An apology for absence was received from Councillor Loxton.  In accordance with the wishes of the Conservative Group, Councillor Foster was substituted by Councillor Brooks.

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 23 June 2022.

The Minutes of the Adult Social Care and Health Overview and Scrutiny Sub-Board held on 23 June 2022 were confirmed as a correct record and signed by the Chairwoman.

To receive an update on the length of time people are waiting to receive care assessments for adult social care and the action being taken to address this.

(Note: Jo Williams – Director of Adults and Community Services and Shelly Machin – System Director will be present for this item.)

The Board considered a report that provided a situational overview of waiting lists in Front End (Triage) and Complex Care Team (CCT) within the Adult Social Care (ASC) Bay Wide Teams and also the overall picture of overdue reviews.  Shelly Machin – System DirectorTorbay and South Devon NHS Foundation Trust informed Members that a risk-based approach was used when assessing those on the waiting list, the number of people on the waiting list had increased and coincided with an increased level of sickness and vacancies.

Ms Machin responded to questions in relation to the following:

·         The reasons for staff sickness and vacancies;

·         The increasing number of ‘60+ days’ on the Complex Care Team waiting list;

·         The number of overdue ‘Adult Social Care Annual Reviews’ and the other intelligence and evidence gathered to ensure that a person who was overdue an annual review was not at risk; and

·         Concerns regarding the impact of the cap in relation to the cost of care.

Members asked that following information be provided:

1)    The number of people who have been removed from the waiting list as a result of seeking private treatment; and

2)    The approach taken to share the waiting list data across teams and with partners.

To receive an update on suicide prevention in Torbay.

(Note:  Rachel Bell – Public Health Specialist and Lincoln Sargeant – Director of Public Health will be in attendance for this item.)

The Board noted an update on Suicide Prevention in Torbay.  Members were advised that over the last year Torbay’s rate of suicide had dropped slightly.  However, the suicide rate was still significantly higher than many other areas in the country and combined with an economic position that currently challenges the most vulnerable individuals in our society, officers and partners could not become complacent. 

The Board was informed of the significant contribution Torbay Community Helpline had made in addressing mental health by looking at an individual holistically.  The ‘train the trainers’ approach to skilling up people to recognise and respond to mental health issues in the community was noted to be a successful method that had aided the delivery of a range of courses that aimed to boost wellbeing.  The self-harm prevention pilot in Torbay schools had also been extended for another year and had already delivered some positive outcomes.  New priorities had been identified and included ‘tackling basic needs’ as a means of preventing poor mental health and tailoring approaches to improving mental health in children and young people.

Members asked questions in relation to:

·         Targeting resources at particularly vulnerable groups such as young men;

·         Resilience within schools and relationship with multi academy trusts;

·         Whether there were local initiatives that could be developed with Licensed Premises; and

·         The ‘Tree of Life’ a peer support model being used by young people to support each other.

Resolved:

That the Adult Social Care and Health Overview and Scrutiny Sub-Board supports the proposals set out in the submitted report to:

1.         Continue to support the multi-agency priorities and actions outlined in the Torbay Suicide and Self-harm Prevention Plan 2022/23 and the Torbay Joint Health and Wellbeing Strategy 2022-26, including:

·         Promoting information and awareness around suicide through all statutory, community and voluntary partnerships in the Bay.

·         Promoting suicide awareness and free suicide training with local employers and businesses to support creation of suicide safe environments.  This will support actions identified in the Cost of Living Summit 5 October 2022.

·         Referral and signposting pathways to appropriate support and services, based on level of need.

2.         Enable Torbay Council staff and providers who interact with vulnerable residents to identify and act on potential indicators of poor mental wellbeing or suicide risk, and also to maintain their own wellbeing.  This is primarily through:

·         Promoting a range of suicide prevention training to all employees (universal and targeted offer based on roles and functions).

·         Partnerships with and signposting to partners providing relevant support e.g., Samaritans, TALKWORKS, QWELL, Devon Wellbeing Hub and the Torbay Community Helpline.

3.         Focus on specific actions to improve children’s emotional health and wellbeing through new multi-agency forums leading implementation of children’s services priorities (SEND action plan, early help, family hubs).

To consider the GP Strategy for Devon and how this impacts on Torbay residents.

(Note:  Jo Turl, NHS Devon’s Director of Commissioning Primary, Community and Mental Health Care will be present for this item.)

Jo Turl and Steve Harris from NHS Devon’s Commissioning Primary, Community and Mental Health Care Team presented an update on the NHS Devon Strategy for Primary Care (General Practice).  Members were advised that in developing the Strategy over the course of the last few months, care had been taken to ensure wide engagement with key partners and stakeholders.  There had been 29 reference-style group meetings with GPs, practice managers, other health professionals (for example within secondary care and mental health services), system partners, patients and Healthwatch.  Surveys were also widely circulated and consisted of two different surveys tailored to those working within the healthcare system and those the healthcare system was there to care for.

A number of emergent themes were identified, for instance, differentially investing to tackle health inequalities, consistency of access and support to users when accessing technology, a strong focus on the prevention agenda and supporting practices with a Greener NHS plan.  The new Strategy had therefore been developed taking into account the output from the engagement.

Ms Turl and Mr Harris responded to questions in relation to:

·         Patient expectations and the balance of ‘want vs need’;

·         The evolution of digital and the need for digital offer to provide a seamless route through to non-digital practice;

·         Homelessness and access to primary care;

·         GP access and waiting times at A&E; and

·         Learning from Vaccination Centres, ability to scale up and development of hubs.

To review the Quality Account for 2021/22 and provide feedback to the Trust.

(Note: Deborah Kelly – Chief Nurse will be present for this item).

The Chief Executive, Liz Davenport and the Chief Nurse, Deborah Kelly for the Torbay and South Devon NHS Foundation Trust, presented the Torbay and South Devon NHS Foundation Trust Quality Account 2021/22.  A Quality Account sets out the quality of services and improvements offered by an NHS healthcare provider.

The quality of the services was measured by looking at patient safety, how effective patient treatments were and patient feedback about the care provided.  Miss Kelly informed Members that 18 months ago it was hoped that the health economy would have recovered, however, the impact of the Covid-19 Pandemic had been long lasting.  Despite this The Trust had made good progress in stepping up recovery and restoration of services and managed to maintain and sustain elective day surgery.  There were concerns regarding the emergency pathway and how The Trust was managing patient flow, this was a priority last year and a single focus for senior leaders. 

The Trust was also subject to an inspection by the Care Quality Commission (CQC) who focused on the escalation and covid wards and identified improvements that needed to be made regarding documentation.  This finding was a frustration for the CQC as it had been previously identified, which had been exacerbated by the Pandemic.  In response The Trust had put in place measures and have identified a compliance level of around 90%.

Miss Kelly and Ms Davenport respond to questions in relation to:

·         The ownership of the Mental Capacity Act by all staff, rather than reliance upon one team;

·         The number of safety incidents and who was reporting the incidents;

·         The development of dementia services; and

·         Maternity and assurance that the service was not an outlier in terms of maternity outcomes.

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).

Members noted the submitted report.