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 £2.6m 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! 

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.”

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.

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 £10 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.

Liberal Democrat Announce Candidate for Mayor of Greater Manchester

Liberal Democrats in Greater Manchester have announced their candidate for the election for Greater Manchester Mayor in May 2020.

Councillor Andy Kelly, who is the Leader of the Liberal Democrat Group on Rochdale Council will take on Labour’s candidate, Andy Burnham.

Andy said: “The Tories are playing parlour games with people’s lives and Labour are betraying those they profess to represent I felt the need to step up to the plate.

Greater Manchester voters deserve better representation, we need someone who is not afraid to be frank about our future. That person is me.

This year the Liberal Democrats made huge gains in the local elections, with 700+ gains nationally – the party’s best local election results. Many of these gains were in the Greater Manchester region. Three weeks later we gained two members of European parliament in the North West as voters turned away from both Labour and the Conservatives.

I am keen to take Burnham on his three years of delivering nothing.”

Andy Kelly’s first pledge has been to scrap the GMSF: “We need to find REAL solutions to the housing crisis. To provide the right homes, in the right places; reversing Labour’s local obsession with socially cleansing our community.”

Answers to Questions: Police Issues

At the last full Council meeting of Bury Council, Liberal Democrat councillor Steve Wright asked a number of questions to the Greater Manchester Police representative: 

Community Policing Expenditure:
Could the Council’s member of the Greater Manchester Police and Crime Panel inform members what proportion of the Greater Manchester Police budget is spent on local community police teams?

We were quite shocked about how low the future is: 
The proportion of Greater Manchester Police budget that is spent on Neighbourhood Policing and Community Liaison is 11%.

Members will also be aware that in March the local approach to community policing changed with the introduction of a new Neighbourhood model. The model reverts back to a previous incarnation with 3 dedicated Inspectors taking responsibility for North, Central and South regions of the borough. This change combined with new shift patterns resulted in more Officers on the beat at any one time.

The new Policing precept announced for 2019/20 also resulted in 3 additional Police Officers for Bury who have now started and will further bolster the Officer numbers available.

Metrolink Incidents: 
Could the Council’s member of the Greater Manchester Police and Crime Panel inform members how many incidents have occurred which have required police attendance on the Metrolink in the current financial year and previous two financial years?

The answer is that there are a lot, and the level is increasing: Unfortunately, limitations of how the data is recorded means that we can’t provide a figure for 2017/18. The following data is a combination of Police data, Metrolink data and Transport for Greater Manchester Data.

In 2018/19 – There were 3481 incidents

Between April 2019 and 30th Jun 2019 there were 946 incidents, which is approximately 8% higher than the same point last year.

Members may be aware that security on the Metrolink is overseen by the Travelsafe Partnership which is jointly led by TfGM and Greater Manchester Police (GMP) with support from:

o Metrolink;
o Stagecoach;
o First Manchester;
o GoAhead NW; and
o British Transport Police.

Travelsafe has been in place since 2015 and commenced as a 3 year pilot. At the end of the pilot the Partnership went through a period of review and a complete change in leadership and moved away from the traditional ‘boots on the ground’ approach to more intelligence-driven tactics and prevention.

There is a TravelSafe Partnership Strategy in place for 2019-21 the following aims:

o Improve the perception of safety & security across public transport, offering reassurance to passengers;

o Manage instances of Crime and Anti-Social Behaviour (ASB) occurring on the transport network; and

o Discourage fare evasion.

Also, Members will be glad to hear that the Travelsafe Partnership have funded 50 PCSOs to help manage security on the network and a further 8 Officer employed by the Network. There is also a proposal to move to 50 Police Officers with a broader Transport remit sometime in the future.

The additional investment combined with the intelligence-led planning will start to see more targeted work, bringing the number of recorded incidents down.

Reporting Back: Health Scrutiny Committee

Last month was the Bury’s Health Overview and Scrutiny Committee. Councillor Cristina Tegolo reports:

The Committee’s role involves reviewing and scrutinising any matters relating to the provision and operation of health services in the area of the Council, scrutinising organisations external to the Council and holding the Leader / Cabinet Members to account. Bury’s Health Overview and Scrutiny Committee meets in public and includes a public question time at the start of the meeting. Scrutiny committees actively welcome involvement with the public and seek the views of members of the public on services that are being considered. Scrutiny committees also welcome suggestions for subjects to be considered for inclusion in the scrutiny work programme.

Geoff Little, Chief Executive Bury Council provided an update on the Health and Social Care Reforms. Chris O’Gorman, Local Care Organisation Independent Chair, and Julie Gonda, Director of Adult Social Care, provided an update on Bury Local Care Organisation. John Hobday, Consultant in Public Health, provided an overview of key health and well-being data for Bury and Highlited areas for future interventions. Mr Little explained how, despite amount of money being spent, outcomes and health expectancies for Bury people are still not acceptable. In Holyrood life expectancy for 2013 – 2017 for a male was 77.6 years to 79.5 years (inSt. Mary’s it is 79.5 years to 81.4 years)and for females was 82.4 years to 84.1 years (in St. Mary’s is 84.1 years to 85.7 years). Bury “One Commissioning Organisation” wants to have a program of reforms based on the needs of Bury residents, clients and patients. Ultimately and over time the Bury “One Commissioning Organisation” will encompass all strategic commissioning from the Council and CCG and other public services where possible. The main goals are to:

  • Empower Bury people to remain well and make healthy decisions
  • Close the financial gap and improve outcomes 
  • Create a different model based on understanding of families and carers
  • Take control of the system as whole 
  • Improve services in the community for the most vulnerable
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I commented on the importance of education and especially promoting health and wellbeing of children under 5. I also welcomed Bury Council’s plan to empower Bury people to remain well for longer and supporting and caring for people in their homes. However, I pointed out that the Planning department is probably not aware of the objectives of the “One Commissioning Organisations”. I gave as an example the planning meeting that I attended on the previous day, in which a Community Centre at the heart of a residential area, which could be used for exercising classes and health promoting activities, was changed into offices and a block of apartments (in Green Belt and in Conservation Area) had received planning permission even if the 16 apartments were missing the most basic accessibility and inclusive design standards.

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

Reporting Back: Overview and Scrutiny Committee

Last week was the first Overview & Scrutiny meeting of the new Council year which saw a series of presentations by representatives from the different Council departments. These outlined each department’s work programme and priorities for the coming year. 

Councillor Michael Powell reports on some of the key priorities for each area are below:

Strategy and transformation:
– Developing a ‘corporate core’- bringing support services and staff together to build up capacity and improve efficiency- Quarterly budget monitoring report updates to be sent to Councillors as well as end of year reports- Lead officers to be put in charge of each work stream (e.g. Finance, Governance, ICT and Digital, HR)Children and young people:
– Increasing number of foster carers inside the borough and reducing reliance on external carers- Enhanced support for care leavers- Working to further reduce permanent exclusion numbers- Enhanced early support strategy to support new LAC (Looked After Children)- Implement early intervention schemes in schools needing support

Operations:
– Continuing to work towards a more productive and reliable waste service operation- Implementing a ‘preventative maintenance’ approach to highways (i.e. developing a programme for all roads to be addressed after a set period to prevent deterioration of highways)- Introducing a plastic strategy to minimise use of single-use plastics across the borough- Improving the customer interface to make reporting problems involving highways even easier and more efficient for residents

Business growth and infrastructure:
– Beginning work on regeneration scheme in Radcliffe- Implementing £10 million investment in Prestwich village centre (following consultation process with residents in the Summer)- Continuing to develop land and property portfolio- Moving forwards with GM spatial framework and focusing on scope for development on brownfield sites- Working towards potential regeneration of Bury Interchange (supported by T4GM)

The papers for the meeting are here. Any questions please just ask!