Stockton-on-Tees Borough Council

Big plans, bright future

Children and Young People's Health and Wellbeing Commissioning Group Minutes

Date:
Wednesday, 31st July, 2013
Time:
10.00am
Place:
Conference Room 2, Municipal Buildings, Stockton on Tees
 
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Present:
Peter Kelly (Chairman) and

Sarah Bowman, Lynda Brown , Cllr Ann McCoy , Shaun McLurg and Simon Willson
Officers:
Nigel Hart.
Apologies for absence:
Audrey Pickstock and Dr Paul Williams.
Item Description Decision
Public
CHW
10/13
DECLARATIONS OF INTEREST
 
CHW
11/13
MINUTES
 
CHW
12/13
LOCAL AUTHORITY/CCG WORKING
RESOLVED that the report be noted.
CHW
13/13
CYPHWCG MEMBERSHIP
RESOLVED that:-

1. the report be noted.

2. a diagram/family tree illustrating the relationship between each of the main stakeholders/partners involved in Public Health be prepared by the Director of Public Health for circulation to this Group.
CHW
14/13
EARLY HELP STRATEGY
RESOLVED that:-

1. the comments on the draft Early Help Strategy be noted.

2. the Head of Children & Young People's Services circulate his detailed comments on the content of the strategy to the other members of this Group for consideration, including the suggested gap in explanation of how schools, Children Centres, Foundations etc can contribute further to the strategy.

3. further consideration be given to the extent to which the proposed vision, objectives and strategic priorities were effectively summarised within the introduction to the strategy with a view to amendments being submitted to a future meeting of the Group.

4. the views of the Children's Safeguarding Board be sought on the content of the Early Help Strategy.
CHW
15/13
EARLY INTERVENTION FOUNDATION
RESOLVED that the report be noted and details of the successful bidders within this particular region be circulated to members of this Group.
CHW
16/13
CAF PROGRESS
RESOLVED that:-

1. the report and comments be noted.

2. the issue regards the decrease in CAF activity be placed on the agenda of the next meetings of the Primary and Secondary Heads meetings.
CHW
17/13
HEALTH NEEDS ASSESSMENT: MENTAL HEALTH AND WELLBEING
RESOLVED that:-

1. the report be noted.

2. further discussions be held in order to better understand the existing commissioning arrangements prior to completion of the Health Needs Assessment.
CHW
18/13
TAMHS UPDATE
RESOLVED that the report be noted.
CHW
19/13
SCHOOL NURSING - UPDATE
RESOLVED that:-

1. the report be noted and the proposed next steps for review of the service be approved.

2. School Nursing be retained as a standing item on the agendas for meetings of this Group.
CHW
20/13
IMPROVING HEALTH OUTCOMES FOR CHILDREN AND YOUNG PEOPLE DELIVERING AND COMMISSIONING CHILDREN AND YOUNG PEOPLE'S PUBLIC HEALTH SERVICES AND INVITATION TO SIGN THE PLEDGE
RESOLVED that this Group agree in principle to signing up to the above pledge.
CHW
21/13
FORWARD PLAN/WORK PROGRAMME
RESOLVED that the information be noted and the Forward Plan be amended accordingly.
CHW
22/13
DATE AND TIME OF NEXT MEETING - 22 AUGUST 2013 AT 2PM IN CONFERENCE ROOM 2, MUNICIPAL BUILDINGS
 
10am/12.05pm

Preamble

ItemPreamble
CHW
10/13
There were no declarations of interest.
CHW
11/13
The draft minutes of the meeting held on 27 June 2013 were agreed as a correct record.
CHW
12/13
Consideration was given to the practicalities of joint working arrangements between the Local Authority and the Clinical Commissioning Group (CCG) regards Joint Commissioning discussions and determination.

It was noted that there were already established links with officers and the Chairman of the HWB Board represented on the Locality Group alongside CCG representatives. The latter were also represented on both this Commissioning Group and the HWB Board, and the CCG had input into the Forward Plan for each.

The Director of Public Health referred to the challenges faced by the CCG in terms of their commissioning arrangements with two separate local authorities, namely Stockton and Hartlepool. Member involvement within this process would initially be restricted to the relevant Cabinet Member. Any requirement beyond this would require further consideration at Director level, although it was noted that it would be essential to also keep members of the Children & Young People Select Committee appraised of developments going forward, whilst this Commissioning Group would regularly report to members of the HWB Board, who in turn had an established joint meeting and reporting arrangement with the Health & Wellbeing Partnership.
CHW
13/13
It was noted that membership of this Group, as appointed by the Health & Wellbeing Board (HWB) was as follows:-

Director of Public Health
Health Improvement Partnership Manager (SBC Public Health)
Consultant in Public Health (SBC Public Health)
Head of Children and Young People's Services (CESC)
Head of Head of Education, Early Years & Complex Needs (CESC)
Head of Performance (CESC)
Cleveland Police
Clinical Commissioning Group Clinical/ Managerial Representative (CCG)
NHS Commissioning Board Representative (Area Team)
Cabinet Lead for Children and Young People (SBC)
Tees Public Health Children's Business Manager (NHS Tees Shared Services)

Co-optees
1. The Group will co-opt key partners and stakeholders in order to effectively discharge its duties.
The Director of Public Health referred to the relationship between each of the external representatives on the Group and it was suggested that it would be helpful for a diagram/family tree to be prepared illustrating the relationship between each of the main stakeholders/partners involved in Public Health, including both Childrens and Adults Commissioning Groups, HWB and Health & Wellbeing Partnership (HWP).

Consideration was given to how the Voluntary & Community could be involved in both Children's and Adults Commissioning arrangements. Representatives of the sector were currently members of the HWP. A strategic view of appropriate arrangements for the future may therefore be required.

Meetings of this Group were open to the public and therefore its agendas, reports and minutes would be made available to all as part of the Council's E-Genda democratic information.

CHW
14/13
Consideration was given to the latest draft Early Help Strategy document, commissioned by Children, Education & Social Care with the aim of reducing the flow of children into social care and fulfilling the Ofsted requirement to demonstrate strategic direction and co-ordination of Early Help services.

The scope of the work had been based on earlier discussions by this Group so as to focus on children already ‘on the edge of care', i.e those children already displaying need commensurate with levels 3 & 4 on the continuum of care (with some cross-over into level 2). Thereafter, it would be necessary to develop the strategy to focus on level 2 on the continuum of care (with some cross-over into level 1).

A draft Improvement Plan was also attached to the strategy upon which it was hoped to formulate a detailed Action Plan based on the Group's knowledge and expertise of the service areas.

In considering the draft strategy, members suggested that the wording contained within the purpose and vision of the strategy be amended to reflect the importance of preventing children coming into care unnecessarily.

The Head of Children & Young People's Services expressed some concern that the strategy was lacking in terms of its strategic objectives and did not sufficiently include the involvement of schools and Children's Centres who's work primarily brought them into contact with children/families who may come into the social care system. It was suggested that should the brief of the strategy be to include levels 2 & 3 on the continuum of care, then Children's Centres and others would have a critical part to play.

The Group also reflected on the vision, objectives and strategic priorities summarised within the introduction to the strategy, and it was suggested that further work be done outside the meeting to ensure that these were comprehensive enough, sufficiently reflected the services and resources that were needed, as well as those that were currently in place, and took into account the commissioning and de-commissioning of services.

It was also noted that the Common Assessment Framework (CAF) was crucial to identifying children who require additional support services beyond those universally available, and were therefore crucial to the success of this strategy. However, further work was necessary to the Improvement Plan to ensure that all agencies involved with the CAF were effectively playing their part.

The Group acknowledged the importance of schools/Governing Bodies being able to relate to the content of the strategy given its public profile, and it was suggested that the views of the Childrens Safeguarding Board should be sought.
CHW
15/13
It was noted that bids to the Early Intervention Foundation (EIF) had been unsuccessful on this occasion, the full reasons for which had been requested.

It was understood that whilst our own bids received some positive comment, the EIF had favoured bids from the PCC and CCG.

Details of the successful bidders within this particular region would be circulated to members of this Group.
CHW
16/13
Consideration was given to the progress of the Common Assessment Framework (CAF) following the last update provided in September 2012.

It was noted that in 2011/12, a total of 2459 CAF 1 and 437 CAF 2 were completed and registered, whereas in 2012/13 only 1770 in CAF 1 activity had been completed and registered, and only a slight increase in CAF 2 activity with 450 being completed and registered. This was particularly disappointing given the focus given throughout the year and the effort of a range of staff across a number of different agencies to promote the use of CAF.

The Ofsted unannounced child protection inspection in January 2103 commented that ‘the quality of practice and use of CAF was variable and take up low', and suggested that whilst ‘most CAF's provide a detailed review of family circumstances and plans clearly identify the actions to be taken', the CAF's were not ‘sufficiently focused on what difference this would make for children'. Of particular concern identified by the CAF Board was the low conversion rates between CAF 1 and CAF 2, with an over use of CAF 1 by agencies working directly with children as a referral pathway. Work was currently ongoing with North Tees and Hartlepool Foundation Trust (NTHFT) to establish more effective pathways for community health services.

It was noted that the CAF system worked well in other parts of the country, with authorities such as Gateshead and Sunderland having more resources to support the process. It was questioned whether other agencies such as Childrens Centres and organisations such as For Children and Big Life could be engaged more as part of delivery of the strategy.

Further discussion on the decrease in CAF activity was necessary by both the CAF Board and Childrens Safeguarding Board, and it was proposed that the report be also discussed at the next Primary and Secondary Heads meetings.
CHW
17/13
Consideration was given to progress on the above following consideration at the last meeting of the draft scope which had prompted a positive response.

It was noted that Emma Thomas (NECS) was leading the Consultative Group looking at the pathways to mental health and that population data would be available and reported to the next meeting for consideration.

A seminar examining the capacity within the voluntary & community sector to cater for children with mental health issues would be held during October, which would help identify the services that were currently available.

Concern was expressed regarding the separate commissioning arrangements for young people, which led to a lack of understanding as to what services each provider commissioned. An example of this was that the Schools Forum had commissioning arrangements in place with Alliance which were due to cease in April 2014, and therefore it would be advantageous for these to be reviewed in October prior to the timetable for completion of the Health Needs Assessment scheduled for November.
CHW
18/13
The Chair of the TaMHS Steering Group referred to her earlier comments regarding the need for a greater understanding of existing commissioning arrangements in this area.

CHW
19/13
Consideration was given to the headlines from the service mapping exercise carried out with the school nurse service and other stakeholders to map the current school nurse pathways and how the service exchanged information/communicated with key agencies.

The next steps would involve examination of the results against the requirement of national policy documents which would assist in determining whether the service was providing value for money, whether there was a continued need for the service to be delivered as a universal service for all schools, and whether there was any future opportunity for joint commissioning.

It was noted that such a review may take some considerable time to achieve and therefore it was suggested that this subject be kept as a standing item for consideration at future meetings of this Group.
CHW
20/13
The Group was invited to lend its support to the joint Department of Health, LGA, RCPCH and Public Health England campaign aimed at Improving Health Outcomes for Children & Young People through the Delivering and Commissioning of Children & Young People's Public Health Services by signing up to a ‘Better Health Outcomes for Children & Young People' pledge.
CHW
21/13
Further to the last meeting, a draft Forward Plan for the Group was submitted based on the content of the HWB Strategy delivery plan.

It was proposed that the Best Practice for a Sure Start report, produced by the All Party Parliamentary Sure Start Group, be added to the agenda for consideration at the next meeting and that members bring copies to the meeting as previously circulated.

Further consideration of the CAF Progress report was required at the November, February and July meetings of this Group to coincide with Safeguard Board reporting arrangements.

Reference was made to why it was necessary to have both an Early Intervention and Early Help Strategy, and it was agreed that discussions be held between the Director of Public Health and the Corporate Director of Public Health.

Consideration would take place at some stage also of the latest results of Child Dental Health within the Borough.
CHW
22/13
22nd August 2013 - 2pm
Conference Room 2, Municipal Building

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