Agenda and minutes

Councillor Martin Mitchell declared a personal interest as the Council’s representative on the Board of Governors for Blackpool Teaching Hospitals NHS Foundation (none of the items directly related to Blackpool Teaching Hospitals).

The Chairman explained that the BBC had commissioned local TV media to film a series of council committee meetings as part of a national project promoting local democracy. He welcomed Paul Faulkner from That’s Lancashire Television who would also be attending the Committee’s next meeting on 14 December 2016. The Committee noted that there were no applications to speak by members of the public on this occasion.

To consider an update regarding the development of health and social care integration in Blackpool (as part of the wider Fylde Coast partnership). 

Mr David Bonson, Chief Operating Officer, Blackpool Clinical Commissioning Group and Mr Roy Fisher, Chairman, Blackpool Clinical Commissioning Group presented an update regarding the development of health and social care integration in Blackpool (as part of the wider Fylde Coast partnership).

He explained that integration required strategic direction and practical changes to service delivery. Sustainability and Transformation Plans had been developed nationally as five-year plans (2016-2017 to 2020-2021) across 44 ‘vanguard’ pilot geographic areas which were leading on transformation and integration of NHS and Social Care services. 

Mr Bonson referred to the Lancashire and South Cumbria Sustainability and Transformation Plan within which were five local ‘footprint’ geographic areas responsible for delivering services, one being the Fylde Coast area including Blackpool. The local areas were based on populations, locations of services and actual patient flow rather than traditional local authority boundaries.

He referred to a good history of partnership working across services within Blackpool and emphasised the need for real partnership working to drive Plans. Key partners included Blackpool Teaching Hospitals and Lancaster County Council. It was important to fully understand different systems and ways of working for effective change to be developed.

He added that service delivery changes would aim to deliver better health and wellbeing outcomes for people. Alongside transformation improvements was the need to ensure that services were sustainable.  Current demand, in particular, for acute hospital services (physical healthcare and emergency treatment) was unsustainable based on resources. He advised the Committee that even though NHS funding was increasing, unlike local authority funding, current projections were for demand to exceed funding supply and that based on current projections the funding gap by 2020-2021 would be £572m for Lancashire and South Cumbria (approximately 25% of the overall health and social care budget).

Members noted that partners were developing an Accountable Care System which would promote further joint working but with a more rigorous formal approach including risk-sharing. Budgets would be pooled as already existed with the Better Care Fund for integration work which was around £15m (budget for 2015-2016).  Co-commissioning for acquiring services would also be developed.  Greater efficiencies were required for systems and ways of working.

Mr Bonson spoke about developing new more practical service delivery options and outlined that hospitals represented the greatest cost burden, in particular accident and emergency and non-elective treatment, and use of beds needed to be reduced. Instead, there needed to be a greater drive towards community-based care whereby people took greater self-care or were able to maintain some independence outside hospital whilst getting necessary treatment and care support.

He acknowledged that Sustainability and Transformation Plans did not provide all the answers to the range of challenges aimed to develop effective strategic approaches in response to the scale of challenge.

Members noted that the Plan was at an early development stage, the first of five years, and that it was a draft document (third version) that had been submitted to NHS England, the national funding body, for approval. NHS England had indicated broad contentment  ...  view the full minutes text for item 3.

To provide a summary of the recent history of Transforming Care in England and an overview of Blackpool’s response to the requirements of Transforming Care for people with a learning disability and/or autism and other challenging behaviours.

Ms Helen Lammond-Smith, Head of Commissioning, Blackpool Clinical Commissioning Group presented an update regarding the development of Transforming Care for people with learning disabilities and/or autism and other challenging and complex behaviours.

She outlined the national background which led to the required local improvements. Crisis support existed in mental health nationally but until now had not for people with learning difficulties. NHS England had issued crisis support guidance.

Ms Lammond Smith stated that as with other health and social care work, it was necessary to help support people so that they had less need to access hospital services and could live independently, with support, in communities.

She referred to a key successful innovation ‘Care and Treatment’ Reviews which involved a small number of professionals (clinician, ‘expert by experience’ and a Blackpool Clinical Commissioning Group officer as the commissioner of services).  Care and Treatment Reviews looked at people’s needs to establish the best support required and where that support should be and aimed to ensure that people were only in hospital if necessary and sought to promote community-based options. Members noted that assessments took place every six months.

Ms Lammond-Smith explained that an ‘at risk’ register was maintained which identified people whose needs met relevant criteria for support and whether they needed to be support through hospital services or within the community. There were nine patients in hospital under various levels of secure settings and around another twenty supported through community care. The register included contingency plans and contact details of carers/families. 

She added that Care and Treatment Reviews were common for people with autism but it was possible more people with learning disabilities were not known to services. The register also aimed to capture the transitional element to ensure people progressed effectively from children’s services to adult services and were not ‘lost’. Details of children in residential care, including 15-16 year olds, were held and details of families. Effective responses to breakdowns in children’s care packages were prepared.

The Committee noted that key challenges included securing local specialist accommodation providers and good development support for well trained staff as current accommodation was costly as it was specialised and ‘out of area’ in Calderstones. Ms Lammond Smith stated that no local specialist facility existed but local provision needed to be developed. One problem for ensuring the most effective CTR assessment decisions was that staff were usually housed within mental health services but not always dedicated learning disabilities.

She added that ‘delayed transfers of care’ (availability of beds for patients moving between different stages of care in health and/or social care), as also referred to under the health and social care integration item, was a significant issue nationally and locally and also involving a great deal of reporting requirements.

She referred to the local governance arrangements for transforming care which were led by the Blackpool Clinical Commissioning Group and the Council who jointly shared transformation responsibilities.

The Committee referred to a recent local press article which had highlighted exceptional low  ...  view the full minutes text for item 4.

To note the date and time of the next meeting as Wednesday, 14 December 2016 commencing at 6pm in Committee Room A.

The Committee noted the date and time of the next meeting as Wednesday 14 December 2016 commencing at 6pm in Committee Room A, Blackpool Town Hall.