Agenda and draft minutes

There were no Declarations of Interest made at this meeting.

There were no members of the public or the press in attendance. 

Discussion took place on the following items:-

(1) Dr. Julie Kitlowski - retirement

Members heard that this would be the last meeting of the Health and Wellbeing Board attended by the Vice-Chair, Dr. Julie Kitlowski, who would shortly be retiring.

Members placed on record their thanks and appreciation of the work of Dr. Kitlowski for the Health and Wellbeing Board and expressed their best wishes for a long and happy retirement.  Dr. Kitlowski thanked the members for their kindness and wished the Board well in the future.

It was also noted that Dr. Richard Cullen was due to be appointed to the position of Chair of the Rotherham Clinical Commissioning Group and would consequently also assume the position of Vice-Chair of this Health and Wellbeing Board.

(2) Health and Wellbeing Board – Partnership Working

The Chair reported that both the Rotherham Clinical Commissioning Group and the Borough Council has expressed satisfaction in respect of the strong partnership working being effected by the Health and Wellbeing Board and that these views were supported by the Local Government Association.

(3) Adult Care Development Programme (Better Care Fund)

Reference was made to Minute No. 68 of the meeting of the Borough Council’s Health Select Commission held on 19th January, 2017 and it was agreed that the possibility of Continuing Health Care funding being included as part of the Better Care Fund should be considered initially by the Better Care Fund Sub-Group of the Health and Wellbeing Board. The Sub-Group would consider examples and cases of individuals’ health care needs not being properly assessed and would report its conclusions to a future meeting of the Health and Wellbeing Board.

(4) Better Care Fund – Draft Plan 2017 to 2019

Although the Better Care Fund Daft Plan 2017 to 2019 would be considered later in the agenda of this meeting (Minute No. 64 below refers), discussion took place on whether the Daft Plan ought to be submitted to the Borough Council’s Health Select Commission for consideration. It was agreed that, whilst the Draft Plan could be submitted for discussion by the Health Select Commission, the ultimate responsibility for the sign-off of the Better Care Fund Plan (before its submission to NHS England) remained with the Health and Wellbeing Board.

(5) Scrutiny of the Health and Wellbeing Board - Concordat

Arising from discussion of item 60(4) above, it was agreed that, with regard to the relationship between the Borough Council scrutiny process and this Health and Wellbeing Board, the previously agreed joint protocol between this Health and Wellbeing Board, the Borough Council’s Health Select Commission and Healthwatch Rotherham will be included on the agenda for the Board’s next meeting, to enable the protocol to be reviewed and clarified.

Minutes of meeting held on 11^th January, 2017

The minutes of the previous meeting of the Health and Wellbeing Board, held on 11^th January, 2017, were considered.

Matters arising updates were provided in relation to the following items:-

(a) (Minute 50) – all sponsors and lead officers for the Health and Wellbeing Strategy have been notified of the timetable in respect of the action plans for the five Strategy Aims being presented to the next meeting of this Board, to be held on 17th May, 2017.

(b) (Minute 50) – it was noted that a new protocol had been developed between the two Rotherham Safeguarding Boards (ie: Adults and Children’s) and the Health and Wellbeing Board, the Safer Rotherham Partnership and the Children and Young People’s Partnership. This protocol was currently being considered by each of the Partnership Boards and would be circulated for comment and feedback after the meeting. Comments were requested to be sent to   kate.green@rotherham.gov.uk  by 31 March 2017.

(c) (Minute 50) - it was noted that work was underway to identify what was currently being delivered in relation to ‘all-age friendly’ communities.  An update on this matter would be provided at the next meeting of the Health and Wellbeing Board, to be held on 17th May, 2017.

(d) (Minute 52(4)) – Both Tony Clabby and Janet Wheatley had now been advised of the key messages for engagement in respect of the Regional Sustainability and Transformation Plan and the Rotherham Place Plan.

(e) (Minute 55) The Rotherham Carers’ Strategy – the requested discussions had now taken place between the Borough Council’s Adult Social Care Service and the Rotherham Foundation Trust concerning the procedures for identifying ‘hidden’ carers upon admission to hospital. There had also been a suggestion that the Carers’ Strategy should be officially launched.

(f) (Minute 56) Rotherham Public Mental Health and Wellbeing Strategy 2017-2020 – members of the Board had been asked for nominations to join the multi-agency working group to develop the action plan for this Strategy. A number of nominations had been received already and any others should be sent to  kate.green@rotherham.gov.uk.

Resolved:- That the minutes of the meeting held on 11^th January, 2017, be approved as a correct record.

Presentation by Rob O’Dell, South Yorkshire Police, supported by Karen Hanson, RMBC

The Chair referred to a survey undertaken in 2011 by the former coalition Government about levels of happiness and anxiety within society. According to data held by the National Office for Statistics, Rotherham is placed in the top ten towns in the country which have the widest disparity between happiness and anxiety amongst its residents.

In that context, the Chair welcomed Mrs. Karen Hanson (Assistant Director, Community Safety and Street Scene, RMBC) and Superintendent Sarah Poolman (South Yorkshire Police), who gave the following presentation about the Health and Wellbeing Strategy Aim 5: Rotherham has healthy, safe and sustainable communities as places:-

Safer Rotherham Partnership – “Working together to make Rotherham Safe, to keep Rotherham safe and to ensure the communities of Rotherham feel safe

-          Statutory partnership under the Crime and Disorder Act 1998

-          Six responsible authorities (Local Authority, Police, Fire and Rescue Service, Probation Service, Community Rehabilitation Company, Clinical Commissioning Group);

-          Statutory duty to develop an annual Joint Strategic Intelligence Assessment (JSIA)

-          Requirement to develop and implement a partnership plan

-          Safeguarding protocol linking Partnership Boards

Safer Rotherham Partnership Priorities

-          Reducing the threat of child sexual exploitation and harm to victims and survivors

-          Building confident and cohesive communities

-          Reducing the threat of domestic abuse and harm to victims and survivors

-          Reducing and managing anti-social behaviour and criminal damage

-          Reducing the risk of becoming a victim of domestic burglary

-          Reducing violent crime and sexual offences

Safer Rotherham Partnership Structure

-          Safer Rotherham Partnership Board

-          Performance and Delivery Group

-          Priority Theme Groups

-          Task and Finish Groups

-          Other meetings and networks

Countywide meeting

CIMs

Area Assemblies

Reducing Crime and Anti-Social Behaviour

-          Prevention

-          Early Intervention

-          Development of integrated neighbourhood model

-          Enforcement

-          Communication

Rotherham’s Local Plan

-          Health is a cross-cutting theme in Rotherham’s Local Plan – which guides all future development in our Borough

-          The Plan includes “Promoting Healthy Communities – Good Practice Guidance” which seeks to strengthen and integrate provision for health and wellbeing within the design of new development

-          It highlights key health impacts and requires the consideration of health and wellbeing in planning applications to promote healthy communities and sustainable development

-          Locating shops and services in accessible areas – can promote improved walking and cycling and use of public transport

-          Providing and protecting green spaces near to home – enables greater use and enjoyment of the outdoor environment

-          The Local Plan also has policies on the Natural and Historic Environment, Air Quality and creating Safe and Sustainable Communities

-          Examples of specific policies (development with Public Health partners)

Promoting hot food takeaways (AP25) to limit their proximity to local schools and colleges, the impact they have on local amenity and their concentration within local areas

Opportunities for people in Rotherham to use outdoor space for improving their health and wellbeing

-          Pensioners playgrounds

-          New and improved children’s play areas

-          Allotments

-          Improved changing  ...  view the full minutes text for item 62.

Verbal update by Chris Edwards, CCG

Further to Minute No. 52 of the meeting of the Health and Wellbeing Board held on 11th January, 2017, members of the Board heard that progress was being made with engagement and consultation in respect of the Rotherham Place Plan. It was noted that the governance arrangements had still to be finalised and that the aims of the Plan would have to be achieved within existing financial resources.

Resolved:- that the Rotherham Place Plan would be included on the agenda for consideration at the next meeting of the Health and Wellbeing Board, to be held on 17th May, 2017.

ACTION:  Chris Edwards

(a)  Better Care Fund Draft Plan 2017/19

(b)  Better Care Fund Quarter 3 Submission

Presented by Nathan Atkinson/Karen Smith, RMBC

(a)  Draft Plan 2017/19

Nathan Atkinson, Assistant Director of Strategic Commissioning (RMBC Adult Social Care), presented the draft version of the Better Care Fund Plan 2017-19 for information which incorporated feedback from the BCF Executive Group.

NHS England had requested a two year Better Care Fund plan covering the financial years 2017/18 and 2018/19. The intention was to “simplify the guidance and assurance process but plans are expected to be an evolution of the 2016/17 plan and not require significant rework”.

The number of National Conditions would be reduced to three from 2017/18:-

·           A requirement for a jointly agreed plan, approved by the Health and Wellbeing Board.

Rotherham - All minimum funding requirements had been achieved

·           Real terms maintenance of transfer of funding from Health to support Adult Social Care

Rotherham’s local plan was higher than the contribution required and there were no plans to reduce this.  It continued to fund several Social Care Services which were strategically relevant and performing well, including Social Workers supporting A&E, case management and supported discharge

·           Requirement to ring-fence a portion of the CCG minimum to invest in Out of Hospital services

In Rotherham there were three admission, prevention and supported discharge pathways all supported by the Better Care Fund and backed by the wider initiatives within Rotherham’s Integrated Health and Social Care Place Plan

Rotherham’s BCF plan sets out key schemes, and how each would be measured and managed.

It has been confirmed that when guidance was published, a template would be issued, but that the use of it would not be mandatory. The current version had been adapted to include the recently issued guidance regarding the narrative plan. Once issued, there would be a minimum of six weeks to complete and submit the plan to NHS England.

The key priorities for 2017-19 were:-

·           A single point of access into Health and Social Care Services  

·           Integrated Health and Social Care teams

·           Development of preventative services that supported independence

·           Reconfiguration of the Home Enabling Service and strengthening the seven day Social Work offer  

·           Consideration of a specialist reablement centre incorporating Intermediate Care 

·           A single Health and Social Care Plan for people with long term conditions

·           A joint approach to care home support

·           A shared approach to delayed transfers of care (DTOC)

Discussion took place on the importance of assisting individuals in the self-management of conditions, without necessarily having recourse to personal budgets.

Members of the Board were asked to contact Nathan Atkinson and Karen Smith (RMBC Adult Social Care) with any further comments they wished to make on the draft Plan.

Resolved:-(1) That the current iteration of the daft Better Care Fund Plan 2017-2019 and the strategic direction be noted.

(2) That the formal approval of the Better Care Fund Plan 2017-2019 shall be delegated to the Better Care Fund Executive Group of this Health and Wellbeing Board.

(b)  Better Care Fund Quarter 3 Submission (2016/17)

Nathan Atkinson, Assistant Director of Strategic Commissioning (RMBC Adult Social Care), presented the  ...  view the full minutes text for item 64.

Presented by Linda Harper, CYPS

The Strategic Director for Children and Young People’s Services presented the Rotherham Joint Commissioning Strategy for Children and Young People with Special Educational Needs and/or Disabilities (SEND). The Strategy provided an overview of how the joint commissioning of services for children and young people with SEND in Rotherham would be developed and implemented in line with the requirements of the Children’s and Families Act 2014 and the associated Code of Practice for SEND.

The Strategy, through a mapping exercise, consultation and a review of transitions with parents/carers and stakeholders, had identified nine priority areas of work that would be implemented over the next three years:- 

1.    Create a joint SEND Education, Health and Social Care Assessment hub at Kimberworth Place.  

2.    Review and re-model services that provided support for children and young people with challenging behaviour. 

3.    Develop a Performance and Outcomes Framework that would be applied across all local authority and CCG SEND provision.

4.    Align local authority and CCG Service Specifications for SEND Service provision, to facilitate commonality of practice and a consistent approach (thus reducing duplication, improving efficiencies and develop clearer pathways).

5.    Audit the Education, Health and Care Planning (EHCP) process to look at how the assessment process (including the decision making process/panels and allocation of resources) could be streamlined, so as to reduce the multiple assessments that young people and their families had to undertake.

6.    Ensure that there was a co-ordinated joint Workforce Development Plan.

7.    Develop and implement Personal Budgets.

8.    Develop pathways to adulthood.

9.    Develop approaches to improving life experiences which were person centred.

The Strategy had been previously approved by the Clinical Commissioning Group’s Operational Executive, the Council’s Children and Young People’s Services leadership team and the Children and Young People’s Partnership Board, and endorsed for sharing with the Health and Wellbeing Board.

The full implementation of the Strategy would require a phased approach to move from the current position.  Work had already commenced in taking forward a number of the priority areas, namely the creation of a joint SEND Assessment Hub, the re-modelling of services that provided support for children and young people with challenging behaviour, the development of personal budgets, the development of aligned Service Specifications for Education, health and social care services, and the development of pathways to adulthood.

Resolved:-  That the refreshed Rotherham Joint Commissioning Strategy for Children and Young People with Special Educational Needs and/or Disabilities (SEND) be noted.

Update by Nathan Atkinson, RMBC

In accordance with Minute No. 50(3) of the meeting of this Board held on 11^th January, 2017, the current position with regard to commissioned Care homes in Rotherham was submitted. The scope of the update included Residential, Nursing, Residential with Dementia Care and Nursing with Dementia Care for Adults i.e. 18-64 and older people.

There was a total of thirty-five independent sector care homes (owned by twenty-threeorganisations) contracted to support older people in Rotherham.  They provided a range of care types categorised as Residential Care, Residential Care for people who were Elderly and Mentally Infirm, Nursing Care and Nursing Care for people who were Elderly and Mentally Infirm.

There was a total of thirty-six Independent sector homes (owned by twenty-four organisations) contracted to support Adults with specialist needs. They provided a range of care for Adults who lived with Learning Disabilities, Physical Disabilities, Mental Health and Sensory conditions (including Acquired Brain Injury).

The independent sector care home market in Rotherham supplied 1,779 beds and accommodated around 1,593 older people. The Council was the dominant purchaser with the majority of the population placed by the Council. There was currently a vacancy factor of 186 beds or 10.5% of the total capacity.  It also supplied 397 beds and accommodated around 386 adults with specialist needs.  The Council purchased 37% (145 beds) with the remaining 63% (252) beds occupied by residents who were fully funded by Continuing Health Care and Out of Authority places.  There was currently a vacancy factor of 31 beds (8%) of the total capacity.

As of February 2016, the total Older People’s care home population was made up of:-

-        26% (409 people) private paying clients including from out of Borough.

-        4.5% (72 people) placed and funded by other local authorities.

-        62% (987 people) placed and funded by the Council – this includes

-        people who receive Funded Nursing Care.

-        7.5% (125 people) placed and funded by our health partners under

-        Continuing Health Care arrangements (fully funded by Rotherham CCG). 

As of February 2016, the specialist care home population placed by the Council was made up of:

-        21% (31 people) funded fully by the Council (no client contribution) – this included people who received Funded Nursing Care.

-        7% (10 people) jointly funded by the Council and Continuing Health Care.

-        72% (104 people) funded by the Council and a financial contribution from the service user.

All Council commissioned providers were registered with, monitored and inspected by the Care Quality Commission (CQC) as well as monitored and inspected by a team of Contracting Compliance Officers.   Providers were monitored against standards set out in the Council’s service specification(s) and the associated contract(s) terms and conditions.  Deviation away from the standards resulted in intervention with providers which may include action plans, special measures improvement plans, contract default action and/or embargoes.  Action undertaken by the Strategic Commissioning Team may ultimately result in contract termination should providers continue fall below the required standard. 

All Older  ...  view the full minutes text for item 66.

The Chair to present

The Chair opened a discussion about the impact of loneliness and isolation upon the mental and physical health of individuals. Specific reference was made to:-

·           the incidence of early deaths amongst sufferers of loneliness and isolation;

·           community support projects/schemes (eg: Men-in-Sheds; Home First);

·           the suggestion of a survey being undertaken of persons within the Rotherham Borough area who suffer loneliness and isolation;

·           identifying the extent of service provision and any gaps in such provision – as well as the possible reluctance of lonely and isolated people to gain access to appropriate advice and assistance.

The Health and Wellbeing Board noted the intention to establish a Working Group to examine this issue further.  A number of members of the Board expressed a willingness to contribute to this Working Group.  The Chair asked for nominations to be sent by e-mail to kate.green@rotherham.gov.uk

The Board received the Quarter 3 update for the CAMHS Local Transformation Plan for information.

The Plan continued to be closely monitored and updated on a bi-monthly basis and was now published on the NHS Rotherham Clinical Commissioning Group website alongside the Local Transformation Plan (LTP) itself. It reflected all the proposed developments in the ‘Future in Mind’ report and went behind the specific priority development areas outlined in the Local Transformation Plan and to which extra funding was attached.

Further detail on each local priority scheme was set out in the report submitted.

All of the priority schemes had started their implementation in 2015/16.  There were a number of other identified areas for development, which were included in the CAMHS LTP Action Plan, scheduled to start in 2017/18 or beyond.  These included:-

·           Undertaking a scoping exercise to understand if the ‘Thrive’ model or something similar could be developed in Rotherham.

·           Undertaking a scoping exercise to understand how ‘One-stop-shops’ could be developed in Rotherham.

·           Implementing a Social Prescribing Service during 2017/18 to support children and young people who transition out of CAMHS services but not into Adult Services.  This would involve new funding from the LTP monies.

·           A new service to be developed from 2017/18 providing education and prevention around self-harm.  This would probably be delivered in school settings by voluntary sector CAMHS providers.  Specific details were being developed and new LTP funding would be allocated to this area.

The report also set out the areas of most challenge in implementation, finance and activity review and review of partnerships.

It was also noted that the Clinical Commissioning Group’s duty to publish an annual engagement report would be fulfilled by including the necessary information within the standard Annual Report.

Resolved;-  That the report be received and its contents noted.

Meetings to commence at 9.00 a.m. on:-

17^th May, 2017

5^th July

20^th September

15^th November

10^th January, 2018

14^th March

Venue to be confirmed

Resolved:-  (1)  That the next meeting of the Health and Wellbeing Board be held on Wednesday,  17^th May, 2017, with the venue to be confirmed.   

(2)  That future meetings of the Board take place on: -

·         5^th July, 2017

·         20^th September, 2017

·         15^th November, 2017

·         10^th January, 2018

·         14^th March, 2018

All meetings to start at 9.00 a.m. and venues to be confirmed.