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Reporting Back Strategic Commissioning Board

Earlier this month was the first meeting of Bury’s ‘Strategic Commissioning Board’. This is a completely new meeting which brings together Bury Council and NHS Bury in one decision making structure to make sure that the work that both organisations are doing in Bury is fully integrated. Significant steps have already been taken to achieve this, for example we now share a single Chief Executive and single Director of Finance, and there are more joint workings to follow.

The meeting is made up of the CCG (NHS Bury Clinical Commissioning Group) with 50% of the votes with the remaining 50% of the votes being the six Labour councillors who make up the Council’s Cabinet. The two opposition Leaders are invited to attend and contribute, but cannot vote (though the Conservatives didn’t turn up). Liberal Democrat Group Leader Tim Pickstone reports on the two main items which will be of interest: 

Health Needs in Bury
The Director of Public Health presented a paper summarising people’s health in Bury. Headlines included: 

– Historic increases in life expectancy are stalling
– People are generally living for moreyears in poorhealt

– The poorer people are, the shorter their lives and the more of those years are spent in ill health. There is a 15 year gap in healthy life-expectancy between the most and least deprived areas of Bury
– Bury’s rates of preventable mortality are significantly worse than England as a whole and among the worst compared to our statistical neighbours. Musculoskeletal conditions are the prime driver of poor health followed by depression and anxiety. These conditions often go hand in hand.
– Around 50% of the burden of disease is associated with smoking, excess alcohol consumption, poor diet and low levels of physical activity.

There are significant differences between different parts of Bury (e.g people expect to live 8 years longer in the better off areas of Bury, than in the worse off areas of Bury.

It was interesting to note that Bury is worsethan similar areas in:
– smoking rates
– diet (number of people who eat our ‘5 a day’ is significantly worse than in similar areas
– high body mass index (BMI)
– drug use
– physical exercise
(We were better than similar areas in terms of alcohol consumption). 

Bury is currently looking at developing a ‘Bury 2030’ plan about what we want to our priorities to be over the next decade, and the Board needs to identify which health priorities form part of that plan. 

I made the point that it was very disappointing that there had been no significant change in the last 15 years in the differences between the health of the poorer areas of Bury compared to the more well off areas of Bury, and that we should be critical of ourselves for failing to achieve this change. I also made the point that we need to identify a small number of priorities for making improvements in, to make a real difference to people’s health in Bury.

Urgent CareReview and Redesign 
The second important issue was an update on the review of ‘Urgent Care’ services in Bury. 

A review is tasing place with the following objectives: 
– Improve performance of 4 hour waits to reach 92% at Fairfield by March 2020 
– Reduce Non-Elective Admissions at Fairfield 
– Deliver ÂŁ2.6m savings from current spend from Urgent Care Services 
by April 2020 
– Redesign to simplify access points to improve patient experience

The following services are being considered as part of the review: 
– Accident and Emergency at Fairfield 
–  Urgent Care Treatment Centre at Fairfield 
– Walk in Centres at Moorgate and Prestwich 
– GP Out of Hours Service (BARDOC) 
– GP Extended Access and GP Extended working Hours 
– GP in hours – availability of appointments 

This is a very sensitive topic. People will, no doubt, recall the public anger at the plans to close the walk-in centres a few years ago. I asked: 
– When the decisions would be made (December 2019)
– Whether the proposed model which was promised to replace walk-in centres ‘locality hubs with some element of walk-in access to GPs’ was still the aspiration, or if things had moved on from this promise (things have moved on from this promise).

Papers for the meeting are here. Any questions please ask! 

Reporting Back: Greater Manchester Corporate Issues Scrutiny meeting about Fire Services

Last month was the regular meeting of the Greater Manchester Combined Authority (GMCA) Corporate Issues and Reform Scrutiny Committee. This month the meeting largely focussed on issues around the Fire Service. 

Prestwich councillor Tim Pickstoneis one of Bury’s representatives on the Committee, and is also the Committee Chair this year. Tim reports: 

Greater Manchester Fire ‘Programme for Change’ Consultation Outcome 
Greater Manchester Fire and Rescue Service (GMFRS) is at the end of a long process of review which has been called the ‘Programme for Change’. 

The Committee received an update on the main issues coming out of the consultation that had been undertaken. Highlights were: 

– The comments from the public (including individuals, groups and organisations) and staff on the proposals were predominantly negative.
– The main issues amongst staff of GMFRS included the ridership numbers (proposals to reduce the numbers of fire fighters on somefire engines from 5 to 4) and increasing the role of the firefighter to include greater place based and partnership working. Operational firefighters also raised that they do not feel that they have the skills, training or expertise to deliver this work, as well as the potential conflict with operational duties â€“ with there being a potentially detrimental impact on both operational incidents and training
– The main issue amongst the public was the reduction in overall number of fire engines in Greater Manchester, with repeat comments about not reducing below 48 (as quoted in the proposals) due to emerging risks of protracted moorland fires, high rise buildings, future developments and the threat of terrorism.

The Committee also heard from the Mayor’s Office, about the changes he was minded to make in response to the consultation. These included: 
– Retaining some specialist prevention staff, and allowing more time for fire prevention activities to be taken. 
– Looking for an alternative delivery model for the current cadets and volunteering programmes within GMFRS.
– Reducing the number of non-firefighter jobs that would be lost (113 to 60), and working across the Combined Authority to see if there were suitable jobs for people who were at risk. 
– No Fire Fighter redundancies until April 2020 – which means maintaining crewing levels of 5, 4 and 4 for fire stations that have three fire engines. 

There remains significant financial uncertainty for next year – a potential big pensions bill that nobody knows whether the Government will fund or not, and also whether or not the Mayor will want to propose an increase in the Fire element of Council Tax that we all pay. It may well be that some difficult decisions are going to have to be made when these processes are being considered early in 2020. 

HMICRFS Inspection of Greater Manchester Fire
Her Majesty’s Inspectorate of Constabulary and Fire and Rescue Service (HMICRFS) undertakes inspections of fire and police services. This is a new merged inspection body, so the first time GMFRS have been inspected in this manner. 

The outcome of the inspection was:

“We are satisfied with some aspects of the performance of Greater Manchester Fire and Rescue Service. But there are several areas where the service needs to make improvements.

Greater Manchester FRS requires improvement in its effectiveness at keeping people safe. It requires improvement at:

  • preventing fires and other risks;
  • protecting the public through fire regulation; and
  • responding to national risks.But we judge it to be good at understanding risk and at responding to emergencies.The service requires improvement to the efficiency of its service, in particular at making best use of resources. But it is good at making its service affordable now and in future.The way the service looks after its people requires improvement, in particular:
  • promoting the right values and culture;
  • getting the right people with the right skills; and
  • managing performance and developing leaders.And we judged the way it ensures fairness and promotes diversity to be inadequate. Overall, we would like to see improvements in the year ahead.”

The Committee agreed to in-particular receive more detailed progress updates from GMFRS on the culture within the service and on equality and diversity issues.

Hope that is useful. Papers for the meeting are here. Any questions please ask! 

Care Quality Commission Report critical of failing health services.

This week the Care Quality Commission published its annual ‘State of Care’ report. This report covers the financial year 2018-19. The report concludes that there are more inpatient services for people with learning disabilities and/or autism that were rated inadequate, and more child and adolescent mental health inpatient services rated inadequate.

Key comments include:

  • Some people are detained in mental health services when this might have been avoided if they had been helped sooner, and then find themselves spending too long in services that are not suitable for them.
  • Too many people with a learning disability or autism are in hospital because of a lack of local, intensive community services.
  • We have concerns about the quality of inpatient wards that should be providing longer-term and highly specialised care for people.
  • Waiting times for treatment in hospitals have continued to increase and, like many areas within the NHS, demand for elective and cancer treatments is growing, which risks making things worse.
  • In hospital emergency departments, performance has continued to get worse while attendances and admissions have continued to rise.

Jeremy Hughes, CEO at Alzheimer’s Society said: “Today’s report once again highlights the desperate situation people with dementia find themselves in as a result of our unjust social care system.  Published on the day that the Government has omitted any detailed plans for social care reform from the Queen’s Speech, questions need to be asked as to how the Prime Minister intends to fulfil his promise to ‘fix the social care crisis, once and for all.’  

“All we’ve had today, aside from promises, is a reiteration of the spending review announcement that councils could be allowed to increase their tax by 2% to fund social care. It’s not new money from the Government.”

Responding to the report, Liberal Democrat Shadow Secretary of State for Health and Social Care, Vince Cable said:

“It is rare for a public body such as the Care Quality Commission to be so scathing of the effects of Government policy. Their honesty is to be congratulated.

“They highlight graphically the decline in standards for mental health and learning disability inpatient services. This means some of the most vulnerable are not receiving anything like the standards of care that they need.

“Staffing shortages, coupled with inadequate funding solutions has meant the strained care system is beginning to crack.

“Liberal Democrats have long argued that mental health in particular should be raised to parity with other forms of healthcare.

“Yesterday’s Queen’s Speech pays lip service to improvements in these services but it must be followed up with real resources.

Read a summary of the full report here (with links to download the full report).

Rise in Homeless Deaths, Scrap the Vagrancy Act

Liberal Democrats are renewing calls for the Vagrancy Act to be scrapped following the publication of new ONS statistics revealing a rise in the deaths of homeless people in 2018.

The ONS data shows that there were an estimated 726 deaths in 2018, an increase of over 20% on the previous year. In the North West alone region 103 homeless people are estimated to have died.

Liberal Democrat Group Leader Councillor Tim Pickstone said:

“These figures are simply shocking. Clearly it takes more than a rough sleeping strategy document and the creation of a Minister for Homelessness to fix this epidemic. We should all be deeply ashamed that this is getting even worse.

“This out of sight, out of mind mentality needs to stop now. People are dying, and we need to take a more compassionate approach to ending this homelessness crisis. We must protect the most vulnerable people in our society, but instead the Conservatives are sitting on their hands.”

Liberal Democrat MP Layla Moran led a Private Members Bill earlier this year to scrap the Vagrancy Act: 

“We first need to scrap the cruel, Dickensian Vagrancy Act, which criminalises rough sleeping. The Conservatives are more than welcome to bring back my Bill that would repeal it in a heartbeat.

“The Liberal Democrats demand better. We would also build up to 100,000 social homes a year to provide the accommodation and support people need.”

Reporting Back: Audit and Scrutiny Committees

Just to report back from two recent Council meetings. Last month the Council’s Audit Committee met.Councillor Steve Wrightreports: 

At the previous meeting in late July the committee should have been presented with the final Audited accounts. The Councils Auditors (Mazars) were unable to sign the accounts because of problems with valuations.At this meeting the Account would be signed off by Mazars and further explanation of the issues with them. The valuations were on Property Plant and Equipment although there wasn’t overall any discrepancies in the values the Auditors said

Significant difficulties during the auditDuring the course of the audit we encountered some significant difficulties with the accounts initially presented for audit, most notably in relation to the compliance with the Code, the capital accounting arrangements, and responses to audit. This meant there was extensive and unexpected effort required to obtain sufficient, appropriate audit evidence, including in respect of the following, which is indicative rather than exhaustive.

  1. Accounting for Property Plant & Equipment is one of the more technically difficult areas of the Council’s accounts. It is also one of the areas of highest value and therefore is identified by us as an area where there is a significant risk of material error. Our audit work identified a number of issues:
    • the fixed asset register did not initially reconcile to the ledger and accounts disclosures;
    • the instructions to the Council’s valuer were last issued in 2014/15 and were therefore out of date. There was no evidence of reviewor consideration of the work required in the intervening period;
    • there was a lack of clarity on the effective date of revaluations undertaken in year – the extant (though dated) instructions to the valuer and valuation certificates were based on 1 April 2018 but finance applied the valuations as at 31 March 2019;
    • the consequence of the confusion above the valuation date gave rise to an error in the depreciation charge for 2018/19, as well as the amounts charged through the capital reserves; With all these issues with the Audit the extra time and effort put in by Mazars it was estimated that the extra cost to the Council for the Audit would be ÂŁ30000.

In Addition to the audited accounts the committee had a look at the quarterly financial monitoring report which didn’t look to bad with the outrun estimated at under one million pounds compared to two and a half the previous year. Which means that no over spend could be achievable this year. However the panel were shocked to hear that nearly two million pounds had been used from the CCG budget to top the figure up.

Councillor Michael Powellreports back from last month’s Overview and Scrutiny Committee: 

Corporate Core and HR
The ‘Corporate Core’ was established recently to bring together several existing areas of the Council into one team. This has seen a single HR team being established to deliver a 20% reduction in costs. A joint communications team has also been set up. 

‘Bury 2030’
Bury 2030 is the name given to the Council’s scheme to work towards the future of the borough over the next ten years. All members of the public will have the opportunity to contribute their ideas and priorities, whether these are for the whole borough, their town or even just their street. A school competition will also take place to ensure the thoughts of school children are taken into account.

Staff Volunteering Policy
A new policy has started up at Bury Council to allow all staff to be entitled to 3 days a year of volunteering during work time. Bury was previously one of only a few boroughs in the region that didn’t have such a scheme. A register will be used to ensure that local charities and organisations that wish to benefit or included on the scheme. 

Other issues
– The Council is updating the corporate risk register to help the Council to deal with the potential impact of Brexit

– A project manager has been put in charge of the Prestwich Village development plan, with a draft plan to cabinet hopefully being ready relatively soon.

– A cross-party working group has been set up to work towards future actions and plans for Bury Market.

Tackling the Climate Crisis Together

Liberal Democrats have committed to ambitious plans for fight against our climate crisis.

Our planet is in crisis, balanced on a knife-edge at the point of no return. 

Due to man-made climate change, global temperatures are soaring, the polar ice caps are melting faster than ever before, and whole nations are already facing the existential crisis of rising sea levels and extreme weather. Whole species of animals are being wiped out month by month, and global famine is a very real threat.  

This is something that we can only tackle if we all work together, collaborating with every single nation across the globe. No one will be unaffected, but, just like with Brexit, the poorest in society will suffer first and suffer most deeply.

We need to take action now. The government needs to move much faster and be much more ambitious in the steps it is taking to prevent the largest global crisis the world has ever faced. And as President Trump unpicks environmental protections one by one, harming the whole world in the process, we need to take centre stage as a global leader on tackling man-made climate change.  

That’s why, at the Liberal Democrat Autumn Conference in Bournemouth, our members have backed radical action to cut carbon emissions by 75% in the next 10 years. 

The Liberal Democrats will:

  • Empower councils and give them the resources to reduce emissions and set up green projects in a way that makes sense in their own communities
  • Plant 60 million trees a year, every year, which is one tree for every person in the UK
  • Convert rail networks to ultra-low-emission technology (electric or hydrogen) by 2035
  • Ban non-recyclable single-use plastics within three years
  • and a whole lot more!

There’s no time for wringing our hands when it comes to the climate crisis. Our new policy lays out a credible plan for fast, effective action to beat global heating.

Find out more here.

GMSF – Next Draft not till summer 2020…..

Greater Manchester’s Council leaders have announced that the next draft of the Greater Manchester Spatial Framework (GMSF) will definitely be delayed to summer 2020.

Over 60,000 comments on the latest draft were received and the Council Leaders say that they will use the next six months to have ‘further engagement’ on the main issues. The comments received from the public on the previous draft will be published at the start of October.

Councils will approve the next draft in June 2020, no coincidence at all that this will be just after the council elections and elections for Greater Manchester Mayor which take place in May………..

GMSF – Next draft not until summer 2020

Greater Manchester’s Council leaders have announced that the next draft of the Greater Manchester Spatial Framework (GMSF) will definitely be delayed to summer 2020. 

Over 60,000 comments on the latest draft were received and the Council Leaders say that they will use the next six months to have ‘further engagement’ on the main issues. The comments received from the public on the previous draft will be published at the start of October.

Councils will approve the next draft in June 2020, no coincidence at all that this will be just afterthe council elections and elections for Greater Manchester Mayor which take place in May………..

Call for Conductors on Trams

At last week’s full meeting of Bury Council, the local Liberal Democrat group proposed a motion calling for Metrolink to trial the use of conductors on trams.

The motion was passed with unanimous support from all parties in the Council, which means the Council will now formally request the move from Transport for Greater Manchester

New Prestwich Councillor Michael Powell used his ‘maiden speech’ to propose the motion, pointing towards the hope that conductors on trams would help to alleviate two particular existing issues with the service – rise in anti-social behaviour and violence, and high levels of evasion. Last year, police were called to nearly 3,500 Metrolink incidents and Metrolink currently estimate that 1 in 8 journeys across the service are currently going unpaid.

Our view is that there is a simple solution for both of these problems- providing permanent on-board staff on all journeys across the network.

Around ÂŁ10 million is current being lost each year from fare evasion. This would be enough to pay for about 300 conductors.

The Liberal Democrat proposal was supported by the whole of Bury Council at the meeting and the proposals will now go forward to Transport for Greater Manchester. 

Reporting Back: Planning Committee

Last week was the monthly meeting of Bury Planning Control Committee. This is the meeting made up of the 11 Councillors who represent the various wards of the borough of Bury. The committee determines planning applications for certain major developments and others where objections have been received. 

Liberal Democrat Councillor Cristina Tegoloreports back:

Prior to the Committee meeting, a site visit took place in respect of planning application 63324, at the Moutheath Industrial Estate off George Street in Prestwich. 

At the meting this application received approval but we raised some concerns:

We discussed a proposed development to the south of George Street, in Prestwich, for the erection of 124 no. dwellings. 

An outline planning permission on the site had already received outline planning consent in February 2017 (for the demolition of the existing buildings and the redevelopment of the site for up to 160 dwellings and 2,959 square metres of employment floorspace). Therefore, the Planning Committee could only consider matters in relation to the layout, scale, appearance and landscaping of the proposed development. 

The applicant will be taking advantage of a national policy, Vacant Building Credit (VBC), which is intended to incentivise brownfield development, including the reuse or redevelopment of empty and redundant buildings. In short term, under the VBC policy, the floorspace of any existing vacant unit is used to offset the number of affordable housing that that the landowner has to provide when redeveloping a brownfield site.

The vacant units in the proposed development have a total floorspace of 5,365.5 square feet, which would reduce the on-site affordable housing to 18 units. 

We analysed the merits and I raised at the meeting the following points:

  • Highlighting that this “generic” development was not catering for the specific needs of the local community which contains a significant Orthodox Jewish population, the second largest in the UK.
  • Identifying those units that did not have an accessible WC at ground floor level and that didn’t allow for manoeuvring space for a wheelchair by the main entrance door.
  • Putting an investigative so that electric vehicle charging points would be included.
  • Clarifying that the proposed 2.1metre high close boarded timber acoustic fence, and any perimetral fence within the boundary, should be installed based on the final FFL of the proposed development, which will be finalised only when the level of Singleton Brook is confirmed.

More information and the full papers for the meeting are here.