The Committee is asked to note any apologies for absence and substitutions received from Members.

An apology was received from Councillor Griffiths (with Councillor Alexander substituting).

To confirm and sign as a correct record, the minutes of the meetings of the Committee, held on Tuesday 14 November 2023 and on Thursday 11 January 2024.

To note that the Members of the Committee met informally on Tuesday 23 January where there was a discussion around various enquires underway and the process of those enquires.

It was RESOLVED that the minutes from the meetings of the Committee held on Tuesday 14 November 2023 and on Thursday 11 January 2024 be approved as a correct record.

Councillors are invited to declare any Disclosable Pecuniary Interests, Other Registerable Interests or Non-Registered Interests, and the nature of it, in relation to any item on the agenda.

There were no declarations of interest by Councillors in relation to any item on the agenda for this meeting.

Subject to providing two working days’ notice, a Member of the Committee may ask the Chairman of the Committee a question on any matter in relation to which the Council has powers or duties which affect the Tendring District and which falls within the terms of reference of the Committee.

On this occasion no Councillor had submitted notice of a question.

The report provides the Committee with an update on its approved Work Programme for 2023/24 (including progress with enquiries set out in its Work Programme), feedback to the Committee on the decisions in respect of previous recommendations from the Committee in respects of enquiries undertaken and a list of forthcoming decisions for which notice has been given since publication of the agenda for the Committee’s last meeting.

The Committee was provided with a report which provided an update on its approved Work Programme for 2023/24 (including progress with enquiries set out in its Work Programme), feedback to the Committee on the decisions in respect of previous recommendations from the Committee in respects of enquiries undertaken and a list of forthcoming decisions for which notice has been given since publication of the agenda for the Committee’s last meeting.

Members heard that in respect of the collaborative working with The Cabinet as part of the governance arrangements at this Council a meeting was held with the Leader and Deputy leader and the Chairman of the Resources and Services Overview and Scrutiny Committee on 4 April 2024. A number of suggestions for enquires in 2024/25 were discussed.

Members also heard how the meeting considered the timing and arrangements for reviewing voluntary sector/community grant funding by the Council. The outcome of this meeting was a recommendation to discontinue the review commenced by this Committee as Cabinet itself was overseeing the same process directly over a shorter timeframe and, as such, this Committees review (through its Working Group) would involve duplication of Council resources. This matter was being considered by Cabinet on 19 April 2024.

The Committee was made aware, that at the time of the meeting, the Democratic Services Team have launched a public consultation with the aim to capture the residents’ ideas as to what they think both Overview and Scrutiny Committees should be undertaking in its enquires for 2024/25. The Consultation was set to end on 10 May 2024 (Appendix D). Arrangements would be made for meetings to consider proposals from the public, Town and Parish Councils, other partner organisations and Councillors and staff for enquires to be undertaken in 2024/25 (ahead of the next formal meeting of the Committee).

The Democratic Services Team had also commenced discussions with both the Chairmen of the Overview and Scrutiny Committees into the Scrutiny Annual Report for the year 2023/24.

After a short discussion it was unanimously RESOLVED to remove Voluntary Sector/Community Grant Funding from its current work programme

To provide the Committee with information on NHS dentistry provision in the District, and the wider Suffolk and North East Essex Integrated Care Board geography. This report will support the enquiry by the Committee into NHS dentistry provision to be undertaken at this meeting of the Committee.

The Committee heard that on 1 April 2023, Suffolk and North East Essex Integrated Care Board (SNEE ICB) received delegated responsibility from NHS England (NHSE) to commission dental services.

There were longstanding issues with NHS dental access including NHS routine dental care and urgent dental care. This problem had been amplified by the current COVID-19 pandemic. Treating oral diseases cost the NHS £3.4 billion per year.

The pain experienced with dental problems such as toothache or abscess could be considerable, intractable, and distressing, and might have led sufferers to extreme measures to address pain if urgent dental care was not available. Examples included DIY dentistry and overdoses of paracetamol, which in turn increased pressure on urgent and emergency care. There were also wider societal impacts and costs that arose when people could not access urgent care, such as increased demands and pressures placed on the wider health care system such as accident and emergency and primary care services, as well as costs to employers and reduced productivity due to time off work.

Commissioning, Legislation, and Dental Fees

The report outlined that Suffolk and North East Essex ICB directly commissioned all NHS dental services at primary, community, secondary, and tertiary settings depending on the care and treatment required.

Currently, almost all dentists in north-east Essex (and Suffolk), were paid by commissioners for the Courses of Treatment (CoT) they provided, each CoT was allocated a Unit of Dental Activity (UDA). A UDA was the technical term used in the NHS dental contract system regulations to describe weighted CoTs. The ICB piloted a primary care contract that did not use CoT or UDA but was based on the availability of appointments.

Members heard that UDAs were developed as part of the 2006 NHS dental contract. Under the old NHS contract, dentists were paid for every item of treatment they provided: examination, filling, crown, or denture. Under the 2006 system, they were paid per course of treatment, irrespective of how many items were provided within it. Thus, a course of treatment involving one filling (3 UDAs) attracted the same fee as one containing five fillings, a root treatment, and an extraction (also 3 UDAs). This factor was behind much of the resentment against this system.

Members also head that in March 2021, NHS England was asked by the government to lead on the next stages of NHS dental system reform. At the outset, six aims were agreed upon when considering what a reformed dental system should bring. They were:

·         Be designed with the support of the profession

·         Improve oral health outcomes

·         Increase incentives to undertake preventative dentistry, prioritize evidence-based care for patients with the most needs and reduce incentives to deliver care that is of low clinical value

·         Improve patient access to NHS care, with a specific focus on addressing inequalities, particularly deprivation and ethnicity

·         Demonstrate that patients are not having to pay privately for dental care that was previously commissioned NHS dental care

·         Be affordable within NHS resources made available  ...  view the full minutes text for item 6.

To enable the Committee to consider and determine the final report of the Task and Finish Working Group into the enquiry undertaken into Mainstream and Community Transport.

The Committee was reminded that a decision was published on 14 August 2023 to agree that the Community Leadership Overview and Scrutiny Committee would set up a Task and Finish Group to enable enquiries into the range of elements concerning mainstream and community transport provision. This proposal had been approved by Full Council.

The Task and Finish Group wanted to look into:

·         Details of mainstream public transport across the District including bus routes and frequency.

·         Issues being experienced with mainstream public transport as outlined to Councillors.

·         Details of Essex County Council’s subsidised bus services in the District and the associated funding.

·         Details of community transport provision across the District and the funding for them from Councils in Essex.

·         Publicly available data on car ownership in the District and use of public transport.

Partner engagement included:

·         Representatives of the local Bus Operators and of community transport providers. 

·         Representative from Essex County Council in relation to subsidised bus services where there are no commercial services.

·         Representatives of transport users.

·         Corporate Director of Place and Economy.

The inquiry started on the 5 September 2023 and ran to March 2024.

The Task and Finish Group agreed to focus on the provision, the extent to which it supported inter-modal exchanges, provided a meaningful alternative to private car usage for work, leisure and medical journeys.

The inquiry supported the then corporate plan themes of:

·         A Growing and Inclusive Economy - Support existing businesses/More and better jobs;

·         Building Sustainable Communities for the Future;

·         Community Leadership Through Partnerships; and

·         Joined up public services for the benefit of our residents and businesses.

External Participants

Wendy Jackson – Local Bus Network Community Engagement Lead (ECC),

Pauline Mann – Tendring Community Transport

Debbie Hill - Harwich Connexions Transport Cooperative Ltd

Pam Playle - Walton Community Hospital Car Service

Wendy Jackson, Senior Transport Liaison Officer, Essex County Council

Angie Tillet, ESNEFT

Pauline Mann – Tendring Community Transport,

Debbie Hill - Harwich Connexions Transport Cooperative Ltd

Pam Playle - Walton Community Hospital Car Service

Internal Officers

Keith Durran, Committee Services Manager , Tendring District Council

Gary Guiver, Director of Planning, Tendring District Council

Lee Heley, Corporate Director, Place and Economy

The Committee heard that the Leader of the Council, the Corporate Director (Place and Economy) and the Economic Service Manager met Hedingham buses in relation to levelling up in Clacton, rather than as a formal part of the scrutiny process; high level messages to Hedingham from that meeting were included in this report with the agreement of the company. 

The report outlined that the purpose of the review was to consider the network of public transport provision (commercial and subsidised) and invite providers / commissioners to review those with the Council based on evidence identified. To look at community transport provision and where best practice could be shared to extend the network. 

The inquiry found that there was a public transport system across the district that provided a wide range of services as an alternative to the car for the 20 percent  ...  view the full minutes text for item 7.

To receive and consider the final report of the Task and Finish Working Group into the enquiry undertaken into school age education provision (absences and mental health).

THIS REPORT WILL BE “TO FOLLOW”.

On 11 July 2023, Full Council agreed the Community Leadership Overview and Scrutiny Committees work programme for 2023/2024, which included a Task & Finish Groups to enable scrutiny of pupil attendance and mental health support in secondary school education.

As agreed by the Task & Finish Group, the overall aims of the enquiry were:

With reference to secondary school age provision, to consider specifically.

• the rate of absenteeism in schools

consideration of the underlying reasoning for the rise in absence rates, and the good practise in place in schools currently to reverse this.

• mental health support available in schools

Partnership engagement would include:

·         Representative/s from Essex County Council education directorate in relation to school attendance/statutory compliance

·         Representatives of Tendring secondary schools

• Assistant Director, Partnerships

The Task & Finish group met on the following dates:

11 October 2023

11 December 2023

15 April 2024

School visits were arranged between January 2024 and the end March 2024.

It was important to highlight that the report was written on the basis that the Council had no statutory role for Education, and had been prepared on the basis of influencing and bringing partners together as the Council’s role as a Community Leader.

The inquiry supported the then Corporate plan themes of:

·         Community Leadership Through Partnerships;

·         Building sustainable communities for the Future and,

·         Joined up public services for the benefit of our residents and businesses

The inquiry found that:-

·         Schools were struggling to ensure that good attendance levels (95%) were being achieved by school cohorts. This challenge had increased considerably since the Covid pandemic.

·         SEND and EHCP student attendance figures were weaker when compared to the general cohort.

·         Schools were using a range of strategies to improve attendance figures. Most responses were in house and rely on school staff to ensure early intervention strategies were implemented.

·         The main cause of absence other than physical illness was mental health.

·         Fines were used for absence but mostly for holiday related absence.

·         Main barriers when attempting to improve attendance were: a) extra cost for additional interventions b) resolving mental health issues c) external support was either too costly or not readily available.

·         Mental health need in secondary schools across Tendring was very high.

·         Mental Health demand had increased since COVID and showed no signs of abating.

·         The mental health needs of young people had become more complex and this had led to teaching staff referring more concerns to higher level professionals/organisations.

·         Main support strategies were (a) In school staff support, Head of Year etc (b) School employed Counsellors (c) External referral agencies e.g. CAMHS.

·         In school Mental Health support was very costly and schools were absorbing these costs while trying to balance ever tighter budgets.

·         External waiting lists for Mental Health support were very long. CAMHS referrals currently stand at 9 months. A child’s need was often immediate, but the professional support that was needed takes months to be delivered.

·         The school GCSE curriculum was a contributing factor to some negative mental health issues. Pressure to achieve certain levels/grades and the  ...  view the full minutes text for item 8.