Agenda and draft minutes

There were no Declarations of Interest made at the meeting.

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

Joint Health and Overview Select Committee

The Chairman reported that he had attended a meeting on 28^th November, 2014.  There were major concerns from the attendees, some of which had been involved from the beginning, around the failure of NHS England to consult until the standards for Coronary Heart Disease had been accepted.  They had been told that until the conditions were accepted, there would be no serious debate or consultation.  This was creating a great deal of frustration. 

They were also conscious that they had 4 surgeons at Leeds but not the workloads.  It was a balance of retaining 4 surgeons/workload against a succession plan given the speciality/experience of the surgeons. 

Information Packs

It was noted that a separate pack had been produced containing items for information.  Should any Member have any issues to raise on the items contained therein they should be raised under Communications.

Access to GPs Review

The Overview and Scrutiny Management Board had requested a special Health Select Commission meeting to discuss the response due to a lack of detail with how some of the recommendations would be actioned even though they had been accepted.

A special meeting had been arranged on 15^th January, 2015, at 9.30 a.m. to which the Clinical Quality Commission, Clinical Commissioning Group and NHS England had been invited.

Meeting with Rotherham Foundation Trust

The last meeting had been held on 24^th November the notes of which were not available as yet.  At the January meeting the Trust would give an update on both their action plan and the Quality Account.  They were applying to Monitor for the enforcement regarding governance to be lifted.

Seminar

A seminar was to be held on 9^th December at 9.00 a.m. on the Care Act.

It was noted that Speak-Up had produced an easy read booklet on the Act.

Care Home Pilot – Waste Medicine Management

Discussions had taken place with Shona McFarlane, Director of Health and Wellbeing. 

Medication in care homes was a complex matter delivered in partnership between the resident, their GP, the pharmacist and the care home.  Most care homes operated a monitored dosage system or systems determined by the operating company many of which were national organisations.  In setting up a contract, the Council required the home to operate a safe system of ensuring that residents received their medication correctly but the Council could not determine which specific system was used.

The key issue when delivering medication in residential care was safety and most homes found that a monitored dosage system resulted in a reduction in errors.  The safety of the systems was not matched by flexibility and should someone not take their medication, or prescription change, the pre-filled cartridges were returned to the pharmacist to be destroyed which could result in wastage.

There were times when the prescription was completed incorrectly or the pharmacist did not complete the order correctly which could also result in waste when the homes had to send back the medication.  ...  view the full minutes text for item 58.

Minutes of the Health Select Commission dated 23^rd October, 2014

Consideration was given to the minutes of the meeting of the Health Select Commission held on 23rd October, 2014.

Resolved:-  That the minutes of the meeting held on 23rd October, 2014, be agreed as a correct record for signatures by the Chairman.

Arising from Minute No. 51 (NHS Rotherham Clinical Commissioning Group – Commissioning Plan 2015-16 – Transforming Community Services), it was noted that Joanna Saunders, Public Health, was the lead officer for the transforming of the 0-5 Child Services Partnership and would submit a report to the Select Commission.

It was also noted that the Foundation Trust would give an update on the Community Transformation programme to the January meeting.

Arising from Minute No. 54 (Health and Wellbeing Board Strategy Progress – Prevention and Early Intervention – NHS Health Checks) it was noted that Health Checks were aimed at everyone over the age of 40-74 years.

Minutes of meetings held on 24^th October and 12^th November, 2014

The Select Commission noted the minutes of the Health and Wellbeing Board held on 24^th October and 12^th November, 2014.

Councillor Doyle, Cabinet Member for Adult Social Care and Health, informed the Commission that since the last meeting of the Board the Council, Clinical Commissioning Group and South Yorkshire Police had signed up to the Mental Health Crisis Concordat.

Progress on the Health and Wellbeing Strategy and plans for refresh would be presented to the Select Commission at its meeting in March 2015.

There were no matters arising.

Richard Armstrong, Interim Director of Commissioning, NHSE, and Dominic Blaydon, Head of Long Term Conditions and Urgent Care, CCG

Richard Armstrong, Interim Director of Commissioning, NHSE, and Dominic Blaydon, Head of Long Term Conditions and Urgent Care, CCG, presented a report on the actions taken to date and those being considered by NHS England in order to ensure adequate, high quality future provision of GP services in the Chantry Bridge area of Rotherham.

Current services were located in the Community Health Centre on Greasbrough Road and were part of the contract with Care UK together with the Out of Hours Service and the Walk-in Centre.

Appendix A of the report provided a detailed account of the context and position regarding future provision as well as:-

·           Introduction and background to the existing service

·           Current position

·           Demographic information

·           Other Primary Care services at Chantry Bridge

·           Engagement

·           Procurement principles

·           Risk management

·           Next steps

Discussion ensued with the following issues raised/clarified:-

-          The service had commenced in 2009, commissioned at that time by the Rotherham Primary Care Trust to provide both a registered practice for patients as well as walk-in patients who chose to visit during the extended opening hours and for convenience due to its central location for people working in Rotherham

-          The contract had been let for 5 years with an expectation that the practice list would grow to 5,000-6,000 people

-          At the time of the contract coming to an end in May, 2014, the practice had a list of approximately 1,700 and Care UK still provided a walk-in service

-          During the 2013 changes to the NHS structure the responsibility for Urgent Care Services (walk-in centre and out of hours) moved to the Clinical Commissioning Group.  NHS England remained responsible for commissioning GP services provided to a registered list of patients

-          Notification had been received that Care UK wished to withdraw from the provision of GP services but were willing to continue with the provision of out of hours services.  Negotiations had resulted in an extension of the contract until September, 2015.  This was timed to coincide with the opening of the new Emergency Centre at Rotherham Hospital but site issues have meant a delay to the opening date

-          Barnsley Clinical Commissioning Group were co-commissioners for the out of hours service and had agreed to end their contract with Care UK in May 2015.  Rotherham CCG would be receiving a paper from Care UK on the costs of continuing alone with out of hours

-          Consultation with the registered patients had commenced to ascertain their preference.  Options to explore would be whether there was a possibility of commissioning another practice in the area or another GP practice willing to take on the full patient list

-          Need to ensure effective engagement with patients who were new arrivals/faced language barriers and patients with learning disabilities or autism. It was noted that not many patient participation groups included disabled people

-          15% of the 1,700 lived more than 1 mile from the practice and travelled past other practices largely due to the convenience of extended opening hours

-  ...  view the full minutes text for item 62.

Joanna Saunders, Head of Health Improvement, Public Health

Joanna Saunders, Public Health, presented an update on the Childhood Obesity Review recommendations which had been considered by Cabinet on 16th October, 2013 (Minute No. 95 refers).

The re-commissioning of the Healthy Weight Framework (West Management Services) had commenced in May, 2014, following Cabinet approval (Minute No. 223 of 19^th March, 2014, refers).    The whole Healthy Weight Framework had been subject to review due to the budgetary pressures and the procurement process suspended at the end of July with all existing services extended to 31^st December, 2014.  However, the procurement had now been resumed and contracts would be awarded in the New Year.

Rotherham’s Healthy Weight Framework continued to attract national interest and its specifications recognised as representing good practice in published papers and guidance.

Since the last update, progress had been made with work underway on a number of the recommendations:-

-          Revised Healthy Weight Framework Service specifications now consistent with updated national guidance.  Re-procurement would be complete and new contracts awarded across the whole Framework by January, 2015

-          The new contracts would include a single point of access and web-based data management system which would ensure all patients were triaged into the correct Service and monitored effectively

-          The new School Nursing specification included targets for referrals to Children’s Weight Management Services

-          Improvements in the relationship between Service providers and School Nursing to enhance their skills in identifying and referring young people

-          The national Policy introducing free school meals to Reception and KS1 children had increased meals served per day

-          The obesity performance clinic held in May, 2014, had led to enhanced collaborative working on the wider determinants of overweight and obesity with other Council services

Discussion ensued on the report with the following issues raised/clarified:-

·           201314 data recently published showed that Rotherham’s rates had slightly gone up

·           The data was always slightly skewed due to it being a different cohort measured every year

·           Public Health England had started to look at trend data averaged on a three year basisto get a better picture looking at Y1-2-3, Y2-3-4 and Y3-4-5

·           Over 1,000 children had achieved weight loss through the Service

·           Children were very dependent upon their parents getting them to/engaging with the Service and a full family approach was best

·           The height and weight measurements were carried out during the term after Christmas up to the Summer.  All the results had to be uploaded onto the national system and analysed over the Summer holidays.  Due to staff resources all schools were not done at the same time

·           Schools were given an indication of when the programme would be coming to them and they wrote to the parents. Should a parent not wish their child to be included they had to opt out

·           There were really good levels of coverage – high 90%.  The measurements were taken sensitively and people were more comfortable with it taking place now it was more well established

·           Currently there was no data connection between a  ...  view the full minutes text for item 63.

Janine Moorcroft, Neighbourhood and Adult Services

Janine Moorcroft, Neighbourhoods and Adult Services presented an update on the above joint scrutiny review which had been undertaken by the Health and Improving Lives Select Commissions.

The report highlighted the joint actions agreed by the Select Commissions and incorporated actions from the Carers Charter action plan 2013-16 and the progress made on each.

The review had acknowledged the need for the recommendations to be contained within existing resources and, in the main, there were no financial implications.  Now the guidance for the Care Act had been published, the working groups established had a clear direction of what they had to achieve and would be built into the action plan.  There was a further meeting arranged with lead partners in early January to look at the budgetary workstreams in relation to the Care Act.

Discussion ensued with the following issues raised/clarified:-

-          Carers assessments and care plans were only done for those carers in receipt of social care.  This had been acknowledged and would be fed back to the relevant workstream officer.  The Care Act guidance would be considered to ascertain what changes were needed to the Carer’s Needs Form and Care Plan.

-          The update for recommendation 11 focussed more on public sector partners but this would be discussed at the meeting arranged for January, 2015 including all partners.

-          Discussions were taking place about Carers Corner moving to the RAIN building next year on a part-time basis, as well as the introduction of a more flexible service in all communities

-          It was still a challenge to monitor changes in the numbers of carers.  The question was asked at over 75’s healthchecks.

-          Bi-monthly carers meetings were held.

Resolved:-  (1)  That the progress report be noted.

(2)  That the incorporation of the scrutiny review actions into the wider action plan be noted.

(3)  That an update be submitted in 6 months.

Anne Charlesworth, Head of Drugs, Alcohol, Primary Care and NHS Contracts, Public Health

Malc Chiddy, Drug Intervention Programme Strategic Manager, presented a report on the above.

The Council, in partnership with Lifeline (Alcohol and Drug ‘Tier 2’ provider service) had been successful in securing £875,000 capital funding from Public Health England to purchase and refit suitable premises as a Rotherham Recovery Hub to support recovery from drug and alcohol dependence. 

The recovery services currently commissioned from RDaSH, alongside Lifeline and other services, would be relocated to the ‘Hub’ which was expected to be open from April, 2015.

The capital grant scheme was made available to support the recovery focus of the coalition government.  Group work, housing, employment, training and lifestyle activities would be provided in a welcoming environment away from the main clinical treatment base offering some respite for Service users and avoiding them coming into contact constantly with other active drug users.

There had been a substantial level of interest in the funding with over 200 bids submitted.  Rotherham’s funding allocation had been the single largest grant agreed.

The ex-Youth Offending Service building, ‘Carnson House’, had been purchased with the process of planning and redevelopment already underway.  It was estimated that the premises would be open for use by 1^st April, 2015 and fully completed by July, 2015.

Under the funding grant, the premises were owned outright by Lifeline but were to be made available for up to 20 years to Rotherham as a Recovery Hub.  After that time the premises became a Lifeline asset to use or dispose of as they saw fit, however, the 20 year timescale could be reduced at any time by the Authority giving the appropriate notice.

Discussion ensued with the following issues raised/clarified:-

-          RDaSH would also be in the building

-          A management group had been set up and had had its first meeting

-          The Hub had to be made available for Alcohol and Drug Services in Rotherham for 20 years as a grant condition

-          The building had been used by the Youth Offending Service for the past 20 years so no problems were anticipated from nearby residents and there was little concern regarding the present centres at Lifeline and Clearways.

-          It was a recovery hub and not a drop-in centre – it was those during their recovery stage that would be provided support.  There would be a programme of work covering debt management, employment, housing, ongoing health etc. with partners brought in to support

-          Both Lifeline and RDaSH worked on recovery now and had ways of measuring such.  It did not have to be total abstinence but massive steps towards it and getting their life back in order.  The main subjects would be housing, training/employment and relationships which were the areas that helped with recovery

-          Clients would be seen by a Clinical Worker regarding medication/injections away from the Centre – it would purely be recovery workers they saw at the Hub although the 2 workers would be in contact

-          Success was measured by someone not coming back  ...  view the full minutes text for item 65.

-        23^rd October, 2014 at 9.30 a.m.

Resolved:-  (1)  That a special meeting be held on Thursday, 15^th January, 2015, commencing at 9.30 a.m.

(2)  That a further meeting be held on Thursday, 22nd January, 2015, commencing at 9.30 a.m.