Agenda for Joint Commissioning Board on Monday, 23rd February, 2009, 5.00pm
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Agenda, decisions and minutes
PDF 340 KBVenue: Committee Room 1, Hove Town Hall. View directions
Contact: Caroline De Marco, Democratic Services Officer
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Procedural Business
(b) Declarations of Interest by all Members present of any personal interests in matters on the agenda, the nature of any interest and whether the Members regard the interest as prejudicial under the terms of the Code of Conduct.
(c) Exclusion of Press and Public - To consider whether, in view of the nature of the business to be transacted, or the nature of the proceedings, the press and public should be excluded from the meeting when any of the following items are under consideration.
NOTE: Any item appearing in Part 2 of the Agenda states in its heading either that it is confidential or the category under which the information disclosed in the report is exempt from disclosure and therefore not available to the public.
A list and description of the categories of exempt information is available for public inspection at Brighton and Hove Town Halls. Minutes: 38 (a) Declarations of Substitutes
38.1 There were none.
38 (b) Declarations of Interests 38.2 The Director of Community Care, (Adult Social Care) declared a personal interest in Item 43 – Dementia Care at Home – Future Options Paper, as her son worked for the ICAST service.
38 (c) Exclusion of Press and Public
38.3 In accordance with section 100A of the Local Government Act 1972 (“the Act), the Board considered whether the press and public should be excluded from the meeting during an item of business on the grounds that it was likely, in view of the nature of the business to be transacted or the nature of the proceedings, that if members of the press and public were present during that item, there would be disclosure to them of confidential information (as defined in section 100A (3) of the Act) or exempt information (as defined in section 100I(I) of the Act).
38.4 RESOLVED - That the press and public be not excluded from the meeting.
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Minutes of the Previous Meeting Minutes of the meeting held on 26 January 2009 (copy attached). Minutes: 39.1 RESOLVED – That the minutes of the Joint Commissioning Board Meeting held on 26 January 2009 be agreed and signed by the Chairman.
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Chairman's Communications Minutes: 40.1 There were none.
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Public Questions (The closing date for receipt of public questions is 12 noon on 16 February 2009)
No public questions received by date of publication. Minutes: 41.1 There were none.
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Section 75 Partnership Budget Strategies 2009/10 Report of Director of Finance, Brighton and Hove City PCT and Director of Finance and Resources, Brighton & Hove City Council (copy attached). Decision: (1) That the Adult Social Care & Housing directorate’s budget strategy as set out in Appendix 1 be noted. (2) That the budget strategies for the health and social care elements of the Section 75 arrangements as set out in Appendix 2, be recommended for agreement by Full Council and the NHS Brighton and Hove Board. (3) That the detailed information provided to support the Learning Disabilities Commissioning Strategy set out in Appendix 3, be noted.
Minutes: 42.1 The Board considered a report of the Director of Finance, Brighton & Hove PCT and the Director of Finance and Resources, Brighton & Hove City Council which updated members with respect to the proposed financial strategies for the health and social care elements of the S75 Partnerships in advance of the budget debate at Full Council on 26th February 2009. This included information about uplifts, identified budget pressures and efficiency savings to be met during 2009/10 (for copy see minute book). 42.2 The paper further outlined the council’s Adult Social Care & Housing budget strategy and provided a more detailed break down of the budget to support the Learning Disability Commissioning Strategy previously discussed at Joint Commissioning Board. The paper also provided details of the NHS Brighton and Hove budget strategy.
42.3 Janice Robinson recognised that officers had a difficult job to do but said she would welcome more detail showing how reductions would be made. She would also like to know the impact of reductions on the service; for example, the loss of posts in the Learning Disability Service.
42.4 The Director of Adult Social Care & Health assured the Board that there was a great deal of detail in the report that had been checked by the Management Team. Posts had been deleted as a result of Value for Money surveys. Economies and efficiencies were in place where officers thought they could be made. Some efficiencies had been made because front line services were being improved and modernised. The Director acknowledged that this process was not easy and that next year would present a greater challenge. There would be a need for closer partnership working.
42.5 Denise Stokoe expressed unease about targeting savings at self directed support and the personalisation programme. She asked if this was realistic. This could lead to cynicism in the public domain.
42.6 The Head of Supporting People & Lead Commissioner for Learning Disabilities explained that personalisation will reduce the anticipated costs for growth in services by preventing people being placed into inappropriate services when they are in crisis. In this way targeted services will provide the necessary “breathing space” while appropriate services that represent value for money are put in place. The Head of Financial Services reported that the Social Care Reform will support the personalisation programme including the administration of self directed support.
42.7 The Director of Adult Social Care & Housing stressed it would be necessary to manage the message about the whole transformation of adult social care. There would be a need to install an access point and sum up strategies. Changes would focus on prevention, value for money and customer care. Officers would bring a report to a future meeting of the Board on the government review of funding of social care.
42.8 Denise D’Souza explained that Value for Money and Personalisation would have an impact and that savings could be made.
42.9 Councillor Norman highlighted the need to inform the public about the changes in adult social care. The Chairman agreed that people became suspicious when they did not understand why change was taking place.
42.10 Janice Robinson was concerned that if the overall approach did not work it would be a risk for the PCT’s finances. She asked if there was some way PCT officers could keep in touch with council officers.
42.11 The Director of Finance, PCT reported that resources would have to be pooled as times grew more challenging. The Head of Finance, Brighton & Hove City Council stressed that proposals in the report had been discussed with colleagues in the health service. The Director of Strategy PCT reported that she met with the Director of Adult Social Care & Housing on many occasions. 42.12 RESOLVED - (1) That the Adult Social Care & Housing directorate’s budget strategy as set out in Appendix 1 be noted. (2) That the budget strategies for the health and social care elements of the Section 75 arrangements as set out in Appendix 2, be recommended for agreement by Full Council and the NHS Brighton and Hove Board. (3) That the detailed information provided to support the Learning Disabilities Commissioning Strategy set out in Appendix 3, be noted.
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Dementia Care at Home - Future Options Paper Report of Director of Strategy, Brighton & Hove City PCT (copy to be circulated separately). Decision: (1) That option four be approved (cessation of the modified DCAH service with the existing ICAST service enhanced, utilising the skills and capacity of the existing DCAH staff). Most of the staff employed by DCAH will be transferred to the ‘Enhanced ICAST’ service, with only three RMNs redeployed into other services within SPFT. This will ensure that the skills of the existing workforce are retained.
(2) That it be agreed that a service specification will be drawn up for the Enhanced ICAST service to ensure that clear outcomes are specified and performance can be appropriately monitored. This will be completed in time for the start of the next financial year. Once the service has been operational for six months, a full evaluation will be carried out, and commissioners will decide whether or not to tender the service at that point. A paper will then be brought to the JCB, setting out the recommendation for the future of the service.
Minutes: The Special Circumstances for non-compliance with Council Procedure Rule 23, Access to Information and Section 100B(4) of the Local Government Act as amended (items not considered unless the agenda is open to inspection at least 5 days in advance of the meeting) are that the legal implications of the report had not been finalised in time for the despatch of the agenda.
43.1 The Board considered a report of the Director of Strategy, Brighton & Hove City PCT which set out options for the future of Dementia Care at Home (DCAH) Service (for copy see minute book). The paper recommended the approval of option four – cessation of the modified DCAH service with the existing ICAST service enhanced, utilising the skills and capacity of the existing DCAH staff. Details of all the options, with benefits and risks for each, were outlined in the report.
43.2 Denise Stokoe stressed the importance of the evaluation of the enhanced ICAST service. She made the point that although there may be a successful pilot, it might not be realistic to have a full scale service.
43.3 The Lead Commissioner, Older People, PCT advised that a detailed service specification would be developed for the proposed new service and would include robust monitoring and evaluation criteria.
43.4 The Associate Director, Older Peoples Mental Health, SPT explained that evidence had shown that early intervention could extend the period a person could remain living in their own home.
43.5 Janice Robinson asked for assurance that money diverted into the service had not been lost to people who needed to go into residential care. The Director of Community Care replied that this was not the case and that there was a community care budget that funded people in long term care.
43.6 Janice Robinson stressed the importance of a very precise evaluation study. She wanted officers to ensure that the service was constructed showing who received it, who did not receive it, and the length of delay in long term care.
43.7 The Lead Commissioner, Older People explained that national and local policy developments, in particular the emerging outcomes of the National Dementia Strategy would be reviewed and inform the development of the local service. It was also hoped that this would be a two way process and that the Brighton and Hove service would also contribute to this emerging national and regional evidence.
43.8 Richard Ford welcomed the proposals and conveyed thanks to all involved in this work. He considered it important to review the proposals in six months time in light of the National Dementia Strategy. He stressed the need for early intervention for people developing dementia. This should fit into the whole service model for the city. Other services should also be reviewed.
43.9 Councillor Norman endorsed the proposals and considered that they fitted in well with other priorities and strategies such as the personalisation programme.
43.10 RESOLVED - (1) That option four be approved (cessation of the modified DCAH service with the existing ICAST service enhanced, utilising the skills and capacity of the existing DCAH staff). Most of the staff employed by DCAH will be transferred to the ‘Enhanced ICAST’ service, with only three RMNs redeployed into other services within SPFT. This will ensure that the skills of the existing workforce are retained.
(2) That it be agreed that a service specification will be drawn up for the Enhanced ICAST service to ensure that clear outcomes are specified and performance can be appropriately monitored. This will be completed in time for the start of the next financial year. Once the service has been operational for six months, a full evaluation will be carried out, and commissioners will decide whether or not to tender the service at that point. A paper will then be brought to the JCB, setting out the recommendation for the future of the service.
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