Agenda and minutes

Apologies were made by Councillor Cynthia Ransome and Councillor Sean Gibbons.

Councillor Derek Smith declared a nonpecuniary interest in Agenda Item No.13, by virtue of his wife who works for RDash but not directly involved in any services to be discussed.

Cllr Mark Houlbrook declared a nonpecuniary interest in Agenda Item No.13, by virtue of his employment within the prison service that may use mental health services.

Cllr J Gilliver declared a nonpecuniary interest in Agenda Item No 14 by virtue of his son who uses such services.

The minutes were agreed subject to the inclusion of the following paragraph;

“A Member queried the current position in relation to Doncaster residents waiting on occupational therapy assessments for re-housing into fully accessible Council owned properties. Officers acknowledged that this was an issue being addressed as a matter of priority.”

[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].

Mr Doug Wright attended the meeting and made a public statement.  He commented on how NHS suppliers were legally bound to consult with public as part of the Social Act 2012.  He raised concern around what was going to happen further down the line, in particular, within areas such as mental health which were underfunded.  He commented that a good example of such problems were outlined in on Page 14 under Financial Implications “referring to the changes proposed or arising from the measures outlined in the report will need to be considered and reported on as appropriate in due course”.  He commented that it cannot or will not be stated how much within Mental Health section of the NHS has been reduced in funding bearing in mind £135m in Doncaster Place, and a £12m reduction of funding out of £25m referred to by the Mayor at the Council meeting that took place the week before.  It was commented that this Council should state where it constitutes £12m out of a total of £25m.  A question had been raised around the criteria of the Panel/Board and Mr Wright expressed his concern that meetings were being held in secret and that no one knew what was going on.  Mr Wright questioned what the role of the Panel was and commented that he felt that the regional Joint Health Overview and Scrutiny Committee (JHOSC) was not properly represented.  Mr Wright commented that the remit of the JHOSC was very narrow only relating to the Hospital Services Review and Paediatric Report.  It was also questioned why Health and Social Care Joint Commissioning Management Board (JCMB) boards do not hold their meetings in public when they drive forward remodelling that moves services into private services. 

Reference was made to the meeting held on the 12^th June 2018 when the Committee was of the view that 80% of matters were resolved at the local Overview and Scrutiny Panel or the Health and Wellbeing Board. 

Mr Doug Wright attended the meeting and made a public statement.  He commented on how NHS suppliers were legally bound to consult with public as part of the Social Act 2012.  He raised concern around what was going to happen further down the line, in particular, within areas such as mental health which were underfunded.  He commented that a good example of such problems were outlined on Page 14 under Financial Implications which stated “referring to the changes proposed or arising from the measures outlined in the report will need to be considered and reported on as appropriate in due course”.  He commented that it cannot or will not be stated how much within the Mental Health section of the NHS had been reduced financially bearing in mind £135m within Doncaster Place, and a £12m reduction of funding out of £25m referred to by the Mayor at the Council meeting that took place the week before.  It was commented that this Council should state where it constitutes £12m out of a  ...  view the full minutes text for item 12.

A report and presentation provided an overview of Mental Health Commissioning in Doncaster.  It was explained that the Panel had requested to focus on Mental Health for 2018/19 and were looking to identify focused topics and themes for future Panel meetings.

An outline was presented on the following areas as part of the 5 Year Forward View;

• Background
• Children and Young People’s mental health
• Children and Young People’s mental health: The Green Paper
• Children and Young People’s mental health: Eating Disorders
• Perinatal mental health
• Adult mental health: common mental health problems
• Adult mental health: community and acute
• Physical Health Improvement for people with Severe Mental Illness (SMI) in Primary Care
• Adult Mental Health: secure care pathway and health and justice
• Adult/Older People’s mental health: Dementia

Children and Young People’s Mental Health - It was explained that the NHS Five Year Forward View for Mental Health had consolidated national mental health policy into a cohesive investment and development package.

Reference was made to a recent Panorama programme ‘Britain’s Mental Health Crisis’ around access to crisis care for young people.  It was explained that in the Doncaster area, setting tiers had been removed and that Advice Workers were now based in all localities. Members were informed that it was critical to commence work with young people from 14 years of age and vital that intensive treatment could be undertaken to help them remain with their families.  It was explained that the biggest challenge was around the workforce and steps were being taken to address the weakest areas by working with partners within the Immediate Care Service footprint.

It was outlined that Doncaster had been involved in a pilot mental health competency framework with the aim to influence the national model.  Members were told how in every school and college there would be a Mental Health lead who would undertake low-level mental health work.  It was noted that funding was in place to provide the necessary training and support needed within the infrastructure. 

It was stated that workforce development was being carried out so that local authorities were not competing against each other although more work needed to be done across partner agencies. 

Concern was raised in relation to the LGBTQ group as it was felt that they were a particularly vulnerable group.  In terms of LGBTQ, it was explained that Young Minds had been commissioned to engage with young people and find out more about how it felt to work in Doncaster.  From this work undertaken, the aim was for schools to develop a more consistent and positive message about diversity.

Concern was raised about young people aged between 15 and 19 years of age, transitioning across secondary school to college. Members were informed that this was a significant area for development and that further work needed to be undertaken with providers and partners.  

Members were informed that young people had raised mental health as a priority area.  It was raised that there needed to be more investment in those services.  Members  ...  view the full minutes text for item 13.

A report was provided Members with an update on the council’s Adults Health and Wellbeing Transformation Programme.  A presentation was provided at the meeting and covered the following aspects of the programme:

a)    Operational, governance and resources arrangements:

b)    The alternative care model for Day Opportunities.

It was explained that there was a need to review the customer journey to work on prevention and be able to make longer term savings.  In terms of capacity, it was felt that more was needed and therefore specific expertise had been brought in to undertake this.  It was stated that the product would be further developed over future months.

Members heard how the Placement Strategy would result in investment into other services.  It was about reducing enablement and transitioning people to a more improved level, intervening at different times and therefore assisting demand management.  It was reported that there had been a positive response as well as it being better financially.

Rapid Improvement Projects  - Members were updated that these projects covered the following areas;

·         Safeguarding 

·         Occupational Therapy

·         Direct Payments

·         Section 117 and CHC Spend

·         DoLS

·         Quality Assurance

Day Opportunities - Concerns were raised around how a quality service could be delivered with less money.  Members were informed that a debate was taking place in Doncaster and at a national level about what the right level of funding looked like at a time when demand was rising and some services were oversubscribing.  It was added that developments with day centres were a positive example of what could be achieved.

Members were assured that there was a focus on investment as well as on the improvement of quality.  Members recognised that steps were still being taken to consider different models and business needs.

Members were told that when reviewing services, a number of duplications were found which had resulted in having a negative impact on customer quality.  It was recognised that there was a funding deficit and improvements had been made within services with an aim to work more on preventative measures. 

Members were informed that expectations had been broadened and feedback was indicating that more people were feeling more supported within their communities.  A Member expressed the opinion that based on their personal experiences it was too early to see if the changed offer was providing a better outcome.

It was outlined using feedback from Mexborough Day Centre that clients were better linked into the community and had benefited from an intergenerational approach.  Other positive examples included from the Bullcroft Memorial Hall in Carcroft, where clients had benefited from the reduction of time and money spent on transport and had become more independent as a result of the close location of the centre.  A Member of the Panel also mentioned how a user who was now attending Rossington Day Centre, had expressed their contentment and looked forward to the new activities at the centre.

Members heard that there facilities and services needed to be utilised more and made more sustainable.

Transport -  ...  view the full minutes text for item 14.

The Panel received a report updating Members on the Panels work plan for 2018/19.

A copy of the work plan was attached at Appendix A of the report taking account of issues considered at the Health and Adults Social Care Overview and Scrutiny workplanning meeting held on the 11th June, 2018.

RESOLVED that the Panel note the Health and Adult Social Care Overview and Scrutiny Workplan 18/19 - October 2018 update.