Councillor Jane Scott has told Marlborough News Online that she will be standing for re-election next May and if re-elected and if chosen again to lead the Conservative group, hopes to lead the Council for four more years.
She thinks seventy is a good time to retire and those four more years will take her close to her chosen retirement date. She has plenty of work to complete.
The work closest to her heart is to get the Council’s care of vulnerable children back on track – to make it, she says, “good “. In April an Ofsted report pointed to ‘serious and significant shortcomings’ in Wiltshire Council’s safeguarding of vulnerable children in seventeen of the ninety-two child protection cases they selected at random.
“Personally, I was absolutely cut-up about the whole thing. I had thought we had a good system in place. I’m taking a personal interest in it now. And I’m very pleased with the work the improvement board is doing and with the people we’re sending out to check things up.”
Ofsted’s judgment was felt especially deeply as before Jane Scott became Council leader in 2003 she held the cabinet post for children’s services.
As Ofsted won’t be back for a while, in the New Year the Council will commission an independent review of their new procedures and staffing: “I feel more confident now that things are moving in the right direction and at the right pace.”
Another reason for Councillor Scott’s decision to stand again is the huge amount of work the Council has to take on as part of the coalition government’s restructuring of the NHS. The Council will be in the middle of the complex web of new arrangements and the Council’s new health teams will only just be finding their feet when the elections take place next May.
At the centre will be the new Health and Wellbeing Board (HWB) which the Council will run. The Board will be responsible for working with the GP commissioners and all the local providers on the annual assessment of the health and social care that Wiltshire’s people need.
Then, Councillor Scott explains, the Board will have two main roles: first to ensure the GPs’ plan delivers – and “challenge the commissioners if the plan or its delivery is not right.” “Secondly, it must challenge all the health partners and providers to ensure they’re working together.”
“I’m really not sure the Health and Wellbeing Board should be digging into anything else – it’ll be a critical friend. I want to be very clear about what we do and about what we don’t do – for instance the Board won’t be looking at individual cases.”
“But there will be times when we need to challenge, say, on closure of hospital beds – but on the evidence rather than on passion. The Board will have a scrutiny role – but not emotionally based scrutiny.”
Wiltshire’s HWB has held five meetings in its shadow form– meeting in private. Councillor Scott, who chairs the Board, hopes it will start meeting in public before the April deadline when it becomes a statutory body.
The exact ‘cast list’ for this board may change before it becomes a statutory body next March. At present four senior Wiltshire Councillors sit on the board and there have been moves to have a lay person as Chairman rather than a councillor or a GP.
Another start-up that Wiltshire Council has to get ready for April is Healthwatch Wiltshire – which will take over the “patients’ voice” role. This was to have been ready by October, but the government postponed it till April 2013. Advertisements for its Chairman and a four or five strong executive board should approved by the Council’s executive within a matter of weeks.
The Council will also become responsible for the public health service with staff moving soon from the Primary Care Trust to County Hall. But as Councillor Scott told Marlborough News Online, there’s been a Joint Director of Public Health and Protection shared between the Council and the PCT for over four years: “So we’re already a little way on that journey. We want to bring public health right into the centre of what we do. It impacts on almost every other Council service from environmental health to uneven pavements.”
One of the great challenges for the new NHS bodies will be the increasing number of elderly people in the county and the complex interface between health care and social care. And there one of the pressure points is the long-standing and costly problem of those who need to leave hospital but are subjected to ‘delayed transfer of care’(now known by the acronym DTOCs– previously known by the inaccurate, headline-grabbing phrase as ‘bed blockers’.)
The latest figure for NHS Wiltshire’s costs in the unnecessary use of hospital beds due to these delays was £90,000 for one week. And a nationwide study put the cost of DOTCs to the NHS as a whole at £545,000 a day.
There is no one solution to this problem. Councillor Scott wants to “Work with all the health partners about who goes into hospital – is that the right place for them? We need to give support at home to those who do not need to go into hospital for clinical reasons.”
“The neighbourhood nursing teams work with social care teams, but must work even more closely with them.” And Councillor Scott cites a scheme in Hertfordshire which teams up paramedics and social workers so as to make sure people who do not really need to go into hospital, even for an overnight stay, get appropriate care at home.
“People have the right to say no to a place [in a care home] – and we’re always working with people to tell them we’ll get you where you want to go as soon as there’s a place available.”
“We’ve put a lot of time and effort into helping people get back to their homes – we need to get them out of hospital in a timely way.” And more and more this will involve specialist placements for those who are physically well but a suffering from some stage of Alzheimer’s or dementia.
One of Wiltshire Council’s new schemes to alleviate part of the DTOCs problem is to reserve places in care homes to provide a six week ‘reablement’ course which involves assessment of needs and confidence building so people can go back safely to living at home.
Finally, Councillor Scott points to another problem with the elderly that is starting to cause concern. In parts of the county, especially in the east and around Marlborough, many of the elderly in care homes are ‘self-funders’ – paying their own care home fees. The Council will probably not have contact with them until their money runs out and they have to be found another care home: “This is crazy – we will work with and give advice to anyone. People need to make the right decisions about the type and quality of care they need at an early stage. We can even help them make their money last as long as possible.”