Items
No. |
Item |
159. |
Apologies for Absence
To receive any apologies for absence.
Minutes:
Apologies were received from
Councillors Fran
Carpenter, Martin Boiles, Jan Warwick,
Rhydian Vaughan, Marge Harvey, and
Adam Carew. Councillors Lance Quantrill
and Graham Burgess attended as Conservative
Deputies.
Apologies were also
received from co-opted members, Councillors Trevor Cartwright and
Alison Finlay.
|
160. |
Declarations of Interest
All Members who believe they have a
Disclosable Pecuniary Interest in any matter to be considered at
the meeting must declare that interest and, having regard to Part 3
Paragraph 1.5 of the County Council's Members’ Code of
Conduct, leave the meeting while the matter is discussed, save for
exercising any right to speak in accordance with Paragraph 1.6 of
the Code. Furthermore all Members with a Personal Interest in a
matter being considered at the meeting should consider, having
regard to Part 5, Paragraph 4 of the Code, whether such interest
should be declared, and having regard to Part 5, Paragraph 5 of the
Code, consider whether it is appropriate to leave the meeting while
the matter is discussed, save for exercising any right to speak in
accordance with the Code.
Minutes:
Members were mindful that where
they believed they had a Disclosable Pecuniary Interest in any
matter considered at the meeting they must declare that interest at
the time of the relevant debate and, having regard to the
circumstances described in Part 3, Paragraph 1.5 of the County
Council's Members' Code of Conduct, leave the meeting while the
matter was discussed, save for exercising any right to speak in
accordance with Paragraph 1.6 of the Code. Furthermore Members were
mindful that where they believed they had a Non-Pecuniary interest
in a matter being considered at the meeting they considered whether
such interest should be declared, and having regard to Part 5,
Paragraph 2 of the Code, considered whether it was appropriate to
leave the meeting whilst the matter was discussed, save for
exercising any right to speak in accordance with the
Code.
No declarations were
made.
|
161. |
Minutes of Previous Meeting PDF 346 KB
To confirm the minutes of the previous
meeting.
Minutes:
The Minutes of the meeting of
the Health and Adult Social Care Select Committee (HASC) held
on 16 September 2019
were confirmed as a correct record and signed by the
Chairman.
There was one matter arising in
relation to the Minutes:
The addition of
the presence of Councillor Liz Fairhurst, Executive Member for Adult Social Care
and Health, and Councillor Judith Grajewski, Executive Member for Public Health at
the invitation of the Chairman.
|
162. |
Deputations
To receive any deputations notified under
Standing Order 12.
Minutes:
The Committee did not
receive any deputations.
|
163. |
Chairman's Announcements
To receive any announcements the Chairman may
wish to make.
Minutes:
The Chairman made one
announcement:
The
Chairman noted that feedback had been received from Councillors
Thornton and Frankum regarding the
Adults’ Social Care and Health Tt2021 programme per the
request noted on Page 18. The
Chairman’s overall feedback was that he did not wish to
affect savings in a way that would eventually generate greater cost
down the line. He thanked the Director
of Adults’ Health and Care for responding timely and
specifically to all concerns and feedback shared by
Members.
|
164. |
Proposals to Vary Services
To consider the
report of the Director of Transformation and Governance on
proposals from the NHS or providers of health services to vary or
develop health services in the area of the
Committee.
None to consider.
Minutes:
There were no proposals to consider.
|
165. |
Issues Relating to the Planning, Provision and/or Operation of Health Services
To consider a report of the Director of
Transformation and Governance on issues brought to the attention of
the Committee which impact upon the planning, provision and/or
operation of health services within Hampshire, or the Hampshire
population.
None to consider.
Minutes:
There were no issues to consider.
|
166. |
Integrated Intermediate Care Update PDF 239 KB
To receive an update on the latest position on
the proposed integration of Hampshire County Council and Southern
Health NHS Foundation Trust Intermediate Care services.
Additional documents:
Minutes:
The
Director of Adults’ Health and Care alongside representatives
from the NHS and Southern Health Foundation Trust provided a
progress update on Integrated Intermediate Care, last presented in
May 2019.
Cllr
Thornton joined the meeting at 10:09.
The
Chairman reviewed the concept of Integrated Intermediate Care (IIC)
and Members then heard:
-
Joint provision of services is intended to avoid
unnecessary admission to acute hospitals and to allow independent
living at home as soon as possible.
-
Support is offered free of charge for a time limited
period (6 weeks), though generally shorter with step down into a
community or care home setting.
-
Rehabilitation, reablement, and recovery are the key
elements.
-
Hampshire County Council (HCC) and Southern Health
Foundation Trust (SHFT) are progressing towards proposals for a
single integrated service.
-
Commissioning along NHS lines is critical but
complex due to lack of consistency in shared information and
technology across providers.
-
This is a positive direction and consultations will
follow in due course.
-
Arrangements covering all aspects and system
functions will be choreographed between HCC and NHS with a possible
Section 75 and Local Care Partnerships.
Cllr
Hayre joined the meeting at
10:14.
-
Modelling in terms of whole population and creating
an appropriate footprint with acute hospitals requires detailed
work and a business plan for ideal outcomes.
-
Commissioning and provider perspectives are both
critical to success.
-
With the challenges of Tt2021, ensuring services are
joined transparently in terms of finances, expectations, and
service delivery details is key.
-
Winter planning is now the focus to match additional
service demand across the county and ensuring appropriate services
and capacity are available for upcoming needs with greater
efficiency and productivity.
-
Service structure planning will reduce areas of
duplication with a thoughtful and sensitive approach that dovetails
together.
-
HCC and SHFT operational and clinical regimes are
different but the integrated service needs to be complimentary,
robust, and capable.
-
Consultation with staff will commence at the turn of
the calendar year.
-
New ways of working together are tested in
forerunner projects countywide with local access points and an aim
for patients to leave acute settings an at earlier stage as the
longer they are there, the more they decompensate.
-
To better their chances for recovery and independent
living, acute hospital avoidance is key for those who would receive
better care at home.
-
Recent collaboration with South Central Ambulance
Service (SCAS) has resulted in over 580 people avoiding acute
hospitals and easing the pressures on acute, community, and social
care providers, with ideal outcomes and benefits.
-
Communication and engagement with all stakeholders
are critical to find new ways of working ground up to meet
population needs.
-
The detailed business case is the current
focus. There will be consultations in
January with legal services, staff, providers, etc., to be brought
back to the HASC in March, and the Executive Member for Social Care
and Health, before the service going live in April
2020.
Cllr
Fairhurst joined the meeting at
10:21am.
In
response to questions, Members heard:
|
167. |
CQC Local System Review of Hampshire PDF 232 KB
To receive a final update on the Care Quality
Commission (CQC) Local System Review action plan following the
local system review which took place in early 2018.
Minutes:
The
Director of Adults’ Health and Care alongside a
representative from the Hampshire and Isle of Wight Partnership of
CCGs provided a closure report following the local system review in
March 2018.
Members heard:
-
The system review identified strengths and continued
development areas for an action plan with key elements to implement
within a 12-month period.
-
IIC (the previous item) was a key action and will be
traveling forward alongside other issues being
addressed.
-
The action plan was signed off by the Health and
Wellbeing Board (HWB) and submitted. A
similar report to the one presented here will be going to the
Board.
-
A response was submitted to the CQC and DHSC, but
there has not been continued interest in the outcomes.
-
Hampshire was one of 20 areas selected to undertake
such a review, based predominantly on the over 65 population and
their experiences and pathways.
-
Areas of strengths and improvements, as well as
positive developments were based on data submitted alongside a
week-long field work on the ground.
-
The Health and Wellbeing Strategy and Business Plan,
local mechanisms, transformation group, and integrated commission
board will drive oversight and improvement for shared investments,
funding, and pooled resources.
-
The Hampshire Together initiative, workforce
planning developments, system improvements with regulated care
workforce, building on strengths, and setting the conditions to
make the work of provider partners possible, is key.
-
There is a limited 1-year view into the funding and
confirmation of assumptions already made, and the degree of
assurance and funding flow is very pertinent.
-
The action plan is closed but progress continues
with bigger pieces of work.
In
response to questions, Members heard:
-
The HWB oversees the progress on key actions with
time scales for delivery.
-
A huge campaign has been undertaken to get the word
about Connect to Support Hampshire out there with advertising and
the support of partners - district and borough councils, libraries,
Fire and Rescue, 111, etc.
-
People may be using the services but not recognize
it as Connect to Support.
-
Finance-wise, a 3-year spending round is typical and
would be useful.
-
The NHS has a 5-year funding solution subject to
meeting performance and other standards.
-
Prudent assumptions have proved true but is
challenging and difficult to look forward beyond March 2021 whilst
waiting for green and white papers.
-
CQC have responsibilities across regulated services
for health and social care.
-
Inspections are being undertaken but in terms of
skill and expertise, there are local team provisions providing a
window into service quality and provisions.
-
Adding CQC intelligence and insight to the
County’s own, allows it to remain above the national average
and much has been done but there is more to do.
-
Carer feedback (formal and informal) are part of the
CQC response and has been used to develop a joint carer
strategy.
-
Informal carers are a vital resource and they
contribute over £60 billion pounds compared to the £20
billion spent on social care.
-
The CQC review was initiated due to delay transfer
care performance but ...
view the full minutes text for item 167.
|
168. |
HIOW Long Term Plan (Hampshire and Isle of Wight Sustainability and Transformation Partnership) PDF 143 KB
To receive a report from the Hampshire and
Isle of Wight (HIOW) Sustainability and Transformation Partnership
(STP) Task and Finish Working Group and an update from the HIOW STP
on the process and progress in developing an NHS Long Term
Strategic Delivery Plan for Hampshire and the Isle of Wight.
Additional documents:
Minutes:
Representatives from the Hampshire and Isle of Wight (HIOW)
Sustainability and Transformation Partnership (STP) provided an
update on the process and progress in developing an NHS Long Term
Strategic Delivery Plan for Hampshire and the Isle of Wight,
alongside a report from the HIOW STP Task and Finish Working
Group.
Members heard:
-
Based on the NHS long term plan blueprint for 10
years, a collaborative plan for implementation of expectations are
to be submitted 15 November.
-
The current work entails a response for 496
commitments laid out, refining strategy to planned implementation
with the greatest value for citizens.
-
While there is some discretion over timing, each
item requires implementation.
-
Existing engagement work and building on the work of
HWBs to meet population needs with a proactive integrated care
program in the community and collaboration of social care
colleagues.
-
Treating patients seamlessly in the right place at
the right time while fostering a culture and behaviour change where
the patient can easily access multiple services, accounting for
cultural, technology, and competency challenges.
-
Population health management, critical NHS changes
and better using capital, digital, workforce resources for
networked care and implementation of the direction of travel with a
new model of health and care.
-
Working together across providers (addressing
workforce and specialization challenges) for 24-7 services to
balance capacity and anticipated demand.
-
Promoting learning from each other and implementing
safe, sustainable changes by building relationships and
collaboration with larger, effective providers.
-
Lack of access can cause a period of fragmentation
of health.
-
Capacity insights are largely unknown but must be
understood to mobilize a more rapid response.
-
A live capacity and demand model would help manage
mismatches and address them with agile responses.
-
Digitalizing outpatient activity would save time and
transportation costs.
-
Coordinated visits would allow for multiple concerns
to be addressed in one go.
-
Transforming access is a massive issue and focus,
including managing mental health out of area beds and collaboration
across all services to use bed stock.
-
Focus on prevention and managing an aging
demographic – live well, age well, live with, rather than
suffer with, and a radical approach to prevent ill
health.
-
STP learning through prevention agenda, considering
existing data, shared information, and especially public health
collaboration for prevention of pregnant women smoking, new-born
care, addressing adverse physical events, care in the right
setting, promoting exercise, living well, child reporting,
etc.
-
Half a billion pounds marked for transformation over
the next 5 years but the STP must deliver and spend to improve
experiences and focused improvements.
-
Workforce remains the most significant challenge for
health and care partners.
-
Better leadership and a strong recruitment position
will help establish Hampshire and the Isle of Wight as an
attractive place to work and key to working well.
-
A bank to allow staff to move seamlessly across
positions with dynamic solutions and improved technology at all
levels (artificial intelligence, electronic medical records, etc.)
will drive efficiency and productivity.
-
Well placed digital solutions, cost suppression and
thoughtful deployment are profoundly important for ...
view the full minutes text for item 168.
|
169. |
Work Programme PDF 394 KB
To consider and approve the Health and Adult Social
Care Select Committee Work Programme.
Minutes:
The
Director of Transformation and Governance presented the
Committee’s work programme.
RESOLVED:
That the Committee’s work programme be
approved, subject to any amendments agreed at this
meeting.
The
meeting closed at 12:52.
|