Agenda and minutes

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

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

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

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

No questions had been received from members of the public or press in respect of matters on the agenda for the meeting.

To consider and approve the minutes of the previous meeting held on 20 February 2020 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 20February 2020.

Resolved:- That the minutes of the previous meeting held on 20 February 2020 be agreed as a correct record.

Information Pack

Contained within the information pack circulated to Members were:-

-        Briefing on Urgent Dental Care

-        Briefing on COVID-19 from Andrew Cash

-        Link to Health and Wellbeing Board papers

o   final draft Rotherham Integrated Health and Social Care Place Plan

o   final draft Rotherham Loneliness Plan

o   Quarter 3 Rotherham Integrated Health and Social Care Place Plan Performance Report.

-        Fitter, Better, Sooner – patient weight management/smoking cessation prior to elective surgery. 

Members were requested to submit any comments or questions on these items to the Governance Advisor.

South Yorkshire, Derbyshire and Nottinghamshire Joint Health Overview and Scrutiny Committee

No date had been agreed for the next meeting but the Joint Committee would resume to consider possible changes to gluten free prescribing, which had previously been deferred.

Presentation giving an overview of initiatives to support the care home sector and work under the Quality Strategy.

Cllr Roche, Cabinet Member for Adult Care and Health introduced the item and confirmed that Rotherham care homes, of which only two were Council homes, were now rated third best in Yorkshire.  This was positive progress although room for further improvement still existed.  Undeniably Covid-19 had had an impact on care homes in Rotherham and he stated his thanks and admiration for staff working in care homes and said that thoughts were with those who had lost a loved one or family member.

Presentation

Context

•        36 Care Homes (Adults 65+) including 2 in-house

•        2 market exits since 2018 Greasbrough Nursing and Residential Home (contract termination-poor quality) Clifton Meadows (business decision)

•        3 market entries - Jubilee - Greasbrough, Roche Abbey - Maltby, Clifton Meadows - Clifton

•        Significant bed capacity - 1849 (including in-house/temporary beds)

•        483 Vacant – 26% on 22^nd May 2020 (164 in general residential, 92 in general nursing, 171 in dementia residential and 56 in dementia nursing)

Current Position

•        Only 48% placements funded by the Council

•        22% of beds occupied by self-funding residents – still support from Council

•        30% from out of borough

•        50% charge a top up fee (10% in 2015/16)

•        Demographic is changing, with the average age entering care increasing to 85 years (83 in 2015/16).

•        The average length of stay is 2-3 years (3-4 years in 2015/16).

•        Increase occupancy in Nursing type provision (90% occupancy) - people living longer - complex needs

•        Market expansion in nursing beds 92 beds and 20 temporary (Covid-19)

•        11% increase in vacancy factor since Covid-19

Challenges to Care Homes due to Covid-19

Initial challenges at the start of the pandemic:

- Implementation of the 3 hour discharge process from hospital

- lack of testing for staff and residents

- high rates of staff absence

- lack of Personal Protective Equipment (PPE)

- care home deaths not being captured in the national data

- digesting and responding to frequently changing guidance regarding outbreaks, PPE use and infection control – support from RMBC

Challenges now are:

- implementing the new testing regime

- high levels of voids

- limited self funder market

- longer term financial viability of care homes

- ensuring that support extends beyond older people (current national guidance limits primary action to this group) – learning disability, neuro-rehab and mental health

Additional Support due to Covid-19

•        Named Council lead officer - Contract Compliance Team and Public Health Officers

•        Clinical lead - GP -  Community Health Team

•        Clinical Contract Quality Officer – Care Home Liaison Service (NHSRFT)

•        Staff testing

•        Whole home testing for staff and residents

•        Supply of PPE – now improved through supply chains but some concerns re costs plus Council some stock with which able to assist providers

•        Council’s website - bespoke section for providers i.e. web form to request PPE/information/support/resources

•        Rotherham Skills Academy to meet their immediate recruitment and training needs for adult social care  ...  view the full minutes text for item 6.

An overview of the declaration and its 14 commitments and what adopting it will involve for Rotherham Council.

The Cabinet Member introduced this item by talking about the change in emphasis around the significant problem of obesity in Rotherham.  Previous focus had been on Tier 3 and when people had already become obese, whereas now the attention was on earlier interventions and joined up thinking across all services, linked to the wider determinants of health.  The plan was a living document and any suggestions from Health Select could be incorporated.

Kate Green from Public Health confirmed that the Council had adopted and signed the declaration in January 2020.  Not all actions had been carried out but it set out a clear statement of intent, including to influence policy, service delivery and partners to work towards healthy weight being the norm in Rotherham.  Work had paused due to Covid-19 and the original timeline would be reviewed but it would form part of the recovery.  The table in the appendix would be updated as the original commitments had been reviewed and amended.

Robin Ireland from Food Active delivered the following presentation.

•        The impact of obesity

•        Statistics showing prevalence of obesity linked to deprivation and excess weight among children

•        The background to the Healthy Weight Declaration (HWD)

•        The 14 Commitments

•        Examples from elsewhere – Blackpool/Cheshire West and Chester

•        The Partner Pledge (Cheshire West and Chester Council) - contains a set of commitments which organisations pledge to work towards to impact on the health and wellbeing of their staff, clients and the wider community and aims to support the actions of the Council’s Declaration.

•        The NHS Declaration - provides NHS organisations with an opportunity to state their commitment to supporting patients and staff to achieve a healthy weight

Covid – 19 and Healthy Weight

•        WHO has highlighted non-communicable diseases (NCDs) as a risk factor for becoming seriously ill with COVID-19

•        Obesity may be a risk factor for developing more severe Covid-19 complications, requiring hospitalisation and critical care.

•        Obesity is commonly associated with decreased immune function = greater risk

•        Emerging evidence suggests men with obesity are more at risk

•        As obesity class increases, the risk of mortality increases. More than double with BMI of over 40 – independent of co-morbidities.

•        People with obesity may be of lower socioeconomic status, race/ethnicity, poorer diets etc – implications on metabolic affects.

•        Affects access to/availability of treatment for obesity – particularly those who have experienced weight stigma and may feel a sense of guilt for using NHS resources.

Food Active – a North West Response

•        A collaborative programme launched by the North West Directors of Public Health in November 2013 to tackle increasing levels of obesity.

•        Focusing on population-level interventions which take steps to address the social, environmental, economic and legislative factors that affect people’s ability to change their behaviour.

•        Less victim blaming, more environment framing

What are the Local Authority Declarations for?

•        Strategic leadership: creates an opportunity for senior officers and politicians to affirm their commitment to  ...  view the full minutes text for item 7.

Outline work programme for 2020-21 for discussion.

Janet Spurling, Governance Advisor introduced an initial draft of the Health Select Commission’s work programme for 2020-21 for discussion.  The work programme needed to address key policy and performance agendas, with a clear emphasis on adding value, leading to improved outcomes for the people of Rotherham.  It should also be focused on issues that Scrutiny would be able to influence.

Central to the work programme would be transformation of health and social care services, a longstanding and continuing focus for Scrutiny over several years.  NHS provider performance would be scrutinised through the Quality Reports and updates in respect of particular service areas.  Adult Care and Public Health Outcome Frameworks enabled progress in Rotherham to be gauged year on year and benchmarked nationally and regionally.  Addressing health inequalities in the borough, through health and social care strategies and plans, and by looking at the wider determinants of health, was an issue that the Select Commission had frequently highlighted and would continue to explore.  In addition, the work programme would have to take account of the response to and recovery from the Covid-19 pandemic.

The initial work programme in Appendix 1 reflected agenda items on which the Health Select Commission had requested progress reports for 2020-21 in order to scrutinise the impact of recent service or policy changes, such as Ophthalmology Services.  It also included items delegated from the Overview and Scrutiny Management Board for monitoring, such as the impact of implementation of the new Home Care and Support Services Contract.

More direct public involvement in scrutiny work was acknowledged as an area to develop further and HSC expected to see qualitative evidence of the impact of service changes and transformation, in addition to the quantitative data and metrics.

Key priorities in the work programme would include:

-   Intermediate Care and Reablement

-   Depression and Mental Health

-   Support for Carers

-   Covid-19 Response and Recovery

-   Respiratory Services

-   Residential and Nursing Care Homes

It was noted that membership of the Quality Sub-groups for each of the NHS Trust Providers would be based on the previous year’s membership to retain the knowledge developed by Members of those health partners’ services.

Following discussion, it was agreed to undertake a spotlight review of issues arising from the impact of Covid-19 on adult and older people’s mental health later in the year, linking in with the preliminary information on prevalence of depression scrutinised the previous year.

The Chair proposed that the meeting in July should be a standard formal meeting if items could be brought forward, with scrutiny of issues arising from the Covid-19 pandemic to be considered in a separate in-depth workshop session, with the outcomes reported back at the next meeting in September.

Resolved:-

1)    That the initial work programme be noted with the priorities agreed for 2020-21 as discussed.

2)    That the July meeting be a formal meeting to include agenda items that could be brought forward.

3)    That a workshop session be arranged in July for scrutiny of issues  ...  view the full minutes text for item 8.

The Chair announced this item would be deferred until the next meeting.

The Chair announced this item would be deferred until the next meeting.

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

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

The next meeting of the Health Select Commission will be a virtual meeting held on Thursday 16 July 2020, time to be confirmed.

Resolved:- That the next meeting of the Health Select Commission take place on Thursday 9 July 2020, commencing at 2.00 p.m. as a virtual meeting.