Agenda Item No 9
The Vale of Glamorgan Council
Scrutiny Committee (Social Care and Health): 13th January, 2014
Report of the Director of Social Services
The Vale of Glamorgan Health, Social Care and Wellbeing Partnership
Purpose of the Report
1. To provide an update on the work of the Health, Social Care and Wellbeing Partnership.
1. That Scrutiny Committee notes the content of this report.
2. That Scrutiny Committee continues to receive reports every six months on the work of the Health, Social Care and Wellbeing Partnership.
Reasons for the Recommendations
1. To ensure that Elected Members can exercise oversight of this important area of work.
2. To ensure effective scrutiny of key developments in the delivery of the Health, Social Care and Wellbeing Strategy.
2. The Vale of Glamorgan Council, Cardiff and Vale University Health Board and Cardiff Council deliver health and social care services to a population of approximately half a million people. There is a history of effective collaboration between the two local authorities and the Health Board since it was created, along with third sector partners represented by the Vale Centre for Voluntary Services (VCVS) and the Cardiff 3rd Sector Council (C3SC).
3. Section 40 of the National Health Service Wales Act 2006 places a statutory duty on each local authority and each Local Health Board (LHB) to prepare a health, social care and wellbeing strategy (HSCWBS) for the local authority's area. The HSCWBS provides a framework within which the two organisations and relevant partners set out how, together, they will:
drive forward improvements in the health and wellbeing of the local population;
strengthen the planning and management of health and social services; and
improve outcomes for those who use them.
4. The overall HSCWBS agenda for the Vale of Glamorgan is the responsibility of a Partnership which operates within the framework for strategic partnerships established by the Local Service Board and the Council. The two strands of work set out in guidance are managed primarily by two Boards which the Partnership has established. These are the Integrated Health and Social Care Programme Board and the Public Health and Wellbeing Board. Both Boards report directly to the Local Service Board.
5. The Public Health and Wellbeing Board (PHWB) operates within the Vale of Glamorgan only. It comprises representatives from health, the local authority and the third sector. They take responsibility for collaborative work to address key health determinants for the population such as use of tobacco, food and physical activity, alcohol consumption and the update of immunisations. The work of the PHWB is guided by two key strategic documents: the Vale of Glamorgan Community Strategy and the Local Public Health Strategic Framework. The priorities are determined by the public health evidence base and population needs assessments.
6. The Integrated Health and Social Care Programme (IHSC) Board works across Cardiff and the Vale of Glamorgan to co-ordinate agreed projects in respect of joint working between the two Councils, the University Health Board and the third sector. The main tasks of the Board are, through the oversight of key projects, to:
identify, by means of appropriate needs assessment, priority areas for improvement which require strengthened joint working to achieve better outcomes within existing resources;
provide a framework to enable the operational integration of services across health and social care (to include workforce planning, resource planning, etc); and
ensure that local government and health professionals are able to work jointly within statutory and organisational governance arrangements that provide a framework of clear accountability.
7. A number of priority workstreams were agreed: Mental Health Services, Older People’s Services (the Wyn Campaign), Learning Disability Services and Services for children with complex needs because of disabilities. Lead responsibility for taking these workstreams forward has been shared between the three sponsoring organisations. Each of them is led by a Senior Responsible Officer (SRO), at Executive Director level within the Cardiff and Vale UHB and at Head of Service level within the local authorities. The SRO is responsible for the overall delivery of projects within their workstream, reporting progress to the IHSC programme board.
8. Together with the Local Service Board, this Committee receives regular updates about the work of the Health, Social Care and Wellbeing Partnership and its two main bodies, the Public Health and Wellbeing Board and the Integrated Health and Social Care Programme Board.
Relevant Issues and Options
Public Health and Wellbeing Board Update
9. In seeking to enhance the wellbeing of the Vale of Glamorgan population, the Board can report significant progress in the following areas:
(a) Following a successful pilot, the smoke-free playgrounds scheme is now being launched across all 63 playgrounds in the Vale of Glamorgan.
(b) Funding approval has been secured to develop a heart-shaped 8km walk within Porthkerry Park, to raise the public profile of the need for exercise and to develop an annual walk in support of the British Heart Foundation, the Council's third sector partner in this work.
(c ) Making Every Contact Count is a scheme designed to bring together organisations from across the public and other sectors, to ensure that their staff promote wellbeing initiatives in their dealings with members of the public. The pilot phase is now complete. A training package and supporting materials have been finalised and training has been delivered to health, local authority and third sector colleagues. There is a particular focus on those who work within our most deprived communities.
(d) Close working links are being developed between Public Health Wales, the University Hospital Board and officers in the Council responsible for planning. A Health Impact Assessment in respect of the Local Development Plan has been undertaken. Healthcare service delivery requirements are now being incorporated as part of the Infrastructure Plan.
10. The Public Health and Wellbeing Board is concerned about evidence of a decline in healthy eating and physical activity levels across the Vale of Glamorgan. Plans to address both issues have been reviewed and will be discussed in detail at the meeting in December, 2013.
Re-structuring the Integrated Health and Social Care Programme
11. Over the past two years, the Board has played a key role in bringing partners together. They produced a Collaborative Agreement through which a series of specific community-focused work streams were developed, to advance integrated working at an operational level within all organisations. People making use of Carers' Services, Mental Health Services, Older People’s Services, Learning Disability Services and Services for children with complex needs because of disabilities have all benefited from this more integrated approach. Where staff (including those from the third sector) have been provided with joint training, integrated management and co-location, they have started very quickly to break down unhelpful role boundaries and to deliver co-ordinated care pathways.
12. However, given the challenges posed by demographic changes, reducing resources and new legislative requirements, all the partners recognise the need to increase the scale and pace of collaboration. There are increasing pressures upon current systems and models of care and support; some of them still generate fragmented care that confuses and frustrates recipients and providers alike. Despite the considerable reforms already undertaken locally, more change is needed to ensure compliance with new legislative requirements that will be imposed as a consequence of the Social services and Wellbeing Bill and to ensure the best possible outcomes for our vulnerable residents.
13. Following completion of an external review by the Kings Fund and the Welsh Institute for Health and Social Care, the five organisations represented on the Programme Board have agreed to work towards a closer, more integrated partnership. This marks a fundamental step forward in strategic intent. The ambition is to provide the best possible health and social community care by bringing services together in a way that best fits people's needs and stops them receiving fragmented care and support.
14. The Integrated Health and Social Care Programme is being re-designed to assist the development of a closer, more formal partnership. A Leadership Team has been established, comprising the Leaders and Chief Executive/Managing Director from the Vale of Glamorgan and Cardiff Councils, the Chair and Chief Executive from Cardiff and Vale University Health Board, and the Chief Executives from the Vale Council for Voluntary Services and Cardiff 3rd Sector current activities of the Council. It is proposed that this team will meet three times a year to consider progress and agree strategic overall direction of the work plans which will be led by a Strategic Implementation Group, consisting of key senior managers from across the five organisations. The Vale of Glamorgan Council is represented on this group by the Director of Social Services. The current work programme of the Group is outlined in Appendix 1.
Resource Implications (Financial and Employment)
15. There is a commitment from all the organisations that projects associated with the Health, Social Care and Wellbeing Strategy will be delivered within existing resources, unless external funding can be secured. At present, the Council has been successful in securing time-limited grants for implementing parts of the programme from a number of Welsh Government funding streams, namely the Regional Collaboration Fund and the Supporting Implementation of the Social Services and Wellbeing Bill (Delivering Transformation) Fund. These grants are being used to provide fixed term increases in service and change management capacity.
16. In the longer term, there are likely to be significant workforce implications arising from plans for changes to current service models and to review options for integration. In these circumstances, the Council's policies in respect of workforce changes will apply.
Sustainability and Climate Change Implications
17. There are sustainability implications arising from forecasted changes in population and demographic patterns, with a specific emphasis on predicted rises in the numbers of older people living within the Vale of Glamorgan.
Legal Implications (to Include Human Rights Implications)
18. There are no legal implications arising directly from this report. The Programme Boards exercise oversight of the work without affecting current executive and scrutiny arrangements for Council services in the Vale of Glamorgan. The Local Authority must have regard to the Health, Social Care and Wellbeing Strategy in the exercise of its functions.
Crime and Disorder Implications
19. There are no crime and disorder implications as a direct result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
20. There are no equal opportunities implications arising directly from this report.
21. The key objective of the Council addressed by this report is "to make the Vale a safe and healthy place in which individuals, children and families can live their lives to the full".
Policy Framework and Budget
22. The report is in accordance with the Council's policy framework and budget.
Consultation (including Ward Member Consultation)
23. There are no matters in this report which relate only to an Individual Ward.
Relevant Scrutiny Committee
24. Social Care and Health.
Scrutiny Committee (Social Care and Health): 15th April, 2013 - The Vale of Glamorgan Health, Social Care and Wellbeing Partnership
Meredith Gardiner, Programme Manager, Health, Social Care and Well being.
Officers attending the Local Service Board and the LSB Implementation Group
Philip Evans, Director of Social Services