Agenda and 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 Pack

The pack contained:-

-          November Health and Wellbeing Board minutes

-          CQC overview

-          Response from Public Health to Councillor Williams’ question on data from the Sustainability Transformation Plan powerpoint

-          Notes from the TRFT and RDaSH Quality Account sub-groups

(2)  Consultations for CWTP and Learning Disability

The Chairman urged Members to get involved in the consultations.  It was imperative that Councillors complete the consultation, whether agreeing to the proposals or not, and then needed to get the facts out to constituents.

The Vice-Chairman stated that at the previous meeting assurance had been given that the consultation documents had been sent to all GP surgeries.  He had recently visited 2 local surgeries and found no evidence of any documents.  He was concerned that either all the documents had gone or that there had been a breakdown in communications which may be indicative of the low response that had been received so far. 

Tony Clabby, Healthwatch Rotherham, confirmed that the materials had been distributed to GPs and that Healthwatch had also been involved in distributing them through their networks.

Councillor Roche, Cabinet Member for Adult Social Care and Health, reported that with regard to the Learning Disability consultation, currently there had been 193 completed online questionnaires and 180 requests for hard copies.  He agreed that there was a need for as many people as possible to be involved in the consultation and he would raise the issue of leaflets in GP surgeries with the CCG.

The Chairman reported that it was the plan that all Members would be provided with a copy of the leaflet at the next Council meeting.

The minutes of the previous meetings of the Health Select Commission held on 27^th October and 1^st December, 2016, were noted.

Arising from Minute No. 43 (Response to Scrutiny Review: Child and Adolescent Mental Health Services), it was noted that:-

-                   there was an agenda item providing more information on the whole School Mental Health Pilot and considering Member involvement.

-                   the Scrutiny Officer had had a recent positive meeting with the CCG and RDaSH to discuss  presenting future progress updates following issues raised at the previous meeting and to revisit timescales where needed with some realistic revised dates.

-                   the latest performance report produced by RDaSH for November was now available for circulation.

Arising from Minute No. 44 (CAMHS), the RDaSH Voice and Influence template was with the Youth Cabinet for comment.

Arising from Minute No. 45 (Response to Children’s Commissioner’s Takeover Challenge Review), it was noted that:-

-                   the new Transition Board would hold its first meeting this month.

-                   dialogue with regard to transition was still to take place.

Arising from Minute No. 54 (South Yorkshire and Bassetlaw Sustainability and Transformation Plan), it was noted that this had been discussed at 11^th January Health and Wellbeing Board.

Cabinet Roche, Cabinet Member for Adult Social Care and Health, stated that he was still very concerned with regard to the consultation on the STP which NHS England was terming “awareness raising”.  He was in discussion with the Chief Executive as to the most appropriate way of gaining Members’ approval/endorsement of the STP.  There would be a meeting on 8^th February regarding governance of the Rotherham Place Plan.

Tony Clabby, Healthwatch Rotherham, reported that NHS England had asked local Healthwatch’s and Voluntary Actions across South Yorkshire and Bassetlaw to deliver engagement and communication sessions.  Further information was awaited from NHS England as to the timetable and the messages they wished to be included.

Arising from Minute No. 55 (Adult Social Care Performance – Yorkshire and Humber Year End Benchmarking), it was noted that the quarterly reports were to link in with other reporting cycles and that the six monthly reports were to be submitted in July and December.

Arising from Minute No. 56 (Adult Social Care Performance – Local Measures), it was noted:-

-                   information supplied with regard to LM01-4 for October and November, 2016. With issues arising to be fed in and discussed in March.

-                   the performance clinic held in July was not a formal minuted meeting.  However, there was now a Practice Challenge Group.

Arising from Minute No. 36 (Learning Disability – Shaping the Future Update), it was noted that the work of the People’s Parliament at Speak Up should be taken into account.

Resolved:-  That the minutes be noted.

(2)  That the minutes of Practice Challenge Group be submitted to this Commission.

Nathan Atkinson, Assistant Director Strategic Commissioning, RMBC and Keely Firth, Chief Finance Officer, RCCG to present (report attached)

Keely Firth, Rotherham CCG, and Nathan Atkinson, Assistant Director Strategic Commissioning, presented a progress report of the Adult Care Development Programme and the Better Care Fund (BCF) as of Quarter 3 December, 2016:-

Nathan Atkinson reported on the Adult Care Development Programme - the overarching strategy to transform Adult Care highlighting the following:-

-          Community Catalysts, a not-for-profit organisation, had recently won a tender to provide expertise as to the development of community groups to deliver preventative services and supplement the wider Adult Care offer

-          The Village integrated health and care locality pilot had been running since July, 2016.  A Key Performance Indicator suite was being developed to enable practical comparisons to be made with other localities in terms of performance and impact.

-          Training commissioned to support operational workers with understanding and delivery of a strengths based approach to assessment.

-          Formal consultation on the future offer in Rotherham for people with a Learning Disability.

-          All eighty-four customers attending Charnwood Day Centre had been reviewed and moved to more appropriate support.

-          Current offer by the Shared Lives Team had been reviewed with a view to the development of an effective expansion plan based on national best practice.

-          Community Opportunity Pathway Programme continued to work with ten customers and their families.  Support for the programme ended in December, 2016.

Keely reported that the Better Care Fund was made up funding from the CCG (approximately £20M) and the Local Authority (approximately £4M).  There were thirty-six schemes which had now been categorised into six key objectives of the Fund.

During 2016/17 a review had been carried out of all the services for strategic relevance, whether there were strong robust contracts in place and ways of measuring success and the outcomes.

Seven of the eight national conditions were being fully met.  The remaining condition was partly met;  better data sharing between Health and Social Care based on the NHS number (fully met) and better data sharing including whether Adult Care could ensure that patients/service users had clarity about how data about them used, who may have access and how they could exercise their legal rights (partly met).

What had the Fund done for the people of Rotherham:-

-                   Defined, improved and increased the joint working with Social Care.

-                   Mental Health Liaison Services introduced where Mental Health Workers from the local Mental Health Trust now worked in the front end of the Hospital allowing people accessing A&E Services to have intervention before admission and if admitted, through the Mental Health Liaison Services, they could be targeted much faster.

-                   Social Prescribing – excellent feedback and had given real benefits to those in receipt.  It had now been extended for Mental Health Services.

-                   Increase in the number of community beds which enabled patients to be discharged safely from Hospital where appropriate and had meant delayed transfers of care was less of an issue.

-                   Increase in the number of people that accessed Personal Health budgets.

-                   Community Occupational  ...  view the full minutes text for item 68.

Louise Barnett, Chief Executive and Dominic Blaydon, Associate Director of Transformation, TRFT to present (paper attached)

Louise Barnett, Chief Executive of the TRFT, and Dominic Blaydon, Associate Director of Transformation, gave the following powerpoint presentation:-

Overview of the Trust’s vision for the next five years

-          We will continue as a stand-alone district general hospital

-          We will build a reputation for innovation and quality care

-          We will achieve a CQC rating of “good” or better

-          We will deliver financial sustainability

-          We will have a strong emergency and urgent care function

-          We will develop sub-regional specialist care centres

-          We will provide a strong community health service offer

-          We will integrate with health and social care partners

Community Transformation Programme

-          Integrated Health and Social Care Teams

-          The development of a Reablement Village

-          A multi-disciplinary Integrated Rapid Response Service

-          A joint approach to care home support

-          An enhanced Care Co-ordination Centre

Acute Care Collaborations

-          Hyper-Acute Stroke Services

-          Breathing Space

Children’s Transformation

-          Integrated Locality Teams

-          Review of Children’s Assessment Unit

-          Rapid access to a Community Paediatrician

-          Reconfiguration of Inpatient Bed Base

-          A joint approach to Workforce Development

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

·           Currently if a Rotherham resident had a suspected stroke they would be taken by ambulance direct to the Stroke Unit at the District General Hospital and assessed for thrombolysis (an immediate treatment to enable to reduce the possibility of having a secondary stroke). If, due to the capacity of the Stroke Unit, a patient would be taken to A&E and receive the medical intervention or wait in A&E for a bed in the Stroke Unit.  They would then spend the first seventy-two hours on a local Stroke Unit and then moved to stroke rehabilitation either at the Stroke Unit, intermediate care or rehabilitation.

·           Under the new model, dependent upon where the patient lived, they would either go to the Hallamshire or Doncaster Hospitals for the first seventy-two hours.  After that time they would be repatriated to Rotherham Hospital. 

·           Currently Rotherham residents would be taken to Rotherham Hospital to receive care unless their needs were particularly specialist/had very severe needs when they would then go to Sheffield.

·           There was concern with regard to the response times, changes to the journey and what affect that would have on a patient if there was a delay in getting the right treatment.  The CCG would be making the decision about what happened to Stroke Services in Rotherham and one of the key principles to making the decision was whether the quality of care to Rotherham patients was going to be better.  The Governing Body would be looking very closely at if outcomes for patients would be better or worse.  Travel factors would be taken into account.

·           The commissioners collectively across South Yorkshire looked into whether the new care pathway would improve the quality of care.  They also looked at the evidence base available which showed that where you potentially centralised the care you could provide high  ...  view the full minutes text for item 69.

Further to Minute No. 43(8) Janet Spurling, Scrutiny Officer, presented a briefing on the pilot that had taken place on adopting a whole school approach to the promotion of mental health and wellbeing in Rotherham.

Six schools had been invited to take part in the scheme representing each of the Social and Emotional Mental Health school cluster areas in north, south and central Rotherham.

The whole school pilot was based on the eight principles outlined in a national guidance document produced by Public Health England and the Children and Young People’s Mental Health Consortium:-

-          Leadership and management

-          School ethos and environment

-          Curriculum teaching and learning

-          Student voice

-          Staff health, development and wellbeing

-          Identifying need and monitoring impact

-          Working with parents/carers

-          Targeted support

Each of the six schools had been encouraged to benchmark themselves against all eight principles and then pick at least two to progress and written up into an action plan.  The schools had until July 2017 to deliver their actions.

The report set out the six schools and their selected actions.

Resolved:-  (1)  That the report be noted.

(2)  That the following Members accompany officers on the one-to-one update meetings with schools:-

Rawmarsh                 Vicky Farnsworth

Newman                    Councillor Short

Wingfield                   Councillor R. Elliott

Wales                         Councillor Marriott

Oakwood                   Councillor Cusworth

Maltby                        Councillor Andrews

Following the meeting the changes below were agreed:-

Rawmarsh                 Councillor Marriott

Wales                         Councillor J. Elliot

Maltby                                    Councillor Andrews and Vicky Farnsworth

(3)  That, subject to the approval of Commissioner Myers, Councillor Cusworth be nominated to represent the Select Commission on the Whole School Steering Group.

Janet Spurling, Scrutiny Officer, submitted a copy of the report to Overview and Scrutiny Management Board following the scrutiny session undertaken by a sub-group of the Select Commission regarding housing for older people in Rotherham.

The purpose of the session was to develop a clear understanding of the key issues involved in increasing the number of homes suitable for older people and to make recommendations to inform future plans for older people’s housing.

The report summarised key issues identified and the ten recommendations which were as follows:-

(1)       That an article be included in the tenant newsletter explaining how bungalows are allocated to different groups of people, not only older people, based on need.

(2)  That discussion takes place with transport providers, including Community Transport, regarding:-

-        Services for proposed sites before building commences

-        Maintaining transport links to those sites in the future.

(3)  That the importance of family pets for older people’s health and wellbeing is considered in developing housing options.

(4)  That consultation is undertaken with older people currently living in three storey buildings to capture their views on how suitable this housing is for their needs, to feed in to decisions about future models.

(5)  That consultation is undertaken with older people to ascertain their views on the term extra care and how housing schemes should be branded.

(6) That the approach to branding and marketing housing options for older people should be a positive one such as promoting the third age rather than one of moving towards the end of a person’s life.

(7)  That new housing schemes are designed to look more generic rather than looking like they are only for older people:-

-        To reduce the risk of older people being targeted

-        To reflect mixed communities and reduce negative perceptions.

(8)  That Shaftesbury House undergoes external renovation and is made more secure for residents.

(9)  That action is taken to maintain high quality in current older people’s housing to avoid the development of a “two tier” system with differences in quality and experience between current and new provision.

(10)  That all multiple storey buildings for extra care housing should have lifts.

This was a good focussed piece of work and showed the role of scrutiny in policy development as opposed to its role in holding agencies and the Executive to account.  It was positive to have all ten recommendations accepted with a clear response and timescales for implementation.

Resolved:-  That the report be noted.

Councillor Cusworth gave the following update on the recent Improving Lives Select Commission meeting:-

-          Independent Chair of Adult Safeguarding Board provided an annual review

-          Domestic Abuse Service provision in Rotherham

The key link to Health was with regard to health partners responding to disclosures or signs of abuse and regional work on implementation of the Mental Capacity Act.

Should any Member require more information they should contact Councillor Cusworth directly.

Councillor Cusworth was thanked for her report.

Janet Spurling, Scrutiny Officer, reported that NHS England had carried out their planned mid-point review of the public consultation in late December led by the Consultation Institute.  The review had found that, although the Christmas period had been taken into account regarding the length of the consultation period, it had had a greater impact than planned as the response rate was lower than expected given the approach and methodology used.

The consultation deadline had been extended until 14^th February to allow for further engagement.  This meant that the final decision would now be made by the Joint Committee of CCGs in April, 2017.

In light of the concerns expressed by the Select Commission regarding the proposals for Hyper Acute Stroke Services, the Chair and Vice-Chair had met with a representative of the South Yorkshire Ambulance Service to discuss their ability to deliver the service, the number of vehicles they had at their disposal currently and how many more they felt they would need to carry out the new service.

The representative had been quite clear that the Service had no problems in maintaining the service whatsoever nor were there any issues with regard to the skilling of staff.  The only issue was that the Service felt it needed an additional three ambulances bearing in mind the new proposed models of working.

Members reiterated the importance of having clear data and evidence when officers and partners were presenting information to the Commission.

Resolved:-  (1)  That the report be noted.

(2)  That the Commission submit a collective response to the consultation.

Tony Clabby, Healthwatch Rotherham, reported that the Autism Strategy was to be launched by the Autism Partnership

Thursday, 2^nd March at 9.30 a.m.

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 2nd March, 2016, commencing at 9.30 a.m.