An apology for absence was received from Councillor Tolchard and it was reported that, in accordance with the wishes of the Liberal Democrat Group, the membership of the Sub-Board had been amended to include Councillor Long in place of the Chairman, Councillor Joyce.  In the absence of the Chairman, the Vice-Chairwoman, Councillor Johns Chaired the meeting.

To confirm as a correct record the minutes of the meeting of the Adult Social Care and Health Overview and Scrutiny Sub-Board held on 14 March 2024.

Subject to the recommendation 4 being reworded as set out below, the minutes of the meeting of the Sub-Board held on 14 March 2024 were confirmed as a correct record and signed by the Chairwoman:

Recommendation 4:

4.         to request that the Director of Adult and Community Services ensures there is a link to information from the Alzheimer’s Society regarding HIV associated neurocognitive disorder (HAND) on the Council’s webpage - HIV-associated neurocognitive disorder (HAND) | Alzheimer's Society (alzheimers.org.uk)

4.         to request that the Director of Adult and Community Services ensures there is a link to information from the Alzheimer’s Society on the Council’s webpage.

To receive a verbal update on delivery of the capital programme and re-design of the hospital.

(Note: presented by the Deputy Chief Executive and Chief Strategy and Transformation Officer, Senior Responsible Officer, New Hospital Programme, Torbay and South Devon NHS Trust).

The Director of Capital Developments, New Hospital Programme Director, Torbay and South Devon NHS Foundation Trust provided Members with an update and presentation on the delivery of the capital programme and re-design of Torbay Hospital.

It was recognised that Torbay Hospital was the third oldest hospital in the country and over 80% of the core hospital estate was in either bad or poor condition, including main inpatient wards, emergency department and outpatient department.  Therefore, the backlog maintenance remained significant and also impacted on delivery of patient care and affected staff morale, recruitment and retention.

The Board was informed that the programme was still at an early stage of development at the business planning and master planning concept design stage, but that the need for a new hospital was as great as ever.

Hospital 2.0 provided a ground-breaking standardised approach to designing and building hospitals and would make the process faster, more sustainable and more cost-effective, reducing the time from planning and design through to completion, commissioning and opening new buildings to patients.  The designs included digital solutions and optimised hospital layouts.  All schemes in the New Hospital Programme would proceed through the development phases up to full business case prior to 2030.  Torbay Hospital was in Cohort 4. 

Following feedback, some changes to the site enabling business case were being made to allow better alignment with the Hospital 2.0 programme.  Although the standardised approach had resulted in a slowing down of delivery of the programme, it was anticipated that site clearance would commence later in 2024.  This would cover three areas:

·         site clearance (two phases);

·         high voltage resilience and infrastructure; and

·         car parking.

In terms of current preparations, the Board was informed that the Masterplan had been reviewed and that the cost of the build, staffing and running the building would be analysed in the business case.  The outline business case and full business case would be required before the build could commence.

The Board asked a number of questions in relation to construction access to the site and engagement with local residents; whether a multi-storey car park was being considered to provide parking; when the build would commence and when the new hospital build would be completed; whether plans for the new diagnostic centre in Market Street were behind schedule; what work was being done to make improvements following the outcome of the Care Quality Commission (CQC) report; whether the current building was affected by Reinforced Autoclaved Aerated Concrete (RAAC); whether any of the current hospital building would remain; the cost of scaffolding around the tower and consultation around patient access and services.

In response, Members were reassured that there would be a wider public consultation once early development stages were completed.  Transport planners would work with Torbay and South Devon NHS Foundation Trust to develop egress and access strategies and construction site access would be addressed within that. Additional parking options were being explored in the interim together with longer term options for the Hospital, for example, a  ...  view the full minutes text for item 34.

To receive a verbal presentation on the work undertaken which allowed the revised work on Adult Social Care procurement and contracting to progress.

(Note: presented by the Associate Director of Operations, Torbay and South Devon NHS Foundation Trust).

The Interim Associate Director of Operations, Torbay and South Devon NHS Foundation Trust provided Members with an outline of the submitted report and an update on contract management improvements in Adult Social Care and Paris (case management recording IT system) replacement procurement.

Members were informed that initial Local Government Association (LGA) recommendations and action plans for Adult Social Care management improvement were complete and there were ongoing efforts to integrate revised processes into daily operations.  Embedding market and contract management practices would take some time given the Team’s recent formation and limited prior contract management activities.  Collaboration with procurement colleagues at both the Torbay and South Devon NHS Foundation Trust and the Council was ongoing with clarification of roles and responsibilities in the commissioning process.  The Strategic Team at Torbay Council and the Tactical Team at the Trust were working closely on the overall development and management of the social care market.  Next steps to progress included:

·         further improvements in individual market segments with clear deliverables in 2024/25;

·         to review the operational effectiveness of the Team;

·         utilisation of the new contract management toolkit;

·         further work around contract management for care homes;

·         ensuring value and risk prioritisation;

·         working closely with the Council to improve integrated working around business case approval processes related to commissioning and contracting processes; and

·         emphasis on co-production of the new Care Home Specification through the Care Home Engagement Project.

Members asked questions around what did improved contract management mean for residents and why a majority of care homes who had complaints from LGBT residents retained a good CQC rating?

In response, Members were informed that residents would benefit from improved contract management in terms of management of cost which was really important as a provider and particularly for those self-funding.  Quality would also be monitored alongside safety and good contract management would ensure a pro-active approach to improvements and to meet the communities’ expectation of appropriate management.  In terms of the LGBT question raised, the Director of Adult and Community Services explained that the Council’s Diversity and Inclusion Lead Officer was working with Torbay and South Devon NHS Foundation Trust with focus groups of people to better understand how they felt about their care.  The question around CQC rating and LGBT complaints could be included within that piece of work. 

It was recognised that care home engagement was a vital piece of work as well as hearing from families, advocates and residents of care homes.  This had allowed Torbay and South Devon NHS Foundation Trust to recognise that the care home specification needed re-writing to co-exist with the contract and it was currently being co-produced with both Strategic and Tactical Teams linking to community research.

Members also received an update on the Paris IT system replacement and were informed that an external delivery partner had been procured to support the options appraisal for the Adult Social Care IT system.  It was necessary to future proof the IT system and the current system had been identified as having  ...  view the full minutes text for item 35.

To approve the work programme for the Board for the 2024/2025 Municipal Year.

Members were informed that the Adult Social Care and Health Overview and Scrutiny Sub-Board Work Programme for the municipal year 2024/25 had been devised with input from Overview and Scrutiny Members.  The work programme was designed to help shape how the Overview and Scrutiny meetings would operate and the work programme would remain fluid to accommodate topics that may require scrutinising throughout the year.

Resolved (unanimously):

1.         that the Initial Adult Health and Social Care Work Programme for 2024/2025 as presented be approved; and

2.         that the work programme will be kept under regular review by the Overview and Scrutiny Co-ordinator and the Chairman of the Adult Social Care and Health Overview and Scrutiny Sub-Board and the Scrutiny Officer with consultation being carried out with other Scrutiny Members via the monthly informal Overview and Scrutiny Briefings.

To receive an update on the implementation of the actions of the Sub-Board and consider any further actions required (as set out in the submitted action tracker).

The Sub-Board noted the submitted action tracker.  The Senior Democratic, Overview and Scrutiny Officer provided the following updates:

·         Update on Minute 18 (meeting 23 November 2023) – the Director of Adult and Community Services reported that information on dental hygiene was provided to care providers by Adult Social Care and the Integrated Care Organisation on a regular basis.  The Director of Public Health reported that Public Health continued to work with partners to address this from a public health perspective.  Therefore, this recommendation was captured within existing work streams and the Sub-Board was asked to note this recommendation as completed.

·         Update on Minute 18 (meeting 23 November 2023) – the Director of Adult and Community Services reported that care homes work with primary care to ensure that all residents access screening services.  The Director of Public Health reported that Public Health continued to work with partners to address this from a public health perspective.  Therefore, this recommendation was captured within existing work streams and the Sub-Board was asked to note this recommendation as completed.

Members were also informed that an annual review on improvements in dental access and planned oral health improvement initiatives featured on the work programme for 2024/25.