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Declarations of Interest
There were no declarations of interest made at the meeting.
A Member asked if any information had been received which the Committee had requested at the previous Committee. The Scrutiny and Support Manager agreed to chase the information and forward it onto the Committee as soon as possible.
RESOLVED: That the minutes of the meeting held on 29 October 2018 be received as a correct record and signed by the Chairman.
Report of the Deputy Leader and Cabinet Member for Health Care and Wellbeing
Councillor Alan White, Cabinet Member for Health Care and Wellbeing, Richard Harling, Director of Health and Care, and Amy Evans, Commissioning Manager, Learning Disability Commissioning Team attended the Committee to present the report and gave a short presentation.
The Committee was asked to consider the future of Day Opportunities for Adults with a Learning Disability (ALD) and/or Autism in advance of recommendations to Cabinet. The report and presentation specifically focused on the provision of Day Opportunities including Complex Needs Services provided by the Council; Day Opportunities provided by the independent sector; and, services provided by Personal Assistants.
The purpose of the ALD Community Offer was described as “To establish the assessed eligible needs and desired outcomes of the Adult and Learning Disability cohort and ensure that there are appropriate and sustainable services across the county to meet the identified needs: supporting citizens to maximise their independence, in accordance with Staffordshire County Councils (SCC) new Whole Life Disability Strategy (WLDS)”. It was reported that the WLDS tries to address the financial challenge of the ageing population, rising costs and a budget that is falling in real terms.
There were currently 1,800 service users; six complex needs centres; and 55 independent providers. It was hoped that the outcomes of the programme would empower citizens and their carers; move from a community presence to genuine community inclusion; maintain or increase quality of support provided; establish clear contracting arrangements; address the differentials in prices paid; ensure the offer is equitable transparent and proportionate to need; and contribute to budget savings.
A Member asked if services would be changing or relocating as in some areas service users travelled considerable distances to access services for short periods of time. The Member also questioned the quality of some of the services which were commissioned through direct payments and were not monitored for quality or value for money. In response, the Director said there were no plans at the moment, but he was not sure that all services were sustainable in the long term. A payment formula would need to be developed to provide fair funding to people based on their needs and taking into account their geographical location and the need for to travel. The Member also questioned how information on providers was exchanged as it seemed to depend on the local area and if you know the right people.
A Member questioned how different disabilities could be categorised in an assessment. In response, the Committee was informed that the person centred approach attempted to address these issues with services for those with complex needs being very different to those with moderate needs. This raised the question of whether this should be reflected in the funding allocated to people.
A Member asked if it was worth looking at the 55 Social Service providers who cared for 400 individuals and if we would reduce this number by using an in-house trading company such as Nexxus. In response the Cabinet Member agreed to look at this suggestion.
A Member ... view the full minutes text for item 50.
Report of the Partnership Director
Helen Riley, Senior Responsible Officer (SRO) and Tilly Flanagan, Head of Child Health and Wellbeing attended the Committee to present the report and give a short presentation.
Across Staffordshire and Stoke on Trent, the Children’s Joint Strategic Needs Assessment (JSNA) provided an understanding of the needs of children and young people. As a result of the JSNA, the STP had recognised that improving outcomes for Children and Young People was a priority. Following consultation, it was identified that the following areas were priority themes:
· Maternal and infant health
· Childhood obesity
· Emotional wellbeing
· Children and disabilities
· Hospital activity
· Children’s social services
The Committee was informed that the childrens work stream had only recently been added to the STP programme and so they were at the beginning of the review process and issues were still emerging as work progressed. However, initial discussion had identified the following themes: Transition from child to adult services: Designing pathways for people not services; Treat cause not symptoms; Mental Health; Access to information; The voice of the child; Early years with a focus on parenting.
A Member asked if children who were carers were included in the review. In response, officers confirmed that these children should be known and should have Children in Need plans, but this was an important area and it was agreed that this would be included in the review.
A Member asked if all the previous work and research that had been carried out had fed into the review as it would be a waste to not take it into account and loose previous knowledge. It was confirmed that this had been included but things had moved on and all partners need to concentrate on the same areas with the approach being early help which reduces the need for more support later.
A Member asked if the results of the trail blazer bid had been received yet. The SRO responded that we were still awaiting more information but if it was successful it could mean an additional £3m to £4m for the service area although it was prescriptive and could only be used for specific roles.
A question was asked on information sharing and if all partners were sharing and passing on information. In response, the Committee was informed that this was an area which needed to be progressed.
A Member asked about the cost of out of county placements, if there should be mental health first aiders in schools and if this support was available through transition from primary to secondary school. In response, the cost could range from £3,000 to £4,000 per week for out of county placements and special school in reach support was part of the place based approach. The Committee was also informed that there had been a large increase in the number of children with moderate special needs accessing special schools which was one of the highest in the Country. Officers felt that this was as a result of mainstream schools not being able to support special ... view the full minutes text for item 51.
Report of the Scrutiny and Support Manager
The Scrutiny and Support Manager presented the report which outlined the activity of the Borough and District Councils since the last meeting.
The Cannock Chase District Council representative reported that they had meet in November and looked at obesity
The East Staffordshire’s Borough Council representative reported that they had meet in November for a special meeting to look at the termination of the Virgin Care contract for End of Life care. Their next meeting was due to be held on 19 December.
The Lichfield District Council representative reported that they had met in November and looked at Community Hospitals in the area and the use of facilities.
There was a short discussion on the availability of Boroughs and Districts to send substitutes if they are not able to attend.
RESOLVED: That the report be noted
Report of the Scrutiny and Support Manager
The Scrutiny and Support Manager presented the Committee Work Programme report. The following items of business were suggested for inclusion in the work programme.
1. At the last meeting the Committee considered the CAMHs Strategy and the Chair requested that the Committee ask for a six months update including the delivery plan and results of the trailblazer bid come back to this Committee.
2. Following the appointment of the new Chief Executive, The University Hospital North Midlands could be invited to discuss their financial position and any service changes.
3. Healthwatch Staffordshire Commissioning contract.
4. Discharge to Assess – South of the county and the relationship with providers.
5. Allied Health Care contract and the fragility of the market and the role of Nexxus.
6. Breast screening services in the South of the County.
7. Cancer and the End of Life Services and what is happening to services now.
The effect of Brexit on healthcare professionals was discussed. It was felt that at this stage, this item could be considered under the workforce workstream.
RESOLVED: That the report be noted and items as listed above be added to the Work Programme.