Agenda, decisions and minutes

Councillor Winnington welcomed Councillor Matthew Cordy, opposition spokesperson for the Portsmouth Independents Party group, and Councillor Spencer Gardner, opposition spokesperson for the Conservative group, who were both new to the portfolio.

Apologies for absence were received from Councillor Gardner, and Emma Baxter, Finance Manager, who was represented by Louise O'Sullivan, Group Accountant.

There were no declarations of interest.

Purpose

To provide visibility to the Portfolio holder and the spokespeople of the approach being taken in Portsmouth to enable equitable access to women's health hubs, as outlined in the core specification national guidance.

RECOMMENDED that the Cabinet Member refer the local women's health hubs development programme of work to the Portsmouth Health Overview & Scrutiny Panel (HOSP).

Referred the local women's health hubs development programme of work to the Portsmouth Health Overview & Scrutiny Panel (HOSP). 

Hannah Byrne, Public Health Principal, introduced the report.

Steph Richards of Endometriosis South Coast made a deputation. Deputations are not minuted but can be viewed here

Agenda for Cabinet Member for Community Wellbeing, Health & Care on Monday, 15th July, 2024, 5.00 pm Portsmouth City Council

In response to points made in the deputation, officers explained that public health came under the local authority so they could not respond on behalf of the NHS. A greater proportion of women's lives was spent in poor health but split commissioning arrangements and services located in different sites complicated matters. Work was being done to support general practice to provide holistic care instead of women having to make multiple appointments. The Women's Health Strategy for England was published in 2022 but Portsmouth had been working on women's health since 2019. The Strategy aimed to make it easier to tackle gender inequality. Officers hoped the approach would help strengthen healthy conversations, give access to accurate information and provide high quality services. For example, officers wanted to optimise assets such as Family Hubs and to train staff to have healthy conversations to identify women's needs. There was also outreach work being delivered in several settings. Work was constantly evolving by building evidence and sharing good practice amongst partners.

Helen Atkinson, Director of Public Health, explained that although the report was prompted by a Notice of Motion at Full Council it had broadened to show public health's role in improving outcomes for women and girls. The Women's Hubs are an NHS core programme and the small amount of central funding has been  provided for innovation, communications and evaluation rather than delivering services. As part of Portsmouth Health & Care Partnership the approach we are taking is an integrated model with the focus broadened. Women's health had been in silos which was why there was a national programme and the hubs were the start of an integrated focus so women did not have to go to different places.

Councillor Heaney thought there might be a mismatch between what was expected and what was delivered or perhaps people's experiences were not very good. He made two suggestions for improvement. Firstly, ensuring more joined up working with the NHS as it and public health needed to work together though this could be difficult as they were funded differently. As Vice-Chair of HOSP (Health Overview & Scrutiny Panel) he could request more information on what the NHS was doing. Secondly, good services and practice could be replicated and increased. Better practice could be encouraged as the NHS could not be directed.

Councillor Winnington thanked Ms Richards for her deputation. He understood her frustration but the hubs were passed down from on high. However, Portsmouth had the advantage of more integration than most places. Most GP surgeries were geared towards the health hubs but they could not be compelled. Officers' point about ante and post-natal care being delivered via Family Hubs was salient. The national objective was a hub in every Integrated Care Board  ...  view the full minutes text for item 9.

Purpose

To provide an overview and key points of the Portsmouth Carers Strategy for the period 2024-2028, the Portsmouth Carers Strategy Action Plan and the results of the survey of adult carers in England (SACE) aimed at supporting unpaid carers in Portsmouth. 

RECOMMENDED that the Cabinet Member note the outcomes of the Survey of Adult Carers and endorse the Portsmouth Carers Strategy and Action Plan. 

Noted the outcomes of the Survey of Adult Carers and endorsed the Portsmouth Carer's Strategy and Action Plan. 

Andy Biddle, Director of Adult Social Care, introduced the report and thanked Ben Muller, Assistant Team Manager at the Carers' Centre, for his work on it. The local and national army of informal (unpaid) carers was the equivalent of another NHS and worth about £160bn annually. Informal carers would be consulted as the Action Plan progressed, including the digitally excluded, who could be reached via the Carers' Centre and partner organisations.

In response to queries from Councillor Heaney, Mr Biddle explained that Appendix 2 contained results for Portsmouth and full survey results for England would be published nationally. With regard to the 58 respondents who did not have a view on carer involvement in care planning, it could be that people interpreted terms differently. Under the Care Act 2014 carers had parity with those they care for so also had an assessment but they might not realise this; people differed in how they defined information and support. He agreed there was always work to do, including identifying carers. Adult Social Care (ASC) worked with around 1,000 carers but knew there were more in Portsmouth. It was worth highlighting this was a national survey so the ability to describe results in local terms was restricted. In addition, information for carers was not always from ASC as it could come from, for example, the HIVE or libraries.

Councillor Winnington thanked Mr Biddle and the Carers' Centre for the report. The social care system would fall apart without informal carers so he was glad they were back on the agenda. The Action Plan helped with the importance of having clear goals. The Accelerating Reform Fund had to be applied on an Integrated Care System basis and ASC was working with a charity until next December to better engage with carers. It was important people identified as carers and realised they were eligible for support, a key part of the local and national strategy. Finally, he thanked every single informal carer as the health and care system and the city owed them everything. He urged them to say if they felt they were not supported as they were the experts on what was needed.

Noted the outcomes of the Survey of Adult Carers and endorsed the Portsmouth Carer's Strategy and Action Plan. 

Purpose

To update the Cabinet Member and opposition spokespeople on the activity of the Integrated Learning Disability Service, (ILDS) in Portsmouth for 2023/24.

Noted the report which is for information and is not subject to call in.

Andy Biddle, Director of Adult Social Care, introduced the report and thanked Ian Chalcroft, Service Manager, for his work on it.

Councillor Heaney welcomed the positive report. In response to his queries, Mr Biddle would check but he thought problems with the Health Action Plans were to do with recording meaning that data could not be reported in an automated way. He agreed the plans should be part of health passports and would bring a more detailed response. With regard to the budget overspend and knowing in advance when children transition to adult services, ASC worked with quite a lot of residents from the age of 14 onwards when it was clear they would need support as adults. Some had been placed outside Portsmouth and when it was known they needed help, ASC tried to bring them back so they could be near friendship and kin networks, and also to see if support costs could be more realistic, which involved intensive planning. There were discussions with Children's Services about earlier intervention to help control costs and provide the right care. When some residents slipped through the net it was more difficult to manage costs. With some residents, ASC worked intensively, for example, with speech and language therapists to lower complexity of needs and thereby reduce costs. There was some success but still work to do.

In response to a query from Councillor Winnington about the effect of Fusion (the merger of local NHS trusts), Mr Biddle said it was on the Secretary of State's list to sign off (after having been delayed from 1 July because of the election) but there was no update at the moment. Although some services from the Isle of Wight and mental health services had transferred before 1 July the "big bang" between NHS Southern Health Trust and NHS Solent had not happened. There was no formal structure yet though there was some assurance Portsmouth's work with learning disabilities and mental health needs was recognised. Mr Biddle would discuss these matters at a meeting with the new Trust's Chief Executive designate Ron Shields the following week. However the new structure was configured Portsmouth needed to maintain the benefits of integrated working. For the Integrated Learning Disability Service to be rated Outstanding showed the level of support for residents.

As the service's most recent inspection was in 2016 it was likely there would be another one soon but officers could not speak for the CQC.

Councillor Winnington thanked officers for the report and also the Learning Disability Partnership Board and John Attrill, the country's only paid Learning Disability Champion, and a tireless advocate. Increased demand meant more cost but the government grant had not kept up so he hoped services would be properly funded. He was pleased to see the dementia pathway so people with learning disabilities who were diagnosed with it would get more support. Finally, he looked forward to the meeting with Ron Shields and would share any update on the date for  ...  view the full minutes text for item 11.