Agenda and draft minutes

To receive Declarations of Interest (if any)

There were no declarations of interest.

To confirm the non-exempt minutes of the meeting of the Improvement and Scrutiny Committee - Health held on 11 December 2023.

RESOLVED – to confirm the non-exempt minutes of the meeting of the Improvement and Scrutiny Committee – Health held on 11 December 2023.

30 minutes maximum for this item.  Questions may be submitted to be answered by the Scrutiny Committee or Council officers who are attending the meeting as witnesses, on any item that is within the scope of the Committee. Please see the procedure (below) for the submission of questions.

There were no public questions.

Councillor Carol Hart, Cabinet Member for Health and Communities discussed her role as Chairman of the Derbyshire Health and Wellbeing Board (HWB).  She gave a brief history of the establishment of the HWB for the benefit of committee members and made reference to the following.

The financial deficits incurred by two of the original five CCGs operating across Derbyshire resulted in the establishment of one, countywide CCG, now called the Derby and Derbyshire Integrated Care Board (ICB) and the introduction of measures including a 5-Year Financial Recovery Plan agreed with NHS England.  This Plan and its associated service transformations had been considered by this committee on a number of occasions to ensure patients’ experience of services was not diminished.

Partnership working across the Integrated Care Partnership (ICP) had been a steep learning curve, not least for NHS partners who were used to working more independently.

The HWB had been refreshed recently to include district and borough Councils.  There were now two place-based partnerships including the County Place Partnership Board on which DCC was represented by the Director of Public Health.

It was not clear if the proposed East Midlands Combined County Authorities of Derbyshire, Derby City, Nottinghamshire and Nottingham City would have an impact on the HWB.  Committee members commented that it would be preferable that the HWB stayed as a county/city partnership and not expand into a more regional network.

Councillor Hart wished to raise the availability of funding for services that prevented ill-health.  Funding for services across the HWB’s remit for 2024/25 was set at 1.4% which would be challenging. 

The ICB and NHS partners had bigger budgets than Local Government partners. The Council’s Public Health team provides services to keep people healthy and Councillor Hart and the Director of Public Health were keen to encourage NHS partners to contribute to schemes which, ultimately, would reduce the number of people seeking NHS services and reduce the pressure on the local NHS.

Initiatives that Councillor Hart gave particular mention to were:

·      Stop Smoking Campaign;

·      0 -19 service transformation which was currently being negotiated with Derbyshire Community Health Service; and

·      Pharmacy First initiative.

Committee members were given the opportunity to ask questions.  In response to how best to involve Districts and Borough Councils on the HWB, Cllr Hart said it was important to stress that the health and wellbeing of people across the county impacted on all council services including housing and other district and borough responsibilities.

It was unclear at this time if pharmacies were able to prescribe anti-biotics and all referrals to the Active Derbyshire Programme were currently made by GPs.

The transition from Tameside CCG to Derbyshire ICB for people in the northwest of the county had gone smoothly, with no perceivable difference for patients.

The Committee thanked the Cabinet Member for her attendance at the meeting and providing the update of the HWB.

RESOLVED to note the work of the Health and Wellbeing Board.

Helen Henderson, CEO of Healthwatch Derbyshire gave the Committee an update on the work recently undertaken by Healthwatch Derbyshire, along with on-going projects.  These included:

·      The monitoring of the Pharmacy First programme and the impact it was having on the patient experience.

·      Looking into dental services provided alongside the NHS England Dental Recovery Plan.  The Committee had requested an update from the ICB on Dental Services for the next meeting and the impact of the NHS England Plan on Derbyshire patients would be a key item for discussion.

·      The monitoring of the new wheelchair service, the procurement of which was about to begin.

·      Accessing GP appointments which had seen bad experiences in a number of cases.  Members suggested that these numbers should be regarded in context so that problems, which were important, did not over-emphasise the problem if it was only in a small number of cases.  The Committee was assured that for most surgeries, there was no problem but Healthwatch were responsible for raising concerns for those patients who were suffering from lack of access to GP services. 

Members also suggested that problems were occurring due to poor management practices at some surgeries and that the ICB should monitor this as part of their procurement process.  The Committee would raise this with the ICB.

·      The Committee noted that the CAMHS service had been difficult to access quickly for a number of years and that delays in accessing appropriate support often exacerbated a patient’s problems.  Early intervention was key in supporting young people with mental ill-health.

·      Healthwatch had been asked by the ICB to undertake work on the take up of vaccines and this work would involve the Council’s Public Health team.

RESOLVED to accept the update.

Jackie Wardle, Improvement and Scrutiny Officer advised Committee of the expected items to be discussed at future meetings:

May 2024 meeting

o   Maternity Services;

o   Dentistry Services across Derbyshire;

o   Post-COVID report; and

o   Director of Derbyshire Community Health Service.

July 2024 meeting

o   Derbyshire Healthcare NHS Foundation Trust – Living Well

Derbyshire NHS;

o   0-19 Services Transformation;

o   Pharmacy Services, including Pharmacy First; and

o   East Midlands Ambulance Service.

Further suggestions were welcomed from Committee members.

RESOLVED to accept the items listed for future meetings.