Report to:	Governance Committee
Date of meeting:	29 September 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 the 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 June, particularly from the committee meetings held during late June and July. The current work programmes for the committees, updated following the recent meetings, are attached at appendices 1-4. An overview of planned scrutiny review and Reference Group activity over the coming months across the three scrutiny committees is attached at appendix 5.

1.3       Two further Member training sessions designed to support the effectiveness of the Council’s scrutiny activity will be delivered during the autumn. A scrutiny leadership workshop is being arranged for Chairs and Vice-Chairs to consider effective strategic leadership of the scrutiny work programme. Questioning skills training will be offered to all Members to expand on the initial consideration of this at the ‘Effective Scrutiny’ sessions delivered in February.  

2          People Scrutiny Committee

Recent work

2.1       The Committee met on 22 July 2022 to consider:

· A presentation from the Assistant Director Education onthe national reforms to education outlined in the Government’s ‘Opportunity for all: strong schools with great teachers for your child’ White Paper, and how the County Council was responding to the reforms with partners in the local education system. The Committee asked a range of questions to better understand the expected impact of the reforms, including on: the Council’s approach to improving school attendance, the length of the school week, inclusion, Council services to schools, alternative provision and the Council’s approach to shaping capacity in the local education system.

· A report on handling and learning from complaints, enquiries and feedback in ASCH. The Committee asked questions to better understand the complaints figures shared, the reasons for the rising complexity in complaints, response time, and how unreasonable complaints are handled. Use of language in communications with residents was also discussed.  

· Reconciling Policy, Performance and Resources (RPPR) update – the Committee considered relevant parts of the quarter 4 (end of year) monitoring report and the State of the County report which together provided an overview of performance achievements and challenges, and forthcoming developments, for the services within the committee’s remit. The Committee was able to ensure that key areas of interest were reflected in its work programme and to identify areas for further consideration at the annual work planning awayday in September. Members also discussed and commented on the proposed criteria for assessing one-off investment proposals and established an RPPR Board to consider draft Portfolio Plans and the developing Medium Term Financial Plan later in the year.

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

2.2       On 8 July the Committee received a briefing presentation from the Children’s Services Department on demand for, and arrangements for provision of, Special Educational Needs and Disability (SEND) support in East Sussex; implications of the SEND and Alternative Provision Green Paper, and ESCC’s proposed response. Members asked a number of questions to understand current challenges in the SEND system and how the proposed reforms might help address those. Members welcomed the proposed consultation response.

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:

Use of technology and digital in Adult Social Care	The Committee held a scoping meeting on 5 July to consider a potential review to examine how the benefits and opportunities presented by technology and digital can be maximised in Adult Social Care. The Board received a presentation from the Adult Social Care and Health (ASCH) Department on the Being Digital Strategy and programme of work underway to use digitisation and technology to improve the efficiency and effectiveness of services and processes, for clients, carers, partners and staff. The presentation also covered the Department’s planned direction of travel for this work, which included encouraging greater use of ‘self-service’ options such as online financial assessments and needs assessments; and, linked to this, working towards a ‘digital by default’ approach where portals, self-assessment tools and directories were offered to clients, carers and providers by default, rather than optionally (while also not removing phone-calls or face-to-face interaction for those who needed to use them). Following discussion about this work and its importance to enabling the Department to meet ongoing strategic challenges arising from demographic and workforce pressures, and to meet new demand arising from planned reforms to social care charging, the Board agreed the area would benefit from closer examination by scrutiny, particularly exploring what cultural and behavioural changes are needed to support the Department’s planned direction of travel. The committee agreed to proceed with a review which will take place during the autumn and agreed Terms of Reference at the July meeting. Review Board membership is Councillors di Cara (Chair), Geary and Maples.
Adult Social Care Equalities and Inclusion	The Committee held a scoping meeting on 1 July to consider a potential review to examine progress in implementing the ASCH Equalities and Inclusion strategy.  Members agreed that, while they were encouraged by the presentation demonstrating the level and detail of work underway to tackle equality issues, have inclusive services, and create a safe, fair and inclusive work environment for staff, there were issues that could benefit from closer examination by scrutiny, particularly work to define and engage with seldom heard groups and assess whether residents of all backgrounds know how to access and have confidence in Adult Social Care services. The Committee agreed to proceed with a review which will take place during the autumn/winter and agreed Terms of Reference at the July meeting. Review Board membership is Councillors Geary, Ungar (Chair) and Webb.
Prevention in Children’s Services	The Committee held a scoping meeting on 11 July to consider a potential review to consider how preventative approaches and early intervention can play a role in improving the sustainability and effectiveness of Children’s Services. The Board received a presentation from the Department on the national policy context and evidence base surrounding preventative work in children’s services, the current local approach, and the benefits of prevention and early intervention for both service outcomes and effective use of resources. The Board also heard about work underway to strengthen preventative approaches, including plans to develop Family Hubs using one-off Government funding. The Board concluded, on the basis of the discussion with officers, that there were areas within the work the Department had in train to strengthen preventative/early intervention approaches that could benefit from closer examination and challenge by scrutiny. The committee agreed to proceed with a review which will take place during the autumn/winter and agreed Terms of Reference at the July meeting. Review Board membership is Councillors Adeniji, Howell (Chair), Field and John Hayling (Parent Governor Representative).
School attendance	The committee undertook scoping earlier in the year 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, 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.
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 Children’s Services Department, it has been agreed to restart this review in the autumn when the Review Board 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. The review in then expected to proceed during the winter and spring 2023.

Reference Groups

2.5       The Committee has two ongoing Scrutiny Reference Groups which are expected to continue their work to provide Member input to areas of work being led by departments during the autumn:

• 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. Following input from the Reference Group earlier in the year 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 this autumn to consider the ASCH Department’s approach to working with partners to implement the project’s key recommendations, 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 meets as required to review the latest developments in local health and social care integration. The Group has agreed that the next meeting, expected to take place in the autumn, will consider the next phase of work establishing the Sussex ICS and 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.

2.6       The Committee also held its annual work planning awayday on 8 September to review its work programme in light of the latest evidence of issues affecting services within its remit. A proposed updated work programme will be considered at the Committee’s next formal meeting on 27 September. The awayday also included scrutiny consideration of potential areas for one-off investment proposed by departments.

3          Place Scrutiny Committee

Recent work

3.1       The Committee met on 18 July 2022 to consider reports on:

· Scrutiny Review of Becoming a Carbon Neutral Council – The Committee considered a further update on progress with implementation of the recommendations from the Scrutiny Review. Members discussed the two heating decarbonisation pilot projects at East Sussex schools, carbon offsetting, the installation of Solar panels on council buildings and the work on Electric Vehicle (EV) charging points. The Committee also commented on the need to have an understanding of costs vs carbon savings and the contribution towards ESCC’s carbon reduction target as part of the Action Plan where possible.

· Support for Businesses and Economic Regeneration – a report on the Team East Sussex Economy Recovery Plan. Members discussed the success of the Recovery Plan and the reduction in funding sources available to support business as the European Structural and Investment Fund (ESIF) comes to an end and is replaced by the less generous UK Shared Prosperity Fund. The Committee also commented on the work of Locate East Sussex and the constraints the County faces in terms of workforce, office and land/industrial space supply.

· Trading Standards Service Update Report – a report covering current work priorities and challenges for the service. Members congratulated the team on their use of apprenticeships to meet staffing requirements and their work on scams to protect residents in East Sussex. They also received an update on the port checks required at Newhaven and other priorities for the team.

· RPPR – as with People Scrutiny, Place Committee considered relevant parts of the quarter 4 (end of year) monitoring report and the State of the County report which together provided an overview of performance achievements and challenges, and forthcoming developments for the services within the committee’s remit. The committee was able to ensure that key areas of interest were reflected in its work programme and to identify areas for further consideration at the annual work planning awayday in September. Members also discussed and commented on the proposed criteria for assessing one-off investment proposals and established an RPPR Board to consider draft Portfolio Plans and the developing Medium Term Financial Plan later in the year.

· Work programme update – the Committee considered feedback from scrutiny activity undertaken since the March Committee, agreed the updated work programme, and agreed to proceed with scoping a potential new scrutiny review on Highways Maintenance (set out in further detail in section 3.5 below).

3.2       The Climate Emergency Action Plan (CEAP) Working Group (membership: Councillors Julia Hilton, Ian Hollidge, Stephen Holt, Eleanor Kirby-Green and Paul Redstone (Chair)) has been established to work with officers on an update of the corporate CEAP. The Working Group met on 21 June and 15 July to review the current Plan and speak to officers involved in the delivering the actions contained in the existing plan. The Group held another meeting on 8 September to continue its work and will meet again during October to comment on the draft updated Plan.

3.3       The Highways Contract Re-Procurement Reference Group (membership: Councillors Kirby-Green (Chair), Beaver, Collier and Hollidge) met on 29 July 2022 to receive an update on the project. A report on the award of the contract by Cabinet is expected to be considered at the 29 September 2022 Cabinet meeting. The Reference Group may hold a further meeting on 26 September to consider the Cabinet report.

Future work

3.4       The Committee’s updated work programme agreed at the July meeting is attached at appendix 2 and includes a range of committee items, scrutiny review topics, briefings and ongoing Reference Groups. Planned committee itemsagreed by Members include:

• Economic Development: The Committee considered a report on the Team East Sussex economy recovery plan at its meeting on 18 July 2022 meeting (see 3.1 above). A report on how projects are developed and selected, including the governance arrangements will be considered at the Committee meeting to be held on 30 September.

· Southern Water – The Committee has agreed 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 following recent incidents. The Committee has also requested that representatives from the regulators, the Environment Agency and Ofwat, are invited to attend. The session with Southern Water is planned for the committee meeting to be held on 24 November.

Scrutiny Reviews

3.5       The Committee’s current active scrutiny reviews are 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. Membership is Cllr Collier (Chair), Cllr Hilton, Cllr Redstone. The review board met on 26 July to comment on the draft Social Value Policy and review the existing Social Value Charter and current policies and procedures. Further review board meetings are being held during September and October to consider evidence, with a view to reporting back to the Place Scrutiny Committee at its meeting on 24 November 2022.
Highways Maintenance	Members have agreed to scope a potential review looking at highways maintenance. This topic has been discussed in some detail at both the Highways Reference Group and at the March Committee meeting. There is an interest in reviewing the maintenance polices that affect the condition of roads and pavements, and the previous scrutiny work in this area. This is likely to include the intervention levels for repairs, current issues, performance measures and the funding available for highways maintenance. A scoping meeting will take place with the outcome to be reported to the November Committee meeting.
Climate Change	The Committee discussed establishing a review board to review the Council’s countywide work on climate change, which could look at countywide actions and how the Council works with other organisations (e.g. District and Borough councils) on this issue. This would follow on after the work on the corporate Climate Emergency Action Plan is completed. It was agreed to add this as a potential scrutiny review topic to the Committee’s work programme and hold a scoping meeting to develop a draft terms of reference for the review.

Reference Groups

3.6       The Committee’s ongoing Reference Groups on the Climate Emergency Action Plan and Highways Contract Re-procurement are expected to continue their work to provide Member input to areas of work being led by departments during the autumn as noted above. In addition, a third Reference Group will begin its work:

· The Local Transport Plan (LTP) 4 Reference Group (membership: Councillors Beaver, Collier, Hilton, Hollidge, Holt, Lunn, Redstone (chair) and Stephen Shing) future meetings will be scheduled to coincide with the key stages of the LTP revision project. There has been some delay in the work of Group due to a delay in Government issuing revised guidance for LTPs, which is now due in the Autumn of 2022. The Reference Group plans to start work by exploring key policy areas and received a briefing on the TfSE Strategic Investment Plan on 2 September 2022.

3.7       The Committee also held its annual work planning awayday on 6 September to review its work programme in light of the latest evidence of issues affecting services within its remit. A proposed updated work programme will be considered at the committee meeting on 30 September. The awayday also included scrutiny consideration of potential areas for one-off investment proposed by departments.

4          Health Overview and Scrutiny Committee (HOSC)

Recent work

4.1       The HOSC met on 30 June 2022 to consider reports on:

• Reconfiguration of Cardiology Services at East Sussex Healthcare NHS Trust (ESHT) – the committee considered the final report and recommendations of its Review Board established to examine the proposed service changes in detail. The Review Board endorsed the service model, particularly the implementation of a ‘front door model’, and recommended its swift implementation. The Committee agreed to endorse the Review Board’s report. Further detail at section 4.2 below.
• Reconfiguration of Ophthalmology Services at ESHT – the committee considered the final report and recommendations of its Review Board established to examine the proposed service changes in detail. The Review Board endorsed the proposed model to consolidate ophthalmology from three sites to two but made several recommendations to improve travel and access to the Bexhill site. The Committee agreed to endorse the Review Board’s report. Further detail at section 4.2 below.
• Access to GP Practices in East Sussex, the Committee considered a report providing an overview of access to GP surgeries, including the challenges practices are facing in returning services to pre-Covid levels and changes in working practices. Members discussed, amongst other things, how access to same-day appointments can be improved, including through the introduction of eHubs; variations to access across GP practices and the plans to improve the overall offer to patients; plans for the use of online booking and moving beyond having to call at 8am; the reintroduction of health checks; the impact on other areas of the health service from hiring additional roles to primary care, particularly paramedics; and access to video consultations for people who are hard of hearing or with other disabilities. Members agreed to consider a further report in six months’ time focusing on the impact of eHubs and NHS Sussex’s Next Steps on Integrating Primary Care strategy.
• HOSC future work programme – the committee considered its future work programme priorities and agreed to add a report on South East Coast Ambulance NHS Foundation Trust (SECAmb) response to a Care Quality Commission (CQC) inspection report at the 22 September meeting.

Future work

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

• Complete the following substantial variation to services reviews in 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 HOSC has now submitted a report and recommendations for NHS Sussex to consider alongside its Decision Making Business Case (DMBC) and the public consultation outcomes. NHS Sussex will then return to HOSC setting out the reasons for its decision. The HOSC will consider whether the decision, which includes single siting cardiology catheter labs and specialist cardiology to either Eastbourne DGH or Conquest Hospital, is in the best interests of health services locally. Consideration of the decision is subject to the NHS timelines – which have been delayed pending a review of the capital envelope due to the impact of inflation – with the final HOSC review of the NHS decisions now expected at the December 2022 HOSC meeting, following NHS Sussex sign-off in October or November. Membership of the Review Board (now complete) comprised Cllr Belsey, Robinson (chair), Turner (Hastings Borough Council representative), di Cara and Marlow-Eastwood.

Ophthalmology

The Committee agreed that proposals for reconfiguration of ophthalmology services provided by ESHT constitute a ‘substantial variation’ to services requiring formal consultation with HOSC.   The HOSC has now submitted a report and recommendations for NHS Sussex to consider alongside its DMBC and the public consultation outcomes. NHS Sussex will then return to HOSC setting out the reasons for its decision. The HOSC will consider whether the decision, which includes reducing day case and outpatient ophthalmology from three sites to two, is in the best interests of health services locally. Consideration of the decision is subject to the NHS timelines – which have been delayed pending a review of the capital envelope due to the impact of inflation – with the final HOSC review of the NHS decisions now expected at the December 2022 HOSC meeting, following NHS Sussex sign-off in October or November. Membership of the Review Board (now complete) comprised Cllr Belsey (chair), Robinson, Azad and Brett (Lewes District Council representative) and Geraldine Des Moulins (VCSE Alliance).

• Consider the action plan of SECAmb to improve its service following its rating as ‘inadequate’ by the CQC.
• Consider how hospital handovers between ambulance crews and Emergency Department staff are being carried out by SECAmb and the three NHS trusts that provide acute services to East Sussex residents.
• Consider an update on the provision of Child and Adolescent Mental Health Services (CAMHS) focussing on efforts to improve referral times and the use and impact of additional investment.
• Consider further updates on access to GP practices, including the impact of eHubs, the NHS Sussex’s Next Steps on Integrating Primary Care strategy and findings of Healthwatch on GP access for residents.
• Consider the performance and future plans of Primary Care Networks, which will include the development of Emotional Wellbeing Services for residents requiring primary mental health interventions.
• Consider proposals to move adult burn services from Queen Victoria Hospital in East Grinsted to a major trauma centre in the South East.
• Consider proposals to re-procure the Sexual Assault Referral Centres in Sussex.

Other Issues

4.3       National reforms to the NHS, including the establishment of Integrated Care Systems on a statutory basis which took effect from 1 July, will impact on HOSC’s work. A report or awayday will be arranged to consider the implications for the committee of the Health and Care Act, including the replacement of East Sussex Clinical Commissioning Group (CCG) with the NHS Sussex Integrated Care Board (ICB) and the effect of regulations that allow the Secretary of State to intervene in local service reconfigurations on HOSC’s powers to refer decisions to the Secretary of State.

5          Audit Committee

Recent work

5.1 The Audit Committee met on 8 July 2022 to discuss reports on:

• Assessment of the Corporate Governance Framework and Annual Governance Statement for 2021/22 – to consider the Council’s Annual Governance Statement, and the assessment of compliance with the Corporate Governance Framework, before they were presented to the Governance Committee. The Committee resolved to recommend to the Governance Committee that the Annual Governance Statement includes a statement that, in relation to the appointment of Members to outside bodies, the Council avoids structural conflict of interests where possible.
• Internal Audit Service Annual Report and Opinion 2021/22 - To consider the opinion on the County Council’s control environment for the year from 1 April 2021 to 31 March 2022.  The Committee commented that there were no audits with a ‘minimal assurance’ opinion in the period of 2021/22 and noted that the overall Audit Service’s opinion on the Council’s control environment had improved from Partial Assurance in 2020/21 to Substantial Assurance in 2021/22.
• Counter Fraud Annual Report – to consider irregularity investigations and proactive counter fraud work undertaken by Internal Audit between 1 April 2021 and 31 March 2022. This was a new report to be considered as Counter Fraud work had previously been reported within the Internal Audit Report.
• Independent External Assessment of Internal Audit – the committee agreed a proposal to commission the Chartered Institute of Internal Auditors to undertake the independent external assessment of Orbis Internal Audit in accordance with Public Sector Internal Audit Standards (PSIAS).
• Strategic Risk Monitoring – Quarter 4 2021/22– To consider the Strategic Risk Register for Quarter 4, as considered at Cabinet in June.  The Committee requested a training session for Committee Members regarding strategic risk monitoring.
• Managing Back Office Systems (MBOS) update – To consider an update from the second meeting of the Sub-Group.
• Audit Committee Work programme

Future work

5.2       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 2021/22 Statement of Accounts (now confirmed to be in November).

5.3       Two training sessions will be provided to the committee on 23 September covering counter fraud work and risk management.

5.4       The Working Group which is providing oversight of the MBOS programme implementation met on 27 May 2022 and 26 August. The Group considered an update from the Chief Operating Officer and the Programme Manager which provided assurance that the programme was working to predicted timeframe and budget.  A further Working Group meeting will be held on 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