Agenda and draft minutes

Inquorate meeting - informal meeting held, Health Scrutiny Committee
Thursday, 13th December, 2018 1.30 pm, CANCELLED

Venue: Ground Floor Committee Room - Loxley House, Station Street, Nottingham, NG2 3NG. View directions

Contact: Jane Garrard  Senior Governance Officer

Items
No. Item

51.

INQUORATE MEETING

Minutes:

With only appointed Councillors Andrew Rule and Anne Peach in attendance, the meeting was inquorate but continued on an informal basis.

51a

Apologies for absence

Minutes:

Councillor Merlita Bryan (Vice-Chair) – other Council business

Councillor Eunice Campbell-Clark – unwell

Councillor Brian Parbutt – work commitments

Councillor Georgia Power – work commitments 

Councillor Chris Tansley – unwell

Councillor Adele Williams – personal

51b

Declarations of interest

Minutes:

None.

51c

Minutes pdf icon PDF 170 KB

To confirm the minutes of the meeting held 22 November 2018.

Minutes:

The minutes of the meeting held on 22 November will be submitted to the next meeting for approval.

51d

Homecare Services pdf icon PDF 10 KB

Report of the Head of Legal and Governance.

Additional documents:

Minutes:

Christine Oliver, Head of Commissioning, Clare Gilbert, Commissioning Lead, and Linda Sellars, Director for Quality and Change, all from NCC, were in attendance to provide the Committee with an update on the implementation of the new Homecare Services model that has been operating for six months.

 

A presentation was delivered and is included with the initial publication of the informal notes. 

 

The presentation outlined:

o  the structure of the new model;

o  the 4 appointed lead organisations;

o  what elements of the model are and are not working well;

o  Nottingham’s ranking against nearest neighbour comparators;

o  The current position and what is planned for the future. 

 

The following additional information was presented during the item and questions from members responded to:

 

(a)  Whilst there are 4 Lead Provider Organisations, a list of accredited providers is maintained and used when Lead Providers (LPs) do not have capacity to meet demand. However, this is the exception as a close relationship must be maintained with LPs which also helps to ensure that quality standards are maintained;

 

(b)  There are National problems with recruiting and retaining staff for homecare and it is anticipated that the Brexit outcome may further exacerbate staffing issues.  Nottingham’s issues are further complicated as the City provides multiple opportunities for less demanding work at the same pay level. In addition, the County Home Care Services generally offer a higher wage;

 

(c)  It is noted that whilst Nottingham City Council has openly challenged the offer of zero hours contracts, some workers prefer the flexibility of not having set hours. In addition, the affordable provision of child care can be a significant influence with potential workers;

 

(d)  Patient access to the re-enablement service can take up to 6 weeks and is reviewed by Level 3 Community Care Officers after 2 weeks to ensure that the appropriate support is in place, to assess re-enablement progress, and determine if longer term support is required;

 

(e)  Due to the formal boundary of Nottingham City not including some of the wealthier suburban areas within the greater city area, there are 11% fewer self-funding clients who pay more and help support the local home care market. This results in added pressure;

 

(f)  There is potential for a pilot of an accredited pay list for personal assistants as the market exists to create an initiative for carers to have more than one person to care for and therefore enough accumulate working hours to make a living;

 

(g)  As of today, there are now 8 people in acute beds who are medically safe for discharge and are awaiting for a homecare date (compared to 20 on 23/11), and there are 15 people at home with no formal support (compared to 12 as of 23/11);

(h)  Quality of care is monitored closely with spot checks taking place. This is in addition to the requirements of the Care Quality Commission. Where delays may occur, it is sometimes as a result of a safeguarding concern;

 

(i)  Internal staff who leave are  ...  view the full minutes text for item 51d

51e

Primary Care Mental Health Services pdf icon PDF 106 KB

Report of the Head of Legal and Governance.

Additional documents:

Minutes:

Lucy Anderson, Greater Nottinghamshire Clinical Commissioning Partnership, briefly updated the Committee on the CCG’s position of withdrawing primary Care Mental Health Services as of 01/01/2019, with advance notice given to GPs during October 2018.

 

Although the CCG intended to review services as the funding from ‘The Better Care Fund’ was to cease, the current position was accelerated as a result of staffing issues within the Primary Care Mental Health Services Team. As movement through the service usually takes about 12 weeks, adequate notice was given to GPs to stop referrals and for alternative services offered.

 

Existing staff were supported in looking for other work and a full redeployment exit strategy launched.

 

New service models are being considered and developed and it is anticipated that a proposal will be presented at the end of March 2019 as part of a broader review of Mental Health Services.

 

AGREED

 

(1)  to thank Lucy Anderson for stepping in to present the item;

 

(2)  to note the update and request a further update to the Committee in May 2019.

51f

Children and Young People’s Mental Health and Wellbeing and the CAMHS AND PERINATAL MENTAL HEALTH SERVICES UPDATE pdf icon PDF 195 KB

Report of the Head of Legal and Governance.

Additional documents:

Minutes:

Charlotte Reading and Lucy Anderson, both from the Greater Nottinghamshire Clinical Commissioning Partnership, Catherine Pope and Richard Glover, both from Nottinghamshire Healthcare NHS Foundation Trust, and Aileen Wilson, Head of Early Help Services NCC, were in attendance and presented a joint update on to the two agenda items focusing on young people’s mental health.

 

Further to the Committee’s review of the Sustainability and Transformation Partnership and Greater Nottingham Integrated Care System at the October 2018 meeting, an update on the review is now presented regarding issues identified during the implementation of the Transformation Plan and priorities for the forthcoming year.

 

In addition to the detailed reports, the following information was provided and responses given to members’ questions:

 

(a)  All services should be working together towards a tierless and seamless system with a single point of access. Screening and assessment may identify the need for behavioural support, parenting issues, or occasionally child protection or physical health issues. There may need to be challenging but necessary conversations;

 

(b)  Following the initial assessment which usually takes place within a week of referral, the length of waiting times for children and young people to receive treatment/support particularly following a mental health episode or suicide attempt would ideally be shortened. Work continues to address this, but initial contact by mental health colleagues is made within 24 hours of referral. Once the initial risk is considered to have passed, parents can be supported through a short parenting group where they are taught what indicators to look for and possible appropriate reactions. It is vital that parents don’t feel that they are on their own and they know that support is available and that they can learn to trust their children. Advice is also now provided in hospitals;

 

(c)  Young people need to be able to manage their own risks and challenge their perceptions. It is important that young people and their parents/carers understand and can apply coping strategies;

 

(d)  The majority of young people entering the service are aged between 12 and 16 years old. Whilst the transition of children to adult services had been historically awkward in some areas, it should be noted that support in the form of a transition champion is available but that the majority of young people suffering mental health difficulties do not go on to access adult services. Statistics are available but were not accessible during the meeting;

 

(e)  There are local challenges in that there are different service providers in the City and the County, but there’s good evidence of partnership working with the organisations working together well;

 

(f)  There has been a lot of work with schools on prevention but also to ensure that young people can access information, help and support with mental health issues and can be referred to specialist services when needed. There has been resistance in some schools which were reluctant to escalate pupil’s mental health support, but work is continuing to encourage improved engagement;

 

(g)  Although a lot of work has been done  ...  view the full minutes text for item 51f

51g

Work Programme 2018/19 pdf icon PDF 107 KB

Report of the Head of Legal and Governance.

Additional documents:

Minutes:

Agreed to note the work programme for the remainder of the 2018/19 municipal year.