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ABERDEEN COMMUNITY HEALTH PARTNERSHIP COMMITTEE
Minute of Meeting
23 June, 2010
Town House, Broad Street, Aberdeen
Present: Bill Howatson, Chairperson; and CouncillorsCormack, Donnelly, Kiddie, Leslie and Hunter; Heather Kelman, Linda Smith,Ian Paterson, Aileen Brownand Anne Anderson.
In Attendance: Mark McEwan, Sandy Reid, Val Tweedie, Laura Gray, Chris Stewart and Kevin Dawson.
WELCOME AND APOLOGIES
1.The Chairperson opened the meeting by welcoming everyone present.
Apologies for absence were intimated on behalf ofGregory Poon, Stewart Notman, Steve Wilkinson, Mary Crawford, Sheila Stewart, Chief Superintendent Watson, Andy Verreydt, Pamela Cornwallis, Ken McLay, Dr. Newnham and Stewart Watson.
DECLARATIONS OF INTEREST
2.The Chairperson asked Committee members whether they wished to declare an interest in relation to the items included on the agenda for consideration today.
There were no declarations of interest at this stage.
MINUTE OF PREVIOUS MEETING
3.The Committee had before it the minute of its previous meeting of 21 April, 2010.
Councillor Kiddie raised concerns about the very low numbers in attendance here today, and the Chairperson indicated that participation in Committee meetings would be one item under consideration at the September workshop.
The Committee resolved:-
to approve the minute.
COMMITTEE BUSINESS STATEMENT
4.The Committee had before it for consideration, the CommitteeBusiness Statement dated 23 June, 2010. In addition to the update included in the Statement, further verbal updates were provided at the meeting as follows:-
(A)Intermediate Care Project at Woodend
Members provided feedback on the visit to WoodendHospital held the previous day, which had included some extremely useful presentations. It was, however, felt that the focus of the visit had been limited by the time available, and that it would be worthwhile to arrange a further visit to enable members to receive a comprehensive tour of the hospital.
The Committee resolved:-
to instruct the Clerk to arrange a further visit to WoodendHospital for members of the Committee; and that Heather Kelman would circulate the date of the Craig Court Open Day when available.
(B)CHP Delivery Workplan
The Committee noted that the Workplan had been considered by the City Alliance at its meeting on 13 May, 2010.
The Committee resolved:-
to remove this item from the Committee Business Statement.
(C)Extended Local Partnership Agreement
The Committee noted that the paper on the Extended Local Partnership Agreement due for consideration at today’s meeting had been withdrawn as it required further work.
The Committee resolved:-
to receive the paper at the next meeting.
(D)Mental Health Services
Sandy Reid updated the Committee on the tendering process for Mental Health Support Services, advising that Penumbra was the selected provider.
The Committee resolved:-
to delete this item from the Committee Business Statement in light of the update.
(E)Future of Woodgrove
Ian Paterson suggested that a report on the future of Woodgrove be accompanied by a brief presentation at a future meeting.
The Committee resolved:-
to schedule this item for the November meeting.
With the agreement of the Committee, the Chairperson moved the following item further up the agenda.
ADVOCACY SERVICES
5.The Committee received a verbal update from Mark McEwan, Service Planning, NHS Grampian, on the review which he was currently undertaking of the provision of advocacy services in the North East.
The scope of the review was to examine practice elsewhere in Scotland through a series of planned visits, to obtain the views of staff, service users, and service providers on advocacy services, and to benchmark advocacy services in this area against those provided elsewhere. The review was at the stage of obtaining more in-depth feedback from service users and had reached no initial conclusions as yet although one early observation was that service provision could probably be improved upon. It would also be necessary to establish the proportion of local authority resource transfer in assessing the resources available to provide advocacy services. It was hoped to conclude the review over the next few weeks.
Councillor Kiddie, who had been involved in some of the visits undertaken within Scotland as part of the review, made reference to a visit to Scottish Independent Advocacy Alliance which was updating its mapping of advocacy services commented on advocacy in the North East which in overall terms demonstrated that expenditure was low by comparison to other areas, and to the statutory basis for the provision of advocacy services as they related to mental health, noting that there was no statutory requirement for any other service at the moment which was an area of particular concern if statutory duties alone were to be prioritised. Councillor Kiddie also highlighted the spend to save opportunities arising out of the provision of advocacy services.
Members of the Committee discussed the update and made reference to the lack of advocacy services at WoodendHospital, although Heather Kelman clarified that the social work team from the hospital had relocated to Aberdeen Royal Infirmary which meant that the service was still available.
The Committee resolved:-
that on completion of the review, it be passed to Heather Kelman who would arrange for it to be circulated ahead of the November meeting of the Committee at which it would be discussed.
FINANCE AND BUDGET REPORTING
6.With reference to article 9 of the minute of its meeting of 21 April, 2010, the Committee had before it a report by Heather Kelman outlining some of the financial issues currently relevant to the CHP.
The report advised (a) that the CHP had reported an overall underspend in 2009/10 for health services in the city; (b) that in 2010/11 and for the immediate future, both the NHS and local authorities faced significant financial challenges, and that to continue to meet the needs of our population it would be important that both agencies worked closely together to ensure the most efficient use of both funding allocations; (c) that the paper on the Extended Local Partnership Agreement (this item was withdrawn at the meeting and it was agreed that it would be submitted to the next meeting) highlighted areas of priority for joint working and collaboration with regard to services to older people in the city, some of which would include joint budgeting; (d) that national pilots were underway in relation to the Integrated Resource Framework, to develop joint information systems on the combined spend of health and social work services for a particular population; (e) that this work was very intensive but could be very beneficial in shifting the balance of care towards home-based services and supported self-care; (f) that it would be possible as an outcome of these pilots to minimise the time and resource required to set up the system; and (g) that discussion and negotiation continued on the allocation of resource transfer funding for 2010/11 between health and social care.
The report recommended:-
that the Committee note the update and that work would continue between the Director of Social Care and Wellbeing and the CHP General Manager to agree the most relevant content and format of the financial information for the Committee.
In response to questions from members of the Committee, Heather Kelman advised that the CHP budget spanned three areas (1) children’s hospital; (2) Grampian services; and (3) community services, and that the underspend had been spread across the three areas. For this reason it was important to provide details of the underspend with an explanation of the exact out-turn for each of these areas to avoid misinterpretation of the financial information. That said, the underspend represented less than 0.01% of the overall budget and was not significant. Councillor Kiddie highlighted the overall monitoring duties resting on the CHP, which reinforced the need to receive additional detail on finance and budgets.
The Committee resolved:-
(i)to note the paper;
(ii)to request Heather Kelman to circulate a detailed budget outturn to the Committee for information; and
(iii)to hold further discussion on the CHP budgetary challenges at the workshop in September.
SEPTEMBER WORKSHOP – DRAFT AGENDA
7.The Committee had before it a paper prepared by Heather Kelman setting out a draft programme for the September workshop.
The paper provided some background information on the national study of CHPs undertaken between February, 2009 and March, 2010, and proposed that the outcomes of this study provide the basis for the September workshop on 29 September, 2010. The paper proposed that the CHP at its workshop undertake an analysis of strengths, challenges, opportunities and threats with regard to the links between the CHP and Community Planning, the Voluntary Sector, and our understanding of pathways and ability to influence these. Following this, priorities would be identified and an action plan put in place. The paper also addressed the matter of reducing attendance at meetings of the CHP Committee, suggesting that this indicated a need to review the way in which the Committee functioned. It was intended that the Chairperson and Community Planning Lead Officer visit a small number of CHP Committees across Scotland, the findings of which would be shared at the workshop.
The report recommended:-
that the Committee consider, discuss and if appropriate, approve the attached draft programme for the September workshop.
Heather Kelman confirmed that Kathleen Bessos would be in attendance at the workshop to present the outcomes of the national study of CHPs. Suggestions from members of the Committee included incorporating a slot within the programme for the Director of Social Care and Wellbeing, and undertaking exit interviews with people who had left the CHP Committee to get to the bottom of poor attendance.
The Committee resolved:-
to approve the draft programme, with further changes to be made by Heather Kelman as suggested.
EARLY YEARS AND YOUNG PEOPLE
8.(A)Children with Complex Needs – Redesign of Services
The Committee had before it a paper by Heather Kelman which provided information on the option appraisal commissioned by NHS Grampian on services for children with complex needs.
The paper explained (a) that this had followed information from Aberdeen City Council that it was redesigning education services for this group of children and that the use of the Raeden Centre would change; (b) that a preferred model of care had been developed as a result of the option appraisal which was now the subject of open public consultation and engagement, this model being an integrated service delivered in partnership with both education and social care services, there being less focus on children aged 0-5 and greater recognition of the need to provide services from 0-18; (c) that there would be significant change to the physical location of the service which would be delivered through community teams working in a number of locations including the new highly specialised provision planned by education colleagues on the Raeden site, the additional support needs units at Bucksburn Academy and Mile End Primary School developmental nurseries, the family home and other locations which a child may be attending; (d) that the consultation period had commenced on 7June and would continue until early September with two open events scheduled, although members of the public were also encouraged to engage with the Steering Group to fully explore and discuss the proposal; and (e) that consultation feedback would be through a questionnaire (attached to the report), face to face meetings, e-mail or by video.
Ian Paterson expressed a preference for VSA Carers Centre as a route to the consultation process to be substituted with the third sector interface.
The Committee resolved:-
that Heather Kelman would arrange a consultation meeting with the CHP which would be open to other interested parties and individuals.
At this juncture in the meeting, some members of the Committee indicated that they had not received a copy of the agenda papers for today’s meeting. The Clerk apologised for any inconvenience caused and indicated that it was intended to move towards electronic distribution of agendas. Anyone wishing to receive a hard copy could continue to do so. This would be progressed outwith the meeting.
CHILDHOOD IMMUNISATION STATISTICS
9.The Committee had before it childhood immunisation statistics for Aberdeen CHP in 2009, compared to the Scottish average. Heather Kelman explained that the statistics were to be submitted to the City Alliance the following day and were for the information of the Committee; and that the statistics reflected some room for improvement but overall did not present any particular concerns and reflected well for an inner city population.
The Committee resolved:-
to note the information.
VULNERABLE GROUPS AND PEOPLE (ADDITIONAL NEEDS)
10.(A)Peer to Peer Project
The Committee had before it for information a report which had been approved by the Council’s Social Care and Wellbeing Committee on 22 April, 2010, endorsing the formation of the Aberdeen Peer to Peer project which would help people coming out of prison with challenging lifestyles to aid their community integration by identifying a wide range of support in communities linked to making life changes for themselves.
Councillor Kiddie as Convener of the Social Care and Wellbeing provided some further background information on the project and expressed a willingness to work alongside Health colleagues in its delivery. Heather Kelman advised that prison health responsibilities had now transferred from the Scottish Prison Service to the NHS, and that work was underway to address the “revolving door” syndrome based on the same principles as the Peer to Peer project. Joint working in this area would certainly be beneficial to the overall aims of addressing the need of this part of the population.
The Committee resolved:-
to note the details of the Peer to Peer project and that Heather Kelman would look at ways of linking the NHS to the Steering Group established by the Council to progress the project.
Councillor Leslie declared an interest in the following item by virtue of his membership of the Board of VSA, but did not consider it necessary to withdraw from the meeting.
(B)Future of Woodgrove
The Committee had before it a paper prepared by Heather Kelman on the present and future use of the Woodgrove Care Home owned by Voluntary Services Aberdeen.
The report explained that Woodgrove Care Home had been a 40 bedded nursing home for older people with dementia owned and operated by VSA, and had been one of several projects developed to assist the transfer of patients from long stay and NHS facilities to community-based facilities. The building was on former NHS land which had been sold to VSA with a restriction in the title of the site to ensure that it continued to be used for the provision of services for older people with mental health issues. The report advised that Woodgrove had closed as a care home in December, 2009 and had been empty since that date which had led to some vandalism and damage to the facility. Discussions had been taking place between VSA and NHS Grampian on the future use of the building and the site, with VSA wishing to continue to support NHS Grampian and the Council in the provision of appropriate care and services for older people with dementia although a detailed joint strategy for the future did not exist. Following the most recent discussions VSA had written to the NHS (a copy of the letter was attached to the paper) outlining the plans for VSA to utilise the site on a short term basis to enable refurbishment and extension of Ruthriestone House, and to allow an opportunity for full discussions to take place between NHS Grampian, the Council and VSA on the strategy for caring for people with dementia in the city and the long term use of the site. This proposal had been agreed by NHS Grampian on an interim basis.
Heather Kelman made reference to the Extended Local Partnership Agreement as the starting point for a joint strategy for the provision of care and services for older people with dementia. Sandy Reid made reference to the National Dementia Strategy which the Council and NHS Grampian were fully engaged with, and which would lead to an event in September for GPs on dementia awareness as well as further work to implement the national strategy locally.
The Committee resolved:-
that Sandy Reid would undertake an audit across the client groups to establish strategy gaps and would circulate this in advance of the September workshop.
ALCOHOL/DRUGS (SUBSTANCE MISUSE)
11.Alcoholism in Elderly People
The Committee had before it a paper prepared by Heather Kelman providing information on the issue of alcohol abuse in older people.
The paper provided statistical information on the incidence of alcohol abuse in older people, based on NHS national statistics from 2009 and 2010, as well as the Scottish Health Survey 2008.