Agenda and minutes

Venue: Committee Room 2 - Town Hall. View directions

Contact: Jade Fortune 01708 432436  Email: jade.fortune@havering.gov.uk

Items
No. Item

109.

CHAIRMAN'S ANNOUNCEMENTS

The Chairman will announce details of the arrangements in case of fire or other events that might require the meeting room or building’s evacuation.

Minutes:

The Chairman advised of arrangements in case of fire or other event that would require the evacuation of the meeting room.

 

110.

APOLOGIES FOR ABSENCE

(If any) – receive

 

Minutes:

Apologies for absence were received from:

Andrew Blake-Herbert, Group Director – Communities and Resources

Joy Hollister, Group Director – Children, Adults and Housing, London Borough of Havering Sue Milner, Interim Director of Public Health, London Borough of Havering

Dr Gurdev Saini, Clinical Director, Havering CCG

 

 

111.

DISCLOSURE OF PECUNIARY INTERESTS

Members are invited to disclose any pecuniary interest in any of the items on the agenda at this point of the meeting.

 

Members may still disclose any pecuniary interest in any item at any time prior to the consideration of the matter.

Minutes:

No pecuniary interests were disclosed.

 

 

112.

MINUTES pdf icon PDF 151 KB

To approve as a correct record the minutes of the Committee held on 11 March 2015 and to authorise the Chairman to sign them.

Minutes:

The minutes of the meeting held on 11 March 2015 were agreed as a correct record and signed by the Chairman.

 

 

113.

MATTERS ARISING

Minutes:

Item 103: BHRUT hospital admissions.  There had been a slight recent drop, but the total was relatively static.  There had been a drop of about 1% in the meeting of A&E targets with a significant dip expected in January, but otherwise totals remained the same.  At Queens, looking at the seasonal variation, there was an overall drop in performance in meeting the A&E targets, but there were grounds for optimism as it was the right direction of travel.

 

There were issues within the Care Board around the Joint Assessment and Discharge team due to the reduction in size of the team.  The Health and Wellbeing Board wanted some reassurance about how the team was to work.  The reorganisation which created the Joint Assessment and Discharge team – hosted by Barking and Dagenham (and set up jointly with NELFT) – had shown a very good improvement of management organisation.  The reduction in staff level was due to the funding being cut, but for the time-being those members of staff were being kept on (to June) whilst attempts were made to put in place other funding arrangements.  In the short term, funding was covered, but planning for its replacement was needed now.

 

Conor Burke reported that Winter Planning had cost £5m and that projects were being reviewed to see what could be kept and what dropped.  He reminded the Board that it needed to be aware of these funding issues.  Doubts were expressed about the Primary Care Strategic Commissioning framework.

 

Item 106: Primary Care Commissioning – Orchard Village.  Alan Steward stated that the CCG were looking for a move to different facilities, partly due to CQC requirements.  They were in the process of negotiating a move from the current clinic accommodation.  It was asked whether this would have greater medical capacity and the answer was that it would provide more than the existing facility as it would include a “walk-in” centre and a practice on the estate.   The Chairman expressed his concerns about this being an under-resourced area within Havering.  He was assured that there would be more local control than previously.

 

The Chairman emphasised the need to have a medical practice on the estate and asked for more information to come to the next Chairman’s Briefing.  He said that there was a need to provide a ”proper” service to what was, he added, the most deprived area in the borough.  He felt that there needed to be an end to the referrals to Harold Wood.  This was not good.  He was informed that temporary measures would be in place shortly.

 

Dr Aggarwal observed that there would be some 10,000 people in the area and there was a need to match service provision to the population’s needs.  The Chairman agreed saying that there would be a huge demographic swing and there would be a need to model all provision for the area over a ten year period.  He wondered whether there would be a large influx of people from Barking  ...  view the full minutes text for item 113.

114.

REVIEW OF ACTION LOG pdf icon PDF 179 KB

Attached.

Minutes:

The Board decided that this should be considered at the next development session by which time some of the elements should have been filled in.

 

 

115.

INTEGRATED MASH PILOT - PROGRESS UPDATE

Update by Pippa Brent-Isherwood.

Minutes:

The Council Chief Executive informed the Board that the Multi-Agency Safeguarding Hub (MASH) had been short-listed for an award which was due to be announced imminently.  The formal multi-agency audit in the Children’s Agency had produced good results.  Most areas had reached their targets – though there were some areas where improvements could still be made.  It was clear that there was a need for better communication between agencies, though overall things were moving in the right direction.    Once again, Havering was leading the field.  The MASH had been very well received and this was good for staff – indeed, the morale of those working in Children’s Care was high.  Those asked said that even though they were under considerable (and rising) pressure, they felt supported, so this was all very positive.

 

 

116.

COMPLEX CARE (HEALTH 1,000)

Update by Alan Steward, Havering CCG.

Minutes:

Conor Burke tabled a document concerning Individualised Personal Commissioning (IPC) on behalf of Havering CCG.  He reminded the Board that this involved the hubs and referenced a new type of primary care relating to those who suffered from multiple conditions (a minimum of five), which could encompass a whole range of issues crossing several agencies.  The basic concept was that the GP was not always best placed to decide what mix of support a patient needed and that whilst most of those receiving this sort of care package would be elderly, that need not always be the case. 

 

The funding to pilot this came from a successful application to the PM’s Challenge Fund.  So far, 79 patients had been taken onto the scheme and this was indicative that the scheme’s target of 1,000 by the end of the year would be achieved.  Conor explained that this would be rolled-out across Barking & Dagenham, Havering and Redbridge and it was estimated that it ought to attract some 2,000 patients across the three boroughs. 

 

So far the data showed that - including costs – each patient would cost between £25 - £30,000 and receive 24/7 support and advice.  The bottom-line was that the team would deal with everything on behalf of the individual.  Conor explained the illustrations. These had been put together from the accounts of those now using the pilot and showed how they perceived the change between having to arrange each component of their care themselves, to having a team member take control of the process and ensure that what they experienced was trouble-free and seamless. 

 

The idea was to release the individual from the anxiety and frustration associated with complex socio-medical problems (which were usually encountered by patients who were probably least able to cope and more vulnerable than those with simpler, or single issues) and by removing the multiple and frequently conflicting processes, empower them to use their commissioning capacity effectively and within a secure, supported environment.  It was, he said, the provision of a “concierge” service.

 

Not only were patients recording that they were now less stressed, but staff too were reporting that they were happier.  It appeared that because the patient was more relaxed and confident, many underlying problems which raised tension between the practitioner and patient were correspondingly lowered or removed altogether.

 

Patients now considered that they were able to fulfil some life ambitions.  The ethos of the team was to facilitate these ambitions and aspirations.  The fact remained that some 30% of those on the programme would die within the next 12 months, so it was imperative that the team focussed on their needs – and delivers those expectations - and not simply provide immediate “care”.

 

The team were, in fact “care negotiators”.  It would broker well considered and approved care plans.  A Care Negotiator would work with an individual patient to provide a tailor-made package for that person – a package that factored in that person’s aspirations.  Care negotiators would come from the voluntary  ...  view the full minutes text for item 116.

117.

ANY OTHER BUSINESS

Minutes:

Members were reminded about the recent CQC inspections.  When the report had been published concerning BHRUT, it would be brought to the Board.

 

 

118.

DATE OF NEXT MEETING

13 May 2015, 13:30 - Committee Room 2.

Minutes:

The next meeting would be held on 19 August 2015, 13:00, CR2, Havering Town Hall.