Councillors and committees
Agenda and minutes
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Venue: Guildhall, Kingston upon Thames
Contact: Marian Morrison 020 8547 4623 email: email@example.com
To consider questions from the gallery on items which are not on the agenda
There were no questions.
Apologies for absence and attendance of substitute members
Apologies were received from Councillors Sushila Abraham, Paul Bedforth, Mary Clark, Shiraz Mirza and Rachel Reid. Councillor Malcolm Self attended on behalf Councillor Reid and Councillor Hilary Gander attended on behalf of Councillor Abraham.
Apologies were also received from Iona Lidington, Director of Public Health.
Declarations of Interest
There were no declarations of interest.
To agree the minutes of the meeting held on 21 February 2018
Agreed that: the minutes of the meeting held on 21 February be approved as a correct record.
To consider the report from Kingston CCG outlining progress to date, scrutinise and make any recommendations
Healthwatch Kingston submitted a formal written request under statutory powers for the Panel to consider the specialist provision of services for people Kingston with complex emotionally unstable personality disorder (EUPD) as an urgent item on 7 December 2017. At that meeting the CCG confirmed that it recognises that this complex group of people are not well served and that it was planning to undertake a three months’ Demand and Capacity Review of services provided by South West London and St George’s Mental Health Trust. The KCCG anticipated that this would be completed in April/May 2018 and the Panel therefore requested that the CCG reported back on an interim basis to this meeting.
The KCCG’s report explained that personality disorder affects around 10% of the general population and is associated with significant impairment of functioning and high levels of distress for the person and their relatives and friends. The person may have difficulty with daily living tasks and may self-harm. It is estimated there are 5,556 people with PD in Kingston and of these 536 have EUPD.
Current provision is to provide secondary care within the recovery support teams (the former community mental health teams). Some people may be referred on to the Home Treatment Team or to Psychotherapy Services for additional support.
The report explained that KCCG has Dialectical Behavioural Therapy (DBT) within its current contract with South West London and St George’s Mental Health Trust but this is currently not provided for Kingston residents and urgent discussions are taking place with the Trust to reinstate this. However, people do currently access the Service User Network (SUN) programme.
Primary Care Mental Health Services (PCMHS) are provided for people who do not reach the threshold for secondary services. Services include the STEPPS programme which offers specialist group treatment. People can be assessed for emotional instability traits using the QuEST inventory and this is used to demonstrate progress in the STEPPS programme. Increasing referrals have been reported by PCMHS in recent months and it has also been identified that inpatient stays for people with PD have increased together with increasing length of stays.
KCCG is embarking on several initiatives to strengthen provision in the borough including a review of specialist PD provision across Kingston and Richmond. Several service models across South West London are in place and the community demand and capacity review due to be completed at the end of 2018 will feed into the PD review.
Fergus Keegan, Director of Quality at Kingston & Richmond CCGs highlighted the main points of the report. He added that most of the care for mental health patients is provided in primary care and that the demand for mental health services is increasing.
Kingston CCG’s demand and capacity review of local mental health services has been delayed slightly for data collection and analysis reasons but is expected to be completed by end May. The review will feed into 2018/19 commissioning and contracting arrangements. He confirmed that KCCG has been diligent in meeting the investment standard ... view the full minutes text for item 41.
Eamonn Gilbert, Associate Director of Commissioning for Achieving for Children will introduce the report and members are invited to scrutinise and make any recommendations
The report provided a detailed summary of transport for children and young people with special education needs and disabilities, the related statutory responsibilities and the approach to developing independence particularly around travel.
SEN transport is a statutory service provide by all local authorities for pupils with special educational needs and disabilities aged 5 to 16 (reception year to year 11). Local authorities can also provide transport on a discretionary basis for under 5’s and post 16.
The statutory duties are to ensure suitable travel arrangements are made to facilitate a child’s attendance at school, and also to promote the use of sustainable travel and transport. Transport should be provided where the nearest suitable school is beyond 2 miles (if under 8 years) or beyond 3 miles (if aged 8 to 16), and also when a child cannot be reasonably expected to walk to school because of mobility problems or associated health and safety issues related to their special educational needs or disability.
Funding for SEN Transport statutorily rests with the home local authority and is entirely from corporate i.e. council tax funding. There is no national funding stream.
A revised SEN Transport Policy was implemented by Kingston and Richmond Councils along with Achieving for Children in September 2016 and this has enabled a change from simply funding transport to developing a wide range of activities to promote independence in travelling and this in line with preparing for adulthood aspiration in the 2014 Children and Families Act. Independent Travel Training is offered by Balance, a community and voluntary partner, and a short video about the programme was shown to the Panel which included interviews with students and their parents. This can be viewed via the following link:
The demand and cost of SEND transport has increased for the following reasons:
· More children require transport and demand has increased by 11% since March 2015 although numbers have been static in the past two years
· More children require the more expensive taxi transport for behavioural, health and logistic reasons
· More older children with more complex needs
· Inflationary costs of the service of 3% pa
The Chair explained that the suggestion to consider this topic arose from a conversation with the Director of Public Health who felt that it would be good to look at the developmental aspects of SEND transport to ensure the SEND polices do not inhibit independence.
Eamonn Gilbert, Associate Director of Commissioning, Achieving for Children, outlined the key points and explained that the service was moving away from the provision of buses and taxis to being more creative with resources. It now offers a range of travel assistance options including the allocation of a travel buddy, reimbursing mileage costs for parents or carers, plus cycling and cycle training where appropriate. This new approach is in line with the Family Act to help prepare young people for adulthood and employment, the main destination for 80% of young people, and journeying to work is a key skill. The Balance programme currently ... view the full minutes text for item 42.
Andrew Osborne, Kingston Co-ordinated Care Programme Manager will introduce the report and Members are invited to scrutinise and make any recommendations
The Panel received a detailed report, introduced by Andrew Osborn Osborn, Kingston Co-ordinated Care (KCC) Programme Manager, on the work undertaken by the KCC Delivery Group on the new way of working being piloted and implemented locally across health, social care and the voluntary sector in order to achieve improved and more effective outcomes for local residents. The report set out the progress on the introduction of the four Locality Teams and Well Being Teams which enable more targetted support for people in their own homes and delivered by a skilled workforce supported by local health and adult social care providers and the voluntary sector.
KCC has two key objectives:
· To ensure people stay independent, healthy and well for longer with good community support so they can enjoy their lives to the full
· To ensure people have easy access to top quality, person-centred, co-ordinated health and social care support when they need it.
KCC key building blocks include:
· Building community and voluntary sector capacity and infrastructure to enable self-support through information, advice and social prescribers.
· A single point of access (SPA) plus multi-disciplinary triage and screening team (health, social care, mental health and voluntary sector) to make the right decision first time.
· Multidisciplinary locality teams based on GP practices with health, social care and a new type of home care worker, all working together
· Enablers – co-location of teams and a single view of the person through joined up ICT via a Kingston Care Record.
In depth analysis of population characteristics by area has been undertaken to understand the levels of deprivation, health, income and age to ensure the care model reflects the needs of each population. Risk stratification of individual patients, based on GP practice and hospital data has been undertaken by Sollis and initial work in the pilot areas has been focused on those with greatest risk. Analytical work has also been undertaken on population projections plus degree of frailty and the anticipated levels of needs which will arise. Costings of different care levels has also been established.
National evidence shows that improving a person’s sense of well-being and quality of life will lead to significantly lower use of health and social care resources and this view is supported by outcomes from the pilot Wellbeing Team in New Malden.
Homecare is being recommissioned to ensure sufficient capacity in the carer workforce and the Well Being Team approach is to organise carer staff into smaller semi-autonomous teams to address quality of care, staff retention and job satisfaction. Wellbeing staff offer a range of prevention and self support options as well as the support currently delivered through intermediate care, reablement and the traditional home care services. A single Well Being pilot team of 8 people has been recruited to test and develop the model. Embedding Well Being teams in the new locality model will enable a blending of roles and responsibilities to enable the new care pathway to work more smoothly.
Four multi-disciplinary Locality Teams are planned for Kingston ... view the full minutes text for item 43.
To note the suggestions for the 2018/19 work programme
The Chair advised that the next meeting will be introductory as there will be a number of new members joining panel. The short report listed items which had been identified in the past year as suggestions for the future work of the Panel during the next four year term.
Agreed that: the report is noted.
The Chair took the opportunity to thank the Panel, advisory members, substitute members and officers for attending meetings during the 2017/18 municipal year and for their valuable contributions to the work of the Panel.