Agenda and draft minutes

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

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

Items
No. Item

19.

Declarations of Interest

Minutes:

There were no declarations of interest made at this meeting.

20.

Questions from members of the public and the press

Minutes:

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

21.

Communications

Minutes:

It was noted that the DoH had issued guidance around Health Scrutiny following the 2013 Regulations.  A briefing would be circulated to the Health Select Commission.

22.

Minutes of the Previous Meetings pdf icon PDF 74 KB

Additional documents:

Minutes:

Consideration was given to the minutes of the meeting of the Health Select Commission held on 12th and 25th June, 2014. 

 

Resolved:- That the minutes of the meetings held on 12th and 25th June, 2014, be agreed as a correct record for signature by the Chairman.

 

Arising from Minute No. 3 (Support for Carers Review), it was noted that the response from the Overview and Scrutiny Management Board would be circulated to Select Commission Members.

 

Arising from Minute No. 10 (Scrutiny Review: Urinary Incontinence), it was noted that the spotlight review had taken place.  A report would be submitted to the September Select Commission meeting.

 

Arising from Minute No. 17(2) (Rotherham Foundation Trust), it was noted a schedule had been drawn up for meetings with the Chairman, Vice-Chair and the Trust Chief Executive.  Notes of the meetings would be submitted to the Select Commission.

23.

Health and Wellbeing Board pdf icon PDF 51 KB

-        Minutes of meetings held on 4th June, 2014

Minutes:

Consideration was given to the minutes of the meeting of the Health and Wellbeing Board held on 4th June, 2014.

 

Resolved:-   That the minutes of the meeting be received and the contents noted.

 

Arising from Minute No. S108 (Sector Led Improvement), it was noted that as requested information from the performance clinics had been supplied to the Chairman and Vice-Chair.  A number of the actions mirrored the recommendations from the Childhood Obesity Scrutiny Review carried out by the Select Commission.

24.

Issues from Healthwatch

Minutes:

Further to Minute No. 6 (Hear to Help Service) of the meeting held on 12th June, 2014, Melanie Hall, Rotherham Healthwatch Manager, reported that, thanks to the support of Councillors, Voluntary Action Rotherham and John Healey, MP, the CCG had given the Foundation Trust funding to re-commission the Service and reinstate drop-in sessions.

25.

Director of Public Health Annual Report pdf icon PDF 31 KB

John Radford, Director of Public Health

Additional documents:

Minutes:

Dr. John Radford, Director of Public Health, presented the first annual report since the 2012 Health and Social Care Act placed the responsibility for Public Health within local authorities. 

 

The report focussed on an analysis of the causes of death and disability in the Borough and the health inequalities that existed between Rotherham and the rest of England.

 

It was split into the following sections:-

 

-          Overview

-          Public Health Outcomes Framework

-          Children and Young People’s Health

-          Life Expectancy and Cause of Death

-          Heart Disease and Stroke

-          Cancer

-          Liver Disease and Other Digestive Disease

-          Mental Wellbeing

-          Respiratory Disease

-          Mortality from Infectious Disease

 

Discussion ensued on the document with the following highlighted:-

 

·           Rotherham was doing a lot better than other parts of North England in respect of health inequalities.

 

·           Approximately 70% of health inequalities was due to other determinants of health.

 

·           Maternal and infant health was an issue across the Borough.

 

·           Maternal mental health was a big issue with large numbers of mothers living in poverty, unemployed, using drugs and/or alcohol and depressed.  This had a knock on effect on the next generation.

 

·           As the Health Visiting Service transferred into the Local Authority there was a need to look at more innovative methods of working to support young mothers and engage them in society.

 

·           Work was taking place with Planning with regard to incorporating conditions in Planning Policy in connection with takeaways near to schools, as recommended by the Commission. 

 

·           Approximately 1/3 of the premature deaths in Rotherham were due to heart disease and stroke.  A number of those were preventable  in terms of lifestyle interventions e.g. increasing exercise, stop smoking.

 

·           The importance of exercise and healthy lifestyles and how Members can promote activities locally to encourage people to become more active, as well as influencing through policies.

 

·           Encouraging on-site policies in secondary schools.

 

·           Approximately 1/3 of Rotherham’s health inequalities was due to smoking related Cancer.

 

·           A number of the respiratory causes of death were linked to historical industries and Pneumonia.

 

·           As a whole, GPs in Rotherham were late in referring patients to hospital with symptoms of Cancer and work was required to improve the referral rate.  Some Cancers could be helped by surgery but early detection was imperative and it is important to get out to the public information about the early signs of cancer.

 

·           1 in 20 respiratory deaths were due to air pollution and was known as the silent killer.  There were issues around the M1 corridor but also traffic hotspots - Rotherham was no different from the rest of the country.

 

·           E-cigarettes and trying to ban them in schools and on non-Council sites.

 

·           Importance to increasing uptake of Healthchecks.

 

·           There had been an increase nationally in Liver disease and Liver cirrhosis.  There were 3 main causes – alcohol cirrhosis, fat due to obesity and Hepatitis B.  Rotherham had very good vaccination programmes against Hepatitis B in terms of “at risk” groups including occupational groups.

 

·           There was an epidemic of  ...  view the full minutes text for item 25.

26.

Healthwatch Annual Report and Escalation Policy pdf icon PDF 30 KB

Melanie Hall, Healthwatch Rotherham Manager

Additional documents:

Minutes:

Melanie Hall, Manager, Rotherham Healthwatch, presented Healthwatch’s annual report and Escalation Policy and Procedure.

 

The report included:-

 

-          Summary

-          Our Work

-          Changes that had happened this year

-          Gathering local people’s views and making them known

-          Enabling local people to monitor the standard of local care services

-          The involvement of local people in the Commissioning and Scrutiny of local services

-          Making reports and recommendations about local care services

-          Providing advice and information about access to care services

-          Working with The Care Quality Commission and escalations of good practice

-          Sharing views with Healthwatch England

-          Working with the people of Rotherham

-          Engagement methods and activities

-          Who are our members

-          Our volunteers

-          Our Board and governance

 

Rotherham Healthwatch’s Mission was to be the first point of contact for all of Rotherham’s communities and individuals, to help them to have a means of improving their own and others quality of health, wellbeing and social care by promoting the local people’s following rights:-

 

·           The right to essential services

·           The right of access

·           The right to a safe, dignified and quality service

·           The right to information and education

·           The right to choose

·           The right to be listened to

·           The right to be involved

·           The right to live in a healthy environment

 

Discussion ensued on the report with the following highlighted:-

 

-          An area for improvement was the collection of data with regard to information and advice given

-          Examples of where Healthwatch had made a positive impact

-          Healthwatch worked with NHS England and had escalated a number of complaints to them

-          Rotherham Healthwatch was held in high esteem and had won a national award for its work

-          Currently the Healthwatch contract was held by Parkwood Healthcare but as from 1st September, 2014, Rotherham Healthwatch would be run by Rotherham people and become a social enterprise

 

Discussion then ensued on the Escalation Policy and Procedure the aim of which was to ensure safe and uniform standards of reporting on the quality of health and social care providers were delivered.  It provided clarity to the public, providers and stakeholders as to when Healthwatch would escalate concerns/complaints/compliments/comments.

 

One comment on its own may not indicate risk or the quality of a service, however, many comments of the same nature/regard to the same service would.  The criteria set out in the Escalation Policy indicated what could be an indicator or risk, poor or good quality service, along with timeframes for services to take action.

 

The report set out in full details of the Policy and Procedure.

 

It was noted that:-

 

·           In the last 3 weeks there had been 2 “urgent” level of escalation but only 3 in total

·           Healthwatch had the power of “Enter and View” which was considered at the low level of the escalation process.  This would be appropriate where further information was required from the people using a Health or Social Care service and/or to satisfy Healthwatch that a change  ...  view the full minutes text for item 26.

27.

Healthwatch - Child and Adolescent Mental Health Services pdf icon PDF 30 KB

Melanie Hall, Healthwatch Rotherham Manager

Additional documents:

Minutes:

Melanie Hall, Manager, Healthwatch Rotherham, presented the report produced in partnership with a group of local parents into the work of the Children and Adolescent Mental Health Services

 

Nationally, health and social care provision was being evaluated in light of the Francis report as well as a national review of CAMHS as part of the Children’s Plan.

 

In Rotherham stakeholders had come together to produce and deliver the Rotherham Emotional Wellbeing and Mental Health Strategy for children and young people.  The Strategy would inform service planning and commissioning for the next 5 years.  The aims of the investigation were to:-

 

-          Seek views on how local people believed the culture of CAMHS was affecting Service delivery

-          Obtain views and ideas as to how things could be done better

-          To share the views of local people with the provider and commissioners of CAMHS

-          Ensure local people in Rotherham knew about the activity

 

To enable Healthwatch to achieve the above, 3 methodologies were used:-

 

-          A purpose designed survey

-          A public 2 day event gathering views on themed topics

-          A review of the Healthwatch Rotherham Database

 

From all the statements made it could be concluded:-

 

-          that there was a high level of dissatisfaction with the Service provided

-          parents/carers did not feel listened to

-          felt blamed for the problems they and their child were experiencing

-          did not feel included or able to participate

-          no clarity on what to expect from CAMHS and what services they provided

-          difficult to make a complaint

-          complaints were not handled consistently or in a timely manner

-          waiting times to be seen were too long leaving families feeling unsupported

-          when children were discharged from the service it did not always include families and they were unaware they had been discharged

-          no crisis planning leaving families feeling unsupported and not sure what to do

 

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

 

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

 

·           This issue was moderate on the escalation policy

·           A good response to the report had been received from RDaSH and a meeting between the participants and RDaSH was to be held

·           It was accepted that the numbers of people with concerns was quite small but they had had negative experiences and the challenge to RDaSH was to prove that these were the exceptions and not the rule

·           Healthwatch had looked into CAMHS because it did not meet the needs of Rotherham’s young people.  It was acknowledged that it was mainly the voice of the young people’s parents who, although very vocal, were still not getting anywhere due to the mechanisms they were using. 

·           They were not being asked to change clinical practices but to be very clear about their customer services, how they treated the families and that they acknowledged the skills the families had

·           The Health and Wellbeing Board Customer Charter that partners were asked to sign up stated how  ...  view the full minutes text for item 27.

28.

Emotional Wellbeing and Mental Health Strategy for Children and Young People 2014-19 pdf icon PDF 585 KB

Paul Theaker, Commissioning Team, and Ruth Fletcher Brown, Public Health

Additional documents:

Minutes:

Paul Theaker, Operational Commissioner, and Ruth Fletcher-Brown, Public Health Specialist, gave the following powerpoint presentation:-

 

CAMHS Commissioning

-          More providers than just RDaSH

-          More commissioners than just Rotherham CCG

 

CAMHS Tiered Model of Provision

-          Commissioners

NHS England

Rotherham CCG

RMBC

-          Providers

Private Sector

RDaSH CAMHS (Sheffield Health and Social Care, Nottinghamshire Healthcare)

RMBC

Voluntary Sector

GPs, RFT

 

Where key services fit in the Tiered Model

Tier 1

-          Health Services - School Nurses, Family Nurse Partnership, Midwives, Accident and Emergency, LAC Nurse, Health Visitors, GPs, Dieticians, Sexual Abuse Referral Centre, Rotherham Institute of Obesity and Parenting Support Advisory Service

-          Social Care – Youth Offending, Parent Support Advisory Service and Family Recovery Programme

-          Education – Rowan Centre

-          Voluntary Sector - Barnardos

Tier 2

-          Health Services - RDASH CAMHS, Child Development Centre, Paediatricians

-          Social Care – Youth Start, Looked After and Adopted Children

-          Education - MIND

Tier 3

-          Health Services - RDASH CAMHS, Child Development Centre, Early Intervention in Psychosis, Paediatricians

-          Social Care – Youth Start, Looked After and Adopted Children

-          Education – MIND, Educational Psychology

Tier 4

-          Health Services – NHS England

-          Social Care – Disability Service, Custody

-          Education – Educational Psychology

 

Background

-          May/June, 2013 – Issues with RDaSH CAMHS Service

-          ‘Contract Query’ process October, 2013

-          GP Surveys – September and December, 2014, May, 2014

-          Universal Workers Survey January, 2014

-          ‘Top Tips’, Directory of Services, locality workers, GP events and IYSS conference

 

CAMHS Strategy

-          Draft format

-          Informed by National Guidance and local feedback

-          Formalisation of some ongoing work

-          From issues raised by families, carers, referrers and services

 

Draft Recommendations

-          Ensure patient/parents/carers input into developing services

-          Develop multi-agency care pathways

-          Develop family focussed services which were easily accessible and delivered in appropriate locations

-          Best value for money for the people of Rotherham

-          Flexible working times – not restricted to normal operating hours

-          Appropriate training and support for staff

-          Transition from Child and Adolescent Mental Health Services to Adult Services

-          Multi-agency single point of access (SPA) to Mental Health Services

-          Services that demonstrate improved outcomes for children and young people

-          Promote the prevention of mental ill health

-          Reduce the stigma of mental illness

-          Reduce waiting times and improve access

 

Next Steps

-          Engagement of parents, carers and young people

-          Finalisation of Strategy

-          Continuing joint commissioner/provider improvement work

-          Opportunities for engagement

-          Pathways event

 

Discussion ensued with the following issues raised/clarified:-

 

·           Improvement Notice served on CAMHS last year

·           GP Surveys had revealed 20% satisfaction rate

·           A lot of work and improvement had taken place over the last year

·           The Local Authority put funding into the contract but no monies had  been realised until receipt of a draft Strategy.  Said Strategy had been produced on 31st March, 2014.  A CAMHS Strategy was now also a requirement of Ofsted

·           A meeting had taken place with parents  ...  view the full minutes text for item 28.

29.

Health Select Commission Work Programme Update 2014-15 pdf icon PDF 48 KB

Janet Spurling, Scrutiny Officer

Minutes:

Janet Spurling, Scrutiny Officer, presented a report that was to be considered by all the Select Commissions and by the Overview and Scrutiny Management Board with regard to the 2014/15 work programme.

 

The proposed programme for the Health Select Commission was as follows:-

 

Continence Services

Child and Adolescent Mental Health Services (CAMHS)

Other Mental Health Services

Nurses in Special Schools

Commissioning Support Unit – Continuing Health Care

Improving Health Outcomes in Rotherham

Quality Accounts

Monitoring Previous Scrutiny Reviews

 

Also set out in the report, for information, was the Select Commission’s terms of reference and the role of the Overview and Scrutiny Management Board

 

Discussion ensued on the proposed programme:-

 

-          Each Select Commission was to conduct 1 full Scrutiny Review and 1 Spotlight Review a municipal year

-          Mental Health and Wellbeing was the Select Commission’s focus for 2014/15

-          Add Maternity Mental Health

 

It was noted that Select Commission’s work programmes would be discussed by the Overview and Scrutiny Management Board on 18th July.

 

Resolved:-  (1)  That the Select Commission’s terms and reference and the role of the Overview and scrutiny Management Board be noted.

 

(2)  That the Select Commission’s 2014/15 proposed work programme be noted.

30.

Date and Time of Next Meeting

-       Thursday, 11th September, 2014 at 9.30 a.m.

Minutes:

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 11th September, 2014, commencing at 9.30 a.m.