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  • Agenda and minutes
  • Agenda and minutes

    Venue: Council Chamber, Sessions House, County Hall, Maidstone. View directions

    Contact: Theresa Grayell  03000 416172

    Media

    Items
    No. Item

    36.

    Apologies and Substitutes

    To receive apologies for absence and notification of any substitutes present

    Additional documents:

    Minutes:

    Apologies for absence had been received from the Leader and Cabinet Member for Traded Services and Health Reform, Mr P B Carter, who was attending a meeting in parliament. 

    37.

    Declarations of Interest by Members in items on the Agenda

    To receive any declarations of interest made by Members in relation to any matter on the agenda.  Members are reminded to specify the agenda item number to which it refers and the nature of the interest being declared

    Additional documents:

    Minutes:

    There were no declarations of interest.

    38.

    Minutes of the meeting held on 1 December 2017 pdf icon PDF 146 KB

    To consider and approve the minutes as a correct record.

    Additional documents:

    Minutes:

    It was RESOLVED that the minutes of the meeting held on 1 December 2017 are correctly recorded and they be signed by the Chairman.  There were no matters arising.

    39.

    Verbal updates by Cabinet Members and Director pdf icon PDF 48 KB

    To receive a verbal update from the Leader and Cabinet Member for Traded Services and Health Reform, the Deputy Leader and Cabinet Member for Strategic Commissioning and Public Health and the Director of Public Health.

     

     

    Additional documents:

    Minutes:

    1.            The Deputy Leader and Cabinet Member for Strategic Commissioning and Public Health, Mr P J Oakford, gave a verbal update on Sustainability and Transformation Programme (STP), on behalf of the Leader.  The STP Board had been in existence for some time and, whereas progress had previously been frustrating, work was now moving forward, steered by Glenn Douglas, Chief Executive of the Kent and Medway Sustainability and Transformation Partnership. The plan was for all eight clinical commissioning groups (CCGs) to work together as one with two ACPs based in East and North and West Kent. These would work as an integrated commissioning body for the whole county, including  Medway.  This represented a good step forward.  Much work was going on around the development of a local corporate partnership, in which local authorities had an integral role, and the STP had set up a local care work stream, made up of NHS partners and local authorities, which Mr Carter had been asked to chair, supported by the Leader of Medway Council as vice-chairman. This group would look at how to develop a good model of local care, and the Corporate Director of Adult Social Care and Health and the Cabinet Member for Adult Social Care had been asked to prepare a detailed report setting out an ideal model of integrated social care, health and public health, to be considered at the Cabinet Committee’s March meeting. 

     

    2.            Mr Oakford responded to questions and comments from Members, including the following:-

     

    a)    prevention work would be embedded across the entire system and, as such, should deliver savings and improved working.  Joint working between professionals would be encouraged, but establishing this working would be a challenge. Concern was expressed that the type of joint working currently planned had not been successful when it had been tried previously;

     

    b)    the role of CCGs was clarified, and their commitment to the new model confirmed. One CCG had not yet fully committed to the programme but discussion was ongoing to try to bring them on board.  Primary legislation had not changed, and all CCGs would continue to exist as legal bodies.  However, each CCG would no longer have accountable officers, as at present, as these would move to a new role.  The programme would create a single organisational structure, and more detail of this would be set out in the report to the March meeting; and

     

    c)    the involvement of Mr Carter as the chairman of the local care work stream would ensure that the County Council would have much input into and influence on the development of the programme, leading to integration and improvement.

     

    3.            Mr Oakford then gave a verbal update on the infant feeding consultation. A special meeting of the CabinetCommittee had been arranged for 8 February, at which the petition received about the community infant feeding service would be debated. 

     

    4.            The Deputy Director of Public Health, Dr A Duggal, then gave a verbal update on the following issues:-

     

    Influenza and ‘flu  ...  view the full minutes text for item 39.

    40.

    Prevention in the Kent and Medway Sustainability and Transformation Plan pdf icon PDF 91 KB

    To receive a report from the Cabinet Member for Strategic Commissioning

    and Public Health and the Director of Public Health, setting out the development

    of a Prevention Workstream and Strategy for the Sustainability and Transformation Plan for Kent and Medway Health and Social Care system. Members are asked to comment on the progress of the Workstream and the future planned work.

    Additional documents:

    Minutes:

    1.            Dr Duggal introduced the report and explained that she had recently taken over the prevention work stream and that Andrew Scott-Clark and James Williams, the Directors of Public Health for Kent and Medway respectively, were the SROs for the project.  The project initially had four key areas of work – obesity, smoking cessation, work place health and reducing alcohol consumption, with obesity and smoking cessation being the top priorities.  A draft action plan and programme plan would be submitted to the STP work stream board for approval, but the budget for the project would need initial cash input before work could start.  Dr Duggal then responded to comments and questions from Members, including the following:-

     

    a)     work on the various work streams (for example, obesity and smoking) would inevitably overlap to some extent, as behaviours tended to be linked, and tackling this work as part of the STP meant that it could happen at a higher level and could be co-ordinated across the south east.  The embedding of prevention work as part of the STP was welcomed. Various speakers highlighted the links and overlaps between other prevention work streams named and concern was expressed that, beside work on smoking cessation, drug use should also be tackled. 

     

    b)     Unhealthy behaviours were often developed as a crutch during times of hardship, so the partners involved in the work should include the Job Centre. Dr Duggal confirmed that all available partnership links would be exploited and that areas in which work should be prioritised in the STP work plan would be identified using statistics for deprivation and premature mortality (defined as death before age 75 from preventable causes);

     

    c)     the clarity of the report and the current activity described were both welcomed but concern expressed that funding available might ultimately prove insufficient to cover all the planned worked, so Directors of Public Health would need to seek additional funding for this purpose. Dr Duggal agreed that it was possible that the budget might be insufficient but the overlapping and streamlining of work should make the best use of the funding available, e.g. GPs could use a patient’s visit to the surgery to introduce preventative work relating to other aspects of their lifestyle or habits;

     

    d)     asked what the County Council was doing to support and improve the health and fitness of its staff, as many worked long hours and could not afford gym prices, Dr Duggal explained that work on an integrated approach to staff health, lifestyle and physical activity would be starting soon;

     

    e)     the importance of good communications and consistency of message across the county were emphasised.  Other suggested partner organisations were churches, community advice centres and food banks.  As well as the links already mentioned, there was also a link between obesity and a patient’s mental health.  Dr Duggal explained that the One You campaign had been designed to draw together the various aspects of public health and lifestyles and address them in an integrated way;

     

    f)      the wide  ...  view the full minutes text for item 40.

    41.

    'One You Kent' campaign update pdf icon PDF 180 KB

    To receive a report from the Cabinet Member for Strategic Commissioning

    and Public Health and the Director of Public Health, setting out progress of the campaign.  The committee is asked to comment on the progress and impact of the campaign and suggest local organisations which could support it.

     

     

    Additional documents:

    Minutes:

    1.               Mr Gough introduced the report and presented a series of slides (included in the agenda pack) which set out the national and local context of the One You campaign and the way in which it related to and reflected the links between behaviours, lifestyle elements and work streams discussed in the previous item. These also included an explanation of behavioural science and its role in identifying patterns and triggers and contributing to campaign work to address ingrained behaviours. Research work had suggested that the Public Health message be established at key points in life, for example, when registering a birth, parents could be handed leaflets about healthy lifestyles so their child could start life with a good message and they as new parents could take the opportunity to adopt healthier habits. The Libraries, Registration and Archives service registered some 16,000 births every year. However, when habits were changed, the health benefit would be offset by the loss of what might have been a social network, for example, at the local pub, so to prolong the new habit, a replacement social activity might need to be established. Mr Gough updated some figures shown in the agenda pack: there had now been 89,000 sessions on the One You website and 27,000 referrals to the Public Health England ‘How Are You?’ quiz, and 30% of the target audience (particularly the 40 – 60 age group) had confirmed that they had seen the One You campaign. He then responded to comments and questions from Members, including the following:-

     

    a)    the suggestion of using hoardings beside highways to advertise the public health message was being explored with Environment and Transport colleagues. Achieving a good visual impact was vital to a successful campaign, although work to support and back up advertising campaigns was important;  

     

    b)    some behaviours were associated with, or were symptomatic of, psychological distress, for example, stress, and if habits were once given up, they could easily re-start at the next episode of stress.  It would be important to build resilience so the ‘comfort’ of smoking or eating junk food would no longer be needed;

     

    c)    GPs used to be able to prescribe free sessions of physical activity at leisure centres but this scheme was not well taken up and so had been discontinued. To prescribe health was better than to prescribe medicine;

     

    d)    two suggestions of partners which could work with the County Council on preventative work were volunteer bureaux and housing associations. Another speaker added that the seven million carers in the UK could also be a useful resource to spread the message. Mr Gough undertook to look into involving these, as well as Kent and Medway Fire and Rescue Authority and leisure centres. He explained that all such potential partners would be invited to a stakeholder event on 14 March;

     

    e)    GPs in west Kent had identified that 25% of patients coming to the surgery did not need to be there but were seeking social contact to assuage feelings of  ...  view the full minutes text for item 41.

    42.

    Draft 2018-19 Budget and 2018-20 Medium Term Financial Plan pdf icon PDF 75 KB

    To receive a report from the Cabinet Member for Strategic Commissioning

    and Public Health and the Director of Public Health, to accompany the final draft 2018-19 Budget and 2018-20 MTFP published online on 12 January. 

    The Committee is asked tonote the draft budget and MTFP and is invited to make suggestions to the Cabinet Member for Strategic Commissioning and Public Health on any other issues relating to Public Health which should be reflected in the draft budget and MTFP prior to Cabinet on the 5 February 2018 and County Council on the 20 February 2018.

     

    Additional documents:

    Minutes:

    1.            Miss Goldsmith and Mr Gilbert introduced the report and explained that the public health budget differed from others in that it consisted entirely of grants and would always make full use of all grants available, leaving a zero balance. They added that briefing sessions had been held with party groups to answer questions about the content of the budget and the medium term financial plan.

     

    2.         It was RESOLVED that the draft 2018-19 Budget and 2018-20 Medium Term Financial Plan be noted.  There were no suggestions to the Cabinet Member for Strategic Commissioning and Public Health on any other issues relating to Public Health which should be reflected in the draft budget and Medium Term Financial Plan. 

     

    43.

    Schedule of contract monitoring reviews pdf icon PDF 108 KB

    To receive a report from the Cabinet Member for Strategic Commissioning

    and Public Health and the Director of Public Health, setting out a proposed schedule of contract monitoring reviews for the next two years.  The Committee is asked to comment on and agree the schedule of contract monitoring reviews to be presented to the Committee over the next two years.

     

     

    Additional documents:

    Minutes:

    1.            Ms Sharp and Mr Gilbert presented a proposed two-year schedule of contract reviews, which had been requested by the committee to support its contract monitoring role.  They explained that contracts had been listed for review based on their strategic importance, any areas of concern arising and the date on which they would be due for renewal.   Ms Sharp and Mr Gilbert then responded to comments and questions from Members, including the following:-

     

    a)    overlaps between areas of contracting would be addressed when reports on each area were submitted to the committee; and

     

    b)    clarification was given of the role of the committee in monitoring contracts against key performance indicators (KPIs), and the importance of this role was emphasised.  Contract management was a separate issue and was the responsibility of a separate Member group.         

     

    2.         It was RESOLVED that the schedule of contract monitoring reviews to be presented to the Cabinet Committee over the next two years be agreed.

     

    44.

    Considering information exempt from publication (agenda item 10)

    Additional documents:

    Minutes:

    The Chairman asked Members if, in discussing agenda item 10, they wished to refer to the information set out in the exempt appendix to the report, and hence if they wished to pass a motion to exclude the press and public from the meeting and  discuss that item in closed session.  Members confirmed that they did not wish to refer to the exempt information and, accordingly, discussion of the item took place in open session.

     

    45.

    Contract Monitoring Report - Sexual Health Services pdf icon PDF 700 KB

    To receive a report from the Cabinet Member for Strategic Commissioning

    and Public Health and the Director of Public Health, setting out an update on the performance, outcomes and value for money of the sexual health services commissioned by the County Council. The committee is asked to note the performance of the County Council-commissioned sexual health services and the processes in place to manage the contract effectively.

     

     

    Additional documents:

    Minutes:

    1.            Ms Sharp and Mr Gilbert introduced the report and emphasised that performance management of the contract was robust and that adjustments would be made to payments to the provider for any shortfall in performance. The service had delivered and was delivering very good value for money and had introduced innovative use of technology, including online testing kits.  Ms Sharp and Mr Gilbert responded to comments and questions from Members, including the following:-

     

    a)    asked if young people were intimidated about attending a sexual health clinic, and if better engagement might be made if testing were to be done at a venue already familiar to young people, for example, a youth centre or gym, Mr Gilbert confirmed that young people’s clinics were well attended and there was no data evidence of them staying away.  Holding clinics which were just for young people meant that they would not be intimidated by attending a general clinic with older people.  A pilot project to test the idea of taking clinics to other venues would run for 3 – 6 months and the feedback from this analysed. In response to concerns expressed, Mr Gilbert undertook to look into a specific example of local practice and liaise with the local provider if necessary;   

     

    b)    the number of outreach sessions available reflected the staff capacity. Most outreach work took the form of drop-ins and opportunistic contacts rather than bookable sessions. Attendance varied but it was very rare to have a session at which there was no attendance;

     

    c)    usage levels of all services were monitored, with a guide level of 80% reflecting a sustainable level of provision. Trends would be identified and responded to, for example, sessions at one venue had been set up on Saturday mornings in response to local demand;

     

    d)     concern was expressed that service supply might not be able to meet demand. Mr Gilbert explained that, as the commissioner and provider were separate bodies, demand could be identified honestly, and commissioners were practised at doing this. Dr Duggal added that, as best practice, the public health team would also consult youth groups such as Youth Advisory Groups to gain first-hand feedback from service users; 

     

    e)    the ‘condom distribution’ programme had proved to be cost-effective and presented good value for money.  Ms Sharp explained that the  budget for this project had covered both the equipment and promotion work and clarified that the current project, which had replaced the previous ‘condom card’ programme, cost less.  She added that it was unusual for the County Council to have statutory responsibility for this sort of provision, however, it sought to reduce costs where it could, for example, by optimising the use of online testing, to achieve best value for money.  The current provision model had proved most successful and had expanded capacity in Maidstone and Canterbury.  The ability to pioneer this sort of provision was a benefit of the flexible contracting arrangements which the County Council had negotiated with providers;

     

    f)     Mr Gilbert clarified that the  ...  view the full minutes text for item 45.

    46.

    Performance of public health-commissioned services pdf icon PDF 115 KB

    To receive a report from the Cabinet Member for Strategic Commissioning

    and Public Health and the Director of Public Health, setting out an overview of key performance indicators (KPIs) for Public Health commissioned services in the latest quarter. The Committee is asked to note and comment on the Q2 performance of Public Health commissioned services.

     

     

    Additional documents:

    Minutes:

    1.            Ms Sharp and Mr Gilbert introduced the report and highlighted the fact that no indicators were rated red and those few rated amber were falling short in just one area of the county and hence were very close to meeting their target and achieving a green rating.  In cases where performance was below the national level, an action plan was in place to support improvement.

     

    2.            It was RESOLVED that the Quarter 2 performance of public health- commissioned services be noted.

     

     

    47.

    Work Programme 2018/19 pdf icon PDF 55 KB

    To receive a report from the General Counsel on the Committee’s work programme.

     

    Additional documents:

    Minutes:

    1.         The Democratic Services Officer introduced the report and explained that, since publishing the agenda pack, the work programme had been updated to include the suggested schedule of contract monitoring discussed in agenda item 9.

     

    2.         It was RESOLVED that the committee’s work programme for 2018/19 be agreed.