To review progress in delivering the third priority of the health and wellbeing strategy, covering older people, to include progress plans and challenges.

The director for adults and wellbeing introduced the update by explaining that there was a change in approach from one that was centred on how conditions were defined to one based on what a person’s needs were. To achieve this, teams were less focused on being condition or cohort specific and were instead more based on geography.  There was therefore no single strategy for older people as they were not a specific cohort.

The BCF joint commissioning manager highlighted the key areas of work and the drivers to the approach in terms of delivery of services to enable people to support themselves: 

• A key work area was the help to live at home project as a redesign of home care services which was to be presented to Cabinet for approval in October and if agreed, would mean dedicated providers for those needing more intensive support
• The approach would seek to address some operational challenges faced by providers by focusing on viable geographic areas
• The council would choose the providers for each area so that the service users would know who their providers were and how care would be provided
• The Golden Valley area would have a slightly different approach, making use of its community hub and using one provider for each pathway rather than a number of providers

A Healthwatch representative commented on the costs and the governance issues associated with volunteering despite the sector not attracting funding.   He asked what could be done to reduce the burden for volunteers in order for them to make a bigger contribution to the community.  In the discussion that followed, it was noted that there were misconceptions by some professionals of the reliability of services provided by volunteers, when in reality many volunteers were very committed to their role. However, volunteer input could be better directed, perhaps through Herefordshire Voluntary Organisations Support Service (HVOSS), to where the need was. There was no formal way for volunteers to find out what was needed in their communities or for it to be easier for them to support their neighbourhood without unnecessary bureaucracy.

On the matter of housing, it was noted that accessibility and schemes for extra care were being considered through the possibility of providing housing stock with room to accommodate a carer, and pursuing social housing provision within planning applications.  Commissioners were looking at this via analysis of need in order to inform planning decisions.  There was no funding to provide housing and it was important to work with registered social landlords about what was required as well as consider fuel poverty issues.

The director for children’s wellbeing noted some good progress on outcomes against the strategy, noting that direction was clearer.

A number of areas were identified by board members that would support better outcomes against this priority area:

• public health services such as active here and diabetes prevention and the contribution of GPs to wider prevention issues and supporting people in the right way
• a whole systems approach to discharge to avoid commissioning silos
• falls responder service to help reduce admissions
• links between public health and warmer homes to  support people to consider different providers in order to reduce heating bills
• better use of the WISH service to raise peoples’ awareness of the services and support available
• greater use of the principle of making every contact count
• greater involvement and engagement of the voluntary sector
• development of support within communities, families and of personal responsibility for self-care
• development of skills in the use of direct payments

RESOLVED

THAT:

(a)         it be confirmed that progress to date was supporting delivery of the health and wellbeing strategy; and

(b)         approaches to remove any barriers to success or further improve rate of progress be identified as summarised above.

Ofsted joint inspection

The director of children’s wellbeing informed the board that there would be a joint inspection of the area by Ofsted and CQC of special educational needs and disability arrangements over five days next week (week commencing 26 September 2016).

She thanked Jacqui Bremner for her assistance in organising sessions with parents and carers, and invited board members to note a parents’ webinar to be broadcast on Wednesday evening, 28 September.  

The inspection was welcomed as this was a priority in the children and young people’s plan which would benefit from external review, which would include education and health care outcomes including short breaks, early years and the full range of disability.  A narrative report would follow after the review.