Agenda and draft minutes

Venue: Town Hall, Moorgate Street, Rotherham S60 2TH

Contact: Dawn Mitchell  Email: dawn.mitchell@rotherham.gov.uk

Items
No. Item

36.

Declarations of Interest

Minutes:

Councillors Price and Hunter made personal Declarations of Interest.

37.

Questions from members of the public and the press

Minutes:

There were no members of the public and press present at the meeting.

38.

Communications

Minutes:

(1) Commissioners Working Together

The above Programme involved 8 Clinical Commissioning Groups and NHS England working collaboratively.  Discussions were taking place with regard to forming a joint health scrutiny committee to scrutinise their proposals for some services in the future.  Letters would be sent out by NHS England to all the relevant local authority Chief Executives.

 

At this stage it was now known how the new body might link in with the existing Yorkshire and Humber JHOSC due to Derbyshire and Nottinghamshire being involved.

 

(2)  Better Care Fund

The Department of Health/Department of Communities and Local Government had issued a joint letter confirming that the Better Care Fund would continue into the 2016/17 financial year.  However, details of the minimum size of the Fund would not be confirmed until after the Spending Review reports on 25th November when there would also be greater clarity on the policy framework that would underpin the Fund next year.  There would still be flexibility at a local level to pool more than the mandatory amount.

 

In the meantime, partners would be expected to carry out an evaluation of Better Care Fund implementation to date – what had worked, what had not worked as anticipated and what could be adjusted, refined or changed moving forward.

 

(3)  Championing Health in your Community: Elected Members Health Improvement Programme

The Local Government Association and the Royal Society for Public Health were running a series of free one day training events for Elected Members to understand health improvement issues, local and national policy and future challenges and opportunities within the region.  The nearest event was in Leeds on 11th November and would comprise discussions, case studies, guest speakers, shared learning and strategies for meeting defined health outcomes across a number of areas, including integrated working and care in the community – vanguards and co-commissioning.  Janet Spurling, Scrutiny Officer, should be contacted if interested in attending.

39.

Minutes of the Previous Meeting pdf icon PDF 99 KB

Minutes:

Resolved:- That the minutes of the previous meeting of the Health Select Commission held on 24th September, 2015, be agreed as a correct record.

 

Arising from Minute No. 28(2) (Treeton GP Practice), Jacqui Tuffnell reported that the Primary Care Sub-Committee had met on 21st October.  Options had been approved to retain the Treeton practice and to build a new health centre on the Waverley site.  The matter would be progressed with NHS Property Services.

 

Arising Minute No. 29 (CAHMS Review), it was noted that the CAMHS Transformation Plan had been developed.  Commissioner Newsam, at his meeting on 13th October, had requested that detail of the Plan be included in the report and would be resubmitted to his next meeting on 11th November.

 

Arising from Minute No. 31 (Health and Wellbeing Board), it was noted that the final version of the Health and Wellbeing Strategy was included in the Select Commission’s “for information” pack.  The Board had signed the Strategy off at its meeting on 30th September and reflected the feedback from the Commission.  There would be opportunities for the Commission to scrutinise the actions plans as they were further developed.

 

Arising from Minute No. 32 (Quarterly meeting notes), a further meeting had recently taken place the notes from which would be submitted to the next meeting of the Commission.  The keys points of discussion had been on the CAMHS Transformation Plan, RDaSH and financial pressures in the NHS.

 

Arising from Minute No. 33 (Yorkshire Ambulance Services – CQC Inspection), it was noted that the first monitoring meeting would be held on 14th January, 2016, in Wakefield.

40.

Annual Review of NHS Rotherham Clinical Commissioning Group's Commissioning Plan pdf icon PDF 403 KB

Ian Atkinson, Deputy Chief Officer Rotherham CCG and Lydia George, Planning and Assurance Manager Rotherham CCG to present

Minutes:

Ian Atkinson, Deputy Chief Officer, Rotherham CCG, presented the annual review of NHS Rotherham CCG’s Commissioning Plan.  The powerpoint informed the Commission of:-

 

Process for reviewing the Plan

Purpose

-          To fully engage CCG member practices and stakeholders in the CCG’s 2016-17 planning process through the review and refresh of the CCG’s 2015-19 Commissioning Plan

-          It was important to note that for 2016-17 the CCG would only refresh the Plan

Process

-          Locality members and stakeholders were asked to review the identified key priorities within the 2015-19 Commissioning Plan, ratify the Plan and suggest any amendments for 2016-17

-          Stakeholders would receive the first draft version of the Plan for comment in mid-December, Plan signed off in February

 

2015-19 Strategic Direction

-          The CCG strategic aims sought to address all six Health and Wellbeing Strategic aims across all life stages and for all communities both geographical and communities of interest:-

·           Unscheduled Care (unplanned care) – Emergency Centre, GP Case Management, 7 day working, enhanced care co-ordination centre

·           Clinical Referrals (planned care) – improving care pathways so patients get the right care at the right time including reducing the number of hospital follow-ups

·           Mental Health – delivery Adults and CAMHS transformation plans including Adult Mental Health Liaison and Parity of Esteem

·           Rotherham Partnerships – to deliver the Better Care Fund and the joint children’s agenda with RMBC

·           Transforming Community Services – Locality-based nursing, safer discharge, admissions prevention, integrated out of hours

·           Medicines Management – increase quality, efficiency, reduce variation and waste across thirty-six practices, six service redesign projects

·           Developing General Practice – delegated responsibility for commissioning general practice and co-commissioning of Primary Care and Specialised Services

·           Regional Partnerships – deliver the ‘Working Together Collaboration’ with other CCGs across South Yorkshire

 

Financial Challenge

-          Rotherham has a £75M financial efficiency challenge over the 5 year period 2014-2019

-          In 2015-16 providers of health care would receive around 2% less for providing the same service

-          Rotherham Hospital has an Efficiency Plan of £12.5M in 2015-16

-          Increased costs and activity meant that Health Services would need an extra 6% in the budget each year just to stay still.  Budgets were increasing at around 1-2%

 

2016-17 Refresh of the Plan

-          CCG Governing Body, Strategic Clinical Executive Members and RMBC representatives had already reviewed the current Plan (2nd September) and had identified the following key elements for specific discussion and feedback:-

·           Approach to joint commissioning with RMBC including Better Care Fund

·           Commissioning of Children’s Services

·           Response to Child Sexual Exploitation (CSE)

·           Hospital and Community Services

·           Mental Health Services (including Learning Disability)

·           Primary Care

 

Joint Commission with RMBC including the Better Care Fund

-          Current Plan states

·           In 2015-16 we will Consolidate the Better Care Fund plan

-          2016-17 propose to include

·           Review of the current Better Care Fund initiatives

·           Explore opportunity for future joint commissioning in the following areas:-

Children

Learning Disabilities

Continuing Health Care

Mental Health

Social Care

 

Commissioning of Children’s Services

-          Current Plan states

·           Focus on Integration of  ...  view the full minutes text for item 40.

41.

Interim GP Strategy pdf icon PDF 254 KB

Jacqui Tuffnell, Head of Co-commissioning, Rotherham CCG, to present

Additional documents:

Minutes:

Jacqui Tuffnell, Head of Co-Commissioning, Rotherham CCG, presented the Interim GP Strategy which set out how the CCG would work with practices to transform services over the next five years.  The ten key strategic aims identified the key issues for general practices and how it was proposed that they be addressed.

 

An update on the re-procurement of the Chantry Bridge and Gateway contracts was also included in Appendix 2 of the report submitted.

 

The ten key strategic aims were:-

 

-          Quality driven services

-          Services as local as possible

-          Equality of service provision

-          Increasing appropriate capacity and capability

-          Primary Care access arrangements

-          New models of care

-          Self-care

-          Robust performance management

-          Continued improvements to medicines management

-          Engaging patients to ensure patient pathways are optimised

 

Engagement and consultation had taken place with GPs, patients and carers via events.  The draft key strategic aims and proposals had been discussed with the Select Commission previously. GPs had a nationally agreed contract that the CCG could not influence but there were opportunities through enhanced services.

 

Discussion ensued with the following issues raised/clarified:-

 

·           Telephone consultations had been in use by practices for 5-6 years with a number of internal governance issues worked through during that period.  The GP Committee supported the model and practices in using the method of consultation.  It had been found that some elderly clients really appreciated the telephone call rather than going to the surgery; if that could not happen they received an appointment for that same day.  It was a GP that would make the call so could make a decision as to whether an appointment was required or not, including triage to a more appropriate person in the practice.

 

·           Some surgeries had been surprised at the take-up of the telephone consultation particularly within the elderly population.  It was just one element of how the service could be accessed.

 

·           Self-care results in contact from the GP practice if there were any issues with the monitoring readings

 

·           There were variations between practices regarding the issue of GP recruitment.  It was hoped that the Limited Liability Partnership of GPs would start to mobilise itself and collaborate with resources and work towards what it wanted to happen e.g. establishment of a locum bank.  It was known that 50% of the GPs that completed their training within Rotherham stayed in Rotherham and it was about supporting them to stay.  Registrars could work across the borough rather than just with one practice. The aim was to have a community provider model with GPs at the hub

 

·           The wider workforce in practices was important e.g. clinical pharmacists in practices for advice on medication reviews and reducing medicines waste, as well as therapists.  There was also a shortage of practice nurses and advanced nurse practitioners

 

·           The practice-based Patient Participation Groups had been discussing whether to become locality based but the preference was for practice-based.  The Rotherham-based wider patient participation network, with reps from all the PPGs,was more strategic.  Healthwatch  ...  view the full minutes text for item 41.

42.

Access to GPs Scrutiny Review - Health and Wellbeing Board Response pdf icon PDF 63 KB

Michael Holmes, Policy Officer, to present

Minutes:

Michael Holmes, Policy Officer, presented an update on the above Scrutiny Review.

 

Three of the Review’s recommendation had been directed to the Health and Wellbeing Board.   The Board’s response was as follows:-

 

Improving information for patients

-          The Health and Wellbeing Board should consider developing a borough wide publicity campaign to raise awareness about the impact of not cancelling unneeded appointments

A text messaging reminder service was provided for patients although it did rely upon patients signing up for such a service.  It was also noted that a significant number of appointments made on the day were missed

Screens and posters in GP practices would promote messages asking patients to cancel unneeded appointments with the intention that a practice would maintain and publicise a running total of appointments missed and hours lost.  Similar messages would be included in staff bulletins and could include Rotherham Chamber pushing the messages out through their member employers.  Within the Council, staff awareness could be raised via the Managing Director’s briefing, Friday Factfile and Take 5 staff newsletter including a request to spread the word amongst family and friends

 

-          The Health and Wellbeing Board should consider revisiting the “Choose Well” campaign to raise awareness of how to access local services and which is the most appropriate service in a range of situations

The Choose Well campaign had been superseded by “right care first time” which had a similar focus on changing behaviour and encouraging people to use options such as Pharmacy First or self-care rather than a GP or NHS111 before attending A&E.  This would tie in with national campaigns

The CCG had now produced a winter communications action plan focussing on four key steps – self-care, Pharmacy First, NHS111 and GP or walk-in centre

 

Capacity to deliver primary care

-          In light of the future challenges for Rotherham outlined in the (review) report, the review recommends that a proactive approach is taken by the Health and Wellbeing Board to mitigate risk to the delivery of primary care

The Board would have a role in bringing partners together to ensure consistent messages were delivered though it would not lead on any campaigns.  It would also take a wider perspective, working with the new Rotherham Together Partners, in promoting Rotherham as a destination and highlighting local health and wellbeing initiatives

There would be a revamped website, Twitter account and quarterly newsletter to raise awareness of partners’ activity and disseminate important messages

 

Discussion ensued on the response with the following raised/clarified:-

 

·           Work with large size employers on how to get the message across to their employees

 

·           Although national research showed that there was a relationship between longer waiting times and missed appointments, and certainly was with hospital appointments, often patients still did not attend if the appointment had been made the same day.  Feedback from GP practices on DNAs was not part of the national contracts but this was something that would hopefully be targeted.  The texting system worked well but there need to be  ...  view the full minutes text for item 42.

43.

Adult Social Care in Rotherham - A Vision and Strategy pdf icon PDF 43 KB

Graeme Betts, Interim Director Adult Services, to report

Minutes:

Professor Graeme Betts, Interim Director of Adult Services, gave a presentation on the Vision and Strategy for Adult Social Care in Rotherham.

 

Adult Social Care

-          Provision of Social Care for adults had undergone enormous change over the past generation with the pace of change accelerating over recent years as the demand for more personalised services continued to grow and traditional models of care seem to be outdated

 

-          The approach was increasingly based on an asset model i.e. identifying with the person what they could do, what they had, who they knew and which community groups they were linked into, what their family and friends could do as carers and what the wider communities could offer

 

-           Improving the help and support for individuals who needed it at any specific time benefited the whole community as they were likely to be family and friends of people requiring support or who may come to need it

 

-          The changes had been reinforced by the introduction of the Care Act.  There had been an increasing development of care based on a personalised model with people enabled to live in their own homes and to access services, facilities and buildings as part of the wider community

 

-          The role of Adult Social Care had accordingly had to change and develop a strong partnership and influencing role.

 

Vision

-          The ambition in Rotherham was that adults with disabilities, older people and their carers were supported to be independent and resilient with the desired outcomes, that they lived good quality lives and their health and wellbeing was maximised

 

-          It was essential to recognise that during the course of someone’s live there may be times when they required support and care and health services needed to be prepared to intervene on those occasions

 

-          The aim should be to intervene appropriately to provide minimal support to enable the client to maintain their independence.

 

Strategy

-          In order to achieve the vision it was fundamental that a network of support be created including Council services, health services, private and third sector services and voluntary, community and faith groups, as well as friends, family and neighbours

 

-          Must recognise that the network of community resources needed development and investment and best delivered through a partnership with the third sector

 

-          Need to ensure that there was a “front door” which listened and addressed what people were requesting in a way which would support them to take control of the situation for themselves e.g. provision of information/advice, equipment or undertaking of a self-assessment

 

-          Aim of assessment to support the client to develop a solution which maximised them taking control and minimised interventions from the formal care sector

 

-          Focus on building prevention, rehabilitation and enablement throughout the system as well as one-off interventions such as telecare to give people back control and independence

 

-          Develop alternatives to traditional services e.g. promotion of Shared Lives, supported living, extracare schemes, homes suitable for older people, key ring schemes  ...  view the full minutes text for item 43.

44.

Healthwatch Rotherham - Issues

Minutes:

No issues had been raised.

45.

Date of Future Meetings

Thursday,      22nd October                          3.00 p.m.

                        3rd December                        9.30 a.m.

                        17th December                      9.30 a.m.

                        21st January, 2016               3.00 p.m.

                        17th March                             9.30 a.m.

14th April                                9.30 a.m.

Minutes:

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 3rd December, 2015, commencing at 9.30 a.m.