Report to:	Governance Committee
Date of meeting:	27 June 2022
By:	Assistant Chief Executive
Title:	Quarterly Scrutiny Update
Purpose:	To provide an overview of scrutiny activity being undertaken by the People, Place and Health Overview Scrutiny Committees and an update on the work of the Audit Committee.

RECOMMENDATIONS: The committee is recommended to note the updates on scrutiny and Audit Committee activity and the current work programmes at appendices 1-4.

1          Background

1.1       These regular quarterly reports aim to provide the committee with a summary of scrutiny activity across the People, Place and Health Overview Scrutiny Committees and the work of the Audit Committee to support visibility to all Members of the wide range of work being undertaken by the scrutiny and Audit committees.

1.2       This report outlines developments since the last update in March. The current work programmes for the committees, updated following their most recent meetings, are attached at appendices 1-4.

2          People Scrutiny Committee

Recent work

2.1       The Committee met on 24 March 2022 to consider:

· The annual update report from the Chair of the East Sussex Standing Advisory Council for Religious Education (SACRE), which covered the work of SACRE for the 2021/22 academic year including work to establish a new Religious Education syllabus.

· A presentation from Sussex Police and Children’s Services on multi-agency work to disrupt county lines and prevent child exploitation. The Committee asked presenters a range of questions to better understand the police response to county lines, risk factors in children and young people becoming involved in county lines, the interventions taken to keep children safe, their effectiveness and the short and longer-term resourcing of interventions. The Committee also requested further information from Sussex Police on Project ADDER and work to reduce drug use and drug-related deaths and offending in Hastings.  

· A presentation update on the position of the older people’s and specialist bedded care and home care markets.

· RPPR update – the Committee considered its input into the RPPR process for the 2022/23 financial year and agreed to make proposed enhancements to the process. The Committee will now consider relevant parts of the quarter 4 (end of year) monitoring report and the State of the County report annually at their July meetings and hold an annual work planning awayday in early September to further consider the issues arising from State of the County and ensure key issues are incorporated in the Committee’s ongoing work programme.

· Work programme update – the Committee considered feedback from scrutiny activity undertaken since the November Committee, agreed the updated work programme, and agreed to proceed with scoping three new scrutiny review topics (set out in further detail in section 2.4 below).

2.2       Two scrutiny Reference Groups have continued their work to provide Member input to areas of work being led by departments:

• Loneliness and Resilience Reference Group (membership: Councillors Clark, Geary, Howell, Maples, Ungar (Chair) and Webb). The group is providing ongoing Member input to Public Health-led work to consider the impact of loneliness on East Sussex residents and identify opportunities for a systematic approach to mitigate its worst effects. The Group last met on 21 March 2022 and considered the findings and draft recommendations of the project. The Group welcomed the draft recommendations, provided further insights on some of the issues covered in the project findings and suggested issues that would need to be considered in practical delivery of the recommendations. ESCC Officers and partners are now considering the final project report and how to take forward its recommendations. A final meeting of the Reference Group will take place to consider the final recommendations and next steps, as well as what and how the Group wish to report back to the Committee on this project.

· Health and Social Care Integration Programme (HASCIP) Reference Group (membership: Councillors Clark, di Cara, Geary (Chair), Ungar and Webb). This group met on 6 April 2022 to review the latest developments in local health and social care integration and considered updates on use of the Better Care Fund, anticipated impacts of the Integration White Paper and progress with establishing an Integrated Care System (ICS) in Sussex. The Group asked for further information on sign-off of reporting on use of the Better Care Fund to Government, discussed how current health and social care reforms would be implemented in practice in East Sussex and what the implications would be for areas such as governance, workforce and resources, and how performance would be monitored. The Group agreed that the next meeting would be held in August or early September to consider the next phase of work establishing the Sussex ICS and work to develop a framework to support integration at a locality level in East Sussex. The Group also agreed they would continue to provide additional Member oversight and scrutiny to HASCIP update reports received by the Health and Wellbeing Board.

Future work

2.3       The Committee’s current work programme (attached at appendix 1) includes a range of committee items, scrutiny review topics, briefings and ongoing Reference Groups.

Scrutiny Reviews

2.4       The Committee’s programme of scrutiny reviews is developing as follows:

School attendance	The committee undertook scoping in early March for a potential review of school attendance to understand more about the drivers of school absences, the impact of school absences on children and young people, the work the Department is undertaking in response, and whether there are areas where scrutiny could make recommendations for change or improvement. The scoping board concluded that a review of this area would be beneficial but that, in light of current pressures on schools arising from COVID and the impact of ongoing COVID disruption on attendance rates, it was too early for the Committee to undertake a review. The Committee has agreed to defer proceeding with this review until Spring 2023 when there is expected to be a clearer understanding of the long-term impact of COVID on school absences. In the interim, an update on school attendance data will be reported to the November 2022 Committee.
ASC workforce	The Committee undertook scoping for a possible further short review of ASC workforce challenges to build on a previous scrutiny review of the topic. Following scoping, the Committee concluded that significant work was already underway by the Department and that a scrutiny review was unlikely to add value to this at the current time. Instead, the Committee has requested a report to the November 2022 Committee on the actions being taken and whether and how these are beginning to have an impact.
School exclusions	This topic had completed initial scoping and a terms of reference for a full review had been agreed prior to COVID. On advice from the Department, it has been agreed to restart this review in the autumn, when the Committee will be able to hear the outcomes of a project the Department is undertaking with ISOS consultancy on inclusion and use of Alternative Provision; and factor the outcomes of the project into updated Terms of Reference for the review.
Use of technology and digital in Adult Social Care	The Committee has identified the potential to examine how the benefits and opportunities presented by technology and digital can be maximised in Adult Social Care. Subject to scoping, this review could consider the opportunities technology and/or digital presents for improving delivery and sustainability of services, responding to ongoing challenges and preparing for future service demand and reforms. Scoping will take place in early July with the outcome reported to the July committee meeting.
Adult Social Care Equalities and Inclusion	The potential for a review of progress in implementing the ASCH Equalities and Inclusion strategy and next steps will be considered by a scoping board. Scoping will take place in early July with the outcome reported to the July Committee meeting.
Prevention in Children’s Services	The Committee has identified the opportunity to consider how preventative approaches and early intervention can play a role in improving the sustainability and effectiveness of Children’s Services. Scoping will take place in late June/early July with the outcome reported to the July committee meeting.

3          Place Scrutiny Committee

Recent work

3.1       The Committee met on 23 March 2022 to consider reports on:

· Superfast Broadband Project and Project Gigabit – an update on the progress of the Broadband Project to enable access to superfast broadband services across the County and to understand how the Project Gigabit programme aims to provide ultrafast services. This included discussion of the overlap between the two projects; the proposals for the provision of ultrafast services; the availability of the voucher scheme; and how this would impact digital inclusion in the County and enable access by the remaining properties currently without decent broadband provision.

· RPPR – to consider The Committee’s input into the RPPR process and suggest any improvements to the process from the Committee’s perspective. It was also an opportunity for the Committee to add any RPPR related items to the work programme. As with People Scrutiny Committee it was agreed to add consideration of Q4 Council Monitoring report and the State of the County report at the July meeting each year. It was also agreed to hold an awayday work planning session in early September each year, which could include items related to the Committee’s RPPR work.

· Work programme update – the Committee agreed the current work programme with the addition of a RPPR report at the July meeting and a request to Southern Water to attend a future meeting to discuss the discharge of sewage into the County’s water courses and along the coast following a number of recent pollution incidents. It was suggested that a representative from the Environment Agency, who is the regulator, is also invited to the meeting. The Committee also discussed undertaking work on areas of highways policy and a number of other topics which will need to be considered further before incorporating them into the work programme

3.2       The Highways Contract Re-Procurement Reference Group (membership: Councillors Kirby-Green (Chair), Beaver, Collier and Hollidge) met in December 2021 to discuss the next stages of the Project. A session on the asset management approach was held on 10 March 2022 to familiarise the Reference Group with how highway works are prioritised and the intervention policies. The Reference Group plans to meet on at least two further occasions to discuss key stages of the Project with the last session timed to take place before consideration of the award of the contract by Cabinet.

3.4       An initial meeting of the Local Transport Plan (LTP) 4 Reference Group (membership: Councillors Beaver, Collier, Hilton, Hollidge, Holt, Lunn, Redstone (Chair) and Stephen Shing) was held in February 2022 to examine the work involved in revising the LTP and to agree the terms of reference for the scrutiny work. The group agreed to schedule the future meetings to coincide with the key stages of the LTP revision project. It is envisaged that the Reference Group will hold three or four meetings during 2022, although this may be impacted by the delay in issuing revised Government guidance for LTPs, which is now due to be in the Autumn of 2022.

Future work

3.5       The Committee’s updated work programme agreed at the March meeting is attached at appendix 2. There were a number of suggested additions to the work programme and the key future work priorities agreed by Members are:

• Economic Development: The Committee has asked for several reports on Economic Development which have been scheduled. This includes the Team East Sussex economy recovery plan, and a report on how projects are developed and selected, including the governance arrangements.
• Climate Change: As part of the update on the Scrutiny Review of Becoming a Carbon Neutral council the Committee was invited to take part in the review and update of the Climate Emergency Action Plan. The Committee agreed to form a working group to work with officers on the revision of the Action Plan. The Members of the working group are Councillors Hilton, Hollidge, Holt, Kirby-Green and Redstone and a draft terms of reference has been drawn up. It is envisaged that the working group will meet on three or four occasions starting on 21 June 2022.
• Highways Infrastructure: This topic was discussed in some detail at both the Highways Reference Group, the Place RPPR Board and raised under the work programme item at the March Committee meeting. There is a clear interest in the polices and funding in this area, and in particular the Council’s performance measure of the percentage of roads requiring repair, ability to tackle potholes, highway drainage and the condition of pavements. The suggested approach is to hold an initial meeting with interested Committee members to review further information on previous scrutiny work, current policies and the Asset Management approach to establish the scope of any further work on this topic.

· Southern Water – The Committee agreed that it would like to invite the Chief Executive of Southern Water to attend a future meeting to outline plans to tackle the discharge of sewage into water courses and the sea in East Sussex as outlined above.

Scrutiny Reviews

3.6       The Committee’s current agreed scrutiny review is as below, with further topics likely to emerge from scheduled committee reports or Reference Group sessions which will provide initial information on topics the committee has expressed interest in:

Procurement

The review is focusing on Social Value and buying local initiatives. An initial meeting has been held and a terms of reference has been drafted. Membership is Cllr Collier, Cllr Hilton, Cllr Redstone (a Chair is to be elected at the next meeting). From discussions at the scoping meeting the review will examine how Social Value and buying local initiatives can support the Council’s objectives including climate change and the local economy. It will review the existing approach to Social Value and Buying Local to see if improvements can be made and will comment on the draft Social Value Policy which has been developed.

4          Health Overview and Scrutiny Committee (HOSC)

Recent work

4.1       The HOSC met on 3 March 2022 to consider reports on:

• Child and Adolescent Mental Health Services (CAMHS), including how services have coped during COVID-19 and how additional funding, greater access to primary mental health care and improved pathways are expected to improve waiting times.  The committee requested a progress report later in the year to assess whether the actions outlined were having a positive impact on access to services.
• Urgent Care: To consider the performance of urgent and emergency care in East Sussex, including the temporary closure of the Crowborough Minor Injuries Unit. The report provided an update on various urgent care services in East Sussex including an update on the actions taken following the closure of the Eastbourne Station Centre; the future use of Station Plaza, Hastings as a primary care led hub and the performance of NHS 111 Clinical Assessment Service and 999 services.
• Hospital handovers between ambulances and Emergency Department staff. A report on the progress over the winter period on delivering proposals to improve hospital handover times between ambulances and the Emergency Departments at East Sussex Healthcare NHS Trust (ESHT) hospitals.

4.2       Key future work priorities for HOSC are set out in the attached work programme (appendix 3) and include:

• Conduct the following substantial variation to services reviews in the first half of 2022:

Cardiology

The Committee agreed that proposals for reconfiguration of cardiology services provided by ESHT constitute a ‘substantial variation’ to services requiring formal consultation with HOSC. The review is considering whether the proposals to single site cardiology catheter labs and specialist cardiology to either Eastbourne DGH or Conquest Hospital are in the best interests of health services locally. Consideration of the proposals is subject to the NHS timelines – which are themselves subject to the establishment of the ICS – with the final HOSC review of the NHS decisions expected at the September 2022 HOSC meeting following ICS sign-off over the summer. Membership comprises Cllr Belsey, Robinson (Chair), Turner (HBC), di Cara and Marlow-Eastwood.

Ophthalmology

The Committee agreed that proposals for reconfiguration of ophthalmology services provided by ESHT also constitute a ‘substantial variation’ to services requiring formal consultation with HOSC. The review is considering whether to reduce day case and outpatient ophthalmology from three sites to two is in the best interests of health services locally. Membership comprises Cllr Belsey (Chair), Robinson, Azad and Brett (LDC) and Geraldine Des Moulins (VCSE Alliance).

• Consider proposals to move adult burn services from Queen Victoria Hospital in East Grinsted to a major trauma centre in the South East.
• Scrutinise access to GP services covering the current position regarding patient access to GP Surgeries and appointments in East Sussex, including the challenges practices are facing in returning services to pre-COVID levels. The report is to include information on the availability and average waiting times for face to face appointments, telephone appointments, and the use of video appointments.
• Primary Care Networks (PCNs) and the development of Emotional Wellbeing Services for residents requiring primary mental health interventions - a report on the performance of PCNs and the future plans for primary care in East Sussex.

Other Issues

4.3       Provisions in the Health and Care Bill for the Secretary of State to intervene earlier in NHS service reconfigurations were amended by the Government ahead of the Bill receiving Royal Assent in late April. The amendment included a requirement for Government to seek views on a relevant service change from the local NHS organisations and councils involved. Further guidance on the revised reconfiguration process is expected in due course, with any change to the role of HOSCs to be implemented at a later date.

4.4       The Health and Social Care Act also confirms the establishment of Integrated Care Systems from July 2022. The Committee will consider the implications for health scrutiny of the formal creation of the Sussex ICS from July 2022 at a future meeting or awayday.

5          Audit Committee

Recent work

5.1 The Audit Committee met on 29 March 2022 to discuss reports on:

• External Audit Plan 2021/22– To consider the External Auditor’s plan for inspecting the Council’s 2021/22 Accounts.  The Committee did not raise any comments for Cabinet to consider.
• External Audit Plan for East Sussex Pension Fund 2021/22 – To consider the External Auditor’s plan for inspecting the Pension Fund’s 2021/22 Accounts.  The Committee did not raise any comments for The Pension Fund to consider.
• Auditor’s Annual Value for Money report on ESCC – To consider the External Auditor’s report on Value for Money after inspecting the Council’s 2020/21 Accounts.  The Committee did not raise any comments for Cabinet to consider.
• Internal Audit Progress Report - Quarter 3 2021/22- To consider and comment on the work of the Internal Audit team during Q3 (October-December 2021).  The Committee did not raise any comments for Cabinet to consider.
• Internal Audit Strategy and Plan 2022/23 - To consider and comment on the work of the Internal Audit Strategy and Plan, developed in part with input from Committee Members at a session held in January 2022. The Committee endorsed the Strategy and Plan that was subsequently reported to Cabinet for approval in April.
• Strategic Risk Monitoring – Quarter 3 2021/22– To consider the Strategic Risk Register for Q3, as considered at Cabinet earlier in March.  The Committee requested the addition of clarification of when and why risks change ratings.
• Managing Back Office Systems (MBOS) update – To consider an update from the first meeting of the Sub-Group.
• Audit Committee Work programme

5.2       The Committee noted the Redmond Review recommendation around the self-assessment of the effectiveness of Audit Committees and officers outlined that they were exploring how this might be addressed.  The Committee also considered the new approach to the value for money (VfM) assessment in the External Auditor’s report, with the move away from a binary verdict to a narrative and recommendations.  The Committee discussed approaches to incorporating climate change into the VfM narrative. The External Auditors note that this is not a requirement at present but may become one in future. Under the item on the External Audit Plan for the Pension Fund the Committee discussed whether there was a risk to ESCC if one of the major employers left the Fund.

Future work

5.3       The Committee’s future work areas are set out in the work programme attached at appendix 4 and include the usual quarterly consideration of Internal Audit reports and the Strategic Risk Register, together with the annual report on the Assessment of the Corporate Governance Framework and Annual Governance Statement for 2021/22 (in July) and the 2021/22 Statement of Accounts (in September).

5.4       The Working Group which is providing oversight of the MBOS programme implementation met on 2 February 2022 and considered an update from the Chief Operating Officer and the Programme Manager.  The Group expressed interest in the critical audits of the Programme’s previous governance arrangements, which the officers confirmed had been addressed.  Dates have been set for three more Working Group meetings this year (27 May, 26 August, and 22 November).

6          Conclusion and reasons for recommendations

6.1       This report provides an overview of recent scrutiny and Audit Committee work and a look forward at planned activity for the committee to note.

PHILIP BAKER
Assistant Chief Executive

Contact Officer: Claire Lee
Tel. No. 07523 930526
Email: Claire.lee@eastsussex.gov.uk