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.

(1)  Information requested from Foundation Trust at quarterly briefing

·         A&E 4 hour target performance

o  This remained a chalIenge nationally but in August the trust had exceeded the 95% target. Over the last year, bar one month, performance had exceeded the national average.

·         Where the Hospital was in terms of staff shortages for emergency consultants.

o  There were currently 5.7 WTE in post and still some use of agency staffing. This position was set to improve by December and there will be further work around rotas and staffing from January 2017.

·         If meeting targets for agency staff use/spend

o  For the five month period to August the trust had spent £393,000 less than the planned spend on agency staff.

(2) Information Pack

The pack contained:-

·         Outstanding issues with regard to the Director of Public Health’s annual report

·         Sustainability and Transformation Plan presentation

·         Quarterly briefing notes from meeting with Health partners

·         Locality Working presentation

The presentation on the STP had been included to set the context for the agenda item in December.  The integrated locality pilot, discussed at the last meeting, was also in the work programme.

(3) An all-day training session concerning prevention to be held on 24 January with HSC Members encouraged to attend.

(4)  Scrutinising Performance Information with Confidence

Working session for the Select Commission, facilitated by Dianne Thomas (Centre for Public Scrutiny) to be held on Tuesday 22 November 2016 from

1.00pm – 3.00pm. This linked with the Commission looking at Adult Social Care performance on 1December when the Yorkshire and Humber benchmarking data 2015/16 would be scrutinised.

The minutes of the previous meeting of the Health Select Commission held on 22^nd September, 2016, were noted.

Arising from Minute No. 32 (Commissioners Working Together Programme) it was noted that the third paragraph should read “options appraisals ….” and not “operations appraisals”.

Arising from Minute No. 30 (previous meeting), the additional information provided after the meeting was noted regarding performance clinics

Arising from Minute No. 31 (Rotherham’s Integrated Health and Social Care Place Plan), it was noted that Councillor Short, Vice-Chair, would be joining the visit to the new Urgent and Emergency Care Centre on 11^th November, 2016.  The visit was now fully booked.  New dates would be supplied for further visits in the New Year.

Members could keep up-to-date on developments through the dedicated website http://www.rotherhamemergencycentre.nhs.uk/.  This included a short video giving a virtual tour of the Centre and the Trust were developing some characters and patient stories to add.

It was also noted that issues raised on the Rotherham Place Plan had been fed back to Nathan Atkinson, Assistant Director Strategic Commissioning, and colleagues at the Rotherham Clinical Commissioning Group.

Arising from Minute No. 34 (Health and Wellbeing Board), the additional information provided after the meeting was noted regarding digital roadmap.

Resolved:- That the minutes of the previous meeting held on 22^nd September, 2016, be approved subject to the above clerical corrections.

Paul Theaker to present

In accordance with Minute No. 96 of the meeting held on 14^th April, 2016, Paul Theaker, Operational Commissioner, Children and Young People’s Service, reported on the current progress of the Scrutiny Review’s 12 recommendations.

The RDASH CAMHS Service reconfiguration had been completed at the end of June, 2016 with a new single point of access and locality workers in place.  There had been positive feedback from partners on the changes made.   However, a small number of posts were not recruited to until after that date due to a difficulty in recruiting appropriate staff to those posts.  This had had an impact on the delivery of a number of the actions within the response to the Scrutiny review (detailed within Appendix 1 of the report submitted)

Consideration was given to the Appendix which contained the progress to the recommendations as at October, 2016.  Discussion ensued with the following issues raised/highlighted:-

-          The draft refreshed needs analysis would be going the following week to the partnership group.

-          The performance framework would be for the full mental health system, so not only RDaSH but also other services including counselling in schools and Early Help counselling, formerly Youthstart. It was also being adapted and refined to meet national reporting requirements and would be tested fully in the new year.

-          It was recognised that some of the timescales had been ambitious given the scale of the reconfiguration, consultation and recruitment but partners had really gone back to unpick the information and fully understand what services were doing.

-          As some of the data was out of date, what impact did that have further down the line for partner agencies? – In terms of RDaSH CAMHS there was detailed information about young people who are in treatment. So there was good high level information but a need to unpick and get consistency in what was provided from partners.

-          RDaSH provided more detail regarding training and awareness raising activities – revamped and more informal letters, meetings with schools to consider how they could work together better, refreshing the “top tips” documents, information packs distributed to all secondary and primary schools, working with South Yorkshire Eating Disorder Association, asking what training people want rather than assuming what they want.

-          Had the CAMHS workforce development strategy been written? – Although a draft had been produced to the timescale it was still a draft.  The plan  had considered training needs at each level across the wider workforce e.g. from a playground supervisor needing basic awareness through to a mental health practitioner, looking at where services’ plans sit in the framework and then directing people to the training packages.

Schools mental health pilot

-          Monitoring reports from the visits to the schools in the mental health pilot could be shared with Members.

-          There seemed to be a low number of secondaries engaged in the pilot, so how were academies encouraged to have a certain level of staff training when there was no requirement  ...  view the full minutes text for item 43.

Nigel Parkes to present (briefing paper to follow)

Nigel Parkes, Rotherham Clinical Commissioning Group, presented a briefing note on the independent review of the nature and extent of children and young people’s voice and influence in Rotherham CAMHS.

The independent review had been commissioned by the Rotherham Clinical Commissioning Group, using non-recurrent funding for CAMHS transformation, with the aim of:-

·         Strengthening children and young people’s voice and influence

·         Increase the responsiveness of services

·         Improve mental health outcomes

The first stage of the review had scoped what children and young people had said about their experiences of Mental Health Services, of being listened to and about their participation priorities.  The second stage had drawn on the findings to frame guided conversations with 4 focus groups and some individual interviews with children and young people all of whom had personal experience of Mental Health Services.  Members of the Parents and Carers Forum had participated jointly with the children and young people in 1 focus group.

The review had considered 9 participation priorities covering experience, personal care and public involvement:-

·         Feeling good – personal experience of being listened to and involved in decisions about own care

1.  Assessment

2.  Routine outcome monitoring

3.  Complaints procedure and advocacy

·         Doing the job right – being able to take part in helping develop the Service (contributing to management)

4.  Staff training

5.  Supervision and appraisal

6.  Recruitment and selection

·         Running the Service well - having a voice and influence with the leadership of the organisation

7.  Involvement in commissioning

8.  Influencing senior managers

9.  Mission statement

Both positives and concerns had been raised in the focus groups with most participants not having been involved in helping to develop the Service or influence the leadership of the organisation.

The review had made 1 overall recommendation: to embed the use of the mapping and planning tool of participation priorities in order to integrated participation more systematically as part of wider organisational and cultural change.

RDaSH had been tasked by the CCG with taking the recommendations forward by undertaking a baseline study to assess the work they did with different groups, such as the Youth Cabinet and the Young Ambassadors.

This linked with the review of the Public and Patient Engagement Strategy by RDaSH.

The report author had visited RDaSH to talk with staff about the findings in the report and also about the tacit information from young people, with discussion focused on what could be done. RDaSH had found the report very insightful and the fact that it was independent gave it extra weight.  It generated a lot of reflection on what it was like for people using RDaSH services.

Actions being taken forward included:

·         Monthly training in place that included record keeping and safeguarding but also used “in their shoes type training” i.e. What is it like for a family coming into our services? What is our welcome like?

·         Youth tube

·         Work at Rotherham Show

·         Improved supervision and percentage of staff having had an appraisal now nearly 90%

·         Recruitment and selection

The following  ...  view the full minutes text for item 44.

Janet Spurling, Scrutiny Officer, presented a report containing the response from partner agencies to the 11 recommendations arising from the spotlight review undertaken by the Youth Cabinet regarding Child and Adolescent Mental Health Services in Rotherham.  The Youth Cabinet were also keen to scrutinise wider working and links between partner agencies especially through the School Nursing Service.

The review was carried out under the Children’s Commissioner’s Takeover Challenge initiative with the young people taking over a meeting of the Overview and Scrutiny Management Board. 

The 11 recommendations were set out in full in Appendix 1 of the report submitted together with the detailed responses from partner agencies.  The recommendations covered the following areas:-

·         Involvement of young people – to inform practice and service development

·         Reporting progress – on implementation of the new models/services

·         Improving information – promoting and maintaining websites and addressing stigma

·         Closer multi-agency working – in localities and with schools

·         School Nursing Service – higher profile and accessibility

·         Enabling informed choices by young people – regarding their treatment

Consideration was given to the Appendix which contained the initial responses to the recommendations.  Discussion ensued with the following issues raised/highlighted:-

A detailed plan was needed with dates and times plus clarity over reporting routes from partners back to RYC and then to HSC if necessary. When would agencies be reporting back to RYC on the actions or with an explanation if there has been no action? – Some will take time, some are easy or already done such as the waiting area – music channels or tv and putting iPads in on stands.  RDaSH will liaise with RYC and their input would be welcomed into action plan.  This also linked with recommendation 5 for an annual update to RYC which could be more frequent if required.

Opening hours for the Single Point of Access (SPA)? – RDaSH want to move to an 8am to 8pm service so that it does not affect young people’s school time and so they can be seen after school.  As much as the trust wants to provide services in schools that is not always acceptable to all young people, so appointments will not always be in schools and it is important to talk to young people about where they want to be seen.  10-12 noon on Wednesdays seemed to be a popular slot for some reason.  Families did say they wanted to be seen on weekends and between 4-6pm. Views on preferred locations for appointments differed but in general Rotherham town centre was seen as better than Kimberworth Place or people wanted an appointment in a locality base, but not always in a school. Again some were happy to be seen in the home and others not. The consultation report could be shared with HSC.  Details around staffing were still to be worked out if parents want 8am appointments as usually mornings are more for people who have been admitted to hospital the previous night.

Out of hours will be through working with  ...  view the full minutes text for item 45.

Councillor Cusworth gave the following update where the workstreams of Improving Lives linked to health:

Domestic Abuse sub-group was looking at support available in Rotherham:

·         In the past referrals had not really been forthcoming from GPs and dentists and it was hoped this situation had improved since the last data was reported from 2013.

·         Health visitors and GPs were required to provide support within 24 hours for children who witness high risk domestic violence.

Post abuse services for CSE – this involves health partners, including as commissioners

National transfer of unaccompanied asylum-seeking children:

·         health assessments for the children might need interpretation services

·         there was a regional approach across Yorkshire and Humber to health care as very specialised

Councillor Cusworth was thanked for her report.

It was noted that the next meeting of the Improving Lives Select Commission was to be held on 2 November, 2016 and all HSC members were invited to attend by Councillor Clark.

Janet Spurling, Scrutiny Officer, reported the following:-

-          Consultation had now commenced on the proposed changes to the Hyper Acute Stroke Care and non-specialised Children’s Surgery and Anaesthesia

-          The final consultation documents had reflected some but not all of the feedback from the Joint Committee and Health Select Commission

-          A Frequently Asked Questions document had been produced which answered some of the concerns and questions raised

-          The Rotherham Foundation Trust needed to do things differently to be sustainable and had realised a few years ago the need for collaboration even as a standalone Trust.

·           Proposed model for Stroke Care reflected that for Coronary Care which was a recognised as a good model.  Manchester and London also had a centralised model of Hyper Acute Care

·           No Rotherham patients would go to Chesterfield for Hyper Acute Stroke Care

·           Children and young people would go to the nearest hospital to where they lived

·           Discussions with staff would take place if changes took place and, due to shortages of skilled staff, the NHS would be looking to match expertise across the region to provide the services

·           Planning and managing bed capacity for the extra numbers of patients in the proposed 3 hospitals were currently being discussed

The next meeting of the JHOSC was to be held on 21^st November when there would be an update on how the consultation was progressing and the business cases for change.  The Yorkshire Ambulance Service were to be invited to discuss the issues raised with them. 

The Chairman would feed back at the next Health Select Commission.

Resolved:-  That the report be noted.

It was reported that no issues had been raised.

The Chair requested that in future any issues or concerns from Healthwatch be raised prior to the meeting.

Thursday, 1^st December, 2016, at 9.30 a.m.

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 1st December, 2016, commencing at 9.30 a.m.