Report of the Sustainability and Transformation Partnership.
Helen Riley, the STP Senior Responsible Officer and Deputy Chief Executive and Director of Families and Communities; Tilly Flanagan, Head of Child Health and Wellbeing; and Mary Barlow, Lead Nurse for North Staffordshire and Stoke on Trent Clinical Commissioning Group (CCG) - Sustainability and Transformation Plan (STP) attended the meeting.
The report detailed the progress on the Maternity Transformation Plan (MTP) and provided an update on priorities agreed for the STP Children and Young People Programme. The Staffordshire Maternity Transformation Board and Plan was originally written in 2016 and had benefited from additional resources from NHS England in the form of Tranche one funding of £390,000 and tranche two funding of £679,000.
There were five key priorities which sat beneath the Staffordshire and Stoke on Trent MTP:
· Enhanced quality and safety of women and new-borns
· Authentic engagement with women and their families
· Reconfiguration of maternity services.
· Improved health and wellbeing of women and their new-born’s
· Increased access to perinatal mental health services
It was reported that the Children and Young Peoples Programme had, to date, not received the same level of support afforded to other STP programmes and had been set up later than the others. It was also the only workstream that dealt with a cohort based on age. Great effort had been made to prevent duplication with the other workstreams such as mental health which cut across many services and work areas. The recent publication of the NHS 10 Year plan which related to Maternity, Children and Young People, had been welcomed and had led to a greater impetus to build on the groundwork developed to date and maximise future funding and wider opportunities. It was reported that the MTP had been modified to ensure that the national priorities were picked up locally. The intent was to develop stronger integrated working across the whole system to improve outcomes.
Members felt that the MTP could be reported further through its links with the Early Years Board and information cascaded down to the local Family Improvement Boards. This could help to inform local areas of work and delivery plans.
There had been significant progress made against the plan, which had been complicated by Stoke on Trent City Council currently focusing its resource and efforts in to improving its Children’s Social Care services following its recent OFSTED report.
A Member felt that local services had reduced in recent years and gave the example of reduced health visitor numbers and asked how, given the financial constraints, the improvement programme could be delivered. It was acknowledged that funding had changed and the delivery of some services was being looked at in different ways. For instance, a recent pilot of a telephone triage system in the Health Visitor Service, had found that a large proportion of telephone calls to midwives were to make appointments or for information. This could be provided by junior staff or via digital information thus free up time of more qualified health professional staff.
Following a question on Children with Learning Disabilities and Autism, it was reported that conversations and work were starting to take place with other workstreams such as the Mental Health stream and links with the Special Educational Needs and Disability (SEND) programme to ensure that services were in the right place and were provided at an appropriate time. Members were concerned that there seemed to be a lack of coordination between the workstreams and that silo working would stop efficient delivery of services. It was noted that at the 2 December 2019 Select Committee meeting, the Autism Implementation Plan would be considered. Members asked for information at that meeting to alleviate their concerns that services would be coordinated.
A Member raised the issue of Cannock Chase District, which had high levels of still births, and infant mortality rates which were double that of the rest of the county. Additional resources had been called for to try and establish why this was and officers were working with the West Midlands Network to review the data. A similar piece of work had been undertaken in the recent past in the Blake area of the District. It was felt that this was an item which needed to be considered further by the Committee.
Following a discussion on the importance of Prevention within each workstream, it was agreed that early intervention and prevention was key to family support and mental health services. Partners were working together to look at this. It was felt that some STP work streams may have become so medically focused, that root cause and prevention had become secondary to treatment. It was suggested that a specific workstream to provide focus may help.
Following a question on maternity services and two of the three Hospitals used by residents being out of the County, the Committee was informed that the STP worked closely with neighbouring areas and their Transformation Programmes to ensure joined up working continued. Work around discharge pathways and organisational culture differences was continuing with hospital and community midwifes. Staffordshire had a strong Maternity Voice Partnership with 15 local champions in communities who reported feedback to Boards. There were also plans to set up sub groups in each area as it was recognised that parents often struggled to travel further afield to access services. Social Media was helping in this area.
A listening event had recently taken place, organised by “Together We’re Better” to ask what people wanted to see from their maternity services. It was hoped that this may shed some light on the reasons for low birth numbers at The County Hospital.
Following a question on the help provided to Children and Young People with mental health issues who are admitted to prison, Members were informed that work was taking place with the prison service to develop the services that were required.
The future of Children’s Services at the University Hospital North Midlands and the possible application to become a children’s hospital was raised along with the question of whether this would enable access to future funding opportunities. Officers agreed to follow up on this and provide the Committee with a briefing note.
RESOLVED: That the report and progress made to date be noted, and the following information be requested:
a) The Autism Implementation Plan, to be considered at the 2 December Select Committee, should provide information on the coordination between the workstreams to alleviate concerns of silo working.
b) Infant Mortality in the Cannock Chase District area and the wider context of prevention be considered by the Committee at an appropriate time.
c) A briefing note on any application by University Hospital North Midlands, to become a children’s hospital and its effect on funding.