Decisions

Submitted – The Minutes (previously circulated) of the meetings of this Scrutiny Committee held on 12 and 19 December 2019.

RESOLVED – That the Minutes of the meetings of this Scrutiny Committee held on 12 and 19 December 2019 be approved as a correct record.

The Review Group Members of the Health and Partnerships and Adults and Housing Scrutiny Committees submitted a report (previously circulated) updating Members on the progress of the Joint Review Group established by this committee and the Adults and Housing Scrutiny Committee to examine end of life care for people with dementia.

The report stated that the Joint Review Group was established following a recommendation in the final report of the Adults and Housing Scrutiny Committee ‘Living Well with Dementia’ and a scoping meeting was held on 25 April 2017 with further meetings held on 10 December 2018 and 20 February 2019.

It was reported that Members of the review group had undertaken visits and made contact with a number of organisations, seeking assurance that patients were receiving the best care at the end of their life.

It was also reported that whilst good progress had been made, Members acknowledged the need for further work including additional contact with organisations such as Alzheimer’s Society and Independent Care Homes and a further meeting of the Review Group to discuss the policy in place at Darlington Memorial Hospital regarding end of life care for those living with dementia, with Dr Nicholson, Consultant on End of Life Care and a representative from the County Durham and Darlington NHS Foundation Trust (CDDFT).

RESOLVED – (a) That the progress of the Joint Review Group be noted.

(b) That the joint work of the Health and Partnerships Scrutiny Committee and the Adults and Housing Scrutiny Committee on the end of life care for people with dementia be continued during the 2019/20 Municipal Year.

Karen Hawkins, Director of Commissioning and Transformation, NHS Darlington Clinical Commissioning Group gave an update presentation on the Stroke Rehabilitation Service Review - Patient, Public and Carer Engagement Phase.

It was reported that Phase One of the review had been completed and common themes that had been identified from the first period of engagement included communication challenges at various points in the patient pathway, emotional wellbeing and support, inconsistency of community rehabilitation provision and a need for longer period of therapy following discharge from a hospital setting.

Phase Two of the review was due to commence following the local borough elections in May and the Stroke Association will lead on the work  to engage with those within the local community identified as at risk of a stroke and to seek their views on initial proposals.  

The Director of Commissioning and Transformation advised Members that feedback on the findings from the engagement, and proposed next steps will be shared with Members at the next meeting of this Scrutiny Committee.

Members’ questions related to the discharge of stroke patients straight to home and the support in the community that was available to those patients during their recovery.   The Director of Commissioning and Transformation advised Members that the review was looking at how community pathways could be better utilised as part of the engagement process and how the voluntary sector can contribute.

RESOLVED – That the Director of Commissioning and Transformation be thanked for her presentation.

The Assistant Director of Adult Services submitted a report (previously circulated) to outline how additional funding is being allocated on adult social care services in order to support the expectations that are applied to it.

It was reported that in October, 2018 the Secretary of State for Health and Social Care announced £240m of additional funding for Councils to alleviate winter pressures on the NHS.

Darlington Borough Council had been allocated £501,172 with spend expected to focus on reducing delayed transfers of care; helping to reduce extended lengths of stay in hospital; weekend discharge arrangements, so that patients are assessed and discharged earlier; and speeding up the process of assessing and agreeing what social care is need for patients in hospitals.

The submitted report detailed the schemes which had been allocated funding in Darlington; gave examples of activity which had been supported over the winter period; delayed transfer of care performance for December 2018; and outlined the governance arrangements to monitor the impact and performance benefits of the additional funding.

Members referred to the positive impact of the funding in particular on discharge from hospital at weekends and Bank Holidays; how some of the funding will be utilised for rapid response domiciliary care packages; and the number of delayed days which had improved to 44 days in December 2018 compared to 128 delayed days in December 2017.

It was also reported that for December 2018 Darlington, when compared to all Single Tier and County Councils in England was ranked five on the overall rate of delayed beds.

RESOLVED – That the report be noted.

The Partnership Director submitted a report (previously circulated) to update Members on the progress of Darlington Partnership as it continues to champion the Sustainable Community Strategy One Darlington: Perfectly Placed.

The submitted report outlined the agreed charter, ‘Fairer, Richer, Darlington’ which aims to narrow the gap between those families who are struggling financially through the three work streams: Interventions to Ensure Families have the Basics: Interventions to Boost Families’ Resilience; and Interventions to Tackle the Causes of Poverty. Steering Groups had been established to take forward each work stream.

The submitted report also advised Members of the Darlington Cares Initiative, established through the Darlington Partnership and launched in October 2012 aimed at providing a means for Darlington’s businesses to support the local community predominantly through employer supported volunteering.  The range of projects include the Pick Pie and a Pint, The Great Parks Auction, The Big Community Challenge, Homework Clubs and Period Poverty.  In total Darlington Cares Members had delivered over 11,000 hours of volunteering during 2018.

The submitted report also gave details of the Festival of Ingenuity; the Best of Darlington Awards; and the Volunteer Fair.

RESOLVED – That the report be noted and the work of the Darlington Partnership in engaging Darlington businesses to support the local community be welcomed.

Nicola Bailey, Chief Officer, Darlington Clinical Commissioning Group gave Members a verbal update on the current position regarding Integrated Care Systems (ICS).

The NHS Long Term Plan, published in January 2019, indicated that all areas of the country would be covered by an ICS by April 2021; the North East and North Cumbria were participating in the aspirant ICS programme to become an ICS; and were working with Local Authorities at ‘place’ level to ensure a focus on population health. A partnership board would be put in place with representation from commissioners, trusts, primary care networks, local authorities, the voluntary and community sector and other relevant partners.

A discussion ensued in respect of the work on clinical pathways and strategies and it was confirmed that a draft clinical strategy had been developed and a full programme of public engagement and formal consultation would commence following the local elections on 2 May 2019. Members requested that the programme be brought to a future meeting of this Scrutiny Committee.

RESOLVED – (a) That the thanks of the Scrutiny Committee be conveyed to the Chief Officer, Darlington Clinical Commissioning Group, for her informative update.

(b) That the briefing note be circulated to Members of this Scrutiny Committee.

The Managing Director submitted a report (previously circulated) to provide Members with performance data against key performance indicators for Quarter 3 2018/19.

It was reported that the performance indicators were aligned with key priorities and the majority were used to monitor the Corporate Plan 2017/21.

Details were provided of the 30 indicators that are reported to this Scrutiny Committee, five Culture indicators and 25 Public Health indicators. The majority of the indicators are reported annually, and all the Public Health indicators are reported in line with the Public Health Framework National reporting schedule which means that that data is at least one year in arrears or relates to aggregate periods.

At Quarter 3 data was available for two Culture indicators and nine Public Health indicators.

Particular reference was made to CUL 063 – Number of school pupils participating in the sports development programme which had shown improved performance compared to Quarter 3 last year; and CUL 064 – Number of individuals participating in the community sports development programme which had shown worse performance than at Quarter 3 last year.

In relation to Public Health is was reported that PBH 013c – Percentage of all infants due a six to eight weeks check that are totally or partially breastfed in 2017/18 in Darlington was 32 per cent which had remained similar to 2016/17 at 34 per cent; PBH 014 – the percentage of women who smoke at time of delivery in 2017/18 in Darlington was 16 per cent, which showed a decrease from 22 per cent in 2010/11; PBH 018 Child development – proportion of children aged 2-2.5 years offered ASQ3 as part of the Healthy Child Programme or integrated review which had significantly improved from 32 per cent in 2015/16 to 98 per cent in Darlington in 2017/18; PBH 035i – Successful completion of drug treatment – opiate users in Darlington in 2017 was 3/7 per cent of those taking opiates had increased from 2.8 per cent in 2016; PBH 035ii – Successful completion of drug treatment – non opiate users had reduced from 30 per cent in 2016 to 20 per cent in 2017; PBH 035iii – Successful completion of alcohol treatment – In Darlington in 2017 was 25 per cent to those who received structured treatment for their alcohol consumption were abstinent at the end of their treatment and did not re-present to treatment within six months; PBH 050 – people presenting with HIV at a late stage of infection in the period 2015-2017 was 17 per cent which was statistically significantly better than the national and regional averages; PBH 056 – Age standardised rate of mortality considered preventable from all cardiovascular diseases (including heart disease and stroke) in those aged less than 75 years per 100,000 population the rate of reduction in Darlington had slowed and was now similar to regional and national averages based on 2015/17 data; and PBH 060 – Age standardised rate of mortality from respiratory disease in persons less than 75 years per 100,000 population Darlington is now statistically similar to England and national averages based on 2015/17 data.

Members commented in particular on the increase in the successful completion of drug treatment – opiate users and requested that the Health Needs Assessment be available to Members a future date; the positive results in smoking in pregnancy; the reduction in the percentage of all infants due a six to eight week check that are totally or partially breastfed; and the performance for the adult population taking part in physical activity which had reduced.

RESOLVED – That the performance data reported for Quarter 3 2018/19 be noted.

The Managing Director submitted a report (previously circulated) requesting that consideration be given to this Scrutiny Committee’s work programme for the remainder of the Municipal Year 2018/19.

Members discussed potential areas to add to the Work Programme and recommended that GP Access to appointments (to be part of a wider review of primary care) and Substance use/misuse be taken forward into the next Municipal Year.

RESOLVED – (a) That the current status of the Work Programme be noted.

(b) That the Work Programme be updated to reflect the decisions of this Scrutiny Committee.