Agenda and minutes

To receive declarations of interest from Members in respect of items listed on the agenda.

There were no Declarations of Interest made at the meeting.

To receive questions relating to items of business on the agenda from members of the public or press who are present at the meeting.

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

To consider and approve the minutes of the previous meeting held on (insert date) as a true and correct record of the proceedings.

Consideration was given to the minutes of the previous meeting of the Health Select Commission held on 11^th April, 2019.

Further to Minute No. 83 (Intermediate Care and Re-ablement Project) it was hoped that the basic principles of the business case would be available by September, 2019 as this had to take into account new requirements regarding Primary Care Networks.

With regards to Minute No. 84 (My Front Door) a seminar was in the process of being arranged in July when the evaluation was complete.  It was also noted that only five people remained at Oaks Day Centre and this this would have reduced to nil by the end of the month.

Further to Minute No. 85 (Implementation of Health and Wellbeing Strategy) it was noted that the Autism Strategy was likely to be on the November meeting agenda and A date for the Carers’ Strategy was yet to be confirmed.

Reference was made to Minute No. 87 (Work Programme) where it was suggested that the Commission revisit the transition from CAMHS and check on its progress. 

The Scrutiny Officer would also liaise with officers and partners on the full draft work programme for agreement in July.  Any further suggestions were welcome.

In regards to the JSNA – Public Health working with I.T., this had moved from October to be listed in either November or December.

It was also noted that Ward Plans helping with prevent work and JSNA profile modernisation should be available in the near future.

With regards to Minute No. 88 (Healthwatch Update) no feedback had yet been received on maternity complaints.

In addition, the database regarding access to GPs issues had been checked and showed comments regarding access to GP appointments that same day with a named GP of choice.  If patients wanted an appointment with a specific GP that usually had to be booked in advance.  Most G.P. surgeries offered a same day appointment with an ANP (Advanced Nurse Practitioner) who could prescribe, or offer a telephone appointment with a G.P.

Further to Minute No. 91 (date and time of the next meeting) the 17^th October, 2019 meeting had since moved to the 10^th October, 2019.

Resolved:-  That the minutes of the previous meeting held on 11^th April, 2019, be approved as a correct record.

(a)       The Chair advised the Commission that an issue had been raised in connection with Yorkshire Ambulance Service.  This would be followed up and brought back to a future meeting.

(b)       Councillor Jarvis provided an update following the last meeting of the Improving Lives Select Commission where it was noted the meeting had considered key challenges for education in Rotherham via John Edwards, Regional Schools Commissioner (East Midlands and the Humber Region).  Officers took on board his comments for consideration.

The agenda also included Rotherham Education Strategic Partnership Update where an overview and update of progress was provided in respect of the key areas for action identified within the RESP strategic plan.   Four meetings had so far taken place and feedback on what was working well, what was not and any issues needing development.  Further detail was provided on the seven issues including SEND, Gypsy, Roma and Traveller students, Early Years, Primary, Secondary, Post-16 and Social Emotional and Mental Health (SEMH).

A report on the Children and Young People's Services 2018/2019 Year End Performance provided a summary of performance under key themes and headlines.

(c)       The Scrutiny Officer provided an update on the membership for the three quality account sub-groups TRFT, RDaSH and Yorks Ambulance, plus the performance sub-group.

It was, therefore, proposed to keep the same membership as last year unless any Member wished to change if they had particular commitments or if any new Members had a particular preference.  Discussion had already taken place with some Members, but as a reminder the membership would be re-circulated.

Consideration was given to the report introduced by Councillor Roche, Cabinet Member, which detailed how the Strategy, previously approved by the Health and Wellbeing Board, had since been refreshed and an action plan agreed ready for consultation.

Gill Harrison, Public Health Specialist, was welcomed to the meeting who presented the 2019-2021 refresh of the Sexual Health Strategy for Rotherham.

The Strategy set out the priorities for the next three years for improving sexual health outcomes for the local population.  It provided a framework for planning and delivering commissioned services and interventions (within existing resources) aimed at improving sexual health outcomes across the life course.

It aimed to address the sexual health needs reflected by the Public Health England sexual and Reproductive Health Epidemiology report 2017 which highlighted areas of concern.  The following were identified as concerns to identify actions for 2019-2021:-

·           Sexually Transmitted Infection diagnosis in young people.

·           Sexual health within vulnerable groups.

·           Under 18 conception rate.

·           Pelvic Inflammatory Disease admission rate.

·           Abortions under 10 weeks.

The refreshed Strategy also reflected concerns expressed in the Rotherham Voice of the Child Lifestyle Survey 2018 which showed increased numbers who said that they did not use any contraception and a significant increase in those reporting that they had had sex after drinking alcohol and/or taking drugs.

Sexual Health had since moved on and it was timely to look at new changes and new priorities.

A PowerPoint presentation highlighted:-

·           Definition – sexual health.

·           Strategic Ambitions.

·           Improving sexual health.

·           Rates of gonorrhoea (2013-2017) – success stories – public awareness and good contact tracing and working with partners.

·           Priorities STI.

·           Improving Reproductive Health – downward trend reduced the rate of under 18 conceptions by 60% between 2008 and 2017 higher, but started off a lot higher.  A range of factors contributed – access to clinics, contraception, good reputation good relationship and sex education – range of other interventions self- esteem and aspirations.

·           Priorities – under 18 conception rate, access to contraception and timely access to abortion services.

·           Focusing on vulnerable groups – showing young people affected.

·           Priorities – diagnosis of new STIs, prevention, treatment and care.

·           Building on successful service planning and commissioning.

·           Priorities – provision of integrated services and building on success.

·           Key indicators for success.

·           Implementation and monitoring – action plan.

Discussion ensued with the following issues explored:-

-        What had been successful in the 2015-19 Strategy, what had not been  delivered on and why was the focus on repeat abortions?

       It was not just repeat abortions but it was important to focus on problems with ongoing care and with relationships.  The Pause Programme dealt with repeated pregnancies, identified problems and how issues could be dealt with.

       The refresh of the Strategy looked further as it had not previously had a fully integrated service delivery model which was viewed as a priority and was now in place.

-        The statistics appeared to be incorrect, especially in relation to Chlamydia.

       The populations were different as the figures for Chlamydia focused on 15-24 year olds  ...  view the full minutes text for item 5.

Further to Minute No. 135 of the Cabinet Meeting held on 15^th April, 2019, Nathan Atkinson, Assistant Director, Adult Care, Housing and Public Health, supported by Councillor Roche, Cabinet Member, gave an update on the recommendations and corresponding actions arising from the Scrutiny Review of Residential and Nursing Care Homes for Adults aged over 65. 

The purpose of the review was to consider progress in bringing about improvements to safety, quality and effectiveness in the sector as well an opportunity to explore the impact of the Care Homes Support Service as the care home sector was one of the transformation initiatives under the Rotherham Integrated Health and Social Care Place Plan.

The Commission was advised that the Service had not closed any care homes, but three private care homes had closed so in two of these cases people placed by the Council had been withdrawn.  One home was re-opening shortly under a new provider but people would not be placed there unless it complied with the Council’s standards. 

The Council’s powers with private care homes were very limited.  However, they were monitored under contract compliance and residents removed if there were issues about their care especially with regard to safeguarding.  There were also close links with CQC and G.P.’s as every care home had a G.P. linked to them.  Wherever possible, good relationships with private care homes were maintained.

In comparison to the rest of Yorkshire, Rotherham did not have a single failing care home, which was an improvement.  Work was still taking place to improve the direction of travel towards outstanding and it was pleasing to report that the Cabinet agreed to the recommendations which endorsed current and planned work in this area.  Scrutiny were thanked for their work on this review. 

All the recommendations were now in place and in recent weeks emails had been circulated to relevant Ward Members to update them on  Care Quality Commission (CQC) ratings for homes in their Wards. Detailed briefings were also provided if there were any concerns or if the CQC had been in. 

Discussion ensued with the following issues being raised and clarified:-

·           Training for staff - how was this being monitored, were there any issues and how was it implemented?

       Of the two care homes that were run by the Council, training was provided and monitored.  However, in terms of private homes, it was made clear what the requirements were and what steps would be taken if they were not compliant.  However, in terms of training, the Council could only suggest, cajole and recommend.

       The Council had maintained the training offer for the independent sector. It also had its own services and needed to make sure these were of requisite standard with staff access to training and refreshers.  Much was also open to the independent sector but the onus was on organisations to take up that offer.  Part of the contract monitoring was to look at where staff were in regard to annual refresher training and any areas  ...  view the full minutes text for item 6.

Councillor Roche, Cabinet Member, introduced the 2018 independent annual report.  For the previous three years, the annual reports had focused on the life course; the 2018 report took a new approach and sought to champion the strengths of Rotherham’s local communities and share experiences of what kept its residents healthy, happy and well.

The general public had been asked to submit photographs which showed what kept them healthy, happy and well where they lived.  These were then grouped by theme and found that they fell into two main themes – community and the environment – as well as capturing all five of the ‘five ways to wellbeing’.

The 2018 annual report was broken down into chapters on:-

-          What does keeping healthy, happy and well in Rotherham mean to you

-          Our communities

-          Five ways to wellbeing

-          What can we do to support health and wellbeing

-          Recommendations

-          What we will do together

-          Progress on last year’s recommendations

The key recommendations in the report were:-

-          Consider ‘health and wellbeing’ in the wider context of being influenced by everything around us

-          Seek first to understand what is ‘strong’ in our communities and what assets we can build on together to support the health and wellbeing of our residents.

Terri Roche, Director of Public Health, gave a presentation via PowerPoint which highlighted:-

·           What does it mean to be healthy in Rotherham? 

·           Health influencing factors.

·           Recommendations – consider health and wellbeing in the wider context, what is strong and what assets can build on together.

·           What can be done together?

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

·           How was Wickersley chosen to host the loneliness project, when it was thought other areas may have benefitted from the research more?

       Multi-agency groups in Wickersley, Dinnington and Maltby explored projects to work on together.  The group in Wickersley were aware of issues around loneliness for all services and chose to run with it.  Comments on the choice of area and disjointedness would be taken back but loneliness did not demonstrate barriers and it was a factor for all age groups. 

·           The asset/strengths based approach was positive, as was the five steps to welling being simple and evidence based.  This process seemed increasingly disconnected and disjointed when much more impact could be achieved if there was joined up work with adults, community learning and some of the work with older people, neighbourhood working etc.  Of concern was the growing level of inequalities in health with the need for discussion on this and how the resources could be targeted at communities who needed them most. 

       In looking at universal proportionalism and how inequalities could be addressed resources were getting tighter.  However, it was time to make a real difference through our good partnership model, with a good Housing Strategy incorporating homelessness, neighbourhood ways of working and robustness in Equality Impact Assessments were building blocks bringing the work together.  This was about engaging  ...  view the full minutes text for item 7.

No issues had been raised.

It was suggested, however, that any written comments be provided when representatives were unable to attend.

There were no matters to feedback from the Committee as it had not met since March, 2019.

A further meeting would be scheduled shortly. Options were being developed around the hospital services programme.

There was no urgent business to report.

The next meeting of the Health Select Commission will be held on Thursday, 11^th July, 2019, commencing at 2.00 p.m. in Rotherham Town Hall. 

Resolved:-  That the next meeting of the Health Select Commission take place on Thursday, 11^th July, 2019, commencing at 10.00 a.m.