Agenda and minutes

The Chair to note any apologies for absence.

Apologies for absence were received from Councillors Duffy and Russell.

Members to state any interests.

There were none.

The Chair to note public address requests.

The public can speak on any agenda item for a maximum of three minutes per speaker per item.  You are not required to register your intention to speak in advance but should arrive at the meeting a few minutes early, complete a Public Address Protocol and notify the Scrutiny Officer of your intention to speak.

There were none.

The Scrutiny Panel to approve the minutes of the meeting held on 8 November 2018.

The minutes of the meeting held on 8 November 2018 were signed by the Chair as a true and accurate record.

The Scrutiny Panel to receive responses to its core questions from key expert advisors.

Detective Chief Inspector Rich Tompkins, within Public Protection, Northants Police, addressed the Scrutiny Panel.  He gave background details to his role and the service.

The Scrutiny Panel made comment, asked questions and heard:

·         Rough sleepers with suspected mental health problems are not always accessing the required services

·         Prevention is key.  The Police often come across individuals when they are at crisis point and they may then present differently to professionals when they are free from the effects of drugs or alcohol.  

·         Around half the calls Northants Police respond to do not involve a  crime but are concerns for public welfare and safety. There are around 120 documented calls a week regarding mental health issues, although the impact of mental health is suspected to be far higher than this. It is not unusual for calls to be received from individuals in crisis themselves, carers or organisations such as the Samaritans. The Local Authority provides an approved Mental Health practitioner (AHMP) Worker, 24/7. However this individual has other responsibilities and out of hours calls can take several hours before being responded to. It is common for Police to stay and monitor persons they detain under the mental health act for many hours where there is no Social Worker or nurse to take ownership for the case. This has been recognised in a new national HMICFRS report on the impact of Police responding to Mental Health  

·         There are a number of effective multi-agency groups coordinating mental health and suicide Prevention – the latter being a new county wide group that is viewed as positive

·         Early intervention at all levels prevents crisis – and is seen as positive by Police. It can negate persons becoming criminalised and reduces the harm (physical and emotional) associated with crisis intervention

·         Partnership working is generally strong in the county. Northants Police have appointed a Superintendent to lead on work associated with the future provision of services and the proposed 2 new local authorities model, replacing the current district and borough approach.   

·         MARAC provides effective support for Domestic abuse victims, and has around 1,200 cases a year.  Adult Social Services joined MARAC around 12 months ago which was welcome.

·         The pressures that Adult Social Services are under are acknowledged by the Police.

·         Police budgets have faced considerable pressure over the last 8 years. Nationally there are 20,000 less officers now than in 2010. Recorded violent crime is increasing for the first time in 10 years; Northants Police budgets and staffing reflect the national picture.  

·         Concerns remain over the future provision of funding to support services. An example is the Sunflower Centre (who support High risk victims of domestic abuse) who work closely with the Police. A third of their budget emanates from the County council. When NCC didn’t pay the contribution for 2018/19 they lost 3 highly trained staff. Funding has been restored by NCC but uncertainty remains and the service provided by the sunflower has had to reduce over the last 6 months – this negatively impacts on  ...  view the full minutes text for item 5a

Lucy Weightman Director of Public Health, Northamptonshire County Council presented her written response to the core questions of the Scrutiny Panel, highlighting key points.

The Scrutiny Panel made comment, asked questions and heard:

·         Positive actions are currently be taken in respect of the opportunities that the proposed Unitary Councils will provide.

·         Capacity and resilience is increasing.

·         During the 12 week period, an Advisor will look for signs of social isolation; not everyone wants to integrate back or have their own “social hub.”  Funding of £3.5 million from the Social Impact Fund will help to develop the additional workforce required.

·         Partnership working is increasing; everyone is committed to taking on shared responsibility.  Services will be aligned to make best use of expertise.

Lucy Weightman was thanked for her address.

AGREED:              That the information provided informs the evidence base of this Scrutiny Review.

David Jones, Chair, and Morcea Walker, Deputy Chair, Healthwatch Northamptonshire, presented the written response to the core questions of the Scrutiny Panel; highlighting the salient points. Background to Healthwatch was provided.

The Scrutiny Panel made comment, asked questions and heard:

• Data published by the CQC states that Norhamptonshire County Council (NCC) is close to national and regional figures regarding adult social care.  The main outlier is delayed transfers of care (DToC) but the most recent data provided orally to HWN suggests that there has been a very significant improvement in DToC. There are some challenges too such as high spend per capita on children's services.
• Dementia is a key issue for health services and social care.
• It was confirmed that Healthwatch is consulted by NCC when it undertakes consultations. Healthwatch has a good relationship with Public Health and health service partners.  Healthwatch is a statutory member of the Health and Wellbeing Board in each area.

·         The Scrutiny Panel heard that a joint appointment of a Housing Officer to improve awareness of health and wellbeing within housing services has been created by Kettering Borough Council, Northants Healthcare Foundation Trust and Kettering General Hospital which is a good, creative initiative.

• There is a need for trust to be built amongst all the partners and for there to be an honest understanding of the situations.
• The public needs to have a more informed understanding of the real costs of health and social care and why it is necessary to see an increase in taxation to pay for these services in order to sustain the current level of service let alone to improve the quality.

David Jones, Chair, and Morcea Walker, Deputy Chair, Healthwatch Northamptonshire, were thanked for their address.

AGREED:              That the information provided informs the evidence base of this Scrutiny Review.

Angela Hillery, Chief Executive Officer, Northampton Health Trust, presented the written response to the core questions of the Scrutiny Panel highlighting the key points.  Background to Northampton Health Trust was given.

The Scrutiny Panel made comment, asked questions and heard:

·         The Trust has been rated outstanding by the CQC. It has also won Trust of the year which is an NHS award. It is all about staff and culture and partnership working.

·         Lots of steps are being taken to improve crisis services.

·         Crisis cafes are a great example of partnership working to support people.

·         A lot has been achieved through partnership working in recent times.

·         £1.8 million of support has been achieved through partnership working

·         Hard work is underway collectively to ensure capacity is directed to the right places

·         It was acknowledged that Adult Social Care Services is under resourced

·         Primary and social care workstreams are very important and need to work together

·         The pilot being run in Kettering whereby a Housing Officer is dedicated resource to Kettering General Hospital is working very well

·         It is important that there is an holistic approach regarding integration and integrated services; integrated care is vital.  It is important that there is one service working together to deliver the same outcomes

·         Discharge from hospital has to be safe; support at home is a social care responsibility.  Previously, teams have worked separately.

·         Ways to increase community support are being investigated

·         Future options need to include:    preventative initiatives, community response, support at home, including appointments etc.  A whole range of ideas will be explored

·         Valuing and retaining the workforce is vital.  CQC acknowledged that staff are valued and recognised for what they are doing

Angela Hillery, Chief Executive Officer, Northampton Health Trust, was thanked for her address.

AGREED:              That the information provided informs the evidence base of this Scrutiny Review.

A local GP was not present.

The Scrutiny Panel to consider the report detailing the findings from its site visits.

The Chair referred the Scrutiny Panel to the key findings from the site visits to Northampton General Hospital and St Andrews Hospital.

It was felt that it would be useful for there to be a facility where individuals could go when they no longer needed hospital care but needed care at home, but such care was not available.

The Scrutiny Panel suggested   potential recommendation of its final report  - that a housing officer is linked to Northampton General Hospital, a similar arrangement to the Kettering Pilot.

AGREED:              That the information provided informs the evidence base of this Scrutiny Review.