Meeting documents

• (Attachment: 1)Minutes

RESOLVED that the Minutes of the meeting held on 16 March 2017 be approved as a correct record.

Committee Members: Cllrs M. Blacker, J.M. Stephenson, J. S. Godden (for whom Cllr J.M. Ellacott substituted) and B.A. Stead.
Other Members: None
The Committee noted its expression of wishes for Cllr Stead’s speedy recovery.
 

None.

• (Attachment: 2)Item 4: Internal Audit Plan (2M/bytes)

The Chairman welcomed Karen Williams, Director of the Council’s Internal Audit Team at RSM, to the meeting.

The Chief Executive introduced the report on the proposed Internal Audit Strategy 2015-18 and Internal Audit Plan 2017-18, which were set out at Annex 1.

The Committee raised comments and questions relating to the following:

• The Internal Audit Strategy and Internal Audit Plan were considered a sensible set of plans;

• New s.151 Officer – it was confirmed by Karen Williams that s.4 of the Internal Audit Plan noted that the document was continually under review and would specifically be reviewed at quarterly meetings with the s.151 Officer once they were appointed; and

• Cyber security – Karen Williams advised that a Cyber Security Review had been conducted in 2016-17 and had found the Council’s arrangements to be sound. Cyber security was an evolving area and becoming increasingly complex so would be kept under review and further audits undertaken in the event a need to do was identified.

RESOLVED that the Internal Audit Plan 2017-18 be endorsed.
 

• (Attachment: 3)Item 5: Health and Wellbeing Company (Pathway) Report (2M/bytes)

The Chairman welcomed Dr Munroe, who had attended to provide a testimonial in respect of the services received by his son from Pathway. The Chairman thanked Simon Laker and Ian Hutchinson of Pathway and the Leader, Councillor V.W. Broad and Cllr Turner who had attended the meeting to support the report.

Tom Kealey, Director of Pathway and the Head of Health and Wellbeing introduced the report and highlighted the salient points, which included:

• The removal of the Revenue Support Grant, necessitating that the Council find alternative revenue streams and the need to protect frontline services;
• A new business plan was to be presented to the Executive Sub-Committee and it would reflect the same financial expectations as those presented in 2016 and profit was still anticipated in the future;
• That Pathway was a continuation of a living and ageing well initiative, which had initially been funded using Personalisation, Prevention and Partnership fund monies;
• Investment by the Council into Pathway was minimal when considered alongside the investment into the borough’s leisure centres;
• The delay in receiving CQC registration led to Pathway cutting back on its activities for several months so as to reduce its operating costs pending receipt of the CQC registration;
• The report identified two KPIs – evidence that Pathway was helping people and that the financial projections for the company were on track to being profitable by 2018/19 – and Pathway were committed to achieving these objectives.

The Head of Health and Wellbeing introduced Dr Munroe, who gave the Committee a testimonial in respect of the assistance Pathway were providing to his son.

Dr Munroe explained to the Committee:
• He was a GP based in Claygate, Surrey specialising in diabetes but had retired from clinical practice in order to care for his son, aged 25, who suffered from autism;
• His son’s experience in residential care after he turned 18 resulted in four disruptive placements, which had had a significant effect upon him so that he now required 24 hour care and could succumb to four episodes of distress per day;
• The importance of responding to the individual’s needs, particularly when individuals suffered from autism because that left them unable to relate to other people so that clustering them with other sufferers was not beneficial and could in fact be detrimental;
• A series of video clips to demonstrate the effect upon Dr Munroe’s son were shown to the Committee; and
• Dr Munroe explained that due to the inability to fund suitable care the family were obliged to sell their home in Surrey and move to Herefordshire where property was more affordable, which in turn meant there were more care workers available because they could afford to live there on carer salaries.

The Committee’s questions and comments related to:

• Viability of providing an individualised service – the Committee heard that whilst an individualised service was an initially high cost, it prevented further deterioration or disruptive episodes which meant in the long term costs would reduce rather than increase as was the case under the current system;
• Good investment and facilities would encourage parental funding;
• The unfortunate distinction between health and social care funding was recognised by the Committee and was a problem faced in respect of the provision of care for the elderly as well;
• The particular financial aspects of the borough, and Surrey, were that care facilities were found in areas such as Horley where property was cheaper so that carers could afford to live there and the acquisition of facilities was more affordable. This resulted in families in the north of the borough being separated as there was no comparable care provision in that area; and
• If Pathway is a success there would be a risk that, as with the excellent special needs education facilities in Surrey, families would move to the area specifically to receive such support and this might strain the services severely.

The Chairman thanked Dr Munroe for attending the Committee.

RESOLVED that the report be noted.
 

• (Attachment: 4)Item 6: Overview & Scrutiny Committee: Annual Report 2016/17 inc. Annexes (255K/bytes)

The Chairman introduced the report and invited questions and comments from the Committee.

Questions and comments from Committee Members related to:

• noting that the report accurately represented the work it had carried out over 2016-17; and

• a request that the method of preparing presentations and the timetable for the Advance Questions process and process for making changes to the Work Programme as discussed with the Chairman and Vice Chairman be provided to Members of the Committee.

RECOMMENDED that the Overview & Scrutiny Committee – Annual Report 2016-17 be noted.

RESOLVED that the Work Programme and method of preparing for presentations be circulated to Members of the Committee.
 

It was reported that there were no items arising from the Executive that might be subject to the ‘call-in’ procedure in accordance with the provisions of the Overview and Scrutiny Procedure Rules.

None.

RESOLVED that members of the Press and public be excluded from the meeting for the following items of business under Section 100A(4) of the Local Government Act 1972 on the grounds that:

(i) it involved the likely disclosure of exempt information as defined in paragraph 3 of Part 1 of Schedule 12A of the Act; and
(ii) the public interest in maintaining the exemption outweighed the public interest in disclosing the information.
 

• (Attachment: 5)Item 10: Part 2 - Health and Wellbeing Company (Pathway) Report (293K/bytes)

The Chairman expressed that the Council would feel proud to know the difference Pathway had made to Dr Munroe and his son.

The Chairman referred to the Advance Questions and Answers received in respect of this report noting in particular the responses in relation Members’ access to company information and invited questions and comments from the Committee.

The Committee’s questions and comments to Pathway and Cllr Broad related to:

• How profit could be achieved. The Committee heard that there were several different strands to the Pathway business model. The provision of care such as that received by Dr Munroe’s son would be commissioned from Pathway by County Councils and would be provided on a cost neutral basis. The provision of technological solutions, mostly provided on a volume basis to residential facilities, would be the profit generating aspect of the business;
• How Pathway intended to provide continuing support to families such as Dr Munroe’s if they moved out of the borough. The situation of Dr Munroe was exceptional and unusual and was not expected to be a regular requirement. The continuation of assistance was vital in that case due to the difficulty of establishing relationships with autistic sufferers. The continuation would be achieved by utilising the network of relationships possessed by Pathway so that care could be arranged locally;
• Continuity of care. This was desirable but Commissioners were unlikely to agree to SLAs beyond a period of 24 months;
• The profit element would derive from technology such as the blood sugar monitoring system to which Pathway had exclusive distribution rights;
• Each revenue strand had a profit and loss account associated with it which would be provided to the Executive Sub-Committee for consideration;
• Marketing – this was being conducted according to the new business plan and included direct marketing and the use of social media. An advert in the Borough News had evinced a number of enquiries due to the readership demographic;
• Governance and accountability of the Executive Sub-Committee to the Overview and Scrutiny Committee. The Committee noted that in conjunction with its duties, there were also audit obligations and directors duties that held Pathway to account so the scrutiny activity of the Committee needed to be of value. The Committee requested that two additional KPIs be considered by the Executive Sub Committee around the following issues:
• Cashflow – the importance of ensuring that profits were realised rather than being held by debtors; and
• Pathway Capital – the importance of assessing how the Council’s financial investment in Pathway was performing.
• The Chairman asked whether the creation of Pathway had been presented to Members in July 2016 primarily as an income generating social venture or a combination of both. It was confirmed that the reports presented to Members at the Executive Meeting in July 2016 focused upon the company improving healthcare services for residents.

The Chairman thanked Simon Laker and Ian Hutchinson of Pathway for attending and answering the Committee’s questions. The Chairman also thanked Cllr Broad, the Head of Health and Wellbeing and the Chief Executive for answering the Committee’s questions comprehensively.

The Leader, Cllr Broad, stated that Pathway was an enterprise of which the Council was proud as it satisfied the social responsibilities of the Council whilst also working to achieve better lives and better financial resources for residents.

RESOLVED that the report be noted and that the Executive Sub-Committee be requested to consider the two additional KPIs (Cashflow and Pathway Capital).