Venue: Carlton Park Hotel, 102-104 Moorgate Rd, Rotherham S60 2BG
Contact: Dawn Mitchell Email: email@example.com
Declarations of Interest
There were no Declarations of Interest made at the meeting.
Questions from members of the public and the press
There were no questions from the members of the public in attendance.
The minutes of the previous meeting of the Health and Wellbeing Board, held on 31st May, 2017, were considered.
Matters arising updates were provided in relation to the following items:-
Minute No. 3 (Sensory Impairment Centre), it was noted that the keys had been handed over to the Royal Society for the Blind and was due to open very shortly. The Centre would be officially opened in October by the Earl of Scarborough.
Minute No. 3 (National Review of Children’s Mental Health Services), it was noted that the review was progressing well.
Minute No. 4 (I Age Well), it was the noted that the event had been very well attended.
Resolved:- That the minutes of the meeting held on 31st May, 2017, be approved as a correct record subject to the following clerical correction:-
Minute No. 11 (Better Mental Health for All Strategy) should read “… 2017-2025” and not 2020 as stated.
There were no communications to report.
Chris Edwards to update
Chris Edwards, Chief Officer, RCCG, submitted for information, the draft terms of reference for the Rotherham Integrated Health and Social Care Place Plan Board (“Place Board”) which was the forum where all the partners across the health and social care system would come together to undertake the regular planning of service delivery.
The Place Board’s role would be:-
- Agreement and sign off of Rotherham Health and Social Care delivery plans
- Ensure a proactive approach to establishing the health and social care needs of Rotherham citizens and to react to the changes within the health and social care agenda
- Operate cost of care effectively in the context of the Rotherham health and social care financial circumstances
- Realise cost saving opportunities through system redesign to meet the Rotherham-wide efficiency challenge ensuring no adverse impact in regard to patient safety and experience
The report also set out the principles the Board would adhere to.
Recommendations for funding would need to be made by the Board to the relevant statutory bodies through individuals where responsibility was delegated by relevant statutory bodies. All recommendations from the Board would need consensus from its membership.
Each member organisation would have one representative on the Board with the joint Chairs of the Health and Wellbeing Boards attending to ensure the delivery was consistent with the strategic direction:-
It was suggested that consideration should be given to the holding of a health conference in Rotherham to showcase its Place Plan and what work was taking place within the Borough
It was noted that the Council had approved its side of the Place Plan which included a joint post of Deputy Director of Adult Social Care.
Resolved:- (1) That the report be noted.
(2) That the Board acknowledges that the Place Board should encompass all commissioners and providers who commissioned or provided health and social care across Rotherham and as such recognised that the membership of the Board may need revising periodically to include additional members.
- Suicide Prevention Strategy
- Better Mental Health for All Action Plan
Kathryn Singh, RDaSH, and Ruth Fletcher-Brown, Public Health, to present
Ruth Fletcher-Brown, Public Health, gave the following updates on Aim 3: Mental Health:-
Suicide Prevention and Self-Harm Action Plan Update 2016/18
Ruth highlighted the following issues contained within the report:-
- The Rotherham Suicide Prevention and Self-Harm Group met quarterly to review progress on the action plan, receive suicide audit data and recommend any necessary response, for example, for high risk groups
- Rotherham had an early alert approach to suspected suicides resulting in a response being made as soon as notification was received
- Partner organisations of the Rotherham Local Safeguarding Children’s Board signed up to the Rotherham Suicide and Self-Harm Community Response Plan in September 2015. The process for activating the plan was the responsibility of RMBC’s Early Help
- The My Mind Matters website had been reviewed and updated with input from the Youth Cabinet
- The Top Tips on suicide prevention for General Practitioners had been updated to include risk factors and at risk groups in Rotherham
- The campaign to target men, ‘Breaking the silence on suicide’ launched in July 2016 with resources distributed across the Borough and advertisements in local press in December, 2016
- 50 workplaces had engaged with the Workplace Wellbeing Charter
- Children and Youth People’s Bereavement pathway continued to be positively received by families
- Families were visited within 48-72 hours of the suspected suicide by officers from the Vulnerable Persons Unit (South Yorkshire Police) and each family offered the Help is at Hand resource and offered telephone support from Rotherham Samaritans
Discussion ensued with the following points raised:-
· There had been an increase in adult suicides of those who had used Drug and Alcohol Services
· For those known to the Mental Health Services wraparound support was provided as much as possible to the people that self-harmed or felt suicidal. They were a high risk group and agencies wanted to make sure they could be supported
· A piece of work recently completed by RDaSH showed that people who suffered any kind of loss were at more risk of suicide. Work was now taking place on post-prevention of suicide. Officers from the VPU offered families telephone support from Rotherham Samaritans
· GPs were notified of any suspected suicide so they were aware should any family members registered with the practice request an appointment
Carole Lavelle commented on the fact that work on suicide prevention in Rotherham was further ahead than many other areas she visited.
Resolved:- (1) That the report on actions taken by the Rotherham Suicide Prevention and Self-Harm Group since the update submitted in May, 2016, be noted and endorsed.
(2) That the areas for future activity, including a commitment to continue Rotherham’s early alert surveillance work, bereavement support and the social marketing campaign work be endorsed.
(3) That an update be submitted on the work of the Rotherham Suicide Prevention and Self-Harm Group annually and exception reports as appropriate.
Better Mental Health for All – Action Plan 2017-2020
Ruth presented the action plan which focussed on work that ... view the full minutes text for item 18.
Presentation by Janet Wheatley,VAR
Janet Wheatley, Chief Executive, Voluntary Action Rotherham, gave the following powerpoint presentation:-
Rotherham Social Prescribing
- Sits alongside clinical interventions – helps people live their lives in a way that feels like living rather than coping and surviving. It provides an integrated response to patient care
- Where the NHS ‘meets’ the community and its assets – shifting the focus from conditions or ages to localities and communities
- ‘what matters to me’ as well as ‘what is a matter with me’
- Involved a leap of faith to working differently – there had to be another dimension to meeting patient needs
- Co-produced – between Rotherham CCG, VCS and service users
- Builds on/enhances local relationships, respect and trust between public sector and voluntary and community sector partners
- Flexible to meet changing needs – embedded within CCT and STP
- Supports and resources VCS – works with groups and patients
- Independent evaluation base – evaluated from onset
The ‘Rotherham Model’
- Voluntary Action Rotherham (VAR) on behalf of Rotherham CCG delivers 2 Social Prescribing (SPS) programmes. VAR manages the programme and micro-commissions activity from the VCS – contracts/spot purchases/grants
- LTC SPS works with all GP practices as part of integrated case management approach. Referral pathway identifies patients referred to a VCS advisor aligned to each GP practice. Started 2012 – 5,835 referrals
- Mental Health SPS works with 2 cluster groups of patients referred by RDaSH to a VCS advisor. Operating since 2014 – 328 referrals
- Patients/service users build and direct their own packages of support, tailored to their specific needs by encouraging them to access services provided by the VCS
Rotherham SPS Research
- We have a rich and systematic evidence base to support our work – both schemes have been independently, academically evaluated from the start
- The evaluations track two main elements:-
Improvement in wellbeing and quality of life
Impact on services either in reduction in demand or potential for discharge/step down
- Plus patients/users stories through case studies
- Health and wellbeing – consistently large improvements in wellbeing for all patients/service users referred. Over 80% improvement for LTC patients and over 90% for MH service users
- Reduction in demand for services – for the LTC service consistent reductions in use of services 6-11% reduction in non-elective inpatient stays and 13-17% reduction in use of A&E services – more detailed analysis shows higher reductions in certain types of patients. For the MHS over 50% discharge from services for those eligible for discharge review
- Financial savings – the above evidence translates into definitive cost avoidance savings for the NHS
Additional Research Findings – Impact on Primary Care
Latest evaluation looks at impact from a GP perspective
- Face to face appointments reduced 28%/telephone consultations reduced 14% (tracked in 1 GP practice)
- Opportunity for holistic response to patient care. A person centred service especially for those with complex needs
- Helps patients manage symptoms. Some impact on medication ... view the full minutes text for item 19.
Nathan Atkinson to present
Nathan Atkinson, Assistant Director Strategic Commissioning, RMBC, presented the 2017-19 Better Care Fund Executive Summary and Plan on a Page which gave an overview of the direction of travel and key priorities for delivery.
The definitive guidance and submission template were still awaited but a draft plan had been prepared in anticipation of the release of the national guidance from NHS England.
The Executive Summary and Plan on a Page had been updated in line with the 2017-19 Integration and Better Care Policy published in March 2017.
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 support independence
- Reconfiguration of home enabling service and strengthening the 7 day social work offer
- Consideration of a specialist reablement centre incorporating intermediate care
- An integrated carers support service
- 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
The following points were highlighted:-
· There was additional funding but it was for 3 years and was a year on year reduction i.e. £6.2M, £3.7M and £1.9M
· Some of the guidance had only been very recently released. There were 3 areas where spend could be made:- sustainability of Adult Social Care, the market/commissioning and delayed transfers from hospital
· Discussions would continue between the Council, Foundation Trust and CCG as to how the funding would be spent
· The Foundation Trust were looking at taking part in the national discharge process so as to use some of the findings
· Need to involve the voluntary and community sector
Resolved:- That the Better Care Fund Executive Summary and Plan on a Page be noted.
Work and Health
Verbal update by Terri Roche, Director of Public Health
Terri Roche, Director of Public Health, gave a verbal update on work and health.
In Marmot’s Fairer Society, Health Lives (2010) he talked a lot about the benefits of work to health and the importance of work to address health inequalities and the social gradient of inequalities.
This could be summarised as: work good, unemployment bad for physical and mental health but the quality of work matters getting people off benefits into low paid, insecure health challenging work was not a desirable option.
One of the roles of the Board going forward might be to look at the wider determinants of health one of which was work. Good quality employment was key to addressing health inequalities. Work and Health was included within the Rotherham Plan 2025 and was a vital part of building stronger communities.
The Sheffield City Region’s long term economic plan was for more jobs, more businesses, more highly skilled occupation and higher productivity. As part of this there was funding for working health projects which included:-
SCR Employment Support Pilot
- £8.7M DWP/European Social Fund
- Aim – to provide early intervention for claimants at risk of long term unemployed
- Key cohorts could include claimants with health conditions and disability, low skills, unstable housing, weak work history, lone parents
- Work taking place in Rotherham as to how this project could work alongside the Troubled Families Programme in the first instance
- Go live date expected September/October with a plan to see approximately 4,500 individuals over the 2.5 years of the programme = 736 Rotherham people
- Voluntary scheme with the referral route to be confirmed but could be Job Centre Plus as well as self-referral, Local Authority, third sector and college referrals
- Clients would be offered up to 18 months personalised support from an employment advisor
- Consideration being given in Rotherham to building on the learning from Social Prescribing projects to support the more holistic approach
Work and Health Unit Employment Trial
- £7M DWP and Department of Health
- Only one of two in the country
- Will introduce a new work health support service consisting of employment specialists working to individual placement support principles located within local health care settings e.g. GP practices, IAPT teams, MSK teams, community hubs
- Referrals primarily from the health system and also self-referral
- Voluntary participation and no implications for an individual’s entitlement to DWP benefits or benefit conditionality
- There would be a Randomised Control Trial with 50% of referrals going onto the IPS trial and 50% being supported by existing mainstream employment and health support
- Aim – to provide innovative and evidence-based form of voluntary health aligned employment support to individuals with mild to moderate mental health and/or musculoskeletal (MSK) conditions who were either unemployed and seeking work or were in work but struggling or off sick
- 12 months personalised support focussed on what individuals needed to help them find or stay in work
- Improve links between work ... view the full minutes text for item 21.
Date and time of next meeting
Meetings to commence at 9.00 a.m. on:-
10th January, 2018
Venue to be confirmed
Resolved:- That the next meeting of the Health and Wellbeing Board be held on Wednesday, 20th September, 2017, venue to be agreed.