BIRMINGHAM CITY COUNCIL
HEALTH AND SOCIAL CARE OVERVIEW AND SCRUTINY COMMITTEE
TUESDAY, 19 MARCH 2019 AT 10:00 HOURS IN COMMITTEE ROOMS 3 & 4, COUNCIL HOUSE, VICTORIA SQUARE, BIRMINGHAM, B1 1BB
A G E N D A
1 NOTICE OF RECORDING/WEBCAST
The Chairman to advise/meeting to note that this meeting will be webcast for live or subsequent broadcast via the Council's Internet site (www.civico.net/birmingham) and that members of the press/public may record and take photographs except where there are confidential or exempt items.
2 DECLARATIONS OF INTERESTS
Members are reminded that they must declare all relevant pecuniary and non pecuniary interests arising from any business to be discussed at this meeting. If a disclosable pecuniary interest is declared a Member must not speak or take part in that agenda item. Any declarations will be recorded in the minutes of the meeting.
3 APOLOGIES
4 ACTION NOTES/ISSUES ARISING 3 - 8 To confirm the action notes of the meeting held on 19 February 2019.
5 PUBLIC HEALTH GREEN PAPER - CONSULTATION UPDATE 9 - 58 Dr Justin Varney, Director of Public Health; Elizabeth Griffiths, Senior Public Health Specialty Registrar.
6 SUSTAINABILITY AND TRANSFORMATION PARTNERSHIP OUTCOMES FRAMEWORK
Rachel O'Connor, Director of Planning and Performance, Birmingham and Solihull Clinical Commissioning Group.
Page 1 of 154 7 DAY OPPORTUNITIES - CONSULTATION 59 - 90 Linda Harper, Interim Assistant Director, Community Services, Adult Social Care & Health.
8 ADULT SOCIAL CARE PERFORMANCE SCORECARD MONITORING 91 - 138 Rebecca Bowley, Head of Business Improvement and Support (Adult Social Care); Maria Gavin, Assistant Director, Adult Social Care.
9 CYSTIC FIBROSIS SERVICE 139 - 142 For information.
10 WORK PROGRAMME - MARCH 2019 143 - 154 For discussion.
11 REQUEST(S) FOR CALL IN/COUNCILLOR CALL FOR ACTION/PETITIONS RECEIVED (IF ANY)
To consider any request for call in/councillor call for action/petitions (if received).
12 OTHER URGENT BUSINESS
To consider any items of business by reason of special circumstances (to be specified) that in the opinion of the Chairman are matters of urgency.
13 AUTHORITY TO CHAIRMAN AND OFFICERS
Chairman to move:-
'In an urgent situation between meetings, the Chairman jointly with the relevant Chief Officer has authority to act on behalf of the Committee'.
Page 2 of 154 BIRMINGHAM CITY COUNCIL
HEALTH AND SOCIAL CARE O&S COMMITTEE
1000 hours on 19th February 2019, Committee Rooms 3 & 4 – Actions
Present: Councillor Rob Pocock (Chair) Councillors Nicky Brennan, Peter Fowler, Ziaul Islam, Paul Tilsley and Suzanne Webb.
Also Present: Max Vaughan, Head of Service, Commissioning, Director for Adult Social Care & Health Natalie Slayman-Broom, Umbrella Business Manager Dr Meg Boothby, Clinical Service Lead, Umbrella Michael Walsh, Service Lead - Commissioning, Adult Social Care Directorate Rebecca Bowley, Head of Business Improvement and Support (Adult Social Care) Rose Kiely, Overview & Scrutiny Manager, Scrutiny Office Gail Sadler, Scrutiny Officer, Scrutiny Office
1. NOTICE OF RECORDING
The Chairman advised that this meeting would be webcast for live or subsequent broadcast via the Council’s Internet site (which could be accessed at “www.civico.net/birmingham”) and members of the press/public may record and take photographs. The whole of the meeting would be filmed except where there were confidential or exempt items.
2. APOLOGIES
Apologies were received from Councillors Mick Brown and Chauhdry Rashid.
3. DECLARATIONS OF INTEREST
Members were reminded that they must declare all relevant pecuniary interests and non-pecuniary interests relating to any items of business to be discussed at the meeting. If a pecuniary interest is declared a Member must not speak to take part in that agenda item. Any declarations will be recorded in the action notes of the meeting. No declarations were received.
1 Page 3 of 154 4. ACTION NOTES/ISSUES ARISING
The action notes of the meetings held on 22nd January and 5th February 2019 were agreed. The following matters have arisen since the committee last met: • Action Notes/Issues Arising (22nd January meeting) Item 8 – Update Day Opportunities Strategy Councillor Pocock confirmed that a copy of the NDTi report had now been circulated to members of the committee. However, he expressed his concern that at a previous meeting the committee was assured that there was no such report. He also read out an email dated 9th November that he had received from an officer who stated that …. “As such, NDTi did not submit any formal review report, but undertook a series of sessions giving feedback …” Therefore, a PowerPoint presentation was circulated. Councillor Pocock confirmed that the report was dated July 2018 but at the 18th December 2018 meeting, when officers were questioned if there was a more detailed report available, the committee was told there was not. Councillor Pocock wants on record the concerns the committee has that it was not made fully aware of the existence of the report either inadvertently or otherwise. He confirmed officers of the council work for both the Executive and Scrutiny and if the committee requests a report then the committee has a right to know of it and either to see it or be advised if it is confidential. Councillor Pocock also said that when an officer presents this item again he would stipulate that the incident was not helpful to the effective working of the committee and seek assurance that it would not happen again. In response to a query from Councillor Fowler regarding the interim statement of costs for the Judicial Reviews, Councillor Pocock said that an email had been circulated but would request that as final figures are made known they are shared with the committee. CGL Visit Councillors Fowler and Webb were thanked for attending a site visit to Change, Grow, Live (CGL) who provide a substance misuse service for Birmingham. In response, Councillor Fowler, on behalf of both Councillors, thanked Scrutiny Officers for arranging the visit and staff and service users at CGL for a very informative session. Enablement Call-In Report Councillor Pocock confirmed that he would be attending the next Cabinet meeting on 5th March 2018 to present the Scrutiny report raising the concerns that the committee have made.
2 Page 4 of 154 5. UMBRELLA SEXUAL HEALTH SERVICES – 3 YEAR PROGRESS
Max Vaughan (Head of Service, Commissioning, Directorate for Adult Social Care and Health) along with Natalie Slayman-Broom (Umbrella Business Manager) and Dr Meg Boothby (Clinical Service Lead, Umbrella) presented the report. The Commissioner gave an overview of the service from a commissioning perspective. This was followed by a comprehensive PowerPoint presentation from Natalie Slayman-Broom which explained the service model; the 10 key outcomes required from the service (including 3 national outcomes set by Public Health England); screening rates for sexually transmitted diseases as well as health promotions which had taken place during the year. The following observations were made by Members:- • It was questioned whether the use of dating apps were leading to an increase in contacts with the service and whether advertising on these apps, such as Tinder, had been considered. In response, members were told that dating apps were already been used to promote health. • A comment was also made about the outcome of ‘reducing under-18s conceptions’ and the stigma this may have for young mothers. It was confirmed that the outcome was a national target not a defined BCC outcome. • If HIV testing data was available by District. • The community work being conducted, in particular, the distribution of STI sampling kits for testing in order to try and prevent late diagnosis was commended. • Query regarding the emotional support given following a positive diagnosis for an STI and reach of the service to young people. • The 10% budget cut to the Public Health Grant in Birmingham. • In response to several comments about promotion of the service in schools:- o ‘Loudmouth’, a theatre in education company, run interactive productions. o schools decide which group of pupils has access to the service and the age group of pupils is 13+. o chlamydia testing and provision of condoms does not happen in schools. RESOLVED: • That the PowerPoint presentation is circulated to committee members. • Natalie Slayman-Broom to contact Public Health England to enquire if the geo-map hot spot area data on HIV testing data can be shared with the committee. • Scrutiny Officers will contact Natalie Slayman-Broom to arrange for committee members to visit the Whittall Street Clinic.
3 Page 5 of 154 • The Director of Public Health is invited to attend HOSC to provide an update on how the priorities for Birmingham are met by the Public Health Grant.
6. PERSONAL SOCIAL SERVICES ADULT SOCIAL CARE SURVEY 2017/18
Michael Walsh (Service Lead – Commissioning, Adult Social Care Directorate) and Rebecca Bowley (Head of Business Improvement and Support, Adult Social Care) attended for this item. Mike Walsh gave an overview of the findings of the survey. The key headline was that there was a marked improvement compared to the previous year. A summary of the profile of service users indicates they have higher levels of care compared to the national average. The general improvement in scores indicates that performance is moving in the right direction. The following responses were given to comments made by members:- • It was confirmed that the survey sample size was 3,000 with a target response rate of 1,000. This year the number of responses received was circa 900+. • The survey does not ask for any detail behind negative responses. Subject to data protection, could consideration be given as to how this might be addressed in future (for example through a consent to follow up later) given that the survey is based on a strict national methodology. RESOLVED: • Michael Walsh to confirm that the survey is available in languages other than English. • That the survey data is reproduced:- o Broken down by District. o Key indicator pattern trend over the last 5 years.
7. THE LOCAL ACCOUNT FOR ADULT SOCIAL CARE SERVICES 2017/18
Michael Walsh (Service Lead – Commissioning, Adult Social Care Directorate) introduced the report explaining that the intention of the report was to make performance transparent to citizens and provides a benchmark against national data. The focus is based on the Adult Social Care Outcomes Framework. In summary, there has been an incremental improvement from previous years with service user perception being the strongest area of improvement. The report will be presented to the Citizens Panel to help with the design and format of the document to make it more accessible and user-friendly. The following comments were noted:- • Performance Indicator 2D – Homecare Enablement – was highlighted as the authority currently stands 145 out of 152 local authorities with a performance that is clearly worsening.
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RESOLVED: • That an informal discussion takes place to ascertain what would be a reasonable expectation in relation to the forecast against other authorities of Birmingham’s standing in the 18/19 Local Account for Adult Social Care.
8. CQC LOCAL SYSTEM REVIEW ACTION PLAN – PROGRESS UPDATE
Michael Walsh (Service Lead – Commissioning, Adult Social Care Directorate) presented a report to update the committee on progress made against the Action Plan and monitoring undertaken by the CQC. Members of the committee made the following observations: • Action No. 6B – Enablers IT – 6.3.1 and 6.3.2 had deadline dates amended from December 2018 the target date for completion in March 2019. Confirmation was sought that the new target date would be met as the CQC recommendation states “…this is currently a key barrier to integrated working”. The committee was told that this work is being carried out under the Sustainability and Transformation Partnership Digital work stream. • Action No. 4 – Ongoing Personal Support –The CQC recommendation states “The local authority needs to ensure it continues to fulfil its statutory obligation under the Care Act 2014 and provide assurance there is capacity of good quality services within the social care market” but 4.2.3 refers to a reduction of 70 homecare providers. Members were told that the homecare market was quite robust and, therefore, gives an opportunity to focus on being more selective and only using high quality providers who will be able to provide the capacity required. RESOLVED: • Michael Walsh agreed to contact colleagues to request an update on the Sustainability Transformation Partnership Digital work stream.
9. BIRMINGHAM CITY HEALTH AND WELLBEING BOARD, HEALTHWATCH BIRMINGHAM AND HEALTH SCRUTINY – DRAFT WAYS OF WORKING AGREEMENT
Agreed. RESOLVED: • As no comments/amendments were made by members of the committee that the Ways of Working Agreement be adopted and implemented in the new municipal year. All parties will review the Agreement after a period of 6 months post implementation.
10. PERIOD POVERTY: DRAFT TERMS OF REFERENCE
Agreed subject to the inclusion of rough sleepers also being considered.
5 Page 7 of 154 11. WORK PROGRAMME
To note that the Healthwatch: Hospital Waiting Room Investigation item has been deferred to the April meeting.
12. REQUEST(S) FOR CALL IN/COUNCILLOR CALL FOR ACTION/PETITIONS RECEIVED (IF ANY)
None.
13. OTHER URGENT BUSINESS
None
14. AUTHORITY TO CHAIRMAN AND OFFICERS
RESOLVED:- That in an urgent situation between meetings the Chair, jointly with the relevant Chief Officer, has authority to act on behalf of the Committee. ______The meeting ended at 1209 hours.
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Report to: Birmingham Health and Social Care Overview and Scrutiny Committee
Date: 19 March 2019
TITLE: BIRMINGHAM PUBLIC HEALTH GREEN PAPER – CONSULTATION UPDATE
Presenting Officer Dr Justin Varney, Director of Public Health
Report Type: Information report
1. Purpose: The purpose of this report is to inform the Committee of the public consultation on the Public Health Green Paper. The Public Health Green Paper, Priorities on a Page and consultation questionnaire are attached for the Committee’s information.
2. Recommendations
The Health and Social Care Overview and Scrutiny Committee is asked to note that the Birmingham Public Health Green Paper consultation runs from 18 March 2019- 28 April 2019.
3. Background
The Director of Public Health has launched a public consultation exercise to seek the views of the people of Birmingham, strategic partners and key agencies on the proposed public health priorities for the City, set out in the Public Health Green Paper.
The Green Paper outlines the proposed priorities to improve the health and wellbeing of Birmingham’s population at every stage of life. These priorities have been informed by data and intelligence on the areas of need in our City. The Green Paper sets out the reasons each priority has been chosen and the actions that we and our partners would like to take to address each priority area.
The priorities have been designed to support the shared ambition across the Council and its partners in the NHS, Police, Fire Service, Voluntary and Community Sector to improve the health and wellbeing of local people and support them to achieve their potential in life.
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The four priorities align with the Council vision of Birmingham as an aspirational city to grow up in, an entrepreneurial city to live, work and invest in, a fulfilling city to age well in and a great city to live in. We also recognise in the Green Paper the shared objective that Birmingham citizens gain the maximum benefit from hosting the Commonwealth Games.
The public consultation on the Green Paper runs from the 18 March – 28 April 2019; the ambition of this consultation is to engage citizens, organisations and stakeholders in recognising and responding to the priorities for the health of the City of Birmingham.
The objectives of the Green Paper public consultation are to:
• Achieve a significant scale of constructive engagement responses in the consultation exercise • Use the consultation to strengthen partnership relationships with stakeholders and a positive conversation with citizens • Use the consultation to increase the awareness and understanding of the public health challenges facing the City • Highlight some of the current plans/frameworks and actions in train to address the City’s health and wellbeing challenges • Promote the HealthyBrum brand (used across Birmingham Public Health’s social media) as the single point of trusted evidence based knowledge of the health of the city • Identify engaged and constructive potential partners for the next stage of framework development
The Public Health division are developing a consultation and engagement plan which includes opportunities for presentations at key stakeholder and citizen forums including Ward Forums and ‘World café’ community events. The division is also looking at how to effectively use social media to strengthen the virtual engagement through things like ‘twitter chats’. Alongside the core Green Paper documents the division is creating a suite of infographics and slide sets on individual priorities to provide deeper background and context in accessible formats and exploring the potential to develop Youtube content as well. We would welcome recommendations from the Committee on community engagement events where the division can support further awareness and engagement in the consultation.
The Committee is asked to note the Public Health Green Paper and to encourage its networks to formally respond to the consultation and actively promote engagement.
Page 10 of 154 Birmingham Public Health: Priorities on a Page
• Reducing infant mortality Our vision: Priority 1: • Taking a whole systems approach to childhood obesity Child health To improve and protect • Supporting the mental and physical health of our most vulnerable the health and children wellbeing of Birmingham’s population by reducing inequalities in health and enabling people to • Supporting workplaces to improve their employee wellbeing offer help themselves Priority 2: • Addressing the cumulative impact of unhealthy behaviours such as Working age tobacco control, substance misuse and physical inactivity Our values: adults • Supporting the mental and physical health of our most vulnerable adults • Equity • Prevention • Evidence based practice • Reducing social isolation • Providing system wide information, advice and support to enable Our approach: Priority 3: self-management • Population based Ageing well • Developing community assets • Proportionate universalism • Supporting the mental and physical health of our most vulnerable • Intelligence led older people • Strategic influence • Communication • Joint working
• Health in all policies • Improving air quality
Priority 4: • Increasing the health gains of new developments and transport Healthy schemes environment • Health protection assurance and response including screening, immunisation and communicable diseases Page 11 of 154
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BIRMINGHAM BIRMINGHAM PUBLIC HEALTH GREEN PAPER
Supporting information to inform the development of the Birmingham Public Health Strategy 2019-2023
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Contents
Foreword ...... Error! Bookmark not defined.
1 Our vision ...... 5
2 Our values ...... 5
3 Our Priorities ...... 6
4 What is Public Health? ...... 7
5 How we operate ...... 9
6 What are health inequalities? ...... 133
7 Priority 1: Child health ...... 144
8 Priority 2: Working age adults ...... 178
9 Priority 3: Ageing Well ...... 201
10 Priority 4: Healthy environment ...... 234
11 Maximising the public health gains from hosting the Commonwealth Games ...... 278
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Foreword
I am delighted to present the Birmingham Public Health Green paper.
This document provides supporting information for our public consultation – the responses we receive will inform the development of the Birmingham Public Health Strategy 2019- 2023.
In this Green Paper you will find the proposed vision for Public Health in Birmingham and the areas we are proposing that the Council and partner agencies should focus our efforts and resources.
Our Public Health function can show us what is needed in our community based upon detailed analysis of our population; what we can do to support our community and where evidence tells us we should focus our efforts to achieve better outcomes for the people of Birmingham.
It is important for us to make a statement of our priority areas so that we can give a clear sense of direction, and focus our efforts over the next four years.
In this document we have given you some information on what exactly “Public Health” and a “Public Health approach” means and how we can utilise Public Health specialist knowledge and skills to reduce inequalities in health and wellbeing in our City.
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Page 15 of 154 Birmingham Public Health: Priorities on a Page
• Reducing infant mortality Our vision: Priority 1: • Taking a whole systems approach to childhood obesity To improve and Child health • Supporting the mental and physical health of our most protect the health and vulnerable children wellbeing of Birmingham’s population by reducing inequalities in • Supporting workplaces to improve their employee health and enabling wellbeing offer people to help Priority 2: themselves • Addressing the cumulative impact of unhealthy behaviours such as tobacco control, substance misuse Working age and physical inactivity adults • Supporting the mental and physical health of our most Our values: vulnerable adults • Equity • Prevention • Evidence based • Reducing social isolation practice Priority 3: • Providing system wide information, advice and support to enable self-management Ageing well • Developing community assets Our approach: • Supporting the mental and physical health of our most • Population based vulnerable older people • Proportionate universalism • Intelligence led • Strategic influence • Improving air quality • Communication Priority 4: • Joint working • Increasing the health gains of new developments and • Health in all Healthy transport schemes policies • Health protection assurance and response including Page | 3 environment screening, immunisation and communicable diseases
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Page 17 of 154 Vision and values
1 Our vision
Here in Birmingham Public Health we have set an ambition to improve and protect the health and wellbeing of Birmingham’s population by reducing inequalities in health and enabling people to help themselves.
2 Our values
We are driven by three values: equity, prevention and evidence based practice.
Equity
Equity is about fairness. We recognise that different groups within Birmingham’s population have different needs and may need additional help or support to achieve their full health potential.
Prevention
Focusing energy and resources on preventative interventions means that fewer people will go on to develop specialist health care needs. There are three levels of preventative activities; for each of these there is a different population of interest:
(a) Primary Prevention
Primary prevention means intervening at a population level before disease occurs. Primary prevention is any intervention that may prevent the onset of disease or illness in the future such as legislation and enforcement; immunisation programmes; and education about risky behaviours like poor eating habits, physical inactivity and substance abuse.
(b) Secondary Prevention
Secondary prevention is about reducing the impact of a disease or injury in its early stages. Targeted interventions to manage and/or reduce the risk of a known medical condition progressing or to identify a condition that is not yet symptomatic such as screening, cholesterol lowering medication or workplace adjustments.
(c) Tertiary Prevention
Tertiary prevention refers to the measures taken to manage long-term—often complex— health conditions, for example interventions to improve function, quality of life and life expectancy.
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Evidence based practice
We have a responsibility to make the best use of our resources. Knowing what works ensures that the interventions we provide are clinically and cost effective. By drawing on the evidence-base we are able to make better, quicker, evidence based decisions; this helps us to maintain high standards of service and achieve the best outcomes for people.
3 Our Priorities
This document sets out the proposed Public Health priorities for the next four years. Our priorities have been informed by data and intelligence on the areas of need in our City. Within this Green Paper we have set out the reasons each priority has been chosen, and the actions that we and our partners would like to take to address these priority areas and, in turn, improve the health and wellbeing of Birmingham’s population.
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Public Health approach
“The art and science of preventing disease, prolonging life and promoting health” Acheson
4 What is Public Health?
Public health is about helping people to stay healthy, reducing the risk of getting diseases and injuries and protecting them from threats to their health and wellbeing.
Essentially we can approach public health practice in three ways: protecting health (such as minimising the spread of diseases like TB or measles); improving health (for example education programmes on healthy lifestyles); and by making sure we have the right services in place that are effective, efficient and equitable.
What do Public Health specialists offer?
Public Health is a multi-disciplinary specialist function that offers technical, professional expertise to the Council and NHS partners.
Public Health specialists are regulated by the General Medical Council and UK Public Health Register (UKPHR) and adhere to professional standards set by the Faculty of Public Health. Public Health specialists undergo rigorous post-graduate training which is assessed by professional examinations and competency based appraisal. Once qualified, Public Health professionals undergo an annual revalidation cycle.
We are health professionals and change agents bringing considerable experience, leadership and credibility. Our scientific knowledge takes into account a number of factors including:
• The epidemiology of diseases (how diseases are distributed across the population). • The positive and negative factors that can cause and are associated with health and wellbeing. • The evidence underpinning different ways to prevent poor health and wellbeing. • The root causes of inequalities in health. • The scientific evidence relating to human behaviour. • The clinical evidence relating to the natural history of disease. • The health economic evidence relating to the cost effectiveness of interventions. • The theory behind cultural and organisational change.
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What are Health inequalities
Health inequalities are the unjust differences in people’s health across the population and between specific population groups. Health inequalities are avoidable and are socially determined. We use data and intelligence to highlight where certain groups are disadvantaged in terms of their ability to live longer, healthier lives.
Wider determinants of health
It is important to look at the root causes of health inequalities so that we can start tackling them. There are a wide range of socio-economic, cultural and environmental factors that have an impact on population health. We call these the “wider determinants of health” because these factors influence and determine the general health of the population.
Dahlgren and Whitehead conceptualised these wider determinants as rainbow-like layers of influence (see figure 1).
The rainbow starts with the genetic and demographic characteristics that influence an individual’s health and that are largely fixed. Surrounding this is the individual’s lifestyle factors, for example their behaviours and choices around smoking, exercise and diet. The second layer represents the individual’s interaction with their families, peers and immediate community. The next layer represents the individual’s living and working conditions and their access to goods and services. Finally there is a layer of social, economic, cultural and environmental conditions that prevail in the population.
These wider determinants can have positive, protective and/or negative influence on population health and wellbeing.
Many different interventions and approaches are required to address the root causes of population ill health.
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Fig 1: Wider determinants of health; Dahlgren and Whitehead Rainbow model
Source: Dahlgren/Whitehead: European strategies for tackling social inequities in health – levelling up part 2 (WHO report, PDF) http://www.euro.who.int/__data/assets/pdf_file/0018/103824/E89384.pdf
5 How we operate
Population based
In Public Health instead of addressing the health needs of an individual person—like in other branches of medicine such as in primary and secondary care—we concentrate on the health needs of groups of people. These groups of interest can be categorised in many ways for example by geographical area, age, ethnicity, school, occupation. Taking a population approach allows us to look at health inequalities and relative needs, enabling us to target our resources accordingly.
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Proportionate universalism
Proportionate universalism describes a Public Health approach to service delivery. Traditionally services are either universal (offered to all) or targeted (offered to those in the greatest need according to a specific characteristic or risk factor). Proportionate universalism recognises that “need” is a continuum and that if it is solely those at the greatest level of need that receive help, then those not quite meeting the threshold of greatest need may become more disadvantaged without access to the service. By taking a proportionate universalism approach, services are available to all with a scale and intensity according to the degree of need. This helps to flatten out health inequalities across the population.
Intelligence led
Data and intelligence allow us to monitor and gauge relative levels of need in our population.
We continually analyse national, regional and local statistics from a wide range of routine and specialist data sources to better understand our population, our population’s health needs and the health and care services our population receives.
We produce regular reports on the Birmingham population to ensure that we in Public Health, the wider Council and our partner agencies can target our collective resources according to need.
Strategic input
With our in-depth understanding of population needs, evidence based practice and intelligence led services, we are able to offer strategic input across the Council and our partner agencies.
Communication
Communication is important to us; it enables us to raise awareness of health needs and the impact of health inequalities and helps to increase health literacy and understanding in the communities we serve. We will provide timely, honest and transparent information that is relevant to communities. We will continue to share our skills and expertise to promote a Public Health approach in public services.
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Joint working
The determinants of health are wide reaching. To truly address complex Public Health issues we need to work jointly with our partners. Figure 2 below represents a whole system approach to obesity but similarly applies to other areas of Public Health. It shows the necessity of joint working to address the health inequalities in our area.
Figure 2: Public Health matters; Whole System Approach to obesity
Source: https://publichealthmatters.blog.gov.uk/2015/10/14/designing-a-whole-systems- approach-to-prevent-and-tackle-obesity/
Mandated functions
Like every other local authority Public Health team, there are a number of functions that we must provide. These include sexual health services (testing and treating of sexually transmitted infections, and contraception); weighing and measuring children in Reception and Year 6; NHS Health Checks; health protection (which is delegated to our Proper Officer in Public Health England); public health advice to NHS commissioners; and health visitor reviews of pregnant women and young children.
Central government is currently reviewing the mandated functions of local authority Public Health.
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In addition to our mandated functions, we also have a responsibility to take steps to improve the health of the people who live in our City. This Green Paper sets out the areas we propose focusing on to improve the residents of Birmingham’s health based upon evidenced need. The following chapters set out our proposed priorities.
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Page 25 of 154 Health inequalities
Birmingham is a place where the health and wellbeing of every child, citizen and place matters
6 What are health inequalities?
Health inequalities are the differences in health status or in the distribution of health determinants between different population groups, for example, differences in mortality rates between people from different social classes, or differences in life expectancy in different geographical areas, such as local authority wards. Figure 3 below shows the health inequalities in life expectancy for both males and females in Birmingham; males living in Sutton Four Oaks can expect to live on average ten years longer than those living in Shard End.
Figure 3: Birmingham life expectancy inequalities
In Birmingham we are striving to reduce inequalities in health and wellbeing. As one of our overarching themes we are proposing to reduce inequalities across the Public Health priority areas – reducing the gap between those with the highest and lowest health and wellbeing outcomes and improving the overall rates within our City.
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7 Priority 1: Child health
Infant Mortality
Why is this a priority? What can we influence? What do we want to do What do we want to about it? achieve?
Birmingham has one The majority of infant We want to Reduce the rates of of the highest rates of deaths are due to understand why infant mortality in deaths in infants immaturity-related Birmingham’s infant Birmingham. aged under 1 year in conditions and mortality rates are Reduce the gap in England. congenital anomalies. amongst the worst in infant mortality rates However, there are some the country – we will Infant deaths are across the City. factors increasing the risk be undertaking an in- measured using an of infant death that can depth data analysis. Reducing smoking infant mortality rate be modified such as: rates in pregnancy. (IMR); this is defined We will strengthen as the number of • Smoking in preventative services deaths under the age pregnancy from preconception of one year, per 1,000 through to early years, • Poor maternal live births. It consists of particularly through and infant two components: our Early Help nutrition Partnership (to ensure • the number of • Poor vaccination that our prevention neonatal deaths uptake offer links with social (those occurring care); and through the during the first 28 • Limited access to Local Maternity days of life) antenatal care System. • the number of The Birmingham and infants who die Solihull United between 28 days Maternity Partnership and less than one (BUMP) are rolling out year community perinatal In 2014-16, the rate of mental health support deaths in infants for mothers; and aged under 1 year in creating local Early Birmingham was 7.9 Years hubs bringing per 1,000 (95% together a number of confidence interval health and care 7.1, 8.7); this is services for young compared to a rate families in the of 3.9 per 1,000 in community. England. We want to reduce smoking rates in pregnant women by
trialling a smoking cessation pilot delivered midwife support workers.
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Childhood Obesity
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
The National Child In order to avoid We want to develop a Against the England Measurement future impacts of whole system approach benchmark of Programme (NCMP) excess weight, to tackling childhood increasing rates, the provides us with a addressing the issues obesity building upon target we propose measure of obesity for of family nutrition existing programmes and would be to maintain all children in and physical activity work across different or reduce the gap in reception and in Year are important. agencies to tackle the childhood excess 6. numerous determinants weight between of childhood obesity. Birmingham and Latest figures show us England. that 1 in 4 reception We’ve asked our early children in Birmingham years partnership to We want to reduce are overweight or promote physical activity the gap in childhood obese. and healthy eating in the obesity rates across postnatal period, the City. In 2016/17, 24.7% of particularly for those who Birmingham’s four year are overweight/obese. olds and 40.1% of 11 year olds were We want to increase overweight or clinically uptake of Healthy Start obese compared to Food Vouchers (available 22.6% and 34.2% in to families on income England. benefits).
We know the risk of We will be working with obesity is greatest in fast food takeaways to our most deprived provide a healthier offer communities and more and with supermarkets to importantly, this gap make the healthier has been widening choice the easier choice. over time. This means We will be supporting the that children from low Naturally Birmingham bid income families face a and emerging policy to much higher risk of utilise our green developing obesity environment to improve when compared to physical activity and children from high mental wellbeing. income families.
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Supporting the mental and physical health of our most vulnerable children
Why is this a priority? What can we What do we want to What do we want to influence? do about it? achieve?
There is strong evidence A Birmingham We want to support Health inequalities – linking poverty and Health and early years reducing the gap. socio-economic Wellbeing Board providers to disadvantage with poor Task and Finish promote physical 90% of all babies health outcomes. More group has explored activity and healthy and children receive than 1 in 4 children in opportunities to eating in our universal checks. Birmingham lives in prevent the impact Startwell poverty, significantly of adverse programme. They Increase in number higher than in England childhood will also promote of children ready to as a whole (16.7%). In experiences and good oral hygiene learn at age 2 (as Birmingham 78,805 developed a and early nutritional measured via the children under the age prevention habits to reduce 2/2.5 yrs. of 19 live in a low framework the likelihood of development income family, higher prompting action in dental caries in check) than in any other local all three prevention children. authority in England. domains: Increase the We want to proportion of In addition to poverty increase the uptake Primary prevention: children ready for and socio-economic of Healthy Start improving school at the end of disadvantage, our most Vouchers in families opportunities for Foundation Stage. vulnerable children are on income benefits. healthy living and those who are addressing poverty. We want to build experiencing or have an evidence base experienced: Secondary for a “Daily School • Domestic Violence prevention: Mile”; we will be • Homelessness identifying early supporting a • Neglect signs of randomised • Parents with developmental controlled trial in 40 substance misuse delay and/or Birmingham Primary • Serious Mental Health behaviour Schools to Conditions changes; early understand the • Learning Disabilities identification of impacts. struggling families; Multiple adverse We want to family focussed experiences in childhood understand the specialist services. can result in significant impact of adversity adverse impacts in later in childhood and Tertiary prevention: stages of the life course. ensure that our enquiry into Research shows that early years previous adverse groups of children who providers experiences in have had more of these incorporate this adult and child adverse experiences will across the system. substance misuse suffer from worse health services. and wellbeing.
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8 Priority 2: Working age adults
Supporting workplaces to improve their employee wellbeing offer
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
There is a mounting The West Midlands We will work together We want to achieve a weight of evidence Combined Authority across the Sustainability reduction in staff that investment in (WMCA) has and Transformation absenteeism. employee wellbeing developed a Partnership (STP) to We want to increase can improve the workplace improve the staff staff satisfaction and productivity and cost- commitment and health and wellbeing wellbeing. effectiveness of toolkit to improve offer to support each organisations and employee wellbeing other’s staff. society at large. The in the Region; this We will adopt a benefits extend commitment covers a common engagement beyond the employee wide range of areas standard to promote adding value to such as health and best practice in how organisations by safety, manager we engage with staff increasing productivity training, physical and respond to their and profitability. activity, active travel, wishes and feedback. healthy eating and Organisations which drinking. We will make mental have more favourable health first aid widely indicators of staff available within wellbeing (e.g. in workforce training and relation to bullying, ensure our managers harassment and stress) have the skills to have lower staff support staff with turnover, less agency mental health spend, higher patient problems. satisfaction better attendance and We will work to ensure better outcome that canteens and measures. food available to staff encourage healthy The National Institute choices and cut down for Health and Care on high fat, sugar and Excellence (NICE) salt content, and that estimates that we make available a implementing range of structured interventions to exercise options for promote staff staff. wellbeing could save employers between We will support the £130 and £5,020 per WMCA Thrive at work participating agenda. employee by reducing absence or illness at work.
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Addressing the cumulative impact of unhealthy behaviours such as tobacco control, substance misuse and physical inactivity
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
The top three causes Many Public Health There are a wide Develop skills and of early death in challenges—including range of evidence competencies to Birmingham are preventable diseases, based preventative commission and Coronary heart smoking, and mental interventions to deliver behavioural Disease (CHD), lung ill-health—are more promote behavioural change interventions cancer and alcoholic often behavioural and change towards and programmes liver disease. sociological than healthier lifestyles: underpinned by medical in nature. The behavioural and The risk of getting and • Brief advice on reason behind this is social science theory dying from these physical activity in that they often arise and evidence. conditions can be clinical care (via from behaviours that reduced by stopping Acute Trusts and are underpinned by smoking, reducing Clinical social and structural alcohol intake and Commissioning determinants. increasing physical Groups) activity. In order to effectively • Increase active prevent poor health, travel; develop In Birmingham less than we need an approach active travel plans two thirds (62.4%) of that takes account of • Evidence based adults (aged 19+) the whole person, exercise meet the social context and programmes recommended levels wider aspects such as • Campaigns such as of physical activity education, Start4Life, (150+ moderate employment, social Change4Life and intensity equivalent norms and the built One You minutes per week) and online • Evidence based (2016/17); (England environment. This weight average 66%). would be a management comprehensive services systems approach that In addition, we want draws on multiple to increase the behavioural and social number of behavioural sciences, including change programmes psychology, and interventions that behavioural are underpinned by economics, sociology evidence and share and anthropology. this learning across the system.
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Supporting the mental and physical health of our most vulnerable adults
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
A nationwide mapping We can offer targeted The National Health Health inequalities – exercise undertaken by services, such as Checks programme is reducing the gap. Lankelly Chase looked health checks and a universal offer to over
at individuals affected other preventative 50 year olds without a by Multiple and services to promote diagnosis of a vascular Complex Need – those wellbeing and early condition to assess their individuals experiencing identification of risk of developing the two or more of symptoms for high risk condition in the next 10 homelessness, groups, such as years. We will make substance misuse and people with diabetes, sure that this service is offending behaviour mental illness or targeted towards those simultaneously. learning disabilities. communities at higher risk, for example Birmingham falls in the We can reduce stigma through socio- top 20 local authorities around mental health economic with the highest and improve access disadvantage and incidence of individuals through early mental health. with multiple and intervention services. complex need at two We will be developing
to three times the a Suicide Prevention national average. The Strategy with our estimated totals for partners to help deliver Birmingham and Solihull the West Midlands are: Combined Authority’s “zero suicide” • 6,700 individuals ambition. experiencing two of homelessness, We will be developing offending and an Autism Strategy for substance misuse; Birmingham. • 2,000 individuals experiencing all three of homelessness, offending and substance misuse; and • 1,000 individuals experiencing all three as well as mental health problems.
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9 Priority 3: Ageing Well
Reducing Social Isolation
Why is this a priority? What can we influence? What do we want to What do we want to do about it? achieve?
Birmingham is Carers assessments are Utilise social assets Reducing social performing now undertaken by a including green isolation in adult social significantly worse voluntary organisation space. care service users and than the England leading to improved adult carers. We can ensure that average, core cities outcomes. the process for carers Empowering those and West Midlands Further work could be to access support with health issues to Combined Authority done to have a specific including for social co- produce their own average but is better focus on social isolation. isolation is made social prescription. If than its statistical simple, quick and they play a part in the neighbours on the Commissioners can easy. decision making following indicators: include a reduction in process we hope the social isolation as an Through the use of % of adult social care solution will be more outcome measure for information, advice users who have as sustainable and meet strengthening and guidance we can much social contact other needs such as community assets better signpost citizens as they would like social interaction. through the to local opportunities according to the Neighbourhood for social contact Engage with people Adult Social Care networks. who have social, Users Survey (2016/17) Target those who emotional or practical suffer from social Birmingham: 37.3 needs to help them isolation who may (32.8, 41.8); England: find and design their experience fear of 45.4 own personal crime and are less solutions. Empowering % of adult carers who active. This group individuals and have as much social create a greater connecting them with contact at they would demand for adult others who suffer like according to the social care, mental similar issues should Personal Social health services and assist in achieving Services Carers survey acute healthcare. long term sustainable (2016/17) Create opportunities solutions. Birmingham: 28.3 for connecting people
(23.8, 33.3); England: with similar needs - 35.5 groups can offer simple, practical, local support and opportunities for isolated people to meet others in their local area.
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Proving system wide information, advice and support to enable self- management
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
Providing system wide We can influence the We want to develop a Citizens are able to information, advice quality and comprehensive self-serve. and support is a key accessibility of Information Advice and Reduced levels of requirement of the information and Guidance (IAG) offer need due to being Care Act. advice available. with multiple methods aware of how to of access (online, social Enabling self- access preventative media, paper based, management supports support locally – face to face etc.). preventing, reducing achieved through and delaying We want to develop a better Information dependency and community directory Advice and maximising the and market place for Guidance. resilience and information, advice independence of and guidance. Where citizens; their families citizens are able to and the community. access information on local activities and community groups as well as identify and purchase products and services. We want to provide a single point of contact for people and agencies inside and outside the locality. We want to promote and increase the use of existing services in the voluntary and community sector.
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Developing community assets
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
All communities have Local communities We can make sure that Community members strengths or 'assets' and commissioners mechanisms are in place are recognised as that they can can work together to to enable members of assets and feel valued contribute to recognise these the local community to by commissioners. developing local assets, building an get involved with Local communities health and wellbeing initiative from a identifying skills, and commissioners initiatives. positive basis rather knowledge, networks, work together to than solely focusing relationships and Community assets recognise existing on the problems and facilities within the include not only assets that health and needs of communities, community. buildings and wellbeing initiatives which may risk limiting facilities but also We will make sure that can be built on. the possibilities for people, with their our Joint Strategic Needs change. skills, knowledge, Assessment includes an social networks and assets based assessment relationships. of need. Develop our social prescribing offer with partner agencies including strengthening links to green space. We want to echo the Social Care “three conversations” approach to community assets: 1. Understanding what resources and support help people live independently. 2. Understanding what assets are available to support intensive work in a crisis. 3. Understanding what resources, connections and support enable people to live their chosen life.
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Supporting the mental and physical health of our most vulnerable older adults
Why is this a priority? What can we What do we want to What do we want to influence? do about it? achieve?
There is strong We can offer targeted We will be developing Achieve an evidence linking services, such as a tool to predict the improvement in poverty and socio- health checks and future need for Adult mortality rates of economic other preventative Social Care. people with a mental disadvantage with services, to promote health condition. We want to introduce poor health outcomes. wellbeing and early a holistic approach to identification of managing mental symptoms for high risk and physical health. groups, such as people with diabetes, mental illness or
learning disabilities. We can reduce stigma around mental health and improve access through early intervention services.
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10 Priority 4: Healthy Environment
Improving air quality
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
Children in high We can work with We will work with We want to achieve pollution areas are four schools and partners to develop Air a reduction in poor times more likely to communities to Quality Improvement air quality exposure. have reduced lung understand the impact plans and proposals in function when they of air quality on Birmingham. become an adult. children’s health. We will advocate for The fraction of all-cause We can work with NOx tubes so that we adult mortality partners to enable can monitor air quality attributable to cleaner ways to travel. outside schools. anthropogenic We can champion the We will embed air particulate air pollution development of Green quality into the planning (measured as fine Travel Districts to of the Commonwealth particulate matter, improve air quality, games. PM2.5) is: transport safety and We will work with Birmingham: 6.2% physical exercise. partners across the England: 5.3% We can support Sustainability and flexible or home Transformation working and cycling to Partnership (STP) to work, where practical, improve air quality in our to prevent City. unnecessary journeys We will work in and emissions and to partnership to improve staff supporting the productivity and development of an wellbeing. evidence base around the impact of air quality on health and wellbeing outcomes.
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Increasing the health gains of new developments and transport schemes
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
We have the Planning policies and We have created Health promoting opportunity to create decisions should Birmingham City environments. health promoting consider the social, Council’s Developer’s places to live which economic and Toolkit to influence promote social environmental benefits changes in the built interaction; are of estate regeneration. environment to improve inclusive; safe and health. Access to a network of accessible and high quality open Support the support healthy spaces and development of the lifestyles. opportunities for sport Birmingham Design and physical activity is Panel. important for the Share learning from health and well-being Birmingham Design of communities. Panel with other areas. We should also be We will embed active considering sustainable travel and air quality transport and active into the planning and travel at the earliest delivery of the stages of new Commonwealth games. developments so that opportunities to We will be supporting promote walking, the use of Health cycling and public Impact Assessments in transport use are new developments identified and pursued such as Langley and and that the Peddimore. environmental impacts of traffic and transport infrastructure are minimised. We should be using the Local Authority’s planning powers to help deliver estate regeneration to a high standard. We can encourage Health Impact Assessments for all new developments.
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Health protection assurance and response including screening, immunisation and communicable diseases
Why is this a priority? What can we What do we want to do What do we want to influence? about it? achieve?
National vaccination The Royal College of We will continue to Reduce variation and programmes are Paediatrics and Child monitor vaccination increase uptake in commissioned by NHS Health’s State of Child uptake via our Health vaccination uptake England – these Health report suggests Protection Forum - across the City. include childhood several actions to seeking assurances on vaccinations, annual improve vaccination delivery and holding influenza and the uptake: the relevant Human Papilloma Virus organisations to • Robust data (HPV) programme. account for delivery. collection and These vaccinations are follow up. We recognise that mainly delivered in • Recognise social Practice based General Practice (GP) factors affecting variation in uptake Surgeries in primary vaccine uptake. exists but we want to care and are overseen • Further research be able to understand by Public Health into methods to the barriers to uptake England and NHS improve vaccine across demographic England. uptake amongst groups. In Birmingham families who make population vaccination a conscious coverage is decision not to significantly worse than vaccinate their the England average, child. other large cities and • All child health other West Midlands professionals to areas for shingles, flu, improve and childhood vaccination rates vaccines such as and if necessary to measles, mumps and signpost families to rubella (MMR). register their children with a GP. MMR is a safe and effective combined vaccine; the national target for MMR vaccination coverage in the population is 95%. In Birmingham the average take up is 82.9% however this hides huge variation across GP practices where uptake ranges from 20-100%.
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11 Maximising the public health gains from hosting the Commonwealth Games
Birmingham City Council has set out the vision that Birmingham should be a great city to grow up in, live in and grow old in, recognising health and wellbeing within this.
The Birmingham Commonwealth Games in 2022 gives a unique opportunity to make this vision real and use the games as a catalyst for a long term health legacy. This legacy has the potential to be far reaching including improving mental health and wellbeing, creating healthier environments that encourage physical activity, building skills and community cohesion, and forging new lasting partnerships and ways of working between the organisations responsible for delivering the games.
Public Health and partners are already working in areas that will contribute towards maximising the Public Health gains of hosting the Commonwealth Games, for example reconnecting communities with their environment and building in air quality and active travel into operational requirements for the Games.
We will seek opportunities for promoting the sustainability of the Games through better decision making and to reduce the impact on the environment in the long term.
The design of residential flats and houses in the Athlete’s village and the transport schemes to move people around during the Games will have a long term impact on health. There is the opportunity for these developments to connect to the legacy of the Games, and as the schemes progress there will be many opportunities to show how they can be developed to best impact on health.
The Local Authority and partner agencies will minimise risks to population health by making sure there is an appropriate health protection response to communicable diseases and by improving accessibility of health services during the Games.
Construction of facilities can increase noise and air pollution as well as increase traffic injury risk or other occupational injuries. Some of these are managed by the construction companies but local communities can also be involved to work out the best ways to mitigate risks.
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Birmingham Public Health
www.birmingham.gov.uk/publichealth
@HealthyBrum
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Birmingham Public Health Green Paper
To inform the development of the Birmingham Public Health Strategy 2019-2023
Public consultation: 18 March 2019 – 28 April 2019
Consultation Questionnaire
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Questions we are asking about the Birmingham Public Health Green Paper
We are asking the people of Birmingham, strategic partners, and key agencies (including current service providers) to let us know your views on the public health priorities for the city set out in the Birmingham Public Health Green Paper.
This Green Paper sets out the proposed Public Health priorities for the next four years. Our priorities have been informed by data and intelligence on the areas of need in our City.
Within the Green Paper we have set out the reasons each priority has been chosen, and the actions that we and our partners would like to take to address these priority areas and, in turn, improve the health and wellbeing of Birmingham’s population at every stage of life.
The priorities have been designed to support the shared ambition across the Council and its partners in the NHS, Police, Fire Service, Voluntary and Community Sector to improve the health and wellbeing of local people and support them to achieve their potential in life.
The four priorities align with the Council vision of Birmingham as an aspirational city to grow up in, an entrepreneurial city to live, work and invest in, a fulfilling city to age well in and a great city to live in. We also recognise in the Green Paper the shared objective that Birmingham citizens gain the maximum benefit from hosting the Commonwealth Games.
We want to hear from you to help us reflect on whether these are the right priorities and to help shape our thinking as we look to develop a framework for action for the future.
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Section One: The Vision
Please see Section 1 of the Public Health Green Paper
1. Our vision is to improve and protect the health and wellbeing of Birmingham’s population by reducing inequalities in health and enabling people to help themselves.
This is driven by three values: equity, prevention and evidence based practice. a. To what extent do you agree or disagree with the vision and core values that we have set out for Public Health in Birmingham?
(Please tick one box only)
Strongly agree Agree Don’t know Disagree Strongly disagree
b. If you disagree, please explain why and let us know how you think this could be improved.
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Section Two: The Four Priority Areas
Please see page 3 of the Public Health Green Paper
2. We have structured our priorities into four priority areas, three life stages from birth to death, and a fourth that reflects the important role of the environment around us on our health. These priority areas are:
• Child health
• Working age adults
• Ageing well
• Healthy environment a. To what extent do you agree or disagree that the proposed priority areas are the right ones to deliver our vision?
(Please tick one box only)
Strongly agree Agree Don’t know Disagree Strongly disagree
b. If you disagree, please explain why and let us know how you think these could be improved.
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Section Three: Overarching Themes
Please see Sections 6 and 11 of the Public Health Green Paper
3. We propose that as well as our four priority areas, there are two overarching themes that should be considered across our work, these are:
• Addressing health inequalities because every child, citizen and place matters
• Maximising the public health gains from hosting the Commonwealth Games a. To what extent do you agree or disagree that the overarching themes should be considered across our work?
(Please tick one box only)
Strongly agree Agree Don’t know Disagree Strongly disagree
b. If you disagree, please explain why and let us know how you think these could be improved.
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Section Four: Improving Children and Young People’s Health and Wellbeing
Please see Section 7 of the Public Health Green Paper
4. In order to improve child health in Birmingham, we propose focusing on the following three priorities: • Reducing infant mortality
• Taking a whole systems approach to childhood obesity
• Supporting the mental and physical health of our most vulnerable children a. To what extent do you agree or disagree that the proposed priorities are the right ones to achieve success in this area?
(Please tick one box only)
Strongly agree Agree Don’t know Disagree Strongly disagree
b. If you disagree, please explain why and let us know how you think these could be improved.
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Section Five: Improving Adult Health and Wellbeing
Please see Section 8 of the Public Health Green Paper
5. In order to improve the health of working age adults in Birmingham, we propose focusing on the following three priorities: • Supporting workplaces to improve their employee wellbeing offer
• Addressing the cumulative impact of unhealthy behaviours such as tobacco control, substance misuse and physical inactivity
• Supporting the mental and physical health of our most vulnerable adults a. To what extent do you agree or disagree that the proposed priorities are the right ones to achieve success in this area?
(Please tick one box only)
Strongly agree Agree Don’t know Disagree Strongly disagree
b. If you disagree, please explain why and let us know how you think these could be improved.
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Section Six: Improving the Health and Wellbeing of Older Adults
Please see Section 9 of the Public Health Green Paper
6. In order to promote ageing well in Birmingham, we propose focusing on the following four priorities:
• Reducing social isolation
• Providing system wide information, advice and support to enable self- management
• Developing community assets
• Supporting the mental and physical health of our most vulnerable older people a. To what extent do you agree or disagree that the proposed priorities are the right ones to achieve success in this area?
(Please tick one box only)
Strongly agree Agree Don’t know Disagree Strongly disagree
b. If you disagree, please explain why and let us know how you think these could be improved.
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Section Seven: Creating Environments That Improve Health and Wellbeing
Please see Section 10 of the Public Health Green Paper
7. In order to enable a healthy environment in Birmingham, we propose focusing on the following three priorities:
• Improving air quality
• Increasing the health gains of new developments and transport schemes
• Health protection assurance and response including screening, immunisation and communicable diseases a. To what extent do you agree or disagree that the proposed priorities are the right ones to achieve success in this area?
(Please tick one box only)
Strongly agree Agree Don’t know Disagree Strongly disagree
b. If you disagree, please explain why and let us know how you think these could be improved.
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Section Eight: Any Other Comments
8. Are there any other comments you would like to make about the proposed priorities and the content of the Green Paper?
If you have comments on a specific section of the document, please note the section along with your response.
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About You
We would like you to tell us some things about you.
You do not have to tell us if you do not want to, but if you do, it will help us understand if we have failed to engage with specific parts of the community.
Data Protection Act 1998
The personal information on this form will be kept safe and is protected by law.
You can see more information about data protection on our website at:
www.birmingham.gov.uk/privacy
9. Are you submitting this response on behalf of yourself or on behalf of an organisation?
Please tick one box only
On my own behalf
On behalf of an organisation
If on behalf of an organisation, please can you tell us which organisation the response is: ……………………………………………………………………………………………………………………………..
10. Are you?
Please tick one box that best describes your interest in the consultation:
A member of the general public
Health or Care professional
Public health specialist
An academic
Other (please state)…………………………………………………………………………………………………
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11. Do you live, work, study or socialise in Birmingham? (tick all that apply)
Live
Work
Study
Socialise
None of the above
12. Please can you tell us the first section of the postcode of your home address? E.g. B1, B26, B5, B16, B64)
......
13. Which age group applies to you? (Please tick one box only)
Under 16 40 – 44 70 – 74
16 - 19 45 – 49 75 - 79
20 – 24 50 – 54 80 – 84
25 – 29 55 – 59 85+
30 – 34 60 – 64 Prefer not to say
35 – 39 65 – 69
14. What best describes your gender? (Please tick one box only)
Male
Female
Other
Prefer not to say
15. Do you have any physical or mental health conditions or illnesses lasting, or expected to last, for 12 months or more? (Please tick one box only)
Yes
No
Prefer not to say
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16. If yes, do any of these conditions or illnesses affect you in any of the following areas? (Please tick all that apply)
Vision (e.g. blindness or partial sight)
Hearing (e.g. deafness or partial hearing)
Mobility (e.g. walking short distances or climbing stairs) Dexterity (e.g. lifting and carrying objects, using a keyboard)
Learning or understanding or concentrating
Memory
Mental Health
Stamina or breathing or fatigue
Socially or behaviourally (e.g. associated with
Autism, attention deficit disorder or Asperger’s Syndrome)
Other (please state)………………………………………………………………………………………………..
17. What is your ethnic group? (Please tick one box only)
White
English/ Welsh/ Scottish/ Northern Irish/ British
Irish
Gypsy or Irish Traveller
Polish
Baltic States
Jewish
Other white European (including mixed European)
Any other White background (please state)……………………………
Mixed/ multiple ethnic groups
White and Black Caribbean/African
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White and Asian
Any other Mixed background (please state)………………………………………………………………
Asian/ Asian British
Afghani
Bangladeshi
British Asian
Chinese
Filipino
Indian Sikh
Indian Other
Kashmiri
Pakistani
Sri Lankan
Vietnamese
Any other Asian background (please state)…………………………………………………………………
Black African/ Caribbean/ Black British
African
Black British
Caribbean
Somali
Any other Black/African/Caribbean background (please state)…………………………………
Other ethnic group
Arab
Iranian
Kurdish
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Yemeni
Any other ethnic group (please state)………………………………………………………………………..
Prefer not to say
18. What is your sexual orientation (Please tick one box only)
Bisexual Gay
Lesbian Heterosexual or Straight
Other
(please state)…………………………………………………………………………………………
Prefer not to say
19. What is your religion or belief? (Please tick one box only)
No religion
Christian (including Church of England, Catholic, Protestant and all other Christian denominations)
Buddhist
Hindu
Jewish
Muslim
Sikh
Any other religion (please state)………………………………………………………………………………
Prefer not to say
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Please return this questionnaire to the FREE postal address below – you do not need to use a stamp.
If you have any further comments or views on the Public Health Green Paper, please contact:
Website: www.birminghambeheard.org.uk
Twitter: @healthybrum
Email:
Write to:
Please note that you do not need to use a stamp.
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To: Health & Social Care Overview & Scrutiny Committee From: Linda Harper – Interim Assistant Director, Community Services, Adult Social Care Subject: Day Opportunities- Consultation
Document To brief Scrutiny Committee on the proposed planning, approach and Purpose: timescales for the Day Opportunities consultation
Date: 19th March 2019
1. Context Birmingham City Council (BCC) has a duty to consult on its draft Day Opportunities Strategy and draft Day Service Model which is aligned to the Adult Social Care Strategy and Vision approved by the Council in 2017. Whilst the draft Day Opportunities Strategy was previously considered by Cabinet on the 31st of July 2018, the decision to approve was quashed following a legal challenge. Subsequently, lessons have been learned in relation to how the Council engages and consults with citizens and as such, this consultation process and approach will be robust, meaningful, in line with good practice and reflective of legal duties. 1.1 Best Value Duty to Consult The Council is under a statutory general Best Value Duty to consult when reviewing its service provision and polices as laid out in the Local Government Act 1999 and the more recent Best Value Statutory Guidance 2011. The guidance states that: ‘to achieve the right balance – and before deciding how to fulfil their Best Value Duty – authorities are under a Duty to Consult representatives of a wide range of local persons; this is not optional. Authorities must consult representatives of council tax payers, those who use or are likely to use services provided by the authority, and those appearing to the authority to have an interest in any area within which the authority carries out functions. Authorities should include local voluntary and community organisations and small businesses in such consultation. This should apply at all stages of the commissioning cycle, including when considering the decommissioning of services…’ The draft Day Opportunities Strategy was considered by Cabinet on 31st July 2018 and will be consulted on prior to being formally adopted. The draft Strategy, attached as Appendix 1 to this Report, sets out high level proposals to re-design and modernise the service to ensure that the Council is in a strong position to deliver good quality and meaningful day opportunities that promote independence and recovery, reduce isolation and loneliness and promote employment and volunteering now and in the future. It is important to note that the draft Strategy will be reviewed by a group of champion citizens and carers in relation to its format and accessibility following internal consideration by the Council and prior to its release at the beginning of the consultation. A draft Day Service model has been developed in line with the Adults Social Care Vision and overall Adult Social Care Strategy. The proposed draft model sets out how the Council might seek to develop, commission and provide day services in the future. The consultation will seek to engage and formally consult Birmingham Citizens and stakeholders on the proposed draft Service Model for both internally provided and externally commissioned day opportunities services, ensuring that outcomes for citizens remain at the heart of what we do. In summary, the consultation will focus on:- Page 59 of 154 The draft Day Opportunities Strategy The draft Day Opportunities Model outlined in the draft Day Opportunities Strategy
2. Consultation Legal Principles The Council has learned a number of lessons in the way it engages and consults its citizens. In order to run a successful consultation, legal consultation principles will be followed to ensure that the council meets its obligations, and that the consultation is lawful and meaningful. . Consultation must be at a place when proposals are still at a formative stage - the draft Day Opportunities Strategy has previously been considered, however, this has now been refreshed to take into account legal advice to ensure that there is no assumption or predetermination of it being adopted or implemented. The draft Day Service Model is in its formative stage. Its focus is to promote independence, health and well -being which is consistent with the fundamental principles of the approved Adult Social Care Strategy . The proposer must give sufficient reasons for its proposals to allow consultees to understand them and respond to them properly – at every stage of planning the proposed consultation approach, legal advice has been sought to ensure that the reasons for the proposals are understood by the reader to enable them to respond in a meaningful way. The aim is to test the draft documents with a select group of citizen champions to ensure the language used is clear and easy to understand . Give sufficient time for responses to be made and considered – the consultation will run for a period of 90 days. This will give sufficient time for people to respond in a meaningful way. Prior to the start of the formal consultation, dates and venues will be publicised through our corporate communications teams. For citizens that currently use day centres, a letter will be sent to them in advance to ensure they are fully aware of the pending consultation activities which will be followed up by a reminder at their local day centre . Responses must be conscientiously taken into account – following consultation, a report of the consultation results will be developed. In addition, a paper will be presented to Cabinet summarising the consultation results, what consultees have said and recommendations made. Cabinet will have the full information to enable them to make a decision.
3. Consultation Planning To ensure a robust consultation process, the following has been put in place:
. A weekly officer Consultation Working Group has been set up chaired by the interim Assistant Director, Community Services, adult Social Care. The group has representations from Legal, HR, Finance, Day Service and Corporate Communications. The group will oversee consultation activities and advise on how to progress different specialist elements as reflected by the membership. There is also a sub group that is focussing on the development of the materials and planning for the logistics of the consultation meetings. . Appointment of a Consultation Lead to ensure robust planning, tracking and recording of all consultation meetings and activities. The role will also have responsibility for liaising with Legal Services to ensure consultation is meaningful and adheres to the Councils legal duties Page 60 of 154 . The commissioning of legal counsel to provide external challenge in relation to the consultation
The focus has been to ensure that the consultation is meaningful and legal and that consultation documentation and background information is accessible and inclusive.
4. Consultation Methods It is proposed to use a number of different ways to consult and engage with stakeholders. A stakeholder analysis has been conducted to ensure that messages and consultation methods are tailored to them. Below is how some of the key stakeholders will be engaged and consulted. A total of 24 consultation meetings are being planned for: . 10 consultation meetings at internal day centres . 10 consultation meetings in each of the social work constituencies . 4 meetings for providers of day opportunities across the city . In relation to the Voluntary and Community Sector dedicated meetings will be scheduled to ensure that the breadth of representation and feedback is captured to inform the outcomes of the consultation in a meaningful way . In relation to partners such as Health, existing joint meetings will be identified to ensure they have an opportunity to contribute to the consultation in a meaningful way, this will include the SEND Improvement Board which will specifically focus on the future facing views from young people preparing for adulthood
Who How Service users and carers including . A letter will be sent containing information about families – BCC operated day the up and coming consultation, including dates centres and venues and how to get involved. This will include consultation meetings that will take place in the internal day centres . Consultation meetings led by Assistant Director, Community Services, Adult Social Care will be held across 10 day centres to ensure service users and carers have their say. Service users and carers including . Commissioning will work with externally families – external day centres commissioned providers to ensure that feedback is sought from those using external day centres. Where providers are able to conduct meetings, officers of the council will support the meetings to ensure consultation is meaningful, consistent and legal. . A letter will be sent (through the provider) to those service users receiving social care support, informing them of the up and coming consultation and how to get involved. Day Centre Staff . The Assistant Director and Head of Service will hold meetings with internal day centre staff to brief them on the consultation proposals and how they can support service users during the process. Page 61 of 154 Who How Please note that there are no implications for staff in this consultation. Staff will also be encouraged to contribute to the consultation in their own right as citizens of Birmingham Scrutiny Committee . Scrutiny Committee Chairman briefing to agree approach on how to engage with Scrutiny Committee Members . The Scrutiny Committee will be briefed on the proposed plans for consultation. . A consultation meeting has also been planned to enable members to provide feedback on proposals. . Post consultation, a summary of the results will be presented at a later date. Trade Unions . Prior to engaging with staff, Unions will be briefed using existing scheduled meetings on how staff will be expected to support service users and carers during consultation meetings within the day centres Cabinet . Through regular Cabinet Member briefings before, during and after the consultation. Citizens . Consultation meeting dates and venue will be publicised through corporate communication using the most appropriate and inclusive communication channels. . The plan is to hold 10 consultation meetings led by Assistant Director, Community Services, Adult Social Care, in each of the social work constituencies External Day Centre providers . A letter will be sent to providers to inform them of the upcoming consultation. The plan is to told 4 meetings across the city aimed at providers to ensure they understand the council’s proposals and enable them to support consultation meetings in their relevant centres Partners including NHS . Partners will be engaged through their existing meetings. It is envisaged that dedicated officers will attend meetings such as multi agency boards to brief them on the consultation. Councillors . A briefing note to all Councillors to be sent by Cabinet Member on the consultation approach and dates. Councillors would be encouraged to get involved. . The Cabinet Member to write to all Councillors before the start of the consultation to invite them to Page 62 of 154 Who How get involved particularly at a local level and how they can feedback on the proposals. Cross Party Members Consultation . The Cabinet Member is keen to involve members Working Group from all parties. A cross party working group is to be established to feed into the consultation process Group Opposition Leaders . The Cabinet Member is keen to involve Group Leaders – a monthly consultation briefing will take place with Group Leaders Executive Leadership Team (ELT) . The Cabinet will be engaged with the process to ensure they are involved prior to Cabinet decision in the autumn
The proposed consultation programme of scheduled meetings is attached as Appendix 2 to this report. It is important to note that the programme of consultation meetings outlined are those that focus on citizens and people who use the services and is subsequently not exhaustive and does not reflect the full programme of activities in relation to wider stakeholder groups. The whole programme will be reflected in the post consultation analysis.
3. Consultation planning timelines & Next Steps It is recommended to carry out a three month consultation starting from 8th April 2019. This will allow for robust planning and execution as outlined above.
What When Consultation Officer Working Group set up (in place) January 2019 Consultation & Engagement Lead appointment (offered & January 2019 accepted) Detailed consultation planning and development of January – March 2019 consultation documentation and background information Cabinet Member Briefing February 2019 Pre Consultation activities including Adult Social Care February – March 2019 Management Meeting, CMT, Scrutiny Committee Set up Cross Party Members Working Group March – August 2019 Set up Opposition Group Leaders Briefings March – August 2019 Set up EMT briefings March – August 2019 Consultation Launch – Draft Day Opportunities Strategy and Mon 8/4/19 – Sat 6/7/19 (90 days) draft Day Service Model Cabinet Member Briefing – consultation results July 2019 Scrutiny Briefing – consultation results TBC Slippage/contingency time for delayed consultation closure Sun 7/7/19 – Sat 27/7/19 (3 weeks) Cabinet Support deadline for draft report Mid-August for October Cabinet (date to be confirmed by Cabinet Support) Report to Cabinet for approval October 2019 – date to be confirmed Page 63 of 154 A Meeting/Event Date (2019) Time Audience Internal Day Centre Events Fairways Day Centre Consultation Event Wednesday 10th April 13.30‐14.45 Day Centre service users & Carers Beeches Goldd Consultation Event Wednesday 17th April 13.30‐14.45 Day Centre service users & Carers Elwood Day Centre Consultation Event Tuesday 23rd April 10.30‐12.15 Day Centre service users & Carers Moseley Day Centre Consultation Event Tuesday 30th April 10.30‐12.15 Day Centre service users & Carers Moseley Day Centre Consultation Event Tuesday 30th April 13.30‐14.45 Day Centre service users & Carers Heartlands Resource Centre Consultation Event Wednesday 8th May 13.30‐14.45 Day Centre service users & Carers Ebrook Day Centre Session to be held at Elwood. Consultation Event Thursday 9th May 10.30‐12.15 Day Centre service users & Carers Harborne Day Centre Consultation Event Wednesday 15th May 13.30‐14.45 Day Centre service users & Carers Hockley Day Centre Consultation Event Thursday 23rd May 10.30‐12.15 Day Centre service users & Carers Hockley Day Centre Consultation Event Thursday 23rd May 13.30‐14.45 Day Centre service users & Carers Alderman Bowen Day Centre Consultation Event Tuesday 28th May 10.30‐12.15 Day Centre service users & Carers Alderman Bowen Day Centre Consultation Event Tuesday 28th May 13.30‐14.45 Day Centre service users & Carers Provider Events Hollyfield Centre Club Consultation Event Tuesday 9th April 10.00‐13.00 Day Service Providers Hollyfield Centre Club Consultation Event Tuesday 16th April 10.00‐13.00 Day Service Providers Highbury Hall Consultation Event Thursday 11th April 10.00‐13.00 Day Service Providers Highbury Hall Consultation Event Thursday 18th April 10.00‐13.00 Day Service Providers Public Events Quinborne /Edgbaston Consultation Event Wednesday 24th April 14.00‐16.00 Public H Suite Consultation Event Thursday 2nd May 10.30‐12.30 People for Public Service Citizen Group Mere Green Community Centre & Library /Sutton Coldfield Consultation Event Tuesday 7th May 10.00‐12.00 Public
St Barnabas Church Centre / Erdington Consultation Event Tuesday 7th May 18.00‐20.00 Public Signing Tree / Ladywood Consultation Event Tuesday 14th May 10.00‐12.00 Public Norton Hall /Hodge Hill Consultation Event Tuesday 21st May 10.00‐12.00 Public Stirchley Baths Consultation Event Wednesday 29th May 10.00‐12.00 Public Kings Heath Community Centre Hall Green Consultation Event Tuesday 4th June 14.00‐16.00 Public Alexander Stadium /Perry Barr Consultation Event Wednesday 12th June 14.00‐16.00 Public TBC Factory / Northfield Consultation Event TBC Public
Page 64 of 154 Carer Groups (Requested) Forward Carers Consultation Event TBC TBC Forward Carers Black Carers Group Consultation Event Friday 3rd May 10.00‐12.00 Black Carers Group Scrutiny Consultation Meeting Meeting Scrutiny Update 19‐Mar 10 Scrutiny Committee
APPENDIX 2
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Adult Social Care Draft Day Opportunities Strategy 2019 to 2022
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Contents
Executive Summary..……………………………………….………………….3
Introduction ………………………………………………………………….…….4
Strategic Context…….…………………………………………….……………5
Key Facts and Figures ………………………………………………………….8
An Overview of Current Provision in Birmingham..…………..13
Work Done to Inform Draft Strategy Development.…………15
Financial Overview………………………………………………………….18
Proposed New Ways of Working ………………………………………19
Proposed New Model of Day Opportunities ………………….…21
Glossary of Terms ……………………………………………..……….……..23
Appendices:
Appendix 1 ….. Full report National Development Team for Inclusion Review Appendix 2 ….. Co‐production stage 1 ‘Having a Good Day’ Appendix 3 …... Co‐production stage 2 Appendix 4……..Community Assets Report
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In summary, the key aspirations of this proposed new strategy are to: Executive Summary Focus on the individual, their strengths, choices, assets, and goals through person centred planning.
Day Opportunities benefit approximately 1600 citizens with a wide Focus on the outcomes that service users and carers wish to range of support needs including older people, people with learning achieve. disabilities, autism, physical disability, and people with mental ill health across the city. Current services are delivered directly by the Council as Provide support that enables the person to access a range of well as by approximately 60 independent organisations. Over the years opportunities in the wider and their own community as an active day opportunities provision has seen little investment and development and equal citizen. and has predominantly been building based offering relatively limited Focus on skills development, improving independence in daily choice and control for those that attend. living ie travel training and employment where possible.
The council recognizes that people value day opportunities. This draft Maximise the opportunity to use budgets or direct payments to Strategy aims to provide a clear set of design principles and actions to access support or activities of the citizens choice. support further development of day opportunities in Birmingham to ensure there is enough and accessible provision for those that need it. It Make the most of a vibrant and developing city, ensuring access is recognised that the city of Birmingham has a considerable way to go to the wide range of opportunities Birmingham has to offer. to close the gap between the current service offer and the proposed vision of the future, and through this draft strategy it is proposed to Make the most of a vibrant and developing city, ensuring access address that gap through a set of actions. to the wide range of opportunities Birmingham offers.
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Introduction
Day opportunities are services that help people to have a fulfilling life: and get involved in activities to maintain health and wellbeing being they provide the opportunity to take part in various interests and based in the wider community should be available. activities, make friends, develop relationships, gain new skills and enable people to make a positive contribution to the community. Day opportunities also provide support to carers by means of creating a respite so that they can pursue own interests outside of their caring role. There are day opportunities available for older people, people with learning disabilities, autism, physical disability, and for people with mental ill health.
The goals that Birmingham Council are seeking to achieve for adults and older people are that they should be resilient, living independently whenever possible and exercising choice and control so that they can live good quality lives and enjoy good health and wellbeing.
Key to the draft Strategy is the need to address some of the barriers which some adults particularly with learning disabilities face in participating fully in communities. The aim is to ensure a range of high quality services are available for all to access.
In addition to building based day opportunities, there is a need to incrementally shift away from, what are regarded as, traditional day care services and to offer people a wider choice of day options based within the community. This proposed Strategy, therefore, seeks to shape the range, type and quality of activities needed in order to effectively meet the current and future needs of the local population.
Our vision for day opportunities is that people should be able to access resources within their local communities. Wherever possible, short term focused support that enables people to find friendship groups
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The review identified that progress had been made with services Strategic Context moving away from large segregated day opportunity services into smaller integrated community based provision; but very few people There are a number of factors at both a national and local level which with a learning disability had moved into paid employment. Trough have influenced and prompted the need to review the day this draft strategy Birmingham CC proposes to move towards that opportunities model in Birmingham. This draft Strategy seeks to direction. ensure that Birmingham is compliant with key Social Care legislation as well as significant national policy. Care Act 2014
National Priorities The Care Act 2014, which came into effect from 1st April 2015, Having a Good Day Having a Good Day? 2007 (SCIE) the Social Care represents the most significant reform of care and support in more Institute for Excellence (SCIE) published a ‘knowledge review’ of than 60 years, putting people and their carers in control of their care community based day activities which remains very applicable today and support. The Act is particularly pertinent to how day opportunity The review of policy and practice highlighted: work, education, provision is commissioned. training and volunteering; participating in leisure, arts, hobbies and Importantly the Care Act changes many aspects of how support is socialising; as essential elements of successful day opportunity arranged, and aims to give greater control and influence to those in services. It goes on to say irrespective of the support people need need of support. This includes:‐ activities need to have a purpose, be undertaken in ordinary places; do things members of the wider community would do and ensure A change to the way in which local authorities complete friendships, connections, and a sense of belonging develop in the assessments with those in need of support ‐ people in need of process. support will be encouraged to think about what outcomes they want to achieve in their lives ‐ these outcomes can be anything, The review also identified a range of barriers that stopped people big or small, which will enable them to feel a greater sense of achieving these outcomes and identified the following key conditions physical or emotional well‐being. This applies to day opportunities for change to support real improvements: and the realisation of the ‘have a good day model’. partnership with people and their families New rights for carers which put them on the same footing as the leadership people they care for. All carers are entitled to an assessment. If a cultural change carer is eligible for support for particular needs, they have a legal person centred planning with and for people right to receive support for those needs, just like the people they individualised funding and direct payments care for ‘smart’ commissioning A greater emphasis on protecting the most vulnerable people in our society from abuse and neglect staff development A greater emphasis on prevention ‐ local authorities and other community capacity building providers of support will encourage and assist people to lead good information healthy lives which will reduce the chances of them needing more diversion and move on support in the future
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A greater emphasis on local authorities providing clear information Prevention and Early Intervention and advice which will help the public to make informed choices on People need to be able to access prevention and early intervention their support arrangements, and enable them to stay in control of services quickly and at any time in their lives. Day opportunities and their lives personal support would help people to maximise independence A greater emphasis on existing Personal Budgets which give through focused activities that promote health and wellbeing. Timely people the power to spend allocated money on tailored care that access to day opportunities would mean support is readily available to suits their individual needs as part of their support plan prevent crisis.
Valuing Employment Now 2009 (DOH) Personalised Support This set out the clear value that all people with learning disabilities, Birmingham City Council acknowledges that the approach that works like all other people, can and should have the chance to work. A goal most effectively always puts users and carers at the centre and builds was set to radically increase the number of people with moderate and support round them rather than fitting people into rigid services. severe learning disabilities in employment by 2025. The document Direct Payments are the preferred option for delivering support describes a definition of work, “…by ‘work’, we mean real jobs in the because they maximise the opportunity for people to exercise choice open labour market that are paid the prevailing wage, or self‐ and control. employment. We do not mean volunteering or work experience, unless this is part of a genuine pathway to real work. This is about Use of resources doing a good job that the employer and the employee value.” Resources need to be used effectively for the benefit of individuals Whilst the Council is in the process of reviewing and developing the using day opportunity provision. Every pound that Birmingham spends employment offer as a whole, the draft Day Opportunities Strategy on care must represent a pound well spent. Day opportunity provision would consider how to compliment and support the opportunities that which offers equitable coverage across the City and is developed to working age adults with learning disability and mental health issues meet the needs of the many different client groups is what the draft have to prepare for and access employment. strategy aims to achieve.
Community Assets Local Priorities The draft strategy proposes that individuals should be integrated into their communities and be able to access a wide range of community Consistent with the Birmingham Adult Social Care Vision and Strategy assets which are local, flexible and responsive. Through being able to (June 2017), the following principles have influenced the development access community resources people can continue to enjoy good of the draft strategy. The key principles of the Adults Strategy include: quality lives while maximising independence.
Information, Advice and Guidance To realise the aims of the draft strategy, people need easy access to Making Safeguarding Personal high quality information, advice and guidance about day opportunities One of the most important duties that Councils have is Safeguarding – across Birmingham to enable citizens to plan their lives. protecting vulnerable adults (and children) from harm or potential harm. We also have a key role in making sure that everyone of us sees safeguarding as our own individual responsibility – it is the duty of us all DRAFT Day Opportunity Strategy Document V5.1 (27th Feb 2019) 6
Page 72 of 154 to make sure that those around us are safe from harm wherever Personal resources, abilities, skills, knowledge and potential. possible. The proposed strategy proposes the introduction of Social networks and the support they provide. quality standards for providers to ensure that safeguarding is The use of community resources. central to service delivery. An Asset Based approach Co‐Production Essentially, there needs to be a strength‐based approach to assessing people’s needs – building on the assets people, their families, friends At every opportunity, BCC will use co‐production to design services and communities can offer to support them. with citizens service users, carers, and service providers within day Facilitating people and communities to come together to achieve opportunities. Co‐production groups have been established to inform positive change using their own knowledge, skills and positive some of the content of this draft strategy. By reviewing the potential experiences of the issues they encounter in their lives. This approach use of direct payments and personal assistants, the use of service builds on a combination of the human, social and physical capital that quality standards and an outcome based focus to delivery, as well as exists within local communities. how the use of community assets could be maximised.
The Three Conversations model Partnership Working This is a fundamental change to how adult social care is provided which seeks: People’s needs can be complex and may require support and To establish an approach based on the assets, strengths and interventions from a range of organisations , e.g. NHS and voluntary capabilities of people, families and communities. sector. Services need to be integrated and built on partnership To build on the assumption that if you collaborate with and allow working and utilise joint resources with partners. This will require a people to be co‐designers of their own support; then their personal drive to ensure all facilities and services in the City are accessible to outcomes are more likely to be realised. people with support needs and/or disabilities, including provision for delivery of personal care, safe spaces for vulnerable adults, and for organisations to consider how activities are adapted to include people.
Transformation of the Adult Social Care Model Birmingham Adult Social Care have undertaken a fundamental review of social work practice. The underpinning principles of the new adult social work model focusing on individual strength and assets would be applied to day opportunities when assessing support needs. The key elements to the social work model include:
A Strength Based approach This involves achieving an individual’s outcomes by identifying the following: DRAFT Day Opportunity Strategy Document V5.1 (27th Feb 2019) 7
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Key Facts and Figures There are more people from Asian backgrounds in day centres than proportionally in other service areas. The Council invests in day care for adults with a learning Population Demands and Demographics disability over other groups and underinvests in opportunities There is considerable learning and trends that this draft Strategy needs for adults with mental health ill health. to account for to ensure the needs of individuals are met as Birmingham grows and changes. Activity within Adult Social Care in Birmingham As at 31st March 2016, there were 15,600 adults (18+ years) receiving The key facts we have gathered from examining local data we have adult social care support from the City Council, of which 1,540 attend looked at are: some form of day care provision. Over the financial year 15/16, the City Council spent £274m on adult social care; with £7m of this being Birmingham is a young and growing city in terms of age profile. spent on external day opportunities and £9.3m (offset by £0.9m There is a significant group of Older Adults, which is also revenue) on internal day care. growing in terms of size. Day service users are aging as are their carers, this is a shift The table 1 below highlights the number of citizens currently accessing from service patterns of ten years ago. day care within Birmingham and the predicted increase reflective of the all population figures and projections from Oxford Brookes Younger adults are not choosing traditional day services and it University and the Institute of Public Care: is unclear what they have chosen instead.
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Table 1. Activity across adult social care and day opportunities
Current day opps 2017 population Projected 2021 Percentage Projected day opps Citizens population increase users in 2021
Older adults ‐ people aged 65 and over with a 379 45,860 48,365 5.46% 400 limiting lifelong illness which affects their daily life 'a lot' Learning disabilities ‐ people with moderate or 861 4,326 4,875 12.70% 970 severe LD (all ages) Mental health ‐ MH population under 65 with a 21 2,790 3,013 8% 23 psychotic disorder Physical disability ‐ people 279 13,948 15,233 9.21% 305 under 65 with a serious physical disability Total 1,540 66,924 71,486 0 1,698
Table 2: Day Opportunites Usage 1200
1000
800
Current day opportunities 600 Citizens Projected day opps users in 400 2021
200
0 Older adults Learning Mental Physical disabilities health disability
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Table 3: Population Projection 60,000
50,000
40,000 2017 population 30,000
Projected 2021 20,000 population
10,000
0 Older adults Learning Mental Physical disabilities health disability
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Table 4. ‐ Ethnic breakdown of those accessing day care
Learning Older Adults Disabilities Physical Disabilities Mental Health Total percentage by ethnicity Asian 96 226 66 8 25.8% Black 75 98 43 1 14.1% Mixed 0 11 4 0 1.0% White UK 177 489 151 11 53.9% White other 16 24 5 0 2.9% Other or not known 13 12 10 1 2.3%
Table 5 ‐ Age breakdown of those accessing day care
Learning Older adults disabilities Physical disabilities Mental health Total percentage by age group 18 to 34 n/a 273 63 1 21.9% 35 to 49 n/a 271 72 6 22.7% 50 to 64 n/a 241 141 14 25.8% 65 to 79 191 72 n/a n/a 17.1% 80 and over 188 4 n/a n/a 12.5%
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Older Adults Birmingham has a relatively young population compared to England as a whole, as illustrated by the population data on Table 1 above. People are living longer, which means that the population aged over 65 is predicted to increase by 29% by 2030; and in particular there will be around 58,000 people aged over 80, which is a significant increase of almost 40%. The number of people estimated to have dementia is also predicted to increase in line with this; over 14,000 people by 2030. Given the proportion of the current older adult population currently accessing day opportunities it is expected that by 2021 alone the numbers overall will increase by 5.46% to 400 Citizen. Whilst this may seem a small increase it should be noted that people are living longer and therefore the expected costs an individual may incur will increase, both with inflation and that fact they require care for longer. Around 74% of people aged over 65 in Birmingham are from a White UK background. It is interesting to note the differing ethnic makeup of people using different types of service; Asian people are noticeably underrepresented amongst residential and nursing home residents, but there is a much higher proportion of people from Asian and Black backgrounds using both Direct Payments and Day Opportunities (this service data does not include self‐funders). This shows that the locations and types of services available do not always correlate with the levels and types of need in each area of the city. This further suggests that personalised planning for aspiration has ethnic differences.
Adults with a Learning Disability Department of Health estimates for Birmingham indicate that 2.47% of Birmingham adults have some level of learning disability. Current data shows that there are 4,326 Citizens under the age of 65 years accessing social care for their learning disability, of which 861 specifically attend day care provision. Prevalence figures taken from the PANSI prediction tool show that by 2021 there will be a further 970 Citizens requiring care for their learning disability in Birmingham; this is a 12.7% increase.
Adults with a Physical Disability Physical disability cover a wide range of conditions, and within this report ‘physically disabled adults’ refers to those aged 18 to 64 who have one of more physical disabilities which may be congenital, be temporary or longer term, stable or fluctuating. Physical disability is unique for each individual in the way it impacts on their life, but has its greatest effect on the ability and confidence the person has to enjoy physical movement. Services therefore need to be person centred and recognise an individual’s rights to independence and self‐determination, dignity and respect.
Adults with Mental Ill Health The Council provides day opportunities provision for a relatively low number of people with mental ill health. It is not currently possible to extrapolate the number of people accessing internal Birmingham City Council services. However, within services delivered by external providers, the current number of people accessing them with a Mental Health need are estimated to Number 21.
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encourages dependency over time as opposed to promoting resilience and independence. Day opportunities are often seen as a ‘safe place’ for vulnerable citizens and hence individuals tend to remain in current services for long periods of time, sometimes for significant periods of An Overview of current provision in their lives. Birmingham It is assumed that a service is a solution and the person fits the service, not that day opportunities respond to individual’s needs and desired outcomes. In general, we are not building aspiration for people at any What we currently have age. Social care reviews do not take place in a timely way and have In the city, much of the investment made in day opportunities provision rarely considered an individual’s strengths, skills and interest. is with traditional day centre building based provision for both internal Services tend to focus on age or disability, rather than interest or and external services. community. Each individual service then tries to create a menu of The price and quality of service varies considerably and appears activities on that basis. arbitrary and historic on examination. There is little linkage to needs, outcomes or aspiration. Some services include transport and meals and charging for this is inconsistent. Day opportunities services run by providers external to the Council External provision of day care includes such services as lifestyle and arts There are currently, approximately 58 providers across Birmingham activities, therapy, luncheon clubs, and to activities to address social delivering day opportunities . The providers are a mix of third sector and isolation private organisations. Services are predominantly delivered from Services tend to be ‘for life’ for the individual – there is rarely an buildings exclusive to the service user group. They currently support expectation that individuals will move on to other forms of provision. over 700 service users from low level to complex needs. None of the Provision tends to be building based with limited community providers have been through a commissioning route and new ones are integration. The building based provision often has a strong sense of added by way of spot purchasing individual packages of care. External community for the attendees which is strongly valued. services are funded in a variety of ways including directly from social care, individuals receiving direct payments, or self‐funded placements. What current services offer Some external services also access a variety of grants from a range of Current services are valued by those that use them and their carers. It sources. can be said that the current day opportunities provision overall
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Table 6. Client Groups attending external day opportunities Primary Care Numbers Need attending External Services Learning 258 Disabilities Older Adults 215 Physical 139 Disability/Sensory Impairment Mental Health 21 Total 633
Day opportunity services run internally by the Council DATA to be updated and referenced when data was collected Younger adults (those people between 18 and 65 years) day care services are currently delivered across 9 sites plus 2 gardening projects. All buildings apart from one are owned by the Council. 678 clients with physical and learning disabilities are currently supported providing 1:1 and up to 3:1 support for clients with complex needs.
Table 7. Client Groups attending internal day opportunities against complexity of need. Complexity of Numbers Need attending Internal Services Moderate 10 Substantial 111 Complex 473 Unknown 48 Total 642
Day opportunity services run by third sector/charity organisations from some form of support from third sector organisations that do not There are also a number of third sector providers which through grant have an assessed care need. funding arrangements with Birmingham City Council offer day support and opportunities for citizens without an assessed eligible need for care and support. There are approximately 16,000 individuals benefitting
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Half of those attending day care are aged over 50 and of those, Work Done to Inform Draft Strategy around a third also receive paid care such as supported living or residential care Development Half of those attending go to a day centre every day of the week and many of those live with older family There are no real mechanisms for individual control or choice, A review of our Day Services conducted by the National Development and in many cases any person centred planning that may of Team for inclusion (NDTi) taken place had been lost over time Birmingham has undertaken a review of all Day Services in order to The focus of services is to keep people occupied and happy, and ensure a reflection against national best practice, independent support often by choosing from a short menu of centre based activities. to do this was provided by the National Development Team for Inclusion There are some examples of skills development, but this is not (NDTi). The work outlined areas for improvement and pockets of good the main focus of effort or resource. practice which need to be built on to ensure a consistency of approach. There are sparks of creativity, but the way services are The review focussed primarily on services provided directly by the organised and planned doesn’t enable or create such sparks. Council but the findings can also be applied to those externally There are high levels of commitment to relationships and to the delivered. See full report Appendix 1. people using services. To inform the review, visits took place to services, people were There is very little person centred planning within Social Work interviewed about their experiences, carers groups were attended, staff practise or services, and needs/goals/outcomes are not were interviewed, activities were observed and data was collected on regularly reviewed. attendance and activities. Services assume that people who use the services will be NDTi report ‐ summary: NDTi found that much of the current service provision has been separated from wider community life. operating for a period of many years and is mainly building based. There Stage 1 Co‐production: ‘Having a Good Day’ is no clear requirement from the Council that specifies that providers help citizens maintain or regain their independence or gain access to We know that people who use or are connected to a service are the employment opportunities. For most clients these services have become lifelong services they are dependent on. There are differing degrees of best people to help design that service, so a co‐production approach has been adopted, working in partnership with service users, their carers quality and prices charged for the provision. and families, and service providers. Day opportunity provision is therefore currently very limited in the main The statutory guidance of The Care Act 2014, paragraph 2.20, offers the to day care and has not been guided by any clear commissioning intentions or even expectations. following definition of co‐production:
The take up of direct payments is limited by individuals accessing “’Co‐production’ is when an individual influences the support and external day opportunities as is the use of personal assistants. For services received, or when groups of people get together to influence external day opportunities approximately 69 of the 635 clients currently the way that services are designed, commissioned and delivered.” receive a direct payment (11%). The key conclusions from the review include: From January to March 2018 services users, across 33 different services, we invited and supported to participate in completing a questionnaire DRAFT Day Opportunity Strategy Document V5.1 (27th Feb 2019) 15
Page 81 of 154 to find out what ‘having a good day’ meant to them. The questions they were asked were; Stage 2 ‐ Working in Co‐production Following on from the ‘Having a Good Day’ co‐production work 1. What do you enjoy doing (at the centre and away from the centre) commissioning officers from Birmingham City Council established a 2. What don’t you like doing (at the centre and away from the centre) series of co‐production forums with service users, carers, and providers, 3. What might you like to do (that you don’t do currently) that would through a mixture of group work and regular meetings. make you “Having a Good Day” See appendix 3 Day Opportunities – Coproduction Report Stage 2 See Appendix 2 Day Opportunities – Coproduction Report Stage 1 The key themes that have emerged from the comments from these The findings from the early engagement questionnaire identified that: groups: Many of the activities that service users said they liked to participate in can be accessed as being available in the wider Direct Payments and Personal Assistants: community, in different venues and different times from the day centres they currently use. There is a widely held view that the use of both direct payments and Service users said that the sense of belonging and being part of personal assistants are to be welcomed if they are the right choice for established community groups is important to them. the individual. It was suggested that the Council does not have good Regular use of traditional day care provision over many years quality information for citizens’ regards how to access a personal has inadvertently created a culture of dependency which leaves budget. service users feeling that there is very little that can be accessed outside of day care provision. Outcomes and Quality Standards: There are five issues that were raised across all of the engagement sessions ‐ safety, transport, accessibility, attitudes People did not relate their use of services to personal outcomes and of the public and access to toilet/changing facilities. goals, as well as having had no sense of purpose as to why they Many buildings out in the wider community increasingly have accessed certain services. In fact it was difficult to see how services had better physical access – ramps, automatic doors – but once been initially chosen given the length of time people had been accessing inside the facilities are not always accessible. Examples include them. A move towards a more outcome focused approach was services on a first floor where there isn’t a lift, disability toilets considered as needed. which are too small for a wheelchair and the support worker, It was felt that a common outcomes framework for day opportunities and a lack of hoists. Similarly, the negative attitude and would be useful to support people and providers of services to behaviour, and lack of disability awareness of some staff does understand what a good service looks like. not encourage repeated use of many community services. Accessible transport is very important. Accessing employment and education opportunities has been identified as being important to many individuals. The use of emerging technology is seen as an area which needs greater understanding and development. DRAFT Day Opportunity Strategy Document V5.1 (27th Feb 2019) 16
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venues where groups and individuals may like to spend some time. These included: Community Assets and Accessibility: Wellbeing Centres and Wellbeing Hubs – run by Birmingham Access to the community was considered important but there is little City Council, focus in current services to build the confidence of people and their Community Centres and Community Hubs ‐ run by Birmingham families to contribute to life outside of traditional day opportunity City Council services. People told us that friendships are important and it was Leisure Centres – run by Serco on behalf of Birmingham City important to have friends who were not disabled as well as those who Council were. Participants said that the City is not accessible, that moulded wheelchairs often cannot access public buildings or public toilets, and Also to areas of Birmingham city including: that community spaces do not have personal changing suites. The Bullring and Grand Central Shopping Centres Transport is a concern for people and public transport is seen as New Street Station dangerous in addition many of the participants spoken to did not have Birmingham Council House access to support or training to use public transport. Train and Tram Access City Centre streets and pedestrian areas Between the beginning of June and the middle of August 2018 visits were made by service users and commissioning officers to a variety of
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Financial Overview
Current Financial Investment The table below outlines current financial spend on the range of day care either commissioned or directly provided by Birmingham City Council.
‐ Table 8 ‐ Current spend on Day Care Provider No of Cost Locations Clients (p.a) External Provision 635 £7.6 m Mainly Birmingham, Sandwell & Solihull Internal 678 £9.2 m Across Provision(Younger Birmingham Adults) Third Sector Clients £1.1m Across (data sourced from supported by the Birmingham providers self‐ services‐ 15,742. assessment of their This includes service users) clients with an assessed need care package Total £17.9m
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Proposed New Ways of Working
Birmingham proposes a fundamental shift in practice in the way that we collectively plan, manage, deliver and commission services to enable the experience that individuals and their carers have from us to improve. The proposal is for a model of day opportunities that will:
Focus on the individual, their strengths, choices, assets, and goals through person centred planning.
Focus on the outcomes that service users and carers wish to achieve.
Provide support that enables the person to access a range of opportunities in the wider and their own community as an active and equal citizen.
Focus on skills development, improving independence in daily living ie travel training and employment where possible.
Maximise the opportunity to use budgets or direct payments to access support or activities of the citizens choice.
Make the most of a vibrant and developing city, ensuring access to the wide range of opportunities Birmingham has to offer
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Personalised Support Proposed new model of Day We know that for some people, they may need a little longer to regain skills and feel confident and need a higher level of support to Opportunities achieve their outcomes. In this phase there would be a focus on enabling people to regain their independence and support for them to connect to their communities over a longer period of time. This An important element of the new approach to the provision of day phase would be suitable for service users with higher support opportunities is a focus on people regaining and developing new needs. skills, as well as the promotion of independence and well‐being. There are three key elements to the draft model: Specialist Intensive Support Enablement For this phase there would be a focus on developing specialist intensive support for people with complex needs. This would At the point of entry to the day service, there would be a focus on involve long term support with a focus on an individual’s outcomes, what people want to achieve (outcomes) and help for them to health and wellbeing. Individuals would be supported to be able to achieve their personal aspirations. The enablement phase would be access the community like everyone else. This phase would be time limited (for example up to 12 weeks) and would focus on suitable for people with more complex, specialist needs for example regaining skills; promoting independence and helping people to dementia and growing old with a learning disability. connect to their communities. This phase would be suitable for
service users with low support needs.
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Glossary of Terms
To follow
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Appendices
Appendix 1 – NDTi report Appendix 2 – Co‐production Report Stage 1 Appendix 3 – Co‐production Report Stage 2 Appendix 4 – Community Assets Report
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Page 90 of 154 Featured measures Cabinet Scorecard - December 2018 Click for full scorecard Daily Average Delay beds per day per 100,000 18+ population – combined figure (Social Care only and Joint NHS and Social Care) Latest Month: 9.14 Previous Month: 8.74 Target: 7.95 Nov 18 Oct 18 (EoY 7.95) Performance: Direction of travel: RED Up (Red) Owner: Pauline Mugridge Commentary: For this reporting period, there has been an increase in the numbers of DTOC from 8.74 to 9.14 . There has been an increase in more complex cases within the hospital teams where patients require long term placements. This has seen an increase in residential placement delays. There is not an increase in nursing home delays in November but there have remained some delays due to complexity of needs
Uptake of Direct Payments
Latest Month: 28.5% Previous Month: 28.1% Target: 28.8% Dec 18 Nov 18 (EoY 30%) Performance: Direction of travel: AMBER Up (Green) Owner: Pauline Mugridge Commentary: The proportion of eligible people receiving a direct payment has continued to increase month-on-month, and is broadly on track to meet the year-end target of 30%. We are continuing to follow a programme of co-production, partnership working, and encouragement from management, to complement the efforts from social work staff in meeting this objective. This programme and the efforts of those involved are making a large positive impact on this measure.
The percentage of births that receive a face-to-face new-born visit within 14 days
Latest Quarter: 90% Previous Quarter: 89% Target: 90% Q2 Q1 Performance: Direction of travel: GREEN Up (Green) Owner: Dennis Wilkes Commentary: Q2 shows that the percentage of births that receive a new born face to face visit within 14 days of birth has risen from 89% to 90% in this second quarter, achieving the target of 90%.
Page 91 of 154 Cabinet Scorecard - December 2018 Intended to be viewed full screen - go to "View" and "Full Produced by AC&H Information and Analysis Team (data from various sources) Screen" above Click for highlight view 1. Use of Resources
Constit- Bench- Measure Status Target Last Month This Month D o T uencies markable Daily Average Delay beds per day per 100,000 18+ 7.95 Up More 1 population – combined figure (Social Care only and RED 8.74 9.14 (EoY 7.95) (Red) detail Joint NHS and Social Care)
The proportion of clients receiving Residential, Nursing or Home Care or Care and Support 66.9% 66.1% Down More 2 RED 75% (supported living) from a provider that is rated as (Q2) (Q3) (Red) detail Silver or Gold (Quarterly)
Proportion of clients reviewed, reassessed or 83.8% Down More 3 RED 70.7% 70.2% assessed within 12 months (EoY 85%) (Red) detail
The number of long-term admissions to residential 668.4 628.7 Down More 4 GREEN 650 or nursing care per 100,000 over 65s (Q1) (Q2) (Green) detail
2. Personalised Support
Measure Status Target Last Month This Month D o T Const. B/mark Social work client satisfaction - postcard 99% 97% Down More 5 GREEN 70% questionnaire. (Q2) (Q3) (Red) detail
Percentage of concluded Safeguarding enquiries Up More 6 where the individual or representative was asked GREEN 85% 90% 92% (Green) detail what their desired outcomes were
28.8% Up More 7 Uptake of Direct Payments AMBER 28.1% 28.5% (EoY 30%) (Green) detail
The percentage of people who receive Adult Social Up More 8 GREEN DoT Only 68.5% 68.9% Care in their own home (Green) detail
109 Static More 9 The number of people who have Shared Lives RED 75 75 (EoY 140) (Amber) detail
Page 92 of 154 Cabinet Scorecard - December 2018 Intended to be viewed full screen - go to "View" and "Full Produced by AC&H Information and Analysis Team (data from various sources) Screen" above Click for highlight view 3. Prevention and Early Help
Measure Status Target Last Month This Month D o T Const. B/mark The percentage of births that receive a face-to-face 89% 90% Up More 10 GREEN 90% new-born visit within 14 days (Q1) (Q2) (Green) detail
Proportion of eligible people receiving an NHS health 2.7% 2.8% Up More 11 GREEN 2.5% check (Q1) (Q2) (Green) detail
Rate of positive chlamydia screens (per 100,000 1725 1628 Down More 12 RED 2300 young people aged 15-24) (Q1) (Q2) (Red) detail
330 201 Down More 13 Number of smoking quitters at 12 weeks GREEN 168 (Q1) (Q2) (Red) detail Percentage of drugs users who are in full time 32% 28.5% 29.8% Up More 14 employment for 10 working days following or upon RED (EoY 33%) (Q1) (Q2) (Green) detail discharge 11934 9409 Down More 15 Children under 5 attending wellbeing service RED 13500 (Q1) (Q2) (Red) detail
22207 21675 Down More 16 Adults over 70 attending wellbeing service GREEN 19500 (Q1) (Q2) (Red) detail
Number of completed safeguarding enquiries which Static More 17 GREEN 9 9 involved concerns about domestic abuse (Amber) detail
Percentage of completed safeguarding enquiries Up More 18 GREEN 9.8% 9.9% which involved concerns about domestic abuse (Red) detail
Fraction of mortality attributable to particulate air 6.2% More 19 N/A DoT Only pollution (2016/17) (2017/18) detail
The percentage of children classed as overweight or 25% 24% Down More 20 GREEN DoT Only obese at reception (2016/17) (2017/18) (Green) detail
The percentage of children classed as overweight or 40% 41% Up More 21 AMBER DoT Only obese in Year 6 (2016/17) (2017/18) (Red) detail
4. Community Assets
Measure Status Target Last Month This Month D o T Const. B/mark The percentage of service users aged 18-64 with 1.5% Static More 22 RED 1.05% 1.05% learning disabilities in employment (EoY 2%) (Amber) detail The percentage of adults in contact with secondary 4.3% 4% Down More 23 RED DoT Only mental health services in employment (2016/17*) (2017/18) (Red) detail The proportion of people who use services who 37.3% 46.5% Up More 24 reported that they had as much social contact as GREEN DoT Only (2016/17) (2017/18) (Green) detail they like The proportion of carers who reported that they had 28.3% More 25 N/A DoT Only as much social contact as they like (2016/17) (2018/19) detail
Page 93 of 154 Theme: Use of Resources Change: Last Month This Month Target Daily Average Delay beds per day per 100,000 18+ population – RED Up 8.74 9.14 7.95 combined figure (Social Care only and Joint NHS and Social Care) 4.6% (Red) (EoY 7.95) Source: UNIFY data as issued by NHS Digital. Data collated by health, available a month in arrears Commentary: For this reporting period, there has been an increase in the numbers of DTOC from Dec 17 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 ## Oct 18 Nov 18 8.74 to 9.14 . There has been an increase in more complex cases within the Reported 8.99 9.41 10.17 9.71 9.72 9.95 10.13 8.44 9.28 8 8.74 9.14 hospital teams where patients require long term placements. This has seen an increase in residential placement delays. There is not an increase in nursing home Recalc delays in November but there have remained some delays due to complexity of Target 5.7 5.7 5.7 5.7 9.8 9.43 9.06 8.69 8.32 8 7.95 7.95 needs EoY Target 7.95 7.95 7.95 7.95 7.95 7.95 7.95 7.95 7.95 8 7.95 7.95 There is a decrease in assessment delays. The Birmingham older people programme is prototyping a new model for early intervention. While it is early days, this may be having an impact on assessment delays. 10.2 10.0 10.1 9.4 9.7 9.7 9.0 9.3 9.1 We do regularly see an increase in referrals during winter impacting on demand 8.4 8.3 8.7 and capacity. We are utilising resources through additional winter funds to address this, via initiatives like the wrap-around service.
This is a target set externally by the Department of Health and Social Care.
Dec 17 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Measure Owner: Responsible Officer: Reported outturn Target Pauline Mugridge Frequently asked questions: (EoY as dotted line) Please advised that there has been a change to the target for this measure which was imposed by the Better Care Fund. This target remains externally set and has changed because the National Better Care Fund Team has now revised the provisional DToC figures following the recent period allowed for baseline challenges. There were 3 accepted challenges nationally of which one was in Birmingham, following counting adjustments by the former Heart of England Foundation Trust. This challenge has been factored in to the revised DToC expectations. This means that the year-end target is now slightly higher, with profiled monthly targets revised in line with this change. The change also affects targets for months which have been previously reported and this has been reflected in the Adult Social Care and Health scorecard.
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Page 94 of 154 Theme: Use of Resources Change: Prev. Quarter Latest Quarter Target The proportion of clients receiving Residential, Nursing or Home RED Down 66.9% 66.1% 75% Care or Care and Support (supported living) from a provider that 0.8 pp is rated as Silver or Gold (Quarterly) (Red) Source: Carefirst service agreements and commissioning provider assessment data Commentary: As at Quarter 3, 66.1% of citizens are receiving Residential, Nursing or Care Q4 Q1 Q2 Q3 and Supported Living from a provider that is rated as Silver or Gold. This is Reported 70 73.7 66.9 66.1 compared to 66.9% the previous quarter. Home care is not currently Recalc included, but will be once it has been retendered under this framework. Since the introduction of the Commissioning Strategy in May 2018, 57 Target 75 75 75 75 Residential or Supported Living providers have received a monitoring visit EoY Target 75 75 75 75 by the Council. Visits are targeted by identifying providers that have not had a visit from BCC or CQC for 12 or more months. This process has identified a decrease in quality at 8 providers (with 89 citizens) which 73.7% 70.0% are/have been subject to the Council’s quality improvement planning 66.9% 66.1% process. It will take time for improvements in quality resulting from the improvement planning process, to start to show in the Council Plan target reporting.
Q4 Q1 Q2 Q3 Measure Owner: Responsible Officer: Reported Outturn Target Alison Malik Frequently asked questions:
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Page 95 of 154 Theme: Use of Resources Change: Last Month This Month Target Proportion of clients reviewed, reassessed or assessed within 12 RED Down 70.7% 70.2% 83.8% months 0.5 pp (Red) (EoY 85%) Source: Carefirst snapshot. The proportion of people receiving a reviewable service who have had a recorded review, assessment or reassessment in the last 12 months Commentary: Priority allocation has to be given to safeguarding and urgent social care assessments. Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 ## Nov 18 Dec 18 This report appears to show that measures put in place may be at least arresting the deterioration of performance against this target. This, however, remains to be confirmed. Reported 75.8 78.5 80.3 77.4 76.7 76.1 76.1 75.5 74.3 72 70.7 70.2 To reiterate the action plan is as follows: Recalc 1. Agency workers currently being recruited, funded from the underspend on the department's staffing budget, will be allocated reviews, as other priorities allow. Target 79.3 79.3 80 80.4 80.8 81.3 81.7 82.1 82.5 83 83.3 83.8 2. Team Managers will ensure that all students on placement now and due to start EoY Target 85 85 85 85 85 85 85 85 85 85 85 85 placements in January will be allocated five reviews each to be completed by the end of March. 3. The Intelligence and Analysis Team have given team managers a report of all people in receipt of services who have been allocated to a social worker for more than four weeks 78.5% 80.3% and who have an outstanding review/reassessment. 75.8% 77.4% 76.7% 76.1% 76.1% 75.5% 74.3% 72.0% 70.7% 70.2% 4. BCC has a narrow definition of what constitutes a Care Act review. The development of the Customer Journey will look at this issue. In the short-term the Assistant Director will discuss with managers responsible for internal day and residential care if it is possible to capture the information from individuals’ service reviews
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Measure Owner: Responsible Officer: Reported outturn Target Pauline Mugridge Paul Hallam Frequently asked questions: (EoY as dotted line)
< Previous: Good provider all Return to Scorecard Next: Long term admissions >
Page 96 of 154 Theme: Use of Resources Change: Prev. Quarter Latest Quarter Target The number of long-term admissions to residential or nursing GREEN Down 668.4 628.7 650 care per 100,000 over 65s 5.9% Recalculated: (Green) 689 Source: Carefirst Commentary: Performance on this measure has been brought back below target, and is Q3 Q4 Q1 Q2 now on track. Reported 636.9 615.6 668.4 628.7 The directorate continues to pursue a Home First policy from hospital, Recalc 641.7 688.3 689 628.7 which aims to avoid residential and nursing home admissions from hospital wherever possible. Target 650 650 650 650 The Three Conversations model has now been active on some teams for EoY Target 650 650 650 650 several months and is currently being rolled out to the rest of the service. This model takes people’s communities as the starting point in meeting their care needs and connects them with opportunities that would previously not have been available through commissioned community- 668.4 636.9 615.6 628.7 based care.
Q3 Q4 Q1 Q2 Measure Owner: Responsible Officer: Reported Outturn Recalculated Target Pauline Mugridge Pauline Mugridge Frequently asked questions:
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Page 97 of 154 Theme: Personalised Support Change: Prev. Quarter Latest Quarter Target Social work client satisfaction - postcard questionnaire. GREEN Down 99% 97% 70% 2 pp (Red) Source: Postcard survey- given to people by their social worker following an assessment Commentary: The postcard questionnaire continues to demonstrate a high level of Q4 Q1 Q2 Q3 positive feedback. While this is a slight drop on the last reported result, it Reported 100 98 99 97 represents only 10 negative answers out of 304, across 76 responses Recalc received in the quarter. The previous quarter's problems with the supply of postacards has been Target 70 70 70 70 resolved and we are now seeing an improved return rate. EoY Target 70 70 70 70
100% 98% 99% 97%
Q4 Q1 Q2 Q3 Measure Owner: Responsible Officer: Reported Outturn Target Fiona Mould Frequently asked questions:
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Page 98 of 154 Theme: Personalised Support Change: Last Month This Month Target Percentage of concluded Safeguarding enquiries where the GREEN Up 90% 92% 85% individual or representative was asked what their desired 2 pp Recalculated: outcomes were (Green) 93% Source: Carefirst. Proportion of qualifying closed Safeguarding Enquiry forms where the question "Was the adult asked about their Making Safeguarding Personal Outcomes" was answered "Yes" Commentary: As previously noted, monthly results can vary above and below the target, Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 ## Nov 18 Dec 18 based upon relatively small numbers. This is a small fall that keeps us Reported 80 83 88 80 89 88 92 91 92 93 90 92 above target for the seventh consecutive month, but the trend around the Recalc 90 90 95 95 92 93 97 92 93 94 93 92 target figure of 85% is probably more representative. The longer view continues to suggest that the service is meeting the target set. Target 85 85 85 85 85 85 85 85 85 85 85 85 For December, we continue to improve on our performance with 92 EoY Target 85 85 85 85 85 85 85 85 85 85 85 85 enquiries completed
93% 88% 89% 88% 92% 91% 92% 90% 92% 80% 83% 80%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Measure Owner: Responsible Officer: Reported outturn Recalculated Target David Gray Frequently asked questions:
< Previous: General satisfaction Return to Scorecard Next: Direct payments uptake >
Page 99 of 154 Theme: Personalised Support Change: Last Month This Month Target Uptake of Direct Payments AMBER Up 28.1% 28.5% 28.8% 0.4 pp (Green) (EoY 30%) Source: Carefirst service agreements. The proportion of clients receiving an eligible care package who have at least part of it delivered via direct payment. Commentary: The proportion of eligible people receiving a direct payment has continued Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 ## Nov 18 Dec 18 to increase month-on-month, and is broadly on track to meet the year-end Reported 23.6 23.8 24.3 24.5 25.3 25.5 26.2 26.6 26.8 28 28.1 28.5 target of 30%. Recalc We are continuing to follow a programme of co-production, partnership working, and encouragement from management, to complement the Target 24.4 24.7 25 25.4 25.8 26.3 26.7 27.1 27.5 28 28.3 28.8 efforts from social work staff in meeting this objective. This programme EoY Target 30 30 30 30 30 30 30 30 30 30 30 30 and the efforts of those involved are making a large positive impact on this measure.
28.5% 26.8% 27.7% 28.1% 25.3% 25.5% 26.2% 26.6% 23.6% 23.8% 24.3% 24.5%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Measure Owner: Responsible Officer: Reported outturn Target Pauline Mugridge Julia Parfitt Frequently asked questions: (EoY as dotted line)
< Previous: Safeguarding MSP Return to Scorecard Next: Care in own home >
Page 100 of 154 Theme: Personalised Support Change: Last Month This Month Preferred The percentage of people who receive Adult Social Care in their GREEN Up 68.5% 68.9% Travel: own home 0.4 pp Recalculated: Upwards (Green) 68.5% Source: Carefirst via finance team. Snapshot proportion of people receiving long-term services who do not receive residential or nursing care Commentary: This measure continues to show a gradual improvement. We have Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 ## Nov 18 Dec 18 introduced several policies and initiatives to support the goal of keeping Reported 68.2 68.3 68.3 68.4 68.6 68.6 68.7 68.1 68.1 68 68.5 68.9 people in their communities as long as possible. These include the Home Recalc 68 68.3 68.1 67.7 68.2 68 68.3 68.1 68.2 68 68.5 68.9 First policy, aimed at preventing avoidable admissions to care homes from hospital, and a new intensive service is being piloted to assist people to Target return home who would previously have required a nursing home bed. EoY Target The Three Conversations model, which continues to be rolled out across the directorate, aims to connect people with their local community as a source of support, and should delay or prevent them needing to move to a 68.2% 68.3% 68.3% 68.4% 68.6% 68.6% 68.7% 68.1% 68.1% 68.3% 68.5% 68.9% care home.
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Measure Owner: Responsible Officer: Reported outturn Recalculated Pauline Mugridge Gian Saini Frequently asked questions:
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Page 101 of 154 Theme: Personalised Support Change: Last Month This Month Target The number of people who have Shared Lives RED Static 75 75 109 0% Recalculated: (EoY 140) (Amber) 75 Source: Carefirst service agreements Commentary: Key priorities for team are growth, productivity and effective working. Shared Lives Plus Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 ## Nov 18 Dec 18 are supporting the team to achieve this and providing helpful challenge where necessary. Key actions include: Reported 72 69 69 69 68 70 72 72 76 74 75 75 Recalc 75 72 72 72 72 74 75 74 75 74 75 75 • Aligning internal team resources to deliver key priorities including a business lead for service development from January 2019 Target 77 77 78 70 72 73 75 76 78 88 98 109 • Clear vacancy management process to ensure capacity is understood to advise social EoY Target 140 140 140 140 140 140 140 140 140 ## 140 140 workers • Increasing team productivity and efficiency through adopting and aligning with national good practice for processes and recording to avoid duplication and wastage. • Through the launch of marketing activity led by Shared Lives Plus. A Shared Lives video launched in December has had a positive impact and in excess of 3000 views on social media • Working with Job Centre Plus to promote Shared Lives as a real viable option for jobseekers 76 75 75 72 69 69 69 68 70 72 72 74 It has been agreed at the directorate management meeting (23/01/2018) to reduce the target for year end to 75 as there is no expected scope for improvement under the current delivery arrangements. This will be revised for 2019/20 following the commissioning of a provider which will enable a realistic target to be set. Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Measure Owner: Responsible Officer: Reported outturn Recalculated Target Melanie Brooks Sonia Mais-Rose Frequently asked questions: (EoY as dotted line)
< Previous: Care in own home Return to Scorecard Next: Home visits after births >
Page 102 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Target The percentage of births that receive a face-to-face new-born GREEN Up 89% 90% 90% visit within 14 days 1 pp (Green) Source: Public Health Commentary: Q2 shows that the percentage of births that receive a new born face to face Q3 Q4 Q1 Q2 visit within 14 days of birth has risen from 89% to 90% in this second Reported 89 90 89 90 quarter, achieving the target of 90%. Recalc Target 90 90 90 90 EoY Target 90 90 90 90
89% 90% 89% 90%
Q3 Q4 Q1 Q2 Measure Owner: Responsible Officer: Reported Outturn Target Dennis Wilkes Fiona Grant Frequently asked questions:
< Previous: Shared lives uptake Return to Scorecard Next: NHS Health Checks >
Page 103 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Target Proportion of eligible people receiving an NHS health check GREEN Up 2.7% 2.8% 2.5% 0.2 pp (Green) Source: Public Health Commentary: We have again met the Q2 target with a performance of 2.86 against a Q3 Q4 Q1 Q2 target of 2.5%. However, it must be highlighted that there are ongoing IT Reported 2.1 2.8 2.7 2.8 system issues as reported at Q1. The systems that collates the data, has Recalc been withdrawn from the BCC contract, therefore data was collected manually and will be again at Quarter 3. We are in the process of resolving Target 2.5 2.5 2.5 2.5 the IT systems issue, but anticipate that this may not be fully resolved until EoY Target 2.5 2.5 2.5 2.5 Q4. Once resolved backdated validation will be undertaken on all data submitted.
2.8% 2.7% 2.8%
2.1%
Q3 Q4 Q1 Q2 Measure Owner: Responsible Officer: Reported Outturn Target Dennis Wilkes Bhavna Taank Frequently asked questions:
< Previous: Home visits after births Return to Scorecard Next: Chlamydia screens >
Page 104 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Target Rate of positive chlamydia screens (per 100,000 young people RED Down 1725 1628 2300 aged 15-24) 5.6% (Red) Source: Public Health Commentary: At Quarter 2, diagnosis rate stood at 1,628 against the national rate of Q3 Q4 Q1 Q2 2,300. Although performance is below the national rate, the target is being Reported 1876 1972 1725 1628 reviewed by the National Chlamydia Screening Programme (NCSP). The Recalc review is in response to many local authorities finding it difficult to achieve this challenging target. Umbrella, which delivers sexual health services, has Target 2300 2300 2300 2300 been working to increase opportunities for chlamydia screening EoY Target 2300 2300 2300 2300 (incentivising screening in GP practices and, providing chlamydia self- sampling kits to pharmacies and Umbrella partners)
The Birmingham chlamydia detection rate has fallen in Q2 Jul-Sept 2018, 1,876 1,972 however, Birmingham is performing above the West Midlands region and 1,725 1,628 just below the England levels. Coverage (percentage of eligible population) follows in a similar manner where Birmingham has out-performed the West Midlands region. Commissioners recently attended a NCSP workshop with Umbrella to explore potential areas of improvement. Commissioners will also be raising this with Umbrella at the next Contract Review Meeting.
Q3 Q4 Q1 Q2 Measure Owner: Responsible Officer: Reported Outturn Target Max Vaughan / Dennis Wilkes Fharat Rehman Frequently asked questions:
< Previous: NHS Health Checks Return to Scorecard Next: Smoking cessation >
Page 105 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Target Number of smoking quitters at 12 weeks GREEN Down 330 201 168 39.1% (Red) Source: Public Health Commentary: As at Q2 we had 201 individuals who quit smoking at 12 weeks. This is Q3 Q4 Q1 Q2 above the Q2 target 168. It should be noted that the figure for Q1 should Reported 182 215 330 201 have been 332 instead of 330 (with 2 late quitters submitted). There Recalc continues to be some issues with the IT system as reported at Q1, this is due to the withdrawal of the BCC contract. Q2 data was again manually Target 168 168 168 168 calculated and will be again at Quarter 3. It is hoped that the true EoY Target 168 168 168 168 verification and correction of performance will be made between January and March 2019. We are in the process of resolving the IT systems issue, however, because of the how data is reported, it is anticipate that this may 330 not be fully resolved until Q4. Once resolved backdated validation will be undertaken on all data submitted. 215 201 182
Q3 Q4 Q1 Q2 Measure Owner: Responsible Officer: Reported Outturn Target Dennis Wilkes Bhavna Taank Frequently asked questions:
< Previous: Chlamydia screens Return to Scorecard Next: Drugs users in employment >
Page 106 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Target Percentage of drugs users who are in full time employment for RED Up 28.5% 29.8% 32% 10 working days following or upon discharge 1.4 pp (Green) (EoY 33%) Source: Public Health Commentary: The drug users and employment Q2 Diagnostic Outcomes Monitoring Executive Summary Q3 Q4 Q1 Q2 (Domes) report is due late November/early December. Reported 31 30.8 28.5 29.8 Based on the proposed changes to this performance measure from Q3 onwards, it is Recalc anticipated that this measure will be reported as two separate measures, one for Opiate and one for Non-Opiate service users, in line with national data returns. The rationale Target 30 30.5 31.3 32 behind this change is that this information is obtained from quarterly reports compiled by EoY Target 33 33 33 33 Public Health England (PHE) who report these as separate and not combined figures. PHE recognise that whilst the two groups are made up of drug users, there are clear distinctions between them - most notably different recovery pathways within the service provider's recovery model. The time service users spend in the service has a direct impact 31.0% 30.8% on their ability to obtain employment and since the opiate cohort of clients will be in the 28.5% 29.8% service for a considerably longer period of time than the non-opiate users, the combined measure is not a true reflection of activity. It should also be noted that the payment by results (PBR) element of Change, Grow, Live’s contract also recognises this difference, and for contract management purposes and PBR payments the measure used is the one relating to Opiate users.
Q3 Q4 Q1 Q2 Measure Owner: Responsible Officer: Reported Outturn Target Max Vaughan / Dennis Wilkes Karl Beese Frequently asked questions: (EoY as dotted line)
< Previous: Smoking cessation Return to Scorecard Next: Under 5s wellbeing service >
Page 107 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Target Children under 5 attending wellbeing service RED Down 11934 9409 13500 21.2% (Red) Source: Public Health Commentary: Under 5 attendance, dialogue is taking place with the Wellbeing Service to Q3 Q4 Q1 Q2 address the continual under performance. This will include reviewing the Reported 6942 7496 11934 9409 recording systems to ensure that all Under 5 attendance data is being Recalc captured, what are the mitigations for the target not being achieved, is their specific target work being undertaken to specifically target this group Target 13500 13500 13500 13500 and is the target realistic given the fact that it has not been achieved for a EoY Target 13500 13500 13500 13500 number of quarters.
11,934 9,409 6,942 7,496
Q3 Q4 Q1 Q2 Measure Owner: Responsible Officer: Reported Outturn Target Max Vaughan / Dennis Wilkes Karl Beese Frequently asked questions:
< Previous: Drugs users in employment Return to Scorecard Next: Over 70s wellbeing service >
Page 108 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Target Adults over 70 attending wellbeing service GREEN Down 22207 21675 19500 2.4% (Red) Source: Public Health Commentary: Although there was as slight decrease in Q2 the figure of 21,675 attendees Q3 Q4 Q1 Q2 over 70 is exceeded the target of 19,500 by 11% Reported 20339 21727 22207 21675 Recalc Target 19500 19500 19500 19500 EoY Target 19500 19500 19500 19500
21,727 22,207 21,675 20,339
Q3 Q4 Q1 Q2 Measure Owner: Responsible Officer: Reported Outturn Target Max Vaughan / Dennis Wilkes Karl Beese Frequently asked questions:
< Previous: Under 5s wellbeing service Return to Scorecard Next: DV safeguarding count >
Page 109 of 154 Theme: Prevention and Early Help Change: Last Month This Month Target Number of completed safeguarding enquiries which involved GREEN Static 9 9 N/A concerns about domestic abuse 0% Recalculated: (Amber) 15 Source: Carefirst Commentary: 91 Safeguarding Enquiries were completed in December, of which 9 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 ## Nov 18 Dec 18 involved allegations of domestic abuse - 9.9% Reported 10 9 8 6 10 6 20 15 9 12 9 9 In the last 12 months there have been 139 completed enquiries relating to Recalc 10 10 8 6 10 7 20 19 11 14 15 9 this. Of these 89% achieved their expressed outcomes, 92% felt that they were involved, 91% felt that they had been listened to, 88% felt we had Target #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! ###### #VALUE! #VALUE! ## #VALUE! #VALUE! acted on their wishes, 82% felt safer and 82% felt happier as a result of our EoY Target #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! ###### #VALUE! #VALUE! ## #VALUE! #VALUE! intervention.
20
15 12 10 9 10 9 9 9 8 6 6
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Measure Owner: Responsible Officer: Reported outturn Recalculated Target David Gray Frequently asked questions:
< Previous: Over 70s wellbeing service Return to Scorecard Next: DV safeguarding proportion >
Page 110 of 154 Theme: Prevention and Early Help Change: Last Month This Month Target Percentage of completed safeguarding enquiries which involved GREEN Up 9.8% 9.9% N/A concerns about domestic abuse 0.1 pp Recalculated: (Red) 10.7% Source: Carefirst Commentary: 91 Safeguarding Enquiries were completed in December, of which 9 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 ## Nov 18 Dec 18 involved allegations of domestic abuse - 9.9% Reported 7.9 6.6 5.9 5.7 6.3 4.4 13 16.7 8.5 10 9.8 9.9 In the last 12 months there have been 139 completed enquiries relating to Recalc 7.9 7 5.9 5.5 6 4.9 11.5 15.4 8.2 9 10.7 9.9 this. Of these 89% achieved their expressed outcomes, 92% felt that they were involved, 91% felt that they had been listened to, 88% felt we had Target #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! ###### #VALUE! #VALUE! ## #VALUE! #VALUE! acted on their wishes, 82% felt safer and 82% felt happier as a result of our EoY Target #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! ###### #VALUE! #VALUE! ## #VALUE! #VALUE! intervention.
16.7%
13.0%
9.8% 9.8% 9.9% 7.9% 8.5% 6.6% 5.9% 5.7% 6.3% 4.4%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Measure Owner: Responsible Officer: Reported outturn Recalculated Target David Gray Frequently asked questions:
< Previous: DV safeguarding count Return to Scorecard Next: Air quality >
Page 111 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Preferred Fraction of mortality attributable to particulate air pollution N/A 6.2% Travel: Downwards
Source: Public Health Commentary: Data available annually. Data will next be available May 2019 2014/15 2015/16 2016/17 2017/18 Reported 5.7 5.1 6.2 #VALUE! Recalc Target EoY Target
6.2% 5.7% 5.1%
0.0%
2014/15 2015/16 2016/17 2017/18 Measure Owner: Responsible Officer: Reported Outturn Duncan Vernon Duncan Vernon Frequently asked questions: Data available annually
< Previous: DV safeguarding proportion Return to Scorecard Next: Obesity in reception >
Page 112 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Preferred The percentage of children classed as overweight or obese at GREEN Down 25% 24% Travel: reception 1 pp (Green) Downwards Source: Public Health Commentary: The percentage of overweight and obese children in reception has 2014/15 2015/16 2016/17 2017/18 decreased in the most recent academic year (2017/18). In addition the gap Reported 23 24 25 24 between Birmingham and England has also reduced - Birmingham rates Recalc are 1.2% higher than the England average rate compared to 2.1% in 2016/17 Target EoY Target
25% 23% 24% 24%
2014/15 2015/16 2016/17 2017/18 Measure Owner: Responsible Officer: Reported Outturn Dennis Wilkes Fiona Grant / Jenny Riley Frequently asked questions: Data available annually
< Previous: Air quality Return to Scorecard Next: Obesity in year 6 >
Page 113 of 154 Theme: Prevention and Early Help Change: Prev. Quarter Latest Quarter Preferred The percentage of children classed as overweight or obese in AMBER Up 40% 41% Travel: Year 6 0 pp (Red) Downwards Source: Public Health Commentary: The percentage of overweight and obese children in year 6 has increased in 2014/15 2015/16 2016/17 2017/18 the most recent academic year in line with a national increase. The gap Reported 39 40 40 41 between Birmingham and England has increased slightly - Birmingham is Recalc currently 6.2% higher than the England average rate compared to 5.9% in 2016/17. Target EoY Target
41% 39% 40% 40%
2014/15 2015/16 2016/17 2017/18 Measure Owner: Responsible Officer: Reported Outturn Dennis Wilkes Fiona Grant / Jenny Riley Frequently asked questions: Data available annually
< Previous: Obesity in reception Return to Scorecard Next: LD Employment >
Page 114 of 154 Theme: Community Assets Change: Last Month This Month Target The percentage of service users aged 18-64 with learning RED Static 1.05% 1.05% 1.5% disabilities in employment 0 pp (Amber) (EoY 2%) Source: Carefirst classifications Commentary: The position has remained steady over the last quarter, however it is Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 ## Nov 18 Dec 18 recognised that this is against a rising target. The service remains Reported 0 0 1 1 1 1.15 1.15 1.1 1.05 1 1.05 1.05 committed to identifying and engaging with employers who are able to Recalc offer meaningful employment. There will be a renewed focus in 2019 on employment delivery. We have also identified: Target 1 1 1 1 1 1 1 1 1 1 1.33 1.5 EoY Target 2 2 2 2 2 2 2 2 2 2 2 2 • A lead to focus on LD employment and work with local employers • The need for a review of recording on CareFirst (our social care database) to ensure citizens with LD in employment are reflected – the Lead is following up on this • Initial links with Job Centre Plus to progress LD employment offer
1.15% 1.15% 1.10% 1.00% 1.00% 1.00% 1.05% 1.01% 1.05% 1.05%
0.00% 0.00%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Measure Owner: Responsible Officer: Reported outturn Target Melanie Brooks Sonia Mais-Rose Frequently asked questions: (EoY as dotted line)
< Previous: Obesity in year 6 Return to Scorecard Next: MH Employment >
Page 115 of 154 Theme: Community Assets Change: Prev. Quarter Latest Quarter Preferred The percentage of adults in contact with secondary mental RED Down 4.3% 4% Travel: health services in employment 0.3 pp (Red) Upwards Source: NHS Digital Commentary: This is a measure taken from the ASCOF framework, and is collected and 2014/15 2015/16 2016/17*2017/18 submitted by NHS Mental Health services. “Secondary Mental Health Reported 5 5.3 4.3 4 services” are part of the NHS rather than part of the council, although a Recalc proportion of these citizens are also likely to be in contact with adult social care. The next data, covering 2018/19, will likely be available in November Target 2019. EoY Target Currently, a bid has been submitted along with Mind to establish a “Time to Change” hub, which will focus in part on assisting people with Mental 5.3% Health conditions in accessing employment. This will involve partnership 5.0% working across the whole health and social care system with NHS Mental 4.3% 4.0% Health services and the Clinical Commissioning Group, and including the wider voluntary and community sector as partners. The hub will use a leadership model that draws on people’s lived experiences of Mental Health services. While funding is likely to be limited, a key consideration will be sustainability, so that the improvements made in the short term can be successfully transferred into long-term practice. 2014/15 2015/16 2016/17* 2017/18 Measure Owner: Responsible Officer: Reported Outturn Melanie Brooks Melanie Brooks Frequently asked questions: This is issued annually as part of the Ascof set of measures. *Please note that due to national data quality issues, NHS Digital did not release this as an official Ascof measure for this year, and this figure should be viewed as a guide only.
< Previous: LD Employment Return to Scorecard Next: Client social contact >
Page 116 of 154 Theme: Community Assets Change: Prev. Quarter Latest Quarter Preferred The proportion of people who use services who reported that GREEN Up 37.3% 46.5% Travel: they had as much social contact as they like 9.2 pp (Green) Upwards Source: NHS Digital Commentary: This represents a significant improvement in this measure from last year’s 2014/15 2015/16 2016/17 2017/18 survey, and a continuation of the upwards trend seen in previous years. In Reported 43.5 44.6 37.3 46.5 terms of our performance against other councils, this is a slightly above Recalc average score (46.5% against the national average of 46.0%), and places us within the second-best quartile at 66 out of 150 councils. Target EoY Target We hope to maintain or improve our performance on this measure, due to the introduction of the three conversations model which happened after this survey was conducted. The three conversations model places an 46.5% 43.5% 44.6% emphasis on the community as a source of support. 37.3%
2014/15 2015/16 2016/17 2017/18 Measure Owner: Responsible Officer: Reported Outturn Frequently asked questions: This is issued annually as part of the Ascof set of measures
< Previous: MH Employment Return to Scorecard Next: Carer social contact >
Page 117 of 154 Theme: Community Assets Change: Prev. Quarter Latest Quarter Preferred The proportion of carers who reported that they had as much N/A 28.3% Travel: social contact as they like Upwards
Source: NHS Digital Commentary: This is issued every two years as part of the Ascof set of measures. Results 2012/13 2014/15 2016/17 2018/19 are due to be published in October/ November 2019. Reported 0 27.4 28.3 #VALUE! Recalc Target EoY Target
27.4% 28.3%
0.0% 0.0%
2012/13 2014/15 2016/17 2018/19 Measure Owner: Responsible Officer: Reported Outturn Frequently asked questions: This is issued annually as part of the Ascof set of measures
< Previous: Client social contact Return to Scorecard
Page 118 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Edgbaston Proportion of eligible people in receipt of direct payments
25.0% 25.1% 25.4% 24.4% 24.5% 24.5% 24.5% 23.7% 23.9%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Edgbaston Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
79.8% 77.5% 76.3% 76.2% 75.6% 74.4% 71.5% 68.4% 68.5%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Edgbaston Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 119 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Edgbaston
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 100.0% 100.0% 100.0% 100.0%
87.5% 90.0%
75.0% 66.7%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Edgbaston Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 120 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Erdington Proportion of eligible people in receipt of direct payments
26.9% 27.2%
25.2% 25.3% 24.4% 24.6% 24.7% 23.0% 22.5%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Erdington Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
84.9% 82.5% 83.4% 81.7% 81.8% 81.0% 79.1% 77.7% 78.2%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Erdington Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 121 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Erdington
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 100.0% 100.0% 94.1% 88.2% 85.7% 80.0% 77.8%
62.5%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Erdington Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 122 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Hall Green Proportion of eligible people in receipt of direct payments
29.1% 28.0%
26.4% 26.6% 26.0% 26.1% 26.3% 26.3% 26.3%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Hall Green Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
81.5%
77.7% 74.2% 74.1% 72.5% 69.0% 65.4% 63.8% 63.8%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Hall Green Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 123 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Hall Green
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 91.7% 86.7% 87.5%
76.9% 77.8%
66.7% 62.5%
50.0%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Hall Green Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 124 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Hodge Hill Proportion of eligible people in receipt of direct payments
27.3% 26.9% 26.4% 26.0% 25.9% 25.5%
23.7% 23.9% 23.3%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Hodge Hill Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
83.6% 81.0% 78.0% 77.4% 75.0% 73.1% 69.9% 67.4% 65.1%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Hodge Hill Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 125 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Hodge Hill
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 100.0% 95.7% 92.3% 88.2%
77.8% 75.0% 72.7% 71.4%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Hodge Hill Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 126 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Ladywood Proportion of eligible people in receipt of direct payments
34.4% 34.6% 33.7% 34.1% 32.5% 32.9% 31.5% 30.5% 30.8%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Ladywood Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
80.9% 78.5% 78.5% 78.2% 77.6% 76.4% 74.0% 73.2% 72.6%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Ladywood Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 127 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Ladywood
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
96.2% 93.5% 90.9% 91.7% 90.0% 87.5%
76.9% 73.7%
61.5%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Ladywood Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 128 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Northfield Proportion of eligible people in receipt of direct payments
22.6% 22.0% 22.0% 21.6% 21.6% 21.7% 21.6% 21.8% 21.0%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Northfield Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
80.9%
76.1% 75.1% 72.8% 71.3% 68.3% 66.2% 64.6% 64.6%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Northfield Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 129 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Northfield
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 100.0% 100.0% 95.5% 92.9% 88.9% 87.5% 85.7% 83.3%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Northfield Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 130 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Perry Barr Proportion of eligible people in receipt of direct payments
37.0% 36.3% 36.8% 35.1% 35.2% 34.5% 33.2% 32.4% 32.6%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Perry Barr Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
77.6% 74.2% 72.1% 69.8% 68.6% 66.3% 64.5% 61.6% 60.7%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Perry Barr Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 131 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Perry Barr
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 100.0% 92.3% 92.3% 87.5% 87.5% 88.9% 84.6% 78.6%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Perry Barr Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 132 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Selly Oak Proportion of eligible people in receipt of direct payments
23.7% 23.7% 22.6% 22.0% 22.3% 21.5% 20.5% 20.5% 20.9%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Selly Oak Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
72.7% 71.2% 71.3% 71.0% 70.5% 70.0% 70.2% 68.9% 69.0%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Selly Oak Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 133 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Selly Oak
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 92.9% 83.3%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Selly Oak Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 134 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Sutton Coldfield Proportion of eligible people in receipt of direct payments
31.5% 30.3% 30.2% 29.3% 29.0% 28.5% 27.8% 27.2% 27.5%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Sutton Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
81.3% 79.5% 79.8% 80.3% 79.6% 78.8% 78.1% 78.3% 78.9%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Sutton Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 135 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Sutton Coldfield
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 100.0%
90.0% 87.5% 87.5% 83.3%
66.7% 66.7%
50.0%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Sutton Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 136 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Yardley Proportion of eligible people in receipt of direct payments
23.6% 23.4% 22.0% 21.6% 21.6% 20.6%
18.8% 18.2% 18.5%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Yardley Citywide Citywide (target)
Spread of results This month Northfield Yardley Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 22.6% 23.4% 23.7% 25.4% 27.2% 27.3% 28.5% 29.1% 31.5% 34.6% 36.8%
12 month average Yardley Northfield Selly Oak Edgbaston Erdington Hodge Hill Citywide Hall Green Sutton Ladywood Perry Barr Lowest Highest 20.9% 21.8% 22.0% 24.6% 24.9% 25.4% 26.1% 26.8% 29.0% 32.8% 34.8%
Proportion of clients reviewed or assessed in the last 12 months
81.9% 80.7% 80.3% 80.4% 79.5% 78.0% 75.2% 72.5% 70.3%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Yardley Citywide Citywide (target)
Spread of results This month Perry Barr Hall Green Northfield Hodge Hill Edgbaston Citywide Yardley Selly Oak Ladywood Erdington Sutton Lowest Highest 60.7% 63.8% 64.6% 65.1% 68.5% 70.2% 70.3% 71.0% 72.6% 78.2% 79.6%
12 month average Perry Barr Selly Oak Northfield Hall Green Edgbaston Citywide Hodge Hill Ladywood Yardley Sutton Erdington Lowest Highest 69.3% 70.9% 72.4% 72.6% 74.7% 75.3% 75.4% 77.2% 78.0% 79.6% 81.4%
Page 137 of 154 Constituency Scorecard Breakdown - December 2018 Showing results for people assigned to the team that covers Yardley
Proportion of completed safeguarding enquiries where the person was asked about their desired outcomes
100.0% 100.0% 94.1% 94.4% 89.5% 81.3% 76.9% 72.7%
60.0%
Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18
Yardley Citywide Citywide (target)
Spread of results This month Sutton Ladywood Hodge Hill Erdington Northfield Perry Barr Citywide Yardley Edgbaston Hall Green Selly Oak Lowest Highest 50.0% 76.9% 77.8% 85.7% 87.5% 88.9% 92.3% 94.4% 100.0% 100.0% 100.0% Performance for people under non-constituency teams: 0.0%
12 month overall Sutton Perry Barr Hodge Hill Edgbaston Erdington Ladywood Citywide Hall Green Selly Oak Northfield Yardley Lowest Highest 75.3% 83.1% 85.5% 86.8% 87.1% 87.2% 87.3% 89.9% 90.1% 92.2% 92.7% Performance for people under non-constituency teams: 82.3%
Page 138 of 154
Birmingham Health Overview and Scrutiny Committee
West Midlands (South and Central) Paediatric Cystic Fibrosis Network – proposed changes to shared care arrangements with City Hospital, Birmingham
Report submitted by: NHS England West Midlands Specialised Commissioning Team and Birmingham Women’s and Children’s NHS Foundation Trust
Date: March 2019
1. Purpose
The purpose of this report is to inform the Committee of a recommendation from Birmingham Women’s and Children’s NHS Foundation Trust (BWC) to make a change to the West Midlands (South and Central) Paediatric Cystic Fibrosis Network following feedback from families.
2. Background to Paediatric Cystic Fibrosis Services in the West Midlands
Cystic Fibrosis (CF) is a genetic condition affecting 10,400 adults and children in the UK. People are born with CF, it cannot be caught. About 1 in every 2,500 babies born in the UK has CF. In 2018/19 it is expected around 29 babies will be born with CF in the West Midlands, around 7 or 8 of whom will be from Birmingham and Solihull.
The gene affected by CF controls the movement of salt and water in and out of cells. People with CF experience a build-up of thick, sticky mucus in the lungs, digestive system and other organs, causing a wide range of challenging symptoms affecting the entire body.
People with CF are vulnerable to different bacteria. While these are usually harmless to people who don’t have CF, they can settle in the lungs and be harmful for those who do. These bugs can be easily transmitted from one person with CF to another. The risk of spreading infections to each other means that two people with CF can never meet face to face.
Paediatric Cystic Fibrosis services in the West Midlands are commissioned by NHS England’s specialised commissioning team from:
Birmingham Women’s and Children’s NHS Foundation Trust University Hospitals of North Midlands NHS Trust 1
Page 139 of 154 Birmingham Women’s and Children’s NHS Foundation Trust provides a service for the South and Central West Midlands. They operate a ‘shared care’ model which means they partner with other NHS trusts to run paediatric outpatient clinics across the area so that patients receive some of their treatment at Birmingham Children’s Hospital (BCH) but some can also attend outpatient clinics at a more local hospital. The hospitals where shared care takes place are:
Birmingham Heartlands Coventry City Hospital Wolverhampton Hereford Worcester
3. Case for Change
The change proposed by BWC affects only the shared service run at City Hospital in Birmingham.
There are currently 11 patients (9 families) registered for the City Hospital clinic, all of whom receive at least some of their treatment at Birmingham Children’s Hospital.
The standard is that children with CF have an appointment every two months. Children attending the City Hospital clinic alternate every two months between appointments at City Hospital and Birmingham Children’s Hospital, although some have chosen not to attend the City Hospital Clinics.
BWC recently undertook a survey to find out what was working well and what was not working well for families using the existing shared care arrangements. The survey asked open questions about their experience. Six of the nine families (8 of the 11 patients) used the survey to express a preference to receive all of their care at BCH. The reasons given were:
Accessibility Confidence in the service Can see the whole MDT Has moved house so Birmingham Children’s Hospital is more convenient Has not attended City Hospital since 2013 and happy to continue at BCH
Over the past 5-10 years the number of patients choosing to attend the City Hospital clinic has been reducing. Four of the remaining nine families have now requested to have their all their care provided at BCH, with a further two families indicating through the survey that given the choice, they would also prefer to attend BCH for all their care. This would mean the City Hospital clinic would serve three families.
2
Page 140 of 154 In addition to patient choice, there are a number of other challenges for the City Hospital clinic:
The full CF Multi-Disciplinary Team (MDT) at City Hospital is not always available when families attend for clinics. When admission is required, this usually takes place at Birmingham Children’s Hospital owing to the small numbers of patients and specialist skills required to manage their care. There is one consultant who provides the clinic at City Hospital, as a small part of a wider clinical role at City Hospital.
As a consequence, the service is recommending that BWC does not renew its sub- contract for the City Hospital clinic, and that the patients receive all their care at Birmingham Children’s Hospital.
As each family affected is being consulted directly, it has not been assessed as proportionate or necessary to undertake a wider piece of public engagement.
In addition to the survey, clinical teams have sought verbal feedback from the families and are now in the process of feeding back the output of their engagement and the change that is being proposed as a result of their feedback.
4. Next Steps
The recommendation not to renew the sub-contract with the City Hospital clinic will be formally put to the Network Oversight Board on 29th March.
Once agreed, this will mean that patients will be invited to attend all six of their annual outpatient appointments at Birmingham Children’s Hospital from April 2019, rather than splitting their appointments between Birmingham Children’s and City Hospitals.
There are currently no patients with booked appointments for the City Hospital clinic beyond March 2019, and the decision on the future of the clinic will be taken before further appointments are made. This process will not delay the treatment of any patient and does not affect the appointments that are planned for the patients at Birmingham Children’s Hospital.
Of the three families who did not indicate a preference to receive all their care at BCH, one family (one patient) indicated they would be happy to either continue with the existing shared care arrangement or move all their care to BCH.
The remaining two families (two patients) were happy with the shared care arrangements. One of these did not hold a strong view, whilst the other felt strongly they would want the shared care arrangement to continue, primarily in order to continue to see the same consultant.
3
Page 141 of 154 The City Hospital consultant currently undertakes sessions at Birmingham Children’s Hospital to ensure he is undertaking sufficient CF work to maintain his expertise. BWC has agreed to continue to offer him these sessions which would enable the family to continue to see him. Following a further conversation between the family and a BWC CF consultant regarding the results of the survey, the family is much clearer about the reasons for the planned change and does not have a problem with the proposed change.
Communication with the families is planned to ensure they understand the change that is being proposed, and particular support provided to the two families who had initially expressed a preference for the shared care arrangements to remain in place.
Recommendations
The Health Overview and Scrutiny Committee is asked to NOTE the recommendation from BWC to change the shared care arrangements with City Hospital, and to NOTE the approach that has been taken to engage with the families concerned.
4
Page 142 of 154
Health and Social Care Overview & Scrutiny Committee 2018/19 Work Programme
Committee Members: Chair: Cllr Rob Pocock
Cllr Nicky Brennan Cllr Chauhdry Rashid Cllr Mick Brown Cllr Paul Tilsley Cllr Peter Fowler Cllr Suzanne Webb Cllr Ziaul Islam
Committee Support:
Scrutiny Team: Rose Kiely (303 1730) / Gail Sadler (303 1901) Committee Manager: Errol Wilson (675 0955) Schedule of Work
Meeting Committee Agenda Items Officers Date 19th June 2018 Formal Session
Send out – Appointments to Deputy Chair and JHOSCs 7th June 2018 Informal Session
NHS Birmingham and Solihull CCG Paul Sherriff, Director of Organisational Developments & Partnerships; Gemma Coldicott, Head of Communications & Engagement, BSol CCG
Healthwatch Birmingham Andy Cave, Chief Executive, Healthwatch Birmingham
Adult Social Care and Health – Member Briefing Melanie Brooks, Interim Assistant Director, Community Services, Adult Social Care & Health
Public Health Dennis Wilkes, Acting Director of Public Health
Adult Social Care and Health – Overview of Performance Management Mike Walsh, Service Lead – Commissioning, Adult Social Care & Health
Health & Social Care Overview and Scrutiny Committee 01 Page 143 of 154Work Programme – March 2019
19th June 2018 Live healthy, Live happy – Strategy Overview – Birmingham and Solihull Rachel O’Connor, STP Director of Planning Send out – and Performance, BSol 7th June 2018 CCG
17th July 2018 Early Years Update re Childhood Obesity Dennis Wilkes, Assistant Director, Send out – Public Health 5th July 2018 Younger Adults Day Service Consolidation – Lessons Learnt Melanie Brooks, Interim Assistant Director, Social Care & Health
Adult Social Care Performance Monitoring Mike Walsh, Head of Service – Service Lead – Commissioning, Adult Social Care & Health
16th August Request for Call In: Younger Adults Day Care Consolidation – Adults Social Councillor Paulette 2018 Care and Health Hamilton; Professor Graeme Betts; Melanie Send out – Brooks. 8th August 2018
18th September Tracking of ‘The Impact of Poor Air Quality on Health’ Inquiry David Harris, 2018 Transportation Policy Manager Send out – 6th September Tracking of the ‘Living Life to the full with Dementia’ Inquiry Zoeta Manning, Senior 2018 Integration Manager - Frailty, BSol CCG
Healthwatch Birmingham Update Andy Cave, Chief Executive, Healthwatch Birmingham
16th October Forward Thinking Birmingham Update Elaine Kirwan, 2018 Associate Director of Nursing; Marie Crofts, Send out – Mental Health Director. 4th October 2018 The Outcome of the STP Engagement Programme Rachel O’Connor, Director of Planning & Performance, BSol CCG
Is the STP arrangement working for West Birmingham? Paul Jennings, Chief Executive, BSol CCG
STP – Public Health Becky Pollard, Interim Director of Public Health
Page 14402 of 154
20th November Cabinet Member for Health and Social Care Update Report Councillor Paulette 2018 including Hamilton; Suman • Birmingham Public Health Priorities McCartney, Cabinet Send out – Support Officer and 8th November Becky Pollard, Interim 2018 Director of Public Health
Birmingham Substance Misuse Recovery System (CGL) Max Vaughan, Head of Service, Universal and Prevention – Commissioning
Birmingham Safeguarding Adults Board Report Cherry Dale, Independent Chair of the Birmingham Safeguarding Adults Board
Update on Day Opportunities Strategy Melanie Brooks, Interim Assistant Director, Community Services
Adult Social Care Performance Monitoring Mike Walsh, Service Lead – Commissioning, Adult Social Care & Health
18th December Budget Consultation 2019+ Cabinet Member for 2018 • Financial breakdown of Public Health spend against priorities Health & Social Care; Becky Pollard, Interim Send out – Director of Public 6th December Health 2018 Birmingham Safeguarding Adults Board Annual Report Cherry Dale, Independent Chair of the Birmingham Safeguarding Adults Board.
The New Social Work Model in Birmingham Pauline Mugridge, Interim Assistant Director, Community Services; Fiona Mould, Principal Social Worker
Update on Day Opportunities Strategy Melanie Brooks, Interim Assistant Director, Community Services
Health & Social Care Overview and Scrutiny Committee 03 Page 145 of 154Work Programme – March 2019
22nd January Homelessness Prevention: Social Care and Health Response Kalvinder Kohli, Head of 2019 Service, Adult Social Care Commissioning; Send out – Carol Herity, Interim 10th January Locality Director, NHS 2019 BSol CCG.
Tracking of the ‘Homeless Health’ Inquiry Kalvinder Kohli, Head of Service, Adult Social Care Commissioning
Direct Payments in Birmingham: Maximising choice, control and flexibility Andy Cave, Chief in the use of Direct Payments Executive; Dr Chipiliro Kalebe-Nyamongo, Policy Officer, Healthwatch Birmingham
19th February Birmingham Sexual Health Services – Umbrella (UHB) Max Vaughan, Head of 2019 Service, Universal and Prevention Send out – 7th February Birmingham City Health and Wellbeing Board, Healthwatch Birmingham Councillor Rob Pocock, 2019 and Health Scrutiny - Draft Ways of Working Agreement Chair, HOSC
Adult Social Care Survey 17/18 Results Mike Walsh, Service Lead – Commissioning, Local Performance Account 17/18 Adult Social Care & Health CQC Local System Review Action Plan
Period Poverty – Draft Terms of Reference Councillor Rob Pocock, Chair HOSC
19th March 2019 Public Health Green Paper Dr Justin Varney, Director of Public Send out – Health; Elizabeth 7th March 2019 Griffiths, Senior Public Health Specialty Registrar
STP Outcomes Framework Rachel O’Connor, Director of Planning & Delivery, Bsol CCG
Draft Day Opportunities Consultation Approach Linda Harper, Interim Assistant Director, Community Services
Adult Social Care Performance Scorecard Monitoring Rebecca Bowley, Head of Business Improvement and Support (Adult Social Care)
Cystic Fibrosis Service - (Note for information) Councillor Rob Pocock, Chair HOSC
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16th April 2019 West Midlands Ambulance Service University NHS Foundation Trust Mark Docherty, Director • General Overview of Clinical Send out – • Winter 18/19 Commissioning and 4th April 2019 Strategic Development/ Executive Nurse; Nathan Hudson, Emergency Services Operations Delivery Director.
Healthwatch: Hospital Waiting Room Investigation Andy Cave, Chief Executive, Healthwatch
Tracking of the ‘Living Life to the Full with Dementia’ Inquiry Zoeta Manning, Senior Integration Manager - Frailty, BSol CCG
Tracking of ‘The Impact of Poor Air Quality on Health’ Inquiry Mark Wolstencroft, Operations Manager, Environmental Protection
14th May 2019 STP ‘West Birmingham Position’ Status Report Paul Jennings, BSol STP, System Lead; Send out – Andy Williams, 2nd May 2019 Accountable Officer, SWBCCG
Forward Thinking Birmingham Elaine Kirwan, Associate Director of Nursing
Mental Health – CCG Commissioning Strategy Jo Carney, Associate Director of Joint Commissioning, BSol CCG
Public Health Grant – Position Paper Dr Justin Varney, Director of Public Health
Day Opportunities Consultation Strategy and Model Linda Harper, Interim Assistant Director, Community Services
Adult Social Care Performance Monitoring Rebecca Bowley, Head of Business Improvement and Support (Adult Social Care)
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Items to be scheduled in Work Programme
• Adult Social Care Commissioning Strategy (Graeme Betts) • Enablement Service Review (Graeme Betts) • Ageing Well Programme (Graeme Betts) • Shared Lives Service Re-design (Graeme Betts) • Neighbourhood Networks Programme (Graeme Betts) • Local Authority Social Services and National Health Service Complaints Annual Report for 2017/18 (Fran Zain) • Paediatric Surgery at the Royal Orthopaedic Hospital – (Kieren Caldwell, NHS England) • Draft Suicide Prevention Action Plan and Mental Health Wellbeing. • GP Practice Delivery – (Late 2019) o Partnerships (e.g. Modality) o Universal Patient Offer (Karen Helliwell) • STP Strategy – Post Engagement Report (Rachel O’Connor) • Quality of Mental Health Services provided by General Practice (Andy Cave, Healthwatch) • Update on the New Social Work Model in Birmingham (Pauline Mugridge) (Early new municipal year) • Birmingham Community Healthcare NHS Foundation Trust Quality Account 2018/19 (Carol Herbert) • Direct Payments in Birmingham: Maximising choice, control and flexibility in the use of Direct Payments ( Andy Cave, Healthwatch Birmingham – September 2019) • Evaluation of the HENRY and STARTWELL programmes (Dennis Wilkes) • BINDI – Birmingham India Nutrition Initiative (Ralph Smith)
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Joint Birmingham & Sandwell Health Scrutiny Committee Work Members Cllrs Rob Pocock, Mick Brown, Chauhdry Rashid, Paul Tilsley and Suzanne Webb Meeting Date Key Topics Contacts 1st August 2018 @ • Terms of Reference 2.00pm in Birmingham • Sandwell and West Birmingham Solid Tumour Oncology and Specialised Catherine O’Connell, Gynaecology Cancer Surgery Services Update Director of Specialised Commissioning, Midlands and East; Scott Hancock, Project Lead, Head of Operational Performance and Business Management Support, UHB; Toby Lewis, Chief Executive, Sandwell & West Birmingham NHS Trust.
• Update on the Midland Metropolitan Hospital Toby Lewis, Chief Executive, Sandwell & West Birmingham NHS Trust.
• Outcome of Consultation into Proposed Changes to 2 GP Practices in Sharon Liggins, Chief Sandwell and 1 GP Practice in West Birmingham Officer for Strategic Commissioning and Redesign
• Update on Same Day Access Sharon Liggins, Chief Officer for Strategic Commissioning and Redesign
18 October 2018 • Sandwell and West Birmingham Solid Tumour Oncology and Specialised Catherine O’Connell, Sandwell Gynaecology Cancer Surgery Services Update Director of Specialised Commissioning, Midlands and East; Scott Hancock, Project Lead, Head of Operational Performance and Business Management Support, UHB; Toby Lewis, Chief Executive, Sandwell & West Birmingham NHS Trust.
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18 October 2018 • Update on the Midland Metropolitan Hospital Toby Lewis, Chief Executive, Sandwell & West Birmingham NHS Trust
• Reconfiguration of services pending (the delayed) MMH
24 January 2019 • Proposed service model for the delivery of a gynae-oncology service for Catherine O’Connell, Birmingham at Sandwell and West Birmingham Director of 2.00pm. Specialised Commissioning, Midlands and East; Scott Hancock, Project Lead, Head of Operational Performance and Business Management Support, UHB; Toby Lewis, Chief Executive, Sandwell & West Birmingham NHS Trust.
• Further update on the Midland Metropolitan Hospital Toby Lewis, Chief o Written report on future service configurations upon opening of Executive, Sandwell the new hospital and any interim reconfigurations as a result of & West Birmingham the delay. NHS Trust
• Progress Report on Measures to Reduce A & E Waiting Times at Toby Lewis, Chief Sandwell and West Birmingham Hospitals Executive, Sandwell & West Birmingham NHS Trust 11 April 2019 • Sandwell and West Birmingham Solid Tumour Oncology and Specialised Catherine O’Connell, Sandwell Gynaecology Cancer Surgery Services Director of o Solid Tumour Oncology - formerly agreed transition plan and Specialised timelines. Commissioning, o Gynaecology Cancer Surgery Services – Options proposal. Midlands and East; Scott Hancock, Project Lead, Head of Operational Performance and Business Management Support, UHB; Toby Lewis, Chief Executive, Sandwell & West Birmingham NHS Trust.
• Further update on the Midland Metropolitan Hospital Toby Lewis, Chief Executive, Sandwell • Further update on Measures to Reduce A&E Waiting times at Sandwell & West Birmingham and West Birmingham Hospitals NHS Trust.
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TO BE • Changes in Primary Care Toby Lewis, Chief SCHEDULED Executive, Sandwell & West Birmingham NHS Trust
• Communication and Information to Patients regarding Changes in Toby Lewis, Chief Primary Care Executive, Sandwell & West Birmingham NHS Trust
• Outcome of Consultation into Improving Access to Local Healthcare Sharon Liggins, Chief Services Officer for Strategic Commissioning and Redesign, SWB CCG
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Joint Birmingham & Solihull Health Scrutiny Committee Work Members Cllrs Rob Pocock, Nicky Brennan, Mick Brown, Peter Fowler, Ziaul Islam, Chauhdry Rashid and Suzanne Webb Meeting Date Key Topics Contacts 18 July 2018 at • BSol CCG – Urgent Treatment Centres in Birmingham and Solihull Paul Jennings, CEO, 5.00pm BSol CCG Birmingham • BSol CCG – Quality, Innovation, Productivity and Prevention (QIPP) Phil Johns, Chief Programme Finance Officer
29th November at • Treatment Policies Clinical Development Group Progress Report Rhona Woosey, 6.00pm Network & Solihull Commissioning Manager; Ben Panton, Transformation Project Manager, Transformation & Innovation – Arden & GEM CSU; Cherry Shaw, Senior Communications Lead, Arden & GEM CSU.
• BSol CCG - Financial Plan 2018/19 Update – Latest figures Phil Johns, Chief Finance Officer
• NHS England (West Midlands) Community Dental Services Review – Howard Thompson, Update on Engagement and Consultation Supplier Manager – Dental NHS England – West Midlands; Nuala Woodman, Deputy Head of Commissioning (dental), NHS West Midlands
21st February • BSol CCG – Update on Urgent Treatment Centres Karen Helliwell, 2019 @ 5.00pm Director of in Birmingham Integration; Helen Kelly, Associate Director of Integration for Urgent Care and Community
• BSol CCG Financial Plan 2019/20 Update Phil Johns, Chief Finance Officer
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Joint Birmingham & Solihull Health Scrutiny Committee Work TO BE • Community Dental Services Review Consultation Document – Committee Howard Thompson, SCHEDULED Response Supplier Manager – Dental NHS England – West Midlands
• Healthwatch Birmingham & Healthwatch Solihull: Birmingham and Andy Cave, Chief Solihull Mental Health NHS Foundation Trust - PPI Executive; Dr Jane Upton, Head of Evidence, Healthwatch Birmingham.
CHAIR & COMMITTEE VISITS Date Organisation Contact
12th February Visit to CGL, Scala House Russell Booth 2019 1015-1215hrs TBC Visit to Umbrella (Birmingham Sexual Health Services) Natalie Slayman- Broom
INQUIRY: Key Question: How can a sustainable supply of free sanitary products be made available to females in educational establishments and council run buildings and, through engagement with our partners, more widely in buildings/venues across the City? Lead Member: Councillor Rob Pocock Lead Officer: Rose Kiely / Gail Sadler Inquiry Members: Councillors Brennan, Brown, Fowler, Islam, Rashid, Tilsley and Webb Evidence Gathering: June and July 2019 Drafting of Report: September 2019 Report to Council: November 2019
Councillor Call for Action requests
Cabinet Forward Plan - Items in the Cabinet Forward Plan that may be of interest to the Committee
Item no. Item Name Proposed date 005730/2018 A Sustainable Solution for the Future of Wellbeing Services and Hubs 26 March 19 005920/2019 Adult Social Care and Health – Day Opportunity Strategy 25 June 19 006126/2019 Public Health Paper – Approval to Consult 05 March 19
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