Agenda and draft minutes
Venue: Virtual Meetings - This meeting will be held virtually. Details of how to access the meeting on YouTube are contained in the meeting page, along with the agenda and papers.. View directions
Contact: Email: email@example.com
Note: This meeting may be viewed live from 5.00pm by highlighting and opening the following link:https://youtu.be/lexyQ_b0W1Y
Apologies for Absence
The Chairman welcomed Members, guests and officers to the first virtual meeting of the Council’s Policy Overview Committee (POC) via the Zoom platform. He confirmed that the proceedings would be live-streamed to the public (via YouTube), and relayed some basic rules of procedure, to help ensure that the meeting proceeded in as smooth and orderly a manner as possible. He thanked Members for their constructive approach in previous meetings, and reminded that the remit of the POC was to concentrate on policy, not service delivery, which was the purview of the Council’s Scrutiny Committee.
The Chairman noted the recent sad passing of Mr Graham Harris, the Council’s Managing Director, and advised that a Minute’s Silence had been observed by Members at DC Board. There would be an opportunity to acknowledge Graham Harris’s significant contribution to the Council as both Finance and Managing Director, at the next meeting of the General Assembly of the Council (GAC) scheduled to take place on 27 July 2020. Funeral arrangements would be advised to Members in due course, but attendance was likely to be limited to the immediate family, given the ongoing COVID-19 restrictions.
There were no apologies for absence.
Declarations of Interest
To receive declarations of interest from Members including the terms(s) of the Grant of Dispensation (if any) by the Audit Board or Managing Director.
There were no declarations of interest, including from Members who subsequently joined the virtual meeting.
That the minutes of the meeting of the Policy Overview Committee held on 28 January 2020 be confirmed as accurate.
The Chairman will announce his decision as to whether there are any urgent items and their position on the agenda.
The Chairman confirmed that there were no urgent items for Members to consider.
To consider references from other Committees (if any)
There were no references from other Committees for Members to consider.
Update on Health Care Services in Dartford
To receive presentations from representatives of the NHS Trust, DGS CCG and Virgin Care Ltd.
The Chairman renewed his welcome to his NHS and Virgin Care Ltd guests and confirmed that Members had received copies of the NHS PowerPoint presentations in advance of the meeting. He proposed that the DGS ICP present first, then the D&G NHS Trust, followed by a verbal up date from Virgin Care. There would then be a joint Q&A session.
Sue Braysher (Programme Director, DGS ICP) re-capped her PowerPoint material for Members benefit, with the following additional comments on individual PowerPoint slides:
· The new Kent & Medway Clinical Commissioning Group (K&M CCG) had been formed on 1 April 2020 with NHS England approval, led by Wilf Williams as Accountable Officer with a new Executive Team, and was tasked with the development of the Kent & Medway Integrated Care System;
· The eight separate Kent area CCGs had closed on 31 March and re-opened on 1 April as a single Kent & Medway wide CCG. The new CCG will support the development of four new Integrated Care Partnerships (ICPs) for East and West Kent, Dartford Gravesham & Swanley (DGS) and Medway & Swale under the overall auspices of the K&M CCG;
· DGS ICP membership was drawn from the three District/Borough Councils plus KCC, DGS NHS bodies and Virgin Care, plus associated KCC health bodies and the Primary Care Networks operating in the DGS area;
· The ICP’s Partnership Board (PB), ‘a coalition of the willing, with a shared ambition to transform population health, and the delivery of services to those in need’; formed the centre of the new structure. Membership of the PB was drawn from the key NHS bodies, the three District/Borough Councils and KCC. It was hoped to add an Elected Members Forum supported by the policy leads from the elected Members for Health during the summer. A virtual meeting of the new Elected Members Forum was proposed for late June/early July, to consider and influence the current 5 Year Work Plan going forward;
· The ICP’s ‘Mission for Dartford’ (via the 5 Year Plan) was to ‘improve population health, reduce health inequalities, and to use the ICP’s collective resources to better effect’; and active links had already been established with both SDC and Kashmir Powar at DBC, including a ‘’Dartford Big Health Day’, originally planned for 25 April with the three Dartford Primary Care Networks at Dartford College of Science & Technology. It was hoped to resurrect the event once COVID-19 restrictions were further relaxed;
· Members were shown organograms detailing the ICP’s ‘Development Structure’ with the PB at the centre, surrounded by an Advisory Board, Staff, Citizen, and Elected Members Panels, plus a Third Sector & Community Voice body. A separate ‘Delivery Structure’ organogram demonstrated how delivery was cascaded down from the PB to separate Boards for A&E Delivery and Local Care, underpinned by Groups for Urgent Care and Operations, and a separate System Efficiencies Board, itself underpinned by Pathways and Reviews covering End of Life Care, High Intensity Users and Respiratory, Cardiology, and Diabetes.
· The development structure of the ... view the full minutes text for item 56.
Mental Health Services for Children and Young People (YPMHS)
To receive a presentation from representatives of NHS Kent & Medway CCG and the West Kent YPMHS.
The Chairman renewed his welcomed to Mr Dave Holman, Associate Director for Children, Maternity and Mental Health Services for NHS Kent & Medway CCG and confirmed that Members had received copies of the Associate Director’s PowerPoint presentation in advance of the virtual proceedings, to facilitate Member comprehension and debate.
The Associate Director’s presentation informed Members in general terms of the political drive and leadership necessary, allied to an understanding of and engagement with, the need that was required to successfully implement the current mental health workforce plan for England ‘Stepping forward to 2020/21’.
Within that overall health initiative, progress transformation plans (PTPs) had been formulated, including for the particularly complicated area of Children and Young People’s Mental Health and Wellbeing. Kent’s Local Transformation Plan for Children, Young People and Young Adult’s Emotional Wellbeing and Mental Health (dated October 2018) was now in its 4th revised edition. The presentation also detailed the success rate across the 12 Kent Districts for Children & Young People with a diagnosable mental health condition (MH) accessing treatment in 2018/19. Further slides gave an overview of the NHS’s Long Term Plan and commitments, and an explanation of the CYP MHS’s High Level Risk Reporting (HLRR) protocol, developed to notify Integrated Care Directors and their Leadership Teams of patients considered to be at increased risk.
In support of his presentation, the Associate Director (AD) advised Members of the background to CYP mental health service provision in Kent which until 2015 had been dis-jointed. An Emotional Welling Strategy for CYP mental health services had subsequently been developed with a single service provider, North East London Foundation Trust (NELFT), who had been awarded a £50m contract in 2017. The Single Point of Access (SPA) nature of the contract with NEFLT had initially led to an increase in demand for CYP services and increased waiting times. However, following a concerted staff and budgetary commitment of some £5m in the past 2 years, some 80% of mainstream CYP patients were now seen within 8 weeks.
The demand for Autism and ATSD (0-25 year old) services in Kent was high, and not currently being met. The County was undergoing a ‘deep dive’ review exercise to address the short-fall in service provision, and the Canterbury Pilot Scheme had helped in the development of Kent’s ASD (Autistic Spectrum Disorder) Care Pathway, prior to the Coronavirus pandemic and the government’s lockdown measures coming into force, which had resulted in an increase in waiting times for access to the more complicated ATSD service provision.
Kent’s Local Transformation Plan was due to benefit from between £2-6m of service investment in 2020 the 5th year of the current Plan, which adopted a whole system approach based on crisis-in-care being delivered by Crisis Teams. In terms of measuring success, Kent was above average for England in the delivery of CYP mental health services, and Dartford was above average within the 12 Kent Districts, with 50% of CYPs with a diagnosed MH condition accessing services against a yearly ... view the full minutes text for item 57.
To receive the annual report and appendices and comment accordingly.
Members considered the Dartford Preventative Health Projects Annual Report for 2018-19 submitted by the Health & Communities Manager (SDC) under the shared services arrangements with the District Council.
Attached as Appendix A to the report was the Dartford Health Inequalities Action Plan Progress Report 2018-19 from Dartford’s Health Team Lead, Kashmir Powar. Appendix A gave a detailed analysis of the progress made in the year ending 31 March 2019, against the priorities identified in the Dartford Health Inequalities Action Plan (2015-18), agreed by the Committee on 15 December 2015 [Min. No. 32 refers]. Appendix B to the covering report comprised case studies and evidence in support of Appendix A.
In response to a query from the Chairman, the Strategic Director (External Services) advised that a new Action Plan had not been developed, however, with the agreement of Kent Public Health, work to support the previous priorities continued. She explained that Dartford operated under an SLA with KCC (Kent Public Health) which drew from county level plans and priorities. In addition, the Kent Health Inequalities Group had been meeting pre-COVID-19, and Dartford was represented on that body by the Vice-Chairman of POC, and Cllr. Allen as Cabinet Member for Youth, Health & Wellbeing.
Kashmir Powar then joined the virtual proceedings by telephone, to reprise her report for Members and respond to their questions and concerns. She advised that the aim of the service at Dartford was to provide an integrated adult health service for residents to reduce alcohol, tobacco and food consumption, and was targeted at people who needed to lose weight, and supported them through a family weight management programme. The Dartford Health Care team targeted areas of most deprivation, and adopted a holistic approach which encouraged weight loss allied to exercise and a healthier life-style through KCC’s ‘ONEYOU KENT’ initiative, which was due to be re-launched in September 2020, following further relaxation of the government’s COVID-19 lockdown measures.
Her team would also be re-establishing links with the Fairfield Leisure Centre, including the Health Walk Scheme which helped to build community engagement, and wellbeing initiatives with the Council Housing Department and its Home, Energy & Renewable Officer (HERO).
She confirmed the following points in response to specific questions from Members:
· Early intervention by GPs was essential in identifying underlying health problems and sign-posting patients to healthy solutions, including 1 to 1 help and support groups, and Mrs. Powar regularly attended such sessions at all 3 Dartford GP Surgeries;
· A Council press release was proposed informing of on-line services during the continued restrictions of lockdown, with a re-focus on mental health issues rather than weight management. Virtual support of clients was being provided via the Microsoft Teams platform, based on the knowledge of what works for Dartford residents, with telephone support provided to those without digital access;
· The Dartford Health team was engaged in the Planet Dartford Initiative for healthy edible garden produce [active in Swanscombe and Ebbsfleet] and also maintained contacts with the gym in the Swanscombe Centre.
The Chairman thanked Mrs. ... view the full minutes text for item 58.
To note the report and appendices and comment accordingly.
The Chairman acknowledged the efforts of the Committee Coordinator in compiling a very comprehensive annual report of the Committee’s work during the 2019-20 municipal year. He noted two significant successes for the Committee in the period under review:
· The securing of Urgent Care Services at Darent Valley Hospital from the (then) DGS CCG [report page 6/7 refers];
· The promotion of new enforceable Council littering measures requiring Dartford businesses to have commercial (trade) waste collection arrangements in place [page 14 refers].
The Committee Coordinator advised that his POC annual report followed a consistent formula with those for other Council scrutiny committees he clerked. It comprised standard elements of background and introduction, Committee Protocol and Terms of Service (ToRs), plus a summary of the Committee’s work in the period under review. The final element was drawn from the agreed committee minutes for the period under review. Given that those minutes were published in full on the Council website, he undertook to attempt to further reduce that final element, in his compilation of the annual report for the 2020-21 municipal year.
In response to a separate question from a Member, the Committee Coordinator explained that the minutes of individual committee meetings were themselves only a summary of those debates. However, he undertook to follow-up any points of perceived ‘omission’ the Member had concerning the contents of the 2019-20 annual report with the relevant Council Officers who had presented to the Committee and revert.
1. That Members note the contents of the 2019-20 annual report on the Committee’s work during the preceding municipal cycle, and that the report be submitted to the next meeting of the GAC.
In closing the proceedings the Chairman thanked all Members, Officers and guests for their constructive contribution to the various debates, and for acceding to his request for a 5 p.m. start time, to accommodate his other work commitments.
He asked that his particular thanks to his NHS and Virgin Care guests be recorded in the Minutes. Their separate presentations and positive responses to Members’ questions and expressions of concern; particularly over the continued provision of health care services to Dartford’s residents during the ongoing COVID-19 pandemic and for the future; had been particularly helpful to Members, and would help inform the Dartford public when the meeting minutes were published on the Council website.