Stockton-on-Tees Borough Council

Thursday, 14 May 2009

Audiology (Services for people suffering hearing loss)-Scrutiny Review

In response to concerns about the very long delays being experienced within the Borough by patients with a hearing problem needing to be examined by an audiologist and fitted with a hearing aid as appropriate, Cabinet considered the findings of a Select Committee review suggesting improvements that could be introduced.

One in seven people in England were expected to suffer from hearing loss of some kind and people with poor hearing were more likely to be socially isolated and have reduced quality of life. More than 50% of people over 60 have a hearing loss.

Most cases of hearing loss are treated with a hearing aid. If a person suffers from Tinnitus, a hearing aid may also help. Digital hearing aids process sound in a fundamentally different way to analogue aids by dividing up the sound into "packets" and then processing them. This means it is possible for digital aids to be more selective in filtering out irritating background noise.  All new hearing aids fitted through the Audiology Service are digital. Repairs are carried out on old analogue hearing aids but where they are beyond repair, a digital hearing aid is provided in its place.

In 2000, the Government introduced the Modernised Hearing Aid Services (MHAS) programme to improve audiology services, mainly through the provision of digital aids. Whilst this programme provided people with digital hearing aids, there was a rise in demand from new patients and also those wishing to upgrade from analogue to digital hearing aids. This led to long waiting lists, exceeding 2 years in some places.

To address waiting times issue, the PCT had now put in significant additional investment in audiology services during 2007/08 and 2008/9. Additional capacity was also commissioned from Specsavers to deal with routine hearing tests, fittings and follow up for patients of 60 years and over. As a result of the additional investment, there has been a significant reduction in waiting times. From June 2008, no one had waited longer than 6 weeks for an assessment and by the end of December 2008, all patients had received treatment within the 18 weeks referral to treatment pathway (tolerance in terms of performance is 95%).

The audiology service is a direct access service on referral by your GP. The service hosted from James Cook University Hospital (JCUH) may also be accessed through services and clinics at various locations including clinics in Stockton, Middlesbrough and Redcar and Cleveland. The service operates flexibly with the facility for patients to move appointments to different locations provided that the clinic offers the appropriate service for the patient. A shared computerised data system enables patients' records to be accessed wherever they present. Some specialist services are only provided at JCUH.

During the course of the review, the Committee heard evidence from Des Robertshaw (Head of Audiology, JCUH) who favoured the provision of more services in community settings and commented that he would ideally prefer a clinic to be located in Stockton Town Centre although cost was identified as an issue. The Committee noted that the service was involved in discussion about the location of future service provision as part of the Momentum proposals. Feedback from service users also supported the provision of more localised services in community settings.

The Committee were supportive of any future plans for the provision of more localised services in community settings. The Committee recognised that there would be the opportunity for discussion regarding local provision in conjunction with the Momentum proposals.

Des Robertshaw estimated that of the estimated 10% of the population needing treatment, only 6.7% were coming forward for treatment. Reasons for this might include the stigma associated with hearing aids or possibly the public perception that waiting lists are still long. In order to assist in addressing waiting times, the PCT had commissioned additional capacity from Specsavers on a pilot basis for hearing aid assessments and fittings. The Middlesbrough and Guisborough branches of Specsavers were involved in this pilot, which commenced on 21 September 2007. The service is only offered to patients who are 60+ and included aftercare for 3 years. Specsavers operated under a 7 week care pathway and the costs of commissioning the service were comparable to the NHS services.

As part of the Committee's evidence, an evaluation of the Specsavers pilot was considered by the Committee. The Committee found that to the end of March 2008, a total of 211 patient journeys had been invoiced and the average time taken to fully complete the patient journey was 7 weeks. The evaluation results were extremely positive with 43% of patients showing an improvement in their hearing ability (benefits from the used hearing aids are generally reported over the first six months of use). User satisfaction levels were very high with 96% of patients satisfied with the overall service provided by Specsavers. General verbal remarks from the pilot had also been positive and GP feedback had been positive.

A copy of the full scrutiny report, with details of the full list of recommendations proposed, can be obtained from   http://www.egenda.stockton.gov.uk/aksstockton/users/public/admin/kab12.pl?cmte=CAB&meet=54&arc=71

At the same meeting, Cabinet received a review of how this Council was delivering services as part of its Older People Strategy in response to the anticipated increase in the numbers of older people in the Borough in the next 18 years.

Services/advice that contributed towards the strategy were highlighted during the review, such as the Handyperson service provided by the Home Improvement Agency, the availability for free swimming in any of the Council's pools for people over 60, and the need to address shortfalls in public transport provision at key times and from rural destinations in particular, which necessitated the need to ensure bus companies were continually advised of the demand for such services, and for an examination to be undertaken of the role the Council's Community Transport provision and Concessionary Bus Passes for people over 60, could play in helping to meet such need. It was hoped that further joint working could be undertaken with organisations such as Help the Aged (http://www.helptheaged.org.uk/en-gb) ; Age Concern ( http://www.ageconcern.org.uk/AgeConcern/default.asp?gclid=CO6V8_vy6JoCFRufnAodpnh3CA) and the University of the 3rd Age (http://www.u3a.org.uk/) in order to plan the delivery of future resources and promote the services and advice available to older people. This information would also feature as part of the Council's website, be provided from all Council buildings including contact centres, and would feature in regular articles within Stockton News.

A copy of the full scrutiny report, with details of the full list of recommendations proposed, can be obtained from   http://www.egenda.stockton.gov.uk/aksstockton/users/public/admin/kab12.pl?cmte=CAB&meet=54&arc=71

Cabinet concluded its consideration of scrutiny reviews by considering the findings of the Regeneration & Transport Select Committee's consideration of both Highways Network Management and Pavement Parking. The issue of road and pavement maintenance had been identified as having a significant contribution towards residents' overall satisfaction with the Council; and the Committee was pleased to see an increase in satisfaction with both of these areas following the 2008 Ipsos MORI survey.

It was noted that the Council maintained a road network of approximately 802km, comprising a principal road network of 73km and a non-principal road network of 729km. Annual revenue and capital expenditure was £4.63 million (2007/08). In addition to the latest MORI results, overall satisfaction with the service was further supported by the relatively small number of complaints received. An analysis of the number of complaints received showed that for the four year period from 2004/05 to 2007/08, 36 complaints were received from members of the public, representing an average of 9 per year. However complaints to the Council were far outweighed by the number of commendations received from over the same period. Overall, commendations exceed complaints by a ratio of approximately 5 to 1, indicating more members of the public are satisfied with the service and prepared to formally report this to the Council.

Results from the monthly telephone customer satisfaction surveys carried out by the Council's Care for Your Area team show an improving trend. The average satisfaction level has risen from 70% in 2004/05 to 72.64% in 2007/08, demonstrating a positive improvement in customer satisfaction with the highway maintenance service.

The Committee learned there had been a rise to 83.5% (2007) in the number of insurance claims successfully defended at nil cost or fees only (the repudiation rate), the highest figure yet recorded and one that represents a significant turnaround from the previous year.

Data published by the Audit Commission shows performance in national indicators (BVPIs) remains high, with three of the four national performance indicators placing Stockton in the top quartile (2007/08 data), based on a comparison against local authorities in the 'All England' category (i.e. all single tier and unitary authorities).

There are approximately 5,000 utilities highway openings within Stockton Borough each year. Generally there are five notices generated for each opening resulting in 25,000 notices received per annum. The job of the Council, as the Highway Authority, is to co-ordinate activities on the highway.

Given the level of activity undertaken by the utilities companies, the Committee wished to gain a better understanding of the working relationships between the utilities and the Council's highways officers. Accordingly the Chair and Vice Chair of the Committee were invited a quarterly co-ordination meeting hosted by the Council's Technical Services department. These regular meetings are attended by representatives from the various utilities companies responsible for installing and maintaining services including gas, water and communications. The meetings are also attended by highways officers representing the Council.

A series of questions to be put to the utility company representatives was prepared and agreed with the Chair prior to the co-ordination meeting. The questions covered several areas including working relationships, co-ordination of works, timescales, quality of reinstatements, complaints, notifying the public and common objectives between the two organisations.

The outcome of the meeting confirmed that both the Council and the utilities companies enjoy positive working relationships. Works are well planned and co-ordinated with the utilities and there is a 'can do' attitude to resolving problems. Works are carried out in accordance with the statutory framework and industry Code of Practice.

However, findings from the Members' and Parish and Town Council questionnaire revealed dissatisfaction with the quality of excavations and reinstatements by utility companies as one of the areas with the most dissatisfaction or disagreement, indicating there is a perception that the standard of workmanship is in need of improvement.

With regard to the review of pavement parking, this review had been identified due to the inconvenience it caused for pedestrians, and the hazards it caused for the visually impaired, disabled and elderly people, wheelchair users, or those with prams or pushchairs. Pavement parking could also caused damage to the kerb, the pavement, or the services underneath. Repairing such damage can be expensive and local councils may face claims for compensation resulting from damaged and defective pavements.

Under current legislation and guidance there is no national prohibition on pavement parking except in relation to heavy commercial vehicles. Previous attempts by Government to ban pavement parking have not come to fruition. Regulation to put into effect the national ban were not brought forward because of the potentially enormous cost to local councils and police of securing proper policing and enforcement of such a blanket ban. Following the introduction from September 2005 of Decriminalised Parking Enforcement, the police have ceased to have any powers to enforce yellow lines or other parking restrictions and would enforce on the basis of obstruction.

The Committee noted that there was approximately £450,000 - £480,000 budgeted annually for repairs to pavements. Two issues appeared to be of particular concern to residents - first, obstruction on pavements caused by poorly parked vehicles, and second, damage to pavements, kerbs and verges caused by parked vehicles.

Accordingly, the Committee was keen to hear the views of local residents in relation to vehicles parking in and around their neighbourhood, of their own parking needs and of any specific problems they have encountered with parked vehicles and the impact this had on their quality of life.

Representatives from Viewpoint, the Council's Residents' Panel, were invited to attend one of three Focus Group meetings to obtain the views of local people. A series of set questions was put to each of the three Focus Groups and the three groups identified a number of areas across the Borough where they felt there were pavement parking problems. In addition, some examples were given of the worst problems caused by pavement parking and these included parking on dropped kerbs, narrow roads, bad design of new housing developments, access problems for people in wheelchairs or those with mobility problems and inconsiderate parking in general.

There was broad agreement that an awareness raising campaign would be useful together with an explanation of the roles and powers of Civil Enforcement Officers, leading to publicity about pavement parking and the problems caused by poorly parked vehicles as well as enforcement action available to the Council. There were mixed views over the efficiency of yellow lines using Traffic Regulation Orders (TRO's) and concerns whether they would be able to be adequately enforced. Most of the group members had experienced some level of damage to the pavements, kerbs or verges in their areas, caused not only by cars but also by vans and commercial vehicles. The groups also recognised and commented on the problems caused by heavy goods vehicles as well as work vehicles parked outside residences during the evening.

Other general comments included recognising the impact on local businesses when sitting TROs, planning issues, making people aware of the problems of pavement parking and residents knowing who to contact if they are having problems with poorly parked vehicles.

To view a full copy of each of the reviews reports, including the decisions agreed to address any problems identified with the services, visit http://www.egenda.stockton.gov.uk/aksstockton/users/public/admin/kab12.pl?cmte=CAB&meet=54&arc=71

Economic Climate Update Report

Cabinet noted both positive and negative economic changes that had taken place in the engineering/manufacturing/chemical industries and the service/retail sector. Support available for businesses included:-

• The One NorthEast (ONE) 'Grant for Business Investment (GBI)' designed to help SME's in disadvantaged areas now totals £1m worth of funding over the next two years.
  
• Teesside University has secured £420,000 of the £27.5m 'Economic Challenge Investment Fund'. The fund would be matched by ONE and the University's business partners to a total of circa £900,000 to support businesses through the recession over the next 18 months.
  
• The HMRC Business Payment Support Service has, to date, helped 101,135 businesses nationally. Pre Budget Report announced a temporary increase from 1 April 2009 to the threshold at which an empty property becomes liable for business rates, from £2,200 to £15,000.  Estimates state over 70% of empty properties will pay no rates in 2009-10.
  
• Pre Budget Report also announced that British small businesses stand to benefit from £4 billion of European Investment Bank (EIB) funding from 2008-2011 and that £1 billion would be available by the end of 2008. Confirm that UK banks have secured £1bn of EIB funds for lending to SMEs and a further £450 million is being negotiated. Banks are lending this money to businesses across the UK.
  
• In January, the Government launched the 'Enterprise Finance Guarantee', a £1.3bn loan guarantee scheme delivered through the banks that will enable an additional £1.3bn of lending to businesses up to end March 2010.  To 11th March, over 1,000 businesses have been registered as eligible for support, with a potential lending value of over £110m.

With regard to the support available for people affected by the economic down turn,  the following support was available:-

• From 6th April, for newly unemployed, job ready, JSA customers within Tees Valley District 1-day provider led seminars enabling them to conduct job searches, group sessions and 1-2-1 coaching are available.
  
• A package of support for JSA customers reaching 6 months of unemployment has also been implemented.
  
• Recruitment and Training Subsidy (Golden Hello).  Up to £2500 for companies that take on new recruits, made up of £1,000 recruitment subsidy paid in 2 sums of £500 (start of employment), and after 26 weeks, circa £1500 of training through Train to Gain once in work.
• A volunteering programme aimed at maintaining skills and help keep in touch with the labour market.
  
• A new training package being delivered via FE Colleges, offering tailored support to improve skill levels, enabling quick re-entry into employment.  £83 million of provision, providing approximately 75,000 additional places in FE support.
  
• On 1st April the National Apprenticeships Service (NAS) will be responsible for delivering the Government's policy on increasing Apprenticeships to 400,000, or 1 in 5 (currently 1 in 15) by 2020.

For further details on any of the above measures, please contact the Head of Regeneration and Economic Development on 01642 527024; e-mail Richard.Poundford@stockton.gov.uk

Cabinet also considered how this Council could, with its partners, exploit the benefits of the 2012 Olympic Games & Paralympic Games for the benefit of the Boroughs residents.

It was proposed that this Council should adopt three strategic priorities that sought :-

• To use the London 2012 Olympic &Paralympic Games, and the interest in sport &elite sports performers that it generates, to increase the number of people of all ages participating in sport and active leisure, towards health, wellbeing, and personal achievement objectives.
  
• To use the London 2012 Olympic &Paralympic Games, and the media and public discourse surrounding the Games, to highlight and celebrate positive national identities and shared values, in ways, which celebrate diversity and strengthen and connect communities locally.
  
• Promote awareness of the business opportunities associated with the London 2012 Olympic & Paralympic Games and enable Stockton and Tees Valley businesses to win direct and indirect new business, through coordination, support and brokerage, including the pursuit of Olympic &Paralympic Games training site opportunities.

Consequently, Council would establish an Olympic & Paralympic Games Opportunities Group (OPGOG), bringing together a range of Council services and partners agencies, to oversee the development and implementation of an Olympic & Paralympic Games Opportunities Plan (OPGOP). The group will consist of officers from relevant services and representatives of local sports bodies such as Tees Valley Sport, the School Sports Partnerships and Tees Active. A draft Olympic & Paralympic Games Opportunities Plan will be presented to Cabinet in September 2009.

For further details regarding this Council's approach can be obtained from Neil Russell, Leisure & Sports Development Manager, tel. 01642 526412,
e-mail Neil.Russell@stockton.gov.uk

Stockton Town Centre & Riverside Sites

Cabinet received an update on progress to date in regard to regeneration initiatives within the Stockton town centre and riverside area. A series of priority interventions were identified that will be taken forward for delivery to ensure the successful regeneration of the urban core of the Borough. It was noted that whilst the proposed interventions were strategic in nature at present, further detailed consultation with key stakeholders and town centre users would help shape the final schemes.

These interventions were split between short (0-12 months), medium (1-5 years) and long term (5-15 years) priorities.

Within the next 12 months a key priority is to sell Stockton as a place to invest, which will require actively engaging with potential operators; formulating a Vacant Properties Strategy and accompanying guidelines for owners, (boosted by the recent announcement by the Communities Secretary that £3million will be made available to communities to fund projects which reduce the negative impact that empty units have on high streets); concentrating on a strong market; extending trading hours and amending emerging planning policies to support the development of a new 'café quarter' at the heart of the town which, along with the proposed year round festivals and ongoing entertainment offer at the ARC will drive up activity in the town centre area and boost the evening economy, which is vital to achieving a vibrant and successful town centre.

A more significant and co-ordinated approach is needed for the promotion and marketing of Stockton town centre, selling the centre's assets, communicating positive messages, maintaining good relationships and regular communication with retailers, developers and landowners, and presenting the centre as a safe, secure and family-friendly destination for day trips as well as during the evenings. Work is already underway to develop brochures, shopping and eating-out guides and the possibility of relocating the Tourist Information Centre and Town Centre Management functions into vacant units in the town centre to create a more front-facing service.

The town centre's heritage is a key asset to be promoted, through the planned expansion of the Cultural Quarter's activity to Hodgsons Yard, where acoustic performances, markets and outdoor eating can be added to the niche offer of the town centre. Work has also begun to restore and enhance the historic fabric of the town centre through the Stockton Heritage in Partnership (SHiP) scheme, utilising £700,000 of English Heritage, private sector and Council resources to repair and restore buildings. Examples of the work underway include the repair and restoration of 16 West Row which will be used as an artists' workshop and gallery, and the reinstatement of the original features at The Buttery (3 Dovecot Street). Work is also underway on the development of a Heritage Strategy, approved by Cabinet in March 2009, to celebrate and capitalise on the Borough's industrial and social heritage, in particular our railway heritage and role played during the World Wars and to reflect the rich heritage of historic buildings and old industrial areas in the town centre.

Selling Stockton as a leisure destination is being enhanced by the work currently underway on the £2.6 million extension of the dry sports provision at Splash leisure centre, which will see existing gym capacity doubled, new multi activity spaces, badminton courts, additional changing rooms and a new reception foyer area complete by November 2009. Stockton International Riverside Festival also continues to be a success, drawing in large numbers of visitors to the town centre. This was followed last year by the hugely successful Christmas Festival with an increase in footfall and turnover reported by traders over the same period in previous years. Funding has been secured to ensure that the Christmas Festival continues for the next two years. Further festivals are planned including a spring festival that will incorporate the official opening of the Infinity Footbridge and a summer festival branded 'Take To The Tees', which will celebrate the River Tees and promote water based activities. Consideration is also being given to a year-round programme of events, which will recognise and celebrate the cultural diversity of the Borough, engage the people of Stockton in a range of entertainment and activities within the town centre and Riverside; introducing new, regular, small or mid-scale events to intersperse the larger spring/Infinity, summer/SIRF/Take to the Tees, autumn/Festival of Light, and winter/Sparkles festivals.

It is essential to deliver a mix of high quality homes and sustainable communities in the urban core of the Borough. Phase one of the Housing Market Renewal scheme at Parkfield, an area akin in architectural style to Jesmond in Newcastle, is already improving housing quality and encouraging people to see the town centre as a quality place to live. Planning permission has been granted for circa 2000 new homes within one mile of the town centre at North Shore and the adjacent former Corus site, the Northern Gateway development at Queens Park North, and Boathouse Lane. The North Shore Masterplan has also been refreshed and submitted for outline planning consent which will be determined shortly. A design competition for the 'Home Zone' has been held with submissions received from nationally and internationally acclaimed architects and a successful consultation session held in the newly refurbished Shambles market hall. The 'home zone' will provide approximately 20% of the new housing on North Shore and will again add to the mix of housing type on offer across the Borough. A result of consultation on the 'home zone' and a decision on which design is to be taken forward is expected imminently.

Interventions are also underway to improve the local workforce available to businesses by tackling worklessness across the Borough. The Government's Working Neighbourhoods Fund (WNF) has awarded the Council £7million over the next three years to adopt a new local, community-wide approach to tackle worklessness, the town centre element of which will be delivered by the Five Lamps organisation. This innovative new initiative will help people in deprived areas overcome barriers, whatever they may be, into work. This new approach will provide specific training and support for each individual, catering for their precise needs, finding ways to help people, with a low level of skills, who have struggled to get work over a long period.

For details of the medium and longer term investment priorities, visit http://www.egenda.stockton.gov.uk/aksstockton/users/public/admin/kab14.pl?operation=SUBMIT&meet=54&cmte=CAB&grpid=public&arc=71) or contact Nigel Laws, Regeneration Projects Manager, on 01642 527565, e-mail nigel.laws@stockton.gov.uk

Integrated Health & Social Care Facility, Billingham

Cabinet considered the next steps to be taken following the announcement in January 2009 that this Council had been allocated in principle £35.155M of Private Finance Initiative credits to provide an integrated Health & Social Care Services and Extra Care facilities in Billingham.

The initial submission put forward by the Council sought to provide:-
i. An extra care facility providing long term residential care services for elderly and vulnerable adults

ii. An integrated facility providing access to information, advice and a range of services including:

a. Adults and children's integrated services
b. Ancillary services resource suite (including community use)
c. Primary Care Trust Services example podiatry diabetes clinics
d. GP Surgeries
e. Library
f. Multi service centre (One-stop shop)
g. Other partner services and facilities as appropriate

The proposal submitted is complimentary to the Tees Primary Care Trust's (TPCT) 'Momentum Pathways to Health' project, which explores the provision of health services as near to people's homes as possible and looking for options for delivery of community based services.  

The Council have committed to submit an Outline Business Case, which will finalise details of the scheme objectives and deliverables; and confirm costs, funding sources and affordability, including demonstration of value for money to DH by the end March 2010.