Joint Commissioning Board Minutes of the meeting held on Friday 20 March 2009 at 2.00pm in Room CG3, Francis Crick House, Moulton Park

Transcription

1 Joint Commissioning Board Minutes of the meeting held on Friday 20 March 2009 at 2.00pm in Room CG3, Francis Crick House, Moulton Park Present: Councillor Rosemary Bromwich John Parkes Richard Alsop Andrew Bailey Andrew Jepps Pat McCarthy Stephen Oakley John Rogers Brendon Macken County Councillor, Northampton County Council (NCC) (Chair) Chief Executive, NHSN (Vice Chair) Director of Strategy and System Management, NHSN Carers Support Interim Head of Planning and Commissioning Associate Director Mental Health & Learning Disabilities, NtPCT Head of Mental Health & Learning Disability Commissioning, NHSN Department of Health Finance Chair of Mental Health Service Users Reference Group (USS) In attendance: Laura Bills Business Support Manager, PCT (Minuter) Karen Walters Committee Support Assistant (Minuter) Jackie Lawley Interim Service Manager (NCC) Silvia Manson Associate Director, Mental capacity act and Safeguarding Adults(NHSN Apologies Bill Clark Chair of Mental Health Thematic Partnership Charlie MacNally Corporate Director of Health and Adult Services, (NCC) Gill Scouler Director of Finance and Performance (NHSN) Ben Gowland Chief Executive, Nene Commissioning Stephen Horsley Director of Public Health, (NHSN) 1. Apologies Action Apologies for absence were received from Gill Scoular, Charlie McNally, Bill Clark and Stephen Horsley. 2. Minutes of the Last Meeting Held on 6 th November 2008 The Minutes of the meeting held on the 6 th November 2008 were agreed to be a true accurate record of the meeting. 3. Matters Arising from the Minutes not covered elsewhere on the agenda The matters arising from the minutes and actions were noted by the Board and the following was discussed: Following the meeting to discuss the roles of the Vice Chair, it has been agreed that the terms will stay the same as the previous year. A summary of abbreviations for the front sheets of reports has been produced by Laura Bills and will be circulated to all the Board members in due course. LB NHSN Joint Commissioning Board Minutes 20 March 2009 Page 1 of 7

2 John Parkes advised the Board that he and Charlie McNally have had a good discussion on the changes required to the project management arrangements to address the issues and project governance discussed in the previous Board Meeting. Andrew Bailey asked if there had been any advancement on the proposal for identifying the benefits and risks of using individualised budgets to which John Parkes informed the Board that Northamptonshire County Council s (NCC) thinking is further advanced than the Primary Care Trust s (PCT) on personalised budgets but both organisations are committed to this notion. The risk implications are still being investigated and therefore have not been presented to the board at present. However within the next week a decision will be made as to whether the organisation will be involved in the National Personalized Budget Pilot Scheme that has been proposed. The Board will be informed of the decision at the next meeting. JP Andrew Bailey asked the Board to clarify the relationship between the PCT and NHS Northamptonshire also what the responsibilities and public funds are? John Parkes informed him that nationally the NHS has moved away from the organisation being known as Northamptonshire PCT to NHS Northamptonshire. This is effectively a rebranding and should help the general public to have a better understanding of the organisation as a whole. Problems have had to been overcome due to the legal entity of the branding. This is why the letterheads still show both titles. Standing Items 4 Mental Health Commissioning Strategy Business 4.1 Finance and Performance Report Steve Oakley presented the Finance and Performance report. The report provided the Board with a financial and activity positioned statement for the pooled budget for The Report identified the risks managed by the commissioning team in and the actions undertaken to maintain financial balance throughout the year. It provided a high level summary of performance and updated the board on the progress with the ongoing development of the Mental Health Performance Framework previously agreed. The report also provided a brief summary of the budget assumptions which are shaping the development of the mental health pooled budget for The Key headlines were as follows: The Pooled budget continues to show a slight overspend The overspend is forecast to remain at year end. Performance data is now being collected by providers and NHSN Joint Commissioning Board Minutes 20 March 2009 Page 2 of 7

3 quality standards are being developed for Northamptonshire Healthcare Trust. The Mental Health Performance Framework continues to be developed to incorporate additional performance information. The self assessment exercise for 2007/08 shows continued steady improvement against Mental Health National Service Framework Indicators. Steve Oakley informed the Board that the Mental Health Self Assessments have not been completed for financial year 2007/08. This is normally completed in the Autumn but will now not be complete until May. It was therefore predicted that there will be a continued improvement overall on the self assessment based on the group information that was received. However this will depend on the targets set as they can change annually. Richard Alsop asked Steve Oakley to clarify what metrics were underpinning the results and if were they were judged on the performance or on the actual process? The Board was informed that there are Commissioning Actions which set the targets and professional guidance is sought when reviewing the performance/quality to form the definition for points within the categories. This then determine the red amber or green status. The Quality standard section and the Northampton Healthcare Trust (NHT) section have now been drafted to be included in the improvement framework. These have been taken from the Mental Health Contract and are currently undergoing revision on quarter one and quarter two. These sections will be lifted into the framework with a range of national and local indicators provided by the Trust and the County Council to monitor the performance and targets. The 2009/10 budgets for client contributions and specialists are still being agreed for the partnership budget and will be reported at the next committee meeting in May SO Richard Alsop commented that although the strategy has been agreed it would be helpful for the Board to be able to make a bridge from this into the operational plan for the budgets this year, helping visualize what the organisation intended to achieve against what can actually be implemented within this budget. Andrew Bailey commented that he is still struggling to obtain the exact figures for the post-line budget particularly for support workers and rest-bite for the current financial year and next. He asked if it was know what proportion would be coming into the mental health area for carers and informed the Board that even trying to gain this information form the Government was not clear. John Parkes advised that he would need to clarify what and how the sum may have been allocated and would report back at a later date. JP Andrew Bailey questioned whether any research has been NHSN Joint Commissioning Board Minutes 20 March 2009 Page 3 of 7

4 completed as to why the Individual care package figures have increased and what preventative methods i.e. earlier intervention, support, etc, had been introduced to avoid the same issues in the future? A discussion took place and it was concluded that current work stream evidence can be used to produce this data. Pat McCathy will update the Board on the situation with the work stream but will not be able to provide a full report on this matter for the next meeting. Andrew Jepp informed the Board that the Council currently have a focus around the Safeguarding of adults and suggested that some of the key point indicators to be concentrated on would be to look at are the levels of training in this area and the numbers of referrals. He advised the Board of the data that he has seen previously which showed extremely low referrals levels. This may have been caused by the lack of awareness which hopefully with further staff training in this area, may increase. Figures will be produced at the next meeting for reference. PMc AJ 5 Learning Disability Commissioning Business 5.1 Learning Disability campus Re-provision Progress Report Councillor Rosemary Bromwich informed the Board of a conversation held with the Chair of the NHT. He expressing his concerns regarding the 36 cases that should have been transferred by end of March and yet have not happened. There has also been a change in the Project Management. Nick Hall is now responsible and has reported that the IPC is not finalised and there is a discrepancy within the budget that is due to be transferred. Richard Alsop commented that following a meeting held that week there has been an elevation of all the issues. There are now senior personnel from the NHSN and the NCC attending the meetings who are able to make the necessary decisions. This should avoid further delays. With regards to the figures, there are still a few discrepancies which are being discussed. The NHT are still awaiting some costings to be passed through. However a discussion between Richard Alsop, John Parkes and Gill Scoular will be taking place to finalise the issues within a 10 day resolution. The Board received a verbal presentation from Andrew Jepps and Pat McCarthy updating them on the Learning Disability Reprovisioning progress report which informed the board of the current progress undertaken on this campus project. Items for Discussion and Approval NHSN Joint Commissioning Board Minutes 20 March 2009 Page 4 of 7

5 6. Mental Health Commissioning Strategy Implementation Progress Report Pat McCarthy informed the Board that the NHSN Board and NCC have now approved the Strategy and Implementation plan. The Mental Health Managed Network Board has now been created and will move forward as the project management group in place of LIFT and the Performance Reference Group. The message that has had been relayed to Provider colleagues is that although funding has been set aside against the strategy and the PCT s Financial Plan, consideration would be given as to how that would be shown in the budget. This would be brought back to the next meeting. Richard Alsop clarified to the Board that there is an opportunity for this structure to become an exemplar programme. It show s good user and carer involvement with a clear strategy, however if all routes are not driven it may not be deliver. All groups need to be focused on the set strategy. A discussion took place as to what would be the best way of tracking and reporting the progress. It was agreed that an Assurance Framework report presented to the Board would be effective. PMc RA Changing minds and Improving Access to Psychological Therapy Services 7 Pat McCarthy presented a report to the board informing them of the increasing access to Psychological Therapies (IAPT) programme and it s first wave of implementation in Changing Minds. Although this is not technically yet a part of the budget it was felt that the Board should be made aware of the current and future situation with the intention to support the commission of the service from the PCT s Provider arm within the Changing Minds dimension. Councillor Rosemary Bromwich asked how many General Practitioners in the county where currently using this service and if they are not using it, why are they not using it? Pat McCarthy suggested that this may be able to be answered when further evaluations to see how this breaks down. A discussion took place around what evaluation evidence should be used to determine how well this scheme is working and what information was taken from the first appointment to refer on for a second appointment. A full evaluation will be brought to the next meeting to clarify to the Board what information is being collected as evidence to monitor this programme. PMc NHSN Joint Commissioning Board Minutes 20 March 2009 Page 5 of 7

6 8. Section 75 Framework Agreement between PCT and NCC Jackie Lawley reported to the Board of the highlighted points in the Section 75 Framework Agreement between NCC and NHSN and informed the Board of its current progress. The Board were also informed that a leaflet has been produced that should help to understand the section 75 framework. This will be forwarded to Laura Bills for distribution to the Board. Councillor Rosemary Bromwich suggested that this leaflet also be made available for distributed to fellow councillors. This will prove to be a very useful tool in helping people to understand the agreement. Andrew Bailey commented that on the appendix one there was no reference or consideration to carers and carer service users. He also sought re-assurance that as a member of the Commissioning Board he would not retain personal liabilities of decisions made and wanted to clarify what where his personal responsibilities if any? Jackie Lawley explained that this overarching framework is a legalised framework of which each schedule will then detail its aims and outcomes of each service. John Parkes explained the reasoning behind the need for this type of framework but commented that as this document has been drawn up by layers some of the practicalities need reworking. It was agreed that he will take responsibility for re-wording this and forwarding back to the lawyers. It was also agreed that more specification was needed in the subsections in regard to pooling the budget, including what the advantages and benefits would be. LB JP 9. Deprivation of Liberty Safeguarding (DoLS) Governance arrangements The board received a presentation from Sylvia Manson regarding the Deprivation of Liberty Safeguards (DoLs) governance agreement which comes into effect on 1 st April The Board heard a summery of the legislation and how it will affect individuals who are not attained but elements of restriction from moving around are required with no legal sanction. Andrew Jepps informed the Board that there may be a financial risk caused by a peak of referrals in the next financial year which then should level out. This will need to be monitored. Silvia Manson explained that this process will be providing a safeguard for individuals who are being deprived from their liberty and will put us in line with the Human Rights Act. There are two key roles that ensure qualifying to this governance: Best Interest Assessors. These are qualified nurses/occupational therapists, who have had additional training in this area. Followed by the Physiatrists and mental health assessors who carry out six statutory areas of assessment. This is then forwarded to the NHSN NHSN Joint Commissioning Board Minutes 20 March 2009 Page 6 of 7

7 or the NCC to be signed off. This then authorises the deprivation of liberty and providing protection for those concerned. Items for Information 9. Living Well with Dementia: a National Dementia Strategy Valuing People Now Any other Business No other Business reported Date of Next Meeting The next meeting will be on 7 th May 2009, am to noon in Room CG4, Francis Crick House, Moulton Park NHSN Joint Commissioning Board Minutes 20 March 2009 Page 7 of 7