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ABERDEEN COMMUNITY HEALTH PARTNERSHIP COMMITTEE
Minute of Meeting
21 April, 2010
Town House, Broad Street, Aberdeen
Present: Bill Howatson, Chairperson; and Councillors Cormack, Donnelly, Kiddie, Leslie and Hunter; Heather Kelman, Gregory Poon, Anne Anderson, Aileen Brown, Fred McBride, Stuart Notman, Chief Inspector Adrian Barclay (Substituting for Adrian Watson), Ian Paterson, Karyn Da Costa and Linda Smith.
In Attendance: Bill Harrison, Simon Rayner, Bruce Davidson and Karen Gunn (item 3 only), Helen Howie, Chris Stewart, Val Tweedie, Kevin Dawson, Andrew Verreydt and Mark Masson (Clerk).
WELCOME AND APOLOGIES
1. The Chairperson opened the meeting by welcoming everyone present.
Apologies for absence were intimated on behalf of Sheila Stewart, Mary Crawford, Pamela Cornwallis, Sandy Reid, Adrian Watson and Donald Newnham.
DECLARATIONS OF INTEREST
2. The Chairperson asked Committee members whether they wished to declare an interest in relation to the items included on the agenda for consideration today.
The Committee resolved:-
to note that there were no declarations of interest.
INTEGRATED DRUG TREATMENT AND REHABILITATION REDESIGN
3. The Committee received a presentation in relation to the Integrated Drug Treatment and Rehabilitation Redesign.
Karen Gunn, Service Manager, NHS Grampian advised that the NHS Grampian Substance Misuse Service (SMS) was undertaking a major re-organisation of the way it delivers services in Aberdeen City in order to meet national targets and best practice. She indicated this represented a restructuring in line with continuous service improvement and lean management principles ensuring cost effective and efficient delivery of services within an integrated service pathway from stabilisation through to recovery.
The SMS would be re-organised into five teams, one team that would be the “front door” service, three cluster teams that correspond with Primary Care Clusters within Community Health Partnership and a fifth team based at Fulton Clinic that would specialise in complex dual diagnosis.
Simon Rayner, Development Manager, Integrated Services explained that Aberdeen City Council had invested £500,000 recurring into capacity building within the new structure which will ensure that there is an integrated Drug Service in the city providing holistic treatment and care through to rehabilitation and long term recovery. He indicated that full public engagement had been undertaken on the redesign and at present builders were undertaking work on the internal building specifications and décor which would last approximately six months.
Bill Harrison, Clinical Director/General Manager Mental Health revealed that in 2008, Aberdeen City had a waiting list of 799 people, 90% of whom were waiting to access the specialist SMS service of NHS Grampian.
The Committee resolved:-
to note the information provided and to receive an update in six months time.
MINUTE OF PREVIOUS MEETING
4. The Committee had before it the minute of its previous meeting of 17th February, 2010.
The Committee resolved:-
to approve the minute, subject to amending (1) Article 2 (Keep Well Initiative) to include reference to the North East of Scotland Credit Union located in Torry, Aberdeen; and (2) Article 12 (Mental Health Services Working Group Referral), resolution (ii) to read “to note that Sandy Reid would provide an update in terms of the Mental Health Support Services tendering process in due course”
COMMITTEE BUSINESS STATEMENT
5. The Committee had before it for consideration, the Committee Business Statement dated 17th February 2010. A number of items were updated as follows:-
(A) Intermediate Care Project – Woodend Visit
The Committee heard the clerk advise that due to unforeseen circumstances, the visit to the Rehabilitation Wing at Woodend Hospital on 8th April 2010 had been cancelled. He indicated that Jason Nicol had identified four possible dates for the rescheduled visit and in this regard, he requested that members who wished to attend should submit their availability based on these dates.
The Committee resolved:-
(i) that members submit to the clerk, their availability in terms of the four dates offered to attend the rescheduled visit; and
(ii) that the clerk liaise with Jason Nicol in terms of restructuring the programme for the visit, specifically to reduce the visit to a maximum three hours.
(B) CHP Delivery Workplan
It was noted that an impact assessment had still to be undertaken on the workplan.
It was anticipated that the report and workplan would be submitted to the Aberdeen City Alliance at their next meeting
The Committee resolved:-
to note the information provided and to update the Committee Business Statement
accordingly.
(C) Mental Health Services
In terms of the Mental Health Support Service tendering process, It was noted that interviews and presentations were scheduled to be held on 1st and 2nd June 2010 and it was anticipated that the new service would be established in August 2010.
Councillor Kiddie made reference to the Childhood Sex Abuse seminar held in Aberdeen Foyer recently and suggested that a report in this regards be submitted to a future meeting of the Committee.
The Committee resolved:-
(i) that a feedback report in relation to the recent Childhood Sex Abuse seminar be prepared in liaison with Ken Milroy and submitted to the Committee in due course; and
(ii) to otherwise note the information provided and to update the Committee Business Statement accordingly.
(D) Future of Woodgrove
Heather Kelman advised that discussions and work were ongoing in relation to the Future of the Woodgrove Nursing Home site and a further update would be provided at the next meeting.
The Committee resolved:-
To note the information provided.
CROSS CUTTING ISSUES
6. (A) Joint Health Protection Plan 2010-2012
The Committee had before it a report by Helen Howie, Consultant in Public Health Medicine which provided information in relation to the 2010-2012 Joint Health Protection Plan.
The report (a) advised that the Public Health Act etc (Scotland) 2008 placed a duty on Health Boards and Local Authorities to co-operate and produce a Joint Health Protection Plan; (b) indicated that NHS Grampian continued to work closely with our partners in the Local Authorities and other agencies to deliver services to protect the health of the Grampian population; (c) stated that Health protection was now the accepted term to describe the work that encompasses the surveillance, investigation, control and prevention of communicable disease and environmental hazards to human health; (d) explained that the Joint Health Protection Plan (JHPP) provided an overview of health protection priorities, provision and preparedness for NHS Grampian, Aberdeen City, Aberdeenshire and The Moray Councils as required by the Public Health etc (Scotland) Act 2008; (e) advised that this was the first Grampian Joint Health Protection Plan and covered the period from 1 April 2010 to 31 March 2012 and was prepared by NHS Grampian in collaboration with Aberdeen City, Aberdeenshire and The Moray Councils; (f) indicated that the plan supported the delivery of the Grampian Health Plan 2010-2013 and the Aberdeen City, Aberdeenshire and the Moray Community Plans; (g) indicated that the plan detailed the national and local priorities for health protection and what actions were being planned to take over the next two years; (h) explained that the appended plan provided detail on planning infrastructure, resources and operational arrangements, capacity and resilience, and public involvement; (i) stated that the JHHP would be considered and approved by the NHS Strategic Management Team, Aberdeen City Council Housing and Environment Committee, Aberdeenshire Council Infrastructure Service Committee and The Moray Council Planning & Regulatory Services Committee; (j) advised that the plan would also be submitted for information to Aberdeenshire Community Health Partnership and Moray Community Health and Social Care Partnership
The report recommended:-
That the Committee -
(a) note that the plan would be signed off by the Director of Public Health and the Chief Officers of Environmental Health for Aberdeen City Council, Aberdeenshire Council and The Moray Council; and
(b) note the content of the first Grampian Joint Health Protection Plan.
In relation to Section 9 of the plan pertaining to Environmental Hazards, Councillor Kiddie made reference to the control of environmental and antisocial behaviour noise and the difficulties in recruiting Environmental Health Officers. He indicated that the public, local community, young people and staff should not be subjected to high levels of noise and that the monitoring of the decibel levels was not as they could be. He concluded by advising that he would be writing to the Chief Executive to address the concerns in this regard. In response, Helen Howie advised that she was aware of the pressures within Housing and Environment service and would raise the issue of noise levels within licensed premises with colleagues in the Council’s Public Protection team.
The Committee resolved:-
To approve the recommendations
(B) CHP Governance Toolkit
The Committee had before them a paper by Heather Kelman, which provided information in relation to the CHP Self Assessment Tool.
The paper indicated that the self assessment was completed by the CHP General Manager in consultation with the Chairperson of the CHP Committee and advised that Audit Scotland had created a self assessment tool/checklist for CHP’s to assess the effectiveness of Governance and Accountability arrangements. The paper explained that the tool would be useful to revisit this self assessment on a regular but not frequent basis. The paper concluded by suggesting that the Committee discuss the present Governance and Accountability arrangements and considers proposals for future development of the arrangements in the CHP.
Heather Kelman (a) advised that at present that there was no prescribed method on how to manage the business of CHP Committees, however the research findings in relation to the study of Community Health Partnerships would be published by the end of May 2010; (b) explained that it was anticipated that the findings would suggest action to review and strengthen CHP governance and structures; (c) indicated that the September CHP Workshop would focus on the role and purpose of the Committee and the CHP Delivery Workplan; and (d) revealled that a visit to four or five other Scottish CHP Committee’s would be undertaken to analyse their structure and to ascertain how they take forward the work on the Single Outcome Agreement.
The Committee resolved:-
To note the paper and the information provided
VULNERABLE GROUPS/PEOPLE (ADDITIONAL NEEDS)
8. (A) Advocacy Services
The Committee had before them for consideration, a report by Heather Kelman relating to the issue of advocacy services in Aberdeen.
The report (a) advised that a meeting was held in March 2010 between representatives of Aberdeen City Council and NHS Grampian to discuss the way forward with advocacy services in Aberdeen; (b) indicated that the meeting comprised David Cameron, Chair of NHS Grampian Health Board, Richard Carey, Chief Executive of NHS Grampian, Councillors Kevin Stewart, Jim Kiddie and Gordon Leslie and Fred McBride, Director of Social Care and Wellbeing, Aberdeen City Council; (c) explained that there was an alleged failure on NHS Grampian’s part, to take the issue of advocacy services seriously; (d) stated that over the years, there had been more than one review of advocacy services undertaken but the issue had remained and therefore a process to assess the adequacy of provision which would be accepted by both parties had to be agreed; and (e) outlined the process as follows:-
· To identify a senior manager within NHS Grampian to review this issue thoroughly, including visiting the Royal Edinburgh Hospital (which is an example of good practice that Councillor Kiddie has identified), meeting Aberdeen Advocacy leads and Councillor Kiddie himself to try to identify where any gaps in provision are;
· That Fred McBride was to identify an officer from the Council with whom to liaise with NHS Grampian in taking this review forward;
· To prepare a report for the CHP Committee and the Board identifying current service provision, service gaps, priorities for action and associated potential costs etc, within the next 3 months; and
· To formally take a Board position on whether or not this required to be a top priority for investment (with any spend coming from disinvestment elsewhere).
Councillor Kiddie (1) advised that the aim of the meeting was to get joint agreement and real commitment from NHS Grampian to address advocacy services in Aberdeen; and (2) referred to the Mental Health Care and Treatment (Scotland) Act which stated that funding should be made available for advocacy services.
The Committee resolved:-
(i) to note that a progress report would be submitted to the Committee at the June or September meeting; and
(ii) to note that Kevin Dawson would circulate details of the non-recurring funding for advocacy services to members of the Committee.
FINANCE AND BUDGET REPORTING
9. The Committee had before them a paper tabled by Heather Kelman relating to the regularly submission of Finance/Budgetary reports to the Committee.
The report (a) advised that on previous occasions the CHP Committee had received reports relating to aspects of finance or elements of the budget, specifically resource transfer, Health Improvement Fund expenditure and the Fairer Scotland Fund; (b) indicated that beyond these limited budgets, there was a far greater spend on health services, health improvement and social care; (c) stated that individual managers were accountable for these budgets directly to their employing organisations, and therefore the role of the CHP Committee was less clear in relation to the broader spend; (d) explained that it was clear that if the Committee was to have real influence over the health and care services that are provided within the city, a greater understanding of budgets, the challenges within those budgets and the choices that have to be made must be achieved, without detriment to the governance and accountability arrangements within the respective organisations; (e) advised that some aspects of this would be addressed by the revised Extended Local Partnership Agreement (ELPA), which would be submitted to the Committee for consideration at the next meeting; (f) indicated that this would raise questions over whether or not some budgets should be pooled, or closely aligned, but would also give greater clarity on the revised governance and accountability arrangements that would be necessary to support pooled or joint budgets; (g) explained that the ELPA would propose that the priority areas for review would be Care of the Elderly, including mental health and dementia services; (h) provided information in terms of the separate budget setting arrangements in place for NHS Grampian and Aberdeen City Council at present and the financial constraints both organisations face over the next two to four years; and (i) raised questions in relation to the finance/budget information which may be useful for the CHP Committee to consider.