Agenda and minutes

Dr Dave Briggs

Sarah Collis

None.

Minutes of the meeting held on 29 March 2023, for confirmation

The Committee confirmed the minutes of the meeting held on the 29^th March 2023 as a correct record and they were signed by the Chair.

Richard Groves, Head of Access and Prevention, presented the report on capitalisation of the Disabled facilities grant (DFG) to secure funding of £449,895 in order to create additional posts in Occupational Therapy, equivalent to the current proportion of work undertaken on adaptations by Occupational Therapists supporting use of the DFG. 

This funding will be used to increase the number of full time equivalent (FTE) posts within Occupational Therapy for the creation of a Principal Occupational Therapist, a Team Manager, 4 Occupational Therapists, and 3.5 Occupational Therapy Advisors.

Usage of the DFG in this way does reduce the amount available for adaptations, however there is a regular underspend on this and a full business case has been conducted to demonstrate feasibility.

Resolved to endorse the decision to capitalise on the Disabled Facilities Grant to increase Occupational Therapy capacity prior to Portfolio Holder decision.

Reasons for decision:

·  The waiting list for Occupational Therapy Assessment is currently at 690 adults and 45 children with an average waiting time of 6 months and 555 citizens having had to wait over 28 days for an assessment. 

·  The resource requested is based upon the number of staff/equivalent cost per locum or per assessment it will take to reduce the waiting list and hold it within acceptable tolerances (less than 28 days).

·  The waiting list is equivalent to 393 citizens waiting for an assessment for Adaptations. The number of unallocated pieces of work continues to be a concern with most referrals into the service waiting over 28 days. This impacts on the experience of citizens as well as the risk of deterioration during the waiting period.

Other options considered:

·  Do nothing - capacity continues to outweigh demand with considerable pressure on the existing Management structure to deliver from within limited confines. Occupational Therapy is a key preventative measure and a failure to meet further demand will create additional pressure on Social work team as well as financial burden on the council. 

·  Create an Interim capacity to reduce the waiting list - there is every likelihood that once the interim facility came to its natural end then demand for the service would increase. An interim facility only goes as far as to address the short term solution and does not create the foresight needed to safeguard the council’s future financial position through preventative action. There is also no guarantee that we would be able to recruit to temporary positions and the continued use of agencies remains questionable in light of the current financial climate. This solution also does not address issues around accountability amongst appropriate numbers of Managers within the team. 

Katy Dunne presented the report on the Nottingham City Better Care Fund 2022 - 23 Year-end reporting template that was submitted to NHS England & Improvement on 23rd May 2023.

The following system challenges in meeting the metric targets for 2022-23 have been highlighted:

·  Urgent Community Response service is operational but has been challenging to ensure all GPs and healthcare professionals are aware of it across the ICS, despite full geographic coverage being in place.

·  Challenges around night time provision for Pathway 1 services – we will be working with system partners to pilot short term night time provision during 2023/24 and the learning will inform longer term Pathway 1 transformation.

·  Figures indicate a result of 687.5 admissions per 100,000 population. This is 77.5 people, over the target of 610 people. The average number of new admissions each month has increased this year.

·  Figures for the proportion of older people still at home 91 days after discharge indicate a result of 78.1% against a target of 80%. A further 10.2% of citizens could not be traced (47), some of whom may still be at home.

Resolved to approve the 2022-23 Better Care Fund Year-end template

To agree to meet on the following Wednesdays at 3.30pm at Loxley House, Station Street, Nottingham:

 27 September 2023

29 November 2023

24 January 2024

27 March 2024

Resolved to meet on the following dates:

·  Wednesday 27 September 2023 at 1:30pm

·  Wednesday 29 November 2023 at 1:30pm

·  Wednesday 24 January 2024 at 1:30pm

·  Wednesday 27 March 2024 at 1:30pm