Agenda and minutes

There were no Declarations of Interest.

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

Healthwatch had organised an Older People’s Conference on 30th October at Fitzwilliam Arms Hotel, Parkgate from 10:30 a.m.  It would feature interactive presentations on various issues including clinical thresholds and lasting power of attorney.

The Yorkshire & Humber Joint Health Overview and Scrutiny Committee were likely to meet in early January 2018 to scrutinise an update from NHS England on Congenital Heart Disease Services.

Consideration was given to the minutes of the previous meeting of the Health Select Commission held on 21^st September, 2017.  Members noted that:-

Arising from Minute No.26 - LGA prevention sessions

New dates were to be arranged in early January due to a clash with a planning event in November.

Arising from Minute No.28 - Sepsis Care Pathway

The Rotherham Foundation Trust (TRFT) was working to review issues relating to the Sepsis Pathway, which was a national pathway.  TRFT were conducting a service review of the current Care Co-ordination Centre (CCC) Service to ensure it was fit for purpose in co-ordinating care and providing robust and safe alternative levels of care.

Arising from Minute No.29 - Patient Records

Rotherham, Doncaster and South Humber NHS Trust (RDaSH) were moving to a single patient record system, Systm1, which would be implemented in Rotherham in April 2018.  A key part of the implementation plan was to reduce paper based processes and standardise unnecessary variation. 

The CCC would be using the templates developed for the Doncaster single point of access to support both physical and mental health referrals and triage and reduce duplication and wasted activity.

Arising from Minute No.30 - Prescriptions

A response was awaited from the Pharmacy at TRFT.

Following the HSC meeting the following response was received from the Chief Pharmacist at TRFT:-

The Trust already had the ability to prescribe on FP10 prescriptions (the green prescriptions that people get from their GP) so that the prescription could be taken to any community pharmacy to get the medicines dispensed, without the need to develop a new form.  Currently these FP10 prescription pads were not available in all areas and using them would mean the Trust incurred additional costs.  This might be offset by additional bed capacity and activity.

Arising from Minute No.31 - Ambulance Standards

Members who had submitted questions for Yorkshire Ambulance Service to be asked through the Yorkshire & Humber Joint Health Overview and Scrutiny Committee were thanked.

Resolved:- That the minutes of the previous meeting, held on 21^st September, 2017, be approved as a correct record.

Ruth Fletcher-Brown, Public Health, to introduce

The Chair introduced the item by stating that all the Members who had been involved in the project had reported back very positively and that it had been a successful and valuable piece of work.

Councillor Marriott reported back on her visit to Wales High School on 25th October when all six schools had showcased their work to a wider audience.  It had been a very interesting afternoon and showed the different approaches taken by the schools.  Councillor Marriott expressed her wish that the good work continue and would lead to other schools becoming involved.

Ruth Fletcher-Brown, Public Health presented an overview of the project to set the context.  This was followed by presentations from 3 of the participating schools – Maltby Academy (Sara Graham), Newman School – Community Special School (Sarah Kulmer) and Oakwood High School (Louise Grice). 

A.  Introduction and context to Whole School Approach

Introduction

—   What is a Whole School Approach

—   Where did it come from?

—   How did this work in Rotherham?

—   What actions did the schools take?

What do we know?

In an average class of 30 (15 year old) pupils:

—    3 could have a mental health disorder

—   10 are likely to have witnessed their parents separate

—   1 could have experienced the death of a parent

—   7 are likely to have been bullied

—   6 may be self-harming

A whole school and college approach

—   Promoting children and young people’s emotional health and wellbeing: A whole school and college approach was produced by Public Health England & Children and Young People’s Mental Health Coalition in 2015.

—   It sets out key actions that Head Teachers and College Principals can take to embed a whole school approach to promoting emotional health and wellbeing. These actions are informed by evidence and practitioner feedback about what works.

8 Principles to promote mental health and wellbeing in schools and colleges

—   Leadership and management that supports and champions efforts to promote emotional health and wellbeing

—   An ethos and environment that promotes respect and values diversity

—   Curriculum, teaching and learning and to promote resilience, and support social and emotional learning

—   Enabling student voice to influence decisions

—   Staff development to support their own wellbeing and that of students

—   Identifying need and monitoring the impact of interventions

—   Working with parents and carers

—   Targeted support and appropriate referral

Future in Mind 2015

NHS, public health, local authorities, social care, schools and youth justice sectors working together to place the emphasis on building resilience, promoting good mental health, prevention and early intervention. (Chapter 4).

Encouraging schools to continue to develop whole school approaches to promoting mental health and wellbeing.

Why whole school approach?

‘Evidence shows that interventions taking a whole school approach to wellbeing have a positive impact in relation to both physical health and mental wellbeing outcomes, for example, body mass index (BMI), tobacco use and being bullied.’

What we did

—   Funding from CAMHS Local Transformation Fund for 1 school year 2016/2017.

—   6 schools piloted this work; Maltby, Newman, Oakwood, Rawmarsh, Wales and Wingfield.

—   Each school looked at  ...  view the full minutes text for item 40.

Beki McAlister, Strategic Commissioning Manager, CYPS to present

Beki McAlister, Strategic Commissioning Manager, Children and Young People’s Services (CYPS), presented a progress report.  Anders Cox and Barbara Murray from RDaSH, Ruth Fletcher-Brown, Public Health, and Susan Claydon, Early Help CYPS, provided additional information.

The report provided an update against the recommendations from the Scrutiny Review of Child and Adolescent Mental Health Services (CAMHS) in December 2015.  The principal focus of the review had been RDaSH CAMHS, however, the review acknowledged that these services were not provided in isolation but were part of a complex system of service commissioning and provision.  The 6 themes included in the update impact on the wider system and had been previously agreed by the Commission as the focus for future updates.

Mental Health was high on the national agenda with a Green Paper due imminently on young people’s mental health and particularly looking at early intervention approaches, working around in schools, the community and workplaces.  Locally, there had been a transformation of CAMHS and the new Section 75 Agreement pooling budgets between RMBC and the CCG had significantly changed commissioning arrangements.

·           Impact of the CAMHS Single Point of Access – The CAMHS Single Point of Access (SPA) was now well established.  Integration with the Early Help Single Point of Access was agreed in 2016 and began a pilot phase in 2017, however there was a delay in progressing this work due to changes to management within CAMHS.  The Single Point of Access had now been revisited alongside Early Help and the work was progressing positively. Strategic discussions were underway to enhance integrated working with the Early Help Single Point of Access.

       The CAMHS SPA was the main access point alongside contact through the locality workers.  There was closer working with services that worked closely with young people and in-reach to the Early Help SPA.  More dialogue was taking place on referrals coming in to ensure the right help and more timely help with young people not being “bounced” around the system as it had been viewed historically.

·           Impact of CAMHS Locality Working – there was now an established and active presence in local communities.  Feedback was now regularly sought to evaluate and improve the locality approach.

This linked in with the presentations on the Whole School Project with locality workers working with secondary schools and some of the primaries, which was helping to support teachers to be more confident in dealing with mental health and identifying need.    RDaSH also supported World Mental Health Day and #HelloYellow.  Locality staff had worked with GPs to raise awareness and were increasingly seeing people in community settings as well as at Kimberworth Place.

·              Training and Development for the wider CAMHS workforce – Strategic links were being made within RMBC and pilot work had commenced with the Yorkshire & Humber Clinical Network around a competency framework for school based staff.

         The Yorkshire and Humber Framework “In It Together” considered what training the different staff groups needed and at what level. They had looked at Early Years  ...  view the full minutes text for item 41.

The Health Select Commission received a short verbal update report from the Scrutiny Officer concerning the Joint Health Overview and Scrutiny Committee (JHOSC) for the Commissioners Working Together Programme. 

Hyper Acute Stroke

The Joint Committee of Clinical Commissioning Groups had all the information required to inform the business case and would be taking a decision at the next meeting in November 2017.

Hospital Services Review

Further to the papers circulated at the last Commission meeting, the Hospital Services Review would produce its final report for the end of April 2018.  The review had been structured in two stages:

·           Stage 1 Assessment (June – December 2017).  This stage included an assessment of the sustainability of services across the South Yorkshire and Bassetlaw footprint to agree a shortlist to be taken forward for a more detailed assessment of sustainability issues, and identification of the problems with these services.

·           Stage 2. Options and New Models (January 2018 – April 2018).  This stage would focus on potential solutions to the issues identified.

The final list of services in scope was not yet available.  A detailed project plan had been developed, including governance groups and communications.  Consultation had commenced with patients and the public.  Any further information would be circulated to keep HSC fully briefed.

There were no issues to report.

Thursday, 30^th November at 10.00 a.m.

Thursday, 14^th December at 10.00 a.m.

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 30^th November, 2017, commencing at 10.00 a.m.