ADULT SERVICES and HEALTH SCRUTINY PANEL Venue: Town Hall, Moorgate Street, Rotherham. Date: Thursday, 12 April 2007 Time: 9.30

ADULT SERVICES AND HEALTH SCRUTINY PANEL

Venue: Town Hall, Moorgate Date: Thursday, 12 April 2007 Street, Rotherham. Time: 9.30 a.m.

A G E N D A

1. To determine if the following matters are to be considered under the categories suggested in accordance with the Local Government Act 1972.

2. To determine any item which the Chairman is of the opinion should be considered as a matter of urgency.

3. Apologies for Absence

4. Declarations of Interest

5. Questions from members of the public and the press

6. Health Service - Annual Health Check (report attached) (Pages 1 - 31)

7. Local Area Agreement - Progress Report (copy attached) (Pages 32 - 58)

8. Patients' Hospital Discharge / Transfer of Care (report attached) (Pages 59 - 65)

9. Adult Services and Health Scrutiny Panel - Draft Work Programme and Scrutiny Reviews 2007/08 (report attached) (Pages 66 - 69)

10. Minutes of a meeting of the Adult Services and Health Scrutiny Panel held on 1st March, 2007 (copy attached) (Pages 70 - 73)

11. Minutes of a meeting of the Performance and Scrutiny Overview Committee held on (a) 16th February 2007, (b) 9th March, 2007 and on (c) 23rd March, 2007 (copies attached) (Pages 74 - 99)

Date of Next Meeting:- Thursday, 31 May 2007

Membership:- Chairman – Councillor Doyle Vice-Chairman – Jack Councillors:- Billington, Burke, Burton, Clarke, Jackson, Turner and The Mayor (Councillor Wootton) Co-opted Members Mrs. I. Samuels, (PPI Forum Yorks Ambulance Serv), Taiba Yasseen, (REMA), Val Lindsay (Patient Public Involvement Forum), Sandra Bann (PPI Forum Rotherham PCT), Mrs. A. Clough (ROPES), Victoria Farnsworth (Speak Up), Jonathan Evans (Speak up), Mr. G. Hewitt (Rotherham Carers' Forum), Ms. J. Mullins (Rotherham Diversity Forum), Mr. R. H. Noble (Rotherham Hard of Hearing Soc.) and Lizzie Williams

Page 1 Agenda Item 6

ROTHERHAM BOROUGH COUNCIL – REPORT TO MEMBERS

1. Meeting: ADULT SERVICES AND HEALTH SCRUTINY PANEL

2. Date: 12 April 2007

3. Title: Annual Health Check 2006-07

4. Programme Area: Chief Executive’s

5. Summary

This report explains the Annual Health Check process and gives the Overview and Scrutiny responses to the local health trusts’ declarations.

6. Recommendations

a. That the responses agreed by the South Yorkshire Joint Health Scrutiny Committee (in respect of Sheffield Children’s Hospital, Sheffield Teaching Hospitals and Yorkshire Ambulance Service) be noted.

b. That Members consider the draft responses in respect of Rotherham PCT, Doncaster and South Humber NHS Trust and Rotherham NHS Foundation Trust and agree or amend them, as necessary.

Page 2

7. Proposals and Details

7.1 Background

7.1.1 In April 2005, the Healthcare Commission launched a new approach to assessing and reporting called the Annual Health Check. This system is based upon measuring performance within a framework of national standards and targets set by Government.

7.1.2 The Annual Health Check has replaced the old ‘star ratings’ assessment system and looks at a much broader range of issues than the targets used previously, and seeks to make much better use of the data, judgments and expertise of others to focus on measuring what matters to people who use and provide healthcare services.

7.1.3 The overall aim of the new assessment of performance, and the information gained through the process, is to promote improvements in healthcare. It will also help people to make better informed decisions about their care, promote the sharing of information and give clearer expectations on standards of performance.

7.1.4 In April 2007, each health trust is required to provide a declaration of its compliance (or otherwise) against the Department of Health’s 24 core standards.

7.1.5 Overview and scrutiny committees (along with patient and public involvement forums and strategic health authorities) are invited to make comments on the performance of their local PCTs. Overview and scrutiny committees are not expected to comment on the trust’s performance against each of the 24 core standards. Instead, comments should be based on the evidence they have gained through their health scrutiny work and, if possible, cross-referenced against the relevant core standard.

7.1.6 The trusts are required to submit overview and scrutiny comments, unedited, with their declarations. The Healthcare Commission takes these comments into account when assessing the trusts and awarding them an overall rating.

7.1.7 This year, the four South Yorkshire local authorities agreed to work together on producing comments for Sheffield Children’s Hospital Foundation Trust, Yorkshire Ambulance Trust and Sheffield Teaching Hospitals NHS Foundation Trust. This was done through the South Yorkshire Joint Health Scrutiny Committee, membership of which is the chair of each Scrutiny Committee, plus two others, from each of the four councils.

7.1.8 The joint committee used a consultant funded by the Centre for Public Scrutiny to help it identify which of the core standards it should focus on and some areas for questioning.

7.1.9 The most relevant core standards were identified as:

C6 (essentially, co-operation to meet patients’ individual needs)

Page 3

C7 (sound governance), C13 (essentially, dignity) C14 (essentially, information and complaints) C15 (essentially, food) C16 (essentially, information on services) C17 (essentially, seeking patient views) C22 (essentially, reducing health inequalities

7.1.10 Each trust was provided with a brief against which it was asked to provide a presentation, followed by answering questions from members.

7.2 Sheffield Children’s Hospital Foundation Trust

7.2.1 The Joint Health Scrutiny Committee met with senior management from the Children’s Hospital Foundation Trust on 9 March 2007. The members involved from Rotherham’s Children and Young People’s Services Scrutiny Panel were:

• Cllr Ann Russell • Cllr Colin Barron • Maureen Morton (co-optee).

7.2.2 A draft response was drafted after the meeting and was amended and agreed at a subsequent meeting of the Joint Health Scrutiny Committee on 29 March. The final response is given at Appendix A, for information.

7.3 Yorkshire Ambulance Trust and Sheffield Teaching Hospitals NHS Foundation Trust

7.3.1 The Joint Health Scrutiny Committee met with senior management from the Yorkshire Ambulance Trust and Sheffield Teaching Hospitals NHS Foundation Trust on 14 March 2007. The members involved from Rotherham’s Adult Services and Health Scrutiny Panel were:

• Cllr John Doyle (Chair of the Joint Committee for the meeting) • Cllr Allan Jackson • Cllr John Turner.

7.3.2 Draft responses were drafted after the meeting and amended and agreed at a subsequent meeting of the Joint Health Scrutiny Committee on 29 March. The final response to Yorkshire Ambulance Trust is given at Appendix B, and to Sheffield Teaching Hospitals at Appendix C, for information.

7.4 Rotherham PCT, Doncaster and South Humber NHS Trust (DASH) and Rotherham NHS Foundation Trust

7.4.1 For the Rotherham health trusts, an Annual Health Check Working Group was set up, comprising members of the Children and Young People’s Services and the Adult Services and Health Scrutiny Panels.

7.4.2 The members involved from Adult Services and Health Scrutiny Panel were:

Page 4

• Cllr John Doyle (Chair of the Working Group) • Cllr Allan Jackson • George Hewitt (co-optee)

7.4.3 The members involved from Children and Young People’s Services Scrutiny Panel were:

• Cllr Colin Barron (Chair of the Working Group) • Cllr Barry Kaye • Cllr John Swift.

7.4.4 Each trust was provided with a brief against which it was asked to provide a presentation. This was given at a meeting with the Working Group and was followed by questions.

7.4.5 Draft responses have been drawn up based on evidence given at the meeting with each local trust, plus additional information that came from other work of the relevant Panel. They are appended as follows:

Appendix D – Rotherham PCT Appendix E – DASH Appendix F – Rotherham NHS Foundation Trust.

8. Finance

There are no financial implications arising from this report.

9. Risks and Uncertainties

Although it is not a specific requirement, the Healthcare Commission suggests that overview and scrutiny comments may be shared with the relevant trust, prior to submission. By doing this, we can ensure that any comment based on a misunderstanding can be modified, before it is submitted.

10. Policy and Performance Agenda Implications

Contributing towards the Annual Health Check process is part of the Panel’s health scrutiny remit.

11. Background Papers and Consultation

The Annual Health Check in 2006-07: Assessing and rating the NHS, Healthcare Commission, September 2006

Contact: Delia Watts, Scrutiny Adviser, direct line: (01709) 822778 e-mail: [email protected]

Page 5 Appendix A

Member of the Council: Councillor L. Picken Office: Town Hall Home: 17 Blackheath Road BARNSLEY Athersley South Yorkshire S70 2TA BARNSLEY S71 3RE Tel: 01226 773452 Tel: 01226 200001 Fax: 01226 773498 Email: [email protected]

Our ref: LP/RO/LH/SC/016/00004

rd 3 April 2007

Mr Chris Sharatt Chief Executive’s Office Sheffield Children’s NHS Trust Western Bank Sheffield S10 2TH

Dear Mr Sharatt

Healthcare Commission Annual Health Check Overview and Scrutiny Comments on 2006/2007 Declaration

On behalf of my colleagues on the South Yorkshire Joint Health Scrutiny Committee, I wish to thank you and Mr Reid for your assistance in relation to the Annual Health Check.

The Joint Committee has considered the findings and their conclusions for the declaration. I attach a copy of the Committee’s submission. This summarises the key aspects of the evidence, together with the conclusions in relation to the selected Core Standards.

I would be grateful if you could acknowledge receipt of the submission. I would also appreciate an outline of your timetable for the Trust’s declaration to the Healthcare Commission. The Committee will be interested in receiving feedback on how their observations have been taken into account in this process.

Again, many thanks for your presentation to the Joint Committee and your responses to questions. This has provided Members with an excellent insight into the work of your Trust and demonstrated a commitment to engaging with overview and scrutiny. On behalf of the Committee, we will look forward to future contact.

Yours faithfully

Councillor Len Picken

Chair of Health and Adult Services Scrutiny Commission

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Annual Health Check 2006/2007

Submission of the South Yorkshire Joint Health Scrutiny Committee – The Sheffield Children’s Hospital NHS Foundation Trust

1. Background: South Yorkshire Joint Health Scrutiny Committee

1.1 The following Health Check Submission (2006/2007) is made on behalf of the South Yorkshire Joint Health Scrutiny Committee. The Joint Committee comprises locally Elected Members from the Health and Children’s/Adult Scrutiny Commissions of the four South Yorkshire districts – Barnsley MBC, Doncaster MBC, Rotherham MBC and Sheffield City Council. The Joint Committee’s remit is to scrutinise issues and service delivery for health which have cross-boundary implications for the South Yorkshire districts.

1.2 As part of the Annual Health Check for 2006/2007, the Joint Committee has undertaken to carry out scrutiny of the various trusts representing the Sheffield Children’s Hospital; the Yorkshire Ambulance Service and Sheffield Teaching Hospitals. Scrutiny is to be evidence based, from documenting services and verbal evidence to be given at meetings of the Committee. Evidence gathering is centred on the Healthcare Commission’s Core Healthcare Standards.

1.3 The Joint Scrutiny Committee met on 9th March 2007 to consider the performance of the Children’s Hospital against selected Core Standards. These were chosen to reflect key issues of Strategic Direction, Patient/Carer interface and Service Delivery. These were:-

C7 – Governance C6 – Co-operation to Meet Patients’ Individual Needs C13 – Dignity C14 – Information and Complaints C15 – Food C16 – Information Services C17 – Seeking Patient Views C22 – Reducing Health Inequalities C24 - Emergencies

1.4 The meeting was attended by senior members of the Trust, Chris Sharratt (Chief Executive) and John Reid (Director of Clinical Operations and Nursing). The witnesses provided a short presentation in relation to the organisation of the Trust and their position in relation to all identified Core Standards. The Trust representatives were then questioned.

1.5 The following brings together key aspects of evidence from the Trust which were considered by the Joint Committee. The main conclusions of the Committee regarding compliance with Core Standards are highlighted in bold italics.

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2. Sheffield Children’s Hospital Foundation Trust: Outcomes of Joint Scrutiny

Core Standard C7: Sound Governance

2.1 The Trust presented evidence based around its status as a Foundation Trust established in August 2006, and one of the first four children’s hospitals to attain this status. In November 2006 the Trust celebrated a 130 year anniversary, being the longest established children’s hospital in the world. The hospital has responsibilities for provision of Specialist Care; Acute Services; Community Child Health; Mental Health; and Regional Genetic Screening. Services are delivered from several sites.

2.2 The Trust outlined their arrangements for public constitution; Board and Committee minutes, which are published; setting strategic objectives; operation of an Assurance Framework approved by Internal Audit; and their Risk Management regime (CNST approved).

2.3 In a recent HCC review of children’s acute services, the Trust was ranked in the top 4% of trusts nationally. Cumulatively the Children’s Trust scores were highest nationally, rated against standards for Emergency Care Environments; Day Care Environments; In-patient Care Environments; Out- patient Care Environments; Emergency Surgery; and Elective Surgery. The hospital’s A and E service has been quoted as an “exemplar” by a HCC review of paediatric A and E’s.

2.4 In evidence to the meeting of the Joint Scrutiny Committee, the Trust indicated that they intend to declare compliance with all core standards in the 2006 Healthcare Check.

2.5 In further questioning, the Joint Scrutiny Committee’s focus was on how the Trust is performing financially, and has appropriate risk management structures in place (C7 (c) and (d)).

2.6 In terms of Financial Management , the Trust is required to achieve annual efficiency targets year of 2.5%. However, due to other pressures such as the Tariff, the Trust is required to achieve a Cost Improvement reduction of 4% over the coming two financial years. This equates to some £9m over a three year financial planning period, including 2006/7. The Trust is in the first year of this period and indicated that savings are on line to achieve the necessary £3m, with a likely surplus of £1m. The Trust is achieving this in what it feels are constraints imposed by the NHS Tariff system for funding, which does not appropriately support specialist paediatric treatments of the kind provided by the Children’s Hospital.

2.7 Despite this financial context, the Trust is achieving an additional 23% treatment rate. This is attributable to short stays (average 1.7 days) and technological advances. The Trust gave specific examples of investment, for example a £10.5m operating theatre facility; and a “state of the art Day Care Unit. The Trust strongly emphasised that their strategy is not based on “cuts”, at the cost of safety or quality. However, reductions in provision will be made to some mental health services – this will lead to a

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reduction in promotion but not to the standard of care provided.. These have not been subject to the overall tariff, but made by the Sheffield PCT as a commissioning body, following reductions in grant from Government.

2.8 The Trust also pointed to a “significant” increase in demand for A and E services, which has created additional staffing demands. Many of these are not for serious conditions and no child is ever turned away. Some 98% of patients are seen within four hours, the majority within one hour.

2.9 The Trust’s strategy is for extended provision of community based services, for users to access as out-patients, not in-patients. There are, in addition, linkages with providers in local hospitals (see following).

2.10 The Trust has Risk Management systems in place. This is supported by an Assurance Framework to the Trust’s Board, together with a statement of Internal Control. Verification is provided by Internal Audit. The Trust indicated their willingness to produce details of these frameworks.

2.11 Other issues of clinical provision, related to governance, which were raised by the Joint Committee included:-

● Emergency Surgery – The Trust received a score of “fair” in the HCC’s Audit (see paragraph 2.3). The Trust attributed this to a primarily technical issue around access to recording of staff education and training, a problem confronted by other Trusts in the HCC assessment. The Trust have however put in place a pilot scheme for electronic register of these records. The Trust expect to receive an “excellent” rating in the next audit.

● In-patient Care Environments – This was rated “good” by the HCC. The Trust pointed to expectations for more rigorous standards, with minor failings such as small amounts of litter taking a score from “excellent” to “good”. Set against this, the Trust has exceptionally low rates of MRSA.

● S2 Ward – Concerns were raised by Members of the Joint Committee regarding previous proposals for closure of this facility as a high dependency unit. The Trust pointed to rationalisation plans for the ward, which has a seasonal mismatch of patients, and noted that services would be reconfigured to better meet patient needs.

2.12 With regard to broader accountability, the Trust is accountable to its Board of Governors and Patients Forum. Databases for these arrangements are open to the public. The Trust are open to accountability through local authority based Overview and Scrutiny.

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2.13 In terms of learning culture, the Trust gave an example of work carried out through the independent regulator MONITOR of lessons learned from governance difficulties experienced at Bradford Hospital and Moorfields Eye Hospital. The Trust see their foundation status as an indicator of their capacity to learn and innovate.

Compliance with Core Standard C7: Conclusions

2.14 The Children’s Hospital Foundation Trust has an impressive history of clinical paediatric care. Its strong performance in service delivery is reflected in recent audits. The future for the hospital holds many challenges, in particular with respect to financial management. The Joint Committee is satisfied that within the scope of its inquiry, appropriate mechanisms are in place to handle these financial pressures. Risk Management systems are in place to track financial performance. Currently the Trust is delivering against financial targets, although years two and three of the Cost Improvement Programme will present increasing challenges, which the Committee will wish to monitor as part of its future work.

2.15 The Committee sought evidence that efficiency and other savings were not adversely affecting service delivery, and this was provided through, for example information on patient throughput and waiting time indicators..

2.16 The Committee is satisfied that the Trust’s governance arrangements are supported by forward strategy, commensurate with its Foundation status. Forward strategy envisages greater provision of services on a community, home based approach which reflects wider aims for health care. Evidence also pointed to the Trust’s willingness to learn and innovate from elsewhere.

2.17 The Joint Scrutiny Committee concludes that the Trust is compliant with Core Standard C7, but will wish to monitor future progress in particular with regard to financial management. The Trust’s commitment not to impair front line service delivery and to maintain standards of quality and safety in this context are welcomed and will also provide bench marks for future scrutiny.

Core Standard C6: Co-operation/Partnerships to Meet Patients’ Individual Needs

2.18 Evidence from the Trust pointed to arrangements for joint working through a number of channels, in particular:-

● A 0 – 19 Partnership (Sheffield) ● Safeguarding Board ● Joint Area Review (JAR) ● CAU ● Dual Diagnosis

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● Children’s Respite ● Integrated Practice

2.19 The Trust referred to examples of joint working including:-

● Barnsley District General Hospital - A concordat is in place, including provision of pathology services. The Trust provides a clinical service for children for cystic fibrosis, betathalassaemia, sickle cell anaemia. The Trust operates specialist schools in Barnsley.

● Looked After Children – The Trust provides specialist services in liaison with the districts. The Trust has a multi-agency register listing contacts with children, which can identify “clusters” on a holistic care basis.

● Child Assessment Unit – This unit is a multi-agency team consisting of police, social workers, specialist paediatricians and psychologists.

● Integrated teaching provision for children with profound disabilities in the Disability Unit, comprising ten teachers employed by Sheffield City Council.

Compliance with Core Standards C6: Conclusions

2.20 The Joint Committee concludes that the Trust has a strong awareness of the need for partnership. There are practical examples of this being put into practice. The Joint Committee concludes that the Trust is compliant with the Core Standard.

Core Standard C13: Dignity

2.21 The Trust in evidence referred to:-

● A Corporate Equality Scheme ● Interpreters Service ● Estates Strategy – encompassing measures to improve patient and carer accessibility ● Parent Facilities ● Bereavement Support ● Consent Policy and Information ● Confidentiality Policy

Compliance with Core Standard C13: Conclusions

2.22 The Joint Committee is satisfied that the Trust has strategy and initiatives in place, but was unable to fully consider the effectiveness of these in relation to compliance with the Core Standard.

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Core Standard C14: Information and Complaints

2.23 The Trust operates the following systems:-

● A Complaints Policy ● Targets for reduction of complaints ● Complaints leaflets, in varying language formats ● “PALS” Service ● Interpreters Service ● Staff training ● Other leaflets and signs

Core Standard C14: Conclusions

2.24 The Trust has mechanisms in place for the processing of information and complaints, and as such is compliant with the Core Standard. However within the scope of its inquiry the Joint Committee was unable to rigorously assess the effectiveness of the Trust’s performance in this area, in particular the outcome of complaints and customer satisfaction with the process.

Core Standard C15: Food

2.25 Aspects of food related care provision highlighted by the Trust included:-

● 24 hour catering ● Food hygiene certification ● Children’s menu ● Family catering ● Special diets kitchen ● Dietician advice ● PEAT quality control ● Children’s nursing support with feeding

Core Standard C15: Conclusions

2.26 While the Joint Committee notes and welcomes the initiatives being undertaken, within the evidence it was not possible to determine whether there is full compliance with the Core Standard .

Core Standard C16: Information on Services

2.27 The Trust provides information through a variety of media, including:-

● Multi-lingual leaflets ● Multi-format leaflets ● Multi-lingual audio booths ● Interpreter and language line ● Web site

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Core Standard C16: Conclusions

2.28 While the Joint Committee notes and welcomes the initiatives being undertaken, within the evidence it was not possible to determine whether there is full compliance with the Core Standard.

Core Standard C17: Seeking Patient Views

2.29 The Trust’s key methods for patient feedback and consultation include:-

● Comments cards ● PALS Service ● Governors and Members ● Patients Council ● Focus groups ● Complaints analysis

2.30 Evidence highlighted efforts to engage young people. The Patient Forum itself has proven helpful in identifying service gaps. However, there are problems of recruitment to the Forum.

Core Standard C17: Conclusions

2.31 While the Joint Committee is satisfied that the Trust is in general compliance with the Core Standard, recruitment to the Patients Forum is an area of concern that should be addressed more rigorously. While this is not the direct responsibility of the Children’s Trust, a stronger Patients Forum will assist development of the Trust from a user perspective. There will be a role for Overview and Scrutiny in assisting this process. In addition there is a lack of clarity as to how consultation is being undertaken throughout South Yorkshire as a whole. The Joint Committee were unable to comment on how effectively the outcomes of patient consultation are taken on board by the Trust.

Core Standard C22: Reducing Health Inequality

2.32 The principles of joint working and partnership within this core standard are referred to elsewhere in this submission.

2.33 In evidence, the Trust pointed to various initiatives which reflect aims to address health inequalities. These included “multi-assessments” being carried out at Ryegate between a range of agencies; interpreter services; evening staffing at A and E to deal with needs of Asian families who may be reluctant to access GPs; and employment of ethnic minority community nurses.

Core Standard C22: Conclusions

2.34 While the examples presented illustrated good practice, the Joint Committee was not convinced that the Trust has a clear policy framework

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to address health inequalities. The Committee recommends that this issue is given greater consideration and understanding by the Trust. This should more transparently reflect the work of local Directors of Public Health and their recent report on Health Inequalities ( Improving Health : Narrowing the Divide ).

Core Standard C24: Emergencies

2.35 The Trust described measures to deal with a possible outbreak of avian flu. There are staffing and physical arrangements in place for this contingency. These arrangements form part of broader emergency planning strategy.

Core Standard C17: Conclusions

2.36 The Joint Committee welcomes the initiative being taken with regard to avian flu. However, within the evidence the Joint Committee was unable to establish whether the Trust is in full compliance with the Core Standard.

Concluding Observations of the Joint Scrutiny Committee

2.37 The Joint Committee is impressed by the track record and general performance of the Trust. This is underlined by external audit. The Trust has strategies in place to meet significant challenges and changes in how future paediatric healthcare will be provided.

2.38 The Committee will have a particular interest in the Trust’s financial management strategy over the coming two year period and associated risk management. There are other issues highlighted in scrutiny, which the Committee may wish to assess in greater depth, for example how consultation and patient involvement affect outcomes. The Trust’s development of policy for Health Inequalities is a further area of interest.

2.39 The Committee wish to express their thanks to the Trust’s witnesses and their willingness to engage openly in scrutiny.

22 nd March 2007

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Metropolitan Borough of Rotherham

Cllr John Doyle Rotherham Town Hall, The Crofts, Moorgate Street, Rotherham, South Yorkshire S60 2TH Telephone 01709 822722/1 Facsimile 01709 822734

29 March 2007

Jayne Barnes CBE Chief Executive Yorkshire Ambulance Service Springhill 2 Brindley Way Wakefield 41 Business Park WAKEFIELD WF2 0XQ

Dear Ms Barnes

Healthcare Commission – Standards for Better Health, OSC Comments on 2006/07 Declaration

As Yorkshire Ambulance Service NHS Trust provides services1 across South Yorkshire, the South Yorkshire Joint Health Scrutiny Committee felt that it would be helpful to provide comments on behalf of the scrutiny functions of the four councils, rather than doing this on an individual council basis.

In addition to the evidence gathered at our meeting with you in March, we have used relevant information from health scrutiny work undertaken by the individual councils, to inform our comments.

For the purposes of this2 exercise we have concentrated on a number of specific core Healthcare Standards :

cont./…

1 comprising members of the Health Overview and Scrutiny Committees of Barnsley, Doncaster,

2Rotherham and Sheffield DH: Standards for Better Health Page 15

…/page 2

nd From the 2 Domain: Clinical & Cost Effectiveness C6 (essentially, co-operation to meet patients’ individual needs) • The Trust’s identification of the specific care needs of each patient – both in terms

of their health and any cultural or language requirements supports its expected3 compliance with this standard. In addition, its response to the Bradley Report , to ensure that each patient receives a timely response from the correct vehicle and person with the right skill set (through an additional triage service offered at Wakefield and York communications centres), provides further evidence. • We understand that working with 12 PCTs, which often commission services at different standards, is a substantial challenge. The Trust’s Effective Commissioning Forum provides a consistent overall approach, but with the flexibility for differing local priorities. This further evidences compliance with this standard • In addition, the Trust’s commitment to understand the health needs of local communities is evidenced by its sharing of information on regular service users with PCTs. rd From the 3 Domain: Governance C7 (essentially, sound governance) • The Trust’s decision to put itself in ‘voluntary financial turnaround’ is evidence that it is working hard towards improving its financial position. • It meets and often exceeds existing performance requirements in respect of response rates. Committee members from Barnsley questioned the services provided in rural areas such as Penistone and were told that a rapid response vehicle was on standby for 20 hours a day and that the remaining period (2-6 am) was covered by ambulances based at Barnsley. However, concern remains about response times and the absence of ‘first responders’ during the night-time period. th From the 4 Domain: Patient Focus and Partnership with Patients/Carers C13 (essentially, dignity) • The design of vehicles, combined with the standards of professionalism shown by ambulance staff, support the Trust’s compliance with this standard. C14 (essentially, information and complaints) • The handling of complaints (including the final signing-off of all responses by the Chief Executive) is done well. However, there seems to be a focus on responding to written complaints. Although the Trust currently has no plans to set up a single telephone number for complaints, we were pleased that its management may consider our suggestion for this, in future.

cont./…

3 Transforming Ambulance Services Page 16

…/page 3

C16 (essentially, information on services) • We understand that although there is some evidence to support good work in this area (e.g. each vehicle contains a booklet in 36 languages to aid basic communications with non-English-speaking patients and regular training is provided on the needs of patients from the BME community), more could be done to ensure full compliance with this standard. It is pleased to note that the Trust’s Media and Communications Group has drawn up an action plan to address this and produce accessible information for the different communities it serves. We therefore support the Trust’s self-assessment of Insufficient Assurance against this standard. th From the 5 Domain: Accessible and Responsive Care C17 (essentially, seeking patient views) • Although the Trust makes use of information gained through public opinion surveys and its Patient Participation Forum, we agree that more could be done to seek patient views, particularly though links with other organisations e.g. PCTs, hospitals and local authorities, for survey purposes. We support the Trust’s self- assessment of Not Met against this standard. • However, early notification of the Trust’s proposal to close the communications centre at Rotherham was given to all the local authorities. This, together with the Trust’s offer to come to discuss the proposals at overview and scrutiny committees as part of its formal consultation, provides evidence of its willingness to seek our views before making such a change. th From the 7 Domain: Public Health C22 (essentially, reducing health inequalities) • The Trust did not provide us with specific evidence to illustrate its work in this area, beyond its engagement with the national benchmarking systems. However, its involvement in the PACE-setters programme may go some way to addressing this gap. We therefore support the Trust’s position of Insufficient Assurance in compliance with this standard and are pleased to hear of plans for closer working with local Directors of Public Health to address this in future. We further welcome the Trust’s offer to work more closely with local overview and scrutiny committees to determine local health inequalities. C24 (essentially, emergency planning) • By retaining the patient contract for Barnsley and Rotherham, the Trust continues to have the resources to play its part in emergency planning, providing evidence to support compliance with this standard.

cont./… Page 17

…/page 4

Overall, we understand the challenges of combining three ambulance trusts into one and the effect of their individual positions on the new trust’s compliance with the core standards. However, we are hopeful that the work already undertaken, together with future plans for extending good practice across the whole of the new organisation will ensure that the Trust is working towards ultimate compliance in all areas. The coming year will be critical and the Joint Committee will look for clear evidence of progress by the Trust.

Over the next few months the Overview and Scrutiny Committees from the four South Yorkshire Authorities will be drawing up plans for work in 2007/2008 and will bear in mind the Annual Health Check process and the knowledge gained through it when doing so.

We support the principals of the Annual Health Check and its aim of raising standards across the healthcare community and welcome the opportunity to contribute to the process.

Finally, we would like to thank you for hosting a meeting with our Joint Committee, for your presentation against our brief and also for answering our questions on your performance against specific standards. It provided Members with a good overview of the work of your Trust and demonstrated its commitment to engaging with the scrutiny process. Close working between our two organisations at officer level has also been very useful.

Yours sincerely

Cllr John Doyle Chair of the South Yorkshire Joint Health Scrutiny Committee

Page 18 Appendix C

Metropolitan Borough of Rotherham

Cllr John Doyle Rotherham Town Hall, The Crofts, Moorgate Street, Rotherham, South Yorkshire S60 2TH Telephone 01709 822722/1 Facsimile 01709 822734

29 March 2007

Mr Neil Riley, Trust Secretary Sheffield Teaching Hospitals NHS Foundation Trust 8 Beech Hill Rd Sheffield S10 2SB

Dear Mr Riley

Healthcare Commission – Standards for Better Health, OSC Comments on 2006/07 Declaration

As Sheffield Teaching Hospitals NHS Foundation Trust provides tertiary services1 across South Yorkshire, the South Yorkshire Joint Health Scrutiny Committee felt that it would be helpful to provide comments on behalf of the scrutiny functions of the four councils, rather than doing this on an individual council basis.

In addition to the evidence gathered at our meeting with you in March, we have used relevant information from health scrutiny work undertaken by the individual councils, to inform our comments.

For the purposes of this2 exercise we have concentrated on a number of specific core Healthcare Standards :

nd From the 2 Domain: Clinical & Cost Effectiveness C4 (essentially, infection control) • Members feel that the very low rates of MRSA and Clostridium difficile within the Trust are evidence to support public confidence in its high standards of hygiene and cleanliness and thus compliance with this standard. cont./…

1 comprising members of the Health Overview and Scrutiny Committees of Barnsley, Doncaster,

2Rotherham and Sheffield DH: Standards for Better Health Page 19 …/page 2

C6 (essentially, co-operation to meet patients’ individual needs) 3 • The JAR of children’s services identified that the Trust works well with others in meeting the needs of children and young people. • We were pleased to hear about existing work with the Sheffield Care Trust on

acute patients with mental health needs, and acknowledge that4 the Trust accepts that it still has further work to do – particularly as it is estimated that 25 to 30% of any acute trust’s patients have mental health needs. • Although the single assessment process is being used across the health and social care communities, the full benefit will not be realised until patient records are held electronically. Only then will this provide good evidence for supporting the Trust’s compliance with this standard.

rd From the 3 Domain: Governance C7 (essentially, sound governance) • The Trust’s achievements in reducing the length of hospital stays are evidence to support its efficient use of resources. • Although there is ongoing work to tackle delayed discharges (using a database that is shared by the Trust and Social Services), the Trust acknowledges that currently the health system (both hospital and PCTs) bear a greater share of responsibility for these delays than Social Services. • The Trust has made great improvements in reducing the number of scheduled operations that are cancelled for non-clinical reasons, with rates currently at about 0.5%. The use of a Theatre Admissions Unit and pre-assessment clinics has helped patient flow and we feel that the substantial reduction in medical outliers provides further evidence to support the Trust’s compliance with this standard. • Whilst we acknowledge the recent developments in sexual health services, including the opening of a new clinic in February, we are concerned that the 48 hour target for access to services is still not being fully met.

th From the 4 Domain: Patient Focus and Partnership with Patients/Carers C13 (essentially, dignity) • The rolling out of the Liverpool End of Life Pathway across the Trust and recent modifications to improve access for disabled people are examples of how the Trust complies with this standard. The very low levels of complaints in respect of privacy/dignity (only 5 in 2006/07) further supports this.

cont./…

3 4 Joint Area Review Ref: ‘Who Cares Wins’ - Royal College of Physicians Page 20 …/page 3

C14 (essentially, information and complaints) • We feel that the systems that the Trust has in place – and particularly the high level of complaints that are resolved informally – support the Trust’s compliance in this area. However, we feel that further work needs to be done on the patient complaints satisfaction survey, to ensure that responses refer to the complaints process, rather than the original issue that was the subject of the complaint. • Updating of consent forms and the provision of personal stereos for people undertaking surgery under local anaesthetic are two improvements made as a result of complaints. This evidence indicates that the organisation makes changes to improve service delivery and thus supports the Trust’s compliance with this standard. C15 (essentially, food) • 24 hour access to food for patients supports the Trust’s compliance with this standard. • We applaud the Trust’s patient satisfaction rates for food of 66-68% at the Central Campus, but are concerned about the lower levels of satisfaction at the Northern site (44%). One of the suggested reasons for this is the use of a cook-chill facility at the Northern site, but we were not made aware of any plans to change or improve the arrangements. Over the next year we would hope to see evidence of a marked improvement in satisfaction with the food at the Northern site. C16 (essentially, information on services) • The wide range of printed information (importantly, checked and approved by patient readers) is evidence to support the Trust’s compliance with this standard. th From the 5 Domain: Accessible and Responsive Care C17 (essentially, seeking patient views) • The involvement of a wide range of patient groups (e.g. visual impairment, wheelchair users, learning disability) when planning services is evidence of the Trust’s compliance with this standard. th From the 7 Domain: Public Health C22 (essentially, reducing health inequalities) • The Trust’s zero tolerance to smoking and its services for substance abuse within maternity services are examples of how the Trust supports public health priorities. Over the next few months the Overview and Scrutiny Committees from the four South Yorkshire Authorities will be drawing up plans for work in 2007/2008 and will bear in mind the Annual Health Check process and the knowledge gained through it when doing so.

We support the principals of the Annual Health Check and its aim of raising standards across the healthcare community and welcome the opportunity to contribute to the process.

cont./…

Page 21

…/page 4

Yours sincerely

Cllr John Doyle Chair of the South Yorkshire Joint Health Scrutiny Committee

Page 22 Appendix D

Metropolitan Borough of Rotherham

Cllr John Doyle Rotherham Town Hall, The Crofts, Moorgate Street, Rotherham, South Yorkshire S60 2TH Telephone 01709 822722/1 Facsimile 01709 822734

2 April 2007

Andy Buck Chief Executive Rotherham NHS Primary Care Trust Oak House Moorhead Way, Bramley Rotherham S66 1YY

Dear Mr Buck

Healthcare Commission – Standards for Better Health, Final Declaration 2007

Under Rotherham Council’s overview and scrutiny arrangements, responsibility for health scrutiny is shared by the Adult Services and Health Scrutiny Panel and the Children and Young People’s Services Scrutiny Panel. Both panels have a wide range of other responsibilities, in addition to their health scrutiny role and therefore, their full work programme does not leave room for health reviews across the full range of standards specifically for the Annual Health Check process. However, we welcome the opportunity to question you on your performance against specific domains.

In addition to the evidence gathered at our meeting with you in March, we have used relevant information from our other health scrutiny work, to inform our comments.

For the purposes of 1 this exercise we have concentrated on the following core Healthcare Standards :

nd From the 2 Domain: Clinical & Cost Effectiveness C6 (essentially, co-operation to meet patients’ individual needs)

1 DH: Standards for Better Health

Page 23

• You state that the PCT is fully compliant with this standard. At a strategic level, we have received evidence to support this. Examples include multi-agency co- operation to reduce teenage pregnancy and action to address COPD. • Questions were asked about the quality of communication between the PCT, hospital and GP with regards to hospital discharge. The PCT suggested that improvements could be made in this process. Similarly, the Chief Executive suggested improvements could be made to dental services for older people in residential units as services had not met expected standards. We are generally supportive of the PCT’s claim to be compliant but consider that service improvements need to be made in a small number of areas (as cited), to ensure continued full compliance with this standard. • During the Adult Services and Health Scrutiny Panel’s review of Reducing Social Isolation, it heard evidence from the PCT about its falls prevention programme. This will be extended via a ‘train the trainers’ programme for staff at care homes and sheltered accommodation – further evidence of the Trust co-operating with social care to ensure that patients’ needs are met. The same review also heard that information on services and initiatives to reduce social isolation (often run by voluntary sector organisations) being made available though doctors’ surgeries and health centres. Both examples are evidence of compliance with this standard. • In November, the Adult Services and Health Scrutiny Panel was told of progress on Rotherham’s Intermediate Care Strategy 2005-2008, based on a joint action plan produced by the Council and PCT. This is further evidence of effective joint working. rd From the 3 Domain: Governance C7 (essentially, sound governance) • The national target for smoking quit rates is unlikely to be achieved this year. However, we understand that is partly to do with Rotherham starting from a much lower baseline with respect to smoking cessation. In order to work towards the national target, a great deal of work has (and continues to be) done. • It is not certain whether the national target for referring suspected cancer patients will be achieved this year. We understand that the problem with achieving a maximum 62 day cancer wait goes back to a situation that arose last August. The problem was identified and action taken to rectify the situation, indicating that good governance arrangements are in place. th From the 4 Domain: Patient Focus and Partnership with Patients/Carers C14 (essentially, information and complaints) • The handling of complaints (including the final signing-off of all responses by the Chief Executive) is done well. The logging of all complaints and subsequent reporting to the Risk Committee and Clinical Governance Committees shows that complaints are taken seriously. The inclusion of ‘actions’ and ‘learning’ columns in the report is evidence that when issues are highlighted by the complaints process, the Trust makes changes to ensure improvements in service delivery and is compliant with this standard. • Although the Trust already has extensive advocacy arrangements in place to support people with Learning Disabilities, it is currently investigating how it can provide more general advocacy. This is further evidence to support the PCT’s compliance with this standard C15 (essentially, food)

Page 24

• Although the PCT provides catering services to only two relatively small groups of patients (in Learning Disability Services and the Hospice), it does this to a high standard, offering bespoke menus to both groups. This supports the PCT’s compliance with this standard. C16 (essentially, information on services) • The Trust’s recently-developed Editorial Board (with user and carer representatives) considers all patient information. It has recently agreed a new editorial policy and ensures that the editorial process is dealt with quickly. This is evidence to support the PCT’s compliance with this standard. th From the 5 Domain: Accessible and Responsive Care C17 (essentially, seeking patient views) • The Trust has engaged closely with its PPI Forum and also attends community and Council meetings such as Area Assemblies. • In June 2006, the Adult Services and Health Scrutiny Panel was pleased to be consulted on the PCT’s ‘Effective and Appropriate Healthcare’ document and changes to the Aesthetic Specialist Plastic Surgery Policy. In November, it also received a presentation on the PCT’s new Out of Hours Dental Service. All three examples provide evidence to support compliance with this standard. • The Panel has found the periodic updates on practice and PCT-led developments of care premises extremely valuable. A separate presentation on proposals for Breathing Space (COPD) centre for Rotherham was very informative and the Panel was impressed with the standard of service developments. This supports the Trust’s compliance with Core Standard C17 and C6.

th From the 7 Domain: Public Health C22 (essentially, reducing health inequalities) • Over the last year, the Adult Services and Health Panel has been kept abreast of joint work being done by the Council and PCT on Rotherham’s Public Health Strategy and commends its direct links with the five themes of Rotherham’s Community Strategy. This supports the Trust’s compliance with Core Standards C22(a) and C22(c). • The Children and Young People's Services Scrutiny Panel were able to call on the officers from the PCT as part of the Council’s response to the consultation on raising the legal age for the purchase of tobacco. This supports the Trust’s compliance with Core Standards C22(a) and C22(c). • In February, we undertook a scrutiny review focusing on the issue of water fluoridation and if this could benefit dental health in Rotherham. The support (in the form of oral and written evidence) that we received from the PCT was excellent and we look forward to submitting our final report and recommendations in due course. This supports the Trust’s compliance with Core Standards C22(a) and C22(c).

Finally, we would like to thank you for the presentation given to members of Adult Services and Health and Children and Young People's Services Scrutiny Panels in March 2007. It provided Members with a good overview of the work of your Trust and demonstrated a commitment to engaging with the scrutiny process. Close working between our two organisations at officer level (through the Local Authority Health Officers Working Group) has also been very useful.

Page 25

Over the next few months both scrutiny panels will be drawing up plans for work in 2007/2008 and will bear in mind the Annual Health Check process when doing so. We support the broader basis upon which health check ratings will be based and welcome the opportunity to contribute to the process.

Yours sincerely

Cllr John Doyle Cllr Ann Russell Chair of the Adult Services and Health Chair of the Children and Young People’s Scrutiny Panel Services Scrutiny Panel

Page 26 Appendix E

Metropolitan Borough of Rotherham

Cllr John Doyle Rotherham Town Hall, The Crofts, Moorgate Street, Rotherham, South Yorkshire S60 2TH Telephone 01709 822722/1 Facsimile 01709 822734

2 April 2007

Dr Gillian Fairfield Chief Executive Doncaster and South Humber Healthcare NHS Trust St Catharine’s House Tickhill Road, Balby Doncaster DN4 8QN

Dear Dr Fairfield

Healthcare Commission – Standards for Better Health, OSC Comments on 2006/07 Declaration

In addition to the evidence gathered at our meeting with you in March, we have used relevant information from our other health scrutiny work, to inform our comments.

For the purposes of 1 this exercise we have concentrated on the following core Healthcare Standards :

nd From the 2 Domain: Clinical & Cost Effectiveness C6 (essentially, co-operation to meet patients’ individual needs)

1 DH: Standards for Better Health

Page 27

• The Trust’s integrated service provision, achieved through its clear commissioning arrangements, indicate its compliance with this core standard. • Further evidence is in the clear protocols for admission, discharge, transfer etc., which ensure that service users cross organisational boundaries effectively. • When our Members asked about how DASH can support the Council in reducing the number of permanent exclusions from schools particularly for children and

young people with mental health issues,2 we were pleased to be told that there will be a single point of access to CAMHS from September 2007. rd From the 3 Domain: Governance C7 (essentially, sound governance) • The Trust’s enthusiastic recruitment of new members to the new Foundation Trust is evidence of its compliance with this standard. th From the 4 Domain: Patient Focus and Partnership with Patients/Carers C13 (essentially, dignity) • The Trust’s plans for working through the revised standards (levels 1 to 3) of the Clinical Negligence Scheme for Trusts (CNST) show its commitment to reducing the incidence of clinical negligence and indicate its compliance with this standard. The involvement of staff at all levels at the Trust’s most recent assessment shows an organisation-wide commitment to this. • There is a strong commitment to staff training and development (e.g. on the Disability and Race Equality Schemes) and the use of ‘Practice Development Days’ ensure that the messages are communicated effectively through the organisation. C14 (essentially, information and complaints) • The Trust’s annual user survey and ‘Your Opinion Counts’ feedback mechanism show the Trust’s commitment to learning from the views of its service users. • The existence of a User/Carer Partnership Council – which sets its own agenda (to which the Trust responds), provides further evidence of the Trust’s compliance with this standard. All performance information is available to the public through the Board papers which are published monthly. C15 (essentially, food) • On enquiring about the Trust’s provision3 of nutrition skills training, we were told that this is done through the CPA , focusing on the ‘supported wellbeing’ agenda. • The Trust’s use of picture menus and provision of food to the Better Hospital Food guidelines supports its compliance with this standard. • Further evidence of the Trust’s compliance with this standard is the provision of nutrition and dietetic advice at local ‘patch’ level. C16 (essentially, information on services) • Our Members were particularly pleased to hear that the User/Carer Partnership Council produces a Plain English summary of its minutes. • The Trust’s commitment to signposting to services is supported by national databases that hold information on what is available is evidence of its compliance with this standard.

2 3 Children and Adolescent Mental Health Services Care Programme Approach

Page 28

th From the 5 Domain: Accessible and Responsive Care C17 (essentially, seeking patient views) • Both Adult Services and Health Scrutiny Panel and Children and Young People’s Services Scrutiny Panel have received presentations from the Trust as part of its consultation on achieving foundation trust status. In addition, Members have been given the opportunity to become Trust members. This supports compliance with standards C17 and C6. • The Trust has agreed to come to a future meeting of the Children and Young People’s Services Scrutiny Panel to discuss Children & Young People’s Mental Health Services (CAMHS), demonstrating a willingness to engage with the scrutiny process and further evidence of its compliance with this standard. th From the 7 Domain: Public Health C22 (essentially, reducing health inequalities) • The Trust works closely with partners including Drug Action Teams and Local Implementation Teams to address the public health agenda. • In addition, it has established public health standards for clients through its Mental Health Promotion Programmes – further evidence if the Trust’s compliance with this standard.

Over the next few months both the Adult Services and Health and Children and Young People's Services Scrutiny Panels will be drawing up plans for work in 2007/2008 and will bear in mind the Annual Health Check process and the knowledge gained through it when doing so.

We support the principals of the Annual Health Check and its aim of raising standards across the healthcare community and welcome the opportunity to contribute to the process.

Finally, we would like to thank you for meeting with members of the Adult Services and Health and Children and Young People's Services Scrutiny Panels, for your presentation against our brief and also for answering our questions on your performance against specific standards. It provided Members with a good overview of the work of your Trust and demonstrated its commitment to engaging with the scrutiny process. Close working between our two organisations at officer level has also been very useful.

Yours sincerely

Cllr John Doyle Cllr Ann Russell Chair of the Adult Services and Health Chair of the Children and Young People’s Scrutiny Panel Services Scrutiny Panel

Page 29 Appendix F

Metropolitan Borough of Rotherham

Cllr John Doyle Rotherham Town Hall, The Crofts, Moorgate Street, Rotherham, South Yorkshire S60 2TH Telephone 01709 822722/1 Facsimile 01709 822734

29 March 2007

Brian James Chief Executive Rotherham NHS Foundation Trust General Management D Level Rotherham General Hospital Moorgate Road Rotherham S60 2UD

Dear Mr James

Healthcare Commission – Standards for Better Health, OSC Comments on 2006/07 Declaration

In addition to the evidence gathered at our meeting with you in March, we have used relevant information from our other health scrutiny work, to inform our comments.

For the purposes of 1 this exercise we have concentrated on the following core Healthcare Standards :

nd 2 Domain: Clinical & Cost Effectiveness C6 (essentially, co-operation to meet patients’ individual needs) • The Trust works in partnership with a wide range of organisations for planning

and development purposes. Recent examples include the development2 of the new Breathing Space project, a purpose-built facility for treating COPD . • Key to joint working is the information sharing protocol that is in place.

1 2 DH: Standards for Better Health Chronic obstructive pulmonary disease

Page 30 rd 3 Domain: Governance C7 (essentially, sound governance) • The Trust is very keen to maintain its good reputation, particularly in the context of increased patient choice. • The Personal Development Reviews for the Chief Executive, Executive Directors and Non-executive Directors show a commitment to continued improvement and holding key individuals to account for their achievements against targets. This supports compliance with the standard. However, as only 65% of employees have currently had a PDR, we would wish to see this figure increase during the coming year, particularly further down the workforce structure (which is also relevant to core standard C11). • Further evidence of this is the Trust’s comprehensive assurance frameworks for the Board, Performance and Risk, which help it assess how well it is doing. • Accountability of Executive Directors is high, with individuals being made responsible for wider corporate issues in addition to their specialism. • The Trust’s audit arrangements are robust. Audit and Assurance Committee consist wholly of Non-executive Director membership and all its sub-committees are chaired by a Non-executive Director with an Executive Director lead, and attendance of other Executives is only by invitation. In addition, independent inspections are submitted straight to the committees, rather than just via management. th 4 Domain: Patient Focus and Partnership with Patients/Carers C13 (essentially, dignity) • The Trust’s commitment to Adult and Child Protection Training and willingness to learn from any mistakes made in Rotherham or elsewhere are evidence to support its compliance with this standard C14 (essentially, information and complaints) • The Trust’s incident reporting system for all problems, large or small, results in an action plan to resolve the matter. Analyses of trends of incidents allow the organisation to make improvements in service delivery. • The signing-off of all responses to complaints by the Chief Executive (together with a willingness to meet them in person) indicates that the organisation takes complaints seriously and complies with this standard. C15 (essentially, food) • Access to food is good, with extended restaurant opening hours (8 am to 2 am) and vending machines available for cold snacks and drinks 24 hours a day • When raising the issue of help being provided to assist patients at mealtimes where necessary, Members were pleased to hear that a new traffic light scheme to identify the amount of assistance that a patient requires at mealtimes has been piloted and is to be rolled out throughout the Trust. • A further piece of evidence to support the Trust’s compliance with this standard is the guidance that is currently being drawn up for bringing food into hospital.

C16 (essentially, information on services) • The provision of patient information in a wide range of formats is evidence of compliance with this standard. • Our Members particularly support the use of Plain English throughout the Trust’s patient documentation.

Page 31

th 5 Domain: Accessible and Responsive Care C17 (essentially, seeking patient views) • In October 2006, an officer from the Trust attended the Adult Services and Health Scrutiny Panel to discuss the Procurement of Non-emergency Patient Transport Services. This enabled elected Members and co-optees to discuss a wide range of issues around the new contract and to schedule a future report once the contract has been running for six months. • The Trust’s commitment to Patient Public Involvement through its PPI Strategy 2005-2008 allows it to design and improve services to take into account the views of patients and carers. This is further evidence to support the Trust’s compliance with this standard.

th 7 Domain: Public Health C22 (essentially, reducing health inequalities) 3 • The Trust is an active member of the ‘Alive’ Partnership Board and works with other organisations to address the public health agenda. • More specifically, it has opted to ban smoking in its grounds from 1 April 2007, in advance of the national legislation. It offers a wide range of support to patients and staff wishing to give up smoking. • Further evidence to support the Trust’s compliance with this standard is its own Public Health Strategy, which focuses on smoking and obesity.

We support the principals of the Annual Health Check and its aim of raising standards across the healthcare community and welcome the opportunity to contribute to the process.

Yours sincerely

Cllr John Doyle Cllr Ann Russell Chair of the Adult Services and Health Chair of the Children and Young People’s

Scrutiny Panel Services Scrutiny Panel

3 Part of the local strategic partnership Page 32 Agenda Item 7 ROTHERHAM METROPOLITAN BOROUGH COUNCIL

1. Meeting: Adult Social Care and Health Scrutiny Panel th 2. Date: 12 April 2007 3. Title: Local Area Agreement (LAA) – progress report 4. Directorate: Neighbourhoods and Adult Services

5. Summary

This report describes progress on the Healthier Communities and Older People (HCOP) block of the Local Area Agreement. It is proposed that performance monitoring of the LAA be part of the new Directorate Management Team (DMT) Performance meetings and that progress is reported to Cabinet Member as part of the quarterly performance reports.

6. Recommendations

Members • Note the progress reported, • Endorse the proposed new Directorate arrangements for monitoring progress on the LAA via DMT Performance meetings, • Receive further progress reports as part of the quarterly performance reports.

7. Proposals and Details

7.1 The LAA HCOP block was developed by Operational Services with the Primary Care Trust (PCT) and agreed via the Alive Theme Board of the Community Strategy. In July 2006 progress reports were requested and an initial report was considered by the then Adult Social Services Senior Management Team.

7.2 Attached is a copy of the LAA HCOP actions plan together with progress to date.

7.3 The Chief Executives office expressed concerns in July 2006 about overall management of the HCOP block and reporting to the Alive board. Subsequently, regular meetings with the Public Health Dept were established to review progress and report to the Adults Board and Alive Theme board.

7.4 Stretch targets were negotiated with Government Office, Yorkshire and Humber and Operational Services have overseen the work on these. It was projected that the stretch targets would be achieved at the end of the LAA. Section 10 highlights last year’s performance and current position. There is a risk with regards to C32 Older people helped to live at home.

7.5 The Chief Executives office prepared a 6 month progress report on the LAA in November 2006 with input from Adult Services and the PCT. Proposed refresh of RMBC’s targets are currently being considered by the Government Office Yorkshire

Page 33 - 2 - and Humber (GOYH). Suggested changes for the refresh were agreed with the Chief Executive’s office (CE) and are marked on the progress report.

8. Finance

8.1 Pump priming funding of £60K per year was agreed last year for the three Adult Services stretch targets. It was originally intended to use the funds to recruit two extra officers to improve performance on reviews, SWIFT recording, direct payments and older people helped to live at home indicators. However, to date, only the use of overtime has been approved for staff to undertake extra reviews although consideration is currently being given by Operations to other options. The use of pump priming monies for the PI stretch targets must link into the PI performance clinics and action plans arising out of them. The achievement of targets is geared to the final year and therefore spend of pump priming funds needs to be managed with this in mind.

8.2 Quarterly monitoring forms have been developed by the CEs/corporate finance and are linked with performance reporting. However, no pump priming funding has officially been drawn down as yet. The LAA actions are supported by a range of Directorate budgets, by NRF funding and the pump priming funding. The reported “alignment” of funding in the original LAA may need to be revised as it no longer appears correct. This also applies to certain PCT funding reported as aligned.

9. Risk and Uncertainties

9.1 Without clear delivery and monitoring arrangements there is a risk of non achievement. Performance clinics have been held on two of the three stretch target PIs in recent months and action plans have been agreed.

10. Policy and Performance Agenda Implications

10.1 There are a large number of outcomes and actions within the LAA HCOP block reflecting the Council’s corporate Alive theme and all of the seven key social care outcomes developed by the Commission for Social Care Inspection. In particular it contributes to Improving Health through the key LAA outcome 1. “Address inequalities and promoting positive health and wellbeing for all”.

10.2 Below are up-to-date performance figures for the PIs within the LAA, as previously reported. LAA Stretch Targets Indicator 04/5 05/6 06/7 projected LAA target 08/9 C32 Older people helped to 92.8 86.75 83.00 102 *risk of live at home non achievement C51 Direct payments 71.3 101 140 155 D40 Clients receiving a 34.70 42.55 50 69 review LAA Other national Indicators included C62 Carers Breaks 1.09% 2.03% 4.50% 7% D54 Equipment 89.6 92 To be in top25% by 2010 Page 34 - 3 -

10.3 There are also a number of actions not attributed to a national PI and to date these have been monitored through the joint meetings with Public Health. Stronger arrangements will be necessary to ensure consistent sources of information, e.g. % share of domiciliary care market, % share of residential provision. It is proposed that performance monitoring of the LAA be part of the new DMT Performance meetings and that progress is reported to Cabinet Member as part of the quarterly performance reports.

11. Background and Consultation Rotherham LAA 19.07.06 Report to SMT 15.08.06

Contact Name: Ian Bradbury Planning, Workforce and Complaints Manager [email protected] LAA HCOP Block progress – March 07

1. Block Name: Healthier Communities & Older People 1. Address Health Inequalities and promoting positive health and wellbeing for all 2. Key Outcome: Rotherham’s residents 3. Lead Officer for Outcome: Terri Roche, Public Health Specialist, Rotherham PCT

4. Community Strategy Theme(s): Alive

5. Key Actions / Operational Plan

Reduce premature mortality rates, and reduce inequalities in premature mortality rates between wards/neighbourhoods, Page 35 with a particular focus on reducing the risk factors for heart disease, stroke and related diseases (CVD) [smoking, diet and physical activity] (mandatory outcome) a) Measure progress against Neigbourhood Renewal Strategy (NRS) baselines and promote health equity audit to ensure the accurate targeting of services to communities and areas of greatest need b) Promote healthy lifestyles through the development of capacity and skills within communities and leisure services (e.g. physical activity through Community Coaches initiative, Keep Moving and NHS Health Trainers) c) Implement Smoke Free Rotherham strategy

Geographical areas addressed: Central, Dinnington, Maltby, Kimberworth Park, Masborough, Rawmarsh and Wath Minority Ethnic communities, Disabled People, people with Mental Health problems, people Population groups addressed: with Learning Disabilities, Vulnerable Older People and their Carers, Children & Young People, Asylum Seekers

6. Key Action Performance Indicators Baseline Milestone Target/ Lead Progress Objective Officer a) Measure progress against i. By 2008/9 to reduce by at Males 4.7 yrs Males 4.0 yrs Males 3.9 yrs John S Y DPH Neigbourhood Renewal Strategy least 10% the gap between the Females 3.1 Females 2.6 Females 2.4 Radford, Annual (NRS) baselines and promote health 20% of areas with the lowest yrs (1997) yrs (2007) yrs (2008/9) DPH, PCT Report equity audit to ensure the accurate life expectancy at birth and the CHD Equity targeting of services to communities population of Rotherham as a Audit and areas of greatest need whole Both confirm progress a) Measure progress against NRS ii. Monitor at neighbourhood From April 06 Objective Research Work baselines and promote health equity level Coordinator, progressed audit to ensure the accurate Area Assembly level Super RMBC (Miles well on the Page 36 targeting of services to communities Output Areas (SOA) Crompton)/ joint and areas of greatest need Robin indicators Carlisle, NRS CPHM, PCT monitoring – we have disaggregate d information to SOA and Area Assembly levels. a) Measure progress against NRS iii. Align health and social care Sept 06 Objective Robin Established baselines and promote health equity data collection and presentation Carlisle, joint group to audit to ensure the accurate through joint indicators/NRS CPHM, PCT align H&SC targeting of services to communities monitoring group data as part and areas of greatest need of strategic needs analysis a) Measure progress against NRS iv. Identify priority work Sept 06 Objective Terri Roche, Equity Audit baselines and promote health equity programme for Health Equity Public Health post funded audit to ensure the accurate Audit in consultation with MBC Specialist, through NRF. targeting of services to communities and FT and strengthen PCT Audits on and areas of greatest need involvement breastfeeding , dental attendance and access to CHD services currently underway a) Measure progress against NRS v. Target services/activity to Action Plan Objective Kath Progress baselines and promote health equity priority neighbourhoods April 07 Atkinson PCT slow, but will audit to ensure the accurate David progress as targeting of services to communities Hamilton, alignment of and areas of greatest need Head of Adult health and Services, social care RMBC data is completed Page 37 b) Promote healthy lifestyles through i. Increase number of schools in 0% (2004/5) 50% (2006/7) 95% (2009/10) Liz Galliver, The majority the development of capacity and the borough who have achieved HS of primary skills within communities and leisure Healthy Schools status Coordinator, schools services (eg physical activity through LEA within Community Coaches initiative, Keep Rotherham Moving and NHS Health Trainers) have initiated work to develop more active and inclusive playgrounds. There is now a Project Officer in post to support them in developing this work.

Five out of sixteen secondary schools have started work on their playgrounds to implement a similar scheme

b) Promote healthy lifestyles through ii. Increase number of people 65% (2002) 70% (2005) 75% (2008/09) FACT Team Lifestyle the development of capacity and who eat fresh fruit, fresh or PCT survey every skills within communities and leisure frozen vegetables or salad actual 69% 2 years, last services (eg physical activity through every or most days 2005, 69% Community Coaches initiative, Keep out of 70 Page 38 Moving and NHS Health Trainers) target b) Promote healthy lifestyles through iii. Increase number of adults 20% (2005) 22% (07/08) 25% (2008/09) Sally Jenks, Targets the development of capacity and participating in sport and 18% 06/7 19% 20% measured Public Health revised in skills within communities and leisure physical activity (5 sessions of nationally via Specialist, Refresh. services (eg physical activity through 20 minutes per week) Sport England PCT and RMBC still Community Coaches initiative, Keep and next is in Steve have issues Moving and NHS Health Trainers) 2009 Hallsworth, about Business recording/ Manager, monitoring Leisure & use of Green facilities. Spaces, NRF/PCT RMBC funded HT programme established & recruiting/trai ning BEM HTs b) Promote healthy lifestyles through iv. Increase % of children age 76% (2005) 85% (2008) 90% (2009) Bev RMBC the development of capacity and 5-16 yrs old spending a 78% 06 85% 08/9 National Target Matthews, appointed to skills within communities and leisure minimum of 2 hours each week yet to be PE & Sport vacancy. services (eg physical activity through on high quality PE/ school confirmed by Development 2010 vision is Community Coaches initiative, Keep sports within and beyond the DCMS”)!) Officer, of 4 hrs PE/ Moving and NHS Health Trainers) curriculum RMBC school sport for all pupils with 2 hrs out of curriculum(tar get not set) c) Implement Smoke Free i. Reduce adult smoking rates 25% (2002) 24% (2005) 22% (2008/09) Provider Next Lifestyle Rotherham strategy (16-70 yrs old) Lifestyle Services/ Survey 2008. Survey Public Smoke Free Health, PCT legislation comes into effect July Page 39 07. Full report taken to Alive Board including update on quits by RSSS.

Community Strategy priorities: − Develop further support services for vulnerable people, promoting collaborative working between organisations & sectors to deal with increases in demand. 7. Describe links to − Respond to Rotherham’s ageing population by developing appropriate support services community strategy & facilities, & extending the choices available to older individuals. objectives Rotherham Achieving – “inequalities between parts of the borough and social groups will be minimised”

Rotherham Alive – “where people feel good, are healthy and active, and enjoy life to the full”… “health services will be accessible and of high quality for those who require them”… “opportunities to be involved in a wide range of high quality cultural, social and sporting activities”

Rotherham Safe – “neighbourhoods… good quality homes and accessible local facilities and services for all”… “environments and people will be protected and nurtured… safe from harm”… “preventive approach to minimise accidents and hazards”

Page 40 Rotherham Proud – “caring place… where the most vulnerable are supported”… “strong, sustainable and cohesive communities”… “opportunities for people to be involved in … local decision making” Key actions a) and b) tackle and further reduce inequalities All actions seek to increase community involvement and enable greater influence in 8. Contribution to decision making crosscutting objective All actions seek to improve quality of life for people in most disadvantaged neighbourhoods and groups and through equity audit ensure that providers are more responsive to needs and improve delivery 9. Impact on other Blocks Potential impacts/outcomes within Safer & Stronger Communities block and Children & (If applicable) Young People block

Progress being reported separately Allocation on this outcome by PCT 10. Name Currently of Funding Stream (External and managed by 2006/7 2007/8 2008/9 Mainstream) 1,723,000 need clarification from Mick Rawson

PCT- subject 35k Smoke Free (until 353,000 need to PCT Board 2009) a) Choosing Health (aligned) clarification from Mick 0 approval of 60k Health Trainers Rawson Local Delivery (until 2010) Plan 45k Food & Nutrition/ Obesity worker (recurrent) b Stop Smoking Service budget 0 266,000 0 PCT (aligned) Page 41 Deputy NRF 48,750 65,000 0 Director of PH, RPCT Other NRF (Health based) Smoke free Rotherham 70K over 2yrs Steve Hawkins has details Health trainers 41k over 2yrs Obesity/nutrition 120 k Oral Health 7/8K over 2 yrs

1. Block Name: Healthier Communities & Older People 2. Improve access to health and social care 2. Key Outcome:

3. Lead Officer for Outcome: David Hamilton, Head of Operations, RMBC

4. Community Strategy Theme(s): Alive

5. Key Actions / Operational Plan a) Enable people to make informed decisions in relation to their own treatment, care and support b) Further develop social care direct payments to include equipment c) Enable service users/patients to be involved in the development and improvement of services d) Respond to Rotherham’s ageing population by developing appropriate support services & facilities, & extending the choices available to older individuals (Rotherham Alive key partnership priority) Page 42 e) Develop further support services for vulnerable people, promoting collaborative working between organisations & sectors to deal with increases in demand (Rotherham Alive key partnership priority)

Geographical areas addressed: Borough wide All older people, disabled people, people with mental health problems and people with Population groups addressed: learning disabilities

6. Key Action Performance Indicators Baseline Mileston Target/ Lead Progress e Objective Officer a) Enable people to make informed i. Launch joint media campaign July 2006 Adult Suggest choices and decisions in relation to with PCT promoting health and Services, deletion in their own treatment, care and social care services September CQP refresh but support 2007? otherwise Needs changing to develop joint approach to info provision Awaiting feedback from GOYH b) Further develop social care direct i. Increase number of adults 04/05 05/06 To be in top 25% David Currently in payments to include equipment and older people receiving baseline: target: 125 nationally by Hamilton, top 25% STRETCH TARGET 155 Direct Payments. (PAF C51) 72 (71) people in 2010. Head of based on people in receipt of Operations 04/5 but need receipt of DPs per to maintain DPs per 100k pop. against 100k pop. aged 18+ national aged 18+ Actual 101 progress Jan = 136 projected outturn 140 no change Page 43 ●●●● Awaiting feedback from Refresh b) Further develop social care direct ii. Increase % of items of 04/05 05/06 To be in top 25% David Currently in payments to include equipment equipment delivered within 7 baseline: target nationally by Hamilton, top 25% working days. 81.22% 85.5% 2010 Head of based on (PAF D54) Actual 89.6 Operations 04/5 but need to maintain against national progress Jan = 95.90 projected outturn 92.0 no change ●●●● ● c) Enable service i. Joint Framework for Service September 2006 Pauline Riley Agreement in users/patients to be involved User/Patient Consultation in instead of June Joint completion in the development and Service Development Commissioni Final improvement of services ng Lead PCT completion and Vicky awaited Brown Policy, Planning & Research Adult Services RMBC c) Enable service ii. Users who said they were 70.52% 72% 75% Pauline Riley Suggest users/patients to be involved satisfied with the help they ?Joint deletion in in the development and received from social services 05/6 64.55 Commissioni refresh as improvement of services (PAF D52, BVI 82) ng Lead PCT survey for Page 44 and Vicky homecare Brown undertaken Policy, earlier this Planning & year. next Research one next year Adult for PDSI Services Need to RMBC reconsider targets if still used Awaiting feedback from Refresh d) Respond to Rotherham’s ageing i. Develop a borough-wide June 2006 David Action Plan population by developing appropriate Older People’s Well-being Hamilton, being support services & facilities, & Strategy to improve the life Head of finalised extending the choices available to experiences of older people Operations older individuals (Rotherham Alive Strategic Action) d) Respond to Rotherham’s ageing ii. Increase % of home care 04/05 05/06 50% David Currently at population by developing appropriate services delivered by the baseline: target: 30% Hamilton, 35% and support services & facilities, & independent Sector 31.15% Head of expect action extending the choices available to Comment – Baseline and Operations/J will result in older individuals targets refer specifically to ohn Harding meeting homecare for older people but if Divisional target take all service user groups Manager, then would be already at 60% Adult Services RMBC d) Respond to Rotherham’s ageing iii. Increase % of long stay care 04/05 Modernisation David Good population by developing appropriate home places provided by the baseline: Strategy target: Hamilton, progress and support services & facilities, & independent sector 87% Retain 120 x LA Head of expect to extending the choices available to beds in 2 x new Operations/J meet this older individuals build ohn Harding target developments Divisional through leaving 93.74% Manager, modernizatio Page 45 of provision with Adult n indep. sector Services (using 04/05 RMBC baseline) (e) Develop further support services i. Co-locate Adult Social 1st 2nd David Still for vulnerable people, promoting Services and Health to facilitate Neighbourh Neighbourhood Hamilton considered collaborative working between a neighbourhood approach to ood team team On track, organisations & sectors to deal with commissioning and service co-located co-located by Head of linked with increases in demand provision by 2007 2008 Operations customer (Rotherham Alive Strategic (Dinnington (Maltby) service Action) / RMBC centre Kiveton Lorraine development Park) Watson s and Expect Associate to meet this Director target RPCT

Community Strategy priorities: − Respond to Rotherham’s ageing population by developing appropriate support services & facilities, & extending the choices available to older individuals − Develop further support services for vulnerable people, promoting collaborative working between organisations & sectors to deal with increases in demand

Rotherham Achieving – “inequalities between parts of the borough and social groups will be minimised”

Rotherham Learning – “aspire to develop and achieve their full potential in their chosen careers, work , leisure and contributions to local life”… “learning and development opportunities will be 7. Describe links to available and accessible to all” community strategy Page 46 objectives Rotherham Alive – “where people feel good, are healthy and active, and enjoy life to the full”… “health services will be accessible and of high quality for those who require them”… “opportunities to be involved in a wide range of high quality cultural, social and sporting activities”

Rotherham Proud – “caring place… where the most vulnerable are supported”… “strong, sustainable and cohesive communities”… “opportunities for people to be involved in … local decision making” 8. Contribution to Links to all four of the crosscutting objectives crosscutting objective 9. Impact on other Blocks Link with general theme of Safer & Stronger Communities block

(If applicable)

Allocation 10. Name of Funding Stream Currently (External and Mainstream) managed by 2006/7 2007/8 2008/9 RMBC – Adult a) Access Systems and Capacity 3,238,000 3,158,000 Not Known Social Grant (aligned) Services NRF - 90,000 55,000 0 RMBC

Page 47

1. Block Name: Healthier Communities and Older People 3. Reduce poverty by maximising income and to maintain in and enable people to 2. Key Outcome: enter employment 3. Lead Officer for Outcome: David Hamilton, Head of Operations, RMBC

4. Community Strategy Theme(s): Achieving, Learning and Alive

5. Key Actions / Operational Plan a) Maximise people’s incomes and reduce levels of debt b) Establish “Investing for Health” initiative to ensure that health and social care organisations are good employers maximising the skills and experience of local communities and reduce absenteeism from work c) Enable people with disabilities to maximise employability through Welfare to Work

Geographical areas addressed: Borough wide with an emphasis on areas of high deprivation Unemployed single parents, disabled people, recipients of pension credits and welfare Population groups addressed: benefits

Page 48 6. Key Action Performance Baseline Milestone Target Lead Progress Indicators Officer a) Maximise people’s incomes and i. Set up Joint Visiting 14,200 people 14,900 people 15,600 people David Targets to be reduce levels of debt Teams between the local claiming pension claiming claiming Hamilton, revised in authority and DWP in order credit in pension credit pension credit Head of Adult refresh after to maximise welfare benefit Rotherham (May in Rotherham in Rotherham Services, liaison with take-up 2005) 2006/7 by 2008/9 RMBC pensions 14774 07/8 15000 08/9 service Awaiting feedback from Refresh b) Establish “Investing for Health” ii. Joint initiative Programme Programme Objective Pauline The focus is initiative to ensure that health and (RMBC/PCT) established developed April implemented Fryer, HR on reducing social care organisations are good 07 Sickness April 07 Director, PCT sickness employers maximising the skills and absence rates onwards and Alan absence from experience of local communities and RMBC10.25days Swann, Head 10.25 to 9.75 reduce absenteeism from work 06/7 of HR, RMBC within RMBC PCT 5.5% Mar and reducing 07 PCT rate to PCT 1% 4.4% reduction RMBC equates to £450k working with at average salary ten Councils in North of England [ jointly funded by 3 Centres

of Excellence] Page 49 studying the reasons for higher level of sickness absence in Adult Social Services and also separately with other South Yorkshire Councils [funded by Regional capacity monies] piloting early intervention on musculoskelet al injuries in Adult Social Services. Results of both projects to be shared with PCT c) Enable people with disabilities to i. Increase number of 102 112 by 07/08 130 by 08/09 David On track and maximise employability through people with learning Hamilton, expect to Welfare to Work disabilities in supported Head of meet this employment schemes Operations, RMBC d) Helping people to return to work i. Condition Management 15,000 people on Reduce new Reduce new Steve Condition following absence from work Programme (CMP) Incapacity claimants by claimants by Hawkins, Management because of illness established by April 06, Benefit/Severe 280 in 06/07 further 360 in Deputy Programme including early assessment Disablement 07/08 Director of established protocol by GPs/others to Allowance in PH, PCT and clients maximise referrals to CMP 05/06 being seen. established by July 06 On target for required outputs d) Helping people to return to work ii. % of LA employees 1.16% 2004/5 2.5% 05/06 2.7% 07/08 Alan Swann, Good following absence from work declaring they meet DDA Head of HR, progress Page 50 because of illness 1995 disability definition actual 2.65 2.8 RMBC

Community Strategy priorities: − Maximise economic and other opportunities to reduce disadvantage and raise quality of life and living standards, particularly in the most deprived communities − Create specific initiatives to maximise the engagement and participation of particular targeted groups or disadvantaged geographical areas − Respond to Rotherham’s ageing population by developing appropriate support services & 7. Describe links to facilities, & extending the choices available to older individuals community strategy − Develop further support services for vulnerable people, promoting collaborative working objectives between organisations & sectors to deal with increases in demand

Rotherham Achieving – “inequalities between parts of the borough and social groups will be minimised”

Local employers more responsive to the needs of employees Page 51 8. Contribution to Improved quality of life for people in most disadvantaged neighbourhoods crosscutting objective Increase employee involvement in decision making about their lives Help to reduce inequalities 9. Impact on other Blocks Economic Development & Enterprise block (If applicable)

Allocation 10. Name of Funding Stream Currently (External and Mainstream) managed by 2006/7 2007/8 2008/9 a) Learning Disabilities Supported RMBC – Adult Employment – mainstream and 335,000 186,000 190,000 Services grant funding (pooled) Condition Management Programme Funding (DWP) – Steve Hawkins checking funding allocation

1. Block Name: Healthier Communities & Older People

2. Key Outcome: 4. Promote independent living

3. Lead Officer for Outcome: David Hamilton, Head of Operations, RMBC

4. Community Strategy Theme(s): Alive

5. Key Actions / Operational Plan a) Develop and increase access to sustained rehabilitation including access to assistive technology Page 52 b) Develop a proactive integrated service which will reduce avoidable hospital admissions and reduce falls in older people using a holistic approach c) Develop and implement services to support independent living including support for carers d) Providing appropriate accommodation, and promoting lifetime homes principles in development, that enables independence and for people to remain in local communities e) Develop programme of Chronic Obstructive Pulmonary Disease (Respiratory Disorder) rehabilitation and support across health and social services

Geographical areas addressed: Borough wide Predominantly Older People, also disabled people, people with mental health problems and Population groups addressed: people with learning disabilities

6. Key Action Performance Baseline Milestone Target/ Lead Progress Indicators Objective Officer a) Develop and increase access to i. Develop inter-agency Strategy to be Implementation Objective David Expect to sustained rehabilitation including strategy for use of developed by end of strategy from Hamilton, meet this access to assistive technology Assistive Technology of 2006 2007 onwards Head of PCT and (including telemedicine) Operations, RMBC joint RMBC initiative one million capital allocated. a) Develop and increase access to ii. Number of homes 36 units by April 66 units January 90 units David Final number sustained rehabilitation including provided with monitored 06 07 2009/2010 Hamilton, of units may access to assistive technology AT linked to Extra Care 28 62 but could be Head of vary slightly Housing slightly less Operations, dependent on RMBC design

completion Page 53 but expect to meet target Proposed deletion in Refresh as same as HCOP4di a) Develop and increase access to iii. Develop Action Plan April 2007 Objective Sally Jenks, Develop Pilot sustained rehabilitation including to establish GP Not known 30 new contacts 150 new Public Health Project. access to assistive technology referrals of patients to New scheme per quarter contacts by Specialist, Propose that leisure services as part Mar 2008 PCT & Steve this is moved of rehabilitation to Hallsworth, to section 1 improve health Business with revised Manager, targets for Leisure & Refresh Green Spaces, RMBC b) Develop a proactive integrated i. Roll out screening Gaps identified Electronic version Audit of falls Kath Rogers, Roll out of service which will reduce tool as part of single revised version of of SAP rolled out related to SAP RPCT SAP avoidable hospital admissions, assessment process SAP incl. to all staff by Mar incl. time and dependent on and reduce falls in older people (SAP) addititional 07 type of NHS using a holistic approach information in intervention Connecting assessor’s guide undertaken & for Health – by April 06 care pathways delayed audit to be Refresh completed by proposes Mar 07 merge of this and next action See biii b) Develop a proactive integrated ii. Provide appropriate SAP training Training Terri Roche, Dependent service which will reduce multiagency training programme programme Public Health on NHS avoidable hospital admissions, related to falls developed and ongoing with Specialist, Connecting Page 54 and reduce falls in older people screening/ intervention rolled out to all comprehensive Rotherham for Health - using a holistic approach tool as part of staff review of SAP PCT delayed and comprehensive SAP and impact on Kath Rogers will not training programme practice support roll undertaken out yet. See above b) Develop a proactive integrated iii. Increase information Monitor progress Roll out falls Falls leaflet Terri Roche, CMs and service which will reduce available on falls and of strategy screening & based on NICE Public Health specialist avoidable hospital admissions, falls prevention to the intervention tool guidance Specialist, nurses and reduce falls in older people public through evidence across PCT. developed Rotherham trained by using a holistic approach based strategy Improve PCT May 07. DNs Comment – see refresh information and Team template – proposed awareness of Leaders merger of falls prevention trained i and ii above agenda across all throughout agencies and to 07/08. the public Low level Provide exercise appropriate multi programme agency training Herringthorpe related to falls roll out to sheltered accommodati on c) Develop and implement services i. No. of carers 04/05 baseline 05/06 target 08/09 target Paul Performance to support independent living receiving services as % 1.09% 1.3% 7% Billingsley Clinic held including support for carers of people receiving Actual 2.03% DIS target Divisional and action community based 6.5% Manager, plan services (PAF C62) Adult developed Services Jan = 2.79 RMBC (+MH estimate of +2.0) projected outturn 4.50 up 1 ●● Page 55 st d) Provide appropriate i. Number of Extra Care 05/06 First 1 developmentnd Deliver 100 David Final number accommodation, and promoting Dwellings development occupied & 2 units in 3x extra Hamilton, of units may lifetime homes principles in provided/planned under development care housing Head of vary development, that enables construction under developments Operations, dependent on independence and for people to construction by 2009/10 RMBC and design remain in local communities 62 90 Simon completion 28 (revised Jan 07) (revised Jan Bunker Head but expect to (revised Aug 06) 07) of Service meet target N’hoods Revision RMBC suggested in

st ? lead officer refresh d) Provide appropriate ii. Improve standards Review of 1 tranche of All sheltered David The review accommodation, and promoting for sheltered sheltered sheltered housing housing Hamilton, has been lifetime homes principles in accommodation accommodation brought up to brought up to Head of completed development, that enables (£213m to be invested completed July new Rotherham Rotherham Operations and 2010 independence and for people to with ALMO) 2006 standard under standard by RMBC and Rotherham remain in local communities Phase 2 of 2010 Simon Ltd will now Decent Homes Bunker Head have to scheme of Service integrate a N’hoods £15M RMBC programme ? lead officer of sheltered housing upgrades into their scheme, starting 2007/08. Craig Myers in EDS - Asset Management is the project manager for this work, in co-operation with Mark Page 56 Whittle, Director of Development with 2010. d) Provide appropriate iii. Improve quality of 2 x 60-bedded David Expect to accommodation, and promoting accommodation new build Hamilton, complete by lifetime homes principles in provided by local residential care Head of March 08 development, that enables authority in residential homes Operations, dependent on independence and for people to care homes constructed by RMBC and construction remain in local communities end 2007 Simon Bunker Head of Service N’hoods RMBC ? lead officer e) Develop programme of Chronic i. Breathing Space 40 Breathing Objective John On track Obstructive Pulmonary Disease Centre established by Space Day Radford, (Respiratory Disorder) 2007 Places and 20 Director of rehabilitation and support across respite care beds Public health and social services, April 2007 Health, PCT leisure and housing e) Develop programme of Chronic ii. Outreach support in John Audit of Obstructive Pulmonary Disease homes and other Radford, COPD in (Respiratory Disorder) community settings Director of primary care rehabilitation and support across (No. of people to be Public for baseline health and social services, served by outreach not Health, PCT will be leisure and housing yet determined) complete in April 07

Community Strategy priorities: − Respond to Rotherham’s ageing population by developing appropriate support services & facilities, & extending the choices available to older individuals. − Develop further support services for vulnerable people, promoting collaborative working Page 57 between organisations & sectors to deal with increases in demand. − Create and sustain opportunities for individuals to be involved in a wide range of high quality physical and sporting activities.

Rotherham Achieving – “inequalities between parts of the borough and social groups will be 7. Describe links to minimised” community strategy objectives Rotherham Learning – “aspire to develop and achieve their full potential in their chosen careers, work , leisure and contributions to local life”… “learning and development opportunities will be available and accessible to all”

Rotherham Proud – “caring place… where the most vulnerable are supported”… “strong, sustainable and cohesive communities”… “opportunities for people to be involved in … local decision making” Improved quality of life for people in most disadvantaged neighbourhoods 8. Contribution to Help to reduce inequalities crosscutting objective Increase satisfaction by local people with public services, and the Borough as a place to live 9. Impact on other Blocks Potential impact on Safer & Stronger Communities block

(If applicable)

Allocation Page 58 10. Name of Funding Stream Currently (External and Mainstream) managed by 2006/7 2007/8 2008/9 DoH capital grant a) Extra Care Housing Capital Funding (£1.27m) plus (DoH plus RMBC) (aligned) 1,577,000 0 0 RMBC contribution. RMBC – capital b) Adult Services Modernisation of funding for 2 new 5,730,000 9,435,000 0 Residential Care Strategy (aligned) residential care units. Capital grant c) Strategic Health Authority & PCT funding 2,500,000 0 0 allocations – Breathing Space (aligned) transferred to RMBC. Capital and d) Coalfield Regeneration Trust – 5,100,000 1,800,000 1,800,000 Revenue grant Breathing Space (aligned) funding

Page 59 Agenda Item 8

ROTHERHAM BOROUGH COUNCIL – REPORT TO MEMBERS

1 Meeting: Adult Services and Health Scrutiny Panel th 2 Date: 12 April 2007

3 Title: Patients’ Hospital Discharge / Transfer of Care in response to Health and Social Care Scrutiny comments on 01/02/07

4 Directorate: Neighbourhoods and Adult Services

5 Summary

'Delayed Transfers of Care' is a joint Health and Social Care performance indicator and has been operating in the top performance band. Rotherham is positioned 21st out of 151 Councils with social services responsibilities.

There has been some increase in delayed discharges, but not due solely to Adult Social Services; some are due to:

• Delays in supplying equipment, • Awaiting assessments by other professionals • Patient choice of care home

Neighbourhoods and Adult Services are unable to significantly influence these factors but we do continue to work in partnership with Foundation Trust colleagues to address them, striving for continuous improvement and quality.

st Adults Social Care and Health Scrutiny Panel on 1 February expressed growing concern around the hospital discharge process with examples cited of people being regularly discharged without appropriate communication and/or care packages in place. This report provides a background to patient discharge, current issues, and ongoing work towards continuous improvement; with an acknowledgement that people may choose to be discharged without being referred to other services.

See Appendix1 for background information and principles of the Discharge Policy and current issues.

6 Recommendations

6.1. This report is accepted.

6.2. Scrutiny acknowledges the work that is being undertaken to address the concerns identified.

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7 Proposals and Details:

7.1 To address the issuing of incomplete Assessment and Discharge Notification documentation.

There are ongoing meetings with the Director of Service Improvement from the Foundation Trust, and Group Manager - Hospital Social Work Service, to monitor and review the Assessment and Discharge Notification issues.

th At a meeting held on 28 February a set of recommendations were agreed to address specific problems and make amendments to the discharge process. They include introducing measures to make individual wards accountable to senior management for their failure to adhere to legislative requirements, both in terms of performance management, and best practice for patient discharge.

7.2 To develop an understanding of assessed Health and Social Care Needs, and associated responsibilities and tasks, and to produce a draft protocol.

th A meeting was held on 8 Februaryst to discuss and address this, and a further workshop took place on 1 March to start the development of a draft framework and protocol for clarifying Health & Social Care Responsibilities and Tasks.

7.3 Provision of individual patient details to address causes for concern in relation to delayed discharges.

A Discharge Monitoring Group meets monthly to discuss discharge issues and associated complaints, and looks at various aspects of health and or social care issues reported by patients / carers or staff.

7.4 Training.

Training to address assessment and discharge notifications, continuing healthcare assessments is made available to ward staff on a monthly basis.

7.5 Review and amend the Discharge Policy and Procedure in accordance with the above.

A review of the discharge process and responsibilities will address all of the above issues, which have significant impact upon the discharge of patients, and will improve the pathway and transfers of care for the patient.

The hospital social work service continues to work positively with its partners from the Foundation Trust to overcome the difficulties outlined above and to achieve a whole systems approach to continuous improvement ensuring the safe and timely discharge of patients;

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8 Finance

A Budget Issues Paper (BIP) has been submitted for additional social work staff in order to maintain performance due to the increased demand / volume to undertake assessments.

9 Risks and Uncertainties

It is likely that there will be delays in the patients’ discharge/transfer of care attributable to Neighbourhoods and Adult Services should the BIP be unsuccessful, thus resulting in reimbursement costs, and a detriment to the wellbeing of patients.

Failure of ward staff to adhere to legislative requirements and complete appropriate documentation will continue to perpetuate the delay in the patient’s transfer of care.

10 Policy and Performance Agenda Implications

During the period January 2004 to January 2007 RMBC has not incurred any reimbursement charges, due to the commitment and application of the Hospital Social Work Service, and of the Community Social Work Teams where their clients have been admitted into hospital.

This is a substantial achievement when compared to both local neighbouring hospitals, and to the national picture, where there are only approximately 10 councils with social services responsibilities (CSSRs) who have not incurred any reimbursement charges; while some neighbouring authorities have incurred significant reimbursement charges over this period.

PAF D41 - Delayed Transfers of Care is a joint health and social care performance indicator, and has been operating in the top performance band. There has been some increase in the figures (delayed discharges), but this has not been due solely to social services; some are due to delays with equipment, other professionals’ assessments, patient choice, and other factors, which the Hospital Social Work Service is unable to significantly influence. The Service does continue to work in partnership with Foundation Trust colleagues to address these issues; nevertheless, the performance indicator continues to remain in the top quartile, and Rotherham is positioned 21st nationally out of 151 councils with social services responsibility.

A whole systems approach has been developed for health and social care interventions delivered to patients by The Rotherham Foundation Trust and Rotherham MBC which contribute to the New Outcomes Framework for Adult Social Care in the following key areas:

1) Improved Health and Emotional Well being; 2) Increased Choice and Control:

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11 Background Papers and Consultation

Contact Name: Mark Joynes; Group Manager Adult Services Hospital Social Work Team Telephone: 304659 E-mail: [email protected],uk

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Appendix 1

Background

The discharge of patients from Rotherham District General Hospital is undertaken in accordance with established Discharge Policy and Procedures, initially produced in March 2002 and reviewed in September 2005. The implementation requirements of the Community Care (Delayed Discharges) Act in January 2004 have been incorporated into the Discharge Policy and Procedures, and have been instrumental in reducing the number of delayed transfers of care.

The Community Care (Delayed Discharges) Act 2003 introduced a system of reimbursement by CSSRs to the relevant NHS Acute Hospital, for delays caused solely by failure to provide timely social care assessments and/or social care services. The reimbursement cost is £100 per day for each person whose discharge is delayed. To date Rotherham MBC has incurred any reimbursement costs.

The purpose of the legislation is to improve services for patients and ensure they have the right care in the right place, at the right time. Central to this, is avoiding situations where patients are put at risk by remaining in an acute hospital bed, when they no longer need acute care.

It is essential for health and social care communities in Rotherham to maintain and develop effective local partnerships and a whole systems approach to care planning and service improvement. This should be implemented within the broader policy framework of the NHS Plan and the National Service Frameworks. An outcome of this approach would be to minimise delays in discharge for patients in acute hospital beds.

Principles

The Community Care Delayed Discharge Act 2003 was introduced in shadow form in October 2003 and implemented January 2004. The major principles of the act are:

• Unnecessary admissions are avoided and effective discharge is facilitated by a whole system approach to assessment processes and the commissioning and delivery of services.

• The need for engagement and active participation of individuals and their carer(s) as equal partners.

• Discharge is seen as a process, and not an isolated event. It has to be planned at the earliest opportunity across the primary, hospital and social care services.

• The process of discharge planning should be coordinated by a named person (the ‘care co-coordinator'), with responsibility for coordinating all stages of the ‘patient journey’.

• Staff should work within a framework of integrated multidisciplinary and multi- agency team working to manage all aspects of the discharge process. The Page 64 - 6 -

team should consider transfer to the patient’s own home before seeking any alternative arrangement.

• Effective use is made of all available services, especially intermediate care services, so that existing hospital capacity is used appropriately and individuals achieve their optimal outcome.

The continued increase in the population of older people in Rotherham and introduction of the Delayed Discharges Act 2003, has contributed to an increase in hospital admissions, and the consequent assessments to facilitate discharge of 47% between April 2003 and March 2006. It is anticipated that there will continue to be an increase in hospital admissions and discharges due to a significant projected demographic increase of 5020 older people in Rotherham (11.5%) between 2001- 2010. (Source: 2001 Census)

Current Issues

There are several factors impacting upon the current discharge process, which are being monitored and addressed, and are identified below:

1. Recent initiatives include: Payment by Results (PBR) by the Department of Health and Interqual the application of an admission and discharge criteria by Rotherham Foundation Trust. Specific discharge coordinator posts have been created by the Foundation Trust, with the aim of improving discharge performance and efficiency.

These initiatives have increased the demands and pressure on the Hospital Social Work Service, and also on Hospital and Primary Health Care staff to facilitate the discharge of patients as soon as possible, whilst ensuring patient care/discharge is not compromised.

These factors, combined with others, sometimes produce inter-agency professional difficulties which if not addressed timeously can contribute to a delayed discharge.

th A meeting was held on 18 January involving the PCT Adult Services and Foundation Trust representatives to discuss and address specific issues, and has resulted in a change of practice to address these difficulties.

Other meetings and workshops to progress the resolution of these difficulties have been scheduled, which may also include a review of the discharge policy as necessary; and it is anticipated that this will lead to an improvement in patients’ experience of transfers of care.

2. There are also legislative and government directives which are required to be undertaken as part of the discharge planning process, i.e. Continuing Care Assessment, and the issuing of Assessment Notifications (referral to Social Services) and Discharge Notifications (Minimum 24 hour notification of a patient ready for discharge). These need to be completed correctly and with appropriate levels and inclusion of mandatory information; this has and continues to provide tensions between health and social care staff. Page 65 - 7 -

3. The completion of these by health staff are often incorrect and with inadequate information, and therefore rejected by the Hospital Social Work Service and returned to be completed appropriately. This contributes to the delay in the discharge process and patients transfer of care.

4. In addition there are conflicting issues which sometimes require day-to-day resolution, for example: a lack of clarity and understanding in differentiating health and social care needs, and the associated responsibilities and tasks. Whilst this is time consuming and may lengthen the patient’s stay, failure to establish responsibility may have a detrimental effect upon the patient and their transfer of care.

Impact of RMBC Christmas Closure Policy

RDGH continues to operate under normal working arrangements during the Christmas and New Year period, while Rotherham Council has relied upon volunteer social workers to cover this period over the last 4 years.

Each Christmas has demonstrated significant pressures and each year requests have been made for social work staff and other key managers and staff to be exempted from the Council’s Christmas holiday policy to enable them to work normally. The reliance of Neighbourhoods and Adult Services upon volunteers makes it difficult to meet the demands generated by RDGH, and the Council has been put at risk of failing to meet its statutory duties, and to ensure best professional practice with regard to the safe and timely discharge of patients.

In addition failure to secure staff exceptions in the future could result in delayed discharges for patients; significant reimbursement costs for the Council; and a negative impact on PAF D41, the joint Health and Social Care performance indicator for delayed discharges form hospital.

Processes and protocols continue to be reviewed and amended in accordance with change requirements for continued improvement / efficiency.

COMMITTEE/AATEMPLATE

Page 66 Agenda Item 9

ROTHERHAM BOROUGH COUNCIL – REPORT TO MEMBERS

1. Meeting: ADULT SERVICES AND HEALTH SCRUTINY PANEL

2. Date: 12 April 2007

3. Title: 2007/08 Panel Work Programme: Scrutiny Reviews

4. Programme Area: Chief Executive’s

5. Summary

The report outlines the areas already identified for consideration by the Panel in 2007/08 and suggests a number of additional topics that could be included in the work programme for the coming municipal year.

6. Recommendations

That (a) The Panel identifies its priorities for the coming municipal year and the approach it wishes to take with any identified scrutiny reviews;

(b) The work programme be monitored and reappraised on a quarterly basis.

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7. Proposals and Details

7.1 Terms of Reference

7.1.1 The role of scrutiny is to:

• Review or scrutinise decisions made in relation to the relevant Council function; • Hold detailed reviews and make recommendations to the Cabinet or full Council; • Assist the Council and the Executive in developing the budget; • Conduct in-depth analysis of policy issues and assist in policy development; • Consider plans and strategies (including the Council Forward Plan of Key Decisions) prior to their implementation; • Question members of the Executive and Boards and Chief Officers about their views on issues and proposals affecting the borough; • Review performance; • Liaise with external organisations.

7.1.2 The work of the Panel includes scrutiny of:

• Strategic Partnerships • Public Health Strategy • Substantial changes to local health provision • Adult Social Services and Health • Older People’s Strategy • Housing Adaptations & Supporting People.

7.2 Work Programming

7.2.1 For effective scrutiny of Adult Services and Health issues, the Panel must plan its work programme, but also leave sufficient capacity for it to respond to issues that arise during the year.

7.2.2 Some meetings are designated as ‘monitoring’ meetings in order to ensure sufficient Panel time is given to its performance management responsibilities.

7.3 Scrutiny Reviews

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7.3.1 These may be either undertaken by the whole Panel at a single sitting (themed meetings/one-day reviews) or by a small review group that gathers evidence over several weeks or months, forms recommendations and then produce a review report for consideration by the full scrutiny panel. If the area under review is cross-cutting, members of the relevant scrutiny panel(s) can be asked to be part of the review group.

7.3.2 It is likely that the Panel will have the capacity to undertake 3 to 4 scrutiny reviews over the coming year.

7.3.3 So far, the areas identified for possible reviews are: • NHS Dental1 Services – Part 2 (review of the new dental contract, one year on) 2 • Disability Equality Scheme (due to be implemented in April 2007)

7.3.4 The Panel may wish to consider the following suggestions:

7.3.5 Adult Services • 3 Provision4 of Respite Care and Support for Carers - including Carers’ Breaks (this could be cross-cutting with Health – including PCT’s investment through its forward plan) • Partnerships – e.g. Learning Disability Service & Mental Health or Health Trusts and Older People’s Services (note: one Our Future group is looking at partnerships) • Extra Care Housing – 2 years on

7.3.6 Health

• Improving Men’s Health Outcomes • Alcohol Services (Safe Theme Partnership is currently monitoring the local alcohol strategy) • Drug Rehabilitation • Mental Health - suicide prevention

8. Finance

All scrutiny work will be met from within existing Scrutiny and Democratic Services budgets.

9. Risks and Uncertainties

Although Scrutiny has a proactive role to play in the way that the Council operates, it must also be able to respond to issues that arise during the municipal year. The draft work programme has allowed for some ‘spare’

1 2 Part 1 – looking at access to NHS Dentistry was undertaken in spring 2006 3 Identified during discussions at the Panel’s 1/2/07 meeting 4 Ref: 2002 Carers’ Legislation Ref. Local Area Agreement target

Page 69

capacity in order to fulfil its reactive role, but nonetheless, the programme will require periodic revision in order to accommodate the key work in a timely way.

10. Policy and Performance Agenda Implications

Policy review work is being co-ordinated by Performance and Overview Scrutiny Committee, which may delegate work to individual scrutiny panels, including Adult Services and Health.

11. Background Papers and Consultation

The Panel had a preliminary discussion about its 2007/08 work programme at its February 2007. Panel members have also suggested other areas for review during the 2006/07 municipal year.

Contact: Delia Watts, Scrutiny Adviser, direct line: (01709) 822778 e-mail: [email protected]

Page 70 Agenda Item 10 1E ADULT SERVICES AND HEALTH SCRUTINY PANEL - 01/03/07

ADULT SERVICES AND HEALTH SCRUTINY PANEL Thursday, 1st March, 2007

Present:- Councillor Doyle (in the Chair); Councillors Billington and Clarke.

Also in attendance were Councillor Kirk and Mrs. I. Samuels, (PPI Forum Yorks Ambulance Serv), Val Lindsay (Patient Public Involvement Forum), Sandra Bann (PPI Forum Rotherham PCT), Mrs. A. Clough (ROPES), Victoria Farnsworth (Speak Up), Mr. G. Hewitt (Rotherham Carers' Forum), Ms. J. Mullins (Rotherham Diversity Forum) and Mr. R. H. Noble (Rotherham Hard of Hearing Soc.).

Apologies for absence were received from The Mayor (Councillor Wootton), Councillors Burke, Burton, Hodgkiss, Jack Jackson, Kirk and Turner and from Mr. J. Evans and Ms. L. Williams.

82. DECLARATIONS OF INTEREST

There were no declarations of interest made at this meeting.

83. QUESTIONS FROM MEMBERS OF THE PUBLIC AND THE PRESS

There were no questions from members of the public or the press.

84. BREATHING SPACE REHABILITATION AND RESPITE CARE FOR PEOPLE WITH RESPIRATORY DISEASE - PRESENTATION FROM ROTHERHAM PRIMARY CARE TRUST

The Scrutiny Panel welcomed Mrs. Kay Vickery (Rotherham Primary Care Trust), who gave a presentation about the Breathing Space Rehabilitation and Respite Care programme for People with Respiratory Disease. The presentation and subsequent discussion included the following issues:-

- the incidence of Chronic Obstructive Airways Disease (COPD), both nationally and in Rotherham (the incidence of the disease in Rotherham was 1.7 times higher than the national average);

- the principal causes of the disease, eg: working in heavy industry such as coal and steel; smoking cigarettes (the disease is more prevalent amongst people aged 35 years and over);

- the symptoms and the consequences of the disease (slow onset and progression; breathlessness; social isolation; lack of exercise; sleeplessness and fatigue; anxiety and depression);

- disease sufferers were categorised as mild, moderate or severe cases;

- current treatment standards, rehabilitation care and sufferers’ recurrent admissions to hospital (nb: modern treatment methods ensured that the disease could often be adequately treated on an out-patient basis;

Page 71 ADULT SERVICES AND HEALTH SCRUTINY PANEL - 01/03/07 2E

sufferers need not be admitted to hospital);

- the pilot scheme in Rotherham of the new treatment centre at Badsley Moor Lane, enabling the better treatment of a larger number of patients; the centre was being developed as a partnership between the Rotherham Primary Care Trust and the Coalfields Regeneration Trust; the pilot scheme would last for two years and would deliver the largest respiratory rehabilitation programme in the country;

- the Rotherham Primary Care Trust was committed to this new facility, which would treat Rotherham residents as a priority (treatment for patients from other areas must be funded by their own PCTs);

- the official opening of thest ‘breathing space’ treatment centre would take place on Wednesday, 21 March, 2007 and there would be a numberth of public open days; the centre would be admitting patients from 30 April, 2007 onwards);

- the new centre must provide value for money; subject to successful completion of the pilot scheme, the Rotherham PCT would continue to fund the treatment centre.

The Scrutiny Panel thanked Mrs. Vickery for the interesting and informative presentation.

Resolved:- (1) That this Scrutiny Panel make a visit of inspection to the ‘breathing space’ treatment centre at Badsley Moor Lane, Rotherham, during April 2007.

(2) That a progress report be submitted to this Scrutiny Panel after twelve months’ operation of the new treatment centre at Badsley Moor Lane.

85. NEIGHBOURHOODS AND ADULT SERVICES - FORWARD PLAN OF KEY DECISIONS MAY 2006 TO MARCH 2007

Further to Minute No. 75(3) ofst the meeting of the Adult Services and Health Scrutiny Panel held on 1 February, 2007, consideration was given to the contents of the Forward Plan of Key Decisions for the Neighbourhoods and Adult Services Directorate for the period May 2006 to Macrh 2007.

Reference was made to the following issues:-

- Transport Policy Implementation Plan - Joint Commissioning Strategy (currently under discussion with the Rotherham Primary Care Trust)

Resolved:- That the contents of the Forward plan be noted.

86. ANNUAL PERFORMANCE PLAN 2006/07 - QUARTER 3 MONITORING Page 72 3E ADULT SERVICES AND HEALTH SCRUTINY PANEL - 01/03/07

Consideration was given to a report of the Performance Analyst outlining the key performance indicator results up to and including the third quarter of 2006/07 for the Adult Services elements of the Neighbourhoods and Adult Services Directorate. The report highlighted:-

- at the end of Quarter 3 (April to December 2006), 73% of key performance indicators are on track to achieve their year end targets, compared to 87% last quarter;

- performance improved in 54% and declined in 46% of PAF PI’s since last quarter, with projected final year end outturns of 76% improving and 24% declining compared to last year;

- such a pronounced swing in performance, on a range of indicators, has resulted in the new management team taking action to ensure that processes are strengthened to improve measurement and monitoring; this action will deal with any deterioration in performance and standards, with early recovery action in future;

- seven performance clinics have been held during January 2007 and action plans to seek maximum achievable year end performance have been agreed.

- CSCI identify “Key Thresholds” for 7 PI’s, which if not achieved restrict the Council’s star rating judgement element, ‘serving people well’ to “Most”; all are currently rated low risk except for indicator “acceptable waiting times for assessment”.

The report provided explanations about those key performance indicators which were not currently on target and those which were improving or expected to improve.

Scrutiny Panel members referred to the complex methods of reporting on performance levels. It was reported that performance monitoring was a necessary requirement to evidence the standard of service provision by Adult Social Services. The high level of service provision was acknowledged and it was also noted that Rotherham was highlighted as an exemplar service provider, attracting interest from other local authorities nationally.

Resolved:- (1) That the report be received and the performance achieved in Quarter 3 with the key performance indicators be noted.

(2) That, at a future meeting, the Performance Analyst arrange a workshop session for this Scrutiny Panel about the overall purpose and operation of the Performance Plus performance management reporting system.

(3) That future performance monitoring reports be presented in the

Page 73 ADULT SERVICES AND HEALTH SCRUTINY PANEL - 01/03/07 4E

revised format now indicated by this Scrutiny Panel.

87. ADULT SOCIAL SERVICES - REVENUE BUDGET MONITORING 2006/2007

The Service Accountant (Adult Social Services) submitted a budget monitoring report providing a financial forecast for the Adult Services Department within the Neighbourhoods and Adult Services Directorate to the end of March, 2007.

The report stated that since January 2007, activity to monitor, act and manage the budget has been strengthened considerably. The new management team for the Directorate has clarified responsibilities and accountability of individual managers and budget holders. The forecasted overspend for the year, assuming the remaining management actions are fully implemented, is now £30,000 a reduction in the projected overspend of £125,000 since the last report.

Resolved:- (1) That the latest projected overspend of £30,000 against

budget for 2006/07, based on actual income and expenditurest to the end of January 2007 and forecast expenditure and income to 31 March 2007 be noted.

(2) That this Scrutiny Panel notes that the range of management actions previously reported to Elected Members will continue to be implemented, together with a continuation of the moratorium on non-essential spend

within the Directorate and robust vacancy management tost bring expenditure closer to budget by the end of the financial year, 31 March, 2007.

88. MINUTES OF MEETINGS OF THE ADULT SERVICES AND HEALTH SCRUTINY PANEL HELD ON 1ST AND 9TH FEBRUARY 2007

Resolved:- That the minutes ofst the meetingsth of the Adult Services and Health Scrutiny Panel held on 1 and 9 February, 2007, be approved as correct records for signature by the Chairman.

89. MINUTES OF MEETINGS OF THE PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE HELD ON 19TH JANUARY 2007 AND ON 2ND FEBRUARY 2007

Consideration was given to the minutes of meetingsth of the Performancend and Scrutiny Overview Committee held on 19 January, 2007 and on 2 February, 2007.

Resolved:- That the contents of the minutes of the meetings of the Performance and Scrutiny Overview Committee, held on 19th January, 2007 and on 2nd February, 2007, be noted.

Page 74 Agenda Item 11 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 16/02/07 1

PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE 16th February, 2007

Present:- Councillor Stonebridge (in the Chair); Councillors Akhtar, Barron, Boyes, Clarke, Doyle, Hall, Jack, G. A. Russell, P. A. Russell, R. S. Russell and Whelbourn.

162. DECLARATIONS OF INTEREST

There were no declarations of interest made at this meeting.

163. QUESTIONS FROM MEMBERS OF THE PUBLIC AND THE PRESS

A member of the public made reference to Post Office closures and in particular the large catchment area for the post office on Broom Lane following the closure of Whiston Post Office. He was particularly concerned that a £1.00 fee was charged by the Post Office for each bill payment in Rotherham when he believed this did not apply in other areas of South Yorkshire and also did not apply at District Council Offices.

The Chairman pointed out that Post Office closures was to be considered next on the agenda but noted the questioner’s concerns particularly with regard to the alleged differential administration payments at post offices and undertook to clarify the position in South Yorkshire.

The Committee sympathised with the questioners regarding the accessibility of post office services in the area mentioned and the unfairness of additional charges to pay bills at post offices.

Resolved:- That the Strategic Director of Corporate Services investigate clarification of the arrangements with post offices for the paying of Council bills and report to a future meeting of this Committee.

164. POST OFFICE CLOSURES

Further to Minute No. 159(f) of the meeting of this Committee held on 2nd February, 2007, Cath Saltis, Head of Scrutiny Services, introduced the submitted report and invitation from Postwatch to respond to the Government’s consultation on the future of the Post Office network, including further closures of both rural and urban branches. The Consultation deadline was 8th March, 2007.

The consultation document described the Government’s future funding and structural plans for both urban and rural branches, including the key proposal of a maximum of 2500 branch closures nationally. This followed on from the previous consultation with the Post Office and the closure of a number of branches in 2004. At present no detailed information was available on the direct impact of the previous closures in Rotherham, nor was it clear which branches in the Rotherham area were now proposed for closure.

Page 75 2 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 16/02/07

The submitted briefing paper from Postwatch highlighting their concerns covered :-

- key proposals in the consultation - what’s wrong with current arrangements? - Postwatch’s view - questions posed in the consultation paper - what to do next

Discussions and a question and answer session ensued and the following views were covered:-

- previous review and involvement of local MP’s

- concerns regarding post offices being allowed to close and the proactive incentives being offered to postmasters/postmistresses to retire

- problems on the south side of the borough with the closure of Whiston Post Office and accessibility problems to Broom Lane Post Office

- no account taken of transport networks and ability of people to access post offices

- social aspect of post offices, not just retail

- counter productive role of Government by not supporting the post office network

- need to reinvest in the post office network not incentivise retirement

- no positive moves to site post office facilities in other venues e.g. supermarkets and make more accessible

- English Heritage initiative to provide postal services in churches one day per week not supported (Post Office could be doing more)

In conclusion it was acknowledged that there was nothing to suggest further closures in Rotherham, but it was reasonable to assume that Rotherham would be affected. It was felt that the Council should respond in the light of experience from the last round of consultation supplemented by the comments now raised. Consideration was given to the views expressed by Postwatch.

Resolved:- (1) That the Council’s response should include :-

Page 76 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 16/02/07 3

(a) support for the extension of funding from Government to the Post Office network

(b) the vast majority of the extended funding should be aimed at improving the network rather than incentivising retirements

(d) reiterate the need for full consultation prior to closure with the local community particularly on socio-economic factors

(e) need to urge a national campaign to market the Post Office in terms of TV, radio etc., and recruit into the Post Office network

(f) need for Government to review the restraints placed on post offices by its agenda to restrict the viability of post offices

(g) need to take account of the impact of closures on the community in terms of queuing, accessibility etc., and be aware of the deterioration of services for the public

(h) urge the need to review in a more sophisticated way the impact of closure rather than just focus on the distance criteria

(i) urge Post Office Ltd. to be more proactive in looking at other initiatives such as the provision of facilities in churches, supermarkets etc., and mobile facility provision

(j) highlight the current perverse disincentive to use post offices, particularly with regard to elderly people with no other provision but to incur surcharges on bill payments at post offices. Suggest that part of the extended funding be utilised to offset such surcharges

(k) encourage pressure to remove all remaining administration charges for everybody by utilising part of the extended funding.

(2) That, in addition to Postwatch, the Council’s response also be sent to the Postmasters/Postmistresses Group in Rotherham and the viability of a meeting with them be pursued.

(3) That Postwatch be requested to supply information regarding the national picture in respect of any proposed closures that did not take place last time as a result of the consultation process/responses.

(4) That the Council’s response be forwarded to the three Rotherham MPs.

165. MINUTES

Page 77 4 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 16/02/07

Resolved:- That the minutes of the meeting held on 2nd February, 2007 be approved as a correct record for signature by the Chairman and arising therefrom:-

Minute No. 161 Changes to Saturday Opening

Reference was made to the supplied information regarding footfall figures for Wath Town Hall and Swinton Customer Services Centre, the accuracy of which was questioned.

It was also pointed out that the respective figures related to different periods of time and it was important to be able to compare like with like.

The source of the figures was explained.

Resolved:- That the Strategic Director of Corporate Services be requested to arrange for the provision of ‘like for like’ statistics, as now discussed, to facilitate consideration and comparisons on fair and accurate data.

166. MINUTES OF A MEETING OF THE MEMBERS TRAINING AND DEVELOPMENT PANEL

The Committee noted the minutes of the meeting of the Members Training and Development Panel held on 25th January, 2007.

167. WORK IN PROGRESS

Members of the Committee reported as follows:-

(a) Councillor Akhtar reported the final stages of the conclusion of the report regarding the Public Engagement Review

(b) Councillor Doyle reported:-

- the budget meeting had been held and recommendations had been made

- the start next week of the Fluordisation Review

- the Transportation Review report was being considered by Cabinet next week

- the budget considerations had taken place at very short notice last week

(d) Councillor G. A. Russell reported consideration of the following at the last meeting :

Page 78 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 16/02/07 5

- presentation regarding the Health Trust

- PFI Education Update

- Budget

(e) Councillor Hall reported discussions on the Forward Plan of Key Decisions again without dates completed although an updated version had been promised

(f) Councillor Jack reported on

- Women’s Strategy Draft Plan

- Centenary Women’s Local Government Society Launch date of 21st June, 2007

(g) Councillor Stonebridge reported

- communications with the Chief Executive regarding the Forward Plan of Key Decisions and good practice examples

- meeting in Warwick last week regarding the LGIU Neighbourhoods Learning Network which had been very useful and reports would be submitted to future meetings of this Committee and the Members Training and Development Panel

(h) Cath Saltis reported that the Scrutiny Self Assessment was to be considered by Cabinet next week.

168. CALL-IN ISSUES

There were no formal call-in requests.

169. EXCLUSION OF THE PRESS AND PUBLIC

Resolved:- That, under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following item of business on the grounds that it involves the likely disclosure of exempt information as defined in Paragraph 3 of Part I of Schedule 12A to the Local Government Act 1972 (financial affairs)

170. BUDGET 2007/08 AND MEDIUM TERM FINANCIAL STRATEGY 2007- 2010

Stuart Booth, Director of Central Finance, gave a presentation on the above.

Page 79 6 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 16/02/07

The presentation covered :-

- Summary Statement of Resources

- Resources 2007/08

- Present Policies Budget (PPB) 2007/08

- Budget Issues Papers (BIPs) 2007/08

- Contingency Fund

- Provision for Capital Priority A’s

- Savings Issues Papers (SIPs) 2007/08

- Medium Term Financial Strategy (MTFS) : Key Features

- “Our Future” : Key Outcomes

- Draft Budget

- Next Steps

Discussion and a question and answer session ensued and the following issues were covered :

- balancing of the budget - treasury management savings - budgetary timetable and reporting process - budget pressures/problems and into the future - use of reserves - Planning Delivery Grant - presentation of SIPs information by theme - customer resistance/savings regarding home care charges/meals on wheels - negotiations with fuel companies and implications for the contingency plan - energy efficiency measures - challenges for next year - sustainability of grant funding particularly with regard to Children and Young People’s Services - budget development and need to identify impacts for the public, sustainability and risk implications - need for complete budget information regarding BIPs and SIPs to enable proper scrutiny consideration of the budget - need to look at process changes necessary to sustain the budget - Community Strategy themes - rescheduling of the capital strategy Page 80 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 16/02/07 7

- partnership working and realisation that there is one pot of money for Rotherham - translation services costs

In conclusion, the Committee felt that budget information should be presented to this Committee with regard to:-

- spend by theme - impact on the public - sustainability - risk regarding delivery of good quality services - LAA targets - Community Strategy

Resolved:- That the comments from the individual scrutiny panels be collated and fed into the budgetary process.

Page 81 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 09/03/07 1

PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE 9th March, 2007

Present:- Councillor Stonebridge (in the Chair); Councillors Akhtar, Barron, Clarke, Doyle, Hall, G. A. Russell, P. A. Russell, R. S. Russell and Whelbourn.

Apologies for absence were received from Councillors Boyes and Jack and, with regard to item 173 below, Councillors Brook and Rowley (Barnsley M.B.C.).

171. DECLARATIONS OF INTEREST

There were no declarations of interest made at this meeting.

172. QUESTIONS FROM MEMBERS OF THE PUBLIC AND THE PRESS

There were no questions from members of the public or the press.

173. THE LEGACY OF CONNEXIONS SOUTH YORKSHIRE

The Committee, in considering the submitted report relating to the above, welcomed to the meeting Joyce Thacker, Senior Director, Children and Young People’s Services and Professor Crook, Pro-Vice Chancellor at Sheffield University and Chair of the Connexions partnership who presented a discussion document arising from the research commissioned into the achievements of Connexions over the previous six years and what could be learned by those setting up new services in the boroughs.

Professor Crook highlighted important points raised in relation to the following two research questions:-

- What has been the impact of the Local Connexions Service on improving outcomes for 13-19 year olds (up to 25 for those young people with learning difficulties and disabilities) ?

- What is the learning on the effectiveness of policy making at central and local level and its impact on the delivery of the Connexions Service? In particular the decision to remove the provision of advice and careers services from local authorities and to place the commissioning of these in the hands of sub-regional bodies directly funded by and monitored by DfES? (This was a key question in the light of the subsequent decisions to ‘return’ these services to local authorities via Children’s Trusts)

The original report set out the key achievements of Connexions across South Yorkshire since the pilot from April, 2000 (formal launch in April, 2001) to its closure in March, 2007.

The report covered :

Page 82 2 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 09/03/07

• background position • proposed arrangements • financing arrangements • risks and uncertainties of the demise of the Connexions Unit highlighting consequences from the legacy research report • lessons learned for the future

Key data covering the sub-region was presented in an appendix to the report concluding with a short summary of the legacy research.

Discussion and a question and answer session ensued and the following issues were covered:-

- perceived lack of effective partnership working

- voluntary sector involvement

- involvement of employers

- report format

- data collection

- teenage pregnancy statistics

- reporting timescales/current statistics

- training (learning based working – national trend)

- ‘runaway’ protocols/statistics

- lessons learned and cross border issues

- need for local authority infrastructure as there would be no central unit for South Yorkshire

- transition plans and Government Office approval

- funding sources

- formula for funding allocation

- need for Children’s Trusts to be allowed a period of stability

- implications of periods of instability through ministerial changes, targets and changes to Government policy etc.

- VAT implications

- viability of a young persons’ observatory Page 83 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 09/03/07 3

- governance of the service

- need for continuity of service across South Yorkshire

- monitoring arrangements through scrutiny

- forthcoming conference in Tankersley

Professor Crook stressed his thanks to Rotherham for being the Lead Body for Connexions over the last two years.

Resolved:- (1) That the information be noted and Professor Crook and Joyce Thacker be thanked for their presentation.

(2) That the contribution made by Connexions, over the last seven years, to the development of services for teenagers across South Yorkshire be acknowledged.

(3) That the learning from the Connexions experience and its application to the emerging Children’s Trust arrangements be noted.

(4) That the statistical information including NEETS, runaway protocol and sleeping rough statistics etc. be reported through the Children and Young People’s Scrutiny Panel.

(5) That the viability of providing a young persons’ observatory be pursued through Professor Crook and the University research group.

(6) That the Cabinet Member for Children and Young People’s Services be requested to speak with counterparts in the other local authorities to ensure matters are not overlooked and there is a continuity of provision across South Yorkshire.

(7) That this Committee requests that the three local Members of Parliament be invited to the forthcoming conference in Tankersley and that this subject be suggested as an agenda item for the South Yorkshire Leaders’ Meeting.

174. CORPORATE COMPLAINTS

Carol Mills, Strategic Director, Corporate Services, introduced the submitted report which:-

- Providedst details of theth complaints received and handled during the period 1 April to 30 September, 2006.

- Provided an update on the position regarding the development of the corporate complaints system.

Page 84 4 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 09/03/07

- Identified good practice amongst the directorates for measuring customer satisfaction.

Carol indicated that future reports would be on a more ‘real time’ basis and that there was a strong commitment from the Corporate Management Team to the corporate system which would include:-

- Information from the surgery system.

- Monitoring/measurement of satisfaction levels upon completion of the complaint.

- Extended use of local performance indicators in responding to complaints.

- Looking at what constituted a complaint.

Mark Evans, Customer Services Client Manager, presented and elaborated on the submitted report highlighting:-

- The Local Government Ombudsman had not issued a report of maladministration against the Council.

- Summary of complaints received during 2005/06.

- 2½% increase on 2005 totals (potentially influenced by individual complaint points being counted).

- Future reporting would include individual complaint points and number of complainants.

- Extended timelines for responses to Stages 1 and 2 in respect of Adult and Children and Young People’s Services.

- Local Government Ombudsman Requests responded to within 28 days.

- Standardised approach to collecting satisfaction levels from complainants.

- Requested capture of 2010 complaints.

Discussion and a question and answer session ensued and the following issues were covered:-

- Reporting timescale.

- Inclusion of figures relating to 2010.

- RBT complaints. Page 85 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 09/03/07 5

- Need for more consistency regarding feedback from directorates.

- Need to include complaints information with regard to RBT.

- Reporting of individual complaint points as well as number of complainants.

th - All Member seminar on 17 April, 2007, regarding the role of the Local Government Ombudsman.

- Need for 2010 representative to attend when statistics reported to the Sustainable Communities Scrutiny Panel.

- Local Government Ombudsman requests.

- Need to report directorate figures to relevant individual scrutiny panel.

- Previous review of the complaints procedure.

- Need to be able to identify complainant profile.

Resolved:- (1) That this Committee expresses concern at the delay in presenting statistics.

(2) That scrutiny panels look rigorously at the figures from the respective directorate and the overall review position be considered by this Committee.

(3) That cumulative data be provided covering the last two and a half years.

th (4) That Members be urged to attend the seminar on the 17 April, 2007.

(5) That this Committee consider a review of the complaints procedure, to see whether or not it is fit for purpose, at the first meeting in the new municipal year.

(6) That concern be expressed regarding the lack of compliance, emphasising the need to do what we say we will do.

(7) That consideration be given to appropriate training for officers with regard to complaints.

(8) That directorates improve the way they monitor the profile of complainants in order to meet the positive duties to promote equality.

(9) That directorates feedback be provided in a consistent format.

Page 86 6 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 09/03/07

(10) That complaints information with regard to RBT be included in the regular RBT performance reports.

(11) That the Corporate Management Team be advised of this Committee’s concerns regarding the seriousness of the issues in respect of complaints and the need for improvement.

175. NEIGHBOURHOOD RENEWAL FUNDING FOR AREA ASSEMBLIES 2006/07

Further to Minute No. 159(c) of the meeting of this Committee held on 2nd February, 2007, Debbie Marks, Community Involvement Manager, presented the submitted report relating to the above, detailing the decision making process for the allocation of Neighbourhood Renewal Funding (NRF) monies within each of the seven area assemblies.

The NRF Steering Group of the Rotherham Partnership had given area assembly co-ordinating groups the responsibility for ensuring that £420,000 of NRF was allocated to work in the 13 most deprived neighbourhoods across the borough as well as the 4 communities of Interest to :

“Improve the quality of life in the most disadvantaged neighbourhoods and groups and ensure service providers are more responsive to needs and improve delivery”.

Attached as an appendix to the report was an agreed “menu of activities” for which funds could be allocated to address community priorities. There was flexibility within the menu of activities for additional activities to be brought forward for consideration by the External Funding Steering Group/Chief Executive Officers Group should they be identified through the area assembly co-ordinating groups.

The report set out the eleven point decision making process for the allocation of NRF monies which had been developed and implemented during the first year of NRF funding to the area assemblies. The process would continue until all funding had been allocated, with all spend and activities having to be completed by the 31st March, 2008.

Discussion and a question and answer session ensued and the following issues were covered :-

- clarification of a recommendation process rather than a decision making process

- target areas for spend

- clarification that each area assembly had also been allocated £30,000 for spend within the area assembly area Page 87 PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE - 09/03/07 7

- clarification that the allocation process was specific to the 13 deprived areas and not anywhere in the borough

In addition to the above discussions, reference was also made to task and finish groups and concerns that borough wide task and finish groups would be a duplication of the work of overview and scrutiny.

It was clarified that none borough wide had been set up and that task and finish groups were for the consideration of local issues.

Resolved:- (1) That the information be noted.

(2) That the Director of Legal and Democratic Services look into the issue of borough wide task and finish groups to avoid future duplication between the work of area assemblies and this Committee.

176. QUARTER 3 PERFORMANCE 2006/07

Darren Merriman, PerformancePlus Officer, presented the submitted report relating to the above. The report was structured around the corporate priorities and the performance data was taken from data entered by programme areas onto the Council’s performance management system (PerformancePlus).

At the end of Quarter 3,62.5% of performance indicators had improved since last year’s outturn continuing to show an improved direction of travel. The number of indicators showing deterioration had had reduced to 33%.

The submitted exception report based on the measures contained within the Corporate Plan, and paying particular attention to the areas of greatest risk, also highlighted areas of strong performance.

The report covered :-

- future reporting : it was noted that a future reporting format was being discussed at Corporate Management Team. On timescales it was proposed to report to this Committee seven weeks from the performance period closure

- scorecard symbols

- direction of travel

- corporate priority theme position

- BVPI quartile positions

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- indicators demonstrating exceptional improvement

- performance clinics

- finance and areas of pressure at service level which could impact on performance and delivery

Discussion and a question and answer session ensued and the following issues were covered :-

- BVPI 8 payment of invoices within 30 days

- percentage of pupils achieving level 4 at key stage 2 Maths and English

- Local Transport Plan Score

- adults with physical disabilities helped to live at home

- PAF C32 older people helped to live at home

- number of road accident casualties killed or seriously injured

- domestic burglaries per 1000 population

- violent crime per 1000 population

- number of parishes and town councils with quality status

- turnout for local elections

- tonnage of household waste collected

- number of green flag awards for sustainable management of parks

- number of incidents reported within the LGBT communities

- percentage of planned/responsive repairs (revenue) expenditure (ALMO)

- timetable for reports

Resolved:- (1) That the overall position and direction of travel in relation to performance be noted.

(2) That the possible impact of the budget on a number of indicators be noted.

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(3) That the actions to be taken to address “red” measures and issues be noted.

(4) That the performance reporting timetable be noted and reports be submitted to this Committee as follows :

Quarter 1 - September, 2007

Quarter 2 - December, 2007

(5) That the Performance Clinic notes in respect of BVPI 8 be submitted to the next meeting of this Committee.

(6) That the performance specialists from the four districts be requested to look at the Local Transport Plan score.

(7) That the Democratic Renewal Scrutiny Panel be requested to look at the number of incidents reported within the LGBT communities.

(8) That a report be requested, as a matter of urgency, from the ALMO Board regarding how ALMO aims to meet performance targets in respect of the percentage of planned/responsive repairs (evenue) expenditure (ALMO)

177. AMENDMENTS TO PART IV OF STANDING ORDERS

The Director of Legal and Democratic Services presented the submitted report indicating that contract standing orders were last revised in April, 2000.

The report highlighted the proposed revisions to Part IV which would bring the standing orders up to date to reflect changes in the way the Council now procured work, goods and services. Submitted as an appendix to the report was the latest draft dated 14th February, 2007.

Whilst only the full Council had the power to make or change Standing Orders, consideration had taken, or would be taking, place prior to submission to Council as follows:-

- Standards Committee : 8th March, 2007 - Audit Committee : 21st March, 2007 - Cabinet : 28th March, 2007

The following key amendments to Contract Standing Orders were proposed:

32 - The link between Standing Orders, Financial Regulations and the Corporate Procurement Strategy had been emphasised

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33 - The delegation arrangements had been given greater emphasis by treating them as orders in their own right rather than as a separate appendix to Standing Orders

35 - To streamline administration, there was a relaxation on the contracts required to be under seal

37 - More emphasis was placed on the adoption of the Standing Guide to the Procurement of Local Authority, Goods, Works and Services in conjunction with Standing Orders

39 - RBT and the services tasked with particular procurements were identified

39.8 - The use of framework agreements was covered

46 - The circumstances in which a contract need not be tendered for had been expanded and clarified

47 - The threshold below which a contract could be let without first seeking quotations was increased to £5,000

49.5 - Electronic procurement through the supplier and Management Contract System Website, which was a procurement website introduced by the Yorkshire and Humber Centre of Excellence. The Council was a participator

51 - The provisions in relation to parent company guarantees and performance bonds had been reviewed and revised.

Discussion and a question and answer session ensued and the following issues were covered :

- company guarantees and performance bonds

- availability of Standing Orders electronically

- need for Forward Plan reference

Resolved:- That, subject to the inclusion of reference to the Forward Plan of Key Decisions, the proposed revisions to the contract standing orders contained in Part IV of Standing Orders, as now submitted, be supported as far as this Committee is concerned.

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178. COMMUNITY LEGAL ADVICE AND INFORMATION

Caroline Webb, Senior Scrutiny Adviser, presented the submitted report by the Manager, Equalities, Community Cohesion and Inclusion, relating to the above with regard to a possible review of community legal advice and information services.

The report covered :-

(a) background and context :

- although Government figures showed deprivation in Rotherham decreasing (48th most deprived in 2000 to 63rd in 2004), Rotherham still ranked amongst the top 20% most deprived local authorities with some communities experiencing disproportionately high levels of worklessness and crime and relatively poorer health and employment prospects

- income deprivation and reliance on welfare and social security benefits

- gaps between most deprived areas and borough average at neighbourhood level

- need to ensure access to free, independent and comprehensive advice and information services as an essential and integral part of approach to tackling income deprivation, social exclusion and improving the life chances of the most deprived and vulnerable in the borough.

(b) current advice and information provision

- identification of priority areas for advice

- advice provision

- workforce development and training

- strategic activity

- joint working within the sector

It was noted that, whilst a lot of money was invested in advice, there was a lack of a co-ordinated approach.

Discussion and a question and answer session ensued and the following issues were covered :-

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- previous research carried out as a part of the curtailed welfare services review

- need for a review of this area

- ownership of the review

- timing of the review

Resolved;- (1) That the information be noted and concerns recognised.

(2) That this Committee undertake a review of this area and consider the matter further at the first meeting in the new municipal year.

179. MINUTES

Resolved:- That the minutes of the meeting held on 16th February, 2007 be approved as a correct record for signature by the Chairman.

180. WORK IN PROGRESS

Members of the Committee reported as follows:-

(a) Councillor G. A. Russell reported :

- this afternoon three of the Panel were going to Barnsley as part of the sub-regional health scrutiny of Sheffield Children’s Hospital

- a review of the future challenges for the Youth Service was commencing

- the meeting on 30th March, 2007 would be looking at the contribution of Neighbourhoods and Economic and Development Services to the Every Child Matters agenda

- on 20th March, 2007 there was a Beacon in London regarding the Rotherham Healthy Schools Scheme

- the April, 2007 meeting was to look at educational attainment in boys

(b) Councillor R. S. Russell reported :

- consideration of Local Transport Plan issues

- the draft report on Highways Small Works was expected early May, 2007

- consideration of the third quarter performance report

- consideration of an improving Forward Plan report

- the ongoing ALMO review was nearing its conclusion

(d) Councillor Doyle reported :

- next Monday there was to be a joint annual health check with Children and Young People’s Scrutiny Panel

- next Tuesday was further consideration of the Fluoridisation review

- next Wednesday there was a South Yorkshire Joint Health Scrutiny Annual health check in respect of hospital/ambulance services

(e) Councillor Akhtar reported that the final touches were being applied to the Public Engagement Review report which would be considered at the April meeting .

(f) Councillor Stonebridge reported:

- need to consider the work programme for next year and the Annual Report

Resolved:- That the above matter be considered at the next meeting.

- the Use of Consultants review group was meeting on 16th March, 2007

- involvement in work this week nationally on LSP benchmarking which would be brought to a future meeting for discussion along with the LGIU publication regarding wider conversations in respect of scrutiny and the LSP. Such consideration to include engagement between scrutiny and LAA.

181. CALL-IN ISSUES

There were no formal call in requests.

182. CAROL MILLS

The Chairman reported that this was the last attendance at the Committee by Carol Mills, Strategic Director, Corporate Services, before taking up her new post in Lancashire.

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Resolved:- That the Committee places on record its thanks to, and appreciation of, Carol for her services to the Council and this Committee and wishes her all the very best for the future.

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PERFORMANCE AND SCRUTINY OVERVIEW COMMITTEE Friday, 23rd March, 2007

Present:- Councillor Stonebridge (in the Chair); Councillors Akhtar, Barron, Boyes, Clarke, Doyle, G. A. Russell and Whelbourn.

Also in attendance was Councillor Sangster (Chairman of the Audit Committee)

Apologies for absence were received from Councillors Hall, Jack, P. A. Russell and R. S. Russell.

183. DECLARATIONS OF INTEREST

There were no declarations of interest made at this meeting.

184. QUESTIONS FROM MEMBERS OF THE PUBLIC AND THE PRESS

There were no questions from members of the public or the press.

185. BVPI 8 - PAYMENT OF INVOICES WITHIN THIRTY DAYS

Further to Minutesth Nos. 140 andth 176(5) of the meetings of this Committee held on 18 January and 9 March, 2007 respectively, the Committee

considered a progress report presented by Sarah McCall, Performanceth Officer, together with minutes of a performance clinic held on 26 January, 2007 relating to the above.

The report indicated that the Council was currently on schedule to miss the 2006/07 target by 4.04%. A series of measures had been put in place to correct the performance and the s ituation had improved steadily. However, performance was not as consistent as it should be and it was necessary to instil and embed good practice in this area.

The report covered:-

- National figures for 2005/06 quartile information in relation to Metropolitan Councils.

- Reasons why the Council’s performance against BVPI 8 had dipped.

- Preliminary work by Procurement Champions.

- Action by Procurement Champions where Goods Receipt Note (GRN) had caused the delay.

- Areas causing problems.

- Actions arising from the meeting of Champions.

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- Cost/resource implications.

- BVPI 8 and SLA PO3 performance.

- Following up identified process/system problems.

Discussion and a question and answer session ensued and the following issues were covered:-

- Internal publicity. - Training. - Procurement cards. - Induction process. - Resourcing action in respect of the 2010 late GRN transactions. - Reporting arrangements. - Provisions for ‘stopping the clock’. - Cultural/attitude issues.

Resolved:- (1) That the information be noted and the current course of rectifying action be noted.

(2) That progress reports be submitted to this Committee on a quarterly basis.

(3) That the issue of resourcing action in respect of the 2010 late GRN transactions be pursued.

(4) That this Committee places on record its thanks to the Procurement Champions for their continuing work and improving performance in this area.

186. SCRUTINY ANNUAL FORWARD PLAN

The Chairman presented the submitted issues paper in respect of the above covering the drivers for development.

Also submitted was the ‘Scrutiny Moving On’ document highlighting provisions impacting on scrutiny from the:-

- Strong and Prosperous Communities White Paper 2006 (WP) - Police and Justice Act 2006 (PJA) - Local Government and Public Involvement in Health Bill 2006 (LGPIH)

Utilising the ‘Scrutiny Moving On’ paper, the Committee considered provisions impacting on scrutiny, Rotherham’s current position and consideration for the future.

The considerations included:-

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- Focus on strategic matters and local priorities. Strengthening the role of scrutiny regarding partnerships/local area agreements.

- Need for appropriate support and resources for overview and scrutiny. Resource implications of being most improved council.

- Scrutiny alignment to the four year plans of how leaders map out their terms of office.

- Executives to respond to overview and scrutiny recommendations within two months of receipt and the importance of good forward plans of key decisions.

- Local area agreements and overview and scrutiny role in improving accountability of local public service providers to be strengthened. Role of Government Office regarding local area agreements.

- Data analysis implications, pooling of information across agencies, identifying commissioners, recommendations to partners regarding overview and scrutiny work and need for system in place for publicity work regarding overview and scrutiny and Community Calls for Action.

- Joint working with primary care trusts to produce a strategic assessment of their area’s health needs to form part of the Community Strategy. Need for real time database and testing mechanisms at a very small local level (e.g. postcode based).

- Scrutiny of response of local authorities and primary care trusts to reports of Directors of Public Health on improving the health of local populations. Influence regarding data presentation.

- Resource issues arising from Local Involvement Networks (LINKS) to replace Patient and Public Involvement Forums and refer matters of concern to overview and scrutiny.

- Overview and scrutiny responsibility for considering Community Calls for Action referred to it. Aim to strengthen system of redress to enable people to report easily concerns and request action. Essential to ensure understanding of the process and have mechanisms in place. Need for working with area assemblies and a joint vision. Meeting needed with Area Assembly Chairs and officers.

- Scrutinising work of local crime and disorder reduction partnerships. Need to resolve at the nearest possible point of concern. Strategic issues to scrutiny.

- Overview and scrutiny to consider community safety issues referred to it by Ward Councillors through Community Calls for Action.

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Resource implications over the next twelve months.

- Increased focus on community and neighbourhood empowerment including concept of scrutiny focused on particular areas. Need to consider roles and relationships of Neighbourhoods and 2010. Issues for the Sustainable Communities Scrutiny Panel.

- Regional Development Agencies.

- Strategic Health Authority.

- Climate change.

- South Yorkshire Passenger Transport Authority, potential future meeting.

- South Yorkshire Police Authority, potential future meeting.

Resolved:- That a draft report on the issues now discussed be prepared and submitted to a future meeting.

187. MINUTES

th Resolved:- That the minutes of the meeting held on 9 March, 2007 be approved as a correct record for signature by the Chairman.

188. WORK IN PROGRESS

Members of the Committee reported as follows:-

(a) Councillor Hall indicated that the report on the ALMO review would be provided in June, 2007.

(b) Councillor Doyle indicated that the final part of the annual health checks would be completed next week.

- There had been a scoping meeting with regard to the review of the use of consultants and a further meeting was scheduled next week.

- The need to consider a joint scrutiny review of equalities work to test the embeddedness of equalities work in everything we do.

Resolved:- That consideration of this matter be deferred to the next meeting.

- The published Lyons report would be distributed to Members.

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- The Comprehensive Spending Review be added to the list of potential items for the work plan.

- On links between scrutiny and audit and the proposal for a future joint meeting.

(d) Cath Saltis reported that Doncaster M.B.C. was to lead on the joint scrutiny of tourism and that a protocol was being prepared.

189. CALL-IN ISSUES

It was confirmed that a call-in had been received in respect of Minute No.

129 of the meeting of theth Cabinet Member for Lifelong Learning, Culture and Leisure held on 13 March, 2007 regarding a play area at Leewood Close, Brampton.

th The Committee was to consider the matter at its meeting on Friday, 13 April, 2007.