Venue: Town Hall, Moorgate Street, Rotherham S60 2TH
Contact: Dawn Mitchell The webcast can be viewed at http://www.rotherham.public-i.tv
Declarations of Interest
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
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.
There were no members of the public or press present at the meeting.
The Chair introduced William Brown from Rotherham Youth Cabinet who was on work experience with the Council.
The Chair formally thanked Councillor Short for his hard work as Vice Chair on the Select Commission.
Improving Lives Select Commission
Councillor Jarvis would supply a written report to be circulated to the Select Commission Members.
Hyper Acute Stroke Care
The changes to the Service were being implemented with patients going to one of the three hub hospitals for the Hyper Acute phase. Additional staff had been recruited to manage the increased numbers of patients in the hubs.
Integrated Discharge Team
The joint team, which comprised staff from RMBC and Rotherham Hospital, had won an award in Acute Service redesign for their work in ensuring care and support were in place for patients on their discharge from hospital. Three other teams at the Hospital had also been commended at the awards.
Monitoring Report on Drug and Alcohol Treatment and Recovery Services
Anne Charlesworth, Public Health and Joy Ainsworth, CGL, to present
Anne Charlesworth, Head of Public Health Commissioning, Joy Ainsworth, Deputy Director CGL North East and Michaela Bateman, Associate Nurse Director for the Rotherham Care Group, Rotherham Doncaster and South Humber (RDaSH) delivered the following presentation:-
Original purpose of scrutiny spotlight review
“To ensure that the drug and alcohol service, operating within a reduced budget, would provide a quality, safe service under the new contract”
Specific updates from the commissioning perspective
• CGL were still having monthly Performance and Quality meetings with Public Health to ensure transparency of performance, look at serious incidents and ensure implementation of recommendations of CQC Report.
• After the CQC inspection delivered its findings of ‘Requires Improvement’ a joint report was produced with Bradford Services, but this was amended to have a Rotherham specific report to enable specific Rotherham improvements.
• ‘Requires Improvement’ was due to issues in at least two areas, and some related to building specific concerns which had been rectified. CGL had an internal team that prepared for CQC and were expecting a return visit this year.
By the end of August all tasks that had been identified by the CQC should have been completed. With regards to the concerns around the building, the CQC inspectors were used to looking at secure mental health facilities where the standard was different rather than community-based drugs and alcohol services.
• There were several performance areas of concern – ‘exits’ generally. Non-opiate exits were under particularly scrutiny as it may have received less focus due to a push to improve opiate exits.
• Alcohol pathways needed more work, as did keeping the number of patients flowing through into Shared Care as Rotherham had quite a tight target for making sure as many patients as possible were with their own GP.
• Original predictions were that it would take 18 months to see any real improvement with regard to opiate exits due to the clinical time required to change long term care packages. Rotherham was still within that timeframe, but a close eye was being kept on progress.
• Despite looking for trends and patterns in the deaths information, no clear picture was emerging as yet. The overview of deaths in service were being built into the Strategic Suicide Review Group, chaired by the Strategic Director for Adult Social Care and Healthto ensure strategic oversight.
• Pre-tender soft market testing was now taking place regularly – a recent example was Children’s Weight Management, as a result of which the approach was changed significantly.
Service Perspective from CGL
Background – CGL Rotherham
ü Fully integrated Drug and Alcohol Services
ü Shared Care provision - 24 GPs/46 % of Service users
ü Pharmacy Contracts for Supervised Consumption and Needle Exchange – 28 pharmacies
1,537 clients entered structured treatment April 2018-March 2019 (NDTMS)
q 1,018 opiate users (66%) – National average 52%
q 361 alcohol clients (23%) – National average 29%
q 103 Non-opiate or crack users (Non-OCU) (7%) – National average 9% ... view the full minutes text for item 15.
Janet Spurling, Scrutiny Officer, submitted the final draft of the Select Commission’s work programme for the 2019/20 Municipal Year.
The overall priorities for the Select Commission for 2019/20 included:-
- Rotherham Integrated Health and Social Care Place Plan
- Adult Social Care - performance and development (in conjunction with Overview and Scrutiny Management Board)
- Autism Strategy and Diagnosis Pathway
- Social and Emotional Mental Health
- Sexual Health
- Developments in Primary Care
- Health and Wellbeing Strategy implementation
- South Yorkshire and Bassetlaw Integrated Care System – NHS transformation (Joint Health Overview and Scrutiny Committee)
- Monitoring past reviews
Appendix 1 of the report submitted showed the schedule to date for agenda items and sub-group meetings, with a small number of Adult Care items still to be scheduled.
Appendix 2 set out the proposed membership for each of the NHS Trust Quality Account Sub Groups and the Performance Sub-Group for consideration. The membership was based on the previous year’s membership to retain the knowledge developed by Members of those Health partners’ services.
With regard to the Health Select Commission undertaking a review on gambling/gaming, liaison would take place with the Cabinet Member and Director of Public Health (Minute No. 4 Health and Wellbeing Board) This would ensure added value and avoid duplication with work currently taking place on Harmful Gambling.
The Commission had agreed to hold a single session on the national Adult Social Care Outcomes Framework once the final data and benchmarking was available rather than 2 sessions, which would free up a sub-group meeting to look at another area of performance.
Members asked when an update on progress with My Front Door would be considered. A Member seminar on July 16th would cover progress with Oaks Day Centre and lessons learned and, following full evaluation, a further update could probably be scheduled from October, including plans for respite.
It was suggested that inequalities in health in Rotherham, and whether enough was being done in Rotherham to address those issues, could be a possible spotlight review in 2020-21. This was acknowledged as an important issue and attention was drawn to the ensuing agenda item on Primary Care Networks where one of the national workstreams coming on board would be addressing health and economic inequalities, which might provide an opportunity to link in with Services such as Planning and Housing that also influenced health inequalities. Councillor Roche welcomed the suggestion for the Commission to look at the work of the Health and Wellbeing Board in this area as it was one of the Board’s 2 main priorities, together with the work of Primary Care.
Ward profiles, which had been introduced through the Health and Wellbeing Board to support work on early intervention, were being refreshed and would soon be available with detailed information on each Ward with regard to health inequalities.
Resolved:- (1) That the draft work programme for the 2019/20 Municipal Year be approved.
(2) That the proposed membership for the Quality Account Sub-Groups ... view the full minutes text for item 16.
Jacqui Tuffnell, Head of Commissioning
Jacqui Tuffnell, Head of Commissioning NHS Rotherham CCG, gave presentations on Primary Care and Developing Rotherham Community Health Centre as follows:-
Investment and Evolution – Primary Care
NHS Long Term Plan: Overview
Published in January 2019
Sets out the key ambitions for the NHS over the next 10 years
Produced in response to a new five- year funding settlement
1 New Service Model
2 Prevention and Health Equality
3 Care Quality and Outcome Improvement
4 Workforce Pressures
6 Sustainable Financial Plan
7 Next Steps
A New Service Model for the 21st Century
Five major changes to the NHS service model:
• Boosting ‘out-of-hospital’ care and finally dissolving the historic divide between Primary and Community Health Services
• Redesigning and reducing pressure on emergency Hospital Services
• People will get more control over their own health, and more personalised care when they need it
• Digitally-enabled primary and outpatient care will go mainstream across the NHS
• Local NHS organisations will increasingly focus on population health and local partnerships with local authority-funded services, through new Integrated Care Systems (ICSs) everywhere - in relation to concerns about health inequality population it was about making sure the population's health would be managed appropriately.
What this means
• Urgent Community Response and Recovery Services – integrated rapid response and care home liaison
• Primary Care Networks of Primary and Community Teams – localities now in place renamed PCNs and strengthened
• Guaranteed NHS support for care homes - already had care home alignment with GP practices so one GP practice tended to look after a care home instead of everybody being assigned to different care homes, getting different levels of care and it being reactive instead of proactive
• Supporting people to age well – right support services when needed
• Increasing patient choice
• Same day emergency care – ensuring people were in and out of hospital on the same day by increasing the kind of conditions managed within a 24 hour period so people went back home
• Personalised care when needed
• Reducing delays in patients going home
• Digitalisation of Primary and Outpatient care
• Integrated Care systems everywhere by 2021 – focussing on population health
Rotherham already had some of these Services, therefore, the long-term plan did not bring any big surprises in relation to the direction of travel already taken.
Investment and Evolution: A Five Year Framework for GP Contract Reform to implement to NHS Long Term Plan
- Introduces automatic entitlement to a new Primary Care Network Contract
- Gives five-year funding clarity and certainty for practices
This was quite significant in relation to how GP practice currently operated. It had not been expected to be so clear on the expectations in relation to how Primary Care would change.
The Vision for Primary Care Networks (PCNs)
• The key building block of the NHS long-term plan
• All GP practices in geographical based PCNs with populations of around 30,000–50,000 patients - < 30,000 probably ... view the full minutes text for item 17.
No issues were discussed.
Minutes of meeting held on 29th May, 2019
Consideration was given to the minutes of the Health and Wellbeing Board held on 29th May, 2019.
Resolved:- That the minutes of the Health and Wellbeing Board held on 29th May, 2019, be noted.
South Yorkshire Derbyshire and Wakefield Joint Health Overview and Scrutiny Committee Update
There were no matters to feed back from the Committee as it had not met.
Further to Minute No. 7 of the Health Select Commission meeting on 13th June 2019, additional information had been provided showing comparative data with other areas and also ward-specific data.
Resolved:- That depression prevalence be a specific agenda item at a future meeting of the Health Select Commission.
To consider any item(s) which the Chair is of the opinion should be considered as a matter of urgency.
There was no urgent business to report.
Date and time of next meeting
The next meeting of the Health Select Commission will be held on Thursday, 5th September, 2019, commencing at 2.00 p.m. in Rotherham Town Hall.
Resolved:- That a further meeting be held on Thursday, 5th September, 2019, commencing at 2.00 p.m.