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Agenda and minutes

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

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

Items
No. Item

50.

Declarations of Interest

Minutes:

Robert Parkin, Co-opted Member made a Personal Declaration of Interest at the meeting (involved in the Learning Disability Offer consultation) – Minute Nos. 58 and 59.

51.

Questions from members of the public and the press

Minutes:

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

52.

Communications

Minutes:

(1) Information Pack

The pack contained:-

 

-          Rotherham Clinical Commissioning Group Clinical Thresholds paper (raised with Members in draft Clinical Commissioning Group Commissioning Plan)

-          Latest version of the Rotherham Place Plan which had taken account of the Select Commission’s feedback

-          Notes from the Learning Disability Offer Sub-Group

-          September Health and Wellbeing Board minutes

 

(2)  Update from visit to the new Emergency Centre

The Vice-Chairman reported that he had visited the new Emergency Centre on 11th November.  The size and scope of the new unit was very impressive and would be a wonderful asset for the town once open.  He had been assured that the facility would open on time and be on budget.

 

(3)  RDaSH had confirmed dates for actions from the CCTOC response:-

 

-          Consultation was taking place with young people on the website and a functioning website for young people would be in place in February, 2017

-          The first meeting of the new collaborative network would be arranged for March 2017 and then quarterly

53.

Minutes of the Previous Meeting held on 27th October, 2016

To follow

Minutes:

The minutes of the previous meeting of the Health Select Commission held on 27th October, 2016, would be considered at the January meeting.

54.

South Yorkshire and Bassetlaw Sustainability and Transformation Plan pdf icon PDF 47 KB

Chief Executives of Rotherham Clinical Commissioning Group, RDaSH, Rotherham Council and the Rotherham Foundation Trust to present

Additional documents:

Minutes:

Chris Edwards (Chief Officer, Rotherham Clinical Commissioning Group), Louise Barnett (Chief Executive, The Rotherham Foundation Trust) and Sharon Kemp (Chief Executive) gave the following powerpoint presentation:-

 

Our Ambition:-

“We want everyone in South Yorkshire and Bassetlaw to have a great start in life, supporting them to stay healthy and live longer”

 

Why we need to change

-          People are living longer – and their needs are changing

-          New treatments are emerging

-          Quality, experience and outcomes are variable

-          Health and care services are not joined up

-          Preventable illness is widespread

-          Shortage of clinical staff in some areas

-          We have inequalities, unhealthy lifestyles and high levels of deprivation in South Yorkshire and Bassetlaw

-          There are significant financial pressures on health and care services with an estimated gap of £571M in the next 4 years

 

Health in its wider context

-          Being healthy is about more than just health services

-          80% of health problems could be prevented

-          60% are caused by other factors:

Socio-economic status

Employment

Housing

‘non-decent’ homes

Access to green space

Social relationships/communities

-          Public service reform

Personalised support to get people into work

Support young people facing issues

Develop wraparound services

Structure ourselves better

Make money work better to achieve outcomes

 

Reforming our services

-          We have a history of strong partnership working

-          We want to work together in new ways

-          Key to our success will be:

Developing accountable models of care

Building on the work of the Working Together Partnership Acute Care Vanguard

Joint CCG Committee

Local Authorities working together

 

Developing and Delivering the Plan

-          £3.9Bn total Health and Social Care budget

-          1.5M population

-          72,000 staff across Health and Social Care

-          37,000 non-medical staff

-          3,200 medical staff

-          835 GPs/208 practices

-          6 Acute Hospital and Community Trusts

-          5 Local Authorities

-          5 Clinical Commissioning Groups

-          4 Care/Mental Health Trusts

 

Developing the Plan

-          Built from 5 ‘place’ based plans – Barnsley, Bassetlaw, Doncaster, Rotherham and Sheffield

-          8 workstream plans (now our priorities)

-          Chief Executive and Chief Officer led

 

Our Priorities

-     Healthy lives, living well and prevention

-     Primary and Community Care

-     Mental Health and Learning Disabilities

-     Urgent and Emergency Care

-     Elective and Diagnostic Services

-     Children’s and Maternity Services

-     Cancer

-     Spreading best practice and collaborating on support office functions

 

Shadow Governance – Strategic Oversight Group

-          Collaborative Partnership Board – membership includes

5 Clinical Commissioning Groups

5 Local Authorities

5 Foundation Trusts

4 Mental Health Trusts

NHS England

Voluntary Sector

Healthwatch

-          Executive Partnership Board

-          Joint Committee CCGs

-          Provider Trust Federation

-          STP Delivery Unit

 

Reshaping and rethinking Health and Care

Our focus will be

-          Putting prevention at the heart of what we do

-          Reshaping and rethinking primary and community-based care

-          Standardising hospital care

 

Putting prevention at the heart

-          Drive a step change in employment and employability

-          Help people to manage their health in their  ...  view the full minutes text for item 54.

55.

Adult Social Care Performance - Yorkshire and Humber Year End Benchmarking pdf icon PDF 146 KB

Nathan Atkinson, Assistant Director Strategic Commissioning, and Scott Clayton, Performance and Quality Team Manager

Minutes:

In accordance with Minute No. 6 of 16th June, 2016, Nathan Atkinson, Assistant Director Strategic Commissioning, and Scott Clayton, Performance and Quality Team Manager, presented the final published year end performance report for 2015/16.

 

The Council had seen continued improvements across the range of 22 national Adult Social Care Outcomes Framework (ASCOF) measures reported in 2015/16.  19 out of 22 comparable measures were recording an improvement since 2014/15.

 

The direction of travel was beginning to evidence that implementation of new Service delivery models led to better outcomes for people and increasing satisfaction levels sustained over the year:-

 

13 measures had improved their Yorkshire and Humber and national rankings

4 measures had retained their Yorkshire and Humber rankings

4 measures Yorkshire and Humber rankings declined and 8 measures national rankings declined

1 measure was not able to be ranked in 2014/15 so no comparison was applicable.

 

However, it should be recognised that some of the areas of improvement when compared to the now published national data, showed that the Council had either not always in the transitional year kept pace with other councils’ performance or the improvement had been from a low baseline.  Possible reasons identified that may have contributed to the negative shifts seen in some rankings were detailed in the report submitted.

 

 

Current 2016/17 performance update on the 8 declined national ranking measures were shown in Appendix 1 but in the main had improved since year end or an additional comment had been added.

 

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

 

-          The information for customers needed to be presented in a way that all understood – This was the challenge and had to ensure that the advice offer was good, met the needs and able to answer what the customer was enquiring about so they could find the services that met their needs.  That would not always be by the Council.

 

-          Did the Service consult with other authorities that were performing better than Rotherham to see what they were doing differently?  There was already a range of networks where officers met and could tie in with other colleagues to check out what they were doing differently to ascertain if it was a genuine difference and what steps they had taken. 

 

-          How did the Mental Health performance impact on the overall score?  In terms of No. 3 (Proportion of adults receiving long term community support who receive services via Self-Directed Support), through the Care Act everybody could approach the Council to be assessed and see how their needs could be best met.  That experience was across the board.   What was found that, if look at activity across the Directorate, excluding Mental Health, almost 98% of Service users were able to have their needs met through a Self-Directed Support.  Similarly, what was found on the Mental Health parts of the Service was that, because of some of the challenges, that some people with Mental Health issues have may chosen not to take that particular  ...  view the full minutes text for item 55.

56.

Adult Social Care Performance - Local Measures pdf icon PDF 84 KB

Nathan Atkinson, Assistant Director Strategic Commissioning, and Scott Clayton, Performance and Quality Team Manager

Additional documents:

Minutes:

Further to Minute No. 20 of 28th July, 2016, Nathan Atkinson, Assistant Director Strategic Commissioning, presented the Q2 Local Measures performance together with the 4 existing Corporate Plan measures.

 

The report set out the current performance challenges as at 30th September, 2016, which included:-

 

LM01 – Reviews

LM02 – Support plans % issued

LM03 – Waiting times assessments

LM04 – Waiting times care packages

LM05-07 – commissioning KLOE’s

LM08 (CP2.B3) – Number of people provided with information and advice first point of contact (to prevent service need)

LM09 (CP2.B5) – Number of carers assessments (only adult carers and not including young carers)

LM10 (CP2.B7) – Number of admissions to residential rehabilitation beds (intermediate care)

LM11 (CPS.B9c) - % spend on residential and community placements new measure 2016/17

 

Discussion ensued with the following issues raised/highlighted:-

 

-          How would the model currently being put together link into budget pressures and budget savings?  If the performance improved what kind of budget savings would that give against requiring the same amount of investment?  If so, would you be able to re-direct that investment across Adult Social Care or would it have to be shared across all the portfolios? In terms of re-investment, a purpose of the consultation was to look at where finances needed to be realigned.  Investment would need to be moved around but there was not much slack in the system.  The savings were challenging but were deliverable, therefore, it had to be ensured that the intelligence and knowledge arising from the Performance Team and Liquid Logic were used to ensure that any issues were addressed quickly.

 

-          If performance was falling where would that sit against the budget pressures within the model and into 2017/18 and beyond?  The key for performance was improved assessments/re-assessments.  In order to make any change in Social Care it was reliant upon re-assessment and the review process formed part of that.  The Service needed to ensure there were good quality assessments that were strength based, considered all the options, and not just statutory services, and ensure that they had longevity and were of good quality.  In the past there had been a tendency to look at numbers rather than quality. 

 

Care Act assessments were a much longer process than previously, if done properly, looking at the person centred approach with long conversations with the individual about what they required, what the person could do rather than what they could not do as well as a built-in time period for reflection.  There was a need, from a workforce point of view, for considerable development in embracing and embedding the principles.  Online Care Act training had been purchased as well as further workforce development initiatives.

 

There also had to be good solutions and services for people.  Some of the work being doing around the strategies was developmental but the challenge was that in some areas there was not a great amount of choice.  There were things out there that may be a more community focussed than perhaps  ...  view the full minutes text for item 56.

57.

Development of a Rotherham All Age Autism Strategy pdf icon PDF 66 KB

Nathan Atkinson, Assistant Director Strategic Commissioning

Minutes:

Nathan Atkinson, Assistant Strategic Director Commissioning, reported that Commissioner Sir Derek Myers on 10th October, 2016, had approved a proposal to implement a strategic approach to the commissioning and delivery of services for people with Autism within Rotherham.  The approach sought to develop a set of strategic commissioning intentions that promoted independent, choice and control for people with Autism.

 

The Strategy would strengthen Rotherham’s statutory commitments and the approach positively added to the direction of the Adult Care Development Programme and the Children and Young People’s Special Educational Needs and Disabilities (SEND) agenda.

 

Since the proposal was approved:-

 

-          Initial consultation event held to launch activity attended by a range of stakeholders from public services, the voluntary sector, users and carers.  The timeline for further consultation was currently being devised

-          The event had focussed on mapping current provision across all sectors and identified gaps in some Services areas including training for staff working in Social Care, lack of specialist accommodation and access to information regarding local support

-          Presentation to Learning Disability Partnership Board where the approach was strongly supported

-          Completion of the Public Health England Autism Self-Assessment Framework which enabled the Council to benchmark progression towards meeting the quality standard goals outlined in the Government’s 2014 Adult “Think Autism” Strategy

-          Grant awarded to SpeakUp for Autism to assist with strategy development and co-production using users by experience

-          Submission of funding bid to the Housing and Care Technology Fund to support the development of specialist housing and assistive technology for people with Learning Disabilities and Autism in Rotherham

 

The consultation plan was currently being devised with full consultation commencing in January 2017.

 

Resolved:-  That the report be noted with an update to come in the future.

58.

Learning Disability - Shaping the Future Update pdf icon PDF 56 KB

Nathan Atkinson, Assistant Director Strategic Commissioning

Minutes:

Nathan Atkinson, Assistant Director Strategic Commission, referred to the report, ‘Learning Disability Commissioning – Shaping the Future’, approved by Commissioner Sir Derek Myers on 10th October, 2016, to implement a strategic approach to the commissioning and delivery of services for people with Learning Disabilities within Rotherham through a market position statement.  The approach sought to adopt a set of strategic commissioning intentions that strengthened independence, choice and control and supported the wider Audit Care Development programme.

 

Since approval of the report, the market position statement had been updated with the final version to be published on the Council’s website in December.  Speak Up had been awarded a £50,000 grant and had commenced a programme of work which would support the overall direction of travel for Learning Disability Services.

 

Two meetings had now been held with Sheffield City Council to progress activity on a Supported Living Framework which would lead to a formal work programme to facilitate the required tender activity and provider selection process during 2017.  A draft specification would be available for consultation in January with feedback from the Commission invited.

 

A bid had been submitted to the Housing and Care Technology Fund administered by the Department of Health on 28th October.  The bid was to support the development of specialist housing and assistive technology for people with Learning Disabilities and Autism in Rotherham. 

 

The tender for John Street and Oak Close had been published on YOURtender.  It was envisaged that the Service provision would be awarded to a new provider in February, 2017, with a view to the transition taking place in March and handover on 1st April.  Customers, carers and families would be actively involved in the provider selection process.

 

Sally from SpeakUp gave a verbal update on the Learning Disability offer consultation and the work they had undertaken:-

 

-          Work had taken place with the Council as well as with people with Learning Disabilities and family carers with regard to how the consultation would work for people

-          Development of a range and variety of methods in which people with Learning Disabilities, family carers, members of the public and staff across the Clinical Commissioning Group, RDaSH and the Council could have their say

-          4 different questionnaires that would be available through the Council’s website along with an easy read version for people with Learning Disabilities and Autism

-          Range of sessions that people could attend -  1:1 and drop-in sessions and focus groups for members of the public and family carers to have their say on the Learning Disability offer

-          Made sure that carers have had their say in terms of thinking about some the questions that would be going into the consultation and making sure that people with Learning Disabilities across the Borough had the options to have their say

-          Look to working with REMA and BME communities because conscious that very few BME communities access Learning Disabilities Services  in Rotherham as well as organisations such as KeyRing and  ...  view the full minutes text for item 58.

59.

Learning Disability - The Transforming Care Partnership pdf icon PDF 25 KB

Kate Tufnell, Rotherham Clinical Commissioning Group, to present

Additional documents:

Minutes:

Kate Tuffnell, Rotherham Clinical Commissioning group, presented a report on the South Yorkshire and North Lincolnshire Transforming Care Partnership (TCP) which comprised Rotherham, Doncaster, Sheffield and North Lincolnshire Clinical Commissioning Groups.  The Partnership would transform care for people with a learning disability and Autism by working collaboratively to deliver the key principles from the national Building The Right Support Framework.

 

The TCP had been set the challenge to remove the need for permanent hospital care for people with a Learning Disability, people with complex and challenging care needs and/or Autism by March 2019.  The plan set out how the Partnership aimed to achieve reducing the need for hospital beds whilst moving to a more proactive community-based care model which was in line with Building The Right Support core values and principles.

 

In 3 years the TCP would have:-

 

-          Lowered the number of inpatient hospital beds for people with Learning Disabilities and Autism to between 10-15 beds

-          Re-invested in new models of care such as expanded care teams, greater use of personal health budgets and a more coherent response to offender and forensic health

-          Developed a coherent engagement strategy to ensure that Service users -and their families were genuine co-producers of models of care

-          Development of the workforce, not just for statutory services, but also supporting the independent and private sector to access training across the system

 

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

 

·           When someone who had been in hospital for a lot of years and was going to live in the community, it was essential that local Ward Councillors were notified to help ease other residents’ concerns, prevent rumours getting out of hand and engaging the community in a positive manner - This was happening nationally.  A challenge for Rotherham was that a lot of the homes that supported people with a Learning Disability did not always notify agencies.  The CCG was working with providers across the Rotherham footprint and talking to them about their plans and how they worked locally.  There had been instances where people had been placed locally, not known to the Services, and that was where things went wrong. It was also noted that in a number of the homes there were no Rotherham people in them. 

 

·           The public were concerned about the changes that were taking place for example support following the death of a family carer– It was really important that people fed into the consultation (Minute No. 58) and put their views forward because it would influence how the Council would take it forward.  The work through the Transformation affected a very small number of people.  Work was commencing to talk to them and find out where they wanted to live, what they wanted to do and it was hoped to do a piece of work with Speakup regarding Person Centred Planning for those individuals.

 

·           Important to note that although the consultation was badged for Learning Disability it was for anyone in the  ...  view the full minutes text for item 59.

60.

Joint Health Overview and Scrutiny Committee for the Commissioners Working Together Programme

Minutes:

The following verbal report was given on the above Programme:-

 

Consultation

-          900 hits on the website and interest via Twitter but these were not being converted into consultation responses as yet even though the information was getting out to the public

-          As at 21st November there had been:-

 78 responses on the Hyper Acute Stroke proposals with 46 disagreeing with the proposals

60 responses on Children’s with 30 disagreeing with the proposals

-          Very low attendance at public meetings with no-one attending the 18th November meeting at MyPlace in Rotherham or the meeting at the Source in Sheffield the following week

-          NHS England were now looking at a gap analysis across all the communities and engagement so far to ensure they were reaching into communities and welcomed any suggestions from Members

-          There had been feedback from all areas on both Services, Hyper Acute Stroke and Children’s, but mainly from Barnsley (49 Stroke/26 Children)

 

Ambulance Service

-          East Midlands – already had the specialist centre model in place for Stroke Care, Coronary Care and major Trauma and were achieving better outcomes and reduced mortality

-          Yorkshire Ambulance Service Staff Training – all frontline staff (Paramedics and Technicians, call handlers for 999 and 111 as well as Community First Responders), were taught to assess the patient suspected of Stroke using the FASt.  Patients at point of call had a fast assessment which was repeated at the time of the face-to-face assessment.  If it was a suspected Stroke staff followed the Yorkshire Stroke Pathway and referred the patient to the nearest Hyper Acute Stroke Unit

 

Children

-          Data to come on the number affected by the proposals on the 6 sub-specialities

 

The Chairman and Vice-Chairman would continue to be involved, feeding in Members’ issues and concerns and reporting back from the JHOSC.

61.

Improving Lives Select Commission Update

Minutes:

Councillor Cusworth gave the following update from the 2nd November Improving Lives Select Commission meeting:-

 

-          Post Abuse Services – significant investment put into the development and commissioning of Child Sexual Exploitation support Services by both Council and the Clinical Commissioning Group.  They identified that this investment had resulted in a very different support offer both for victims and survivors to that identified in the Jay report.  There was now a very comprehensive range of services existed.

 

-          Unaccompanied Asylum Seeking Children that Rotherham committed to welcoming – the main concern expressed by the Select Commission was the possibility of an extra burden on services particularly CAMHS.  The Clinical Commissioning Group did say they were fully prepared for this and appreciated there may be some extra service required.  They did see the more locality plans and joint working as prepared to alleviate that and did commit to Looked After Children being prioritised as part of the assessment process.

 

Councillor Cusworth was thanked for her report.

62.

Healthwatch Rotherham - Issues

Minutes:

No issues had been raised.

63.

Date of Future Meeting

Thursday, 19th January, 2017 at 9.30 a.m.

Minutes:

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 19th January, 2016, commencing at 9.30 a.m.