Agenda and minutes

Janet Mullins expressed a personal interest in item 158 (Scrutiny Review of the Transportation of Vulnerable People October 2006)

There were no members of the public and press present.

Resolved:- That Councillor John Doyle be appointed as the representative to serve on the Members Sustainable Advisory Group for 2008/09.

Councillor Kirk gave a presentation on the Adult Services Priorities.  The presentation outlined the priorities as follows:

• Shifting the balance from in-house domiciliary care to the independent sector
• Modernising the OT Service
• Helping people to live at home
• Investment in assistive technology
• To increase annual reviews
• Personalisation – giving choice and control
• Improve services for carers
• Strengthening our approach to Safeguarding

A question and answer session followed and the following points were made:

• Why there seemed to be no services available for people aged between 25-60 that focused on enabling
• There was a need for elected members to undertake training in relation to adult protection.  It was confirmed that basic awareness training had been run in the past and that this would be offered to members.
• In what areas did the Council feel they had the capacity to improve?  Councillor Kirk confirmed that the main concern at the present time was related to OT Equipment and Adaptations
• What was being done to modernise the OT service?
• How many care home were still under the ownership of the local authority?

Members thanked Councillor Kirk for his presentation.

Shona McFarlane, Director of Health and Wellbeing, presented the submitted report which provided an update on the implementation of the Transport Scrutiny Action Plan.

The Scrutiny Review was initiated by the Performance and Overview Scrutiny Committee in October 2005 following the Older People’s Conference. A range of issues were raised but the review group decided to focus on transport for vulnerable adults provided by the Council and contracted companies and also to look at transport for children within its remit.

It aimed to examine the current situation regarding transportation of vulnerable people by RMBC and to identify any potential areas for improvement.  A desk top review was undertaken which included interviews with Council staff, consultation with voluntary organisations and day services and also collated good practice from other local authorities.

The review group found that service users across Adult Social Services (as it was then) and Children and Young People’s services were generally satisfied and pleased with the quality of service, with only specific isolated areas identified for improvement.

An outline of the key areas of recommendation together with action that had been taken against them was appended to the report.  Work was still underway to identify areas of improvement, and Internal Audit were undertaking a review of the resources and facilities that were currently allocated within NAs and CTU for the purposes of transport, to identify whether any further economies of scale could be created through further integration.  A review of depots was underway, which could also add further efficiencies within the overall transport budget.

The outcome of the review had been an improvement in quality of service through:

• An improvement in the type and level of training that was offered to all staff
• Improvements in the quality assurance systems that were in place
• Improvements to the procedures implemented by transport staff, ensuring that vulnerable people were transported safely.

One area of the review which had not yet been resolved was the commissioning of all transport through the CTU contract with Translinc.  It was intended to review transport services internally, once the Internal Audit review of resources was concluded, and once service changes that were currently being examined were resolved.

A question and answer session ensued and the following points were raised:

• Concern relating to the transportation of vulnerable people with learning difficulties not being properly looked after by the driver of the vehicle.  Clients were being given forms to complete when they boarded instead of the driver making a note of their attendance on the vehicle.  It was agreed that this would be looked into.
• How the action plan would be monitored and how user satisfaction would be assessed
• Whether the same security checks were undertaken in relation to temporary staff as permanent staff.  It was confirmed that they were.
• How often the review group had met – initially it had been on a monthly basis, but once established it had moved to 6 weekly.
• When would the performance indicators be produced
• In relation to  ...  view the full minutes text for item 158.

ShonaMcFarlane, Director of Health and Wellbeing, presented the submitted report, outlined the plans to reshape domiciliary care services from a service which provided 60% of home care service in-house to one which provided 35% of services in-house.  The plans would seek to maintain the quality of services while significantly reorganising the allocation of resources to create greater capacity with Neighbourhoods and Adult Services to provide support to people to help them live at home for as long as possible.

As part of the process, trades unions had been consulted with, through both the Strategic Consultative Committee and separate meetings which had been arranged to update and outline plans.  Some problems had been experienced in getting the trades unions engaged, and whilst every effort had been made to arrange meetings to suit all representative availability, representation at meetings had been patchy and inconsistent.  This had resulted in some messages not being fed through or messages being misinterpreted and had required follow up meetings to provide explanation.  However, it was confirmed that this situation was now much improved and there was now regular representation at meetings.

The Shifting the Balance Steering Group was set up in January 2008 and met fortnightly.  They co-ordinated the work of the sub groups detailed below:

• Weekly Impact Group
• Commissioning Group

• Re-ablement Team

• Communication Plan
• Turnaround Team
• Staffing Change Group

The Director of Health and Wellbeing outlined to members the purpose of each of the groups and their objectives.

A question and answer session ensued and the following points were raised:

• Why there had not been any involvement with the service users from the outset. 
• It was felt that there was a gap in relation to services offered to people between the ages of 25 and 65 and that this should be addressed
• Whether there were any communication systems in place for keeping members informed
• concerns expressed about safety of jobs as a result of the shift – it was confirmed that it was not anticipated that any staff would be moving to the private sector

Resolved:- That the content of the report be noted.

Delia Watts, Scrutiny Adviser presented the submitted report which gave an outline work programme for the Panel for the 2008/09 municipal year.

The Panel had a remit that covered two wide-ranging areas, which were Adult Social Services and all aspects of adults’ health.  With such a breadth of issues which it could scrutinise, it was important that the work programme focused on a realistic number of key issues.

The report outlined eight clinical pathways which had been identified by the review of the NHS.  These were:

• Staying Healthy
• Maternity and Newborn
• Long Term Conditions
• Children’s
• Planned Care
• Acute Episode
• Mental Health
• End of Life

The Maternity and Newborn and Children’s would fall within the Children and Young People’s Scrutiny Panel, but the remaining six would fall within the Adult Services and Health’s terms of reference.

It was suggested that the Panel held themed meetings to focus on three of them during this municipal year:

• Staying Healthy
• Long Term Conditions
• Mental Health

The relevant health trusts would be asked to give an overview of their response to the SHA’s recommendations to improve that pathway and specific issues could form the basis of separate reports and presentations.  The issue of adult access to dental services, which was originally planned for the 2007/08 municipal year would be incorporated into the Staying Healthy themed meeting.

The panel had already identified, supporting people on incapacity benefit back into work as an issue and by holding a themed meeting on the broader subject of employment, scooping for this review could begin.

It was also proposed to monitor performance of services within the remit of the Panel’s terms of reference during the year, and two meetings were allocated for this purpose.

As many services required co-operation between the Council and the PCT, it was suggested that some of these services be scrutinised at a themed meeting focusing on joint working.

The Panel were also committed to reviewing two health issues during the year, and it was suggested that these would be to look at how Rotherham could increase breastfeeding rates with the other to be agreed later in the year.

In September 2007, the Chair and Vice Chair attended a capacity building day, organised by the regional health authority, which focused on local health structures, health finance, commissioning and health inequalities.  It was suggested and agreed that a half day session be arranged for all members of the Panel during July, which would focus on the work of our local health trusts and service commissioning.

Lizzie Williams, read out two emails for and on behalf of the representatives from Speak Up, to request that consideration be given to producing future minutes in a more accessible way to would make it easier for people with learning disabilities to understand. 

Resolved: (1) That the thematic approach suggested in Appendix 2 be approved

(2) That the panel begin a scrutiny review of support for Breastfeeding in Rotherham

(3) That the support available to people on Incapacity Benefit who wish to  ...  view the full minutes text for item 160.

Resolved:- (1) That the following members of the Panel be nominated to sit on the Breastfeeding Review Group:

• Councillor John Doyle
• Councillor Beryl Billington
• Councillor Hilda Jack
• Mrs Irene Samuels

(2) That the Children and Young People’s Scrutiny Panel be asked to nominate 1-2 members to join the review group.

Steve Turnbull, gave a presentation in relation to the Rotherham Health Profile 2008.

The presentation drew specific attention to:

• What health profiles were
• Key findings
• Local Inequalities
• Heart Disease
• Eligibility for free school meals
• Our communities
• Children and Young People Health
• LAA Indicators
• Breastfeeding
• Obesity
• Smoking in Pregnancy
• Teenage pregnancy
• Adult Health and Lifestyle
• Diseases and Poor Health
• Life expectancy and causes of death

A question and answer session ensued and the following points were raised:

• A request for a breakdown of categories in relation to cancer for future meetings
• A request for a further breakdown in relation to smoking for future meetings
• Whether there was any work being undertaken with fast food outlets to reduce the size of portions

Members thanked Steve for his informative presentation.

Steve Turnbull, gave presentation in relation to the Health Communities Challenge Fund.

The presentation drew specific attention to:

• What the Healthy Community Challenge Fund was
• What it was for
• How do we bid for it
• Why obesity?
• Themes
• How did we get here?
• Changing relationships
• Social aspects of food
• Physical environment
• Prevention plus

A question and answer session ensued and the following issues were raised:

• Many Local Community Centres were being underused.  There was a need to organise more activities
• Need to make playgrounds more user friendly for disabled children
• Encourage schools to introduce extra cookery lessons and demonstrations to encourage children to cook and eat more healthily

Members thanked Steve for his presentation.

Kevin Gallacher, Head of Strategic Projects presented the submitted report for the Panel to consider the proposals to develop and improve primary care services in Rotherham.

Rotherham PCT commissions primary medical services from 38 GP practices and the PCT providers.  The strategy for these services was last reviewed in 2004.  Since that time that had been significant changes in the NHS and more recently the Government had instructed PCTs to place a much greater priority to issues of choice and access in primary care.  In light of this the decision was made to review the PCTs approach to commissioning primary care.

Primary Care services in Rotherham were generally of a high standard.  All residents were able to register with a GP, mainly within a mile of their home.  The PCT had a responsibility to ensure that the public across Rotherham was able to access good quality primary care services 24 hours a day.

Primary Care services were important as they were a first port of call at times of illness and played a key role in helping to prevent long term ill health.

The strategy for the future would focus on ensuring consistent high standards of delivery and access for the public across an extended working week and would address the following five key principles:

• Quality
• Access
• Range of Services
• Premises
• Choice

Public input to this process so far had been by way of consultation on specific issues, but a wider consultation was also being undertaken with stakeholders.

A mapping exercise was underway to enable the PCT to identify the capacity gaps in the provision of primary care, and to invest for improved service in the areas of greatest need.

There was a significant variation in the cost of primary care.  Whilst some of this was explained by differing need and differing levels of service provided, it was important to ensure the PCT obtained value for money for the public purse.  Primary Care capacity was not currently linked to deprivation and/or health needs and the PCT would be taking positive action to address the situation.

A question and answer session ensued and the following points were raised:

• Local practices had petitions opposing the idea - why were doctors against it?
• Concerns about the consultation document not being provided with an envelope, which could leave people open to identity theft
• The lack of attendance by GP’s at Patient Forums.

Resolved:- That the minutes of the meeting of the Panel held on 29 May 2008 be approved as a correct record for signature by the Chair.