Agenda and minutes

Health Select Commission - Thursday, 20th February, 2020 2.00 p.m.

Venue: Town Hall, Moorgate Street, Rotherham S60 2TH

Contact: Janet Spurling  The webcast can be viewed at http://www.rotherham.public-i.tv

Items
No. Item

61.

Declarations of Interest

 

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

Minutes:

There were no declarations of interest in respect of any of the items of business on the agenda.

62.

Exclusion of the Press and Public

 

To consider whether the press and public should be excluded from the meeting during consideration of any part of the agenda.

Minutes:

The Chair advised that there were no items of business that would require the exclusion of the press or public from the meeting.

63.

Questions from members of the public and the press

 

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

Minutes:

There were no questions from members of the public or press in respect of matters on the agenda for the meeting.

64.

Communications

Minutes:

Members were advised that there was an opportunity to take part in the development of the respiratory rehabilitation service if they were current respiratory care patients.  More details would follow and if anyone was interested in taking part they were asked to contact the Governance Advisor.

 

Michael Wright, the new interim Deputy Chief Executive at The Rotherham Foundation Trust was welcomed to the meeting as an observer.

65.

Minutes of the previous meeting held on 23rd January, 2020 pdf icon PDF 128 KB

 

To consider and approve the minutes of the previous meeting held on 23rd January, 2020 as a true and correct record of the proceedings.

Minutes:

Consideration was given to the minutes of the previous meeting of the Health Select Commission held on 23rd January, 2020.

 

Resolved:- That the minutes of the previous meeting held on 23rd January 2020 be agreed as a correct record.

66.

Rotherham Respiratory Pathway pdf icon PDF 100 KB

Jacqui Tuffnell, Head of Commissioning at Rotherham Clinical Commissioning Group to present.

Additional documents:

Minutes:

Jacqui Tuffnell, Head of Commissioning at Rotherham Clinical Commissioning Group (CCG) delivered a short presentation to update Members on developments since September following the public consultation.

 

Context

The NHS 10 year plan stresses the need to develop better integrated care pathways with emphasis upon Primary Care Networks, with practices working together at scale, with a combined workforce to better care for patients.

 

Right Care Data – highlights

        Rotherham has high cost respiratory services, high admission levels and poorer outcomes for our patients than our counterparts across the integrated care system – as things had moved on quicker elsewhere.

        Non elective admission levels are high particularly for chronic lower respiratory, especially COPD.

        Asthma, influenza and pneumonia were also highlighted as areas where Rotherham admitted more non-electively than the right care peer group.

 

Respiratory health outcomes – Under 75 mortality rate ‘preventable’

2015-17 data showed Rotherham had a rate of 25.4% and a ranking of 12th highest of 15 local authorities in Yorkshire and Humber, where the average was 22%.  The England average was 18.9%.  Deprivation was a factor in Rotherham being an outlier.

 

Respiratory disease in the North East and Yorkshire

Impact on Urgent and Emergency Care (2017-18)

-        Highest rate of emergency admissions for (Chronic Obstructive Pulmonary Disease (COPD)

-        Last two winters non-elective admissions (NEL) for adults up to 4.400 admissions in a single week

-        Opportunities to reduce respiratory bed days (136,000), primary care prescribing (£25m) and NEL spend (£38m)

Opportunities

-        Flu and pneumonia

o   33,500 more patients could receive the PPV vaccine

o   25,500 more patients aged 65+ could take up the seasonal flu vaccine

o   4,200 more patients with COPD could receive an influenza immunisation

-        COPD

o   24,400 more people with COPD could be registered

o   2,500 more people with COPD could have diagnosis confirmed by spirometry

o   6,000 more people could have a review by an HCP

 

Right Care was part of the NHS which looked at peers and changes achieved elsewhere.  Although people may choose not to have vaccines, Rotherham could do better on this.

 

Local Challenges

        Fragmentation across the respiratory pathway

        Fragmentation of the home oxygen service

        Inconsistent diagnosis across Rotherham – it was important to get the diagnosis right at the beginning

        Inconsistent management of respiratory patients across the system

        High admissions to hospital, which could have been prevented

        Low uptake of smoking cessation

        No respiratory Community team – now best practice

 

56% of the admissions to Breathing Space could have been avoided with support in the patient’s own home from a Community Respiratory Team, saving 156 bed days.

 

Patient Engagement Feedback

        Timely access to primary care  - Day time, evenings and weekends for reviews and feel unwell

        Pulmonary rehabilitation closer to home and at evenings and weekends – at more convenient times

        Alternative access to care and information via APPs and websites, phone and video – being confident to use these

        Faster discharge  ...  view the full minutes text for item 66.

67.

Rotherham Loneliness Action Plan 2020-2022 pdf icon PDF 96 KB

Ruth Fletcher-Brown and Terri Roche from Public Health to present.

Additional documents:

Minutes:

The Cabinet Member for Adult Social Care and Housing introduced the draft Rotherham Loneliness Plan 2020-22, which was important given the strong negative impact that loneliness could have on people’s mental and physical health.  Loneliness is a priority within the Health and Wellbeing Board Strategy (Aim 4) and the plan was a key aspect of the Health and Wellbeing Board’s agenda on the preventative side.  There was also an important role for ward members in this work.

 

It was essential to recognise the difference between loneliness and isolation and also to be aware that loneliness could affect people of any age; it was not confined to older people.  The causes of loneliness were difficult to determine but known trigger factors could be seen at an individual, community and societal level.  In order to tackle loneliness and promote good social connections a collective response was required from individuals, communities, statutory partners, voluntary and community sector and local businesses.  Actions to tackle loneliness could be very simple and in many cases low cost, building on local assets.

 

The overall vision in the plan stated: “People of all ages in Rotherham feel more connected to others and loneliness is reduced”.  Underpinning this vision, a high level action plan had been developed, informed by a stakeholder event, focus groups and needs analysis work.  It was based on four broad aims, as follows:

 

1.     To make loneliness everyone’s responsibility.

2.     Improving how organisations and services in Rotherham connect people
at risk of experiencing loneliness to support.

3.     Make it easier for people living and working in Rotherham to access information about local community groups, activities and support services for loneliness.

4.     Spread good practice and encourage knowledge sharing on tackling loneliness across Rotherham.

 

Members recognised the difficulties in detecting loneliness and that it was hard for people to admit to feeling lonely.  They welcomed having a good plan in place and asked whether it was likely to be further developed and refined over time.  This was confirmed as the evidence base was still emerging so any local initiatives would to be thoroughly evaluated and reported on, taking the learning and building from that.

 

Raising awareness with partners of what was already happening in communities, such as the coffee mornings organised by Churches Together was highlighted.  Officers were mindful that a lot of good practice was happening and were attempting to bring everything together in one directory by encouraging people to include activities in GISMO the on-line database hosted by Voluntary Action Rotherham.  The Making Every Contact Count initiative would play a key part in identifying loneliness through staff sensitively asking questions and spotting triggers such as life events. 

 

As GISMO was central to informing people about activities and groups, assurance was sought in relation to funding to maintain and update the information.  The CCG had provided funding to update it but there was uncertainty regarding funding for the next few years, although it was hoped to access South Yorkshire and Bassetlaw funding for the  ...  view the full minutes text for item 67.

68.

Outcomes of Workshop on Refresh of Rotherham Integrated Health and Social Care Place Plan pdf icon PDF 127 KB

Minutes:

A short briefing paper summarised key points raised at the workshop held in January to scrutinise the refreshed Rotherham Integrated Health and Social Care Place Plan. The purpose of the session had been to consider and comment on the general thrust of the plan, priorities and focus – including any perceived gaps and any specific issues in relation to any of the three transformation workstreams.  Delivery and governance arrangements and how partners would measure success was also covered.

 

Five recommendations resulted from the workshop

 

1.     That consideration be given to renaming the Transformation Group as the Mental Health, Learning Disability and Autism Transformation Group to give Autism greater recognition as a discrete issue.

 

2.     That the issues raised in section 3 be considered by the Integrated Care Partnership for inclusion within the plan or in existing workstreams as appropriate.

 

3.     That a further update on the development of Primary Care Networks and transformation of Primary Care be presented to the Health Select Commission in 2020-21.

 

4.     That the final draft of the refreshed plan be circulated to the Health Select Commission.

 

5.     That following consideration of this paper written feedback is provided to the Health Select Commission for its meeting in March.

 

The Chair of Licensing Board and Licensing Committee praised the speedy responses from health partners to requests for information related to licensing.  It was also hoped to make good use of the alcohol and licensing toolkit once in place.  Officers were already using an excel based version and it would soon be available within the Rotherham Data Hub (formerly known as the Joint Strategic Needs Assessment or JSNA) in a more accessible way.  All the information was now available to inform analysis of specific areas.

 

Members were advised that in relation to recommendation 1 above, it had already been confirmed that the name of the group would be changed but to include Neurodevelopment rather  Autism, which was a broader term.

 

Resolved:- To note the recommendations made at the workshop as set out in section 4 of the briefing.

 

69.

South Yorkshire, Derbyshire, Nottinghamshire and Wakefield Joint Health Overview and Scrutiny Committee - Update

Minutes:

The Governance Advisor confirmed that the date of the next meeting had not been finalised but was expected to be in March.  The Health Select Commission was informed that Wakefield Council had withdrawn from the joint committee.

70.

Urgent Business

 

To consider any item(s) which the Chair is of the opinion should be considered as a matter of urgency.

Minutes:

The Chair advised that there were no matters of urgent business to discuss at the meeting.

71.

Date and time of next meeting

 

The next meeting of the Health Select Commission will be held on Thursday 26th March, 2020 commencing at 2p.m. in Rotherham Town Hall. 

Minutes:

Resolved:- That the next meeting of the Health Select Commission take place on Thursday, 26th March, 2020, commencing at 2.00 p.m. in Rotherham Town Hall