Agenda and draft minutes

There were no questions from the press and public,

Resolved:-  That the minutes of the meeting held on 4^th June, 2014, be approved as a correct record.

(a)           Carers Review

Janet Wheatley asked if the voluntary sector and multi-agency working group had been set up and, if so, who was the contact.

 

Shona McFarlane reported that the Service Manager would be Janine Moorcroft.  The Steering Group for Carers at present had no 3^rd sector representative but it was being refreshed.  There would be an invitation extended to VAR and others to take part in that process.

 

Councillor Jenny Andrews was the Champion for Carers.

 

(b)           Dalton and Treeton Health Centres

Prior to the PCT reorganisation last year, 2 capital projects had been agreed in Rotherham (replacement of 2 ageing health centres in Dalton and Treeton).  However, no progress had been made. 

 

In the reorganisation it had been passed to Propgo and it was believed there was still the intention to proceed with the development.

 

Resolved:-  That Carol Stubley, NHS England, submit a progress report to the next Board meeting.

Dr. John Radford, Director of Public Health

(9.15 a.m.)

Dr. John Radford, Director of Public Health, gave the following powerpoint presentation on Performance Management:-

 

Performance Management

-          Clear accountability for each performance measure – 1 accountable lead

-          Targets, action plans and milestones track progress and direction of travel

-          Performance monitoring – current performance, RAG status and direction of travel

-          Governance arrangements play a fundamental role managing performance/risk

-          Concerns and outliers are identified to prompt necessary action including clinics

-          Trigger points for a performance clinic:

·           If performance is below target/is predicted to not meet the year end target

·           On target but due to a known event/issue is predicted to n ot meet the year end target

-          The clinic will develop and agree a remedial action plan with the accountable lead

-          Service improvement work takes place immediately upon agreement of the plan

-          Progress monitored and reported to provide assurances that issue is under control necessary improvements in performance are delivered

-          Latest available Public Health data used as a ‘can opener’ to prompt where performance clinics could take place

 

Public Health Outcome Framework Scorecard Summary – 110 National Public Health Outcome Framework Measures

-          National Benchmark RAG Status

·           32 Indicates rated Red

·           27 Indicators rated Amber

·           35 Indicators rated Green

-          Regional Benchmark RAG Status

·           23 Indicators rated Red

·           46 Indicators rated Amber

·           24 Indicators rated Green

 

Green Measures

-          Wider determinants of health

1.02i/ii School Readiness

1.06i LD Settle Accommodation

1.06II MH Settled Accommodation

1.06ii LD/MH Employment (Gap)

1.10 Killed and Seriously injured casualties on England’s roads

1.15i/ii Statutory Homelessness – Acceptances/Households in temporary accommodation

1.17 Fuel Poverty

1.18i Social Isolation

 

-          Health improvement

2.07ii Rate of Emergency Admissions caused by unintentional and deliberate injuries in young people aged 15-24 years

2.20i/ii Cancer Screening Coverage (Breast/Cervical)

2.22i/ii NHS Health Checks – Take up/Offered

2.24i/ii/iii Injuries due to falls in people aged 65 and over

 

-          Health protection

3.02i/ii chlamydia Diagnoses (15-24 year olds)

3.03iii/iv/v/vivii/x/xii/xiii/xiv/xv Vaccination Coverage

3.05ii Incidence of TB

 

-          Healthcare and premature mortality

4.1 Suicide Rate

 

Amber Measures

-          Wider determinants of health

1.09i Sickness Absence – the % of employees who had at least 1 day off in the previous week

1.18ii Loneliness and Isolation Carers

 

-          Health improvement

2.04 Teenage Conceptions

2.06i Excess Weight in 45 year olds

2.07i Rate of Emergency Admissions caused by unintentional and deliberate injuries in children aged 0-14 years

2.12 Excess Weight in Adults

2.13i % of physical active and inactive adults – active adults

2.15ii Successful completion of Drug Treatment – non-opiate users

2.18 Alcohol-related Hospital Admissions

2.23i/ii/iii/iv Wellbeing response from Integrated Household Survey

 

-          Health protection

3.03viii/ix MMR Vaccination Coverage

3.04 People presenting with HIV at a late stage of infection

 

-          Healthcare and premature mortality

4.01 Infant Mortality

4.06i/ii U-75 Mortality Rate from Liver Disease/considered preventable

4.07ii U-75 Mortality Rate from Respiratory Diseased considered preventable

4.14i/ii/iii Hip Fractures in People aged 65 and over

4.15i/ii/iii/iv Excess Winter Deaths Index

 

Red Measures

-          Overarching Indicators

0.1i/ii Health Life Expectancy  ...  view the full minutes text for item 4.

verbal update

(letter attached from NHS England)

(9.45 a.m.)

Chris Edwards reported that the final submission had been due to be made to NHS England.  However, NHS England had requested that the 10 exemplar areas test out the system which would then be rolled out to the remaining 200.

 

Rotherham had been selected as of the exemplar areas as its plan was judged to be 1 of the most developed plans and fit for purpose.

 

The new submission date for the return was now 9^th July, 2014.

 

Discussions had taken place and it was felt the deadline would be achievable with the return being submitted to the August Board meeting.

 

A telephone conference call to the 10 areas was taking place that morning.

 

Rotherham had no option but to conform to this request.

 

Naveen Judah reported that from a national point of view, it seemed that a number of plans submitted were not considered realistic or achievable.

 

It was noted that the requirement for further work would place a burden on the resources of Adult Social Care who were currently working on the significant changes brought about by the Care Act and the Local Authority’s budget process.

 

Chris Edwards stated that no additional work was required and the return would have to have been made but was now to a different timescale and on a different template.

 

The Chairman stated that no decision would be made until the results of the telephone conference was reported to the next Board meeting.

Naveen Judah, Healthwatch Rotherham, to present

(10.00 a.m.)

Naveen Judah, Chair of Healthwatch Rotherham, presented the report produced in partnership with a group of local parents into the work of the Children and Adolescent Mental Health Services

 

Nationally, health and social care provision was being evaluated in light of the Francis report as well as a national review of CAMHS as part of the Children’s Plan.

 

In Rotherham stakeholders had come together to produce and deliver the Rotherham Emotional Wellbeing and Mental Health Strategy for children and young people.  The Strategy would inform service planning and commissioning for the next 5 years.  The aims of the investigation were to:-

 

-          Seek views on how local people believed the culture of CAMHS was affecting Service delivery

-          Obtain views and ideas as to how things could be done better

-          To share the views of local people with the provider and commissioners of CAMHS

-          Ensure local people in Rotherham knew about the activity

 

To enable Healthwatch to achieve the above, 3 methodologies were used:-

 

-          A purpose designed survey

-          A public 2 day event gathering views on themed topics

-          A review of the Healthwatch Rotherham Database

 

From all the statements made it could be concluded:-

 

-          that there was a high level of dissatisfaction with the Service provided

-          parents/carers did not feel listened to

-          felt blamed for the problems they and their child were experiencing

-          did not feel included or able to participate

-          no clarity on what to expect from CAMHS and what services they provided

-          difficult to make a complaint

-          complaints were not handled consistently or in a timely manner

-          waiting times to be seen were too long leaving families feeling unsupported

-          when children were discharged from the service it did not always include families and they were unaware they had been discharged

-          no crisis planning leaving families feeling unsupported and not sure what to do

 

When the concerns had first been raised, Healthwatch had looked at the work being done so as to avoid any duplication and to tackle the area of how Services users were feeling/being treat as opposed to diagnosis and pathways.

 

It was very important that CAMHS communicate and set out the correct expectations from the community.  Services users often thought that CAMHS would be there throughout the process when in actual fact they may only be involved at the referral stage and then someone else took over resulting in CAMHS being wrongfully blamed for everything that subsequently went wrong.

 

Sharon Schofield, CAMHS, apologised that the carers and children had not received the service they felt they should have received from the Service.   It was a small number given the numbers that used the Service nevertheless it was important that the best possible care was given to everybody.

 

A lot of work had taken place, supported by CCG commissioners, to improve both the processes in terms of looking at how appointments were made in a timely way and working within the issues  ...  view the full minutes text for item 6.

verbal update

(10.30 a.m.)

Chris Edwards reported that from the commissioner’s point of view, they were receiving reports from GPs that the Patient Record system was working in an acceptable manner and had no current concerns.

 

David Hicks stated that the Trust had requested Monitor to lift the Enforcement in this area.  The response had been quite encouraging when they had last visited and expected to hear formally very shortly as to whether the request had been acceded to.

 

Resolved:-  That the report be noted.

NHS England to report

(10.40 a.m.)

Fiona Jordan, Consultant in Public Health and Vaccinations and Immunisations, presented a report on Rotherham’s performance against the Public Health Outcomes Framework in terms of vaccinations and immunisations.

 

She drew attention to the following areas:-

 

-          Men C – the red Indicator was due to a problem with data and not performance.  The schedule had changed from 2 dose to 1 dose but the IT system still counted dose 2 as a missed appointment.  This was expected to be rectified for Quarter 1

-          Neonal Hep B – the new local service specification from April, 2014, included data collection.  Intensive work was taking place to ensure that every baby involved received the correct dosage etc. and on time

-          Pertussis vaccination in pregnant women – there was currently a 50% standard against this indicator due to it being relatively new.  Locally this was being pushed with GPs, however, there was a problem in that the IT systems between Maternity and GPs did not always link up in specific time for the practice to pick up that a vaccination was required.  Work was taking place with Maternity Services and GP practices to try and ensure a more rigorous call and recall programme.  Discussions had taken place with the Foundation Trust that the Midwives would be best placed to administer the injection

 

Resolved:-  That the report be noted.

Wednesday, 27th August, 2014, commencing at 9.00 a.m.

Resolved:-  That a further meeting of the Health and Wellbeing Board be held on Wednesday, 27th August, 2014, commencing at 1.00 p.m. in the Rotherham Town Hall.