Agenda and minutes

There were no Declarations of Interest.

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

-          There were no comments or questions on the papers in the information pack that had been circulated to Members.

-          Councillor Jarvis provided a short update on the work of Improving Lives Select Commission.  In Adult Safeguarding the Vulnerable Person’s Team was already making a difference and seeing results.  Some Team members had won awards, in particular for their work Supporting People who were involved in court cases. 

-          RMBC was considering participating in the Pause project working with mothers who had had multiple children taken into care to help them turn their lives around.  From experience elsewhere many of those involved would have been likely to need Adult Mental Health Services without that support.  A further update would be provided.

-          The Chair highlighted recent enlightening and informative sub-group sessions looking at progress on the 2017-18 quality priorities for Rotherham, Doncaster and South Humber NHS Foundation Trust (RDaSH) and The Rotherham Foundation Trust (TRFT) and a useful workshop on the drug and alcohol service.  A visit to Carnson House would be organised for early 2018.

Consideration was given to the minutes of the previous meeting of the Health Select Commission held on 26^th October, 2017.  Members noted that:-

Arising from Minute No. 30 - Prescriptions

A response from Rotherham Hospital in relation to the question on prescriptions had been included in the minutes.

Arising from Minute No. 40 – Evaluation of Whole School Project and Minute No. 41 - Response to Scrutiny Review of Child and Adolescent Mental Health Services,

Further progress monitoring reports would be factored in to the 2018-19 work programme.

Resolved:- That the minutes of the previous meeting, held on 26th October, 2017, be approved as a correct record.

Steph Watt, Strategic and Transformation Lead for Integrated Physical and Mental Health Projects (TRFT and RDaSH) and Dianne Graham and Jo Painter, Rotherham Care Group, to give a powerpoint presentation

Dianne Graham, Rotherham Care Group Director and Steph Watt, Strategic and Transformation Lead for Integrated Physical and Mental Health Projects (TRFT and RDaSH) presented an overview of the transformation work which built on the presentation at the September meeting.

Previously the service had been structured around services for older adults and services for younger adults but now the pathways were less age specific. The prevention, recovery and wellbeing approach linked in with the Council’s strategic objectives and was more community focused.

Rotherham Care Group Objectives

Integrated and streamlined services for adult mental health and learning disabilities

•        Where care wraps round the patient, removing age and structural barriers

•        Prevention, recovery and wellbeing approach

•        Delivered as close to home as possible

•        With clear and timely access

•        Which deliver efficiency savings

Phase 1: Completed

•        Care group formation

•        Leadership and management team

•        Hospital Liaison Service – for mental health and learning disability, supporting TRFT on services and reducing time spent in A&E

•        Dementia Local Enhanced Service (LES) - support for GPs who are supporting people with dementia and facilitating diagnosis in primary care

New place based structures had been implemented for Rotherham, Doncaster and Lincolnshire respectively, which enabled them to focus on their own localities and understand their own communities better and to work within them.

Phase 2: Update

Care co-ordination centre

•        Moved to Urgent and Emergency Care Centre

•        RDaSH Staff transferred and trained

•        Launch January 2018 with phased implementation

Ferns: extended pilot

•        Re-hab for medically fit cognitive and neuro patients

•        Positive evaluation particularly from patients /carers

12 beds for patients with cognitive decline or dementia who had also been in TRFT for a physical health issue. The joint pilot with TRFT would run until April 2018 and the trust was building the business case to be able to sustain it.  Patients benefitted from the extra care and more were returning home on discharge rather than to residential care. 

Community Team formation

•        Interim: North base: tbc  South: Swallownest

•        Release Howarth and Badsley Moor Lane – efficiency savings

•        Co-locate with physical health and social care

Admin review

•        Staff consultation November 2017

•        Implementation February 2018 to align to the new structures

Unity: new patient record system

•        Development phase nearing completion

•        Rotherham go live: April 2017

Pathway Framework

•        Prevention, recovery and wellbeing model

•        Objective, resolve more, sooner

•        Pathway framework:

–       Brief Interventions

–       Complex care

–       Long term conditions

Rotherham ‘All Age’ Clinical Pathways

Retaining specialism & expert approaches within an integrated model - based on NICE guidance and evidence around the types of intervention.

Pathway Development

•        Access: to services planned and unplanned

•        Acute: urgent & emergency

•        Common MH disorders

•        Complex emotional needs

•        Early intervention in psychosis

•        Group review – collation of local groups in Rotherham

•        Trauma pathway - for people experiencing Post Traumatic Stress Disorder or trauma as a result of sexual or emotional abuse  ...  view the full minutes text for item 49.

Jo Hinchliffe, Adult Care and House, Liz Bent, Crossroads Care, and Jayne Price, Carers Forum, to present

Jo Hinchliffe, Adult Social Care, Liz Bent, Crossroads Care and Jayne Price, Carers Forum presented an update on the Carers’ Strategy – The Story So Far.  Sean Hill from Children’s Commissioning and Kevin Hynes, Barnardo’s provided additional information regarding work to support young carers.

Crossroads Care

We aim to:

·           Relieve stress in the family or for the Carer of the person with the disability

·           To prevent a breakdown in care or inappropriate admission into hospital or residential care

·           Supplement and complement existing statutory services and work closely with them

Philosophy of Care:

Crossroads Care Rotherham respects the individuality of Carers and people with care needs and seeks to promote their choice, independence, dignity and safety.

Originally respite care was provided but activities had expanded to include activity groups, therapies and a befriending service, increasingly working with volunteers to deliver services.  Traditional respite was still important but it was also about people coming together and enjoying a life outside caring.

Crossroads Care was regulated by the CQC and were proud to have been rated as outstanding, which they could not have achieved without the support of partners.

Carers Forum

Supporting & empowering Carers to be heard & achieve better outcomes

Rotherham Carers’ Forum is an independent group which enables informal and family carers (unpaid), to have voice in shaping services in Rotherham.

We aim to work together as a strategic partner with Local Authority, Health Service, Voluntary and Communities organisation, charities and groups as an equal partner, participating and influencing local decision making on services for carers and their families. 

Carers Forum meets on the 1st Wednesday of each month between 12 noon - 2.00 pm

The Forum, comprised of unpaid volunteers, had been relaunched to get into the 21^st century and had a website plus Facebook and Twitter accounts with this virtual presence helping carers who were unable to attend meetings.  The group was solvent after accessing external funding.  A key focus was promoting carers wellbeing such as encouraging people to have flu vaccinations and through sessions on destressing and mindfulness.  It also acted as a two-way conduit for information and a mechanism was in place for raising concerns through an issue log.

Caring Together Strategy

Our aims are:

·           That every carer in Rotherham is recognised and supported to maintain their health, wellbeing and personal outcomes.

·           To ensure carers are supported to maximise their financial resources.

·           That carers in Rotherham are recognised and respected as partners in care.

·           That carers can enjoy a life outside caring.

·           That young carers in Rotherham are identified, supported, and nurtured to forward plan for their own lives.

·           That every young carer in Rotherham is supported to have a positive childhood where they can enjoy life and achieve good outcomes.

Four key priorities for supporting carers (National Carers Strategy DoH 2014)

·           Identification and recognition

·           Realising and releasing potential

·           A life alongside caring

·           Supporting carers to stay healthy

Rotherham Context

Profile of carers based on 2011 census data

For 2016 Rotherham had increased by approximately 600  ...  view the full minutes text for item 50.

The Health Select Commission received a short verbal update from the Scrutiny Officer. 

Hyper acute stroke

The Joint Committee of Clinical Commissioning Groups (JCCCG) met on 15^th November 2017 to consider the business case and make a decision on the proposals for hyper acute stroke services.  The executive summary of the business case, link to the full business case and powerpoint presentation to the JCCCG meeting had been included in the Members’ information pack.

The unanimous decision was to support the proposed option to cease providing hyper acute stroke services at Barnsley and Rotherham hospitals.  There would be a phased implementation to ensure patient safety and to ensure that the changes were manageable for the hospitals.  Implementation would be closely monitored by the JCCCG and by the JHOSC.  The service would be decommissioned in Rotherham from July 2018 and in Barnsley by January 2019 with hyper acute stroke services provided in Sheffield, Doncaster, Chesterfield and Wakefield.  The new model required approximately £1.8m investment for tariffs and patient transport and the pathway would include thrombectomy.

Hospital services review

The purpose of the review was to explore how services could be delivered to ensure local people had access to safe, high quality care provided by the most appropriate healthcare professionals and in the best place.  The key was future proofing and sustainability of services.  It was very important to reiterate that the review was not looking at closing any of the current general hospitals in South Yorkshire, Bassetlaw or Chesterfield. 

The five services in scope were:

·         Urgent and Emergency Care

·         Maternity

·         Gastroenterology including endoscopy

·         Stroke care - early supported discharge and rehabilitation

·         Hospital services for children who are particularly ill

Consultation had commenced in the summer and there would be a public event on 6^th December 2017 at The Source, Meadowhall.  There would also be other opportunities for local people to get involved, including an event for Elected Members in January 2018.

JHOSC

The next meeting would take place on 11^th December 2017 and the agenda would include progress on implementing the changes in children’s surgery and anaesthesia agreed earlier in the year; an update following the decision on hyper acute stroke care; and an update on the Hospital Services Review. 

The agenda would be published on 1^st December 2017 and HSC members were asked to submit any questions to the Chair by

7^th December.

There were no issues to report.

Thursday, 14^th December at 10.00 a.m.

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 14^th December, 2017, commencing at 10.00 a.m.