It was reported that, in accordance with the wishes of the Conservative Group, the membership of the Sub-Board had been amended to include Councillor Brook in place of Councillor Fellows.

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 11 April 2024.

The minutes of the meeting of the Sub-Board held on 11 April 2024 were confirmed as a correct record and signed by the Chairwoman.

To consider a report outlining the Peninsula Acute Sustainability Programme draft Case for Change and provide feedback.

(Note: to be presented by Liz Davenport, Chief Executive, Torbay and South Devon NHS Foundation Trust and Kate Lissett, Chief Medical Officer, Torbay and South Devon NHS Foundation Trust).

The Chief Executive, South Devon NHS Foundation Trust and the Chief Medical Officer, South Devon NHS Foundation Trust presented an outline of the Peninsula Acute Sustainability Programme (PASP) Draft Case for Change.

Members were informed that the Case for Change was a technical document that used data to evidence the need to change and was currently being developed.  A summary of the document would also be produced to support local populations and stakeholders to understand the challenges.

The purpose of the Peninsula Acute Sustainability Programme (PASP) was to ensure clinical, workforce and financial sustainability of services at the five acute hospitals in Devon, Cornwall and the Isles of Scilly.  The primary role was to support service sustainability in the long-term creating a sustainable platform for strategic service improvement and the recovery of fragile services in the medium term.  However, this needed to be aligned with short-term tactical improvements to ensure support for recovery of elective, cancer and diagnostic services for example.

It was recognised that the pandemic had exacerbated the challenges and that acute service transformation was required to address services that were struggling to meet the increasing demand and needs of patients.  In addition, there was a need to support staff to deliver safe and high quality care whilst ensuring that services conformed to national and professional standards.  It was important to provide safe and high quality services across the whole geography to meet demand now and into the future whilst making best use of limited resources.  It was acknowledged that medicine was getting more specialist and that currently it was necessary for some patients to travel outside the locality to receive the specialist care they needed.  With innovative thinking, the aim was to provide the same specialist care locally.

Members welcomed the fact that preliminary progress had already been made.  For example, the One Devon Elective Pilot enabled use of the Nightingale Hospital as a specialist centre for orthopaedic, ophthalmology and spinal surgery services.  Staff and clinical networks enabled hospitals across the peninsula to work together in a networked way to provide care (for example, neonatal networks and an interventional radiology rota) and the use of technology such as Shared Picture Archive System enabled radiologists to share images across all Peninsula Trusts.

The starting point for the acute services model was to recognise different approaches to delivering the non-core services and that would start to address some of the significant workforce challenges facing the Peninsula.

Phase Two of the PASP would now be undertaken and would include developing a detailed formal case for change in partnership with staff and local people together with undertaking some detailed modelling in conjunction with staff and patients to further explore possible ways to tackle the challenges.

Members asked questions around how people would be encouraged to support the proposed changes and document; whether the nurse/staff ratio could be increased alongside staff retention;  whether the initial survey included social media feedback and if this was sought solely from patients and why was there  ...  view the full minutes text for item 3.

To review the consultation draft Homelessness and Rough Sleeper Strategy 2024 – 2030 and make recommendations to the Cabinet.

(Note: presented by Tara Harris, Divisional Director Community and Customer Services, Torbay Council; Lianne Hancock, Head of Housing Needs, Torbay Council and Dave Parsons, Strategic Lead for Community Protection, Torbay Council).

The Divisional Director of Community and Customer Services, the Head of Service for Safeguarding, Early Help and Business Intelligence and the Strategic Lead for Community Protection, Torbay Council provided Members with an outline and overview of the draft Homelessness and Rough Sleeper Strategy 2024 – 2030.

Members were reminded that the Homelessness Act 2022 required local housing authorities to take strategic responsibility for tackling and preventing homelessness.  The draft Homelessness and Rough Sleeper Strategy 2024 – 2030 set out the framework of what needed to be achieved and why.  It linked in with other strategies and areas of work so would have an impact on the wider system.

An evidence based document had been produced and engagement sessions had been held in April – June 2024 which concentrated around:

• rough sleeping including hidden homelessness;
• young people affected by homelessness;
• homelessness that impacted the wider population;
• overall session with elected members; and
• a series of structured conversation which included hearing the voice of those that have lived experiences.

Members were informed that the draft Strategy was out for consultation until the end of August 2024, following which there would be a review of the document and development of the action plan.  This would then be submitted through the relevant governance structures for approval.

The priorities concentrated upon increasing early help and prevention, intervention and better outcomes, better lives which involved supporting people independently, particularly those with complex needs, assisting with quality of lives which in turn would enable people to create a home.

Members acknowledged that the key objective of the Strategy was to provide the right advice at the right time and provide targeted prevention to reach people whose homelessness was hidden from services and to reduce repeat homelessness, rough sleeping and youth homelessness.  The main reason for homelessness in Torbay was loss of private rented accommodation, this was due to various factors around stability and affordability.

Members asked questions around how much support was provided by other services, for example, upon prison release and whether such groups had been consulted; why, during the pandemic, there was no-one sleeping on the streets and what had been done differently to achieve that; whether there was engagement with schools already in terms of education and prevention; whether the report data timeline could be widened to provide a clearer view of the overall issues against priorities; whether key data could be provided over the last five years, broken down into specific areas to show where there had been intervention, so that the data could inform actions going forward; how performance against the priorities and objectives of the Strategy would be measured; what were the numbers in respect of those individuals who refused to accept support; how did Torbay compare with other seaside towns; what the intention was in terms of working with the voluntary sector; how would feedback be measured and how would that influence the Strategy; and how would it be possible to bring together local charities to tackle the situation.

In  ...  view the full minutes text for item 4.

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.