Stockton-on-Tees Borough Council

Big plans, bright future

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

Date:
Tuesday, 1st March, 2016
Time:
10.00 a.m.
Place:
Conference Room 2, Municipal Buildings, Church Road, Stockton on Tees, TS18 1LD
 
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Present:
Peter Kelly(Chairman), Emma Champley, Cllr Mrs Ann McCoy, Martin Gray, Diane McConnell, Louise Okello, Jane Smith (Sub for Sarah Bowman- Abouna)
Officers:
Michael Henderson, Sarah Whaley (SBC), Jo Heaney (CCG)
In Attendance:
Jill Kirby (NECS)
Apologies for absence:
Shaun McLurg
Item Description Decision
Public
CHW
28/15
DECLARATIONS OF INTEREST
 
CHW
29/15
MINUTES OF MEETING HELD 1ST FEBRUARY 2016
 
CHW
30/15
MINUTES OF THE CHILDREN AND YOUNG PEOPLE'S PARTNERSHIP HELD ON 20 JANUARY 2016
 
CHW
31/15
YOUNG PEOPLE'S SUBSTANCE MISUSE SERVICE REVIEW - UPDATE
RESOLVED that

1. the Young People's Substance Misuse Service contract be extended for 12 months

• a Service Development Plan be implemented for the 12 month extension to respond to areas for improvement identified during the review process

3. the contract for the 12 months extension be varied to include:

- increased assertive outreach to engage vulnerable young people misusing substances within T3 provision.

- strengthening of targeted T2 outreach provision

4. an update report be provided to the Group's September meeting.

5. consideration be given to how best to communicate with parents on these issues
CHW
32/15
0-5 HEALTHY CHILD PROGRAMME SERVICE REVIEW (HEALTH VISITING AND FAMILY NURSE PARTNERSHIP)
RESOLVED that

1. the detail within the report and the findings of the review be noted.

2. the two year extension to the current contract be
endorsed.
CHW
33/15
FORWARD PLAN
RESOLVED that the Plan be amended as per discussion above.
CHW
34/15
EF=
SPECIALIST SCHOOL NURSING
RESOLVED that the update be noted.
10.00 a.m.

Preamble

ItemPreamble
CHW
29/15
The minutes of the meeting held on 1st February 2016 were confirmed as a correct record and were signed by the Chair.
CHW
30/15
The minutes of the meeting of the Children and Young People's Partnership held on 20th January 2016 were noted.
CHW
31/15
Members considered a paper that outlined the current commissioning arrangements for the provision of Tier 3 Young People's Substance Misuse Services. The paper presented an overview of the recent review into service performance prior to a proposed 1 year extension of the service contract. Areas of variation for the contract extension were included within the paper recommendations

The Group discussed the report and the following areas were covered during that discussion:

- there was concern that interventions were not working given the static number of CYP engaged with the service.

- there was limited interaction with schools and the service had been asked to engage with all secondary school (set up SLA), and private schools, post 16 education etc and eventually primary schools.

- staff present in A and E were there at a time when young people were unlikely to be presenting, so the opportunity to have discussions with the young person and parents was deferred until a later date, which was far from ideal. Parents were often unwilling to engage when contacted after the event.

- educating parents and providing a consistent message to them about the dangers of their children drinking and the consequences of them ignoring/ condoning such behaviour may help. This could be a discussion at the Stockton Youth Assembly.

- it was suggested that an operation encompass model may be helpful in terms of schools being informed of any pupil presenting at A and E. This may act as a deterrent.

The Group accepted the recommendations but agreed that it needed to be updated, at an early stage, and, in sufficient time to look at procuring something different for the following 12 month, if necessary. Therefore the Group asked for an update report to its September meeting.
CHW
32/15
The Group considered a report that provided the Commissioning Group with a summary of the findings of a review which had recently been undertaken for 0-5 Healthy Child Programme services (comprised of Health Visiting and Family Nurse Partnership services).

The commissioning responsibility for these services transferred from NHS England to Local Authorities on 1 October 2015, completing the transfer of Public Health responsibilities. The current contract, valued at 1,304,000 for a period of six months was held by North Tees and Hartlepool NHS Foundation Trust (NTHFT) and was due to expire at the end of March 2016.

Members were provided with findings from the Service Review

It was explained that in September 2015, the Council's Corporate Mangement Team had agreed to the award of a 6 month contract with a two year extension to the current provider to allow for an audit of compliance against the current contract to be completed, a review of the service's functions and pathways and to allow time for EU procurement processes to be followed.

The review of the service had now been undertaken and its findings indicated that a number of amendments were required to both service specifications for the two year extension period to ensure that the services were delivering positive outcomes for children and families and offer best value to the Local Authority as the commissioner.

Four workshops were planned for March 2016 which would bring together staff from Stockton Borough Council and NTHFT to negotiate a revised service specification which would commence from July 2016 until March 2018. This specification would build upon the findings of the service review and would seek to ensure that the service offered 'proportionate universalism' with those who were more vulnerable and had greater need able to receive an enhanced offer.

In terms of FNP it was explained that a workshop was planned for April 2016 which would bring together staff from Stockton Borough Council, FNP National Unit and NTHFT to negotiate a revised service specification which would commence from July 2016. The specification would build upon the findings of the service review and the opportunity to flex the programme's licence. This process would seek to ensure that the service prioritised and engaged the most vulnerable families, worked closely with 'A Fairer Start' and the Troubled Families programmes and focused upon the longitudinal outcomes for the child, mother and family.

Following implementation of the new specification, the two year extension would allow for the consideration of opportunities/future synergies with other Local Authority responsibilities for the early years and children's services. The Local Authority was already the commissioner for school nursing services - Healthy Child Programme 5-19. This provided the option to consider joining up the commissioning of the 0-5 Healthy Child programme with that for 5-19 year olds and to implement any lessons learned from the 'A Fairer Start' work within any future service model and potential procurement.

It was anticipated that to secure the successful mobilisation of a new service delivery model from April 2018, a procurement exercise would need to commence from January 2017.

It was proposed that this work would be supported by a Public Health led Programme Board with ongoing strategic oversight provided by CYPHWJCG.

The Group discussed the report and that discussion could be summarised as follows:

- It was noted that holding off for two years allowed the council to line up the Health Child Programme with school nurses, and other contracts. In two years' time there would be an opportunity to look to have specification for a comprehensive 0-19 procured service.

- Safeguarding would be a major part of health visitors role and there was no reluctance from Health Visitor on this issue.

• Work would be on-going and, in twelve months, there would be a clearer view of the service we wished to commission, with the resources available. Also, progress would have been made around linking with early help.

• There would be service development meetings every month to ensure progress was being made and this group would receive an update.

• There may be an opportunity for the nursery nurses to work with early years team in education to potentially share resources.

• Health Visitors' one year assessment didn't need to be undertaken by qualified staff and other suitable staff could undertake this role e.g. in children's centres. This could free up capacity of Health Visitors.

• Targeting the service would be important in terms of families who needed more support.

• It was suggested that the development meetings should explore the gap following two - two and half year reviews. There may be potential for some children, most at risk, to receive further reviews, at three, 4 years, for example. Indicators of risk may be obesity in older siblings, troubled families, Early Help Assessments etc.

• The model of any future the service could, potentially, comprise different levels:

~ Universal i.e. the five mandated areas
~ enhanced support for vulnerable families
~ Family Nurse Partnership

• Universal services must be as efficient as possible to free up capacity for targeted work.

It was suggested that FNP and Health Visitors to provide an update to children's partnership later in the year.
CHW
33/15
Members considered the Group's Forward Plan.

Mental Health mapping and further overarching report, from CCG, on Mental Health (FiM) coming to the May meeting, linking in some of the mapping work.

Reference was made to the following items being presented to future meetings:

Health and Wellbeing of young carers update - Julie Young CCG
School Nurse Children with Complex Medical Needs - Joe Heaney CCG
SEND - Ofsted Area Reviews Commissioning Implications - Diane McConnell SBC
Speech and Language Community Services Review - Tracy Jacobs CCG
Children's Centres update - Lynda Brown SBC

Operation Encompass to be removed.

It was suggested that there might be an opportunity to look at speech and language, children with complex medical needs, OT, Physio etc alongside health visitors and school nurses and undertake a joint procurement of one large integrated service for children 0 - 19. Joe Heaney to prepare report on services, plus timescales for procurement.

• CSE - Early Help Commissioning Update to be provided by Shaun McLurg at a future meeting.
CHW
34/15
A brief update was provided and it was noted that contracts would be extended to the end of the school Year. Consideration was being given to how this would then be taken forward.

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