Agenda and minutes

(1)  Russell Wells had sent his apologies for the meeting but wished to inform the meeting that it was World Mental Health Day on Sunday, 10^th October, 2010.

(2)  Councillor Barron gave a verbal report on a recent Alcohol Strategy meeting he had attended on 25^th September, 2010.  The focus of the meeting was street drinking in Rotherham and young people.  There were a number of places young people, or their parents, could go for help e.g. Milton House, Youth Start, Safe as Houses.  There were also street pastors, a group of Christians, who went around the town centre offering help and advice.

No declarations of interest were made at the meeting.

There were no members of the public or press present.

Joanne Hallatt, Community Pharmacy Development Pharmacist, NHS Rotherham gave a powerpoint presentation in respect of the consultation on NHS Rotherham’s Draft Pharmaceutical Needs Assessment.

The Government had introduced Legislation requiring all Primary Care Trusts to publish a Pharmaceutical Needs Assessment by 1^st February, 2011.  The document would help to inform the PCT’s decision making process in relation to pharmaceutical services for the next 3 years.

The presentation drew specific attention to:-

• What is the PNA?
• Objectives of the PNA.
• Assessment of Need.
• Provision of Pharmaceutical Services.
  • Essential Services which must be offered by all community pharmacies.
  • Advanced Services.
  • Enhanced Services.

• Patient and Public Involvement.
• Gaps in Services Provided.
• Consultation.
• What we need to know.

Discussion ensued on the presentation with the following issues highlighted/raised:-

-        The Minor Ailments Scheme had not been evaluated in its entirety as yet due to it not being fully available in a number of pharmacies.  There were issues with regard to its availability and was something addressed in the Needs Assessment.

-        The Assessment had not specifically looked at health screening or the early non-invasive testing for Diabetes.  What had been considered in the past was screening for cardio vascular and general NHS health checks and had been included in the Assessment that there was a desire to work with providers to provide this new service.

-        Currently pharmacists were not incentivised to discourage patients from collecting repeat prescriptions that they were unlikely to use, but waste management and waste was part of their contract.  It was extremely expensive to dispose of waste as was the original cost of the medication so there was a section in the Assessment that was to be expanded upon.

-        There was an out of hours pharmacy service in localities which were different pharmacies that opened extended hours, not through the night, but after working hours, and some that opened earlier.  There were 3 100 hour pharmacies that opened extended hours throughout the week and weekends.  There was 1 pharmacy, St. Ann’s, that was a 365 pharmacy, open every day.  The Trust also paid pharmacies and pharmacists to be available through the night should an emergency prescription be required.

-        It had been identified that the services provided by the pharmacies were not widely known by the general public so were not being accessed to their full potential.  Work with community pharmacists would take place to advertise the services they provided.  It was a key priority in the long term plan.

-        It had not been made clear at the present time how pharmaceutical services could be affected by the proposals for GP consortia to commission services or where they fitted into the Commissioning Strategy.

-        Due to the uncertainty around budgets and finance at present, the focus was the things it was known pharmacists had to be paid for and what pharmacists were currently paid for which were not value for money. These would have to be looked at dependent upon the funding streams available. 

-  ...  view the full minutes text for item 37.

Julie Slatter, Head of Policy and Performance, presented the submitted report in respect of “Equity and Excellence: Liberating the NHS” – Responding to the Consultation.

The paper provide information on proposals for increasing local democratic legitimacy in health, as set out in the consultation paper.  It stated that the proposals would provide real local democratic accountability and legitimacy in the NHS through a clear and enhanced role for local government and elected members.  It suggested local authorities were uniquely placed to promote integration of local services across boundaries between the NHS, social care and public health and local authorities would be given an enhanced role in public health promotion in their local areas.

A key proposal in the White Paper was for local authorities to establish a statutory partnership, the ‘Health and Wellbeing Board’ which would have four main functions:

• To assess local need and lead on Joint Strategic Needs Assessments.
• To promote integration and partnership across the NHS, social care and public health.
• To support joint commissioning and pooled budget arrangements.
• To undertake a scrutiny role in relation to major service re-design.

Membership of the Board would include: the Leader of the Council, social care, NHS commissioners, local government and patient champions, GP consortia, representative of NHS Commissioning Board and a representative of the local Health Watch.  Other public body officials, the voluntary sector and providers may also be invited as the local authority wishes.

Views were being sought on whether these Boards should be a statutory function, or whether local authorities should have the power to decide how best to take forward joint arrangements within their own area.  Consideration also needed to be given in relation to the membership and functions of the Board.

The statutory overview and scrutiny functions would be transferred to the new Health and Wellbeing Board, if it was established and functions would include:

• Calling NHS managers to give information and answer questions about services and decisions.
• Requiring consultation by the NHS where major changes to health services were proposed.
• Referring contested service changes to the Secretary of State for Health.

Members of the Board would be able to identify shared goals and priorities and identify early on in the commissioning process how to address any potential disputes.  Government would work with local authorities and the NHS to develop guidance on how best to resolve issues locally.

Views were being sought on whether these functions should be transferred to the Board and how best to ensure local resolution of issues and concerns through scrutiny and referral.  The document also sought ideas on what arrangements local authorities could put in place to ensure effective scrutiny of the Board’s functions.

The paper proposed to increase choice and control and control for patients, by creating a local infrastructure in the form of local Health Watch.  It was the intention that the current Local Involvement Networks (LINks) would become the local Health Watch branch, which would have the power to refer concerns to Health Watch England  ...  view the full minutes text for item 38.

Delia Watts, Scrutiny Adviser, presented the submitted report in respect of the Breastfeeding Friendly Action Plan.

Following the breastfeeding review, the recommendations made by Elected Members had been consulted with colleagues in RMBC and NHS Rotherham.

Since the scrutiny review took place, there had been considerable progress made with the breastfeeding agenda in Rotherham and a number of recommendations had already been implemented and/or completed.  The commentary provided to Cabinet, therefore, made suggestions for re-wording some of the actions to reflect this progress to ensure the recommendations remained relevant.

To ensure the breastfeeding agenda continued to progress effectively, there needed to be adequate joint working between the Council and NHS Rotherham and the action plan reflected this with actions for both organisations being included.

Discussion ensued on the report with a number of questions referred to the Policy Team:-

A.      Action 1:  Currently the website made no reference to breastfeeding friendly Council buildings (except Children’s Centres).  When would this be rectified?

B.      Action 3 :  When would the discussions take place?

C.      Action 4 :  When would the first tranche of training be rolled out?

D.      Action 7 :  When would the current directory be linked to the websites?

E.       There should be dates stated in the timescale column instead of “on-going”.

Resolved: (1) That the Breastfeeding Friendly Action Plan be noted.

(2) That the questions above be referred to the Policy Team.

(3) That the monitoring of the Action Plan on a 6 monthly basis be agreed.

Delia Watts gave a powerpoint presentation on the findings, conclusions and recommendations of the Assistive Technology Review as follows:-

Terms of Reference:-

-        To examine how technology can assist older and vulnerable people in our society to be in greater control of the way in which they live their lives and manage their own risks.

The Review looked at:-

-        How assistive technology (AT) can help people remain independent and prevent early and unnecessary admission to hospital/residential care.

-        How AT is used in Rotherham.

-        How Rotherham has benefited from receiving the Preventative Technology Grant.

Assistive Technology:-

-        Recently introduced equipment which assists people who have difficulties due to age or disability to carry out everyday tasks.

Key Findings:-

-        Nationally take of AT is slow.

-        Technology not a substitute for human contact.

-        Privacy concerns.

-        Dependency.

-        Potential for reducing social care costs.

-        Historically no strategy for AT.

-        Various AT projects.

£500,000 from NHS Rotherham.

£442,000 Preventative Technology Grant.

£225,000 Neighbourhoods and Adult Services.

Recommendations:-

-        Produce guidelines for usage/repair of AT systems.

-        Produce joint long term AT strategy.

-        Expand and promote AT on offer.

-        Create robust monitoring system

.

Next Steps:-

-        Discuss/amend/endorse the recommendations.

-        Circulate draft report to review team.

-        Send draft report to witnesses to check for technical accuracy.

-        Circulate final report to ASH Panel Members.

-        Refer report to Cabinet and NHS Rotherham.

Discussion ensued on the presentation with the following issues raised:-

o       Importance of a Strategy and clarification that it gave.

o       Balance of AT and human contact imperative.

o       Potential for reducing social care costs but the aim was to give the user a better feeling of wellbeing.

o       AT would deliver some of the independent choice and wellbeing in the future.

o       New Social Care Assessment being undertaken as part of the Personalisation process included a question as to the suitability of AT for that individual, had it been discussed and utilised and had the Social Worker considered AD as part of the package.  The service user would be asked to complete a simple monitoring form so their request could be evaluated for equipment.

o       Training sessions/presentations were taking place by 1 of the major AT suppliers about what equipment was available.

o       NAS had spent 20% of the budget so far.

Resolved:-  (1)  That the draft report be circulated to the Review Team for comments and witnesses to check for factual accuracy.

(2) That the final report be circulated to Panel Members prior to submission to the Performance and Scrutiny Overview Committee and Cabinet.

Resolved:- That the minutes of the meeting of the Panel held on 9^th September, 2010 be approved as a correct record for signature by the Chair.

Resolved:- That the minutes of the meeting of the Cabinet Member for Adult Independence Health and Wellbeing held on 13^th September 2010 be noted and received.