Minutes of Scrutiny Board 19 June 2006
MEETING OF THE HEALTH AND COMMUNITY CARE SCRUTINY AND POLICY DEVELOPMENT BOARD | ||
Meeting held 19th June, 2006 | ||
PRESENT: | Councillors Roger Davison (Chair), Ian Auckland, Jane Bird, John Campbell, Jan Fiore, Patricia Fox, Martin Lawton, Helen Mirfin-Boukouris, John Robson and Clive Skelton. | |
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1. | APOLOGIES FOR ABSENCE FROM MEMBERS OF THE BOARD | |
There were no apologies for absence received from Members of the Board. | ||
2. | DECLARATIONS OF INTEREST AND PARTY WHIP | |
There were no declarations of interest or party whipping. | ||
3. | PUBLIC QUESTIONS AND PETITIONS | |
There were no petitions or public questions received. | ||
4. | MINUTES | |
The minutes of the meeting of the Board held on 18th April, 2006, the Special Meeting held on 3rd May, 2006 and the meeting held on 17th May, 2006 were agreed as a correct record. | ||
Arising from the minutes of the meeting held on 18th April, 2006, Eddie Sherwood, Head of the Care 4 You Service, agreed that he would provide copies of the project profile relating to the Partnerships for Older People’s Projects (POPPS) to Members of the Board. | ||
5. | INSURING A PATIENT LED NHS – OUTCOME OF CONSULTATION | |
Members of the Board considered a letter from the Chief Executive of the South Yorkshire Strategic Health Authority, announcing that the three Strategic Health Authorities in Yorkshire and the Humber would become one from 1st July, 2006 and would be called the Yorkshire and the Humber Strategic Health Authority. | ||
The configuration for the Primary Care Trusts (PCTs) had also been announced and there would be four PCTs in South Yorkshire namely Barnsley, Doncaster, Rotherham and Sheffield. The one primary care trust for Sheffield combined previous trusts for North Sheffield, South West Sheffield, Sheffield South East and Sheffield West. Each of the new PCTs was aligned with its local authority boundary. | ||
RESOLVED: That the information now submitted be noted. | ||
6. | COMMUNITY CARE PLANS 2006-2007 | |
The Board considered a report of the Director of Adult Social Services concerning community care service plans for 2006-07 and an accompanying presentation outlining the service’s performance. | ||
Eddie Sherwood, Head of Care 4 You and Deputy Head of Adult Services, gave a presentation to the Board in relation to the performance for community care in 2005-06. He stated that more people were being helped to live at home including older people, those with physical disabilities and learning disabilities. There had also been an increase in the number of people receiving intensive home care packages and items of equipment or adaptations delivered within seven days. Waiting times had reduced by 4% for assessments and 10% for care packages. | ||
More than 1,300 statements of need had been produced above the number for the previous year and 1,000 reviews had been completed. The number of direct payments had also doubled. | ||
The key priorities for the Neighbourhoods and Community Care Directorate were to provide high quality standards for access and response to customer needs; budget and efficient and effective resource management; and a further strengthening of collaborative working with partner agencies. | ||
In particular relation to community care, greater independence and choice would be achieved through the development of self directed services, direct payments, community based services including domiciliary and daytime activities and carer services. | ||
Partnership working could be evidenced by the service working with PCTs in relation to intermediate care with patients after treatment or trauma; the development of extra care housing for community care services and use of this model for other services; and work in connection with the Decent Homes standard. | ||
The third key priority of service user consultation and feedback was evidenced through the engagement of older people in the POPPS initiative and the inclusion of the views of existing service users in the development of a new specification for contracts for independent sector homecare. | ||
Finally, Eddie Sherwood outlined the challenges for community care services. This included increased demand for services, illustrated by a 20% to 25% increase in the number of assessments undertaken and rising customer expectations. The service also worked within budgetary constraints from the growth of services and the finances of partner organisations, particularly the health service. There was the challenge of change, illustrated by the Single Assessment Process and the development of an electronic social care record. The reconfiguration of PCTs in the City would also provide challenges including the potential knock-on effects for support from social care services and how such additional demands on the social care provision in the city might be resourced. | ||
Members of the Board asked questions in relation to the report and accompanying presentation and Eddie Sherwood responded as follows. | ||
In response to a question in relation to the development of an electronic social care record and whether this was nationwide or developed locally, Eddie Sherwood stated that the City Council was moving towards increased levels of electronic recording. With regard to the NHS Information Technology project, the Department of Health had not properly accounted for the development of the Single Assessment Process when it procured IT and had not apparently considered the need to link local authorities and health services as part of any such assistance. However, there was work being undertaken to link local authority and health service systems in Sheffield and to achieve this whilst also maintaining confidentiality in terms of patient and user information. Such a development had been successful in relation to Children and Young People’s Services. | ||
A further question was asked in relation to the performance indicator relating to delayed discharges and whether the level of delayed discharges was to decrease further. Eddie Sherwood responded that the indicator for the number of delayed discharges from hospital also incorporated cases, where a delay to the discharge of an individual from hospital was the responsibility of the health service. The City Council had made significant progress in the last year and was within the targets set for delayed discharges of five each day. The greater proportion of delayed discharges were the responsibility of the Health Service and any further reduction in numbers was likely to depend upon the priority and investment decisions of PCTs. | ||
Questions were asked in relation to whether the review of city-wide alarms applied more widely than to older people’s services as indicated in the Plan and concerning the provision of services to adults with mental health problems who also had a learning difficulty or misused drugs and/or alcohol. In relation to the review of city wide alarms Eddie Sherwood informed Members that the review applied to all areas of the City regardless of people’s age. In respect of mental health provision he stated that more detail could be provided on improving the provision to adults with mental health problems who also had a learning difficulty or misused drugs/or alcohol. Information could also be provided in relation to any plans relating to substance misuse with people who did not have a mental health problem. | ||
A question was asked in relation to the implementation of the Home Support Forward Strategy and how advanced progress was in relation to the strategy and in response Members were informed that the strategy for Care 4 You was progressing separately to preparations for changes to home support contracts which were being developed for the independent sector. Eddie Sherwood stated that further information could be provided in relation to the specification for support services for older people and their carers including preparations to change home support contracts. | ||
A question was asked concerning improving the transitional experience for young people with profound learning disabilities and in response members were informed that an increasing amount of work was being undertaken between services for young people and adult services through co-operation between the Council and the Care Trust. This included wider consideration of provision of services according to need. There were also examples of individuals placed outside of the City where suitable provision could only be made externally. | ||
In relation to a question concerning the financial challenges facing health services in the City and the level of input from the City Council to the PCTs financial turnaround strategies Eddie Sherwood stated that responsibility for financial turnaround was within the remit of PCTs themselves and the City Council had not had a significant input into this process although had entered into discussions in relation to the implications of financial challenges facing the health services and social care services. | ||
In response to a question concerning initiatives to find employment for people with learning disabilities, the Board were informed that there were increasing employment opportunities being developed for people with learning disabilities and adults with disabilities and mental health problems. | ||
A question was asked concerning the distinction between the development of a culturally competent workforce and improvement of ethnic monitoring for service users and the development of improved services for carers within the black minority ethnic communities and other minority groups. Eddie Sherwood informed members that the Care Trust was undertaking work to improve the confidence of the workforce in relation to cultural issues and stated that he could provide further details to Members of the Board in relation to this matter and the improvements of ethnic monitoring in relation to service users. | ||
In relation to initiatives to decrease the number of delayed discharges from hospital, a Member of the Board commented that in some cases early discharge might not be appropriate and in response Eddie Sherwood stated that if an individual was discharged when not fully fit or when they had not regained the confidence, there was an increased chance that they would need long term nursing care and in some circumstances any attempts to reduce length of stay in hospital might carry such a risk. Discussions were ongoing and it was thought that intermediate care services might need to be strengthened to provide for appropriate support after trauma or treatment. | ||
A Member of the Board asked what steps would be taken to ensure that the social services and health IT systems were able to communicate effectively. Eddie Sherwood responded that the Social Services IT Project Manager was working with the Care Trust and health service in relation to this issue and one of the IT priorities was to develop such links with PCTs systems. He underlined that progress was being made in relation to IT. | ||
In response to a question concerning the establishment of Sensory Champions within learning disabilities services, Eddie Sherwood stated that, through the establishment of Sensory Champions, clinicians and key managers could develop their knowledge of people with a physical disability, who also had recourse to the sensory impairment service. | ||
In response to a further comment from a Member of the Board concerning the use of abbreviations and generally plainer use of language in reports to the Board, Eddie Sherwood stated that he would inform officers of Members’ comments concerning the use of language and presentation of numerical information, including the explanation of abbreviations. | ||
A Member of the Board acknowledged the increased level of direct payments but expressed concern in relation to the Single Assessment Process which was not functioning and asked whether this was because it could not be facilitated by IT systems. Eddie Sherwood responded that as well as problems with information technology there appeared to be resistance from some health colleagues particularly around assumptions concerning roles and responsibilities and the sharing of information with social care colleagues. It was recognised that a culture change was necessary before the Single Assessment Process could work satisfactorily. Some progress was being seen, particularly among clinicians and senior professions and the item was on the Board’s Work Programme to be discussed at a future meeting. It was felt that Members should be made aware of progress in relation to the implementation of the Single Assessment Process and have opportunity scrutinise where progress had and had not been achieved. | ||
RESOLVED: That (a) the plans for Community Care Services 2006/07 and the presentation upon the progress made now submitted be noted; | ||
(b) the Director, Adult Services be requested to submit a further report in relation to progress made with respect to community care plans following the third quarter of 2006/07; and | ||
(c) the Director, Adult Services be requested to provide information to Members of the Board in relation to the further development of a culturally competent workforce and improvement of ethnic monitoring of service users and improving services for carers with black and minority ethnic communities and other minority groups; provision for adults with mental health problems who also had a learning difficulty or misused drugs and/or alcohol; changes to the specification for current contracts relating to home care services; and improving transitional experiences for young people with profound and multiple learning disabilities. | ||
7. | FUTURE PROGRAMME | |
The Board received a proposed programme of work for 2006/07. | ||
Other issues identified by Board Members for inclusion in the work programme included the provision of respite services at Beech Hill; and the impact of increased care charges. | ||
The Health Scrutiny Policy Officer also reported that a Special Meeting would be arranged on 25th July, 2006 in relation to the Care Trust’s application for Foundation Status. | ||
In relation to the item on the Work Programme concerning NHS finances, a Member of the Board asked whether support could be given to the Board from a financial expert in analysis of the financial position of the respective health trusts in the City. A member of the Board also asked for the turnaround plans relating to NHS Trusts to be included in the Board’s consideration of NHS finance particularly in relation to proposals within the turnaround plans and potential impact upon health and social care in the City. | ||
RESOLVED: That the Work Programme for the Scrutiny and Policy Development Board now submitted be noted. | ||
8. | FORWARD PLAN AND KEY DECISIONS | |
The Board received a schedule submitted by the Assistant Chief Executive, Legal and Governance, concerning the Forward Plan and Key Decisions in respect of items to be considered from June to September, 2006 upon which the Scrutiny and Policy Development Board might be responsible for any potential scrutiny exercises. | ||
RESOLVED: That the report now submitted be noted. | ||