Agenda and draft minutes

To consider and approve the minutes of the previous meeting held on 3 October 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 3 October 2024 were approved as a true and correct record of the proceedings.

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

There were no declarations of interest.

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.

To receive an annual update in respect of the Rotherham Place Winter Plan.

The Chair welcomed Steph Watt, Health and Care Portfolio Lead, SY ICB to the meeting.

They provided an overview regarding what had worked well last year and what was being implemented under the 2024/25 winter plan.  The Health and Care Portfolio Lead explained that there was a whole system approach which involved health, social care and the voluntary and community sector, adding that they had rolled forward what had worked well from last year and added additional work streams.

Against the context of an aging population in Rotherham, and an otherwise challenging demographic, demand had increased, particularly around acute care and complexity which mirrored the national picture.

Last year, industrial action exerted additional pressure on the healthcare system along with the impact of the cost-of-living crisis.  For 2024/25 money from the BCF (Better Care Fund), which was a joint health and social care fund, was targeted to seasonal pressures spread across partners including the Acute Respiratory Hub which, in partnership with GPs, diverted pressure aware from urgent and emergency care. There was also additional investment in enablement services and social workers to support people at home which data reflected better outcomes were achieved. This also supported better flow, and was supplemented by additional community beds for non-acute care where return home was not feasible. The hours of the community ready lounge had been extended, to efficiently process discharge and mitigate unnecessary bed blocking.  More evening and weekend transport was also running to facilitate even flow and Age UK were operating a bursary scheme which supported discharge.

The virtual ward, which went live in 2022, had been particularly successful, with 3611 admissions since 2022.  In quarter two, this avoided 442 admissions.  They described the routes into the virtual ward and how this maximised care at home. There was a frailty pathway, a respiratory pathway and a heart failure pathway had just been launched.

The Health and Care Portfolio Lead described work that was being done with YAS (Yorkshire Ambulance Service) to reduce avoidable conveyances to hospital, through utilising community teams and services to deliver care.  This was a new pilot for this winter.  A new falls pathway for care homes was also being piloted, to offer wrap around care in care homes and avoid unnecessary attendance and waits at hospital which research showed did not improve outcomes.

They were also looking at patient flow through acute care, with increased medical and nursing staff leaving far fewer gaps in the workforce. Discharge was another focus of system flow, with the development of the transfer of care hub with multiple agencies providing wrap around care at home.  This was extended to consider how this could incorporate YAS. Co-location with YAS to a view to impactful cross-fertilisation of conversation was anticipated.

A discharge to assess model was being implemented, to improve the real-world assessment of need to reduce overprescribing, whilst maintaining patient safety and welfare.  It was acknowledged that this was complex and required effective collaborative working across agencies.

Trusted assessor roles had been  ...  view the full minutes text for item 34.

To receive an update in relation to a peer review undertaken in respect of Public Health.

The Chair invited Councillor Baker-Rogers, Cabinet Member for Adult Care and Health to introduce the presentation.

Councillor Baker-Rogers set out the background to the Council’s participation in the peer review.  They advised the focus of the review was determined following an internal self-assessment process which generated leadership and governance, culture and challenge and making a difference as the three domains. Councillor Baker-Rogers advised that feedback was predominantly positive and had identified a number of key strengths, alongside key recommendations which focussed on the refresh of the Health and Wellbeing Strategy.

The Director of Public Health, Ben Anderson explained the contents of the agenda pack as they related to the peer review.  They described that this had included an overview paper, the storyboard that had supported the peer review process, an overview of the LGA strengths and risks tool and the slide pack. The peer review undertaken was described as smaller scale and less resourced than some other LGA peer reviews that may have been seen in other areas of scrutiny, and the slide pack provided was the feedback received.

The Director of Public Health described the sector led improvement approach of the peer review, and outlined that lots of preparatory work was undertaken including reviews of around 60 documents such as strategies and minutes to allow the peer review team to form a picture of Rotherham. There was a large evidence base, and the work undertaken equated to 159 hours of public health consultancy, which was a significant investment.

The Director of Public Health reiterated the key lines of enquiry, where added value was sought and highlighted the positive affirmations and quotes included in the slide pack from interactions during the peer review which had acknowledged strong governance, strong partnerships and effective use of the JSNA (Joint Strategic Needs Assessment).  The peer review was approached with honesty and openness by staff who participated, and reported that the Public Health team was well respected, knew itself, was effectively embedded in the partnership and was adding value to the system. The children’s capital of culture next year was also highlighted as a meaningful opportunity to engage young people and seek feedback on health and wellbeing matters.

The Director of Public Health noted the strengths and areas for further consideration identified which included, clear and consistent partnership working hard-wired into governance arrangements but not led by them alongside strong and stable leadership across the partnership.    

In terms of areas for further consideration, the refresh of health and wellbeing strategy was a large piece of work which would be reported into the Health and Wellbeing Board in Spring 2025.  This represented an opportunity to build upon existing practice and maximise focus on delivery and outcomes. There was also the opportunity to go further with the health in all policies approach and to consider how to make space for looking ahead in the context of anticipated financial challenges. As there were 2-3 years left on most Public Health contracts, as it  ...  view the full minutes text for item 35.

To consider the Health Select Commission’s work programme for 2024/2025.

Resolved:-

That the Health Select Commission:

1.  Approved the work programme.

2. Agreed that the Governance Advisor was authorised to make any         required changes to the work programme in consultation with the Chair/Vice Chair and report any such changes back to the next meeting.

To receive and consider the minutes and recommendations of the 10 October 2024 South Yorkshire, Derbyshire and Nottinghamshire Joint Health Overview and Scrutiny Committee, and the revised Terms of Reference as approved during that meeting.

The full agenda and reports pack can be accessed via:

Agenda for South Yorkshire, Derbyshire and Nottinghamshire Joint Health Overview and Scrutiny Committee on Thursday 10 October 2024, 1.00 pm | Sheffield City Council

The Chair invited the Governance Advisor to summarise the key points of note from the JHOSC minutes.

The Governance Advisor drew members attention to the revised JHOSC Terms of Reference included in the agenda pack, and explained that the changes reflected in the document were minimal and borne solely of associated legislation changes.

They also advised members that an item arising from work undertaken by JHOSC relation to Oncology Transformation, specifically regarding the relocation of the Lung Clinic to Rotherham hospital had been added to the Commission’s work programme due to the localised nature of the impact.  This was expected to be brought before members towards the end of the municipal year.

They advised members that JHOSC were interested to be kept informed of work being undertaken by Public Health Consultant, Andrew Turvey in relation to barriers to accessing and attending medical appointment based on levels of deprivation as outlined by the Director of Public Health and TRFT Managing Director, Michael Wright during the 3 October Health Select Commission Meeting.  This was because this type of work was not being undertaken elsewhere to JHOSC’s knowledge and it was felt that this piece of work would offer insights of wider benefit.

Resolved:-

That the Health Select Commission:

1.    Noted the minutes and recommendations of the 10 October 2024 JHOSC meeting.

2.    Noted the updated JHOSC Terms of Reference as approved during the 10 October meeting.

To receive and consider the Health & Wellbeing Board’s Annual Report in respect of how this can inform the future work of the Health Select Commission.

Resolved:-

That the Health Select Commission:

1.    Noted the Health and Wellbeing Board Annual Report.

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

The Chair updated members regarding the review scoping, scoring and prioritisation meeting that had taken place and outlined the two items that had been identified to take forward as reviews by the Health Select Commission.

The Chair explained that detailed and considered discussion had resulted in members determining that there was the need to increase knowledge and awareness around the existing social prescribing access routes via an awareness workshop, alongside establishing a reliable evidence base regarding the demand and deployment of social prescribing before more specific and targeted scrutiny was taken forward.

The Chair invited members’ question and comments on the review proposals.

Councillor Yasseen queried whether she had understood correctly that social prescribing had not been prioritised for review. The Chair confirmed that this was the case.

Councillor Yasseen explained that members had engaged in a healthy discussion on the unique place of social prescribing during the pre-meeting and outlined that social prescribing had originally been identified as a potential review topic as a result of an LGA (Local Government Association) led away day. They expressed concern that the topic would be lost were it not prioritised, and sought reassurance that social prescribing would return as a future option for scrutiny.

The Chair confirmed that this was the intent of the proposal.  They explained that progressing an awareness workshop in the first instance aimed to achieve universal understanding of the social prescribing offer, service position and access routes, particularly for newer Councillors who had not had the benefit of the previous input. The intention was that this would facilitate further meaningful discussion to identify targeted scrutiny around social prescribing at a future date, with the greatest potential for tangible impact for Rotherham residents.

Resolved:-

That the Health Select Commission:

1.    Agreed to proceed with two reviews in relation to a) access to contraceptives and b) access to NHS dentistry in that priority order.