Agenda item

RDaSH Rotherham Care Group Transformation Plan - Update

Steph Watts and Michaela Bateman to present

Minutes:

Steph Watt and Matt Pollard presented an update on the RDaSH Adult Mental Health transformation activity, as outlined to the Commission in Summer 2016. 

 

Members were reminded of the key issues that had emerged from consultation with stakeholders, which had been drivers for the reconfiguration.  In particular, care closer to home, “telling it once”, better access to health and not being bounced between services due to issues within the organisational structure had been raised by patients and carers

 

RDaSH had now moved from age related, cross-Trust business divisions to place based locality Care Groups. The Rotherham Care Group was comprised of Adult and Older People’s Mental Health Services, Learning Disability Services and Drug and Alcohol Services.  A recovery and wellbeing ethos underpinned the services with care wrapping around the patient through multi-disciplinary teams and a new pathway framework. The new structure was based around two localities, north and south, although smaller specialist services, such as young onset dementia, continued to be borough-wide. A “deep dive” into access to front door services was also planned.

 

The Trust had also considered how IT would support the new structure and a new patient record system (PRS) would be introduced from April 2018 to be more streamlined and effective.  Information governance was an important issue for mental health and processes were in development. RDaSH were working with TRFT on Electronic Patient Records (EPR) to help with information sharing across physical health and social care, supported through funding from the Better Care Fund (BCF).

 

It was hoped to extend the two social prescribing pilots with the voluntary and community sector to “front door” work. Discussions were taking place with The Samaritans regarding work with people needing support but who did not necessarily meet statutory service requirements, again through the BCF.

 

The new management team was in place and work is underway on estates to move teams into the localities – on an interim basis initially, with a view to future co-location with health and social care, generating economies of scale and efficiencies as well as benefits for patients.

 

A phased roll out of the new pathways was commencing with brief interventions initially - prevention and stopping deterioration.  RDaSH would be working proactively with TRFT and RMBC on the Integrated Rapid Response service mentioned above.

 

Benefits for patients would be a better experience through care closer to home, improved access and a more unified structure.  There were also efficiencies, firstly from the management restructure and the PRS, plus an admin review was taking place. Efficiencies had been looked at from back office functions rather than clinical teams.

 

More integrated working had many positives but changes did bring about anxieties and the trust was continuing to work closely with stakeholders and patients.

 

Discussion ensued with the following issues raised/highlighted:-

 

·         Patient records kept and stored in paper files, including off-site, and practical issues and timescales for moving fully to EPRS
– Services were trying to be “paper-light” but there would still be a need to archive paper records for a period of time.  To follow up with a written response.

 

The development of the Rotherham Care Record would enable information sharing across partners when they were directly involved in patient care, including Primary Care and Social Care.  This would enable services to see what care a patient was receiving and also patients who were in hospital, which linked back to the CCC and IRR service and who they could support. The strategic intent was there within the appropriate information governance arrangements for each organisation to develop this to improve patient care.

 

The local Accountable Care System came under the auspices of the Health and Wellbeing Board and there had been discussions about the development of the common record with Adult Social Care fully involved and willing to share information as appropriate to improve care.

 

·         Would the economies of scale mentioned have an impact on clinical face-to-face provision over time?  - A staff skills review was under way and there may be changes but no intention to reduce front-line staffing but rather to improve the quality of the service.  The other areas mentioned had been looked at first in terms of efficiencies.

 

·         Would there be an increase in generic working or was the intention to retain all the specialisms? – The intention was for staff integration into teams to avoid the “patient hand offs” referred to, but there were specialist skills within the teams that need to be retained.  So although there might be a generic front point of access and a generic process for people to work through, there would still be specialist workers who could deal with individual service user/patient’s needs.

 

·         Dovetailing RDaSH’s two localities with other different locality models and the distribution of resources aligned to need – RDaSH had started with two localities as they needed to change but they were working really closely with TRFT and RMBC around how services would be delivered and managed in the community going forward.  They were very aware of other plans and would map in the RDaSH services and where possible co-locate as this would bring so many benefits.

A piece of work had been  undertaken mapping demand for RDaSH services which had shown extra demand in the smaller north locality, so they were looking at mapping staff/team volumes for localities and overlaying these with demands from other services or placed on other services from outside RDaSH.

 

·         More information on the RUST project, such as uptake and how to access – It was early days still so more information would be provided in November.  This work had already been taking place at Rotherham United through Sport England funding.  RDaSH made contact with them at a social prescribing event and the activity they were doing had developed and was now underpinned by professionally trained workers providing some additional support.

 

Resolved:-

 

(1) That the Health Select Commission note the update.

 

(2) That the Health Select Commission receive a more detailed update on
      the pathway framework at the meeting in November 2017.

Supporting documents: