Agenda and draft minutes

Councillors Joan Butterfield and Hugh Irving

The following members declared a personal interest in agenda items 5 and 6 –

Councillor Gareth Davies – Employee of Betsi Cadwaladr University Health Board

Councillor Emrys Wynne – Member of the Community Health Council

No urgent matters had been raised.

To receive the –

(a)       minutes of the Partnerships Scrutiny Committee held on 20 September 2018 (copy enclosed), and

(b)       minutes of the Special Partnerships Scrutiny Committee held on 1 October 2018 (copy enclosed).

The minutes of the Partnerships Scrutiny Committee held on 20 September 2018 and Special Partnerships Scrutiny Committee held on 1 October 2018 were submitted.

Matters Arising –

Special Partnerships Scrutiny Committee (1 October 2018) – The Chair reflected upon the positive meeting held with Health Board officials to discuss the findings of the investigations with regard to the Tawelfan Ward at Ysbyty Glan Clwyd.  The written responses to the questions raised at that meeting and additional supplementary reports provided by the Health Board had been previously circulated as part of the Committee’s Information Brief together with the Board’s Dementia Strategy for 2018 – 2020.

RESOLVED that the minutes of the meetings held on 20 September 2018 and 1 October 2018 be received and confirmed as a correct record.

To receive a presentation from Betsi Cadwaladr University Health Board representatives regarding the future plans for the provision of services at Denbigh Infirmary following the closure of Fammau ward.

10.10 a.m. – 10.50 a.m.

The Chair welcomed Bethan Jones (Area Director: Centre), Gareth Evans (Director Clinical Services – Therapies) and Alison Kemp (Assistant Director Community Services) from Betsi Cadwaladr University Health Board (BCUHB) to the meeting for discussion on Health Service related business items.

Denbigh Infirmary – the Assistant Director Community Services, via a PowerPoint presentation, briefed the Committee on the background to the decision to close the upstairs Lleweni Ward at the Infirmary having undertaken fire safety checks in accordance with guidance received from the Welsh Government (WG) in the wake of the Grenfell Tower fire tragedy.  The fire safety checks had identified “poor compartmentation and the presence of a first floor …constructed from timber joists and lath and plaster” at the two hundred year old building.  On this basis the fire safety assessors had concluded that “considering the number of mobility impaired patients and the limited number of staff, even following the completion of the remedial works, [the] building [would] still present an extremely challenging situation to manage safely during a fire incident requiring vertical evacuation”.  Based on this information a decision was taken initially to suspend 10 of the 17 beds on Lleweni Ward in order to minimise any risks associated with an evacuation.  To compensate for the loss of community beds in Denbigh 5 additional inpatient beds were opened in Ruthin Hospital, and remedial work, i.e. fire alarm panel, zoning and compartmentation in ceiling void etc. was undertaken on the ground floor area of the Infirmary building.  Whilst this work was taking place a detailed survey of the hospital building was undertaken by a fire safety consultancy.  The consultancy’s brief was to determine the quality of compartmentation within the original hospital building and the level of fire resilience afforded by the building’s construction.  This survey found that there were significant defects within the compartmentation of the original hospital building at both first floor and roof level.  This meant that it did not comply with current fire safety regulations and therefore the current fire evacuation strategy for the first floor, which was based on horizontal evacuation and reliance on compartmentation, was compromised and therefore did not comply with the requirements of the Regulatory Reform (Fire Safety) Order 2005.  As a result a decision was taken to suspend the use of the remaining 7 inpatient beds on the upstairs ward and to suspend the use of the midwifery led delivery room.  She emphasised that whilst the first floor was deemed no longer suitable for inpatient beds, etc., it did not mean that it could not be used for other purposes.

In taking the above decision the Health Board engaged with a wide range of stakeholders, including local and national politicians, the Community Health Council (CHC), staff, trade unions, local authority staff and the hospital’s League of Friends.  It also agreed longer term arrangements with Ruthin GPs to cover the additional beds at Ruthin Community Hospital and redeployed a small number of staff mainly to Ruthin Hospital.  As a consequence of the loss of beds work was also commissioned to identify alternative inpatient capacity and explore alternative pathways to inpatient care.

NHS Specialist Estates Department was currently in the process of identifying high level costs required to make the first floor area compliant with health and safety regulations, including fire safety standards.  It was already known that major structural work would be required and that whilst this work was taking place it would impact on the ground floor accommodation.  Due to the need to meet modern health service standards it was already envisaged that not all of the 17 beds, lost following the  ...  view the full minutes text for item 5.

To receive an update from Betsi Cadwaladr University Health Board representatives on progress made in respect of capital projects relating to North Denbighshire Hospital (Business Case enclosed), Ruthin Clinic and Corwen Health Centre.

10.50 a.m. – 11.30 a.m.

The Health Board’s Director Clinical Services – Therapies gave the Committee a presentation outlining the progress achieved to date in relation to three major capital projects in Denbighshire.  He outlined the background to each project and advised that with respect of the current position –

Corwen Health Centre

·         a fit for purpose facility which provided a high quality environment for primary care services and enhanced dental services had opened on the site in Corwen on 12 October 2018, with an official opening scheduled for 29 November 2018.  The site also had potential to accommodate a broader range of health related services

·         the Health Board had awarded £1.48m towards the project from its Discretionary Capital Allocation

·         the Centre now housed a GP practice which had the added facility of consulting rooms for trainee doctors, specialist GP led cardiology services, two dental surgeries, district nursing services, health services, physiotherapists, podiatry services along with services for mental health and substance misuse, and

·         with a view to expanding the services further work was underway to recruit additional dental staff and to assess whether there was a potential to increase the Voluntary Sector’s (Third Sector) presence on the site to support the Health Service’s work in the area.

Mount Street Clinic, Ruthin

·         in 2016 a Primary Care Estates review had identified that this facility was not fit for purpose.  Due to its poor condition of repair the Health Board concluded that spending circa £750k to undertake maintenance and upgrading work on the building would not equate to an effective use of resources and would not deliver a long term solution to meet future needs in the Ruthin area

·         a strategic decision was taken to bid for £1.7m of WG capital funding for the purpose of delivering primary care services close to patients’ homes through the relocation of the services currently delivered at the clinic on the Ruthin Community Hospital site with a possibility of delivering other health services at the new site in due course

·         at present the proposals were to relocate the GP practice, Health Visitors, School Nurses and Community Mental Health (CMH) practitioners from the current Clinic site to the Ruthin Hospital site.  The Community Dental team were currently considering two options, whether to relocate to the Ruthin Hospital site or to utilise current facilities available at both Denbigh and Corwen and deliver a mobile service where appropriate, whilst the Welsh Ambulance Service Trust (WAST) was in discussions with North Wales Fire and Resource Services (NWFRS) to explore possibilities in relation to delivering their services from a shared facility.  Work was also underway to examine the potential of delivering additional services from the relocated facility at Ruthin Hospital, i.e. secondary/community care activity such as pulmonary rehabilitation services for the south of the county, well-being activity and services to support training for rural GPs

·         several stakeholder events had already been held to gauge community interest and support for the new service model and potential take-up of proposed ‘new’ services.  It was anticipated that all of these events would be concluded before Christmas 2018.  Designers were currently preparing to produce design briefs for the proposals along with costings and a business case was being written with a view to securing the WG capital funding for the project.  It was anticipated that the Health Board would consider the business case at its March 2019 meeting prior to it being submitted to WG for approval.  Subject to no timetable slippages and WG capital funding being approved it was envisaged that the building work could commence during the summer of 2019, with the final services being transferred from  ...  view the full minutes text for item 6.

To consider a report by the Homelessness Prevention Commissioning Officer (copy enclosed) detailing progress made with delivery of the Action Plan and presenting the draft Denbighshire Supporting People/Homelessness Prevention Commissioning Plan prior to its submission to Cabinet.

11.45 a.m. – 12.10 p.m.

Introducing the report and appendices (previously circulated) which updated members on the Council’s progress to date in delivering its Homelessness Prevention Action Plan, the Lead Member for Well-being and Independence informed the Committee that the Council’s aim was to prevent homelessness.  In its bid to achieve this objective a multi-service and multi-agency approach had been adopted with a view to supporting people who were at risk of being made homeless from becoming homeless.  Also attached to the report was Denbighshire’s draft Supporting People/Homelessness Prevention Commissioning Plan 2019-222, which outlined how the Council proposed to develop and remodel support projects in the county over the next three years to support people who were either homeless or at risk of being made homeless.  Confirmation was still awaited from WG on the amount of Supporting People grant funding the Council was to be awarded for 2019-2022, whilst a budget cut was not anticipated for next year the Council as part of its budget planning had built in a 5% budget cut contingency into the delivery plan.

Responding to members’ questions the Lead Member, Corporate Director: Communities and the Homelessness Prevention Commissioning Officer –

·         confirmed as a matter of routine that, when compiling the Commissioning Plan and Action Plan, officers built in a 5% cut contingency plan into its budget assumptions.  For the forthcoming year this had been done on the basis of potential efficiency savings and the re-configuration of services to deliver more homeless prevention work rather than intervention work.  It was widely acknowledged that prevention work in the long-run cost less than reactive intervention work

·         confirmed that the Service worked very closely with Canolfan Dewi Sant in Rhyl, which provided shelter and support to individuals and families experiencing homelessness.  The Council’s Homeless Officer and its Citizen Engagement Officer visited the Centre on a regular basis.  In addition the authority commissioned services at the centre

·         referred to the shift in focus to a more proactive preventative service, e.g. by a Criminal Justice Homelessness Prevention Officer visiting prisoners before they were discharged from prison to prevent them leaving prison and immediately presenting themselves as homeless

·         advised that the Service was currently working with around 500 households in Denbighshire at present in relation to housing and homelessness matters

·         advised that there were a variety of reasons why individuals and families were at risk of losing their home, i.e. drug/alcohol/substance misuse, welfare reform, financial difficulties/debt, the effect of adverse childhood experiences (ACE).  Hence the reason taken to reconfigure the team to enable them to give more specialised prevention support

·         emphasised that every individual who contacted the Service was a vulnerable person

·         illustrated, via a case study, the effectiveness of the Homelessness Prevention Officer post hosted by the Revenues and Benefits Service (Civica) in the Job Centre in helping people manage their debts and plan their finances in order to prevent a crisis occurring

·         confirmed that the Annual Homelessness Prevention Day had been well attended during which a number of personal experiences were shared.  The feedback received following the event had been positive.  Nevertheless there would always be areas for improvement.  As a result of this event stronger links were being forged between internal partners with a view to strengthening working practices to prevent situations escalating into crises

·         advised that the competitive tender process undertaken for the provision of supported housing had been undertaken in accordance with the Council’s Contract Procedure Rules (CPR).  A new provider had been appointed.  The majority of ‘supported units’ had transferred over from the previous provider to the new appointed provider.  However, six units had not transferred over, and the  ...  view the full minutes text for item 7.

To consider a report by the Scrutiny Coordinator (copy enclosed) seeking a review of the committee’s forward work programme and updating members on relevant issues.

12.10 p.m. – 12.25 p.m.

The Scrutiny Coordinator submitted a report (previously circulated) seeking members’ review of the Committee’s work programme and provided an update on relevant issues.

During the ensuing discussion –

·         items on the work programme for the December meeting were reaffirmed and it was agreed to invite the relevant Lead Cabinet Members to attend; the Corporate Director Communities submitted her apologies for that meeting advising that the Corporate Director Economy and Public Realm would attend in her place

·         it was noted that the Scrutiny Chairs and Vice- Chairs Group had not directed any matters to the Committee during their last meeting

·         the Scrutiny Coordinator confirmed that proposals for the joint scrutiny arrangements of the Conwy and Denbighshire Public Services Board had now been approved by both Councils and would be progressed by officers; Group Leaders would be approached to appoint a total of eight representatives (non-Cabinet members) for the Joint Scrutiny Committee based on political balance

·         it was noted that work was underway to compile the information report on young carers requested by the Committee at their meeting on 20 September 2018 which would be circulated to members in due course

·         it was confirmed that reports requested by the Committee under the previous agenda items would be added to the work programme

·         the Chair encouraged all members to attend the meeting of the Corporate Parenting Forum scheduled for 2.00 p.m. on Tuesday, 11 December 2018 in Conference Room 1b, County Hall, Ruthin.

RESOLVED that, subject to the above, the forward work programme as detailed in Appendix 1 to the report be approved.

To receive any updates from Committee representatives on various Council Boards and Groups.

12.25 p.m.

The Chair reported upon her recent attendance at the Communications and Marketing Service Challenge advising that the service was performing well – she encouraged members to read the notes of the meeting once they became available.

Councillor Melvyn Mile advised that he had attended the Business Improvement and Modernisation Service Challenge on 2 October, the notes of which had been previously circulated as part of the Committee’s Information Brief.

RESOLVED that the verbal reports be received and noted.

The meeting concluded at 1.00 p.m.