Approved

MINUTES of ABERDEENSHIRE CHP COMMITTEE meeting held

Wednesday 9th December 2009, at Lochter Visitor Centre, Oldmeldrum

Present:

Prof V Maehle, Dean RGU,Chair

Mr J Stuart, CHP General Manager

Mark McEwan, CHP Planning Lead

Sandy Dustan, CHP Older People’s Lead

Mike Ogg, General Manager, CALCHP

Cllr Gurudeo Saluja, Chair, Social Work & Housing Committee

Audrey Findlay, Public Representative, SALCHP

Lesley Meldrum, Senior Communications Officer

Jennifer Hall, CHP Public Health Lead

Marcus Humphries, Member, Infra Structure Services Committee

Samantha Melrose, Community Pharmacist

Shona Strachan, AHP Representative

Gwynne Cromar, CHP HR Manager

Garry Kidd, CHP Finance Manager

Alan Young, Third Sector Representative

Cllr Alison Grant, SNP Group Representative

Cllr Richard Stroud, Chair, Education & Recreation Committee

Ritchie Johnson, Director of Social Work & Housing Committee

Cllr Anne Robertson, Chair, Policy & Resources Committee

Mrs L Taylor, CHP Lead Nurse

1 / WELCOME AND APOLOGIES
Professor Maehle welcomed those present to the meeting and apologies were note from:
Ms Agnes Taylor, Acting General Manager, NALCHP
Mary Bonner, PA to Mr J Stuart
Bob Liddell, CHP Clinical Lead
Dr A Palin, Clinical Director, MHS
Ian Powell, CHP Services Redesign Manager
Roger White, Head of Policy, Aberdeenshire Council
Robin Gatenby, Clinical Lead, NALCHP
Fiona Francey, General Manager, SALCHP
Janice Rees, Clinical Lead, CALCHP
Bruce Robertson, Director of Education
Steve Wilkinson, Group Interface Director / ACTION
2 / MINUTES OF PREVIOUS MEETING HELD SEPTEMBER 2009
Accepted as an accurate record of discussion.
3 / MATTERS ARISING
HMIe Child Protection Inspection Update
Mrs L Taylor reported back on the HMIe Child Protection Inspection Update stating that she was pleased to report on behalf of her colleagues, a “very satisfactory” and “glowing” report following a lot of work and self-evaluation. It was noted that Aberdeenshire knew where we were and are aware of what was required to be done, and clearly identified children at risk. There were examples of good practice noted –e.g. The Peer Listening project at Portlethen.
Three areas of improvement were identified - strengthening quality of services; involvement of children and young people in the process and structuring; continue to strengthen ways to ensure children’s health needs are being addressed. The latter will involve a considerable amount of work.
The overall clear message from the report was very positive.
The HMIe report also stated that they were confident that Aberdeenshire has the necessary improvement in sight and will not be doing a follow-up inspection.
Mrs Taylor commented that the new process employed works better as it is more dialogue-based. She was a little disappointed only to receive “good” on self-evaluation and a process has been set up to ensure that self evaluation is worked on. The challenge is to be sustain progress.
4 / GRAMPIAN MACMILLAN PARTNERSHIP PROJECT
Professor Maehle welcomed Kerry Townsley to give an update on the Grampian MacMillan Partnership Project.
Ms Townsley gave a brief background to the project which came about as a response to the 2004 report “Unseen Millions” which identified Grampian as one of the lowest areas for claiming disability allowance. MacMillan links with the Citizens Advice Bureau and the Pensions Service to ensure people have access to all the benefits they are entitled to. They have confirmed 100% funding to August 2010 with an expectation of funding to March 2011.
The project offers information and advice to anyone affected by cancer be it the patient‘s themselves, families, carers and friends and there is no age limit. They cover the whole of Grampian (City, Shire and Moray) and Orkney & Shetland. There are no MacMillan staff based in Orkney and Shetland, but funding is provided to the Citizen‘s Advice Bureaus there.
The project attends to financial and operational matters (not medical) and 90% of help required is benefit related. They also offer representation at tribunal regarding appeals.
Other issues covered by the project:-
Housing issues - unsuitable accommodation, payments of rent, etc
Debts - due to giving up work (patient, partner or to become a carer), new clothes, etc
Employment - re-introduction after therapy, change of carer circumstances, deaths, etc
General advice
Any health or social work professional can refer into the project and a client can self-refer. They offer to see clients at various locations and tried outreach areas at community hospitals, but this turned into home visits.
Staff includes 4 Project Workers (2 based in Aberdeen, 1 in Elgin and 1 in Peterhead), 3 Admin support staff and 1 Manager.
The project has been running since January 2007 and in the first year reported 660 new clients with a £1.2m in benefitclaims. Year 2 reported 730 new clients with a £1.5m in benefitclaims and figures for Year 3 to the end of October/beginning of November reported 740 new clients with a £1.7m benefit claims so far.
Future developments include opening more support services in Stonehaven, Westhill, Huntly, Turriff and Peterhead.
The term “palliative” could be applied to other medical conditions and the service offered by the project could be rolled out to include these and may attract more money from further funding streams.
MacMillan are keen to develop further on Social Work and Housing contacts and also to do some joint training with financial services (especially those dealing with benefits). Both Cllr Robertson and Mr Johnson offered to take this back to the Council.
MacMillan have leaflets in their offices and at clinics for those who have been diagnosed with cancer, but want to make their leaflets more accessible for everyone. They reported some problems in doing this in hospitals, etc. Professor Maehle offered to raise this issue at Board level regarding the problems with getting information into hospitals.
Following Ms Townsley’s update a lengthy discussion around the followingissues took place:
Is there an estimate on the number of people with palliative needs
How many people are diagnosed and how many of them have asked for support
How close to diagnosis is help sought
Funding to March 2011 - then what?
Ms Townsley reported that they log the stage clients are at when they seek assistance and offered to obtain figures on the other points and come back to a future meeting to provide a further update.
Professor Maehle thanked Ms Townsley for a very interesting and positive update on the Project and wished it continued success.
Contact details for Ms Townsley, Project Co-ordinator:
Grampian Macmillan Partnership Project
Aberdeen Citizen Advice Bureau
41 Union Street
Aberdeen AB11 5BN
Tel: 01224 569764
Email: / AR/RJ
VM
KT
5 / CHP PLAN
Mr McEwan talked to the previously circulated documents and presentation and referred specifically to pages 1 - 15 of the CHP Plan explaining it‘s layout, etc.
He gave a brief background to the work explaining that this was a huge portfolio of work which must be approved at the next CHP Committee meeting in March so it can start running from 1st April 2010.
The Plan has been taken to various forums on several occasions (CHP Management Team, Health and Community Care Team and the Planned Care Group) and redrafted following comments received following each of these meetings.
The Committee were asked for agreement of the plan with any further recommendations prior to its final approval at the March meeting. Mr McEwan asked the Committee to consider whether there was sufficient detail for the Committee, how reporting should reporting be undertaken it and if the priorities were correct.
There was a lengthy discussion during which the following comments were noted:-
Mr Johnson felt the Plan required to be further simplified and should link appropriately to different formats and committee structure.
Cllr Robertson asked if the Plan showed what we were trying to achieve and how it will make a difference to Community. There is a lot in the plan relating to local authority, but only one Lead Officer is identified as Local Authority - is this joint working?
Mrs Findlay stated that there must be ownership by all partners and asked the role of the CHP Committee - is it a Monitoring group?
Professor Maehle confirmed that the Committee was a monitoring group and needed to look at the joint working and cross-sector working issues.
Mr Stuart asked if it was only joint-working actions that was required in the plan. He felt that there was a need for high level, strategic actions and the need to agree set traffic lights and identify issues. Did we want a high level Operational/Management document that shows agreed priorities that we can report against.
Mr Young felt that there was a need for some detail to show direction of travel. Focus and priority is not captured, but is in the detail. Need to show effect.
Dr Hall wondered if there should be two plans - an NHS element one and a multi-agency element one.
Mrs Strachan felt that Long Term Conditions was explicit rather than implicit.
It was suggested that elements that are purely NHS do not need to come to the CHP Committee. However it should be borne in mind that there will be some NHS actions that will have an impact on the Local Authority and vice versa there Committee will need to be made aware of these.
It was also stated that this plan has been developed while the Health and Community Care Team Strategic Group was evolving and while the format of the plan was still evolving. Therefore it will need to be taken back to joint structures for sign up and the CHP Committee is one of these groups.
The following points require formalisation - What are the priorities? What are the outcomes? How do we performance manage and ensure we are aware of the consequences.
Professor Maehle thanked everyone for a good debate which provided a lot of steer for Mr McEwan to take forward in the further development of the Action Plan.
It was agreed that a small group meet to finalise and redefine the plan to a higher level with less complicated issues. Mr McEwan and Mr Johnson to arrange outwith the Committee and bring back the final CHP Plan to the March meeting for approval. / M McE/RJ
6 / HEALTH PLAN CONSULTATION
Mr McEwan talked to the previously circulated Grampian Health Plan 2010-2013 Consultation document.
He referred to the presentation he has been given around Aberdeenshire taking it to Peterhead, Fraserburgh, Banchory, Inverurie, Cardiology, Managed Clinical Networks and the Planned Care Group.
He asked the Committee to comment on 3 key questions as outlined in the presentation (also circulated):-
1.Do you agree with NHS Grampian’s vision?
(Why/Why Not)
2.Have we set out the right priorities?
(If no, what changes would you make)
3.Do you think we should involve patients and members the public in prioritising resources?
(If yes, how should we do this)
1.Do you agree with NHS Grampian’s vision - “Proudly working together to deliver the best possible services for a healthier Grampian“?
Comments:-
“together” ambiguous - change to “in partnership”
“best possible” - staff agree this is right as we cannot do everything, public feel this is a get out clause. Agreed it should remain as services dependant on resources.
2.Have we set out the right priorities - Focus for next 3 years?
Comments:-
“Improving health and reducing health inequalities“ - should read “Improving health & wellbeing and reducing health inequalities”
“Involving patients, carers, the public, staff and partners towards mutuality” - what does “mutuality” mean? is this the best word? Agreed to remove “towards mutuality”
“Delivering safe, effective and timely care in the right place” - Feel we do our best at present, but could always do this better.
“Developing the workforce and empowering staff” - Developments ongoing (I.e. Staff Nurse development). Recognised that workforce is vital to our survival.
Above links to
“Getting the best from our resources” - Joint training, engagement, employment, management, resources. We must take ownership of service and of one’s own health.
3.Do you think we should involve patients and members of the public in prioritising resources -
Comments:-
Yes - involve, consult on all strong single issue problems
The time has never been more right to consult with the public! Patients are much more aware of their rights!
Questions would need to be straightforward - I.e. What do we need to do?, What can we do without?
Involve them at end of/just finished treatment stage
Improve how they involve - give more than five weeks to consult!
Consultation with Local Authority is the next phase due in February.
7 / JOINT FINANCIAL PLAN
Mr Kidd reported that at the last meeting the format of the Plan was agreed and that there would be an update at each meeting in terms of overall resources (Health and Local Authority) and where we’re at around priorities of resources. The Plan will be developed and improved based on ongoing information provided.
It was also agreed to create a joint financial plan group and whilst there has been agreement on the initial membership of the group, they have not met as yet, but this will be taken forward in the new year.
As Mr Kidd had not received any feedback he was working on the assumption that everyone was in agreement with the new format, but welcomed any comments or further information to be sent to either himself or Gillian Neal.
It was agreed that there will be a short presentation on the Joint Financial Framework at the next Committee meeting.
Mr Kidd reported that we have agreement regarding joint resource management and we should now look at making decisions about resources by targeting the ones we control. He also encouraged everyone to look at a larger health pot.
Redesign provides a concrete focus on where savings are and where is it being redirected to.
The Group looking at the plan will also look at the resources attached to the actions. / G Kidd
8 / CHP MANAGEMENT PROPOSALS - UPDATE
Mr Stuart reported that we now had the final draft for the restructuring of the CHP Management Team, however as NHS Grampian is also considering a wider restructuring of Senior Managers across Aberdeenshire, AberdeenCity, Moray and the Acute Sector. A decision will be made in January and we have slowed down the progression of ours until the New Year.
The restructure will have more alignment with the Local Authority and it is noted that Older Peoples Services is fundamental to both.
Agreement is to build management structures by areas based on Community Hospitals and the GP Practices that feed into them which loosely matches Local Authority school areas.
It has been agreed to keep a General Manager and Clinical Lead in each of the 6 areas which will help support agendas. Some issues that still require attention are areas of disalignment in Older People’s services and Mental Health. It is also noted that there is a restructuring in Social Work ongoing which will be reported at the January CHP Management Team meeting.
Recommendations will be brought to the next CHP Committee meeting in March. / JS
9 / OVERVIEW OF MENTAL HEALTH SERVICES IN SHIRE
Mr Johnson talked to the previously circulated document on the Overview of Mental Health Services in Aberdeenshire and stated that services for the elderly are much more critical. He also highlighted that the recommendations only covers some of these services.
He reported that this would be managed through joint teams and it would be reported back to the Committee through the key strategic reporting group.
It was noted that Aberdeenshire CHP will be responsible for the healthcare of the inmates of the new prison in Peterhead providing a single service for dual diagnosis - mental health and drug & alcohol issues.
It was reported that the Community Planning Partnership has made early contact and asked to be involved in the development as should the Third Sector.
10 / STRATEGIC COMMISSIONING STRATEGIES
Mr Johnson talked to the previously circulated report on the Guidance issued by the Social Work Inspection Agency (SWIA) on self-evaluation and drew attention to points 3.6 regarding current strategic reviews, 7 regarding financial implications and 8 regarding sustainability implications.
He reported on two major influences to inform the direction of services for Learning Disabilities and for Older People with Dementia.
With reference to point 3.5 regarding the relationships between the Voluntary Sector and Social Work & Housing, Mr Young reported that these issues are being addressed.
It was noted that it is important to learn from experiences of good and bad relationships.
11 / DATE OF NEXT MEETING
The details of the next meeting were confirmed as:-
Wednesday 24th March 2010
1.30pm - 4.00pm
The Kintore Arms Hotel, Inverurie