Agenda and draft minutes

Councillor Fleming declared a personal interest as he was an employee of the Sheffield Teaching Hospital Foundation Trust.

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

A.  Information Pack

Health and Social Care Integration

The discussion paper was important in context of the Select Commission’s brief.

BCF Q3 Return

The cover report contained key information.  The return template to the NHS England could be found at

 (http://moderngov.rotherham.gov.uk/documents/s104800/BCF%20Appendix%20A%20%20BCF%20Quarterly%20Data%20Collection%20Template%20Q3%2015-16%20FINAL.pdf )

Care Quality Commission Guidance Documents

Any comments to be forwarded to Janet Spurling, Scrutiny Officer.

B.  General Practice

Contracts

Further to Minute No. 41 of the meeting held on 22^nd October, 2015 (Interim GP Strategy), it was noted that the Gateway procurement had concluded.  The Gateway CIC had retained the contract so there would be no changes.

Chantry Bridge patients had been dispersed to other practices.  Only one patient had raised an issue with the Clinical Commissioning Group who had then worked with the patient to get them into a practice they were happy with.  There were still some patients who had not yet registered with another practice but the CCG were confident that this was primarily because they had left the area.

Treeton GP Practice

The Clinical Commissioning Group had met with the developers regarding a new medical centre on the Waverley site.  They were keen to explore options for the community in that area but were mindful that Treeton was at capacity and work should progress as soon as possible.  The developers were meeting regularly with the Planning Service and, subject to planning permission, the CCG were looking to an opening at the end of 2017.

YAS Quality Account Feedback

Members were thanked for submitting their comments with a reminder to those who had not done so yet of the 18^th March deadline.

Rotherham Clinical Commissioning Plan

The deadline for comments was Friday, 18^th March.

Adult and Older People Mental Health Transformation

It was hoped that an update would be submitted to the April Select Commission meeting.

Joint Health and Overview Scrutiny Committee Meeting held on 26^th February, 2016

The powerpoints were available from the meeting which provided good background information for the national picture.  The information contained therein included:-

-          NHS England Specialised Commissioning and National Service Reviews

-          Regional Strategic Overview including delivering the Five Year Forward View and Sustainability and Transformation Plans

-          Care Quality Commission – their approach to inspection and regulation and how they work with Overview and Scrutiny Committees

-          Further work around delayed transfers of care (DTOC) could be included in the work programme for the Joint Committee

Resolved:- That, subject to the following clerical corrections, the minutes of the previous meeting of the Health Select Commission held on 21^st January, 2016, be agreed as a correct record:-

Minute No. 72 (Overview of Public Health/Spend the Public Health Grant in Rotherham)

Health Challenges in Rotherham – should read “Rotherham women 81.4 years”

and Value of the Ringfenced Grant – should read “2014/15 - £14.175M”.

Arising from Minute No. 72 (Overview of Public Health/Spend the Public Health Grant in Rotherham), attention was drawn to the fact that the figures did not add up to 100%.

Tracey McErlain-Burns, Chief Nurse to present

Tracey McErlain-Burns, Chief Nurse, gave the following powerpoint presentation:-

Quality Ambitions 2014-16

-          SAFE Mortality – Reduction in HSMR (Hospital Standardised Mortality Ratio) year on year

-          SAFE Achieve 96% Harm Free Care (HFC) with zero avoidable grade 2-4 pressure ulcers and zero avoidable falls with harm

-          CARING & RELIABLE Achieve improvements in all Friends and Family responses

-          RELIABLE Achieve all national waiting times targets i.e. 18 weeks, cancer and A&E

Quality Improvements 2015/16

-          100% of unpredicted deaths will be subject to review

-          From a baseline of 120 we will reduce the number of patients with a LOS>14/7 (length of stay greater than 14 days)

-          Improved reporting of the deteriorating patients

-          Reduce noise at night

-          Increase the number of colleagues trained in Dementia care and reduce complaints

-          Improve complaints response times

-          Meet stroke targets

So how have we done?

Mortality

-          Rolling 12 months HSMR

December 2014 = 99.28

November 2015 = 108.06

(March 2015 – 112.48)

-          SHMI (Standardised Hospital Mortality Index) July 2014 to June 2015

111.64

Harm Free Care

-          Achieve minimum 96% Harm Free Care with the following percentage reduction on the 2014/15 baseline (No.  Trending at 94.85%; a 0.5% improvement on the previous year):-

-          70% reduction in avoidable pressure ulcers grade 2-4 (yes – 74% achieved)

-          50% reduction in avoidable falls with significant harm (yes – 57% achieved)

Family and Friends Test (FFT)

-          Achieve and maintain a minimum 95% positive (FFT) score – in-patients (yes – 97% achieved)

-          Achieve and maintain a minimum 86% positive FFT score – A&E (yes 88% achieved)

-          Achieve a 40% FFT response rate – in-patient areas (yes 41% achieved)

4 Hour Access – National Comparison

Other Improvement Priorities

-          100% of unpredicted death reviews – yes

-          Reporting of the deteriorating patient – yes

-          Noise at night - ?

-          Dementia training – yes (61% of TRFT colleagues have had first level dementia training)

-          Complaints performance – no

-          Stroke targets – yes (improved proportion with AF anti-coagulated on discharge; proportion admitted directly to Stroke Unit and spending 90% of their time on the Stroke Unit; proportion scanned within an hour.  Business case for allied health professional ESD team supported)

Other items to be covered in the Quality Account/Report

-          Staff and patient survey results

-          Listening into Action work

-          Environmental improvements

-          Community transformation

-          Progression from the CQC action plan to a Quality Improvement Plan

-          Serious incidents and Never Events

-  ...  view the full minutes text for item 82.

Jon Tomlinson, Assistant Director Commissioning (Adults), to present

Jon Tomlinson, Interim Assistant Director Commissioning, gave the following update on the Better Care Fund:-

Background

-          The Select Committee has previously received updates about progress with the Better Care Fund (BCF)

-          Rotherham has successfully established robust governance and submitted returns to NHS England in a timely manner

-          The BCF remains a key vehicle for integration between the NHS and local authorities

-          The original BCF plan was developed around 2 years ago

-          NHS England recommend that partners review their plans to ensure that progress is maintained and that funds are effectively targeting the right areas

-          An initial review has been carried out on our plan and the outcomes are as follows

BCF Review

-          The original BCF plan had 72 lines of funding and 15 themes

-          The revised plan has 33 lines of funding with 6 broad themes

-          The 6 themes cover:-

Mental Health

Rehab/Re-ablement and Intermediate Care

Social Care Purchasing

Case Management and Integrated Care Planning

Supporting Carers

BCF Infrastructure

-          Each theme has then been rag rated in relation to strategic relevance, service specification in place, performance framework in place and are there any performance issues

-          There are then recommendations about each service within the theme

-          The schedule of reviews have been programmed and will take place between now and October dependent on priority

-          These reviews cover 18 BCF schemes and where there are funding or performance issues or where there are concerns regarding strategic relevance

Other BCF Development

-          A joint visioning event has taken place between the NHS and RMBC to further strengthen work around integration

-          Our latest submission confirmed that national targets are being met

-          We continue to perform well against a number of the metrics

-          The BCF has increased by £1.3M from £23.2M to £24.5M

-          Additional funding will be invested in Community Services

-          New integration measures were introduced for the Q3 submission

-          Further planning guidance has been received during February and March and officers are responding to it

-          A BCF Service Directory is almost finalised

Discussion ensued with the following issues raised/clarified:-

·           Currently in the Assurance period for the 2016/17 plan.  Guidance had been received regarding what was required to meet assurance in terms of the plan and it was currently being written.  The second stage of the Assurance process would be updated shortly with the final plan being submitted to the Health and Wellbeing Board for sign off on 20^th April and NHS England on 25^th April

·           In order to achieve Assurance, it had to been ensured that the Plan was responding to the Key Lines of Enquiry.  It was a fairly extensive process at the moment and was being reviewed through the BCF Executive by senior managers of both RCCG and RMBC to ensure the budget submitted in April responded effectively which would gain Assurance.  The plan would be assessed and there would be a decision taken as to whether or not it  ...  view the full minutes text for item 83.

Karen Cvijetic, Head of Quality and Patient Engagement, to present

Karen Cvijetic, Head of Quality and Patient Engagement, gave the following powerpoint presentation:-

Quality Report

-          Nationally mandated

-          2015/16 was the eighth quality report

Care Quality Commission (CQC) Ratings (September 2015)

-          Overall rating – requires improvement

-          Safe – requires improvement

-          Effective – requires improvement

-          Caring – good

-          Responsive – good

-          Well-led – good

What the CQC said we do well

-          Learning Disability Services

Solar Centre – commended by patients and carers

88 Travis Gardens – outstanding for caring

-          Adult Mental Health Services

Mental Health Crisis Teams – rated overall by CQC as Outstanding

Mulberry House – introduction of the ‘Perfect Week’

Doncaster Perinatal Service

Rotherham dedicated service for deaf patients with mental health problems

-          Children and Young Peoples’ Mental Health Services

Safeguarding Advisor in post and training at a high level across all services

Out of hours duty system provides excellent coverage of emergency/crisis calls

Peer Support Workers assist with transition to Adult Mental Health Services

-          Drug and Alcohol Services

Peer Mentor Scheme developed including training packages to provide service users with the skills and knowledge to become Peer Mentors

Peer Mentors from New Beginnings worked across the services in Doncaster and three had progressed into paid employment

-          Older People’s Mental Health Services

Community-based services for Older People rated as Outstanding for Caring

Young Onset Dementia Day Care offering carer respite and patient engagement

Male Carers Support Group for patients with Huntingdon’s Disease

Cognitive Stimulation Programme – support patients with cognitive functioning

Kings Fund advice and guidance to make Wards Dementia Friendly

Our Approach and Response

-          September, 2015 – immediate actions were taken and action plan drafted following initial feedback from CQC

-          November, 2015 – Trust Quality Improvement Plan developed following receipt of draft CQC reports

-          December, 2015 – Executive Director leads identified for all quality improvement actions

-          February, 2016 – Trust Quality Improvement Plan shared at Quality Summit

-          March, 2016 – action plan submitted to CQC

Governance Arrangements

-          Published CQC reports to the Board of Directors’ meeting on 28^th January, 2016

-          Monthly action plan updates to Board of Directors

-          Monitoring and oversight by Executive Management Team (EMT)

-          Divisional action plans monitored through Trust Board of Directors’ Sub-committees

-          Divisional-level action plans to address local issues and share learning

Patient Safety

Janet Spurling, Scrutiny Officer, advised that consideration was required as to the 2016/17 scrutiny work programme and priorities. Cabinet, SLT and Commissioners would all have a view as well as Scrutiny Members.

The Select Commission had had a clear brief for the 2015/16 Municipal Year to scrutinise Health and Social Care Integration and work towards ensuring sustainable high quality Health and Social Care Services.

A lot had been achieved through the Better Care Fund and the Members’ Working Group for Adult Health Transformation but there was still a lot of further work to take place.

Members should consider whether they wished this to continue to be a priority for the forthcoming year as the wider changes began to take place.

In 2015/16 the Select Commission had also:-

-          Taken a more detailed approach with sub-groups on the Quality Accounts

-          Been part of the consultation on the Clinical Commissioning Group’s plan as well as the refresh of the Health and Wellbeing Strategy and Members might wish to ensure the action plans for the Strategy were being implemented next year

-          Scrutinised progress on the Interim GP strategy

Mental Health had clearly been identified as a priority in the past for the Commission and ongoing transformation both for adults and older people; CAMHS could be included next year.

Sub-regional scrutiny of the NHS Commissioners Working Together initiative was also being developed

An e-mail would be sent to all the Select Commission Members with suggestions for the 2016/17 work programme and requesting further ideas.

Resolved:-  That Health Select Commission Members give further consideration to the 2016/17 work programme and pass any suggestions to the Chair and Scrutiny Officer by 31^st March, 2016. 

Councillor Ahmed reported that the Select Commission had not met since the 3^rd February.

One of the areas the Commission would be focussing upon in the 2016/17 Municipal Year would be the scrutiny of CSE Services.  Following the meeting in April she would give a detailed update.

No issues had been raised.

Thursday,      14^th April                                9.30 a.m.

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 14^th April, 2016, commencing at 9.30 a.m.