Item 8.4 for 5 April 2011 Aberdeen City CHP 171210

ABERDEEN COMMUNITY HEALTH PARTNERSHIP COMMITTEE

Minute of Meeting Board Meeting 05 04 11 17 November, 2010 Open Session Town House, Broad Street, Aberdeen Item 8.4

Present: Bill Howatson, Chairperson; and Councillors Cormack, Donnelly, Kiddie and Leslie; Heather Kelman, Heather Hardisty, Linda Smith, Fred McBride, Karyn Da Costa, Aileen Brown, Sheila Stewart, Anne Anderson, Stuart Notman and Pamela Cornwallis.

In Attendance: Sandy Reid and Val Tweedie; Jennifer Upson and Linda Duthie (Aberdeen Foyer - Article 8(B) only) and Simon Rayner and Karen Gunn (NHS Grampian – Article 12(A) only).

WELCOME AND APOLOGIES

1. The Chairperson opened the meeting by welcoming everyone present.

The Chairperson advised the Committee that Sergeant Andy Verreydt had replaced Chief Superintendent Adrian Watson as the Grampian Police representative on the Committee.

Apologies for absence were intimated on behalf of Mary Crawford, Andy Verreydt, Ian Paterson, Donald Newnham and Kevin Dawson.

DECLARATIONS OF INTEREST

2. The Chairperson asked Committee members whether they wished to declare an interest in relation to the items included on the agenda for consideration today.

There were no declarations of interest submitted.

MINUTE OF PREVIOUS MEETING

3. The Committee had before it the minute of its previous meeting of 23 June, 2010.

The Committee resolved:- to approve the minute subject to the removal of the following wording at Article 5 (Advocacy Services), paragraph 4:-

“although Heather Kelman clarified that the social work team from the hospital had relocated to Aberdeen Royal Infirmary which meant that the service was still available.” 2

COMMITTEE BUSINESS STATEMENT

4. The Committee had before it for consideration, the Committee Business Statement updated following the meeting held on 23 June, 2010. In addition to the update included in the Statement, further verbal updates were provided at the meeting as follows:-

(A) Extended Local Partnership Agreement

It was noted that this item was contained on the agenda (Article 7(A) of this minute refers).

The Committee resolved:- to remove this item from the Committee Business Statement

(B) Future Use of Woodgrove/ National Dementia Strategy

The Committee heard Heather Kelman provide an update on the future of the Woodgrove site, advising that meetings had been held with NHS Grampian and VSA to discuss the substantial costs needed to renovate the building.

In terms of action 2, (Dementia awareness and the National Dementia Strategy, it was agreed that an audit across the client groups would be undertaken to establish strategy gaps and that it would be circulated in advance of the September workshop) it was noted that a paper was included on the agenda for consideration. Article 8(C) of this minute refers.

The Committee resolved:- (i) to remove action 2 from the statement; and (ii) to note the information provided

(C) Child Sex Abuse (Adult Survivors) Seminar

It was noted that this item was contained on the agenda (Article 8(B) of this minute refers).

(D) Finance and Budget Reporting

It was noted that this item was contained on the agenda (Article 7(B) of this minute refers).

The Committee resolved:- to remove this item from the Committee Business Statement 3

(E) Children with Complex Needs – Redesign of Services

It was noted that this item was contained on the agenda (Article 9(A) of this minute refers).

CHP DELIVERY PLAN

5. With reference to Article 4(B) of the minute of the previous meeting of 23 rd June 2010, the Committee had before it the Aberdeen City CHP Community Health Partnership Delivery Plan (April 2010 to March 2013) for approval.

The Committee resolved:- To approve the CHP Delivery Plan

ANNUAL WORKSHOP EVENT

6. (A) Note of Meeting of 29 th September 2010

The Committee had before it for information, the Note of Meeting of the CHP Annual Workshop event held on 29th September 2010 in Woodhill House, Westburn Road, Aberdeen.

The Committee resolved:- to note the paper.

(B) Action Plan

The Committee had before it for consideration, a report by Heather Kelman which provided details of the SCOT (strengths, challenges, opportunities and threats) exercise held during the annual CHP Committee workshop on 29th September 2010 and the draft action plan prepared to take forward the issues from the workshop.

The report (a) advised that the annual CHP Committee workshop concluded with a SCOT exercise which aimed to review the Strengths, Challenges, Weaknesses and Threats of the Committee and facing the Committee; (b) appended feedback of the SCOT exercise from which, it was agreed that Heather Kelman should liaise with Fred McBride to draft a ‘straw man’ action plan arising from this analysis for discussion and debate at the November CHP Committee meeting; (c) appended the action plan which proposed a way forward for the CHP Committee to build on the existing strengths, to meet the challenges, address the weaknesses and mitigate the threats; (d) indicated that the SCOT analysis covered diverse aspects of the work of the CHP Committee including:-  the name, membership, effectiveness, agenda and clarity of role and purpose of the Committee; 4

 the focus of the Committee – strategic or operational; outcome or process; future forward facing or governance of what has already passed?  the broader partnership context e.g. Community Planning, third sector interface;  the commitment to partnership working and the communication challenge to sustain this;  the diversity of the Aberdeen population, the needs of the population and the opportunity to include the population as part of the solutions;  the resources, data and intelligence available and the constraints on these;  the uncertain economic and political climate that exists; (e) explained that the plenary discussion following the SCOT exercise also focussed on the relationship between the CHP Committee and the governance arrangements of the two main ‘parent’ agencies, namely NHS Grampian and Aberdeen City Council; (f) advised that the discussion suggested that the focus of the Committee should be on a shared or joint agenda with issues purely concerning NHS Grampian or Aberdeen City Council remaining outwith the Committee to be taken forward within the individual management and governance processes for each organisation; (g) suggested that joint working including the governance of joint working could be the sole responsibility of the CHP Committee having devolved powers from the relevant agencies for the resources involved in joint service provision; (h) stated that this would reduce the bureaucracy involved in reaching a joint decision, and should ensure the CHP Committee can demonstrate that it adds value; and (i) indicated that the name of the CHP Committee was discussed as being too ‘health’ dominant and it was proposed that the name should be reconsidered.

The report explained that since the workshop, draft guidance on “Reshaping Care for Older People, Local Transformation Plans: Guidance for Local Partnerships” (Article 13(A) of this minute refers) had been received for comment. This draft guidance suggested a ten point checklist for readiness for reshaping care. This checklist had been referenced in the development of the draft action plan.

The report further advised that the action plan when finalised and adopted would be presented to each meeting of the CHP Committee Executive Group for review. Actions would be closed when completed and new actions added as necessary. This could if necessary be used as a means of keeping Grampian NHS Board and Aberdeen City Council informed of the work and actions of the CHP Committee.

The draft action plan (1) outlined a series of actions and changes in behaviour that should lead to the Committee having a clear purpose, being able to demonstrate added value and to enable joint services to be governed once by a joint Committee; (2) advised that at present, many of the actions were procedural or process based, which could over time evolve to create more service outcome type actions; and (3) explained that some of the actions proposed were outwith the present delegated authority levels of the Committee and would require endorsement by the parent agencies and The Aberdeen City Alliance.

The report recommended:- that the Committee - (a) Discuss the content of the plan and consider whether or not it addressed the issues raised within the workshop; 5

(b) Review the proposed actions and consider whether or not these are the correct actions and if there are any areas omitted from the plan that should be included; and (c) Discuss how the plan should be progressed and the next steps.

The Committee resolved:- (i) to approve the actions contained within the draft Action Plan subject to advice being sought regarding the joint governance and accountability framework arrangements to enable pooled budgeting; (ii) that a paper outlining details and progress in relation to “Total Place” including suggestions on how the CHP Committee could contribute to it be submitted to a future meeting of the Committee; and (iii) to note that the Action Plan would be populated in terms of timescales, responsibility for taking action and progress and would be submitted to the next meeting of the Committee in February 2011.

CROSS CUTTING ISSUES (WHOLE POPULATION)

7. (A) Extended Local Partnership Agreement – Reshaping Care for Older People

The Committee received a powerpoint presentation from Sandy Reid, Programme Development Manager, Social Care and Wellbeing in relation to the Aberdeen Partnership Agreement for Reshaping Care for Older People.

Sandy Reid (a) outlined the vision of the agreement, namely that the Aberdeen Partnership (Aberdeen City Council and NHS Grampian) aimed to improve the health, wellbeing, social inclusion and independence of the people of Aberdeen; (b) indicated that good working relationships were developed over many years and several, jointly planned, funded and executed community developments had been undertaken including Community Mental Health Teams, Integrated Health and Social Care Teams, Elimination of Delayed Discharges and Shifting the Balance of Care; (c) explained that there was now a clear vision for delivering joint services including the establishment of the Performance Management Framework for Aberdeen which reflected community care outcomes, Single Outcome Agreement Indicators and HEAT Targets; (d) provided a summary of the Partnership Agreement for Reshaping Care for Older People including the following:-  that there was an emphasis that older people were an asset, not a burden;  that there would be 58% more over 65 year olds by 2033;  that the current pattern of care provision was not sustainable;  that it fits with National Strategy;  that it optimises Independence;  that services need to be more focussed on re-enablement; (e) explained that integration would provide simpler pathways for service users and carers, reduce bureaucracy and duplication, provide greater value for the public pound and produce faster progression in “shifting the balance of care”; (f) outlined the challenges for integration; (g) advised that in terms of financial arrangements, the Aberdeen Partnership would initially continue to operate within the strategic and governance frameworks established by both NHS Grampian and Aberdeen City Council; and (h) raised the question as to whether the Aberdeen City CHP 6

Committee should become the single governance framework for adult community care in Aberdeen.

The Committee resolved:- (i) to approve the Aberdeen Partnership Agreement for Reshaping Care for Older People; (ii) to instruct Senior Officers to commence its implementation; and (iii) to agree to receive six monthly progress reports

(B) Finance and Budget Reporting

The Committee had before it for consideration, Aberdeen City Council’s Priority Based Budgeting Report which provided the output of work between May and September 2010 to identify options to deliver services differently in a sustainable manner.

The report (a) advised that the vision for future services in Aberdeen responds to the drivers for change and aspires to deliver services which were efficient but still outcome focussed; (b) explained that the package of options provided acknowledged that services must maximise the expenditure on actual services and reduce indirect overhead costs; (c) indicated that current service delivery models need to be challenged and redesigned to ensure the customer is at the heart of what Aberdeen City Council does; (d) stated that there will need to be a significant increase in joint working with other public, voluntary and business sector partners within the region building on the initial conversations that have been undertaken in joining up service delivery to the community; and (e) outlined the 750 options and provided a summary of the potential savings which totalled £127m over a five year period, of which £48m had been highlighted as having a high implementation risk.

The Committee heard Fred McBride advise that the report would be considered by the Finance and Resources Committee on 2nd December 2010, thereafter the Full Council on 15th December 2010. He indicated that there was still an opportunity for partners to submit comments in relation to the report.

In relation to the Social Care and Wellbeing Service, Fred McBride explained that the savings options proposed for the service totalled £24m, of which a significant proportion was based on transformational options currently being undertaken including Telecare.

The Committee resolved:- to note the report and the information provided.

VULNERABLE GROUPS/PEOPLE (ADDITIONAL NEEDS)

8. (A) Advocacy Services

It was noted that Mark McEwen was unable to attend the meeting today to provide additional information regarding the paper he prepared in relation to the review of 7

Advocacy Services, therefore it was agreed to defer consideration of this item until the next meeting of the Committee.

The Committee resolved:- to defer consideration of this item until the next meeting of the Committee.

(B) Childhood Sex Abuse Seminar – Presentation by VSA

The Committee received a presentation from Jennifer Upson, Aberdeen Foyer in relation to Supporting Survivors of Childhood Sex Abuse (CSA).

Jennifer Upson (a) provided background information relating to Aberdeen Foyer, advising that it was a charitable organisation working to prevent and alleviate youth homelessness and unemployment with the aim to empower individuals to reach their potential; (b) outlined referral routes and the issues prevalent in those people who use the service; (c) advised that a research pilot was funded by the Scottish Government’s National Strategy for Survivors of CSA, which aimed to improve responses to the needs of CSA survivors and encourage the mainstreaming of services; (d) indicated that Aberdeen Foyer had been chosen as a pilot site due to its holistic services for vulnerable young people and its record of innovative practice; (e) explained that CSA contributes to major issues such as self harm and suicide attempts, substance misuse and homelessness; (f) outlined the aims and findings of the data collection pilot; (g) outlined staff attitudes in terms of how they question and respond towards CSA prior to and following the training courses; (h) advised that the only specialist support specifically for CSA identified in Aberdeen and surrounding area was the Children 1st’ Corrieneuchin project; (i) revealed that there was no dedicated service for CSA survivors over the age of 18; and (j) detailed the action points and next steps for the Foyer working group, including the launch of a new one year project and improving links between professionals through the local advisory group linked with Survivor Scotland.

The Committee resolved:- to note the information provided and to thank Jennifer Upson for the informative presentation.

(C) Stock Take of Community Care Strategies

With reference to Article 10(B) of the minute of the previous meeting of 23 rd June 2010, the Committee had before it for information a stock-take of existing Community Care Strategies, in order to establish gaps and agree immediate and future priorities.

The following strategies were identified:-  A Brighter Future (Mental Health) – 2004-2010 (Grampian);  The Same as You (Learning Disability) – 2000 (National);  Aberdeen Partnership Agreement for Reshaping Care for Older People in Aberdeen – 2010-2013;  Grampian Brain Injury Strategy;  Aberdeen Carers Strategy - 2004-2010; 8

 Aberdeen Physical Disability Strategy – 2004 -2010;  Aberdeen Sensory Impairment Strategy – 2004-2010;  Aberdeen Palliative Care Strategy – 2004-2010.

The table included the current status for each strategy.

The Committee resolved:- to note the information provided

EARLY YEARS/YOUNG PEOPLE

9. (A) Children with Complex Needs – Redesign of Services

With reference to Article 8(A) of the minute of the previous meeting of 23 rd June 2010, the Committee had before it a report by Heather Kelman on behalf of the Redesign Steering Group relating to the Redesign of Services for Children with Complex Needs.

The report (a) provided background information in terms of the decision taken by NHS Grampian to review the services provided for children with complex needs as a result of work being undertaken by Aberdeen City Council in terms of the services provided at Raeden Nursery School; (b) advised that an Implementation Steering Group had been established to oversee the multiple strands of the NHS redesign project which included representation from Aberdeen City Council and Aberdeenshire CHP; (c) explained that a meeting with Annette Bruton, Director of Education, Culture and Sport had been held to discuss the multi-agency aspects of the redesign and the significant change programme which was underway within Aberdeen City Council; (d) indicated that a joint project plan would be created to ensure coordination, but with two distinct and clear governance structures with Aberdeen City Council leading on the new special needs facility and the developmental nurseries; (e) advised that formal consultation to progress the plans for closure of some schools would commence shortly; (f) stated that Aberdeen City Council and NHS Grampian would work together to manage the transition from the present service to the proposed new integrated model for the service; (g) indicated that the indicative timescale to vacate the current buildings was at the end of the school year (July 2011) with the new specialist facility taking approximately two years to build (opening August 2013); (h) identified the key risks to the project including the possibility that the new service may not be delivered due to the national financial position leading to a significant change in Council and NHS financial planning; and (i) explained that there would be ongoing engagement with the public, carers, clinicians and other staff involved in the service which would be critical to the success of the redesign.

The report recommended:- That the Committee – (a) supports the implementation of the proposed redesign model to be taken forward in partnership with staff, parents/carers and our partner agency; and (b) recognises the risks associated with the redesign, and in particular the financial risks.

The Committee resolved:- 9 to approve the recommendations.

(B) Integrated Children’s Structures

The Committee had before it a report by Kay Dunn, Strategist for Integrated Children’s Services, which provided details of the review of Governance and Planning to Support Integrated Children’s Services. Attached to the report was the report by the Council’s Director of Education, Culture and Sport which sought approval of the future planning and governance arrangements to strengthen the delivery of Integrated Children’s Services in the City. The report advised that in 2009, the Children and Young People’s Strategic Planning Group (CYPSPG) reviewed the governance and planning to support the delivery of integrated children’s services in the City. The review considered the governance and resource management arrangements in place locally to deliver the Integrated Children’s Services Plan (ICSP) “For Aberdeen’s Children”. One-to-one interviews were held with 20 members of the CYPSPG and Children and Young People’s Services Management Group (CYPSMG) including elected members, the Education, Culture and Sport and Social Care and Wellbeing Directorates, NHS Grampian, Grampian Police, and the Aberdeen Council of Voluntary Organisation (ACVO) who represented the Third Sector. The following report recommendations had been put forward:- The proposals contained within the report before the Committee for approval had been designed to relate specifically to these recommendations:-  Improving outcomes for Children and families;  Overseeing the effective use of resources ;  The roles and accountabilities of partners in delivering improvements set out in the Integrated Children’s Services Plan;  Effective consultation, engagement and involvement of key stakeholders;  Supporting local capacity building and capability development;  The governance and principles of the partnership; and  Managing risks and exercising controls. The report also advised of the large membership of both the CYPSPG and CYPSMG and noted that the large size of both groups was not conducive to effective strategic planning. Following a meeting of representatives from key agencies, it had been agreed that governance and membership of the strategic planning structure should be designed around key outcomes, and that membership of the management group should be at a more senior level. The management group would then remit work programmes to a small number of focused delivery sub-groups. Finally, the report noted that the proposed strategic planning structure would take forward key message from the “Getting It Right for Every Child” pathfinder model which was being developed in Highland Council in order to drive forward a change in practice. A series of seminars led by the proposed Integrated Children’s Services Partnership and Management Group was to be arranged to deliver these key messages to staff. Further to this, events would be organised for teams within localities and associated school groups to ensure the change in practice was embedded at all levels. 10

Appended to the report were structure diagrams showing the current and proposed governance structures for Integrated Children’s Services, as well as the proposed membership for the governance structure and a diagram detailing the committee reporting arrangements for the Children and Young Peoples Strategic Partnership. Fred McBride advised that the Education, Culture and Sport and Social Care and Wellbeing Committees had approved the Integrated Children’s Structure. The Committee resolved:- to note the report

CHP COMMITTEE AND EXECUTIVE GROUP MEETING DATES

10. The Committee had before it for information, details of the 2011 meetings scheduled for the CHP Committee and CHP Executive Group.

The Committee resolved:- to note the CHP Committee meeting dates, times and venues for 2011.

PUBLIC HEALTH FORUM – MINUTE OF MEETING OF 1st SEPTEMBER 2010

11. The Committee had before them for information, the minute of meeting of the Public Health Forum held on 1st September 2010.

The Committee resolved:- to note the minute

ALCOHOL/DRUGS (SUBSTANCE MISUSE)

12. (A) Integrated Drug and Alcohol Treatment Services - Newsletter

The Committee had before it for information, the Aberdeen City Alcohol and Drug Partnership Newsletter relating to Integrated Drug Treatment and Rehabilitation Services.

The Newsletter provided an update in relation to (a) the Timmer Market Facility advising that building work was on schedule for completion in February 2011; (b) a Government visit on 3rd November 2010 to gain updates on performance of HEAT targets and recovery agendas; (c) service redesign relating to drug treatment services advising that all 27 Aberdeen GP practices had been visited and had now signed up to the Integrated Drug Service; and (d) community based rehabilitation, capacity building, pre-treatment support and the service delivery plan.

Simon Rayner and Karen Gunn advised that Angela Wood had been appointed as the Nurse Consultant for NHS Grampian substance misuse services. 11

The Committee resolved:- (i) to note the information contained in the Newsletter; and (ii) that arrangements be made for members of the Committee to visit the new GP practice development at Whinhill Road, Aberdeen.

ANY OTHER COMPETENT BUSINESS

13. (A) Reshaping Care for Older People – Local Transformation Plans: Guidance for Local Partnerships

Heather Kelman circulated a paper entitled “Reshaping Care for Older People – Local Transformation Plans: Guidance for Local Partnerships” which informed Health, Housing and Social Care interest within Community Planning Partnerships of the introduction of a “Change Fund” to facilitate a shift in the balance of care for older people, and provide advice on how to access the fund through preparation of Local Transformation Plans.

Heather Kelman sought comments on the draft guidance from the Committee, and asked if they could be submitted to her by 24th November 2010.

The Committee resolved:- to note that any comments to the draft guidance required to be submitted to Heather Kelman by 24th November 2010. - BILL HOWATSON, Chairperson.