Agenda and minutes

There were no declarations of interest made at the meeting.

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

Care Quality Commissioning Registration: -

The Cabinet Member for Health and Wellbeing informed the Health Select Commission that the Health and Wellbeing Board and the Health and Wellbeing Strategy had been well received as part of this process.  In particular, the clear lines of ownership that existed, the three years of targets and the partnerships and relationships had been endorsed. 

Maltby Ambulance Station: -

The Cabinet Member for Health and Wellbeing reported that consultation was underway with stakeholders on the possible closure of Maltby Ambulance Station.

The Health Select Commission and the Health and Wellbeing Board agreed to seek further information from the Yorkshire Ambulance Service. 

Changes to prescriptions: -

The Vice-Chair of the Health Select Commission was aware that there were potential guidelines to stop doctors issuing prescriptions for a period of two months, making a maximum prescription length of one month.  This move could potentially double the costs of patents and could lead to patients deciding to take less medication. 

It was agreed to raise this issue at the Health and Wellbeing Board’s meeting with the Secretary of the Rotherham Pharmacology Committee in October. 

Rotherham Hospice: - 

It was reported that a meeting would take place with the Chief Executive of the Rotherham Hospice to discuss how end of life care and experience for patients could be improved as far as possible. 

Consideration was given to the minutes of the previous meeting of the Health Select Commission held on 12th July, 2012.

Resolved:- That the minutes of the previous meeting be agreed as a correct record for signature by the Chairman.

- minutes of meeting held on 11^th July, 2012

Consideration was given to the minutes of the meeting of the Health and Wellbeing Board held on 11th July, 2012.

Resolved:- That the minutes of the Health and Wellbeing Board meeting be noted.

Consideration was given to a report presented by Shona McFarlane, Director of Health and Wellbeing, stating that the Government had published its vision for a reformed care and support system in a White Paper and a draft Bill.  An online consultation process was now taking place, with the deadline for responses being Friday, 19^th October, 2012.

The report summarised the key features of both the White Paper and the draft Bill and outlined the themes and questions in relation to the Bill, on which the Government was seeking responses. It was suggested that a sub-group of Members, chosen jointly from the Health and the Improving Lives Select Commissions, be established to prepare a detailed response to the Government’s consultation.

Resolved: - (1) That the report be received and its contents noted.

(2) That a sub-group of Members, chosen jointly from the Health Select Commission and the Improving Lives Select Commission, be established to consider the Government’s consultation documents and submit a formal response by 19th October 2012.

(3)  That the Health Select Commission representatives on the sub-group be Councillors Steele and Hoddinott and co-opted member Mr. Robert Parkin. 

(4) That the Improving Lives Select Commission be asked to nominate Members to join this sub-group.

- update by Councillor Wyatt, Cabinet Member for Health and Wellbeing

Councillor Ken Wyatt, Cabinet Member for Health and Wellbeing, provided an update in relation to HealthWatch: -

• The Chair of HealthWatch England had been appointed; 
• There was an agreed budget until March, 2013, and possibly a regional network to provide support;
• Rotherham MBC and NHS Rotherham had run an event at Rockingham Professional Development Centre;
  • 18 organisations had attended;
  • The purpose of the event was to share information and service priorities.

The main issues that the partners agreed were: -

• Engagement with children, young people and families’ issues was necessary;
• HealthWatch must take care to not just listen to the loudest voices;
• Staff transferring into the organisation and TUPE issues. 

HealthWatch England had received £3million in funding for the period October, 2012, to March, 2013, to fund their national set-up.  The organisation would have to fulfil the following roles: -

• Include Children’s Agenda;
• Support Local HealthWatch;
• Complaints and Advocacy;
• Engagement work with carers and patients;
• Proactive role in alerting local authorities, hospitals and Clinical Commissioning Groups to issues.  

HealthWatch would operate along a social enterprise model.  It was acknowledged that the organisation would have a large number of work streams to maintain and that there would be many draws on their funding.  It was imperative, therefore, that HealthWatch did not duplicate other work such as that carried out by Quality Care Commission or Ofsted. 

A pilot of a Local HealthWatch organisation had taken place in Essex County and had been successful; there were 24 members of the public involved in this pilot. 

It was noted that as a service commissioned by the Rotherham Local Authority, the contract would be monitored by the Commissioning Team within the Resources Directorate.  The contract would be fully operational by April, 2013. 

Resolved: -  That the information shared be noted and the Cabinet Member be thanked for his attendance.  

- report of Shona McFarlane, Director of Health and Wellbeing

(as considered by the Cabinet Member for Adult Social Care on 23^rd July, 2012)

Consideration was given to a report presented by Shona McFarlane, Director of Health and Wellbeing, Neighbourhood and Adult Services, concerning the range of day care services for adults and older people with a learning disability. The Cabinet Member for Adult Social Care report ‘Day Services Review’ dated 13 February, 2012, outlined savings targets for the Council’s Day Care Services, which included a savings target of £150,000 for Learning Disability Day Care Services.  The report identified options to achieve this savings target and outlined the need for further work in respect of the longer term personalisation of Learning Disability Day Care Services, to ensure that they aligned to local and national strategic direction and provided value for money.

The report included proposals to: -

·        Change the provision of meals in the Day Care Centres;

·        Staffing restructures.

Reference was also made to Minute No. 18 of the meeting of the Cabinet Member and Advisers for Adult Social Care held on 23^rd July, 2012, concerning the review of Learning Disability Day Care Services and the savings target.

Discussion ensued, and the following issues were raised: -

·        Assurances were requested from the Director of Health and Wellbeing that the proposed staffing restructures would continue to mean that service users had their care plans met and that they were safe whilst accessing Day Care Centres;

·        Communications with staff groups and unions;

·        Communications with service users;

·        Skill development opportunities for service users were within the proposals;

·        Stakeholder responses to the consultation were being responded to by Health and Wellbeing Service Managers and the Cabinet Member for Adult Social Care;

·        The proposals did not have any implications for the Partner organisations that worked within the Day Care Centres but they had been made aware of them. 

The Director of Health and Wellbeing confirmed that the proposals aimed to have least impact on those who accessed front-line services. 

Resolved:- (1) That the report be received and the background and history to this issue be noted.

(2) That the proposals to achieve the financial savings for the Learning Disability Day Care Services during the current 2012/13 financial year, as detailed in the report now submitted, be approved insofar as the Health Select Commission was concerned.

(3) That the proposed report to Cabinet Member, Adult Social Care, outlining the longer term strategy for the Learning Disability Day Care Services, be submitted to a future meeting of the Health Select Commission.

- report of Shona McFarlane, Director of Health and Wellbeing

(report as submitted to the Cabinet Member for Adult Social Care on 23^rd July, 2012)

Consideration was given to a report presented by Shona McFarlane, Director of Health and Wellbeing, Neighbourhood and Adult Services, concerning the In-house Transport Service provided by Neighbourhood and Adult Services. The Service primarily provided transport for customers to access Adult Social Care Services, such as In-house Day Services and Respite Units, but was also utilised by external organisations and other Council Directorates to transport their customers; thereby generating income.

The Cabinet Member for Adult Social Care report ‘Day Services Review,’ dated 13th February, 2012, outlined savings targets for RMBC Day Care Services. The report identified options to achieve these savings specifically for Transport Services and requested approval to commence formal consultation with customers on the new revised transport eligibility criteria.   

Reference was also made to Minute No. 19 of the meeting of the Cabinet Member and Advisers for Adult Social Care held on 23^rd July, 2012, concerning the review of Transport Services and the savings target.

The Director of Health and Wellbeing confirmed that risk assessments would continue to be used to determine a Service user’s travel requirements. 

Discussion ensued and the following responses were made: -

• Potential need for Service users to challenge decisions made, either through and appeal or complaints procedure;
• Importance of providing ‘bus buddies’ to those Service users who needed them;
• The outcome of the Equality Impact Assessment on the proposals;
• Potential to drain an individual’s mobility component of the Disability Living Allowance through attendance at a Day Centre, leaving less for other activities/outings;
• Would the impact of the proposals on those on the higher, middle or low level of Disability Living Allowance be different?;  
• The range of professional support that was provided to service users when completing the Service User Eligibility Criteria for Transport Services. 

Resolved:- (1) That the report be received and the background and history to this issue be noted.

(2) That the revised Transport Eligibility Criteria, as now submitted, be approved insofar as this Select Commission was concerned.

(3)  That the proposed report to Cabinet Member Adult Social Care be submitted the Health Select Commission following the closure of the consultation period outlining the responses received. 

Further to Minute No. 28 of the meeting of the Health Select Commission held on 27^th October, 2011, consideration was given to a report presented by Deborah Fellowes, Scrutiny Manager, containing the findings and recommendations of the Scrutiny Review of Continuing Healthcare in Rotherham. The draft Review report was submitted as an appendix to the main report.

Members had learned that expenditure on Continuing Healthcare in Rotherham was lower than that of surrounding and statistical neighbours and there were anecdotal concerns in relation to the customer experience of the CHC process and time taken to receive decisions.  Scrutiny Members were concerned about this level of spending locally and the impact this was likely to have on customers as well as Local Authority budgets. The key findings of the review were:-

(i) There had been some positive engagement between the two organisations (local authority and NHS) to address some of the strategic issues faced locally in relation to budgets and procedures;

(ii) In Rotherham, the lower spend on Continuing Healthcare meant that Adult Social Care spending was higher than it would be if the Continuing Healthcare spending was either at average levels, or in line with the levels of health inequalities in the Borough;

(iii) Interviews with professionals raised a number of issues and concerns around the process of assessments and decision making, including the Continuing Healthcare panel;

(iv) It was clear that although the processes were being adhered to, there were huge inconsistencies in the way they were implemented;

(v) Information gathered from customers reflected the concerns raised in relation to the lack of clarity and inconsistencies in the process and delays being experience.

The Cabinet Member for Adult Social Care thanked the Review group for the work that had taken place as part of the Review, and the recommendations that had been made.  He was confident that the recommendations addressed issues of concern reported by the Service users.  As such, this was a positive development. 

The Scrutiny Manager reported that, as the Review recommendations contained implications for Health Services, constitutionally the report was required to be submitted to the Health and Wellbeing Board for their consideration.

Resolved: - (1) That the report be received and its contents noted.

(2) That the findings and recommendations of the report of the scrutiny review of Continuing Healthcare in Rotherham be endorsed.

(3) That the be submitted to both the Overview and Scrutiny Management Board, the Health and Wellbeing Board and to the Cabinet for further consideration.

(4) That the response of the Cabinet to this Scrutiny Review’s recommendations be reported to a future meeting of the Health Select Commission.

- Thursday, 25^th October, 2012 at 9.30 a.m.

Resolved:-  That the next meeting of the Health Select Commission be held on 25^th October, 2012, commencing at 9.30 a.m. in the Rotherham Town Hall.