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:-

Quarterly briefing notes

Paper regarding The Village as requested

(2)  Consultation

NHS England had launched national consultation on Congenital Heart Disease Services.  This would probably be considered by the Yorkshire and Humber JHOSC www.engage.england.nhs.uk/consultation/chd/.

The minutes of the previous meeting of the Health Select Commission held on 19^th January, 2017, were noted.

Arising from Minute No. 67 the STP consultation commenced on 13^th February and ran until the end of March.  It included an on-line survey as well as the work by Healthwatch and Voluntary Action Rotherham. www.smybndccgs.nhs.uk/what-we-do/stp

Arising from Minute No. 68 it was noted that supplementary information had been provided after the meeting.  There were recommendations with regard to the Better Care Fund (BCF) and these would be discussed at the next Health and Wellbeing Board.  Select Commission Members were asked to feed back any comments on the BCF plan (available on the website under the Board’s agenda papers for 8 March).

Arising from Minute No. 69 further information had been received from the Foundation Trust and would be e-mailed to Commission Members.

Arising from Minute No. 70 it was noted that the representatives for the Schools visits had been amended slightly.  The visits were being arranged with the first two (Newman and Maltby) taking place next week.

Presentation by Jacqui Tuffnell, Rotherham CCG

Jacqui Tuffnell, Rotherham Clinical Commissioning Group, gave an update following the Scrutiny Review carried out in 2014/15.  The powerpoint presentation illustrated:-

Improving Access to General Practice

We said

-          We would bid to improve telephony systems across Rotherham

We have

-          Bid unsuccessful to date so Primary Care Committee has approved utilising Primary Care funding to enable the upgrades and also to enable call recording to support telephone consultation

-          Appendix A details completed practice upgrades and those which will be completed before 31^st March, 2017

We said

-          We would introduce telehealth across Rotherham

We have

-          Piloted and now rolled out telehealth to 19 practices (as at the end of January) and will complete full rollout before 31^st March, 2017

-          Appendix B details the benefits already being seen from implementing the telehealth system

We said

-          Access would be a significant element of our Quality Contract

We have

-          Access improvement will be a requirement of all 31 practices from 1st April 2017. Practices have all confirmed that they will meet the requirements of the quality contract by this date    

-          Appendix C - confirms the requirements of practices by 1st April 2017            

-          All practices undertaking a resilience programme ‘Productive General Practice’ to support their ongoing sustainability by the end of March, 2017

-          It provides essential tools for practices to support for example skill mix,  front and back office functions, planning and scheduling

-          Examples

The Village - care navigators

Woodstock Bower - telephone consultation for Advance Nurse Practitioners

Rationalisation of back office functions such as clinical documentation

We said

-          We would work with practices to provide more flexibility in appointments

We have

-          We have audited the number of appointments in practices to understand if more or less capacity is being provided.            

-          Appendix D - report and papers associated with the access audit

–       Commenced a pilot of Saturday routine appointment availability to complement our urgent appointment offer in January

–       Publicising appointments in practices

–       Text messages regarding Saturday appointments to all patients with mobile phones

–       Article in Rotherham Advertiser (Appendix F)

-          Appendix E - initial report of the uptake and patient feedback regarding the Saturday service        

-          Patient online numbers have significantly improved over the last year. The CCG and NHS England are working with practices who are struggling with their uptake of patient online

-          Appendix G - current information regarding uptake of patient online

-          We continue to look at ways of raising the profile of the availability

We said

-          We would implement our interim strategy for general practice    

We have

-          The Strategy has now been superseded by ‘the Rotherham response to the GP Forward View’

-          Appendix H – our response to the GP Forward View

-          Appendix I – NHS England’s February assessment of our progress in relation to implementation

We said

-          We would consider health implications of building schemes impacting on Rotherham

We have

Waverley development

-  ...  view the full minutes text for item 80.

Scott Clayton, RMBC, to present

Further to Minute No. 56 of 1st December, 2016, Councillor Roche, Cabinet Member for Adult Social Care and Health, together with Scott Clayton, Interim Performance and Quality Team Manager, and Sarah Farragher, Head of Service Independence and Planning, presented the Q3 Local Measures performance together with the four existing Corporate Plan measures for the period October-December, 2016.

The report set out the current performance challenges as at 31^st December or as at 30^th November ‘shut down’ of SWIFT/AIS data, 2016, which included:-

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

The report also set out responses requested with regard to LMO1-LMO4 at the 17^th January, 2017 meeting.

Discussion ensued with the following issues raised/highlighted:-

-          Recently signed agreement for the Royal Society for Blind in Sheffield to develop an Enabling Centre in Rotherham.

-          Overall the indicators across Adult Social Care (ASC) showed a very positive upward trend with most of the targets met or on the way to be met.

-          Review of the current KPIs to check they were appropriate and fit for purpose.

-          Summary of the pressures and challenges facing ASC overall and in relation to the Indicators.

-          Improved information and availability of better cohort data meant a greater understanding of the customer base.

-          LGA Peer Challenge findings of Commissioning in People’s Services across Children’s and Adult Social Care had been extremely positive.  It had found good direction and that capability was not an issue, however, capacity was an issue.  There had also been positive feedback about the Protection Team.

-          LM01-04 were all Adult Social Work Services that clients were receiving some of which would be crosscutting packages and/or commissioned services from the independent sector.

-          Once in receipt of services, clients should be reviewed in time. At the point of access there was a duty system which responded to immediate and priority cases within 24 hours and clients would be triaged and assessed.  There were waiting times for assessments and reviews, the reasons for which were set out in the report, but the Service was picking up those that were in immediate need and prioritising that work.  Whilst the figures needed to be improved significantly, people were being kept safe.

-          It was known that there was an issue with the assessment of care packages and work was taking place.  Services that impacted upon people were so very important.

-          The four new cases would be young people that had come through CYPS TO Adult Services.  Young people with complex learning disabilities and physical disabilities were now surviving into adulthood with increasing numbers of young people with Autism and the package  ...  view the full minutes text for item 81.

Paul Theaker, RMBC, to report

Barbara Murray and Christina Harrison (RDaSH), Paul Theaker and Ruth Fletcher-Brown presented an update on response to the Scrutiny Review of Child and Adolescent Mental Health Services.

Barbara gave the following powerpoint:-

Rotherham Children and Young People’s Mental Health Services – Progress Report

Service Model

-          Incorporating local and national priorities and agendas

·           Future in Mind, local transformation plans, including eating disorder pathways

·           Building early intervention and prevention

·           Community focussed engagement

Pathway Overviews

-          Learning Disability

·           Specifically working with young people with a mental health problem and moderate to severe learning disability

-          Single Point of Access

·           Receiving all referrals and triaging for urgency on the same day

·           Available as a point of contact for anyone to ring with any concerns

·           Working towards working jointly and some co-location with Early Help and MASH (‘First Response’)

-          Crisis/Intensive Community Support

·           Urgent assessments

·           Short term additional support during crisis supporting people into and out of hospital

·           Longer term interventions where there are high levels of risk

-          Locality Teams

·           Assessments and brief interventions (6-8 sessions)

·           Liaison with other services – GPs, schools, Early Help

-          Psychological Therapies

·           Time limited specialist therapy alongside other workers and consultation to colleagues

·           Longer term work with young people/families

-          CSE

·           Works alongside other colleagues

·           Provides support, advice and consultation to different services

-          Developmental Disorders (ASD and ADHD)

·           Diagnostic assessment for ASD and ADHD

·           Post-diagnosis support for ADHD

Attention was drawn to:

-        All pathway leads were now in post, with the last one, the Locality Work Lead from January 2017.

-        Closer working with Early Help had led to greater mutual understanding of each other’s work and resulted in fewer people “bouncing round” the system in the last few months.

-        Due to the work of the Crisis/Intensive Community Support Team there had been a reduction in Tier 4 or inpatient stays in the last 6-12 months

-        The new lead for Developmental Disorders had changed the pathways and reduced waiting times significantly in a short period.

In accordance with Minute No. 43 of 16^th October, 206, Paul Theaker, Operational Commissioner, and Ruth Fletcher-Brown, Public Health Specialist, presented a further update against progress of the Scrutiny Review’s 12 recommendations. 

It was noted that the refresh of the Emotional Wellbeing and Mental Health Needs analysis was complete and a common performance framework that provided improved and standardised data collection across the whole mental health system had been developed and was being tested with service providers.

The timescales for outstanding actions within the response template had been revisited due to the impact of delays in the CAMHS Service reconfiguration and were now achievable and realistic.  There was robust monitoring of the actions taking place through the CAMHS Contract Monitoring Group and CAMHS Partnership Group to ensure that they were completed by the due dates.

Discussion ensued with the following issues raised/clarified:-

-          Findings from the Needs Analysis refresh had shown a need for improved links between CAMHS and SEND and work on pathways for vulnerable  ...  view the full minutes text for item 82.

Janet Spurling, Scrutiny Officer, presented a report on the progress of the Rotherham Youth Cabinet Review – Improving Access to Child and Adolescent Mental Health Services.

The review had formed part of the ongoing work by the Youth Cabinet to improve access to Mental Health Services and support for young people in Rotherham following their work on self-harm in 2014.  The key focus of the young people’s attention was on services provided by Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH) following a major reconfiguration that resulted in a new service model.  They had also been keen to scrutinise wider working and links between partner agencies especially through the School Nursing Service as previous work had shown inconsistency in access to School Nurses and a need to raise their profile in schools.

Progress was being made in transforming wider CAMHS through the CAMHS Strategy and Partnership Group.  Integrated multi-agency working, both strategically and in localities, was central to the transformation and the new service model linking RDaSH CAMHS with Early Help Services through a single point of access was now being rolled out.

The Youth Cabinet had made 11 recommendations all of which had been accepted (set out in Appendix 1 of the report submitted) together with the latest progress updates on the actions agreed by partner agencies.

Several of the recommendations aimed to enhance consultation and involvement with children and young people in Service development and monitoring.  They also linked in with the outcomes of the RDaSH Voice and Influence Review commissioning by the Rotherham Clinical Commissioning Group.  The review had identified a number of priorities for developing engagement with children and young people in direct practice, Service management and organisational leadership.

Resolved:-  That the progress updates for the review undertaken by the Rotherham Youth Cabinet be noted.

The Commission’s consultation response for both Service proposals had been submitted online on 10^th February with only minor amendments from the version circulated for comment.

The JHOSC would meet on 3^rd April with an additional CSC meeting on 29^th March to consider the papers as they would include the final outcomes from the consultation and the high level business case.

The Joint Committee of Clinical Commission Groups was to meet on 18^th April to make the final decision.

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

-          Lifestyle Survey completed by students in Y7 and 10

Young people appeared to be making healthier choices, high percentage drinking less than one sugary drink a day, many saying they had never tried smoking at all but the use of contraception had increased.  There had also been a slight increase in the number of young people trying drugs for the first time and consistency with last year in those identified has having a disability or long term health problem.

-          Looked After Children’s Care Leavers Strategy 2017-2021

1 of the underpinning outcomes was that children were healthy and safe from harm with one of the strategic objectives being to improve the physical health of LAC including their emotional wellbeing.

-          The concern regarding delay in undertaking health assessments should improve as nurses how have access to LiquidLogic with notifications coming through in 3-4 days.  Good joint working was taking place between RDaSH CAMHS and RMBC.

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

Councillor Cusworth was thanked for her report.

No issues had been raised.

Thursday, 13th April at 9.30 a.m.

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 13th April, 2017, commencing at 9.30 a.m.