Stockton-on-Tees Borough Council

Big plans, bright future

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

Date:
Wednesday, 25th September, 2013
Time:
1.00pm
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, Cll Ann McCoy, Ian Coates (substitute for Gordon Lang)
Officers:
Michael Henderson (LD), Dave Brown and Gemma Mann (PH)
In Attendance:
Emma Thomas,
Apologies for absence:
Shaun McLurg, Dr Paul Williams, Victoria Cooling, Simon Willson, Gordon Lang and Hilary Hall.
Item Description Decision
Public
CHW
32/13
DECLARATIONS OF INTEREST
 
CHW
33/13
MINUTES
 
CHW
34/13
DIRECTOR OF PUBLIC HEALTH - ANNUAL REPORT
RESOLVED that the report be received and members supply the Director with any comments.
CHW
35/13
EARLY HELP STRATEGY AND IMPROVEMENT PLAN MONITORING
RESOLVED that:-

1. Group members should send comments to the Chair regarding how the scope of the broader Strategy, should be reflected in the current Strategy document.

2. the Strategy be signed off with the caveat that these comments would be received.

3. the Implementation Plan be populated by the Group members.
CHW
36/13
JSNA, JHWS, JHWS DELIVERY PLAN AND PERFORMANCE FRAMEWORK
RESOLVED that the update be noted and the actions identified be taken forward.
CHW
37/13
TAMHS UPDATE
RESOLVED that:-

1. the update be noted and consideration be given to resources in terms of preparation of specification.

2. access to Tier 2 service specifications to be investigated.
CHW
38/13
SCHOOL NURSING - UPDATE
RESOLVED that:-

1. the report be noted.

2. the CCG be briefed.

3. issues surrounding children with complex needs be considered

4. options relating to the commissioning be reported to the December meeting of the Group.
CHW
39/13
SEN REFORMS - JOINT COMMISSIONING
RESOLVED that:

1. the report be noted.

2. discussions be held with the Project Manager on the leadership of the joint commissioning workstream.

3. an update be brought to a future meeting regarding the joint commissioning element of the SEN Reforms.
CHW
40/13
DOMESTIC ABUSE SERVICE - COMMISSIONING
RESOLVED that the information be noted.
CHW
41/13
SPARK OF GENIUS
RESOLVED that the information be noted.
CHW
42/13
FORWARD PLAN/WORK PROGRAMME
RESOLVED that the plan be amended.
CHW
43/13
DATE AND TIME OF NEXT MEETING - 30 OCTOBER 2013 AT 10AM - CONFERENCE ROOM 2, MUNICIPAL BUILDINGS, STOCKTON ON TEES
 
1pm/3pm

Preamble

ItemPreamble
CHW
32/13
There were no declarations of interest
CHW
33/13
The draft minutes of the meeting held on 22 August were confirmed as a correct record and were signed by the Chairman.
CHW
34/13
A draft Annual report of the Director of Public Health was circulated and Members were asked to provide comment outside of the meeting.

CHW
35/13
Members were presented with the final working draft of the Early Help Strategy.

The Group discussed the strategy and there was broad agreement on the content. There was some discussion on how the scope of the broader Strategy (to be developed), should be reflected in the current Strategy document.

It was noted that the Implementation plan needed to be populated with success criteria. More actions needed to be added, in liaison with the NHS Area Team and Clinical Commissioning Group. Group Members would progress this.
CHW
36/13
The Group was provided with a brief update on the delivery plan for the Joint Health and Wellbeing Strategy. It was noted that a report had been prepared on this issue for the Joint Health and Wellbeing Board and Partnership and it was suggested that this report be circulated to Group Members for information.

It was noted that performance monitoring was being populated but there were still some gaps due to issues in accessing data and awaiting the release of baseline data by Public Health England..

It was queried if there was any scope for new topics to be added to the web based JSNA i.e Children with Complex needs. Emma Thomas would contact Mark Reilly (Tees Valley Public Health Shared Service) with regard to this.

Previously, the PCT set targets on public health issues. There would need to be a strategic discussion on how targets are set in future, coordinated through the Health and Wellbeing Board and to then be discussed at a future meeting.
CHW
37/13
Head of Education, Early Years & Complex Needs updated Members on TaMHS.

It was intended that there would be joint commissioning with the CCG - Commissioning against need.

It was noted that preparing the specification would need to be developed in a tight timescale. There may be a need to identify a short term resource to take forward development of the spec. Emma Thomas indicated that service specifications for tier 2 services may be available to help with this process.

RESOLVED that:-

1. The update be noted and consideration be given to resources in terms of preparation of specification.

2. Access to Tier 2 service specifications to be investigated.
CHW
38/13
Members considered a report relating to progress on the School Nurse Service in the Context of Healthy Child Pathways.

It was explained that the Healthy Child programme for 5-19yr olds identified school nurse services as having a pivotal role in effective delivery of its evidence-based national Public Health work. The Healthy Child Programme is a core programme of evidence-based preventative health care with additional care and support provided for young people who needed it.

Members were reminded of the objectives of the review and noted the methodology being employed. A ‘brown paper' service mapping approach had been used and this was illustrated to the Group.

The work undertaken to date was detailed to Members and headline themes and findings to date were provided in an appendix to the report.
Members were provided with details of the high level themes that had emerged through the mapping processes which needed to be considered in the context of the functions of the school nursing service and wider service delivery across the Healthy Child Programme:-

• The service was not clearly visible to stakeholders; including schools.
• Where it works, it works very well; no clear direct access for young people themselves
• Unclear to stakeholders what the core business is / The prevention outcomes of the service are not clear
• There was an assumption that school nursing only deals with Child Protection Cases
• It appears that representation at Child Protection conferences is often information-gathering and delivery rather than the need for a specific professional
• General feel that the large majority of school nursing service time is taken up by CP, followed by LAC with the smallest amount of time for prevention work in the non-CP/LAC population
• Unclear how CAF is used beyond the School Nursing service; CAF appears well-used within the service
• Highly skilled and committed staff with high level of skills; where services work with School Nursing, there is a very high level of regard

More work was required throughout the consultation period to gather detailed information on the themes and what local approaches needed to be taken to address them.

It was explained that the next step was to complete the formal consultation (running September - November 2013). Further progress reports would be brought to the Group
Members discussing next steps and the following points/issues arose:

• the use of CAF as part of early intervention may need to be highlighted in the specifications.
• it was important that the responsibility of all partners was clear and who would be responsible for commissioning different elements of the service.
• a briefing for the CCG was to be prepared
• it was queried who the clinical lead was from the CCG on Children with Complex needs
• interface with children with complex needs care plans needs to be considered
• there was potential to bring other elements into any contract to provide a holistic service e.g Educational phycology, autism, dental health
• options in terms of the commissioning process needed to come back to the Group. Dave Brown would discuss with Martin Skipsey.
CHW
39/13
Members considered a report relating to Special Educational Needs reforms and the requirements set out in the Children and Families Bill.

The main features of the Bill relating to joint commissioning include:

• A requirement for LA, health and care services to commission services jointly, to ensure the needs of disabled children and those with SEN are met
• A new duty on health commissioners to deliver the health elements of EHC (Education, Health and Care plans)
• To agree arrangements required for commissioning of mediation and disagreement resolution

The bill was expected to be implemented from September 2014 - a project group was overseeing the work that needed to take place to ensure implementation was achieved across Stockton-on-Tees within that timeframe. A number of task and finish groups had been identified as part of the project group to progress the different work streams involved in the reforms, including:

• 0-25 integrated options
• Joint Commissioning
• Local Offer
• EHC Plan
• Personal Budgets
• Information / Data

Key tasks for establishing joint commissioning within the SEN reforms have been identified as:

• Engagement of commissioners in education / health social care to develop plans, systems, outcomes, operating structures and local processes
• Alignment of individual planning to strategic planning
• Engagement of parents / carers, children & young people in commissioning

The remit of the joint commissioning work stream was to set key milestones and complete actions to ensure the joint commissioning element of the reforms were in place by September 2014.

Members considered the work being undertaken by the project group and agreed that further discussions with the Project Manager should take place on the leadership of the joint commissioning workstream.
CHW
40/13
Members noted that a commissioning process would be taking place for a new Domestic Abuse Service with a view to it being in place by 1 April 2014.

Reference was made to the impact domestic abuse had on children and the commissioning of the service would look to include programmes that would improve outcomes for such children.

CHW
41/13
It was explained that a Cabinet report on this issue would be circulated to the Group.

CHW
42/13
Members were provided with a copy of the current Forward Plan.

The chairman indicated that he would look to shorten the October agenda to enable a focus on a discussion on commissioning intentions.

It was agreed that Best Practice for Sure Start would slip to a later meeting.

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