Agenda and minutes

To approve as a correct record the Minutes of the meeting held on 5th September 2017.

The Minutes of the meeting held on 5th September 2017 were approved as a correct record and signed by the Chairman.

To receive from Members declarations as to disclosable pecuniary and other interests in relation to any Agenda item.

Councillor T D Alban declared a disclosable pecuniary interest in relation to Minute Numbers 38 and 40 as an employee of a company that engages in commercial activities with the North West Anglia NHS Foundation Trust.

Councillors S J Criswell and D A Giles both declared a non-statutory disclosable interest in relation to Minute Numbers 38, 39 and 40 as Members of Cambridgeshire County Council.

A copy of the current Notice of Key Executive Decisions is attached. Members are invited to note the Plan and to comment as appropriate on any items contained therein.

The Panel received and noted the current Notice of Key Executive Decision (a copy of which is appended in the Minute Book) which has been prepared by the Executive Leader for the period 1st October 2017 to 31st January 2018.

Mr Stephen Graves, Chief Executive Officer of the North West Anglia NHS Foundation Trust will be in attendance to discuss the latest developments of the Trust.  

With the aid of a report (a copy of which is appended in the Minute Book), Stephen Graves, Chief Executive of North West Anglia NHS Foundation Trust (NWANFT), and Caroline Walker, Finance Director & Deputy Chief Executive of NWANFT, provided an update on the merger of Hinchingbrooke Health Care NHS Trust and Peterborough and Stamford Hospitals NHS Foundation Trust.

Following formal approval, the merger took place and NWANFT was formed on 1st April 2017 with Hinchingbrooke staff transferred to the new organisation on that date. Corporate service structures had been consulted on prior to the merger so those staffing structures were in place on 1st April 2017. Consultation on clinical service structures have followed, with new clinical divisions coming into operation on 3rd July 2017 and appointments made to Divisional Director, Divisional General Manager and Divisional Head of Nursing posts for each division. Consultations on the structures to support these key appointments are underway, with more posts available than staff members as a result of vacant positions being held open. Clinical integration includes a single cross-site clinical leadership structure. Recruitment of doctors has been successful with nearly 80 doctors, including 26 consultants, joining with agency costs reducing and sustainability increasing as a result.

Other developments through the merger include delivery of new ICT systems, although this will take time with a two year timescale for completing the change programme. A review of Hinchingbrooke hospital’s finances by NHS Improvement has highlighted the core underlying challenges there, clarifying the situation. As part of this, the proposed sale of land at Hinchingbrooke was reviewed and this found that parts of the plan would not deliver value for money. Assessments such as the demand for key worker residences and alternative costs of refurbishment or replacing buildings had not been completed. The planned Strategic Estates Partnership at Hinchingbrooke has therefore been paused to allow a whole site estates strategy to be developed.

The Panel welcomed the update as Members had been keen to hear how the merger was progressing and how local residents were being served. The £9m savings planned over three years is dependent on longer term developments such as savings from new ICT systems. £4m savings should be delivered this year and the Trust are still expecting to reach the £9m total in the first 3 years.

Members asked about the impact of the merger on services delivered at each site and were informed that no services had been withdrawn or reduced as a result of the merger and the haematology service had been enhanced. Generally, existing differences in services delivered at each hospital remain. For example, Hinchingbrooke hospital has never been a hyper acute stroke unit and ambulances will continue to take stroke patients to Cambridge and Peterborough where specialist staff are equipped for thrombolysis. However, as part of the Sustainability Transformation Programme, work is underway on options to improve stroke rehabilitation services at Hinchingbrooke so local residents can be transferred there for intensive rehabilitation.

There are plans to introduce a single diagnostic  ...  view the full minutes text for item 38.

The Panel are to receive an update from the Children and Adolescent Mental Health Service (CAMHS).

With the aid of a report (a copy of which is appended in the Minute Book), Lee Miller, Head of Transformation and Commissioning (Children and Maternity) at Cambridgeshire and Peterborough Clinical Commissioning Group (CCG), provided an update on progress on projects from the Local Transformation Plan for Children and Young People’s Emotional/Mental Health and Wellbeing.

The CCG works closely with children and young people, families, Peterborough City Council and Cambridgeshire County Council and the report highlights progress made over the last 2-3 years, which has seen resources shifted into early intervention/prevention. There are increasing numbers who can access services following investment in training for schools, a website developed (keepyourhead.com) to provide self-help information, investment in parent support/engagement and counselling services. Recruitment is now underway to fill a new emotional wellbeing worker role – based in communities to support schools, GPs, youth centres – to be operational from November. Other developments include a specialist service for eating disorders based in Huntingdon, extra resources for ADHD/autism which allow diagnosis for those over the age of 12 and crisis assessment out of normal hours. Peer support workers and transition workers will support 17 year olds to transition between child and adult services.

The Transformation Plan is in the process of being refreshed and other plans include developing a ‘single front door’ to allow one referral to be made to NHS or Local Authority services and a working group is developing proposals to best support looked after children as a particularly vulnerable group.

Members were told that there has been a 30% increase in funding locally as a result of the programme, with additional vanguard funding from the Government to trial new approaches which are evaluated after six months so that learning can be shared and a case made for further funding if successful.

In response to a question about the impact of the young people’s engagement worker, the Panel was told that this has been helpful with Healthwatch recently publishing a report on improving services for young people at greater risk of mental ill-health (‘Minding Us’) and their input sought to help design services. This has been more useful than young people attending meetings. There is little contact with District Council officers as services are funded by Peterborough City Council, Cambridgeshire County Council and the CCG.

When asked about attendance of counsellors at schools, Members were informed that schools have their own funding for counselling services so this varies. There are some concerns about inconsistency so guidance on commissioning counselling services is being produced to help schools. As the District Council’s representative on the Health Committee, Councillor Tavener was asked to request that the County Council look at the consistency of counselling qualifications for those providing counselling services at schools.

Mr Aidan Fallon, Head of Communications and Engagement, Sustainability and Transformation Programme – System Delivery Unit will be in attendance to update Members on the Sustainability and Transformation Programme.

This item was deferred to a future meeting of the Panel.

The Homelessness Strategy is to be presented to the Panel.

In presenting the draft Homelessness Strategy (a copy of which is appended in the Minute Book), the Housing Needs and Resources Manager explained that it focuses on early intervention and supporting people experiencing homelessness as well as delivering more affordable homes together with the Housing Strategy. It has been prepared to meet the requirements of the new Homelessness Reduction Act due to come into force in April 2018. The Trailblazer project, which resulted from a successful bid for Government funding, was intended to enable early intervention and prevention of homelessness and to help co-ordinate across local public sector organisations. This project covers the whole of Cambridgeshire and Peterborough and started earlier in the year with recruitment to all posts now completed.

The Panel was informed that many of the actions proposed are expected to be delivered within the next 12 months and that innovative approaches through the Trailblazer project are likely to identify additional solutions. Actions will be reviewed regularly and the Strategy is a live document which is likely to be refreshed sooner than the 5 year statutory timeframe.

When asked if the Council has considered building homes itself as South Cambridgeshire District Council have done on exemption sites, the Panel was reminded that they are a stock-owning council and that it was generally accepted that the Council does not want to become a social landlord again. However, there are various options being explored through which the Council could help to provide more social housing. A range of options for housing, including modular housing units, are being explored through the Housing Strategy.

Members were concerned about wider impacts of homelessness on residents, with those losing homes often finding it difficult to access jobs, education and other services. The Executive Councillor for Housing and Planning stated that the Council is committed to tackling housing issues to reduce such issues for residents.

Concerns have been raised about the number of empty homes owned by registered providers in the area. The Panel was informed that Luminus’ disposal program is capped at 25-30 homes being sold each year and that decisions were taken after viability assessments with stringent standards applied, for example standards related to energy efficiency. The process is approved by the Homes and Communities Agency (HCA), with the Council agreeing to the limit on numbers. Void times, when properties are empty, have been above average and this is monitored by the Council and policed by the HCA. Steps are being taken to improve void times and when individual properties are vacant for a longer time investigations have taken place which identify reasons for this.

A Member raised concerns about the effect of Government changes and further housing development on private landlords as their investments can be affected by housing development where this affects house prices and impacts on their capital appreciation. When asked about how the need to build more housing should be balanced with the impact on private landlords, the Housing Needs and Resources Manager explained that both nationally  ...  view the full minutes text for item 41.

The Panel are to receive the Annual Review of Green Space and Play Provision. (Report To Follow)

With the aid of a report (a copy of which is appended in the Minute Book), Councillor Jim White, Executive Councillor for Operations, and Neil Sloper, Head of Operations, presented the annual review of green space and play provision.

The Panel received a progress update from September 2016 which summarised work undertaken by the Council and with partners in providing green space and play facilities. Previously much of this was funded by Section 106 (S106) funding but most of this has been spent so the Operations team’s most important function now is influencing developers to incorporate green space and play provision into designs. Among new options being reviewed is the possibility of crowd funding, with a budget proposal to be put forward for a trial which would see capital ‘seed’ funding from the Council allocated so customers can get involved in making decisions on which projects to fund. The focus of recent provision has been on those areas where needs are greatest, as previously identified through analysis of requirements across the District.

Members who also sit on St Neots Town Council requested further information on discussions with the District Council and the inclusion of the Riversmead play area which was funded by the Town Council. The Head of Operations undertook to check the Town Council’s involvement and share the details.

Concerns were raised over the possibility of further housing being added to planned developments at the expense of green spaces and play areas and a Member suggested that land should be allocated for these facilities. This was noted by the Head of Operations who told the Panel that they would make planners aware of the need to allocate sufficient green space and play facilities. Alconbury Weald was highlighted as a good example of where early input has influenced delivery of green space and play areas and it was suggested that the Panel may benefit from a visit to the site in the Spring.

In response to a query about a perceived focus on Huntingdon and St Neots, the Panel was informed that the focus of new development and improvements is on those areas where under provision has been identified and that deliverability is influenced by funding so tends to be concentrated on where S106 or Community Infrastructure Levy (CIL) funding is available.

The Head of Operations confirmed that the assessment of need for green space and play provision for new developments was broadly based on the number of homes planned rather than how many children may live there. If a higher level of children is expected that increases the importance of designing in sufficient space for green space and play facilities from the start.

In response to requests for allotment fencing, accessible gate entrances, a good mix of play equipment across age ranges, facilities which can be shared with older people and provision of sensory facilities, it was confirmed that these could be considered where the Council has responsibility although decisions will be subject to the resources available  ...  view the full minutes text for item 42.

The Head of Operations is to provide a verbal update on the Waste Round Reconfiguration.

The Panel received an update from the Head of Operations and the Executive Councillor for Operations six months on from implementation of the waste round reconfiguration project.

The Panel had previously received the closure report on the project which had shown an initial increase in missed bins followed by a reduction in numbers. There has been a blip since in August when the number missed increased to 630 for the month but numbers have fallen again throughout September. The increase in August was partly due to driver availability as well as the effects of a shift in workloads between rounds which didn’t work and has been reversed. While the project set out to reduce the number of vehicles collecting waste across the District, this has proved extremely difficult and Operations are unwilling to make further changes which could increase bins missed.

Driver shortages have resulted in some cover being provided by managers but the Council is currently recruiting to driver posts and three loaders are receiving driver training to bring numbers back up.

Operations are working with APSE (the Association for Public Service Excellence) to benchmark with compactors and undertake a waste service healthcheck which will look at costs and value for money provided. They will also be reviewing the forward trajectory of housing growth and the impact of this on the waste collection service. Operations are also jointly out to tender with South Cambridgeshire District Council and Cambridge City Council for an in-cab system which will increase drivers’ access to information.

In response to a question about delivering the aims of the project, it was confirmed that the bulk of the cost savings were not going to be achieved as it had not been possible to remove a refuse truck and crew and that fuel costs would be broadly similar to before the reconfiguration. There will be reductions in the amount of green waste collected over the coming months with fewer staff needed to collect bins for green waste rounds but the collection days won’t change. Future savings will depend on the outcome of the reviews of value for money and projected housing growth.

A Member asked what could be done to reduce the likelihood of staff being trained and then moving on to other driving jobs. The Head of Operations stated that individual training agreements created a financial deterrent for up to five years and explained that training loaders who like the working hours on offer made it less likely that they would work elsewhere where these differ.

In response to a question about recycling waste collection at flats where only combined waste is collected currently, the Panel was told that the Council is talking to Luminus about this and trying to replace the waste chutes currently in use at some sites. There is a need to locate larger bins but there is also a challenge to change resident practices. The Council has offered to support and part-fund these changes.

Concerns about access for refuse trucks were raised  ...  view the full minutes text for item 43.

Members are to receive the work programmes for all Overview and Scrutiny Panels.

With the aid of a report by the Democratic Services Officer (Scrutiny) (a copy of which is appended in the Minute Book), the Panel reviewed the latest work programmes for each of the Overview and Scrutiny Panels.

The Panel noted that the Corporate Enforcement Policy would include graffiti and fly tipping and requested confirmation that fly posting would be included.

The Panel requested that an item on air quality to follow on from the discussion at their last meeting be scheduled and asked for the annual update on the Home Improvement Agency to be listed on their work programme.

The deferred item on the Sustainability Transformation Programme will be re-scheduled for the next available date.