Agenda and minutes

To consider and approve the minutes of the previous meeting held on 28 July 2022 as a true and correct record of the proceedings.

Resolved:-

1.    That the minutes of the meeting held on 28 July 2022 be approved as a true and correct record of the proceedings.

To receive declarations of interest from Members in respect of items listed on the agenda.

There were no declarations of interest.

To receive questions relating to items of business on the agenda from members of the public or press who are present at the meeting.

The Chair Confirmed there were no members of the press or public present at the meeting.

To consider whether the press and public should be excluded from the meeting during consideration of any part of the agenda.

The Chair advised that there was no reason to exclude members of the press or public from observing any items of business on the agenda.

To receive nominations for a representative to the the Health, Welfare and Safety Panel.

The Chair invited nominations for a representative to the Health Welfare and Safety Panel. No nominations were received.

Resolved:

1.    That nominations be received at the next meeting on 24 November 2022.

To receive a verbal update in respect of recent activities and findings of Healthwatch Rotherham.

Consideration was given to a verbal update presented by the Healthwatch Community Engagement Officer which included a breakdown of the referrals that had been received since the last update. The update ongoing work in the community to receive direct feedback from service users and to raise awareness around important topics. The updated noted open consultation surveys.

In discussion, it was noted that insights from Healthwatch were valuable in work planning and would continue to be sought in upcoming scrutiny work.

Resolved:-

1.    That the update be noted.

To receive a presentation in respect of medicine management arrangements and practice in place across Rotherham.

Consideration was given to a presentation presented by NHS South Yorkshire in respect of medicine management. The presentation addressed the range and scope of medicine management activity in Rotherham. The presentation outlined the remit of the NHS South Yorkshire, Rotherham Place Medicines Management as well as strategic aims and therapeutic pathways.

Among successes highlighted in the presentation, reduction in antibiotics prescribing had taken Rotherham from a high prescriber pre-pandemic to a below average prescriber during pandemic without returning to pre-pandemic levels. In terms of challenges, it was noted that staff turnover made it challenging to work with care homes. The context behind medicine shortages was explained, with the likelihood of more shortages to manage in near future due to the low prices for drugs in the UK. It can happen that a drug can be sold elsewhere for a higher price, which interrupts the supply to the UK. It was also noted that variation exists in support across heart failure treatments, and the Place were working to address these inequalities.

In discussion, Members expressed interest in hearing more about therapeutic alternative, and whether alternatives have worked for the patients in terms of quality. The response from the Head of Medicine Management noted that alternatives can reduce costs, but there can be variation because each batch is slightly different. It was confirmed that sometimes generic medicines can be this way. Nevertheless, where these medicines are used to treat chronic conditions such as in rheumatology, the services were not hearing of relapses.

Members expressed interest in the Care Hydration Project and asked to hear more about culture in care homes. The response from the Head of Medicine Management described a previous wound care project that had to stop for reasons of economics because as soon as a staff member had been trained, they had left. It was early days, of the Care Hydration Project, but the training had been well received. Because interventions are well received, it was clear that there was appetite for more support. Hydration is key for training.

Members sought further clarification around pain management approaches that are not pharmacological. The response noted that Rotherham has need of psychologists and pain specialists. Funding was in place for designated pain specialist nurses, and these had been identified. The commissioning process was described and the timescale for delivery was projected to go live in January 2023. The service would be patient-led, for patients who are working with their GPs to try a different approach.

Members expressed a desire for more information around measures of performance. The response averred that performance is most certainly monitored in terms of prescribing against disease registers. It was observed that no practice wants to be at the wrong end of the graph. Feedback is provided to the practices, identifying the highest rates of antibiotic prescribing, and narrowing down to individual practices that appear to under-medicate heart failure. In terms of diabetes control, it was known which practice was the best and the worst. This information prompted  ...  view the full minutes text for item 29.

To receive a presentation in respect of recent activity regarding suicide prevention.

Consideration was given to a presentation by the Director of Public Health,  Public Health Specialist, and the Cabinet Member for Adult Social Care and Health in respect of the Council’s and Place Partners’ recent activity in respect of suicide prevention. This presentation follows on from a previous scrutiny discussion on this topic in September 2021. The presentation outlined the national and local context, the Rotherham Suicide Prevention and Self Harm Action Plan, workforce development, ICS-wide activity, and support services available. The presentation provided updates in response to previous recommendations including the facilitation of suicide and self-harm prevention trainings and public health work in the community.

In discussion, Members expressed interest in learning more about whether any unique factors about Rotherham could be influencing the situation. The response from officers noted the difficulty in identifying any one factor that makes Rotherham unique. It was noted that service provision for child and family health was very good, and that thinking about childhood trauma and adverse experiences was of great importance. The service and partners across the Place were focusing on vulnerable locations and ensuring actions were taken to protect people in those areas. It was noted that this was very complex. Therefore, no one thing would alleviate it, but everything done to help alleviate poverty and deprivation would also help prevent suicide.

Members requested more information regarding the high percentage of people not in contact with mental health services. Members sought assurances that efforts are being made to bring vulnerable people into contact with support. The response from officers noted the context of the high percentages was national. Locally, a third of people are known to mental health services. When signposting is offered to people, this needs to signpost people to other organisations in addition to mental health services. This is because sometimes people prefer to contact Papyrus or Samaritans, for example. People have options as to where to find help. Sometimes the best option for the person may be provided through a voluntary sector organisation. It had been observed during the pandemic that more people go where they have an existing relationship.

Members requested more information around collaboration with local authority housing services. The response from officers noted that the service does learn if people were tenants. The service communicated through the Home Matters publication to say where people can access support. The Cabinet Member noted the importance of recognising early signs and being willing to be the one to talk. With understanding of early signs, there was a better chance to help others then move forward.

Members noted the work is top class and expressed interest in knowing more about work by the service that speaks to the needs of late middle age, gender inclusively, especially taking into account the rising cost of living. The response from officers noted that there was research on groups being affected by the pandemic, and women were one of the groups that emerged. Rotherham had fortunately identified this and had done some prevention work  ...  view the full minutes text for item 30.

To receive and note the annual report of the Health and Wellbeing Board of the Council.

Consideration was given to a summary report of achievements of the previous year and priorities for the forthcoming year of the Health and Wellbeing Board. These included  developing a framework to give every child the best start in life, supporting children’s mental health in schools, ongoing work to support carers and supporting the Covid-safe delivery of Rotherham Show as one of the first in-person large scale events many residents attended since the start of the pandemic. Tackling health inequalities had been the core focus over the last year. In order to ensure that the health of vulnerable residents was improving at the fastest rate possible, a prevention and health inequalities sub-group has been established at place level.

In the coming year, there was an intention to hold a review of the impact of Covid-19 and lessons to be learnt from it. Health inequalities would continue as the uniting theme. Consideration of the changes being brought in through the Health and Care Bill, including to place-level ICP was also needed. Most of the work had taken place over the last year, but changes were still being finalised at the time of reporting. The coming year would also bring refresh of the Health and Wellbeing Strategy, as well as the accompanying action plan to ensure alignment with the reviewed priorities and any place-level changes.

In discussion, Members expressed interest in knowing the distinctions between urban and rural populations, and the differences across the Borough. Members noted the need for an approach to strategies to be Borough-wide, emphasising the role of parks in terms of health. Members also emphasised the importance of working with voluntary and community organisations. The response from the Cabinet Member affirmed the mental and emotional benefits derived from green spaces, and the role of providing for every park. Examples were cited of developing a community park on land that was formerly a council-owned wasteland as well as ambitions for community orchards. The need for volunteers and to enlist the partnership of voluntary organisations were also key. The Director of Public Health added that the next update would report on the health inequalities work around the Place Development Programme was focusing on Wath, Maltby and Dinnington and would span across the Borough. Conversations around being active are ongoing in partnership with South Yorkshire Sport which will build social movement and look at what is happening in communities at sports clubs to derive strategic approaches and keep communities and parish councils informed of the work being done.

What consideration is being given to anti-poverty strategies. The response from the Cabinet Member noted that this is being taken forward on several fronts, especially in response to the cost of living crisis. This has impacts through food, health, heating and housing deprivation as well, therefore it is being taken forward. In terms of tackling health inequalities, the Director of Public Health noted the work that happens through RIDO and through Improving Places and Improving Lives. The work of the Health and Wellbeing Board  ...  view the full minutes text for item 31.

To receive an updated outline programme of scrutiny work for endorsement.

Changes to the work programme were noted, including the consideration of frailty prevention in March to facilitate the earlier attention to a review in respect of oral health. The physical activity strategy would be considered in January to enable room on the 24 November agenda for a consideration of winter pressures and surge planning across the place. The recommendations of previous review work would be submitted for endorsement on 24 November. And the spring workshop item would be updated to reflect the most current priorities for scrutiny, as significant work had been undertake by partners in respect of social value. 

Resolved:-

1.    That the updated work programme be noted.

2.    That authority be delegated to the Governance Advisor to make changes to the work programme in consultation with the Chair and Vice-Chair and to report changes to the next meeting for endorsement.

To consider any item(s) which the Chair is of the opinion should be considered as a matter of urgency.

The Chair announced that there were no urgent items in need of consideration at the meeting.

The next meeting of the Health Select Commission will be held on 24 November 2022, commencing at 5pm in Rotherham Town Hall. 

Resolved:

1.    That the next meeting of Health Select Commission will be held on 24 November, 2022, commencing at 5pm in Rotherham Town Hall.