Agenda and draft minutes

The following interests were identified in business items to be considered at the meeting.

Agenda Item 5:  North Denbighshire Community Hospital/Health Facility Project, and Agenda Item 6: Healthy Prestatyn and Rhuddlan Iach Primary Healthcare Project – A personal interest was declared by Councillor J. Chamberlain-Jones in both agenda items.  The reason for the declarations were that a relative of the respective Committee Member was employed by the BCUHB.

No items were raised which in the opinion of the Chair, should be considered at the meeting as a matter of urgency pursuant to Section 100B(4) of the Local Government Act, 1972.

The order of business was varied at this juncture in order to receive the presentations from Betsi Cadwaladr University Health Board (BCUHB) officials. Mr Geoff Lang (Director of Strategy), Mr Gareth Evans (Area Director Clinical Services – Central Area) and Dr. Chris Stockport Medical Director (Central Area) – were welcomed to the meeting for the discussion on the Health Service business items.

To consider an update by the Betsi Cadwaladr University Health Board (BCUHB) on the progress of the North Denbighshire Community Hospital / Health Facility Project.

                                                                                      9.35 a.m. – 10.10 a.m.

Mr Gareth Evans introduced this item in his capacity as the Project’s Director.  Via a PowerPoint presentation he detailed the various stages of the business case process required to bring the Project into fruition, explaining that they were now at the Outline Business Case (OBC) stage. 

The preparation of the OBC, which would include identification of the design and site development options and the production of the business case itself, would continue throughout the summer into autumn ready for submission to the Welsh Government (WG) in late 2016 or early 2017 for approval to proceed to the Full Business Case (FBC) stage.  During the presentation he emphasised that BCUHB was committed to delivering the project.  The scope of the project had been reviewed following widespread consultation and would now include, along with other services, the provision for minor injuries in a unit that could help support broader primary healthcare services in the area, Child and Adolescent Mental Health Services (CAMHS) and sexual health services at the site of the former Royal Alexandra Hospital in Rhyl. 

It was also envisaged that the Single Point of Access (SPoA) Service would be located on the site as well as the Older Persons Mental Health Outpatient Service.  However, whilst there would be 28 inpatient beds at the site, none of these would be for people with long-term mental health problems.  BCUHB was committed to delivering the Project on the site of the former Royal Alexandra Hospital, despite the complexities of redeveloping a listed building and the cost premium associated with the work, as this was the only suitable site in the area. 

The concept behind the project was the development of a modern health service facility that was able to deal with both the physical and mental health needs of older people, deliver urgent same day care where required, provide accessible outpatient care closer to the patient’s home and where a range of partners concerned with the health and well-being of citizens worked seamlessly together for the patient’s benefit whilst also providing access to well-being and prevention information. 

Responding to members’ questions BCUHB officials advised that:

·                     The OBC would include details on how the Health Board intended to deliver the project and the anticipated timescales involved once the FBC was approved;

·                     A 28 bed in-patient unit would be included in the OBC, however no decision had yet been taken on the configuration of the inpatient unit;

·                     Car parking facilities and public transport arrangements to the facility would all feature in the OBC;

·                     The WG had approved the Outline Business Case in September 2013 and it was still keen to see the project come into fruition.  £24m had been committed by the WG towards the project at that time.  Due to the time lapse and amendments to the project brief following consultation with the public and stakeholders, the funding for the project would require some refinement;

·                     An engagement strategy was in the process of being drawn up for the purpose of informing both residents and stakeholders on the project’s progress;

·                     Some stakeholders would be involved with the process of drawing up the OBC;

·                     They would welcome any ideas from councillors with regards to communicating  and engaging with residents on the plans for the facility;

·                     Once the new facility was operational information on the services available there would be widely shared with residents and stakeholders;

·                     Staff already working elsewhere in services that will eventually be available at the North Denbighshire Healthcare Facility site would be transferred there, whilst ‘new’ services would be subject of a recruitment campaign;

·                     Issues relating to the practicalities of utilising  ...  view the full minutes text for item 4.

To consider an update by Betsi Cadwaladr University Health Board (BCUHB) on the progress of the Healthy Prestatyn and Rhuddlan Iach Primary Healthcare Project.

                                                                                     10.10 a.m. – 10.45 a.m.

Dr. Chris Stockport introduced this item and via a PowerPoint presentation he illustrated the geographical area covered by the new service. 

He explained that service provided a range of health care services to patients registered at 5 surgeries in the Rhuddlan and Prestatyn area, and delivered services to their patients some of which lived in Denbighshire and others in Flintshire.  BCUHB had been planning for the introduction of this type of holistic healthcare facility in North Wales for some time.  Nevertheless, its introduction had to be expedited following receipt of three GP contract resignations in the Prestatyn and Rhuddlan areas in late 2015, early 2016. 

As a result of these resignations the Health Board established the Healthy Prestatyn and Rhuddlan Iach project.  Due to time and practical constraints not all aspects of the project were yet fully operational, but from 1 April 2016 the core services had been available.  Dr Stockport advised that:

·                     5 of the previous GP partners had signed up to the project on a permanent basis and another 5 GPs had joined the venture.  All GPs were now salaried by the Health Board rather than partners at the practice;

·                     In addition other members of staff had either been transferred to the Project or had joined it from elsewhere, these included Team Co-ordinators (who did the administrative work and ensured the professionals were in the right place at the right time), nurse practitioners, occupational therapists, clinical pharmacists, physiotherapists and an audiologist.  Having such a range of skills available in the project had facilitated a realignment of skills and eased the pressure on GPs as they could now refer patients to other appropriately qualified healthcare professionals as and when required;

·                     Emphasised that all the answers to successful primary healthcare did not lie within the NHS, this Project had proved this and its success to date was down to the effective partnership approach adopted by all public sector and voluntary organisations that were involved with it;

·                     The model now operating in the Prestatyn and Rhuddlan area was not a medical model of primary care, it was rather a psychosocial model where patients were guaranteed an appointment on their day of initial contact with the service as long as that contact was made before 4pm.  The focus of the service was on the individual and once in the service patients would be allocated to teams who could manage and support their needs;

·                     Work was currently underway to establish an Academy with a view to developing locally staff’s professional skills.  It was anticipated that the well-being arm of the Academy would be launched in the not too distant future and the feasibility of establishing a Well-being Campus were being explored, possibly on the site of the former Prestatyn library;

·                     During July 2016  there would be some disruption to normal services as the IT system for all sites was being migrated.  Patients had been notified of this and alternative arrangements had been made to deal with enquiries etc. during this period; and

·                     The former local authority building and associated car parking facilities at Tŷ Nant had been secured as a facility for the Service.  Work was currently underway to adapt the building for the Service’s requirements, whilst there had been some slippage with this work the facility was expected to be ready in early 2017

Responding to members’ questions Health Board officials confirmed:

·                     That at present the Central Surgery site at Prestatyn operated as the Service’s ‘hub’, but all five surgeries still provided services;

·                     That the partnership approach taken with this project had worked well on the ground and had  ...  view the full minutes text for item 5.

To receive minutes of the Partnerships Scrutiny Committee meeting held on the 26th May, 2016 (copy attached).

The Minutes of a meeting of the Partnerships Scrutiny Committee held on Thursday, 26^th May, 2016 were submitted.

RESOLVED – that the Minutes be received and approved as a correct record.

To consider a report by The Corporate Director: Communities (copy attached) on the development of the Regional Safeguarding Boards.

                                                                                      10.55 a.m. – 11.30 a.m.

A copy of a report by the Corporate Director: Communities (CDC) had been circulated with the papers for the meeting.

The Lead Member for Social Care (Adults and Children’s Services) introduced the report in the Corporate Director:  Communities’ unforeseen absence.  She explained that this was the Regional Safeguarding Board’s first Annual Report since its establishment and therefore the focus of the report was on the progress made with the establishment of the regional arrangements.  The Regional Board was an operational Board, and therefore because of its operational focus Denbighshire’s representative was the Corporate Director:  Communities.  The Lead Member served on the Conwy and Denbighshire Safeguarding Board, which was a sub-group of the Regional Board. 

The introduction of the Social Services and Well-being Act (Wales) 2014 had placed adult safeguarding on the same statutory footing as the safeguarding of children.  With its introduction a number of weaknesses with respect to safeguarding vulnerable individuals had come to light.  Addressing these weaknesses formed part of the Regional Safeguarding Board’s remit. 

Members referred to a number of areas within the Annual Report which were a cause of concern to them.  These related to the roles and remits of the various sub-groups, unfilled positions on boards and within the staffing structure, the running costs of the Board, each local authority’s financial contribution and the associated return on investment.  Due to the unavoidable absence of the Corporate Director:  Communities from the latter part of the meeting, the Committee requested that the Scrutiny Co-ordinator raise the above concerns with her seeking a written response to the questions raised.  It was:-

RESOLVED – that:-

(i)            subject to the above observations, to receive the Annual Report of the North Wales Safeguarding Children’s Board and North Wales Safeguarding Adults Board for 2015/16; and

(ii)          a further report detailing the progress achieved with the Boards’ development  from April 2016 to date be submitted to the Committee at its January 2017 meeting.

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.

                                                                                      11.30 a.m. – 11.40 a.m.

A copy of a report by the Scrutiny Coordinator (SC), which requested the Committee to review and agree its Forward Work Programme and provided an update on relevant issues, had been circulated with the papers for the meeting. 

A copy of the ‘Member’s proposal form’ template had been included at Appendix 2, Cabinet’s Forward Work Programme had been included as Appendix 3, and a table summarising recent Committee resolutions and advising on progress with their implementation had been attached at Appendix 4. 

The Committee considered its draft Forward Work Programme for future meetings, Appendix 1, and the following amendments and additions were agreed:-

6^th October, 2016:-

The Committee agreed that Lead Members Councillors H.H. Evans, J. Thompson-Hill and D.I. Smith be invited to attend the meeting for the three items included in the Committee’s forward work programme.

24^th November, 2016:-

The Committee agreed that an update on the North Denbighshire Community Hospital/Health Facility Project be included in the work programme for the above date and that Lead Members Councillors R.L. Feeley and D.I. Smith be invited to attend the meeting for their respective business items.

19^th January, 2017:-

Members noted that it had been agreed that an update report in respect of the North Wales Safeguarding Boards, be included in the Committee’s forward work programme for the January, 2017.

At the request of the Chair it was agreed that an agenda item in respect of services pertaining to Maternity, Gynaecology and Sub Regional Neonatal Intensive Care Centre (SuRNICC), and Out of Hours Services be included in the Committee’s forward work programme for the March, 2017 meeting.  Members also agreed that consideration be afforded to arrangements being made for Members of the Committee to visit the new facilities at Ysbyty Glan Clwyd.

Members were informed that the Scrutiny Chairs and Vice Chairs Group had met on the 28^th June, 2016 and that no items had been referred to the Partnerships Scrutiny Committee for consideration.

The SC referred to the North Denbighshire Communities First Information Report, included with the information Brief circulated prior to the meeting.  A report had been considered by the Committee at its meeting on the 30^th July, 2015, when it had been agreed that an information report be circulated to Members of the Committee following a period of twelve months.  Members agreed that following receipt of the information report a further detailed progress report should be presented to January, 2017 meeting of the Committee.

Members were reminded of the Scrutiny Training Event scheduled for Thursday, 14^th July, 2016.  Members were request to inform the SC of their intention to attend the event by the 8^th July, 2016.  Councillors P.M. Jones and W.N. Tasker confirmed that they would be in attendance. 

Following further discussion, it was:-

RESOLVED – that, subject to the above, the Work Programme as set out in Appendix 1 to the report be approved.

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

                                                                                      11.40 a.m. – 11.50 a.m.

Councillor P. Prendergast had attended a North Wales Fire and Rescue Authority meeting.  He explained that in order to meet budget constraints consultation would take place regarding the possible removal of a fire tender from Wrexham Fire Station.  Under such circumstance it had been confirmed that the respective Fire Officers would receive appropriate training.

Councillor M.L. Holland informed Members that the Local Joint Consultative Committee (LJCC) meeting had been cancelled due to a lack of Union representation.  He explained that he had attended a meeting of the Tackling Poverty Working Group and issues pertaining to the provision of Breakfast Groups for children had been discussed.  Councillor Holland agreed to forward details of the meeting to Councillor B. Mellor, Chair of the Rhyl Area Member Area Group.

RESOLVED – that, subject to the above, the reports be received and noted.

Meeting ended at 12.40 p.m.