Agenda and draft minutes

To consider and approve the minutes of the previous meeting held on (20 June 2024 as a true and correct record of the proceedings and to be signed by the Chair.

Resolved:-

That the minutes of the meeting held on 20 June 2024 be approved as a true and correct record of the proceedings.

The Chair also noted that the following actions arising from the previous meeting had been addressed, with members having received communications by email:-

·       The creation of a glossary of terms.

·       The provision of additional information concerning Family Hubs.

·       The provision of additional information concerning testing following outbreaks e.g. E-coli.

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

The following declarations of interest were made:-

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 questions from members of the public or the press.

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

There were no items of business on the agenda which required the exclusion of the press and public from the meeting.

Members to receive an update in relation to an LGA peer review undertaken in respect of Adult Social Care from the Assistant Director of Adult Care and Integration, Kirsty Littlewood and the Cabinet Member for Adult Care and Health, Councillor Baker-Rogers.

The Chair welcomed Councillor Baker Rogers, Cabinet Member for Adult Care and Health and Kirsty Littlewood, Assistant Director of Adult Care and Integration.

The Cabinet Member for Adult Care and Health outlined that the report presented detailed the findings of the LGA peer review report commissioned by the service in December 2023. They noted that there were five key improvement areas identified:-

1.    Feedback and communication.

2.    Deprivation of Liberty Safeguards (DoLS) Assessments.

3.    Carers Assessments.

4.    Market Position Statements.

5.    Better Care Fund.

The Cabinet Member for Adult Care and Health also noted that the report had recognised twelve areas where the Council was performing well, in addition to providing several top tips including:-

·      Appointing a dedicated lead for regulation.

·      Learning from CYPS (Children and Young Peoples Services).

·      Strong partnership approaches.

·      Ensuring the voice of the resident is prominent in developing services.

They advised that the overall findings from the peer review were positive, with the service intending to deliver the associated work programme by the end of 2024 in readiness for a peer review by ADASS (Association of Directors of Adult Social Services) in January 2025.

The Assistant Director of Adult Care and Integration introduced Dania Pritchard, the newly appointed Regulatory Assurance Lead for Adult Social Care whose role was to ensure that the service’s provision meets the standards expected by the CQC (Care Quality Commission) through the delivery of the improvement programme.

The Assistant Director of Adult Care and Integration provided the history and context to the decision to pursue the peer review, resulting from the enactment of the Health and Care Act 2022 in April 2023 which provided new powers for the CQC to undertake independent assessment of Local Authorities.

The Assistant Director of Adult Care and Integration explained that whilst an inspection primary focus was Adult Social Care the whole Council is assessed. They detailed the four domains of the assessment framework:

1.      Working with people.

2.      Providing support.

3.      How the Local Authority ensures safety.

4.      Leadership.

They explained that the purpose of the peer review was to allow the Council to identify areas of strength and weakness against that framework, through the objective lens of independent insight, enhancing existing self-assessment processes.

The Assistant Director of Adult Care and Integration summarised the findings of the peer review and focussed on each of the five key themes outlined by the Cabinet Member for Adult Care and Health.

In respect of feedback and communication the Assistant Director of Adult Care and Integration noted that staff had described the need for more frequent engagement and communications to remain informed of the developments in Adult Social Care, which often occurred at pace.  They described that in response the service had developed a new communication framework, with directorate wide and Adult Social Care specific tiers, which incorporated whole service events led by the Assistant Directors.

Residents campaigns were reinvigorated using a variety of media to maximise reach, and work with commissioning partners including provider forums has taken  ...  view the full minutes text for item 14.

To receive information from Claire Smith, Deputy Director of Place (Rotherham), South Yorkshire Integrated Care Board (ICB) about her role and that of the ICB in the context of the Health Select Commission.

The Chair welcomed Claire Smith, Director of Partnerships/Deputy Director of Place, South Yorkshire Integrated Care Board (ICB).

The Director of Partnerships/Deputy Director of Place, South Yorkshire ICB provided a high-level overview of their role and that of the ICB in the context of the work of the Health Select Commission.  They outlined the journey from previous arrangements as Clinical Commissioning Groups (CCGs) to the current structure and arrangements as an ICB.

Members were advised that when comparing South Yorkshire to similar regions, population health outcomes weren’t where they needed to be across a number of areas. They likewise acknowledged that there were variations in outcomes across and within the four South Yorkshire places.

The Director of Partnerships/Deputy Director of Place, South Yorkshire ICB outlined the legislative drivers prompting the formation of the Integrated Care System (ICS), South Yorkshire ICB’s role within that, and its relationship with the Integrated Care Partnership (ICP).

They outlined the ICB’s four key aims:-

·      Improve outcomes in population health and healthcare.

·      Tackle inequalities in outcomes, experience and access.

·      Enhance productivity and value for money.

·      Help the NHS to support broader social care and economic development.

They described the ways in which the ICB works in partnership with Local Authorities, the NHS and the Voluntary Community Sector to collaboratively deliver those aims, through joint plans and strategies.

The Director of Partnerships/Deputy Director of Place, South Yorkshire ICB confirmed that the ICB became responsible for POD (Pharmaceutical, Ophthalmic and Dental) services in April 2023 and was expected to take responsibility for commissioning of some specialised services over the next 12 months.

They explained the structure and operating methodology of the Rotherham Place Team, outlining the benefits of collaboration across places to bridge service gaps and achieve value for money. They also provided an overview of the Rotherham Health and Care Delivery Plan 2023-25.

Councillor Yasseen queried whether the strategic positioning of the ICB and the overarching structures will genuinely improve the performance of GP services and access to dentistry etc. and sought information regarding the evidence base giving rise to the implementation of that structure.

The Director of Partnerships/Deputy Director of Place, South Yorkshire ICB stated that Rotherham was in a strong position in terms of partnership working compared to others at the start of the transformation journey, and added that this had minimised the visible impact at local level. They acknowledged that there was still work to do to build that evidence base.

Councillor Yasseen queried whether the ICB had agreed any targets or benchmarks with the Local Authority against which progress was assessed to give Members assurances that the intended impact and improvement priorities were being met in the Rotherham context.

The Director of Partnerships/Deputy Director of Place, South Yorkshire ICB explained that it was Councillor Roche, Councillor Baker-Rogers’ predecessor who had driven that agenda, and the expectation was that this would continue with the new Cabinet Member for Adult Care and Health. It was acknowledged that it had proven difficult in the past  ...  view the full minutes text for item 15.

To receive information from Michael Wright, Managing Director/Deputy Chief Executive, The Rotherham NHS Foundation Trust about his role and that of TRFT in the context of the Health Select Commission.

The Chair welcomed Michael Wright, Managing Director/Deputy Chief Executive, TRFT.

The Managing Director/Deputy Chief Executive, TRFT provided a high-level overview of their role and that of TRFT in the context of the work of the Health Select Commission. 

An outline of the Trust’s five-year strategy, launched in 2022 and underpinned by the Trust’s vision, values, behavioural framework and strategic ambitions was provided. The strategy had recently undergone a refresh, which would enhance and increase the pace of delivery against its aims and objectives.

The Managing Director/Deputy Chief Executive, TRFT set out some notable achievements to date from the strategic plan describing the primary objectives for 2024/25 and the measures against which performance was assessed. Approximately 5 years ago, the Trust scored in the bottom quartile for positivity, with this having improved to the upper quartile following the most recent NHS staff survey.

The Trust was described as a combined Acute and Community Trust which employed five thousand staff, with operational bases which delivered health services at various locations across the borough.  It was explained that following a recent restructure, the Trust was operationally divided into four Clinical Care Groups:-

·      Care Group 1: Medical and Emergency Care.

·      Care Group 2: Surgery.

·      Care Group 3: Family Health (including Maternity, Paediatrics and Pharmacy).

·      Care Group 4: Community Care (including Imaging and Diagnostics).

The Managing Director/Deputy Chief Executive, TRFT explained that there were a number of quality improvement projects underway, which aimed to reduce staff turnover, notwithstanding the value of fresh perspectives.  This had already realised a reduction in Health Care Assistants (HCAs) turnover of 40% and 36% for entry level nursing staff.

The Trust’s HSMR (Hospital Standard Mortality Ratio) stood at 120 four years ago, which exceeded the national average of 90.  This had reduced to 90, which was below the position expected at that stage.  There were also significant reductions in locum and agency staffing costs incurred to the tune of approximately £3.7 million.

The Trust had achieved a notable reduction in 4 hour breaches in the Accident and Emergency (A&E) Department, it was one of the first Trust’s post pandemic to regain compliance with the diagnostic target, it’s neonatal unit had undergone refurbishment and the Trust’s charity work was considerably expanded.

The Managing Director/Deputy Chief Executive, TRFT summarised the Trust’s Leadership Structure, noting that the Trust worked closely with place partner including the ICB, Local Authority and relevant others.  They described their broad portfolio and their contributions to the Health Select commission, detailing items relating to which the Health Select Commission received routine updates.

They stated that TRFT derived real value from its involvement in the work of the Health Select Commission.

The Chair thanked the Managing Director/Deputy Chief Executive, TRFT for their presentation and continued contributions to the Commissions work.

The Chair advised Members that the Managing Director/Deputy Chief Executive, TRFT was scheduled to present TRFT’s Annual Report at the next Health Select Commission meeting, and suggested it may be prudent to pose questions around their  ...  view the full minutes text for item 16.

To receive the Oral Health Review Report and recommendations, along with a supplementary briefing and consider the appropriate way forward.

The Chair introduced the Oral Health Review Report and Supplementary Briefing, requested Members consider the options outlined in the briefing and invited comments and questions relating to the material presented.

Councillor Tarmey noted that the Oral Health Review Report contained some very good material, but that it had been sixteen months since the workshops were held and recommendations agreed, since which time there was a change of government with new health priorities which were likely to develop over the next 6 months.  It was felt it would be beneficial to see more recommendations which were specific and measurable arising from the report. As such, Councillor Tarmey proposed that the Commission agree to proceed with option three within the supplementary briefing and refresh and re-scope the review to take account of the changing landscape. Councillor Garnett seconded the proposal to agree option three.

Councillor Yasseen indicated their agreement with Councillor Tarmey’s observations. For the benefit of new Members of the Commission, they provided context explaining that dental care had not previously featured on the Commissions work programme prior to 2022 when it was added for the first time.

Prior to that time, the Commission had a limited relationship with Dental Care providers and commissioning decision makers, which was of concern in the context of statistical data concerning oral health in Rotherham.

Councillor Yasseen suggested that a bundle was prepared around the Access to Dental Care Report, and the South Yorkshire Dental Stakeholder event held in November 2023 and shared with members to add further background and context.

They explained that the regrettable delay in presenting the review and recommendations aside, recent data indicated that only 55% of children were accessing dental care in Rotherham, reflecting a worsening position post-pandemic, which they felt validated this as an ongoing issue which the Commission should address.

Resolved:-

That the Health Select Commission:

1.    Agreed to proceed in accordance with Option Three as described in the supplemental briefing in respect of the Oral Health Review Report and Recommendations.

2.    That re-scoping work associated with that undertaking would commence before 25 December 2024.

To receive and consider the minutes and recommendations of the South Yorkshire, Derbyshire and Nottinghamshire Joint Health Overview and Scrutiny Committee (JHOSC).

The JHOSC meeting scheduled to take place on 5 July 2024 was cancelled.

As such, there are no minutes or recommendations to receive on this occasion.

The next meeting is scheduled to take place 5 September 2024.

The Chair advised Members that the JHOSC meeting scheduled to take place on 5 July 2024 was cancelled and the next meeting was scheduled to take place 5 September 2024.

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

There were no items of urgent business.

The Chair advised Members that the agenda for the next Health Select Commission meeting would include receipt of the TRFT Annual Report and an Introduction and Overview from Healthwatch Rotherham Manager, Kym Gleeson.  Members were advised that discussions with the Overview and Scrutiny Management Board (OSMB) regarding co-ordinated work-programming intended to maximise productivity, cross-commission collaboration and impact would have concluded by the next meeting and the work programme was expected return to the Commissions agenda as a standing item at that stage.

Resolved:-

That the Health Select Commission noted that the next meeting would take place Thursday 3 October 2024 at 5.00 pm.