REPORT FOR HEALTH AND SOCIAL CARE OVERVIEW AND
SCRUTINY COMMITTEE – WORK PROGRAMME AND RELATED
ISSUES
4 JUNE 2003
The purpose of this report is to help inform members of the issues to be
considered for the forthcoming work programme.
The first section of the report highlights for members suggested areas
for inclusion in the work programme and the second section highlights
issues relating to the scrutiny process which members need to consider
and address as part of this process.
1.0
SECTION ONE
1.1
Director of Public Health
The Director of Public Health has suggested that the following area
would be a useful piece of in-depth work for the Scrutiny Committee to
focus on:Tobacco Control in Salford – The Director of Public Health will expand on
this at the meeting
Inequalities in health in Salford are very high. The poor continue to
experience the highest levels of disease and are more likely to die
younger than others. The major killers in Salford – heart disease, stroke
and cancers – are caused by smoking. A disproportionately high number
of poor people smoke. Co-ordinated and targeted efforts would reduce
smoking, and so far progress has been limited. There are numerous
opportunities to implement effective programmes, control tobacco and
reduce smoking. For these reasons, it would be beneficial if scrutiny
committee undertook an in-depth piece of work about this topic.
1.2
Issues from the Community Health Council
Salford Community Health Council recently published its Annual report
for 2002/03 and following their imminent abolition from 1 September
2003 are asking the Scrutiny Committee to consider the following issues
for inclusion within their work programme:
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1.3
The future of Secondary Surgical Services for Salford Children
Local Long term care or accommodation for younger disabled people
The quality of GP deputising service especially out of hours service
Accessibility of pharmacy services in the evenings and at weekends
in Salford
Eligibility Criteria – Continuing care
Issues from Members of the Public
2 Members of the public have written to the Chair of the Scrutiny
committee asking for Women’s services in Salford Royal Hospitals NHS
trust to be looked at.
Another Member of the Public has also written concerned about the
standards of care on the Eric Rawlings ward of Hope Hospital
1.4
Issues from Partners
Salford Royal Hospitals NHS Trust
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Understanding the 3 year Local Delivery plan
Development of Intermediate Care and Tier 2 Services (developing
services out in the Community)
Improvements in Transfer of Care arrangements and preventing
delays in transfers/discharge from hospital
Development of stroke services and an acute stroke unit
Developments in Children’s Services
New financial flow arrangements
SHIFT Project
Salford Primary Care Trust
To be reported at the meeting
Bolton, Salford and Trafford Mental Health Trust
A copy of a letter received from the Trust is attached
Community and Social Services Department of the City Council
To be reported at the meeting
1.5
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Issues from 2002/03 work programme
Review of Community Centres
Health Inequalities development programme (as outlined below)
Local delivery Plan and capacity plan
Palliative care (report due July 2003)
Delayed Discharges (monitoring of the situation)
Children’s Trust
Joint Review – Community and Social Services (expected July)
Young people leaving care
Child and Adolescent Mental health Plan
Community and Social Services Department response to the
Victoria Climbie Inquiry
2.0
SECTION TWO
2.1
SHIFT AND LIFT
Members will be aware that at the meeting of the Scrutiny Committee
held in May 2003 scrutiny officers were asked to meet with the
SHIFT/LIFT Project Managers to discuss how the 2 projects could be
more effectively scrutinised.
A meeting was recently held and outlined below is the proposed way
forward for members consideration:
Focus on four key themes of the project to be reported regularly,
probably every 6 months, to a schedule yet to be agreed. The
suggested areas are:
o Access
o Transport
o Public involvement
o Regeneration
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Reports to be structured against an agreed format to cover the
four key areas
Reports will be presented to the Overview and Scrutiny Committee
by appropriate members of the SHIFT and LIFT Teams
A further suggestion is for a member of the Health and Social Care
Overview and Scrutiny Committee or a Scrutiny Officer (whichever is
deemed more appropriate) to be invited to future meetings of the SHIFT
Partnership Board to act as a link on behalf of the Scrutiny Committee in
an observer role without voting rights. If Members were in favour of
this approach further work would need to be done in clarifying the role.
The SHIFT Partnership Board at their meeting held on 16 May fully
endorsed the proposals outlined above.
Members views are sought.
2.2
Health Inequalities
At recent meetings of the Scrutiny Committee the Director of Public
health has done some work with the Scrutiny Committee around the
health inequalities in Salford and at the last meeting it was agreed that
Development work to build organisational capacity in understanding
inequalities would be progressed to identify inequalities and take an
inequalities perspective in considering future interventions and service
developments. Key points in this development work which is to be
undertaken with the Scrutiny Committee, the Local Strategic Partnership
and other stakeholders are:
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Developing a broader understanding of health inequalities ; and
Use of a structured template for each of the priority areas that
will draw together
o Background information on each priority area
o Targets
o Evidence of effectiveness
o Current work
o Local barriers and challenges to progress
o Next steps
o Performance measures (including identifying gaps in data)
In addition how the relationship between Healthy City Forum and the
Scrutiny Committee will work is also to be progressed. Members need to
be mindful of this important piece of work when setting the work
programme.
2.3 Consultation of the Overview and Scrutiny Committee by Local
NHS bodies
It is a legal duty for local NHS Bodies to consult the overview and
scrutiny committee if they have under consideration any proposal for a
substantial development of the health service in the area or for a
substantial variation in the provision of such service.
There is a need for the Overview and Scrutiny Committee to determine
how they would want to deal with various different consultations that may
need to be looked at in the forthcoming municipal year and also how
issues which the scrutiny Committee should be looking at are highlighted
for their consideration.
To a certain degree we must rely on our partners to highlight such
consultations, however, it is suggested that the Scrutiny Support Officer
furthers the links that have already been made with key contacts at each
Trust to maintain regular dialogue of the issues coming forward in each
organisation AND that (on a pilot basis for 6 months) any consultations
coming through be considered by the Assistant Director of Scrutiny, the
Scrutiny Support Officer and the Chair of the Overview and Scrutiny
Committee to determine how statutory and non-statutory consultations
should be handled and with a report back to the scrutiny committee at
the end of the 6 months on the number and types of consultations
considered
2.4
Co-opted Members
The Health and Social Care Overview and Scrutiny Committee has 4 coopted Members from the following organisations:Foster Carers Association
Age Concern
British Red Cross
Salford CVS
It may be that in the future the Scrutiny Committee could be faced with
Scrutinising some of the organisations that the Co-opted members
represent and Members are asked to consider whether standing cooptees are the best way forward for scrutiny. The current co-opted
members represent organisations who are providers of services, which
could be the subject of scrutiny in the future. It may be more
productive if members from particular organisations/members of the
public were co-opted for specific pieces of work rather than as standing
members of the Overview and Scrutiny Committee.
2.5
Protocols
Attached to this report are suggested protocols for the operation of
health scrutiny in Salford. The protocols have been sent to all partners
for their comments – the Director of Public Health made some comments
in relation to the emphasis of health inequalities and these have been
incorporated. No further comments have been made and therefore
members are asked to comment and suggest any changes where necessary
and agree to adopt them for the forthcoming year.
2.6
Overview role
Members’ views are sought on an alternative approach in the way
performance management information can be considered in the future.
Members are asked whether they would consider nominating 4-6 members
of the Scrutiny Committee to sit on a sub-group for the consideration of
performance management information.
The sub-group would meet each quarter to consider the relevant
performance information from the Community and Social Services
Directorate, and each Trust and it is envisaged that each of these groups
would bring to the attention of the main committee any pertinent issues
following such meetings.
It is also envisaged that reports from the Patient Advice and Liaison
Service (PALS) collaborative, Patient and Public Involvement Forums, the
Independent Complaints and Advocacy Service (ICAS), Health Service
Ombudsman, NHS direct, patient Surveys and Best Value Review
Improvement plans would be considered by the Sub-Group.
It is acknowledged that this approach would require certain members to
attend four extra meetings a year, however it is anticipated that the
benefits to the scrutiny function of freeing up the time of the main
committee would enable it to concentrate its work programme to consider
more focused issues.
The actual mechanics of what information will be scrutinised would be
looked at the fist meeting of the sub-group and it is hoped that a more
helpful and focused approach on specific indicators could be adopted.
2.7
AGMA Health Scrutiny
In January 2003 the Association of Greater Manchester Authorities
(AGMA) set up an AGMA Health Scrutiny panel, which meets monthly and
comprises one elected members from each local authority in Greater
Manchester. Councillor Mrs V Burgoyne is Salford’s representative on this
body and work is underway to progress and formulate the work plan for
the Panel.
The purpose of the Panel is to scrutinise issues which affect the whole of
Greater Manchester and it is proposed that the information being
considered at an AGMA level be reported to Salford’s Health and Social
Care Overview and Scrutiny Committee on a regular basis in the future.
The Strategic Health Authority for Greater Manchester has a legal duty
to consult with every overview and scrutiny committee within Greater
Manchester and the options put forward for doing this are as follows:1.
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Consult each Overview and Scrutiny Committee
Ask the Overview and Scrutiny Committees across Greater
Manchester if they were willing to delegate their power of
scrutiny to a single Council
Ask the Overview and Scrutiny Committees if they were willing
to delegate their power of scrutiny to the AGMA Health
Scrutiny Panel
Members’ views on the above are sought.
A further consideration will be the joint scrutiny of the Bolton, Salford
and Trafford Mental Health Trust and how this is developed in the
future.
RECOMMENDATIONS
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To determine the work programme for 2003/04
Agree for the Chair, Assistant Director of Scrutiny and the
Scrutiny Support Officer to determine how statutory and nonstatutory Consultations should be handled on a pilot basis for 6
months
Clarify the role of Co-opted Members
Agree the Criteria relating to the Scrutiny of SHIFT and LIFT
outlined in paragraph 2.1 of this report and determine who
should be nominated to take the observer place on the SHIFT
Partnership Board
Agree the protocols for the operation of scrutiny as appended
to the report
Consider appointing a Sub-group to consider performance
management information and determine the membership
Give consideration to the operation of AGMA Health Scrutiny
For further information in relation to this report please contact
Amanda Hewitt on 0161 793 3316 email amanda.hewitt@salford.gov.uk
or fax number 0161 794 2027.
DRAFTS TO BE DISCUSSED
PRINCIPLES FOR HEALTH AND SOCIAL CARE OVERVIEW AND
SCRUTINY IN THE CITY OF SALFORD
Overview and scrutiny of health and social care in Salford will be
carried out based on these principles:
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the primary focus will be on improving health and reducing health
inequalities in its widest sense, rather than just health and social
care services
all activities will be about issues that affect communities and
populations, and will not deal with individual cases or complaints
work will be informed by evidence of what makes a difference to
health and well-being
issues to be scrutinised will be those that Salford citizens say are
of high priority to them
all activities will reflect and address the diversity of the local
population (including those who are most disadvantaged or
vulnerable)
scrutiny processes will always seek and take account of the views
of local citizens and communities affected by the issues under
consideration
the scrutiny process will be open and transparent
while the Committee will retain its independence at all times, its
work will be done in constructive partnership with others
scrutiny will be undertaken only when it does not duplicate work
being done elsewhere and is likely to make a significant positive
difference to policies, decisions and services that affect the
quality of life of local citizens
The Health and Social Care Overview and Scrutiny Committee will:
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maintain, through its Chair and/or Support Officer, regular
contact with nominated officer contacts in the Community and
Social Services Directorate of Salford City Council, each local NHS
agency, and each local patient forum
consult with patients’ forums, the Community and Social Services
Directorate of Salford City Council, all local NHS bodies, and major
independent service providers on topics for review and scrutiny and
on its proposed work programmes
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make its work programme available to the public, patients’ forums,
local health and social care agencies, the media and other
interested parties
liaise with the overview and scrutiny committees of other local
authorities when planning work that may have significant relevance
to populations outside Salford
In the case of Bolton, Salford and Trafford Mental health Trust ,
the Committee will advise Bolton, Trafford and Bury about health
scrutiny exercises they are planning on the work of the Trust and
discuss jointly the most appropriate way forward
consult and invite all interested parties to comment on each matter
under scrutiny
seek to involve, as appropriate, service users, carers and
communities in its work, including through their representative
organisations
seek and use existing knowledge of the views and concerns of
citizens to inform the review and scrutiny process
take account of all relevant information made available to it
only make recommendations that are based on evidence and are
likely to improve health and/or reduce health inequalities
make reports and recommendations to the City Council and local
NHS bodies on any matter reviewed or scrutinised – and publish
these at the same time to the public and all those involved in the
review and scrutiny process
The Community and Social Services Directorate of Salford City Council
and local N.H.S. bodies will:
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maintain regular contact through the Chair and/or Support Officer
of the Committee
provide such information to the Committee as it reasonably
requires to discharge its functions
assist the Committee in identifying relevant health and social care
issues for review and scrutiny
inform the Committee, as soon as known, of any consultation or
other significant issue that is likely to arise concerning health and
social care in Salford
provide, at reasonable notice, a senior officer to attend a meeting
of the Committee to answer questions it wishes to raise
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consult the Committee at an early stage on any proposal for a
substantial development or variation of a service within the City of
Salford
respond in writing to a report or recommendation by the Committee
within 8 weeks of this being requested – setting out its response to
the report and each recommendation, including proposed action or
reasons for inaction
This and any other protocols will be regularly reviewed and amended as
appropriate in the light of practical experience.
AH
May 2003