDF 241 KB

Additional documents:

Minutes:

Report CS18061

 

The Committee considered a report providing an update on the contractual arrangements and provider performance of Public Health commissioned services in 2016/17.

 

Public Health Programmes were grouped into three broad areas comprising Adult Public Health Services which included NHS Health Checks and a number of healthy lifestyle programmes, Children and Young People Public Health Services which included School Nursing and Health Visiting, and Risky Behaviour for Young People and Adults which included Sexual Health and Substance Misuse Services.  A diverse range of organisations had been commissioned to deliver these services such as third party organisations, local community health providers and acute hospital providers.

 

A Co-opted Member raised concerns about the high abortion rate in Bromley and questioned whether anything was being done to address this.  The Assistant Director of Public Health explained that provision of abortion is not the responsibility of local authorities but work had been carried out to reduce the abortion rate, targeting those women who were at risk of having repeat abortions.  This included advice on appropriate contraception methods and the promotion of long acting reversible contraception (LARC) to prevent further unplanned/unwanted pregnancies.  Provision of LARC from GP practices remained a vital service which continued to contribute towards the reduction of unplanned pregnancies.  The Assistant Director agreed to provide the Committee with further information on this area of work.

 

Members recognised that there was a great deal of information within the report, including detail on the outcomes that were being achieved.  A Member noted that the public health services that were being provided would be hugely beneficial in terms of delivering additional future savings.

 

RESOLVED that the activity and performance of Public Health programmes during 2016/17 be noted.

35b

Annual ECHS Debt Report pdf icon PDF 167 KB

Additional documents:

Minutes:

Report CS18043

 

The Committee considered a report providing an update on the current level of Education, Care and Health Services debt and the action being taken to reduce this.

 

The level of Education, Care and Health Services debt as at 31st March 2017 was £10.3m, of which £7.1m was less than a year old.  This outstanding debt had reduced to £8m by 31st July 2017, and was expected to decrease by 40-50% by the end of March 2018 with further reductions during 2018/19.  The increasing number of households in temporary accommodation continued to impact on the level of outstanding debt, particularly in relation to recent welfare reforms which required some clients to make personal contributions to ‘top-up’ housing benefit.  A range of measures were in place to recover outstanding funds including a significant increase in the number of clients paying for adult social care services by direct debit and an ongoing review of policies and procedures, as well as specific measures relating to temporary accommodation including the recruitment of two visiting officers and the introduction of a new Housing IT system in April 2018.  Proposals were currently being developed to establish a visiting officer and social worker to work primarily with clients who lacked capacity to manage their finances and those who had difficulties in paying their care charges.  The total amount of debt written off in the period 1st April 2016 to 31st March 2017 had been £652,401 and was largely due to debtors being untraceable, no funds in a debtor’s estate or because the debt had been identified as uneconomical to pursue. 

 

The Head of Exchequer Services confirmed that the challenges in relation to reducing debt faced by the Council were challenges that were being faced by local authorities nationwide.  The level of resourcing required to manage debt at an earlier stage was also being reviewed.

 

In relation to training, the Head of Exchequer Services reported that there would be no costs as the training would be provided in-house.

 

In response to a question the Head of Exchequer Services confirmed that a service level agreement was in place with Liberata and this established the timeframe for dealing with estate debt.  There had been an improvement in the length of delay however it was important that colleagues within Care Services provided notification when an account was terminated.

 

RESOLVED that the level of Education, Care and Health Services debt over a year old and the action being taken to reduce this sum be noted.

36.

QUESTIONS ON THE CARE SERVICES PDS INFORMATION BRIEFING pdf icon PDF 284 KB

The briefing comprises:

 

  • Annual ECHS Complaints Report
  • Overview of Respite (Orpington Beds)
  • Contract Activity – Information Briefing

 

Members and Co-opted Members have been provided with advance copies of the briefing via email.  The briefing is also available on the Council’s website at the following link:

 

http://cds.bromley.gov.uk/ieListMeetings.aspx?CId=559&Year=0

 

Printed copies of the briefing are available on request by contacting the Democratic Services Officer.

 

This item will only be debated if a member of the Committee requests a discussion be held, in which case please inform the Clerk 24 hours in advance indicating the aspects of the information item you wish to discuss.  Questions on the briefing should also be sent to the Clerk at least 24 hours before the meeting.

 

Additional documents:

Minutes:

The Care Services PDS Information Briefing comprised three reports:

 

  • Annual ECHS Complaints Report
  • Overview of Respite (Orpington Beds)
  • Contract Activity – Information Briefing

 

RESOLVED that the Information Briefing be noted.

37.

LOCAL GOVERNMENT ACT 1972 AS AMENDED BY THE LOCAL GOVERNMENT (ACCESS TO INFORMATION) (VARIATION) ORDER 2006 AND THE FREEDOM OF INFORMATION ACT 2000

The Chairman to move that the Press and public be excluded during consideration of the items of business listed below as it is likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.

 

Minutes:

RESOLVED that the Press and public be excluded during consideration of the items of business listed below as it was likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.

38.

EXEMPT MINUTES OF THE CARE SERVICES PDS COMMITTEE MEETING HELD ON 4TH JULY 2017

Minutes:

RESOLVED that the exempt minutes of the Care Services PDS Committee meeting held on 4th July 2017 be agreed.

39.

Formal Consultation on Outline Service Proposals and Procurement Strategy for Point of Care Testing to Support the NHS Health Checks Programme Part 2 (Exempt) Report

Minutes:

The Committee considered the report and supported the recommendations.

Appendix A: Written Questions to the Care Services PDS Committee pdf icon PDF 10 KB

Appendix B: Homelessness and Temporary Accommodation Comparative Data 2016/17 pdf icon PDF 435 KB