Agenda and minutes

            The Minutes of the meeting held on 8 November 2011 having been printed and circulated were signed as a correct record.

            The Board was advised that no public questions had been received.

The Minutes of the Health Strategic Partnership Board of its meeting held on 13 October 2011 were submitted to the Board for consideration.

 

RESOLVED: That the minutes be noted.

 

The Minutes of the Shadow Health and Wellbeing Board of its meeting held on 5 December 2011 were submitted to the Board for consideration.

 

RESOLVED: That the minutes be noted.

 

(Note:  Councillor M 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 Primary Care Trust).

The Board received a presentation from Mel Pickup, Chief Executive, Warrington and Halton HNS Foundation Trust which:-

 

§                     Outlined the following developments that had taken place in   2011/12:-

 

-     A new political landscape – The Health Social Care Bill - The NHS Architecture had been reconfigured, the demise of the PCT’s – advent of Clinical Commissioning Groups, PCT Clusters and SHA Clusters;

 

-     The economic pressures – a £13m improvement programme;

 

-     Business as usual – high quality, safe healthcare, targets and regulatory compliance;

 

-     Clinical and service developments – Elective work moves to Halton, the Vascular Services Review; Urgent Care Centre, the Repatriation of Cardiac Interventions and the accreditation of Endoscopy Services;

 

§                     Set out future developments in Warrington and Halton in 2012/13 as follows:-

 

-     A continuing emphasis on quality and safety as outlined in   the quality report;

 

-     Preparing for the economic challenges ahead – doing things differently;

 

-     Change programmes coming into place – rostering, remodelling of admin functions for greater efficiency;

 

-     A continued investment in new and improved services;

 

-     Working with GP commissioners; and

 

·        Highlighted the following key issues:-

 

-     The vascular services review outcome;

 

-     Musculoskeletal services development’

 

-     Halton campus development and the ISTC building;

 

-     Improvements to car parking, catering and other patient services; and

 

-     The development of community based outpatient services; and

 

·        Set out the following conclusions:-

 

-     The changes were some of the most challenging times in NHS history;

 

-     A magnitude of financial savings would be required and would force difficult choices to be made;

 

-     There would be no compromise on service quality and safety;

 

-     Partner bodies were equally challenged – The Health Summit and Health and Wellbeing Board; and

 

-     Collaboration would need to take place with other health care providers.

 

         The Chairman of the Board reported that they did not agree with the proposals for the vascular review and that there should be three centres of excellence not two.  In addition, she reported that a joint Overview and Scrutiny Board had been established with Warrington and St Helens to consider the proposals and the first meeting would take place at 2 pm on 23 January 2012 in Warrington Town Hall,  She indicated Manchester was establishing three centres and had a similar population.  They and other areas had used a different criteria (75 not 100) and the same criteria should have been used.

 

The following comments arose from the discussion:-

 

·        It was noted that endoscopy services would operate from the Warrington site as the Halton site did not meet the criteria.  However, it was also noted that work on an elected basis, where clinically possible would be undertaken at Halton Hospital as it was a much better environment for the patient;

 

·        It was suggested that Halton Hospital could have been utilised more during the refurbishment of Warrington Hospital to minimise the disruption to patients;

 

·        Clarity was sought on future services at Halton Hospital.  In response, it was reported that Halton  ...  view the full minutes text for item 44.

The Board considered a report of the Strategic Director, Communities which gave information of the 5 Boroughs Partnership NHS Foundation Trust proposals to re-design the Adult Acute Care Pathway and the Later Life and Memory services for older people.

 

The Board was advised that during 2010/2011, 5 Boroughs Partnership NHS Foundation Trust, with the support of Commissioners, had examined the Acute Care Pathway.  This process had been led in its initial stages by an expert group of 5 Boroughs clinicians and senior managers, mental health commissioners, social care leads and the GP Clinical Lead for Mental Health.  This group reviewed current service configuration, utilisation, care pathways, service pressures and other demands to inform potential adjustments to care pathways across adult and older people services. The intention was to enable improvements in access, quality of care, recovery rates and increased avoidance of acute care bed use and out of area treatments.

 

The Board was further advised that the Acute Care Pathway re-design related to adult mental health services only.  It would include services for older people with a functional illness who access adult services, but did not include services for older people and frail elderly people with mental illness.

 

It was reported that by re-designing acute care for adults and older people, there was a potential for a reduction in the need for beds across the 5 Boroughs Partnership localities. This may result in a need for estate rationalisation.  The proposals, if agreed would lead to a joint Warrington and Halton Assessment Team and Home Treatment, alongside six Recovery Services, which were set out in the report.

 

It was also reported that the Later Life and Memory Service re-design related to older adults mental health services. The model included a proposal to develop a single point of access, which would provide cognitive and functional screening for patients. It was envisaged that this function would considerably reduce the waiting time from referral to service delivery and greatly improve patient experience.

 

The proposals were discussed by 5 Boroughs Partnership NHS Foundation Trust, with the support of Commissioners. This process had been led in its initial stages by an expert group of 5 Boroughs clinicians and senior managers, mental health commissioners, social care leads and the GP Clinical Lead for Mental Health.

 

            In this respect, the Board received a presentation from Trust Assistant Directors, Pauline McGrath and Sam Oliver which:-

 

§         Explained the reasons for changer the Later Life and Memory Services (LLAMS);

 

§         Outlined the LLAMS current services;

 

§         Set out LLAMS proposed services in Halton in the future;

 

§         Highlighted why the changes to LLAMS would benefit the residents of Halton;

 

§         Set out the LLAMS current and proposed structure;

 

§         Detailed the conclusions to the proposals – that it would be clinically led, local project groups would involve all local key players, there would be user and carer involvement throughout and GP and Commissioners were now fully signed up; and

 

§         Detailed the business activities to support the change,

 

In  ...  view the full minutes text for item 45.

         The Board considered a report of the Strategic Director, Communities which presented the first draft of the Adult Social Care Local Account.

 

The Board was advised that In past years all Local Authorities had a duty to report Adult Social Care performance to the Care Quality Commission (CQC) on an annual basis.  The annual performance assessment consisted of both performance data and a contextual document which centred on seven outcome areas – detailing achievements in the current year and priorities for the forthcoming year.

 

            The Board was further advised that CQC’s focus had recently changed to an increasingly regulatory role.  In light of this, the role of the Department of Health (DoH) had strengthened in relation to the performance management of Councils. 

 

It was reported that to replace the CQC annual performance assessment, the DoH now required Councils to produce a ‘Local Account’ which reflected annual performance in Adult Social Care, where local residents were the audience, as opposed to a regulatory body.  This represented a shift in terms of accountability whereby Councils would become increasingly accountable to their local population, rather than to Central Government.

 

In addition, it was reported that In order to reduce the possibility for confusion, it had been agreed that the ‘Local Account’ be named as the ‘Adult Social Care Annual Report’.  This followed discussions with other Local Authorities who had steered away from naming the document as a ‘Local Account’, in case the intended audience may not know what a ‘Local Account’ was.  It was perceived that ‘Adult Social Care Annual Report’ may be more self-explanatory.

 

It was reported that Appendix 2 to the report set out how the Adult Social Care Annual Report would be published.  It had been circulated to all partners and published electronically in line with other Local Authorities.

 

The Board congratulated Officers on the excellent structure and design of the report.

 

RESOLVED: That the report be noted.

The Board considered a report of the Strategic Director, Communities which informed Members of the requirement to produce a local Joint Health and Wellbeing Strategy and the process involved.

 

The Board was advised that one of the functions of the new Health and Wellbeing Board (HWB) was to produce a Joint Health and Wellbeing Strategy. It was reported that the strategy should provide the overarching framework within which commissioning plans for the NHS, Social Care, Public Health and other services which the HWB had agreed were relevant, would be developed.

 

The Board was further advised that HWB would be required to produce the strategy as part of its statutory responsibilities.  In addition, it was reported that the HWB Board would be able to consider whether the commissioning arrangements for social care, public health and the NHS, developed by the local authority and Clinical Commissioning Group respectively, were in line with the Joint Health Well Being Strategy; and if not, the HWB Board would be able to write formally to the NHS Commissioning Board & the Clinical Commissioning Group or Local Authority leadership. 

 

It was reported that in developing the strategy a range of views would need to be gathered from a wide range of partner organisations especially given the scope and remit of the strategy. It would also be essential to develop ways of involving members of the public in the preparation of the strategy.  Members would also have a vital role to play in helping to develop the strategy in conjunction with identifying the priorities for action.

 

In conclusion, it was reported that at a local level Halton had recently updated its Joint Strategic Needs Assessment for Health and Wellbeing and was currently in the process of developing locality needs analyses. Both of these would be used to underpin the Joint Health and Wellbeing Strategy.  In addition, some initial scoping work had begun in terms of gathering the evidence base, determining the outline of the strategy and collating best practice (where available) from other areas

 

The Board noted the Strategy would be required by the end of July 2012.  It was suggested and agreed that the document ‘Peeling the Onion’ be circulated to all Members of the Board.

 

RESOLVED: That the report and comment raised be noted.

The Board considered a report of the Strategic Director, Communities which gave Members an update on the key issues and progression of the agenda for Safeguarding Vulnerable Adults.

 

The Board was advised that discussion had began, aimed at developing a pilot project in Halton based on the ‘Safe Around Town’ scheme which was currently running in St Helens.  The scheme’s purpose was to provide a safe sanctuary for people with learning disabilities in St Helens town centre. 

 

The working group were considering widening the proposed scope of the scheme in Halton to include vulnerable people of all ages and needs in the wider community rather than limiting it to shopping areas. 

 

Halton Speak Out also had a lead role in the project and it was hoped that collaboration could also be achieved with other voluntary groups, community centres and employers.    

 

The report highlighted that a range of issues surrounding dignity had been developed and were attached at Appendix 1 to the report.  A report would also be presented to the Safer Policy and Performance Board on 17 January 2012.

 

The Board noted the various activities that had taken place and were set out in paragraphs 3.2 to 3.7 of the report.

 

RESOLVED: That the contents of the report be noted.

 

 

The Board considered a report of the Strategic Director, Policy and Resources regarding the Quarter Monitoring Reports for the second quarter of 2011/12 to September 2011:

 

·        Prevention and Assessment; and

 

·        Commissioning & Complex Care.

 

The Board received and noted a number of questions relating to the performance monitoring reports.  It was reported that the questions and responses would be appended to the minutes.

 

A Member of the Board thanked Officers for the performance on CCC9 – that the Authority had sustained a zero repeat homelessness status.

 

RESOLVED: That the reports be noted.

 

The Board considered a report of the Strategic Director, Communities which gave Members information on the work of the Positive Behaviour Support Service (PBSS).

 

The Board was advised that the report set out the development, current activities and future direction for the Positive Behaviour Support Service (PBSS).  This was a new service with the primary purpose of supporting and improving the lives of children and adults with learning disabilities and/or autism, and who exhibit ‘challenging behaviour’.  It was reported that such behaviour could include: stereotypical behaviour, self-injury, disengagement or aggression.

 

The Board was further advised that the consequence of such behaviour could place carers and parents under considerable stress and there tended to  be limited opportunities for an ordinary life for the individuals concerned.  The PBSS had been established to counter such consequences.  It was reported that the service was staffed by Board Certified Behaviour Analysts, who held  an internationally recognised qualification requiring intensive training and continuous supervision.

 

It was reported that recruitment for the team had commenced in late 2010 hand the full team of 13 had been established in November 2011.  The service was funded by St Helens Council (Adults), Knowsley Metropolitan Borough Council, NHS St Helens and Halton Primary Care Trust and Halton Borough Council.  The service worked with children and adults in four areas, early intervention, crisis prevention and management, technical support and placement development.  Examples of case studies were set out in the report.

 

In conclusion it was reported that a key issue was related to future funding in that the Primary Care Trust would cease to exist and alternative funding was being explored.  

 

The Board noted the excellent work that was being undertaken by the team.

 

RESOLVED: That the report be noted.

 

The Board was reminded that Standing Order 51 of the Council’s constitution stated that meetings should not continue beyond 9 pm

 

RESOLVED: That Standing Order 51 be waived to allow the meeting to continue beyond 9 pm.

The Board considered a report of the Strategic Director, Communities which represented the first step in developing a work programme of Topics for the Board to examine during 2012/13.

 

            The Board was advised that the autism review was near completion and a report would be presented to the 6 March 2012 meeting. It was reported that the Homelessnes review would not be completed until March 2012 and a report would be presented to the Board in June 2012.

 

            After discussion, the Board agreed that a Topic Group be established on Public Health Prevention.  Members were encouraged to email their interest in becoming part of this group to the committee officer as soon as possible.  In addition, it was agreed that a topic brief would be presented to the next meeting of the Board.

 

            RESOLVED: That

 

(1)               an Public Health Prevention Topic Group be established;

 

(2)               Members indicate their interest in becoming part of this Topic Group via email to the Committee Officer; and

 

(3)               A Topic Brief be presented to the next meeting of the Board.