HIGHLAND COUNCIL/NHS HIGHLAND LEADERSHIP AND PERFORMANCE GROUP HIGHLAND COUNCIL. Mrs M Davidson Mr D Hendry Mr J Gray Mr A B Dodds (AD)

Transcription

1 DRAFTHighland NHS Board 6 December 2011 Item 3.12 HIGHLAND COUNCIL/NHS HIGHLAND LEADERSHIP AND PERFORMANCE GROUP Minutes of the Meeting of the Highland Council/NHS Highland Leadership and Performance Group held in Committee Room 2, Council Headquarters, Glenurquhart Road, Inverness, on Tuesday, 18 October 2011 at 3.30 p.m. Present:- NHS HIGHLAND Mr I Gibson Ms E Mead (EM) HIGHLAND COUNCIL Mrs M Davidson Mr D Hendry Mr J Gray Mr A B Dodds (AD) Also in attendance:- Mr B Fernie Present / For Action Mrs J Baird, Transitions Director, NHS Highland (JB) Mr S Steer, Head of Community Care Integration, NHS Highland, (SS) Mr B Alexander, Director of Social Work, The Highland Council () Mrs R Moir, Principal Administrator, The Highland Council (RM) Mrs M Davidson in the Chair Item Subject/Decision Action 1. Apologies for Absence Apologies for absence were intimated on behalf of Mr G Coutts, Mr A S Park and Dr M E M Foxley. No Action Necessary 2. Declarations of Interest No Action Necessary There were no declarations of interest. 3. Minutes of Previous Meeting There had been circulated Minutes of Meeting of the Leadership and Performance Group held on 16 August 2011, the terms of which were APPROVED. The Leadership Group NOTED that a report on care at home would be brought to its next meeting.

2 4. Planning for Integration JB There had been circulated Report No. LP/21/11 by the Transitions Director on progress on the Planning for Integration Programme. In speaking to the report, the Transitions Director highlighted a number of issues including: the re-affirmation by the Programme Board of the direction of travel in relation to both Adults and Children s Services and its request for a stronger emphasis on health improvement the proposals regarding the management and development of Self- Directed Support the agreed review of the risk register ongoing work in relation to Human Resources, Finance, Information Management and Technology, and Property matters, with proposals to be firmed up and brought to the Programme Board following further consideration by Chief Officers. The Transitions Director also outlined the projected timescales in relation to approval of the commissioning documentation, proposed to comprise a Strategic Outcomes Framework, a Partnership Agreement, a Delivery Specification and a Performance Framework. It was anticipated that the formal agreements would be signed off at the December Programme Board, allowing the Council and Health Board to consider them within their respective governance structures ahead of the planned implementation date of 1 April Whilst it was expected that the full commissioning documentation would be agreed by the respective authorities in February 2012, an update report was being submitted to the Highland Council at its meeting on 27 October 2011, requesting early approval in principle in principle of certain human resources and property issues, to permit progress within the planned timescales, with other issues such as governance structures similarly requiring initial consideration by the Council and Health Board in December 2011, to take account of the necessary lead-in time. A list of milestone dates would be drawn up and issued to the members of the Group. It was also acknowledged that redesign would be taken forward only after the transfer date, with any necessary change negotiations continuing under the new structure. During discussion, concern was expressed about the various areas of risk, including information technology robustness, the potential impact of Scottish Government strategy and the need for agreement on new governance and management structures. Staff anxieties and the importance of continuing effective communication were also acknowledged. It was confirmed that there was a high focus on the IT risk. On Government strategy, whilst no announcement had yet been made as to the preferred model for integrated care, there was no reason to believe 2

3 that the Highland model would not be supported to go ahead. After discussion, the Leadership Group NOTED: i. the progress made in the Planning for Integration work programme; ii. the proposals put to the Programme Board at their 27 September meeting and the decisions made, as outlined in the report; and iii. the emerging timelines. 5. Local Partnerships AD There had been circulated Report No LP/22/11 by the Chief Executive, The Highland Council on the proposed remit of Local Partnerships for the Lead Agency Model of Service Delivery. The report reminded the Group that it had agreed at its June 2011 meeting that, as part of the governance arrangements for the Lead Agency Model, a number of Local Partnerships would be established within each of the Service Delivery Districts. These Partnerships, for which a suggested remit had been developed and was appended to the report, would be required to operate within the policy framework and budget set by The Highland Council and the NHS Highland Board and would not meet until the strategic governance structure and revised Senior Management structures had been agreed. Partnership minutes would be submitted to the relevant Governance Committees of the Council and the Board. Comments made during discussion included: Local Partnerships would provide an opportunity for engagement with local communities and for local voices to be heard, but would not have a decision making function. Establishment of the Partnerships should not be unduly delayed; however, it was important that their context, remit, role and powers within the overall governance framework was clear and agreed, to avoid misunderstanding or confusion. Whilst there could be advantages in maintaining a degree of flexibility, issues of numbers / membership / attendance / speaking rights, etc should be clarified. After discussion, the Leadership Group AGREED that the draft remit be further refined to take into account comments made during discussion. 6. Transformational Change Programme for Community Care: A Progress Report There had been circulated Report No. LP/23/11 by the Director of Social Work providing an update on the Transformational Change Programme in community care services established early in 2010 and planned for implementation over a two year period. The Community Care Partnership had originally agreed fifteen separate workstreams. Following a major review of the workplan undertaken late in 3

4 2010, as Planning for Integration began, these had been reorganised into three categories: mainstreamed operational activity, commissioning processes and change management processes. The report outlined the eight change management workstreams now making up the Transformational Change Programme: ensure the full implementation of the Joint Community Care Plan and develop an outcomes framework to measure its effectiveness develop and implement an integrated and seamless assessment and care pathway develop new sustainable models of care to support people with a learning disability to live in their own community and invest in Highland-based services to support people to move back to Highland to be closer to their families undertake a comprehensive review of day services for older people and support the development of new targeted services based around the principles of reablement and designed to maximise independence undertake a comprehensive review of day services for people with a learning disability and support the development of new personalised solutions for people and, where necessary, the development of targeted day services for those with the highest and most complex needs encourage and support community capacity building and development of community-based solutions develop joint, streamlined reviewing processes as part of wider quality assurance arrangements improve the range of support for unpaid carers, to enable them to continue in their caring role In speaking to the report, the Director of Social Work clarified that this work would have been undertaken even in the absence of the Planning for Integration programme. He saw the Transformational Change Programme (TCP) as being aligned with and complementary to the Integration programme, with the two coming ever closer together in the run-up to implementation of the Lead Agency arrangements in April During discussion, attention was drawn to the potential for improved data gathering and performance monitoring and for demonstrating value for money. After discussion, the Leadership Group NOTED the position 7. Change Plan for Reshaping Care of Older People - Update SS There had been circulated Report No. LP/24/11 by the Head of Integrated Community Care on progress on the Change Plan for Reshaping Care of Older People, with particular reference to the development of local plans, engagement with the third and independent sectors and recent national developments. The report advised that all initial Local Change Plans had been progressed 4

5 since the previous report to the group in August 2011 and the necessary action was being taken to appoint staff etc. However, these processes took time and most initiatives were only now or imminently commencing actual delivery. The Group was reminded that the Change Plan had been developed in collaboration with representatives of the Voluntary and Independent Sectors. A major engagement event with the Third Sector Interface and Independent Sector representatives was planned to take place in early November The Group was also advised that, at a national Strategic Commissioning event in September 2011, attended by delegates from the Highland Partnership, it had been confirmed that the Change Fund would be available for the next three years and in 2012/13 would see a national increase from 70m to 80m. The report also drew attention to a number of specific expenditure proposals: (a) an additional initiative to address delayed hospital discharge total cost 265,000, anticipated return 795,000 approved by the Chief Executives; (b) proposals received from Alzheimer s (Scotland) to develop post diagnosis support total cost 104,500 currently being considered by the Chief Executives; (c) proposals received from a consortium of Independent Sector providers to provide training to support the Reablement agenda total cost 44,5000 currently being considered by the Chief Executives. Comments made during discussion included: The value of dealing with smaller local Third Sector/Independent groups was recognised, as was the importance of building local relationships with larger organisations. It was important to have a strategy in place to address any expenditure slippage. After discussion, the Leadership Group AGREED the expenditure on additional proposals at (a) to (c) above and NOTED: i. the further development of The Change Plan; ii. the development of joint planning arrangements with the Third and Independent Sectors; and iii. recent national developments. 8. Change Plan for Reshaping Care of Older People - Monitoring SS There had been circulated Report No. LP/25/11 by the Head of Integrated Community Care on progress on the Change Plan for Reshaping Care of Older People, providing an initial statement on expenditure, impact/performance trajectories and achievement against return. 5

6 The report reminded the Group that the NHS Highland/Highland Council partnership had submitted a high level Change Fund application in February 2011, and had since developed a more detailed Change Plan, built from local level plans and describing a 3:1 return on investment, to be achieved by a number of changes in activity. The challenges involved in establishing this return had resulted in a degree of slippage and 375,000 had been allocated to a number of short-term, non-recurrent initiatives. The report argued that a demonstrable impact could not be expected at this early stage of the process and confirmed that more detailed reports would follow on the impact of Reablement and on the detail of changes to care home activity, as information became available. In speaking to the report, the Head of Integrated Community Care highlighted some of the data provided and confirmed that more detail should be available for inclusion in future reports, permitting a more complete analysis to be made. Comments made during discussion included: It was important to demonstrate the impact on reducing delayed discharges. Dedicated beds needed to be identified. Mental Health Officers would remain employees of the Council. After discussion, the Leadership Group AGREED the proposed Change Plan monitoring framework and NOTED the half year impact on return. 9. Telehealthcare Update Report There had been circulated Report No. LP/26/11 by the Locality General Manager Lochaber/Out of Hours/Unscheduled Care Development Manager and the Service Manager, Care at Home, on developments in relation to Telehealthcare. The report highlighted progress on the Highland Hub Redesign project, designed to capitalise on the opportunity offered by co-location of services to deliver a single point of access for unscheduled or emergency contacts, in order to provide a more integrated, appropriate response and reduce emergency admissions. The Hub would also provide call handling and remote health monitoring with a view to ensuring that individuals with long term conditions were supported with early interventions. This should minimise acute exacerbations, prevent avoidable admissions to hospital and reduce length of stay through early supported discharge. The report also provided an update on the status of the Designing Assisted Living Lifestyles at Scale (DALLAS) project, with particular reference to attendance at a recent national workshop by Highland Council staff on behalf of the Highland partnership and the initiatives going forward from this event, at which it had been apparent that this project was at a more advanced stage in Scotland than elsewhere in the UK. 6

7 During discussion it was suggested that, given the difficulties in broadband coverage experienced in many areas of Highland, there should be greater exploration of the potential of 3G and 4G mobile technology to support telehealthcare roll-out. The Leadership Group NOTED the status updates on the Highland Hub Redesign, the DALLAS project and telehealthcare service delivery. 10. Performance Report There had been circulated Joint Report No. LP/27/11 by the Chief Executive, NHS Highland, and the Director of Social Work providing an update on a range of performance targets. EM Mr I Gibson expressed the view that the Group was not adequately carrying out its performance scrutiny role, which should be given greater priority in the agenda business and be supported by better performance information. Some of the data/targets currently provided were no longer the most relevant and lacked sufficient context and narrative. He had understood that a new suite of targets was to be drawn up. This should be done to aid preparation for change. Other members acknowledged that new measures would be adopted in the future. Mr Gibson expressed his dissatisfaction over the delay. After discussion, the Leadership Group NOTED the information given in the report. 11. Possible Future Items The Leadership Group NOTED that a report on Home Care would be brought to the next meeting of the Group. 12. Next Meeting Date RM The Group NOTED that the next meeting would be held on Tuesday, 13 December 2011, at 3.30 p.m., in Committee Room 2, Council Headquarters, Inverness. The meeting ended at 5.25 p.m. 7