Agenda and minutes

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

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

Items
No. Item

68.

Declarations of Interest

Minutes:

Councillor Fleming declared a Personal Interest as he was an employee of the Sheffield Teaching Hospital Foundation Trust.

69.

Questions from members of the public and the press

Minutes:

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

70.

Communications

Minutes:

(1)  Wakefield Health Scrutiny Committee

The Chair had attended a meeting for an update on the progress of the Yorkshire Ambulance Service action plan following the CQC inspection.  The action plan was nearly complete and an internal audit plan was to be developed to increase the monitoring of the changes to the processes being implemented.  Future work included the roll out of a pilot to ensure ambulances were always clean and fully equipped and the development of an Estates Strategy.  Progress reports would be submitted in due course. 

 

(2)  Podiatry Service

The Chair reported of a recent situation within his Ward concerning the above Service that would end without any consultation having taken place.  Following discussion with the Hospital, that decision had now been suspended pending a full review of the process and the availabilities have taken place.

 

(3)  Kirklees and Connect to Support

If Members wished to receive a version of the powerpoint that was included in the “For Information” pack with notes they should contact Janet Spurling, Scrutiny Officer.

 

(4)  Rotherham CCG Commissioning Plan

The final draft was likely to be circulated shortly to stakeholders, including the Select Commission, for comments before it was approved by the Board.

 

(5)  Future Children’s Surgery Services

Consultation by the NHS had commenced with an event held at Meadowhall on 12th January, 2016, to capture families and young people’s experiences.  This was a workstream under the Commissioners Working Together Programme and would probably be scrutinised by the new Joint Health Scrutiny Committee once established.

 

(6)  NHS Planning Guidance from 2016-17 to 2020-21

This was published in December and included nine must do priorities for local health economies including new sustainability and transformation plans, waiting time targets for A&E and ambulance response times, cancer referral and treatment targets, mental health waiting time targets, improved care for people with learning disability, sustainability and quality of general practice.

 

The briefing notice giving an outline of the Guidance would be circulated to Members.

71.

Minutes of the Previous Meetings pdf icon PDF 96 KB

Minutes of meetings held on 3rd and 17th December, 2015

Additional documents:

Minutes:

Resolved:- That the minutes of the previous meetings of the Health Select Commission held on 3rd and 17th December, 2015, be agreed as a correct record.

 

Arising from Minute No. 48 (GP Event), a report had been included in the “For Information” pack.  A progress report on the GP Strategy and recommendations from the previous Scrutiny Review would be submitted to the April Select Commission meeting.

 

Arising from Minute No. 51 (Better Care Fund), it was noted that a report was to be submitted to the March Select Commission meeting.

 

Arising from Minute No. 58 (Proposed Joint Health Overview and Scrutiny Committee), it was noted that Commissioner Sir Derek Myers had approved the Select Commission’s recommendations that the Council should be involved in the new Joint Committee with the Chair as its representative.

 

The Scrutiny Officer had attended a meeting recently with counterparts from the other six local authorities to discuss practical issues such as resourcing and support for the new Committee and to start drafting Terms of Reference.

 

Arising from Minute No. 59(2) (Rotherham Foundation Trust Quality Account), it was noted that the information requested had not been supplied due to the Chief Nurse being on leave.

 

Arising from Minute No. 66 (Adult Services Transport Fleet), it was noted that the lead officer had met with Finance and the information should be available shortly.

72.

Overview of Public Health/Spending the Public Health Grant in Rotherham

Presentation by Terri Roche, Director of Public Health

Minutes:

Terri Roche, Director of Public Health, gave the following presentation:-

 

Health Challenges in Rotherham

-          Life expectancy lower than England average

-          9 year gap in life expectancy across the Borough for men and 7 year gap for women

England average men             79.4 years

Rotherham men                                    78.1 years

England average women        83.1 years

Rotherham women                   8.14 years

-          Rotherham people live longer with ill health and/or disability than England average

-          Rotherham men live 21 years and women 22 years in poor health

-          Health Life Expectancy is:

England average men             63.3 years

Rotherham men                                    57.1 years

England average women        63.9 years

Rotherham women                   59 years

 

Health Challenges

-          High levels of unhealthy behaviours (obesity, smoking, alcohol use)

-          Too many children not having a good start to life: high rates of smoking in pregnancy, low breastfeeding rates, 11,000 children in poverty

-          1 in 4 will have a mental health problem.  Half first experience mental health problem before the age of 14

 

What is Public Health?

-          “The science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society”

Faculty of Public Health

-          Individual lifestyle factors – social and community networks – general socio-economic, cultural and environmental conditions

 

Core Functions of Public Health (examples of activity within each function)

-          Health Protection (Health Protection Committee, Suicide Prevention)

-          Health Improvement (Tobacco Control programme recommissioned, Active for Health funding)

-          Healthcare Public Health (Better Care Fund, Potential Years of Life Lost plan)

 

The Director of Public Health

-          Accountable to the Local Authority Chief Executive

-          Must have a place on the Health and Wellbeing Board

-          Duty to write an annual report on the health of the population – Local Authority has duty to publish the report

 

Role of Local Authority in Public Health

-          Statutory Public Health programmes

Protect the health of the local population

Ensuring NHS commissioners receive the Public Health advise they need

Appropriate access to Sexual Health Services

National Child measurement Programme

0-5 Child Health Services (Health Visiting)

NHS Health Check

 

What other services does Public Health Commission:-

-          Non-statutory Programmes

Sexual health advice, prevention and promotion

Adult and child weight management

Adult and child physical activity

Substance misuse (drug and alcohol) – Adult and Youth Services

Tobacco control including Stop Smoking Services

Children 5-19 health programme

Non-statutory 0-5 children’s health services

Public mental health

Nutrition, dental public health, information and intelligence, wider determinants, health at work and more

 

How is our impact measured?

-          Public Health Outcomes Framework

-          Overarching indicators – life expectancy/healthy life expectancy

-          Four domains

Wider determinants

Health improvement

Health protection

Healthcare and premature mortality

 

Public Health Staff Review

-          Required within 8 weeks of Director of Public Health appointment (Improvement Plan)

-          Simplified structure focussed on:-

Core Public Health functions

Supporting integration of Adult Health and Social Care

Increasing capacity for Children and Young People’s agenda

Increasing support for Health and Wellbeing Strategy delivery

 

Discussion ensued with  ...  view the full minutes text for item 72.

73.

Detail of Public Health proposed Efficiency Savings to Public Health Service Providers pdf icon PDF 115 KB

Terri Roche, Director of Public Health, and Anne Charlesworth, Commissioning and Quality Manager, to report

Additional documents:

Minutes:

Anne Charlesworth, Public Health Commissioning and Quality Manager, presented details of the Public Health proposed efficiency savings of 1.8% across commissioned services. 

 

The All Service Review process undertaken by Public Health during June and July, 2015, had identified a savings programme to deliver the requested £1M from the Public Health budget over 3 years from April, 2016-19. Part of the savings programme included a cost efficiency reduction from the large NHS contracts held as follows:-

 

0-19 Children’s Health including Health Visiting from 2016 full cost

Sexual Health

Substance Misuse

 

In addition it was also proposed that 1.8% efficiencies could be delivered across the Stop Smoking Support programme area.

 

The service providers had been asked to identify how the savings could be achieved with minimal impact to patients and to work with leads in Public Health for each area to identify any areas of service that needed to vary in the service specification that was in place.  Timely and helpful responses had been received from the South West Yorkshire Partnership NHS Trust and RDaSH. A less detailed response had been obtained from the Foundation Trust in respect of how the savings would be made, however, they had indicated that they recognised that the efficiencies would need to be delivered.  Some services would also be going out to tender as outlined in the Appendix to the report.

 

Lynn Cocksedge, Head of Contracts and Business Development, Foundation Trust, stated that the discussions to date had been very difficult but progress had been made and the Trust was confident that they would be able to deliver the savings with as little impact as possible.  With regard to the Health Visitors Intervention, it was a management restructure and not a clinical provision restructure.  A number of meetings had been set up with Public Health to further progress the areas that were referenced in the report and as well as internal meetings within the Trust.  Due to some of the issues impacting upon staff, consultation by the Trust would be carried out in accordance with the associated regulations.     

 

Discussion ensued with the following issues raised/clarified:-

 

-          Many of the services were previously under the domain of the NHS.  Part of the process was to bring them in line with all other Council processes and, therefore, the tendering process would be in accordance with the Council’s procurement framework.  There would be supplementary clauses such as adherence to NICE guidelines and registration with the Care Quality Commission if applicable.  Attention was drawn to the briefing paper on procurement and commissioning in the information pack

 

 

-          It was the Trust’s intention to look at the footfall of each of the Sexual Health Clinics as some were better used than others but to ensure as limited impact on clients as possible.  It may be that some had different hours of opening to accommodate clients.  It was hoped that detailed information regarding the number of clients at clinics would aid better commissioning of Sexual Health services.  GP surgeries also provided  ...  view the full minutes text for item 73.

74.

Health and Wellbeing Board pdf icon PDF 64 KB

Minutes of meeting held on 25th November, 2015

Minutes:

The minutes of the Health and Wellbeing Board held on 25th November, 2015, were noted.

75.

Updates from Improving Lives Select Commission

Minutes:

The next meeting of the Improving Lives Select Commission was on 3rd February, 2016.

76.

Healthwatch Rotherham - Issues

Minutes:

No issues had been raised.

77.

Date of Future Meeting

Thursday,      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, 17th March, 2016, commencing at 9.30 a.m.