Agenda and draft minutes

Councillor Fleming made a Declaration of Interest in that he was an employee of Sheffield Hospital Trust.  As the Declaration was of a personal (and not prejudicial) nature, Councillor Fleming remained in the meeting and spoke and voted on the items.

There were no members of the press and public present.

(1)  Yellow Cards

The Chairman reminded Members that they should raise the yellow card if they required clarification on any issue/terminology used.

(2)  Joint Health and Overview Scrutiny Committee

It was expected that a meeting would be held in October, 2015, on the issue of Congenital Heart Disease Services

(3)  Treeton GP Practice

The Rotherham Clinical Commissioning Group had met with NHS Property Services at the beginning of August and, in conjunction with NHS England, an options appraisal for the Treeton/Waverley site had been submitted to the Primary Care Sub-Committee on 23^rd September.  Jacqui Tuffnell was to attend the next meeting of the Select Commission and would update on the outcome of the meeting.

(3)  RDaSH

The Trust was to hold its third workshop on 25^th September at the Unity Centre from 1.30 p.m.-3.30 p.m. to involve local people and partners in plans to transform Adult Mental Health Services across the Borough.  RDaSH was particularly interested in hearing from those with direct experience of their Services including family members and carers.

(4)  Terri Roche, Director of Public Health

Terri introduced herself to the Select Commission.  She had been in post since 29^th June, 2015.

Public Health had a statutory responsibility to protect the health of the public and improve the public’s health.  The Department was organised into 3 domains:-

Health Care Public Health – work to ensure the Health Services worked with health providers to ensure they were the best they could be and ensured they reached the right people in the right ways to address inequalities;

Health Protect – emergency planning – not to deliver the services but to hold other organisations to account and ensure things happened e.g. working with NHSE to make sure Rotherham residents were taking advantage of preventative measures to make sure they lived a long and healthy life

Health Promotion/Education – work in partnership to ensure Rotherham residents had all the information they needed to make healthy choices

Resolved:- That the minutes of the previous meeting of the Health Select Commission held on 9^th July, 2015, be agreed as a correct record.

Arising from Minute No. 15(5) (Access to GPs and RDaSH CAMHS Reviews), it was noted that the CAMHS response would be submitted to Commissioner Newsam’s 13^th October meeting.

Arising from Minute No. 17 (Health and Wellbeing Board – Scrutiny Review of Access to GPs), it was noted that the outstanding part of the response in relation to the recommendations specific for the Health and Wellbeing Board had been discussed and an update would be submitted to the next meeting.  Jacqui Tuffnell would be presenting the final Interim GP Strategy to the October Select Commission meeting which would address many of the points raised in the Scrutiny Review particularly GPs and practice workforce issues given the national media coverage regarding the shortage of GPs.

Arising from Minute No. 19 (Hospital Discharges), it was noted that the Quarters 1 and 2 data would be available shortly.  Councillor Fleming also raised that he had asked for information relating to pressure ulcers.

Arising from Minute No. 21 (Health and Wellbeing Strategy), it was noted that the Commission had had the opportunity to comment on the draft Strategy. The final version would be submitted to the October Select Commission.  It was evident that there was greater emphasis on mental health.

Arising from Minute No. (Provisional Sub-Groups for Quality Accounts), it was noted that the final sub-group memberships had now been confirmed.

-                      Presentation by Lynda Bowen, Sam Newton and Dominic Blaydon

Lynda Bowen, Dominic Blaydon, Kathryn Rawlings and Sarah Whittle gave the following presentations on the Better Care Fund and potential developments from the recent Service review.

Lynda Bowen gave the following overview presentation of the Better Care Fund:-

Better Care Fund Overview

-          Plan agreed by NHS England in January, 2015

-          Formalised in a Section 75 Partnership Framework Agreement in April, 2015

-          Strengthened governance

What does the BCF Plan aim to achieve?

-          Better patient/customer experience

-          Integrated service provision – seamless services

-          More effective provision

-          Fewer admissions to permanent care and unplanned emergency hospital admissions

-          Shorter lengths of stay in hospital

-          Effective reablement

BCF Metrics

-          Reduction in non-elective admissions

-          Permanent admissions of older people to care homes

-          Delayed transfer of care from hospital

-          Number of older people at home 91 days after discharge from hospital into rehabilitation

Governance

-          Health and Wellbeing Board

-          Strategic Vision

-          Strategic Executive

-          Operational Executive

Current BCF

-          Complex Plan

-          72 lines of funding

-          16 workstreams

-          2 pooled funds

-          Mixture of new and existing services

-          Fragmented data collection

-          Fragmented reporting lines

-          Potential overlap/gaps in provision

Review of Workstream 13

First review of this workstream showed:-

-          Lack of clarity

-          Historic grants/funding lines

-          Segments of Services funded from other budgets

-          Diverse reporting and governance

-          Overlap with separate funding areas

Service Review Methodology:-

72 funding streams each reviewed to identify:- 

-          Strategic relevance

-          Areas for merging funding

-          Areas for reallocating funding

-          Services receiving funding from outside BCF

-          Services that required detailed review

Outcomes from the Service Review

-          Directory of Services

-          Simplified structure for BCF

-          Clear measures for metrics

-          Revised governance for BCF services

-          Recommendations for integrating BCF governance

-          Recommendations for future integration and joint commissioning

Key drivers for the new BCF Plan

-          Improving services for people of Rotherham

-          Complementing transformational change underway in Social Care and with secondary and community health providers

-          Integration with Children’s Services

-          Framed by:-

Role and requirements of NHS England and Better Care Fund Team

Ability to impact on metrics and meet performance targets

Discussion ensued on this part of the presentation with the following issues raised and clarified:-

·           The 72 lines of funding was a narrative which stated where the Fund would make a difference to the Services that would be funded but there was no project plan as such for each of them.  They were aggregated up to a project view for each of the workstreams.  It was acknowledged that it was far too complicated but it had served a purpose.  The BCF had had to be put together very quickly in the beginning so a pragmatic approach had been taken of what there was, what met the criteria and transferred into a plan

·           The way that the metrics were measured was not entirely consistent with the preferred reporting that the CCG used  ...  view the full minutes text for item 30.

Minutes of meeting held on 8^th July, 2015

The contents of the minutes of the meeting of the Health and Wellbeing Board held on 8^th July, 2015, were noted.

Councillor Roche, Chair of the Health and Wellbeing Board, informed the Commission:-

-          BCF – The Board was moving forward and positively commended by the Commissioners in their half yearly report to the Secretary of State. 

-          Health and Wellbeing Strategy - Final draft would hopefully be approved at the Board meeting on 30^th September

-          Dame Carol Black had visited Rotherham as part of the National Obesity Service.  Even though Rotherham had a higher percentage of overweight people than the norm, Rotherham was seen as a leader for Obesity

The Chairman reported that a number of questions had been received from Select Commission Members who had not been able to attend the meeting.  They would be e-mailed to Councillor Roche with the responses submitted to the next meeting. 

Arising from Minute No. 5 (Care Act Progress – cap on care costs), it was noted that a number of providers nationally had contacted the Government stating more time was required for planning purposes in regards to the care cap element of the Care Act and this has now been deferred. The cap would have allowed people to have their financial contributions to care managed so that when they reached the care cap (which was set at £72,000) it would then have allowed them access to funding from the local authority.

Local authorities would have been able to start to identify self-funders to enable offers of an assessment to be made and advice/information given.  The introduction of the cap in 2016 would have meant these people potentially coming forward to the local authority, so the deferment means there may be unknown potential clients with self-funded care not getting the necessary information and advice they require.

The deferred payment scheme was a loan to be paid back at some stage against their property and the amount of money they could be loaned previously was very limited.  Rotherham already had a scheme in place but the new scheme now made this available to everybody.

The notes of the first quarterly meeting with health partners, held on 23^rd July, 2015, were noted.

It was noted that the action plan in response to the CQC Children’s Safeguarding inspection had been developed and was now on the website as part of the agenda pack for the 30^th September Health and Wellbeing Board.

RDaSH had invited the Select Commission to submit input into their CQC submission.  The Commission had submitted its CAMHS review report

Janet Spurling, Scrutiny Officer, presented a summary of the outcomes of the CQC Quality Summit for Yorkshire Ambulance Service held on 18^th August, 2015.  It highlighted that, although there were areas of outstanding practice, there were a number of areas for improvement.  The overall rating for the Trust was “requires improvement”.

Following a CQC inspection, a Quality Summit was convened to develop an action plan and recommendations based on the findings of the inspection team.  A range of stakeholders were invited to the Summit to hear the findings and respond/contribute to the action plan

It had been previously been agreed by the regional Joint Health Overview and Scrutiny Committee that Councillor Rhodes, Wakefield Metropolitan District Council, would attend the Quality Summit on behalf of Health Scrutiny as Wakefield Clinical Commissioning Group were the lead commissioner for the Service.  It was proposed that Wakefield Health Overview and Scrutiny Committee would undertake any ongoing monitoring of improvement actions from the CQC inspection report with an invitation to attend such meetings extended to other Health Scrutiny Chairs from the JHOSC.

Resolved:-  (1)  That the Yorkshire Ambulance Service Quality Account sub-group consider the findings of the inspection and resulting action plans when they scrutinise the Quality Account.

(2)  That Wakefield Metropolitan District Council lead on the follow-up work on behalf of the Joint Health Overview and Scrutiny Committee ensuring all JHOSC members are brief and invited to future monitoring meetings.

No issues had been raised.

Thursday, 22^nd October, 2015 at 3.00 p.m.

Resolved:-  (1)  That the planning meeting for the next commission meeting be held on Tuesday, 13^th October, 2015, commencing at 3.00 p.m.

(2)  That, in light of the Better Care Fund and the current review of the 72 funding streams, a special scoping meeting be arranged to give consideration to the review outcomes and issues that the Select Commission may wish to scrutinise in more depth.