Agenda item

(a)       That the continued success in managing and developing regional project/service collaboration be noted;

(b)       That the content of the Statement of Intent be supported;

(c)        That a quarterly update from the Social Services and Health Programme Board and other relevant boards be submitted to the Committee.  

The Director of Community Services introduced a report to receive a progress report on projects and services running collaboratively across North Wales including the development of a Statement of Intent on Integrated Care for Older People with Complex Needs. 

He detailed the background to the report and explained that there were a significant amount of social care projects and services that were well established and continued to run effectively across the North Wales region.  A draft of the Statement of Intent was required by the end of January 2014 and it would then be commented upon by Welsh Government (WG); it would not be formally agreed until the end of March 2014.  The Director of Community Services provided detail on the established collaborations which included North Wales Commissioning Hub, Telecare/Telehealth & Assistive Technology, Emergency Duty Team, North Wales Adoption Service and Mental Health Measure/Partnership.  Details of new developments, such as Commissioning New Services and Safeguarding Systems and Workforce, which had recently secured WG funding to develop the collaborations were also reported.  Section three of the report provided details of the governance arrangements and management structures in place.  A Strategic Partnership Board with Betsi Cadwaladr University Health Board (BCUHB) had been established and the Board was chaired by the Leader of the Council and membership included the Chief Executive and Cabinet Member for Social Services.   

The Statement of Intent provided a single regional statement on Integrated Care for Older People with Complex Needs between the North Wales Local Authorities and BCUHB.  It was designed to be responsive to local need and historical service developments whilst developing an ambitious agenda to develop new innovative services.  The Director of Community Services explained that it was a lengthy document which was not yet complete and a draft version had been attached as appendix one to the report.  There was a need for a strong integrated approach to services for older people and the document highlighted current arrangements and future intent and included sections on Leadership to drive the vision, Commissioning, Resources Management/Pooled Budgets and Managerial/Service Integration.  Partnership working within North Wales was further supported by the Social Services and Health Programme Board and the Director of Community Services provided details of the membership of the Board. 

Flintshire County Council was the lead on the Community Equipment Service.  A significant amount of progress had been made on the development of locality teams and the co-location of one of the teams had taken place in December 2013.  The Director of Community Services explained that WASPI on page 24 stood for Welsh Accord Sharing of Personal Information and was a data sharing protocol which supported joint working.  It was reported that there were a number of excellent examples of citizen centred/co-produced services in Flintshire and service delivery integration and service provision were also reported.  Flintshire was the host organisation for the Regional Programme Manager and was currently developing a local Single Point of Access (SPOA) project team to take the development forward locally. 

Councillor Hilary McGuill felt that the Statement of Intent required further information and suggested that it should include ways of expanding facilities for older people to keep them busy and active.  She queried whether there was a link between the Telecare/Telehealth service and the Out of Hours GP service and she added that she did not think that the SPOA was working and that there was not enough emphasis on user needs.  The Director of Community Services confirmed that the report could be strengthened about all older people making a contribution and that this could be included in the introduction.  On the SPOA, the Head of Adults Services said that there was acknowledgment that there was a need to do it better and that the project was about directing the person to the right place first time.  He felt that the ‘front door’ into social care worked well but the SPOA  was about directing service users to a wider range of health, voluntary sector and social care services, and resources available within their local communities to maintain their wellbeing .  He recognised that there were some issues across partners and that there was a need to deal with referrals better.  On the issue of Telecare and Telehealth, he spoke of a national funding resource available  which may support better linking the two services and explained that a pilot scheme had been in place with Galw Gofal monitoring telehealth monitors on behalf of district nurses.  Improved links with out of hours services had not yet been established. 

Councillor Stella Jones felt that collaborative working was a good idea if it saved money but in the current financial climate she raised concern that Flintshire County Council could end up with a significant bill if the other partners in the collaboration failed.  Councillor Jones felt that the service for Telecare provided by Galw Gofal was not as good as the service that was previously in place as the telephone operators who were based in Colwyn Bay did not know where some of the smaller areas in Flintshire where; she added that covering a bigger area meant bigger problems. 

The Director of Community Services said that the financial element was the hub of the issue and that it was very important.  He felt that responsible partners would try and work together to reduce the demand on the service and that having strong governance in place would ensure that the financial impact was monitored; the Partnership Board would also need to be vigilant in the longer term.  The Enhanced Care Service was fully funded by BCUHB and on the issue of Galw Gofal, the Director of Community Services said that the concerns could be taken forward by the Head of Adults Services who sat on the Telecare Board.  The Head of Adults Services added that a report on Telecare was to be submitted to the Joint meeting of this Committee and Housing Overview & Scrutiny Committee which was scheduled to take place on 6^th February 2014 and suggested that Members contact him if they were aware of any specific incidents or had concerns.     

Councillor Jones felt that Members would have more faith in collaboration if they were able to undertake more scrutiny of collaborative projects.  She felt that there was a need for Members to be better informed and asked whether an update report could be provided every three months.                                      

The Chair raised concern that health budgets were protected but social services budgets were not so the implications on social services were quite worrying. 

Councillor McGuill said that Members did not have the power to scrutinise BCUHB but that it was important that they were informed of proposed withdrawal of services before it happened instead of after. 

Councillor Dave Mackie commented on the proposal for integrated IT systems and said that it was an important issue.  The Senior Manger: Commissioning and Performance said that there was a project to look at the potential for procuring a system for community health and social services.  They were looking at how to share information between a number of agencies in a safe and appropriate way.  Councillor Mackie queried how an all Wales system would affect the use of PARIS and the Senior Manger: Commissioning and Performance responded that this was being looked at but explained that there was no requirement to move to the new system.  There would be a need to look at the cost, benefits and risks which would assist in the decision of whether to move to the new system or not.  Work was being undertaken locally but the provision of a new system could be some time away.  A new framework for assessments and core data set was also being explored with the idea being that data could be shared other than by email.  A range of work was ongoing for a national IT system but work was also being undertaken locally. 

Councillor Peter Curtis said that it was a good document but that there was a need to see the effect of the Statement of Intent along with some examples of outcome as this would determine how successful it had been.  The Director of Community Services said that there was a need for Members to be informed of the intent and how the Council would respond to the needs of older people and said that information on evaluation and implementation could be added to the document.  He added that effectiveness was more important than intent and that updates could be provided in the future. 

The Chair referred to the Social Services and Health Programme Board and suggested that the findings of the Board be reported back to this Committee as Members were currently unaware of major changes.  The Director of Community Services said that the minutes could be made available subject to the agreement of the partners on the Board.  Councillor McGuill suggested that the representatives on the Board put forward an item about Members being informed of any changes to Flintshire services that would affect residents. 

Councillor Jones said that she wanted to make a distinction between the medical/nursing care that she received from Wrexham MaelorHospital which was second to none and the management at BCUHB which she was critical of.         

RESOLVED:

(a)       That the continued success in managing and developing regional project/service collaboration be noted;

(b)       That the content of the Statement of Intent be supported;

(c)        That a quarterly update from the Social Services and Health Programme Board and other relevant boards be submitted to the Committee.