Agenda and minutes

There were no Declarations of Interest made at the meeting.

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

Consideration was given to the minutes of the previous meeting of the Health Select Commission held on 14^th June, 2018.

Reference was made to Minute 6 (Director of Public Health Annual Report) and the recommendations; the detail of which had been followed up and information was attached at Pages 11 and 12 of the agenda pack, including the video clip link. 

Page 11 also made reference to Treatment 2 and the percentage of patients who were treated within 62 days.  Latest data available had been requested.

Minute No. 7 (Health Village Evaluation Workshop) Recommendation 2 – the issues raised by Health Select Commission for inclusion in the outcome measures had been passed to relevant officers.  A response to Health Select Commission feedback and a further report on the plans for the next phase of implementation would be submitted in September, 2018.

Resolved:-  That the minutes of the previous meeting held on 14^th June, 2018, be approved as a correct record.

The Chair invited Councillor Jarvis from Improving Lives Select Commission to provide a brief update regarding the work currently taking place, which included:-

·             Key activity and progress in relation to the provision of Domestic Abuse Services across Rotherham.   The Domestic Abuse Strategy set out the collective vision for Domestic Abuse (DA) Services within Rotherham for the next three years.  Important issues discussed included access to IT, informing commissioning, data quality, training and ensuring the voice of the child was heard.  The referrals process was being looked at again. 

·             2017/18 year-end performance under the key themes for Children and Young People’s Services

·             Implications for Looked After Children, previously Looked After Children and Care Leavers as a result of the Children and Social Work Act 2017 which was intended to improve the support for Looked After Children (LAC), promote the welfare and safeguarding of children and make revised provisions about the regulation of Social Workers.

Presentation by Richard Smith, Adult Care, Housing and Public Health

Richard Smith and Nathan Atkinson gave the following powerpoint presentation on the Caring Together action plan:-

Caring Together Strategy Aims:-

-         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.

Six Key Themes:-

-         Carers Support.

-         Young Carers.

-         Unknown Carers.

-         Publicity and Promotion.

-         Training Offer.

-         Quality Assurance.

Progress:-

-         Memorandum of Understanding developed.

-         Bite size training modules co-produced and delivered to carers groups.

-         Networking and light respite opportunities provided to support carers.

-         Established a triage system through a single access point shared by Early Help and Children’s Care.

-         Four young carers awareness sessions delivered by Barnardos to Safeguarding Leads/Year Heads from Rotherham Schools and wider South Yorkshire School representatives.

-         As part of Safeguarding Awareness Week and Open Day Safeguarding Event was held at Barnardos Headquarters on 10^th July, 2018.

-         Two newly qualified Rotherham G.P.s met with Rotherham Young Carers Service users and staff on 19^th June, 2018 to raise their awareness of issues faced by young carers and their families in accessing healthcare.

-         Sarah Champion MP met with Service users and staff from Rotherham Young Carers on 22^nd March, 2018.

Future Work:-

-         Partnership workshop with Carers’ Forum – August, 2018.

-         Review of Carers Self-Assessment process and pathway.

-         Strengthen carers’ voice with My Front Door.

-         Communication plan for engagement and involvement of carers.

-         Develop Quality Assurance Standards as part of the operational framework (to deliver Care Act responsibilities).

-         CYPS Commissioning and Barnardos are exploring other ways to raise awareness with G.P.’s.

-         G.P.’s have bi-monthly learning event and within schools and wider services who work with children and young people.

-         New Rotherham Young Carers’ Service leaflet distributed widely at events, schools and libraries.

The Carers’ Strategy was very comprehensive and its implementation was ambitious and exciting moving forward.  Its strategic aims recognised the work with carers and support to maintain carers’ health, wellbeing and personal outcomes.  Additional resources had been put into the carers’ workstream with new commissioning and operational leads.

A discussion and a question and answer session ensued and the following issues were raised and clarified:-

·             Under the key theme 3 building on the knowledge base of unknown carers and how they could be identified.

It was noted that a new joint post with the CCG recognised the need to focus on work with carers and with a model in place this would focus on the challenge for those who had not self-identified.  The  ...  view the full minutes text for item 18.

Gill Harrison, Public Health Specialist, presented a report on the progress made in relation to the All Service Review (ASR) savings 2019/20 from the Integrated Sexual Health Services budget as agreed at the 28^th February 2018 Council meeting (Minute No. 157 refers) which resulted in a 2.6% reduction from the overall contract value for the commissioned Integrated Sexual Health Service (ISHS).

Since 1^st April, 2013, every local authority had a legal duty to protect the public’s health with the Regulations stating that the Director of Public Health was responsible for ensuring that there were effective arrangements in place for preparing, planning and responding to health protection concerns.  Following a tendering exercise in 2016, the contract was awarded to Rotherham NHS Foundation Trust (TRFT) with the new service, providing a broad range of contraceptive services and a comprehensive STI prevention, testing and treatment, starting on 1^st April, 2017.

The savings had been profiled for 2019/20 due to the service only having recently been out to tender with a budget reduction from the original value and also due to them taking on the responsibility for the provision of contraceptive services in primary care (GPs and Pharmacy).

As part of the original tender TRFT were commissioned to provide clinics at a range of times and locations to give more opportunities to members of the public to attend clinic sessions.  TRFT proposed to stop providing the newly opened Sunday clinic as it was not as well utilised as other clinics and was more expensive to run.  This would result in a saving of £26,000 and the TRFT had also undertaken an equality analysis to consider the impact of the Sunday clinic cessation.

Local authorities were mandated by the Health and Social Care Act (2012) to prevent the spread of STIs including HIV prevention.  Public Health had a budget of £30,000 for this work and the current contract had now come to an end.  TRFT sub-contracted with a third sector organisation, Yorkshire MESMAC, who were already providing awareness raising, prevention and testing for all STIs including HIV.  A contract variation had, therefore, been agreed between Public Health and TRFT to include specific HIV prevention work within their existing service.  This resulted in a £30,000 saving.

The ISHS was a good service that achieved good results and had worked well with survivors of CSE.

Discussion ensued and Dr. Nadi Gupta, Lead Clinician, and colleagues, Natalie Gibbons (Lead Nurse) and Julie Bentley (Service Manager)responded on:-

·             Demographics of people using the service on a Sunday.

The service was for Under 25’s, a high risk group for STIs and a targeted service.  Over the past year there had been 400 attendances to the Sunday clinic, which began on 1^st April, 2017 and was open to males and females.  Further demographic information was not available.

·             Concerns about a reduction in the service. 

Data from the Police website indicated 138 active CSE ongoing investigations and the service had active cases  ...  view the full minutes text for item 19.

The Chair reported on the main findings and recommendations arising from the Scrutiny workshop undertaken by the Select Commission in April, 2018 to consider residential and nursing care home for adults aged over 65.

The Council contracted with 35 independent sector care homes for adults aged 65+ with 1,709 beds available for residential care and nursing care, including residential and nursing places for people with dementia.  As at April, 2018, 19 were rated as Good, 14 Required Improvement, 1 was Inadequate with one still to be inspected by the CQC.

Rotherham had 700 more beds than comparator local authorities, but most were residential beds.  There was a shortage of nursing beds due to a number of homes deregistering from providing nursing care and becoming solely residential care homes.  Greater availability of nursing beds could assist in reducing demand for acute services by potentially reducing hospital admissions and facilitating discharge back to the care home after an inpatient stay once the patient was well enough.

The findings were set out in the report but the key themes were:-

-         Governance.

-         Management.

-         Operational issues.

-         Finances.

-         Workforces.

A discussion and a question and answer question ensued with the following issues being raised:-

·             Contract compliance  and information sharing with individual ward councillors on care homes experiencing problems to aid queries at surgeries.

Ward Members would be given some insight into concerns in their own areas, but the detail of concerns would remain commercially confidential and sensitive.

·             Process for someone becoming a Care Home Manager and the qualifications required.

The process was controlled by CQC and registration of Care Home Managers was their responsibility, but the Quality Board would be proactive regarding any concerns.   Details of qualifications required would be subject to confirmation.

·             Availability of training for staff in care homes, monitoring take up and application of the training.

Training and workforce development for 2019/20 was currently under review.  This training would be open to care homes and any adult care provider whether they were private or voluntary.  There was regular liaison with managers about specific training needs and how best the training could be taken up by operational staff.

·             How was take up of the Care Home Support Service and the Clinical Quality Adviser monitored?

The service was commissioned by the CCG and overseen by key members of the Quality Board.  Compliance Officers were in regular dialogue with front line staff to focus on any identified areas.  Care homes need to be receptive to this service and engage.  Statistics on take up would be fed back. 

·             How could residents and families be made aware of an expected level of care before someone went into a care home and so they recognised signs or concerns so these could be addressed and resolved quickly?

Families were welcome to look at CQC ratings for care home who worked closely with the Council.  It was important that family members visited regularly and liaised with staff.  Anything of concern should be fed back to the  ...  view the full minutes text for item 20.

Janet Spurling, Scrutiny Officer, submitted the final draft of the Select Commission’s work programme for 2018/19 Municipal Year.

The overall priorities for the Select Commission for 2018/19 included:-

-         Rotherham Integrated Health and Social Care Place Plan

-         Adult Social Care including Carers

-         Autism Strategy

-         Health and Wellbeing Strategy implementation

-         Social and Emotional Mental Health

-         South Yorkshire and Bassetlaw Integrated Care System (Joint Health Overview and Scrutiny Committee)

Appendix 2 of the report submitted set out the proposed membership for each of the NHS Trust Quality Account Sub Groups for consideration.  The membership was based on the previous year’s membership to retain the knowledge developed by Members of those health partners’ services.

It also included the proposed membership for the new Performance Sub-Group that would meet quarterly to consider performance issues particularly where requested by the Overview and Scrutiny Management Board.

Discussion ensued on the detail and it was noted that the reducing health inequalities work may link in with the work by the Overview and Scrutiny Management Board on the roll out of universal credit and poverty flow which was still to be fully determined.

Sub-group memberships had been drafted and any Member unable to commit should contact the Chair.

Resolved:-  (1)  That the draft work programme for the 2018/19 Municipal year be approved.

(2)  That the proposed membership for the Quality Account Sub-Groups and Performance Sub-Group for 2018/19 be as follows:-

(3)  That it be noted that should any urgent items emerge during the year this may necessitate a review and re-prioritisation of the work programme.

No issues had been raised.

If anyone required a copy of the Annual Report if they contacted the Chair he would arrange for one to be circulated after the meeting.

The Chair gave an update for the South Yorkshire, Derbyshire, Nottinghamshire and Wakefield Joint Health Overview and Scrutiny Committee (JHOSC) by confirming:- 

·             The Governing Bodies of the CCGs were currently considering the hospital services review report.

·             Information was also awaited on the timelines from NHS colleagues to develop the JHOSC work programme for the year.

·             The Judicial Review appeal regarding the hyper-acute stroke service changes had been rejected so health partners were proceeding to implementation of the decision as soon as possible.

Resolved:-  That the information be noted.

Consideration was given to the submitted minutes of the Health and Wellbeing Board held on 14^th March and 16^th May, 2018.

Reference was made to consultation on the proposals for the Children’s Ward at Rotherham and for a regular update to be provided to the Health Select Commission.

The Cabinet Member for Adult Social Care and Health confirmed his concerns about the consultation with Councils and the need for more detail arising from the review.

Resolved:-  That the minutes of the Health and Wellbeing Board held on 14^th March and 16th May, 2018, be noted.

Thursday, 6^th September. 2018, commencing at 10.00 a.m.

Resolved:-  That a further meeting be held on Thursday, 6^th September, 2018, commencing at 10.00 a.m.