Meeting documents

Apologies for absence were received from Trisha Horobin, David Keston, Elaine Norris and Tony Upward.

The minutes of the meeting held on the 28 March 2013 were agreed as a correct record.

Matters Arising

Workability website

Andrew Clark is to be contacted to provide an update at the July meeting.

Action: Sharon Griffin

Linda Warmbier, Day Opportunities Transformation Project, Adult & Family Wellbeing was welcomed to the meeting.

Linda began her update by explaining that she has been working in Commissioning and Strategic Improvement in Adult Family Welfare for just over a year and that she manages the Day Opportunities transformation programme.

The new model for Day Opportunities includes;

·         Increased choice and control for people

·         Direct Payments to buy their own services

·         Meeting the needs of people with highly complex needs

·         Developing a range of services that people want to buy

Six day opportunities centres are being designed to meet the needs of people with more complex needs and also a range of community services.  As part of the structure of the programme the following were looked at;

·         Buildings

·         Internal service and restructure of the staff,

·         Assessments, reviews, brokerage and the transition work

·         Future management of the day opportunities services 

There will be six day opportunities centres;

·         Buckingham

·         Aylesbury

·         High Wycombe

·         Chesham

·         Burnham

·         Seeleys (Beaconsfield)

Buckingham

The existing centre in Well Street is being refurbished.  The planning application has been submitted and has been successful.  The tender to refurbish the building went out at the beginning of May and the time period has been extended slightly.  It is expected that refurbishment will start in June/July with the aim to complete the works in April 2014.  Clients in Buckingham are currently using the Red Cross Centre.

Aylesbury

The Hartwell Centre in Aylesbury is currently being refurbishing and extended.  The centre will open in December 2013 and clients will move in during into the Centre in January 2014.

High Wycombe

Orchard House was being used but for a number of reasons this is no longer the preferred site.  A new site in the centre of High Wycombe has been identified and negotiations to purchase the site are currently taking place. Consultations about the design of the building are expected to commence in July 2013 and the site to open early/mid 2015.

Chesham

The Amersham Library site is no longer feasible.  A site for a new build has been identified in Chesham.  A public exhibition of the plans was held in February 2013 with very positive feedback.  A planning application will be submitted in June 2013 with the aim of opening the centre on February 2015.

Burnham

The existing building will be refurbished with the expectation of the centre being open in October 2015.

Beaconsfield

Seeleys House is in good condition.  It is not envisaged that any major work is required only the usual on-going maintenance.

Other work taking place is as follows;

·         The internal service and staff restructure.  The restructure began in June 2011, and was completed March last year.  22 day centres have been moved to 6 day centres.  There are two other services, Thrift Farm and the garden centre (Missenden Abbey).

·         The assessment of approximately 950 internal and external clients by care managers i.e. did clients still need a day centre or a community type service, or was it that they no  ...  view the full minutes text for item 3.

The Chairman welcomed Jackie Prosser, Primary Care Mental Health Transformation Lead, Buckinghamshire to the meeting.

Ms Prosser began her update by explaining that she is nurse by background, (both general and mental health).  She has been involved with the Improving Access to Psychological Therapies programme at a regional level for quite some time and has worked with the Strategic Health Authority before it closed.  She now works part time as a commissioner for IAPT in Buckinghamshire and is also a carer.

When the programme started over 6 years ago there was very little input, support and certainly a lack of evidence based interventions for people with depression and anxiety.  The Government has now engaged in the programme and have provided funding of over £300 million in the last six years (after the original investment for £170million in the first three years was reviewed).

Evidence suggested that if cognitive behavioural therapy or psychological intervention is offered to support people, then they would recover.  Two national pilots were able to demonstrate that if you treated two people, of the two one would improve and recover completely.  Many of the others made significant changes but the way in which the recovery was measured alongside patients and user satisfaction was to demonstrate changes in a clinical score of depression and anxiety. 

One of the other drivers for the programme was that it would be reducing healthcare costs and it would be self- financing.

The economic gains were not just about helping people with a health cost burden but also helping the wider system in terms of moving people off welfare benefits.  Part of the programme is to support adults of working age, i.e. people who weren't working because they were depressed or anxious and unable to work. 

The IAPT programme is currently being developed and delivered by Healthy Minds and is run by Oxford health at a cost of £2.2 million.  The service has employed and trained two new types of workers that deliver these psychological interventions - high intensity workers and psychological well-being practitioners (PWPs).  High intensity workers will work and offer primarily one to one support and PWPs do a lot of group work and telephone interventions.  The PWPs will see a large number of people because they would only see people for a short time (a six week period).

Two projects have been developed, one in Aylesbury Vale and one in Chiltern CCG.  The first project is specifically aimed at supporting people who are co-morbid i.e. have a mental health, depression or anxiety problem as well as their long-term condition.  The second project around developing cognitive behavioural intervention for insomnia as well as developing a group for carers and people with dementia.  In Buckinghamshire you would expect to see between 40,000 and 45,000 people with anxiety but not all of those will require or seek treatment.  The National Commissioning Board is expecting at least 6,500 of those people in Buckinghamshire to be treating by 2015 with 4500 of them completing treatment  ...  view the full minutes text for item 4.

Nadiya Ashraf, Lead Commissioner, Carers and Service User Engagement was welcomed to the meeting.

Members were referred to the results of the Consultation to Develop Services document which was circulated with the agenda.  Nadiya explained that the contract for the current core service which is provided by Carers Bucks is coming to an end as it has been extended for the maximum period of time. 

The intention was to go out to tender last year but due to the Care and Support Bill, and the need to reconfigure what Bucks County Council commission and some internal BCC process, the decision was taken to delay and consult with local carers on the changes. 

Over the past 12 months various pieces of work have taken place with focus groups and carers to understand their experiences of Social Services and support services and to understand the positives and negatives.

Carers Bucks carried out a survey of people registered with them and in November Bucks County Council carried out the first National Carers Satisfaction survey followed by a consultation and a consultation event.    There is no legal duty BCC to go out to consultation on this piece of work, but it gave BCC the opportunity to hear carers experience of the service, what they felt was valuable and what they wanted to be followed through in the new service. 

The main difference in the new service is bringing together a closer working relationship between Bucks County Council and the new provider to ensure a seamless service.  There are also things that need to be done differently such as giving carers timely information, responding in the most appropriate way and the best way to deliver the services to carers.  In order to do this piece of work, visits have taken place to Surrey and Hertfordshire to investigate best practice.

The next steps are to use this information and go out tender for the service in September with the aim of a new provider being in place by April 2013.  The new provider will work slightly differently.  They will have access to Swift, the Social Services database, to enable information to be entered onto the service user database and facilitate a direct referral system.

The Bill will be signed off in 2015 so BCC need to work with a partner who will assist them in being able to meet their new responsibility and the needs of the clients.

During the update the following questions were asked and points made;

Was there anything particular learning to emerge from the visit to Surrey County Council? Surrey are more advanced in their assessment process. With regard to Surrey, they have direct payments but have a slightly different approach and their internal processes are different.  It is also about a closer working relationship and a smoother relationship in terms of people transferring from the service and knowing the service offer available. The process needs to be clearer in Bucks.

Accessibility to the Social Services team is an area of concern.  ...  view the full minutes text for item 5.

This item was deferred to the next meeting.

Chris Reid explained that the current membership list for the PSDPB needs to be reviewed as there are several non attendees

Action: Chris Reid/Sharon Griffin

Debi Game, SUCO, gave the following update on the recruitment of new service user and carers representatives for the Partnership Board and the plans for the election of Co-chair. 

The membership of the PSDPB includes five service user and carer representatives supported by SUCO.  The optimum number of service user/carer representatives is between seven and eight.  A further expression of interest has been received from a lady who is a carer for someone with Parkinson's, which is currently a community that is not represented on this board.  Discussions have also taken place with Jo Woolf, Chilterns MS Centre to recruit someone to represent multiple sclerosis.

The recruitment process involves visits and discussions with lots of groups and voluntary organisations to try to identify individuals who might be interested in becoming involved with the Partnership Boards.  Individuals who express an interest are asked to complete an interest form are then invited observe the meeting followed by an informal discussion with the Chairman.  If all goes well the individual is invited to become a member of the Board and is supported by SUCO.

With regard to the election for co-chairs, a number of comments were received following a consultation exercise and a document was put together by SUCO.  The SUCO board have some issues with the process to elect co-chairs.  The first is that there are resource implications to enable SUCO to administer and manage the process, particularly in terms of the level of support to be provided, the preparation of personal statements, presenting to the boards etc and the managing the process of elections.  SUCO has asked for a discussion around how best the election process could be resourced.

The second issue is round the actual role of the chairs.  The Terms of Reference that were agreed at the Executive Partnership Board is that there are two co-chairs, one of which is a service user and a carer and one of which is the lead officer for the statutory authority. The SUCO Board feel quite strongly that as this is the mechanism that Bucks County Council uses to engage with service user and carers, both the chair roles should be service users and carers.  This is at odds with the Terms of Reference for the Partnership Boards. 

A letter has been sent to Rachel Rothero asking for a discussion round this because as a change to the Terms of Reference would need to go to the Executive Partnership Board for discussion and agreement.  

During the update the following questions were asked; 

Is the proposal that service users should be chair and co-chair of all the Partnership Board as this would require an individual with a certain skill set?  Where practical the aspiration would be for service users and carers to be chair and co-chair of the Partnership Board.  The Assistive Technology Partnership Board has  ...  view the full minutes text for item 7.

The Chairman explained the Safeguarding Board is currently responsible for overseeing Dignity in Care agenda. Following a review of this arrangement, the decision has been made to set up a new board solely focused on Dignity in Care issues including safeguarding matters and how to respond to risks and concerns. 

The new board will consists of posts at director level - a high level group of people who have influence in their organisations and can delegate responsibility to people to implement actions round dignity.  The new Board will report to the Joint Executive Team for Adults (JET) which in turn will report to the Health and Wellbeing Board.

Nationally there have been some key enquiries looking into abuse or neglect in care homes or hospitals such as the Winterbourne and mid-Staffordshire.  Locally there is increased recognition about increasing the promotion and profile of Dignity in Care and action to be taken.

The Chairman took members through the PSDPB action plan, highlighting the following key points;

The last column on the first page of the Action Plan gives an indication of what has been reported to the meeting so far and what has not.  So in terms of actions for outcomes of those reports, they are being captured in the minutes of the meeting.

Item 4.2 - Rachel Daly from the Care Quality team has been invited to the September meeting to give an update on nursing and residential care homes fully addressing the needs of disabled people through the provision of training.

Item 5.1 – Chris Reid to give an update on the future commissioning of neurology and neuro rehab services in July.

Item 5.3 – the development of personal health budgets – an update will be placed on hold as this is still in the pilot stage.

The action plan for 2013/2014 needs to be updated.   An email is to be sent to members of the Board asking them to review the action plan and forward any suggestions for priorities and actions to Christopher Reid by Friday 12 July 2013.

Action: Sharon Griffin

No items of other business were raised.

The next meeting of the Board will take place on Thursday 25 July 2013, 10.30am, The Common Road, Main Building, Green Park, Aston Clinton.