Agenda and minutes

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Items
No. Item

52.

Apologies for Absence

Minutes:

Apologies for absence were received from Councillors Sean Gibbons and Linda Curran.

53.

Declarations of Interest, if any

Minutes:

There were no declarations of interest made.

54.

Minutes of the Health and Adult Social Care Overview and Scrutiny Panel held on 20th September, 2017 pdf icon PDF 78 KB

Minutes:

The minutes of the Health and Adult Social Care Overview and Scrutiny held on 20th September 2017 was agreed as a true record.

55.

Public Statements

[A period not exceeding 20 minutes for

Statements from up to 5 members of the public on

matters within the Panel’s remit, proposing action(s)

which may be considered or contribute towards the

future development of the Panel’s work programme].

 

Minutes:

The Chair paraphrased a public statement issued from Doug Wright that had been circulated and read out the following;

 

MOU Concerns

In my statement I wish to raise and develop in particular two key concerns around the implications of the MOU.

Firstly, around the governance implications for Doncaster Council, including having key responsibilities, but not being party to decision making.

Secondly, some of the financial implications for the Council within the proposed SYB reduction budget.   

Background

Mayor Jones said at the January Council meeting, 'I have significant concerns about the budget pressures which will have to be accommodated with that'. (referring to STP now ACS)

On 21st September 2017, the Mayor at the Council meeting responded to my MOU/STP question by saying 'we do have concerns in relation to the projected funding gap £571 million within the plan over the next 5 years and the implications of this on the care, health and wellbeing of local people'.

NB: Around £570 million will be required by 2020/21, not over the next five years.

It was noted that the Memorandum of Understanding would be considered as part on the first item of the agenda and would address the issues raised in Mr Wright’s statement.

56.

The South Yorkshire and Bassetlaw Accountable Care System Memorandum of Understanding. pdf icon PDF 190 KB

Additional documents:

Minutes:

Members were provided with a report that gave them the opportunity to discuss and comment upon the South Yorkshire and Bassetlaw (SYB) Accountable Care System (ACS) Memorandum of Understanding (MOU).

 

It was clarified that the MOU was an agreement, not a plan or a legally binding contract.  It did not replace the legal framework or responsibilities of statutory organisations, yet sat alongside to complement and enhance them.  It was explained that 27 partners were supporting the direction of travel, that there were implications around how those partners worked together and the agreement acted as a commitment to resolve some of the issues.  

 

It was stated that role of the NHS Clinical Commissioning Group’s (NHS CCG) was to commission the right services at a high quality for people, something that they will continue to do.  It was advised that resources would be used collectively for some services across that area, alongside the Place Plan in Doncaster.

 

It was explained that South Yorkshire and Bassetlaw had agreed to work collectively to do things in a different way.  It was added that with an increase in demand and ageing population there was expected to be a health and social care funding gap of around £140M for Doncaster by 20/21.

 

It was outlined that the Accountable Care System (ACS) was the NHS England’s current way of delivering improvements in care. Colleagues from the NHS were taking account of this new policy direction and were collectively taking precautionary and sensible steps to develop joint approaches to service delivery.  It was noted that there has been no change in law and statutory responsibilities at an organisational level remain, therefore this is a coalition of the willing.  It was shared that local authorities, without contribution or commitment had been invited to join the NHS as part of the journey, as what happens within the NHS impacts on local people and social care.

 

Governance – It was explained that there were no governance implications for the Council who were only supporting the agreement.  It was clarified that the MOU does not supersede any statutory or legal responsibility where the Council was commissioning or providing services.  That any changes would need a decision by Cabinet and services changes would be considered by the Council’s Health and Adult Social Care Overview and Scrutiny or by the regional Joint Health Overview and Scrutiny Committee.

 

An example of recent service changes was a decision around hyper acute stroke services currently being considered by the regional health scrutiny group. The decision included a proposition that Doncaster became a hyper stroke service unit; one Member raised their own concerns about the impact from this on the overall availability of beds at Doncaster Royal Infirmary.  It was explained that this this may mean an up to an additional 400 admissions and that work would be undertaken with the Trust to look at this.

 

Accountability - It was shared that there was a huge commitment from all those involved, that a governance structure was in place  ...  view the full minutes text for item 56.

57.

Doncaster's Strategic Health and Social Care Plans (Sustainability and Transformation Plan, Place Plan, Adults Health & Wellbeing Transformation Programme). pdf icon PDF 170 KB

Minutes:

A presentation was made to the Panel around Doncaster's Strategic Health and Social Care.  The Panel received a verbal update on progress made on the Councils’ Adults Health and Wellbeing Transformation Programme alongside Quarter 2 of the 2017/18 performance information.

 

Members were informed how the programme was about enabling people to stay independent through providing a very different and more personalised offer.  It was explained that this was something that needed to be achieved through integrated services involving health colleagues, as well as building up additional community capacity. 

 

After consideration of the report and details presented, the following areas were highlighted;

 

Day Care Services – It was outlined that this was about presenting a range of alternative community led day opportunities for people.  It was stated that there needed to be best interest meetings starting with the individual, looking at their personal needs and that of the wider family to ensure the most appropriate offer.

 

It was commented that previously there had been concerns about centres in Mexborough that provided a combined service to individuals with learning disabilities alongside the elderly.  Members were also informed that there had been reservations around facilities available to support adult’s with higher dependency needs. 

 

A Member who had recently visited the centre, commended staff and expressed that there was real warmth present, with happy people being well supported by staff who had an enthusiasm and willingness to embrace change.  The Member praised the community involvement, engagement and interaction that were taking place with local groups using the facilities.  It was recognised that this had been a big change which had resulted in a highly regarded model, with users receiving a better and more personalised service.

 

Short Stay and Respite Care - Members were informed that a focus was being placed on preventing admissions and there was an opportunity for this within the Place Plan.  Members were told how there were currently four different admission routes to Intermediate Care and how they could be brought together was being reviewed.  It was stated that sometimes individuals were placed in hospitals when they didn’t need to be.  It was added that there should be more of a focus on the outcomes of people to receive the necessary care and respite before being moved on appropriately dependent upon their needs.

 

Concern was raised regarding those with dementia who had been left and had found themselves in the emergency ward alone. Members were informed that the Rapid Response Services offered a chaperone facility which provided a mechanism for those in hospital at risk of harming themselves.  It was commented that an effective handover point could be when someone was being transported over. 

 

Home Care – Members heard that this was an area of challenge, where contracts were being looked at to see whether the right provision was in place moving forward.

 

Supported Living – Members were told that steps were being taken to review the current Supported Living offer to develop a more effective demand management led approach.  It  ...  view the full minutes text for item 57.

58.

Doncaster Suicide Prevention Plan. pdf icon PDF 185 KB

Additional documents:

Minutes:

A report was presented to the Committee around the Doncaster Suicide Prevention Plan.  It was explained that Local Authorities had a responsibility to have local suicide prevention plans in place. The report provided an overview of local suicide data and provided Members with the Doncaster Suicide Prevention Plan for their consideration.

 

In relation of the data provided in relation to local suicides, it was explained that Doncaster’s prevalence was 10.1 per 100,000 compared with Yorkshire and Humber whose prevalence of 10.7 per 100,000 was higher.  It was outlined that between the years of 2013 and 2015, 65 males had taken their own life by suicide compared to 16 females and it was recognised that men were more at risk.  It was explained that Doncaster was not an outlier and that it was the national picture issue that presented concern to all of us and in particularly, males as a group. 

 

Members were informed that an action plan had been developed as the Public Health England (PHE) guidance made it clear that all Local Authorities required a local prevention plan.  It was explained that the Suicide Prevention Plan contained a range of themed actions in accordance with national PHE guidance and that this contributed to the prevention of suicides in Doncaster as well as support for those affected.  It was further explained that the new guidance challenged local partnerships about how they worked effectively together.

 

It was added that the delivery of the plan was overseen by the multi-disciplinary Suicide Prevention Group which met bi-monthly and was chaired by Dr. Seddon from Doncaster NHS CCG with support from the Public Health team.

 

It was outlined that in January 2017, a local conference had been held to refresh the local suicide prevention plan in accordance with the new Public Health England Guidance.  Members were informed that over 80 professionals from a range of disciplines  attended and workshops were conducted to define the actions for the refreshed plan in accordance with the nine themes of the national guidance, these included;

 

  1. Reducing risk in men.
  2. Preventing and responding to self-harm.
  3. Mental health of children and young people.
  4. Treatment of depression in primary care.
  5. Acute mental health care.
  6. Tackling high frequency locations.
  7. Reducing isolation.
  8. Bereavement support.
  9. Data and intelligence.

 

Veterans – Concern was raised of what was in place for Veterans from this issue and that there were no figures within the report.  Members were informed that this group was at risk and was classed as an equality characteristic.  This group will therefore be audited and areas of concern picked up, in  addition to that, real time data surveillance could be provided for the following year and this would allow for further investigation.  It was also added that mortality data only presented information on the person’s last occupation where for veterans, being a member of the armed services was often that person’s first occupation and therefore that wouldn’t have been picked up.   In respect of the wider issues around Veterans, it was suggested that the  ...  view the full minutes text for item 58.

59.

The Care Quality Commission (CQC) Inspection and Regulation of Adult Social Care. pdf icon PDF 193 KB

Minutes:

It was explained to Members that this was a regular item on the workplan.  The report provided an update and summarised:

 

·         Key findings from CQC’s ratings report on the state and quality of adult social care services as of August 2017.

·         Comparisons between the CQC’s national, Yorkshire and Humber and South Yorkshire key findings as well as the local data and intelligence relating to provision of adult social care in the Doncaster district.

·         Contract monitoring, engagement and other improvement activity undertaken by commissioning staff to support and drive up standards and quality.

·         Recently announced programme of health and social care local system reviews to support those areas facing the greatest challenges to secure improvement.

 

Members were reminded that the report applied information from a national report, localised it and considered lessons learnt.

 

Members were informed that although there was some reliable data, work was being undertaken with the CQC on South Yorkshire wide information as further validation was required.

 

It was clarified that the CQC was a national body who provide us with the data and that the methodology was to inspect less frequently with good providers although they do tend to re-inspect where there is evidence of poor providers.  It was clarified that poor services were judged then re-judged. It was outlined that unannounced inspections took place at different times of day and where required an improvement plan with put in place with CQC in a supportive way.

 

Concern was raised about care homes that were sold on or where management had changed.  It was explained that when a company was sold, the CQC archived and removed the company’s current rating.  The rating was not given to the new owner but instead was earnt through having another inspection.  Also, there was a dispensation for care homes that were in liquidation where administration came in to run that alongside authorities before selling it on.

 

It was explained that 3% of residential care homes in the South Yorkshire region were rated as ‘inadequate’ compared to 2% in Doncaster.  It was outlined that whilst there were 2 inadequate care homes in Doncaster, one was inactive and the other had recently been inspected by CQC. 

 

Members were reminded of the strategy in place to enable people to remain in their own homes and that people were living longer with complex conditions. 

 

RESOLVED that the report is noted and that the outcomes of each CQC inspection rating going forward are notified to future meetings.

 

60.

Overview and Scrutiny Work Plan 2017/18 - Update pdf icon PDF 178 KB

Additional documents:

Minutes:

The Panel received a report updating Members on the Panel work plan for 2017/18.  A copy of the work plan was attached at Appendix A to the report taking account of issues considered at the Health and Adult Social Care Overview and Scrutiny meeting held on 21 June and OSMC meeting held on 29 June 2017.

 

RESOLVED that;

 

1.       The Health and Adult Social Care Overview and Scrutiny work plan for 2017/18 at Appendix A, be noted; and

 

2.       That the following items should be added to the workplan for future consideration;

 

·                Continuing Health Panel

·                Clinical Waste – Environmental Health

·                Veteran’s Plan