ABERDEEN COMMUNITY HEALTH PARTNERSHIP COMMITTEE. Minute of Meeting. 4 th February, 2009 Town House, Broad Street, Aberdeen

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1 ABERDEEN COMMUNITY HEALTH PARTNERSHIP COMMITTEE Minute of Meeting 4 th February, 2009 Town House, Broad Street, Aberdeen Present: Bill Howatson, Chairperson; and Councillors Cormack, Leslie and Kiddie; Heather Kelman, Stuart Watson, Linda Smith, Jennie Biggs, Stuart Notman, Pamela Cornwallis, Bob Hamilton, Bob McDonald, Donald Newnham, Liz Taylor (substitute for Philip Cotterill) and David Rodger (substitute for Kath Beveridge). In Attendance: Val Tweedie, Bill Cowling, Sandy Reid, Elizabeth McDade, Marka Rifat, Mark Masson and Lynsey Davidson. WELCOME AND APOLOGIES 1. The Chairperson opened the meeting by welcoming everyone present to his first meeting as Chairperson. Apologies for absence were intimated on behalf of Councillor Donnelly, Craig Stirrat, Mary Crawford, Bert Donald, Andy Verreydt, Ken McLay, Kevin Dawson, Aileen Brown, Christine Burgess, Rhonda Kelly, Gregory Poon, Philip Cotterill and Kath Beveridge. MEMBERSHIP OF THE COMMITTEE 2. The Committee had before them for information, correspondence from Linda Juroszek advising that Stuart Notman would be replacing Steven Webster as the Community Pharmacist representative on the Committee. The Committee heard the Clerk advise that Kath Beveridge had replaced James McGinlay and Ken McLay had replaced Dr. Michael Bisset as representatives from the Healthy Living Network and Children s Service Clinical Lead respectively. to note the information provided. MINUTE OF PREVIOUS MEETING 3. The Committee had before them the Minute of their previous meeting held on 5 th November, to approve the Minute.

2 2 MATTERS ARISING 4. (A) Elmwood House Project With reference to Article 5 of the Minute, the Committee heard Councillor Kiddie seek an assurance that the individual case in terms of a resident living within Elmwood House be progressed. In response Heather Kelman indicated that an update in this regard would be circulated to all members of the Committee. Councillor Kiddie suggested that the Committee consider the preparation of an outstanding business statement which would be populated with resolutions and other pieces of work which require action and that it be circulated on future agendas as a standing item for consideration. (i) that an update in terms of the position of the individual case relating to a resident of Elmwood House be circulated to members of the Committee; and (ii) that the preparation of an outstanding business statement be considered by the CHP Executive Group at its next meeting. (B) Alcohol Strategy Consultation With reference to Article 13 of the Minute, the Committee heard Jennie Biggs provide an update in relation to the Alcohol Strategy consultation events held in the Town House on 15 th January and Woodend Hospital on 16 th January, She indicated that discussions held at the two events would form the response to the consultation. to note the information provided. CHP WORKPLAN 5. (A) Progress on the Development of the Workplan With reference to Article 6 of the Minute of the previous Meeting of 5 th November, 2008, the Committee had before them a report prepared by Heather Kelman, which provided information in relation to the development of the CHP workplan. The report (a) made reference to Heather Kelman s meeting with Philip Cotterill to discuss the content of the workplan and to ensure that it was focussed on key objectives; (b) made reference to the Single Outcome Agreement (SOA), which underpins partnership working and as such, was expected to be fully supported by all public sector agencies and committees such as the CHP; (c) indicated that the SOA was expected to replace former joint plans such as the Joint Health Improvement Plan and Joint Future Partnership Agreement; (d) explained that the aim of the CHP Committee should be to focus its attention on the actions that require joint working across any or all of the partners to achieve the required

3 3 outcome; (e) advised that the SOA was an outcome focused document, which would describe the improvement in health or other relevant factors that is to be achieved, but would not describe the individual or cumulative actions that would be taken to achieve that outcome; (f) indicated that it was the intention to re-write the CHP delivery plan to focus on the action that would be necessary to progress achievements, which would enable the CHP Committee to undertake its functions in relation to performance managing achievement of those outcomes on behalf of the Aberdeen City Alliance; (g) stated that other important joint actions would also be incorporated into the delivery plan as determined by the CHP Committee; (h) made reference to the SOA workshop held on 29 th January, 2009 which clarified the local outcomes, indicators and partners involved; (i) explained that the CHP planning team would develop this by adding relevant information such as the present base line of performance, proposed targets for improvement and timelines which would be ratified by the Aberdeen City Alliance and the agencies involved; and (j) outlined the four risks which were to be managed. The report recommended:- that the Committee (a) accept a verbal update from members who attended the SOA workshop on 29 th January, 2009; (b) approve this as an appropriate way to take forward the development of the delivery plan and therefore focus the attention of the Committee on the key areas for improvement; and (c) agree to the draft delivery plan for 2009/10 being brought to the next meeting. Heather Kelman (1) advised that the CHP Committee would have responsibility for two national outcomes namely, children having the best start in life and people living longer and healthier lives; and (2) explained that the three top prioritising areas were as follows:- to reduce incidents of non-intentional injury at home; addressing inequalities in communities; reducing harm. (i) to approve the recommendations contained in the report and outlined above; and (ii) that a progress report on the development of the delivery plan be submitted to the next meeting for consideration. CHOOSE LIFE 6. With reference to Article 6 of the Minute of Meeting of 25 th April, 2006, the Committee had before them for consideration, a paper prepared by Cliff Watt, Choose Life Co-ordinator, which provided details of the Choose Life 10 year plan to see a 20% overall reduction in suicide rates across Scotland by The paper (a) advised that the Choose Life initiative had proven hugely valuable in increasing public awareness in terms of suicide and enabling individuals to be ready, willing and able to support someone at risk of suicide; (b) indicated that in

4 4 terms of local involvement, the initiative was looking at ways to increase knowledge and understanding about how best to support people who have lost someone to suicide, as well as trying to identify local suicide hotspots and suicide trends; (c) provided information in relation to locally funded projects namely, Aberdeen Foyer s sorted not screwed up project, Penumbra s self harm project, Aberdeen Samaritans outreach and publicity activities, CRUSE Bereavement Care Aberdeen which subsidised counselling training for 12 volunteers and the Schools Project which continues to bring mental health and wellbeing awareness raising programmes to a number of schools and community groups; and (d) outlined a number of other activities, awareness raising events and training initiatives. The Chairperson suggested that an executive summary to include guidance and recommendations for the CHP Committee should be prepared for all future lengthy documents. (i) that a summary of the Choose Life paper be produced and remitted to the Mental Health Services Working Group and the Children and Young People s Strategic Planning Group for consideration; (ii) that the summary paper also be submitted to the Aberdeen Early Years and Childcare Partnership for their consideration; and (iii) to otherwise note the paper. JOINT BUDGETING 7. The Committee had before them for consideration a report prepared by Sandy Reid, Joint Future Programme Development Manager which provided an update in relation to Joint Budgeting and the use of Resource Transfer Funding in Aberdeen. The report (a) advised that some progress had been made in terms of Joint Budgeting, however, through the lack of dedication finance support, it had not been maximised, (b) explained that the purpose of Resource Transfer was to effect a shift of resource from the closure of NHS long-stay institutional care to services in the community commissioned by local authorities, (c) indicated that the main care groups covered were learning disabilities, mental health (old age psychiatry and adult mental health) and care of the elderly, (d) stated that resource transfer was recurring and was subject to an annual inflationary uplift, (e) advised that resource transfer funds were NHS funds and as such, the NHS Grampian Chief Executive remains ultimately accountable for these funds, (f) explained that the Resource Transfer Budget was devolved to the CHP s and in 2008/09 NHS Grampian was scheduled to transfer a total of m to Aberdeen City Council, (g) indicated that to ensure appropriate and effective use, NHS Grampian requires regular monitoring data and budgetary information, (h) stated that Aberdeen City Council was working to ensure that individual projects and services were cost effective and that best value and equity were achieved within and across each client group, and (i) had appended the Aberdeen CHP Statement of Expenditure as of December In furtherance to the report, Sandy Reid advised that Aberdeen City Council invest significant funding on top of the resource transfer from NHS Grampian.

5 5 (i) to note the report and the appended Statement of Expenditure; and (ii) that a report in terms of the purpose of Joint Budgetary outlining the difference joint budgeting would have on service provision be submitted to a future meeting of the Committee. MENTAL HEALTH SERVICES WORKING GROUP - REMIT 8. The Committee had before them by way of a remit from the Mental Health Services Working Group meeting of 2 nd July, 2008, a minute extract relating to four key findings and recommendations from its Plan. The four key issues were remitted to the Committee for consideration as follows:- (1) further development of referrals from GP s to mental health primary care workers (key finding and recommendation 2.3); (2) growing demand for talking therapy, lack of experienced practitioners and a need for a wider range of counselling services across the city (key finding and recommendation 2.10); (3) people with mental health problems who have been sexually abused (key finding and recommendation 2.16); and (4) concerns expressed about the needs of people with personality disorders and the lack of appropriate resources (key finding and recommendation 2.17). The Committee heard Bill Cowling make reference to a paper prepared by Kevin Dawson, which (a) proposed that all four key issues and recommendations be delegated by the CHP Committee to the Aberdeen Mental Health Partnership Group (AMHPG), (b) advised that the Group oversee progress and ensure specific actions through its representatives and links with dedicated project and service development groups are taken forward, (c) indicated that the AMHPG would be asked to provide bi-annual updates to the Joint Future Strategic Management Group, (d) further proposed that under the overview of the AMHPG, that the specific issues were also included in the work plans of the undernoted projects and lead responsibility allocated to agencies and partnerships as follows:- that the Depression Integrated Care pathway Working Group take forward key finding number 1 referred to above; that the Psychological and Psycho-Social Therapies Steering Group take forward key finding number 2 referred to above; that Aberdeen Mental Health Partnership Group take forward key finding number 3 referred to above; that the Personality Disorder Integrated Care Pathway Working Group take forward key finding number 4 referred to above. (i) that the paper prepared by Kevin Dawson and referred to by Bill Cowling above be amended to include timescales for the Groups to conclude the work/actions and that it be circulated to all members of the Committee; and (ii) that updates from the Groups in terms of the progress of the work to be taken forward be submitted to the Committee for information on a bi-annual basis.

6 6 AGENDA ITEMS SUBMITTED BY COMMITTEE MEMBERS 9. The Committee had before it for consideration (a) a letter dated 8 th January, 2009 prepared by Councillor Kiddie requesting that the CHP consider (1) the replacement of low visual aids and (2) the implications for Health in terms of Aberdeen City Council s budget; and (b) a report prepared by Heather Kelman which responded to the letter received from Councillor Kiddie. (A) Low Visual Aids The letter from Councillor Kiddie made reference to a personal situation in terms of obtaining a replacement large magnifier and which suggested that the Committee invite Denis Robertson, Grampian Social for the Blind, to a future meeting to outline a model of good practice in Fife. The letter of response from Heather Kelman advised (a) that NHS Grampian Outpatient Department and Grampian Society for the Blind supply low visual aids such as magnifying glasses but also repair or replace such items, (b) that there were many different types of low visual aids, therefore maintaining a stock of all such items would be costly and would require considerable storage space, (c) that at present items were replaced through ordering from the manufacturer, which may take several weeks, and (d) that within NHS Grampian a new Eye Care Network had been established to take forward the continued development of eye care services and covers all three CHP s, the acute sector and the community based optometry services. The report recommended:- that the Committee remit the issue of the provision and replacement of low visual aids to the Eye Care Network. to approve the recommendation referred to above. (B) Aberdeen City Council Budget Implications for Health The letter from Councillor Kiddie made reference to the Council s budget decisions and concerns with regards to mental health services. The letter of response from Heather Kelman advised (a) that it was difficult to assess the implications for health in advance of the proposed budget 2009/10, (b) that it may be appropriate to discuss how the impact of the new budget on health could be assessed over the forthcoming months, (c) that NHS Grampian along with the rest of the NHS in Scotland also face a period of challenge in relation to the budget, which has not yet been set, but it was clear that greater efficiencies would be required of all budget holders, (d) that it was even more important that both agencies work closely together to ensure the effect of reduced budgets in one agency does not increase the work for the other, as this could have a detrimental affect on the partnership, and (e) that it was also important that the budgets were considered together to ensure that both agencies do not inadvertently make budget cuts in the same area, on the assumption that the partners spend would remain as it was historically.

7 7 The report outlined five key risks which were to be managed. The report recommended:- that the Committee discuss and debate the issues surrounding budget setting and the impact on health and to propose practical solutions by which the risks arising from this could be minimised. During the discussion, a number of issues were raised and noted as follows:- that there was a requirement to develop practical solutions to work together to minimise cuts which may also involve the voluntary sector, social enterprise and community development; that the situation in terms of the Council s Mental Health Services budget had improved slightly; that Aberdeen City Council s commitment was to involve service users, the voluntary sector and Health to take issues forward; and that joint working was the way forward. (i) that members submit to Heather Kelman, any suggestions and innovative solutions to modernise and improve services; and (ii) to note that Heather Kelman would liaise with Liz Taylor and David Rodger in terms of the suggestion to involve social enterprise initiatives. ELECTRONIC PATIENT REFERRAL SYSTEM (EDISON) 10. The Committee had before them for information, a paper which provided details of an electronic patient referral system known as Edison (Electronic Discharges On-line). The paper (a) advised that NHS Grampian and social work organisations in Aberdeen City, Aberdeenshire and Moray Councils had joined forces to counter delayed discharges by introducing an electronic patient referral system, (b) indicated that the Edison system would be rolled out Grampian wide on 9 th March, 2009 which would help both health and community care workers, (c) made reference to the reasons behind the occurrence of delayed discharges, (d) explained that Edison was a website based system originally created by NHS Tayside, but subsequently sponsored by the Scottish Government to be rolled out to all local authorities/nhs partnerships, (e) advised that Edison would be a catalyst that fosters even closer co-operation between health care and social service professionals, (f) stated that it would guarantee the earlier preparation of post-discharge arrangements and the more efficient management of the transition from hospital to discharge destination, and (g) explained that Edison would compliment the NHS Grampian ExtraMed system as well as providing a practical platform for real time inter-service communication. to note the information provided. - MR. BILL HOWATSON, Chairperson.