Apologies were received from Councillor SD Williams.

To receive details any details of members nominated to attend the meeting in place of a member of the committee.

Councillor AW Johnson attended as a substitute for Councillor SD Williams.

To receive any declarations of interest by members in respect of items on the agenda.

There were no declarations of interest.

To approve and sign the minutes of the meeting held on 27 March 2018.

RESOLVED:

That the minutes of the meeting held on 27 March 2018  be confirmed as a correct record and signed by the chairman.

To receive questions from members of the public.

Deadline for receipt of questions is 5pm on Friday 11 May 2018.

Accepted questions will be published as a supplement prior the meeting.

For guidance on how to submit a question to the committee, please see: https://www.herefordshire.gov.uk/getinvolved

Please submit questions to: councillorservices@herefordshire.gov.uk

There were no questions from members of the public.

To receive questions from councillors.

Deadline for receipt of questions is 5pm on Friday 11 May 2018.

Accepted questions will be published as a supplement prior the meeting.

Please submit questions to: councillorservices@herefordshire.gov.uk

There were no questions from councillors.

To review the draft Adult Social Care Local Account 2017 and supporting key performance presentation to enable the committee to make recommendations to the executive about the discharge of any functions which are the responsibility of the executive.

The Interim director for adults and wellbeing introduced the draft local account, which, although it was no longer a requirement to produce, was believed to be best practice to do so. In his accompanying presentation the director also provided an update on the adult social care pathway, and made the following points:

·         The local account was a draft for consideration, plus a broader set of performance information focusing on the past year from January 2017

·         Phase 2 of the adult social care pathway project had now closed; the development of the pathway involved providers and the voluntary sector to look at the call handling and responses to calls to the front door at the assessment and referral team (ART).

·         A new strengths-based route explored why someone has contacted the front door and explored what outcomes they were looking for, identified the risks and supported someone to be as independent as possible. 60% of callers were offered information, advice and signposting, with the remaining callers being offered additional support.

·         The pathway involved a community broker function; the council tax precept had been used to develop community connectors in order to map community resources across the county and identify trusted providers through the third sector, which led to the introduction of the community broker function as a team of seven, 2 of which were funded through a grant from the MOD for supporting service personnel.  The brokers were organised so that there was always one at the front door to provide information for the call handlers so that the offer was of high quality and took into account someone’s wider wellbeing.

·         The new arrangements made it possible for callers to be responded to quickly and ensure that they knew when their appointments were and who their practitioner was. Support was now allocated immediately and this was felt to be a great achievement. 

·         The community brokers were soft market testing the roll-out of Talk Community across the market towns and the city where they would be available for drop-in contact. 

·         The pathway works with a strengths based approach to look at what people can achieve and do for themselves, what risks were attached, and what the neighbourhood and community could do. Community brokers were experts in the communities, being at the front door and throughout the discharge process. 

·         In terms of delayed transfers of care, there were known pressures in the system and most delays were not as a result of waiting for assessment. There was more robust monitoring of performance data and making changes to the flow of transfers to increase speed of transfer. 

·         Reablement and rapid response services were being brought together into the home first social care offer. Adult social care and Wye Valley NHS Trust were working together to continue to integrate health and social care but it was important to make the distinction between the different pathways for clinical health input and the council home first service. 

·         Planning for the home first programme started last summer before the  ...  view the full minutes text for item 7.

To review the Healthwatch Herefordshire annual report for 2017/18 and to consider areas that Healthwatch has raised for inclusion in the committee’s work programme for further scrutiny.

The Chair of Healthwatch Herefordshire presented the annual report for 2017-18.  In his opening remarks he thanked those members who attended the Healthwatch annual showcase event held that morning. It had been a big year for Healthwatch Herefordshire as a standalone company. This was a big achievement, where a lot had been learned from the relationship with Healthwatch Worcestershire, which continues with collaborative work.  The day to day operation of the organisation continued thanks to the appointment of the chief officer, and it was a vote of confidence to have the contract to provide the Healthwatch service extended to 2020.

In summarising the annual report and the work of Healthwatch during 2017-18, he described work undertaken on major projects to properly influence change within the county, which included:

·         GP access – 313 people spoken to about access to GP services. Two thirds were happy with their services, and the findings were being used to make improvements, such as increasing understanding of what different GPs offer and managing reasonable adjustments. A number of recommendations were made and used for a number of projects to realign primary care services around the market towns.  The work also informed a quality review of end of life by the Clinical Commissioning Group. 

·         Public health and children’s mental health – there are plans to work with the new director of public health on further work.

·         Children’s dental health – there was in-depth work on this, involving 537 people, with lots of information gathered, concluding that people needed to know more about what is on offer for dental health.

·         Walk-in centre – work would continue to monitor the impact of the closure of the walk-in centre to see what alternative provision people presented at instead.

·         Hillside - there had been useful meetings with WVT and adult social care around the development of community health and social services.  There were improvements but more needed to be done. The key was how the different parts were co-ordinated and moving people away from having too many carers.

·         Complex and multiple conditions – work was nearing completion around the co-ordination of all the components of care where people have dual diagnoses.  Healthwatch was engaging with special interest groups to find out more about the issues faced. 

·         There had been a lot of contact with people to give information and advice and Healthwatch had moved to visiting existing groups rather than holding general events. Healthwatch had visited 101 groups which had increased engagement and allowed for richer information to be gathered.

·         There was contact with patient participation groups where Healthwatch involvement had positive impact. A good example of engagement with Ledbury health interest group over concerns about the impact of significant housing development led to the issue being raised with the Clinical Commissioning Group.  There was also engagement in Kington and Leominster looking at providing more comprehensive services, and there would be an open public meeting to look at proposals for Leominster.

·         The mental health working group was reinstated, with regular meetings  ...  view the full minutes text for item 8.