Agenda and minutes

Apologies for absence were received from Councillor N Clarke.

There were no declarations of interest.

RESOLVED:

           That the minutes of the meeting held on 30 November 2022 be            approved    as a correct record and signed by the Chairman.

The Executive Councillor for Adult Care and Public Health clarified that the delay in hospital discharges in Lincolnshire was not due to a lack of social care beds. The Committee was advised that there were 1,200 beds available for discharges out of hospital.

To receive a report by Pam Clipson, Head of Finance Adult Care and Community Wellbeing, which invites the Committee to consider the Council's budget proposals for Adult Care and Community Wellbeing (ACCW) for the financial year 1 April 2023 – 31 March 2024 and the assumptions made given the national context. 

Consideration was given to a report by the Head of Finance – Adult Care and Community Wellbeing, which invited the Committee to consider the Adult Care and Community Wellbeing Budget Proposals 2023/24 which had been informed by by both the Autumn Statement announced 17 November 2022 and the Provisional Settlement published 19 December 2022.

The proposed budget for the Adult Care and Community Wellbeing Directorate for 2023/24 was £177.767m, which was a £15.145m increase on from 2022/23. The Head of Finance – Adult Care and Community Wellbeing advised Members of the reason for the increase, as well as providing further detail on the Better Care Fund (BCF), the Public Health Grant, the Capital Programme and financial risk for the directorate.

The Committee supported the budget proposals and during the discussion the following points were noted:

·       The Committee acknowledged the pressures on the budget such as inflation and increases in demand for services, as well as the risks. 

·       The Committee welcomed the contribution to budget reductions by the improvement and development programme, whose extensive scope had included improvements to the financial assessment process for clients.   

·       The Committee welcomed the continuing emphasis on preventative services and initiatives, which had the potential to improve the outcomes for people, whilst also recognising a need to reassess the model used for providing health and social care across the Country. Reducing demand for other services in turn would lead to savings for both Lincolnshire County Council and the public sector overall.  For example, effective substance misuse services could lead to reduced demand on the NHS and the criminal justice system, realising benefits over the longer term. 

·       The Committee welcomed comparative financial and performance measures, which enabled comparisons to be made with other local authorities.  The comparisons generally showed that Lincolnshire County Council provided good value in its adult social care and public health services. 

·       The Committee had suggested that in the light of further anticipated constraints on public expenditure, expected in two years’ time, consideration be given to developing a mechanism for valuing the benefits of the services provided.  This could take the form of evaluating costs per head; and how expenditure on one service might lead to savings in another.  This would assist the Council if difficult decisions were to be required on the levels of future services, although several services were statutory, and discretion in these areas would be limited. 

·       The Committee promoted the concept of self-help and self-responsibility, so that people had the knowledge to make informed choices about their own health and lifestyle and to lessen the demand on services overall.     

·       The contingency fund available to providers was well utilised. Issues with small providers not having the resource or infrastructure to make claims was highlighted, however reassurance was provided that the Council supported providers in making claims.

·       The challenges posed by the rurality of Lincolnshire had generated a change in the rate structure for homecare rates to reflect the cost of delivery by area. Grant agreements would introduce an increased homecare rates  ...  view the full minutes text for item 53.

(To receive a report by Derek Ward, Director of Public Health, which invites the Committee to consider the The Director of Public Health's Annual Report 2022 - The Diverse Communities of Greater Lincolnshire)

Consideration was given to a report by the Director for Public Health, which invited the Committee to consider The Director of Public Health’s Annual Report 2022 – The Diverse Communities of Greater Lincolnshire.

The report provided an analysis of local data and identified four types of community across Greater Lincolnshire - urban centres, urban industrial centres, coastal communities and rural and market towns, including the key challenges and opportunities for health and wellbeing that varied across different areas. Findings highlighted the challenges of coastal communities in Lincolnshire and North-East Lincolnshire, identified some of the reasons for inequalities and set out a range of recommendations to improve outcomes.

Consideration was given to the report and during the discussion the following points were noted:

·      The Committee acknowledged that the use of percentage figures for rural and urban areas could be misleading as it did not reflect the density of populations. However, it was acknowledged that the requirements of services and the way they were delivered would differ between communities based on their population.

·      The Director of Public Health considered the options available to restrict the density of fast-food outlets in some communities, including through planning regulation and local saturation zones for alcohol and fast food outlets.

·      Concerns were raised over the mental health impact that social isolation could pose. Despite the Council’s wellbeing service continuing to provide a preventative offer to help and connect, it was acknowledged that Lincolnshire could benefit from an expansion of suitable services and Public Health would work in partnership with mental health services to improve the offer. 

·      Assurance was provided that Public Health would continue to work with District Council partners on the support offer available in areas identified as having deprivation and poverty, which included working with parish councils in identifying their role in driving change.

·      Concerns were raised over the potential loss of GP services in rural areas and the consequences of this on the health of communities. The importance of ensuring that all residents had access to a local GP surgery was highlighted.

·      The importance of preventative services in reducing the impact on social care services was emphasised.

·      The Committee congratulated the Director for Public Health on his first report as the Director for Public Health for Greater Lincolnshire.

RESOLVED:

           That the report be noted.

(To receive a report by Lucy Gavens, Consultant in Public Health, which provides an overview of the services provided by ‘We Are With You’ and presents recent performance data for the Substance Misuse Treatment Service)

Consideration was given to a report by the Director for Public Health and the Programme Manager – Public Health, which invited the Committee to consider a report on Substance Misuse Treatment Performance. The report provided details on the performance of the Council’s commissioned treatment misuse and recovery services by ‘We Are With You’; the impact of the Covid-19 on complex alcoholism; provider workforce challenges and the commissioned Integrated Lifestyle Service with ‘One You Lincolnshire’.

Consideration was given to the report and during the discussion the following points were noted:

·      The Committee recognised the health risks associated with the change in drinking habits and the misuse of alcohol following the pandemic, and welcomed further support to people who required access to services.

·      The Committee were pleased to hear that evidence had suggested a reduction in the number of younger people interested in using alcohol. The importance of educating young people on the risks of using drugs and alcohol was emphasised.

·      An extensive package of training was provided to staff working in the substance misuse services, including training around substances, motivational interviewing, Cognitive Behavioural Therapy, solution focussed therapies and trauma training. Recruitment of staff to the service was focussed on getting the right person to provide support to clients in the role, rather than specific qualifications.

·      Some Members raised concerns about the performance of the substance misuse service, such as the trading figures, dual diagnosis and successful completions. Assurance was provided that We Are With You was rated ‘Good’ by the Care Quality Commission, however the recommissioning process would be thorough and consider all available providers equally.

·      Additional Government funding to substance abuse services would provide a mechanism to create ‘combatting drugs partnerships’ and provide better value and quality for the money for residents of Lincolnshire.

·      Officers reiterated the benefits of a preventative approach as being essential to combatting a rise in substance and alcohol abuse.

RESOLVED:

           That the report be noted.

(To receive a report by Emma Rowitt, Senior Project Manager – Corporate Property, which provides an update on the De Wint Court scheme which opened in March 2022)

Consideration was given to a report by the Senior Project Manager – Corporate Property, which introduced a presentation on the Extra Care Housing and Supported Living Programme – De Wint Court.

The presentation provided an overview of the Extra Care Housing and Supported Living Programme, including live projects; future opportunities for the programme and an update on the success of the De Wint Court Housing Scheme.

The Committee commended the programme and the Executive Councillor – Adult Care and Public Health thanked the Senior Project Manager – Corporate Property for her work on the successful scheme.

The Board noted the positive impact that the housing facility had made to people lives. It was suggested that a visit to the housing facility would be planned.

RESOLVED:

           That the report be noted.

(To receive a report by Simon Evans, Health Scrutiny Officer, which invites the Committee to review its work programme)

Consideration was given to a report by Simon Evans, Health Scrutiny Officer, which invited the Committee to consider its work programme, as set out on pages 81 – 84 of the agenda pack.

The Committee was advised that the Day Service Update would now be considered at the meeting scheduled for 6 September 2023.

RESOLVED:

              That the work programme be agreed.