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Meeting Details

Health and Adult Social Care Committee
27 Sep 2017 - 19:00 to 21:41
  • Documents
  • Attendance
  • Officers in Attendance
  • Declarations of Interests



1. Welcome and Introductions
The Chair to welcome councillors, officers of the Council, witnesses and the public to the meeting and introduce councillors, officers and witnesses who are present.
2. Apologies
To receive any apologies of absence.
3. Disclosures of Interest

Councillors to declare any disclosable pecuniary interests, or personal interests (including other pecuniary interests) they may have in the business to be transacted, and officers to disclose any interests they may have in any contract to be considered.

4. pdf Minutes (173Kb)
To approve, and the Chair to sign as a correct record, the Minutes of the meeting of the Health and Adult Social Care Committee held on 13 July 2017.

The HM Chief Inspector of Prisons Annual Report 2016–17 informs that conditions in many prisons have generally worsened over the last year. However it is widely recognised that the conditions in which prisoners are held has an impact on their sense of wellbeing. The Report outlines that many individuals in prison suffer from varying degrees of learning or mental impairment and there is an ageing prison population.


There are no quick or easy solutions to deep seated care problems which affect many prisons. The state and its institutions however have a responsibility for the well-being of prisoners, including their physical and mental health. Despite this responsibility, the Report informs that there is clear evidence that for too many prisoners the state is failing in its duty. The reason for this situation is no doubt complex, but needs to be understood so as to aid in addressing the associated problems. In this regard there is a public focus on the need to improve conditions in prisons.


Milson Keynes Council has a responsibility to help ensure that all individuals in the borough have access to adequate care services, irrespective of their circumstance. The Health and Adult Social Care Committee will therefore review the health and social care provision in Woodhill Prison. Woodhill Prison is the only prison located in Milton Keynes and is a category-A male prison, with a youth offenders institution adjacent to the prison.


Victoria Collins (Service Director- Adult Social Care) and Ruth Weetman (Service Director- Offender Care, Central and North West London NHS Foundation Trust) will make a presentation to the Committee.

Population demand pressures on the NHS are great. Across the country almost 11% of patients are unable to get an appointment within two weeks, and the situation is worse if patients want to see a preferred doctor. Since 2009 the number of GPs per head of population has declined nationally and there are currently major problems with recruitment and retention of GPs, and as consequence nationwide more people are going straight to A&E for treatment putting a strain on hospitals.


The situation is now so serious that the House of Commons has in the past conducted an inquiry into the challenges affecting the provision of primary care nationally and to investigate whether the Department of Health and its arms' length bodies have the plans and policies in place to ensure that high quality care is consistently available to patients at the point of need.


Details of the inquiry, the evidence received and the final report can be found via the following link:


The Primary Care Workforce Commission has also produced a report, the Future of Primary Care – creating Teams for Tomorrow, which identifies solutions to meet the present and future needs of the NHS and explains how primary care could develop so that patients can continue to be confident that they are receiving the high quality primary care they expect from the NHS. The Commission’s report is available via the following link:


The NHS is 68 years old and the first generation of UK citizens to have been entirely cared for by the NHS are now approaching old age with the not unreasonable expectation that they will continue to receive the same high standard of care and be able to access the services of a local GP when required.


In 2016, a Milton Keynes Council Task and Finish Group which looked at the provision of GP services in Milton Keynes identified in its Report that the provision of healthcare through GP surgeries was the most cost effective way of caring for local populations. However, current difficulties experienced by some patients in being able to get a GP appointment in a timely manner meant that an increasing number of people were presenting at A&E with non-emergency conditions because they saw no alternative. This the Report made clear was putting a strain on hospitals and the NHS budget as A&E care is much more expensive to deliver than that provided in GP surgeries.

Given that there are already problems with the existing GP provision in Milton Keynes, the Group outlined a concern about the impact of the continued rapid expansion on both the Eastern and Western flanks of the borough on the provision of healthcare services. The Report also highlighted a perception amongst Ward Councillors generally that planning for future provision by both the NHS England Area Team and the Milton Keynes CCG was not keeping up with the current rate of growth in the borough. This issue was also picked up by the Council’s Health and Adult Social Committee at its meeting on 5 January 2016 which included an item on NHS Service Planning. Although some improvements were noted by the Report for example as a result of the work being done under the Prime Minister’s GP Access Challenge Fund (pilot scheme), the Task and Finish Group’s view was that it was not clear whether this would deliver lasting, positive changes or whether these improvements were significant enough.


Within Milton Keynes the Report highlighted that doctors’ workloads have increased by 20% since 2008, and are still rising, and a combination of increased life expectancy and rising demand will only get worse in the future.


Milton Keynes is one of the fastest growing Local Authorities in England. In the last 10 years (2004 and 2014), it grew by 18%. The population of Milton Keynes is projected to grow from 261,750 in 2015 to 308,500 in 2026. This is an increase of 46,750 people and a growth rate of 18 %. Over the next 11 years MK’s population is also forecast to grow by an average of 4,200 people per year, and this will impact NHS services within the borough. NHS service planning in light of population growth and its anticipated is of crucial importance to the borough.


Further information on Milton Keynes population is provided in the attached “2016/17 JSNA Population and Growth Update.


Matthew Webb (Chief Officer-Milton Keynes Clinical Commissioning Group), Maria Wogan (Director- Strategy and Planning, Milton Keynes Clinical Commissioning Group) and John Cheston (Development Plans Team Leader- Plan MK) will make a presentation to the Committee.

7. pdf Better Care Fund (95Kb)

The Better Care Fund (BCF) was announced by the Chancellor of the Exchequer in the Comprehensive Spending Review in June 2013. It provides a mechanism for joint health and social care planning and commissioning, bringing together several budgets and also funding paid directly to local authorities for adult social care services. The BCF requires Clinical Commissioning Groups and Local Authorities in every Health and Wellbeing Board (HWB) area to pool budgets and to agree an integrated spending plan for how they will use their BCF allocation. For 2017-18 the full allocation is £18,697,839 and is composed of three main elements – (i) the improved BCF (iBCF) which is additional funding to contribute to the protection of adult social care and reduce hospital pressures; (ii) the Clinical Commissioning Group (CCG) contribution; and (iii) the Disabled Facilities Grant (DFG) for major housing adaptations. The BCF is therefore of crucial importance to health and care services in the borough.


Michael Bracey (Corporate Director- People) and Mick Hancock (Assistant Director- Joint Commissioning) will make a presentation to the Committee.

The Quality Accounts Panel is appointed each year by the Council’s Health and Adult Social Care Committee, which has statutory responsibility for scrutiny of local health services. For the 2017 period the Panel received and commented on the Quality Accounts of Milton Keynes University Hospital NHS Foundation Trust, South Central Ambulance NHS Foundation Trust, Central North West London NHS Foundation Trust (Community & Mental Health Services), and Brook Services.


The primary purpose of a Quality Account is to encourage Boards and leaders of healthcare organisations to assess quality across all of the healthcare services they offer, and encourage them to engage in the wider processes of continuous quality improvement. Quality Accounts aim to enhance accountability to the public and enable engagement with leaders of an organisation in their quality improvement agenda. Providers are asked to consider three aspects of quality- patient experience, safety and clinical effectiveness. The visible product of this process- the Quality Account- is a document aimed at a local, public readership. Quality Accounts therefore go above and beyond regulatory requirements and focuses on essential standards. If designed well, the Quality Account should assure commissioners, patients and the public that the healthcare provider is regularly scrutinising each and every one of their services, and concentrating on those that need the most attention.


The Committee will received and note the Panel’s Report.



9. Joint Sub-Committee with the Health and Adult Social Care Committee
The Committee will remember earlier in the year nominating members to a joint sub-committee with the Children and Young People Committee which would scrutinise the work of the Health and Well Being Board. We have been asked by the Scrutiny Management Committee not to proceed with this at the present time and the item has therefore been withdrawn from our Work Programme pro tem.
10. Sub-committee to monitor / review the NHS’s Strategic Transformation Plan

The Health and Adult Social Care Committee at its meeting on 13 July 2017 resolved that the Overview and Scrutiny Management Committee be asked for authorisation for the Committee to form a Sub-Committee to scrutinise the progress of the Sustainability and Transformation Plan. The Scrutiny Management Planning Group at its meeting on 24th July has given approval for the appointment by the Health and Adult Social Care Committee of this Sub-committee.


The Committee is requested to nominate and approve Members to the Sub-Committee.

11. Proposed 2017/18 Work Programme

To receive and note the updated Work Programme for 2017/18:


6 December 2017

  • Discharge from Hospital Procedures and Discharge Planning
  • Provision of Public Transport to Medical Facilities around Milton Keynes
  • Healthwatch Annual Report
  • Directly provided Domiciliary Care Services
  • Access to Mental Health Service for Homeless- Task and Finish Group Report

20 February 2018

  • Safeguarding Adults Board- Annual Report
  • 2017/18 Budget Proposals for Adult Social Care and Implementation and 2018/19 Draft Budget Proposals
  • Quality Accounts 2018
  • Review of 2017 Patient Satisfaction Survey

Additional Meeting Documents


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Declarations of Interests

Member NameItem Ref.DetailsNature of DeclarationAction
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Officers in Attendance

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