Agenda and minutes

            The Minutes of the meeting held on 11^th March 2008 having been printed and circulated were signed as a correct record.

            The Board considered the Minutes of the meetings of the Executive Board Sub Committee relevant to the Healthy Halton Policy and Performance Board.

 

            RESOLVED: That the minutes be noted.

(NB: Councillor Lloyd Jones declared a personal interest in the following item of business due to her husband being a Non-Executive Director of Halton and St Helens PCT)

            The Board received a presentation from Fiona Johnson, Director of Public Health, on the Halton and St. Helens Primary Care Trust’s (PCT’s) Ambition for Health Strategy. The presentation set out the six key themes of the Ambition for Health draft document for the next five years which included:

 

-         supporting a healthy start in life;

-         providing modern services for specific disease groups;

-         improving access to services and facilities;

-         tackling major killers through prevention;

-         modernising services for vulnerable people; and

-         strengthening disadvantaged communities.

 

            The Board discussed the apparent high number of stroke incidents in Halton and ways of reducing this figure and problems experienced with access to dentistry in Halton. An update report from the PCT on dentistry services in Halton would be provided at the Board meeting in September 2008.

 

            RESOLVED: That the presentation be noted.

(NB: Councillor Lloyd Jones declared a personal interest in the following item of business due to her husband being a Non-Executive Director of Halton and St Helens PCT)

            The Board received a presentation from Alan Rice on the proposals for opening a NHS Walk-in-Centre, based at the Health Care Resource Centre, Widnes. Members were advised that the original plans contained proposals for a two centre development one in Widnes and the other in Runcorn. However, limited funding had been secured from the Department of Health to contribute to the centre. Therefore the PCT decided to pursue the development of the Widnes site in the first instance, with the Runcorn option to be considered at a later date.  The Walk in Centre (WiC) would be co-located within the Health Care Resource Centre, Widnes and would open in June 2008.

 

            It was noted that the development of the WiC would integrate with the GP Out of Hours Service and would work collaboratively with the two access centres and the Halton Urgent Care Centre which was being developed later this year. It would also provide an alternative to local A&E departments.

 

            A communication strategy had been developed which included a stakeholder event. This would be rolled out over the next few weeks prior to the introduction of the new service.

 

            The Board discussed the proposals for a Runcorn WiC. The Board was advised that consultation and negotiations were ongoing to identify a model on what services could be delivered at Halton Health Campus.

 

            RESOLVED: That the presentation be noted.

(NB: Councillor Lloyd Jones declared a personal interest in the following item of business due to her husband being a Non-Executive Director of Halton and St Helens PCT)

            The Board received a presentation from Alan Rice, Halton and St. Helens PCT on Equitable Access to Primary Medical Care. As part of the national program there would be additional GP provision in areas identified as having current under provision and GP led health centres open 8.00 am to 8.00 pm 7 days a week, one per PCT area, would be created. In Halton and St Helens PCT there would be 1 GP led health centre (based in Widnes) and 3 new practices (1 based in Windmill Hill, Runcorn, 2 x St Helens).

 

            In addition, Members were advised on the tight timescales with the new services due to commence on 1^st January 2009. Although formal consultation was not required wide stakeholder engagement had began in February 2008.

 

            Members noted that at present the proposals had been accepted by the Strategic Health Authority as meeting the Department of Health core criteria, adverts had been placed and 29 expressions of interest and pre qualification questionnaires had been received.

 

            Arising from the discussion Members enquired if any member of the public would be refused access to the GP led health centre i.e. servicemen. In response Members were advised that reference to treatment for servicemen etc would be included in the specification.

 

            RESOLVED: That the presentation be received.

(NB: Councillor Austin declared a personal interest in the following item of business due to being a voluntary driver for Halton Borough Council. Councillor Wallace declared a personal interest in the following item of business due to her being a Board Member of Halton Transport).

            In February 2007, the Directorate consulted widely on proposals for changes to charges for social care services. All service users/carers were sent a copy of a survey form to complete and return and eight open forums were held in locations across the Borough. Following the results of the survey charging for social care services was considered and recommendations for changes to charges for social care services were made including the introduction of a charge for transport provision. For the first time, a charge of 50p a trip with a maximum charge of £2 per day/£8 per week was introduced in 2007.

 

            As a consequence of introducing charges for transport it was now necessary to review the Travel Policy, Procedure and Practice. Currently an average 520 service users received transport services from Transport Coordination each month. The service continued to change and expand due to the re-design of the provision of day services, which had led to wider dispersal of daytime activities including gardening, catering, crafts and drama across 14 centres.

 

            Given increased transport usage per day with day centre modernisation, demonstrable improvements in service quality, previous consultation responses and the need to cover a greater proportion of the service/petrol costs and assumed budgetary savings targets; increases to transport charges were approved by full Council on 5^th March 2008 and the Executive Board Sub Committee on 20^th March 2008 as follows:

 

-     To charge a maximum weekly charge of £10.00 to those not in receipt of the higher rate mobility component of Disability Living Allowance; and

-     To charge a maximum weekly charge of 50% of the higher rate mobility component of Disability Living Allowance of £46.75 per week for 2008/09 namely £23.00 per week to those in receipt of it.

 

            In addition, it was noted that the following changes to the Travel Policy and Procedure were proposed in the following areas:

 

-           To promote a range of travel options available to adults over the age of 18 who access social care services

 

i)    with an update on the concessionary travel pass which could now be used nationwide;

ii)      information on the Blue Badge Scheme;

 

-     To approve the introduction of a criteria for the single occupancy use of taxis or other Local Authority provided transport;

-     To place emphasis on reducing air pollution and encourage the use of sustainable resources by promoting the use of public transport; and

-     An Eligibility Quick Practice Guide which professionals may detach and take with them on visits.

 

            Arising from the discussion it was noted that a further report would be submitted to the November meeting on the impact on service users.

 

            RESOLVED: That the review of Travel Policy and Procedure be noted.

            The Board considered a report which outlined a review of Direct Payments Policy and Procedure. The Direct Payments Policy and Procedure had been amended as follows:

 

-     changes in rate approved by Executive Board Sub-Committee on the 20^th March 2008;

-      introduction of an eligibility criteria to determine the rate at which direct payments would be set, based on current good practice;

-     to reflect the growth in personal assistance and to include payroll charges in the set up costs if required, and annually thereafter as a supplement to be paid to the service user if required, when employing a personal assistant/s from 1^st April 2008;

-     to reflect changes introduced by the Mental Capacity Act 2005, with additional detail on capacity; and

-      development of a proposed guidance on direct payments rate criteria to       determine future payment rates.

 

            In order to phase the introduction of this policy change, consultation would take place with existing service users, with implementation of the new assessed rates for both agency and personal assistants proposed to be in place in nine months time by 1^st April 2009. This criterion would be used to assess all new service users from 1^st April 2008.

 

            RESOLVED: That the review of the Direct Payments Policy and Procedure be noted.

            The Board received a presentation from the Service Planning Manager regarding the draft Carers Strategy 2008/09. The draft Carers Strategy 2008/09 built upon the aims, objectives and activities outlined in the 2006/08 Carers Strategy and included an action plan for the continued development of services for carers in Halton over the next 12 months. It had been developed as a result of on-going consultations and contributions from all stakeholders. The format of the strategy followed a similar one adopted previously and outlined recent activity and proposed actions within the following areas:-

 

-      Recognition – identifying carers;

-      Information;

-     Emotional support and support services;

-      Assessment and assessing carers needs;

-     Having a voice;

-     Providing a break;

-     Support that helps carers care and maintain their own health;

-     Young Carers;

-     Parents of children with a disability; and

-     Financial Security/Carers in employment.

 

            The main objectives of the Strategy included the need to identify hidden carers, recognise and respond to carers needs, and improve information and access to support services.

 

            RESOLVED: That the draft 2008/09 Carers Strategy and associated Action Plan be noted.

            The Board considered a draft of the Housing and Support Strategy and Housing Allocations Policy for people with learning disabilities. The Strategy set out the plans for delivering housing and support services for Adults with Learning Disabilities (ALD) in Halton. It covered the period 2008 to 2011, which reflected the timeframe of the Council’s Draft Housing Strategy. It aimed to influence mainstream housing policy in Halton so that people with learning disabilities had greater choice and, where possible, in control of their housing and support needs.

 

            The Strategy promoted a range of housing and support options.

 

            The Strategy and Action Plan had been developed over several months under the steer of the Adults with Learning Disabilities Partnership Board Sub-Group relating to Housing. Consultation was also undertaken through the Council’s Housing Needs Survey 2005 and Learning Disability Stakeholder events with people with learning disabilities, carers and families, care and support providers and registered social landlords. The Learning Disability Executive Commissioning Board promoted this strategy and was responsible for ensuring that actions were taken forward.

 

            It was reported that the allocation of tenancies for Adults with Learning Disabilities (ALD) had historically been co-ordinated by the Lead Occupational Therapist in the ALD Specialist Community Team at The Bridges. The development of a Housing and Supporting People Co-ordinator post within the ALD team led to the review of the procedures for allocating tenancies and had culminated in the existing Policy and Procedure being revised. The allocation process itself would now be managed and co-ordinated by the Housing and Supporting People Co-ordinator.

 

            RESOLVED: That the Housing and Support Strategy 2008 – 2011 and the Housing Allocations Policy be noted.

            The Board had previously requested a scrutiny review be conducted of choosing health initiatives. These initiatives arose from a Government funded programme detailed in a White Paper Choosing Health Making Health Choices Easier, published in 2004. The essence of the Department of Health document was to drive forward a 21^st century approach to prevention and public health.

 

            The Choosing Health initiatives reviewed in the report comprised of Halton and St. Helens Primary Care Trusts response to this White paper. The Topic Group sought to assess the likely impact on choosing health on health inequalities in Halton. The importance of Choosing Health initiatives was clearly evident by the current emphasis placed on health improvement and prevention but there had also been a clear Government policy shift from a whole population approach to reducing health inequalities.

 

            As a result of this policy shift, the review focused on potential gains to date that Choosing Health might provide in addressing health inequalities. This approach would best serve the needs of the Local Area Agreement as well as enhancing the golden thread of health improvement across all service plans.

 

            As a consequence of the need to enhance the links between choosing health and the Local Area Agreements and the need to embed health improvement within commissioning and service provision, the Topic Group recognised the role of Halton Health Partnership in taking this work forward. The Scrutiny Topic had made the following recommendations -

 

1) that Senior Management Team note the findings of the Choosing Health Scrutiny review and progress to date;

 

2) the report be submitted to Halton Health Partnership; and

 

3) the Healthy Halton Special Strategic Partnership be responsible for monitoring and evaluating progress to achieving the above recommendations. The SSP may wish to ask the Performance Sub-Group to ensure these actions continued to be addressed in future commissioning.

 

            RESOLVED: That the report and the above recommendations be noted.

            The Board considered an outline of the topic review of the commissioning and service provision in Halton for younger adults (age under 65) who develop dementia, so as to establish an agreed approach and model across all stakeholders. This topic would focus on the health needs of the local population and would therefore contribute significantly towards meeting the Council’s key strategic priorities. The key outputs and outcomes sought were as follows:-

 

-     A full and detailed analysis of the current extent of the development of dementia amongst younger adults in Halton;

-     An understanding of the extent of future need in Halton, informed by local, national and international research;

-     To establish whether there were any preventative or early intervention approaches that could reduce the burden and impact of these conditions on local residents;

-     An analysis of national best practice and the extent to which this can be delivered locally;

-     An agreed commissioning plan across all key stakeholders for this group of people; and

-     The development of support networks for carers and families of people affected by these conditions.

 

      RESOLVED: That

 

1) the terms of reference for the topic be agreed; and

 

2)      membership of the Services for Younger Adults with Dementia Topic Group be as follows: Councillors E. Cargill, P. Wallace, M. Lloyd-Jones, Gilligan, J. Lowe.

            The Board considered the Annual Report for the Healthy Halton Policy and Performance Board. The report outlined the membership and responsibilities, the review of the year, work topics, performance issues and the work programme for 2008/09.

 

            RESOLVED: That the Board agree and endorse the Annual Report for the purpose of its adoption at a forthcoming meeting of the full Council.

            The Board considered a report of the Strategic Director Healthy Halton Policy and Performance Board regarding the 4^th quarter monitoring report for the Older People’s and Physical and Sensory Impairment Services, Adults of Working Age and Health and Partnerships.

 

            RESOLVED: That the 4^th quarter year end performance monitoring reports be received.