Agenda Item No. 7
The Vale of Glamorgan Council
Scrutiny Committee (Social Care and Health): 21st May, 2015
Report of the Director of Social Services
The Vale of Glamorgan Health, Social Care and Well-being Partnership
Purpose of the Report
1. To provide an update on the work of the Health, Social Care and Well-being Partnership.
1. That Scrutiny Committee notes the content of this report.
Reason for the Recommendation
1. To ensure that Elected Members can exercise effective oversight of this important area of collaborative working.
2. The area of Health, Social Care and Well-being for the Vale of Glamorgan is a key component of the Council's Community Strategy. The work is driven through two main partnership bodies, i.e. the Integrated Health and Social Care Partnership and the Public Health and Well-being Board.
3. The Integrated Health and Social Care (IHSC) Partnership oversees the collaborative work undertaken between the Vale of Glamorgan Council, Cardiff Council, Cardiff and Vale University Health Board, the Vale Centre for Voluntary Services and Cardiff Third Sector Council, to develop and support the growing number of joint social care and health services .
4. The Public Health and Well-being Board originally operated within the Vale of Glamorgan only, with responsibility for steering collaborative work that addresses key health determinants for the population such as use of tobacco, food and physical activity, alcohol consumption and the uptake of immunisations. Following development of a Joint Local Service Board with Cardiff Council, it was agreed that this partnership stream should explore how its original agenda might best be aligned with similar work within Cardiff.
Relevant Issues and Options
Integrated Health and Social Care Programme
5. The Integrated Health and Social Care Partnership is benefiting from the revised governance structure which was set in place 12 months ago with the aim of increasing the scale and pace of integration across health and social care services. Progress within a number of areas can be summarised as follows.
6. An independent consultancy has been commissioned by the Partnership to undertake a review of current resources and activity levels across community health and local authority services for older people. The work seeks to identify key priority areas for further development. In April 2015, all members of the IHSC Governance Board confirmed their support for this programme and acknowledged the need for pooled or aligned funding across the agencies to support delivery. The final report will be discussed by the IHSC Strategic Leadership Team, which is attended by the Council's Managing Director in May, and by the Governance Board at the end of June 2015.
Delayed Transfers of Care (DToCs):
7. Following a meeting with the Deputy Minister for Health, the IHSC Partnership has been asked to take a lead in ensuring a significant reduction in Delayed Transfers of Care across the Cardiff and Vale of Glamorgan community. The Vale of Glamorgan Local Authority is able to demonstrate significant progress in this area over the last two years and, as such, it is in a position to share the learning from that process with other partners. The Vale will participate fully in ongoing data analysis, to explore the reasons for a recent increase in delays in January and February of this year. It should be noted that there has been a significant reduction in delays as of March. Following further work to map out and change operational processes which get in the way of timely discharge, the IHSC Partnership will oversee a new performance management system and the delivery of remodelled services to be set in place through the Intermediate Care Fund and the Regional Collaborative Fund as outlined in the following paragraphs.
Intermediate Care Fund:
8. Through the Intermediate Care Fund in 2014-2015, the Partnership was able to test new ways of working across the health and social care system using the short term funding available. This has been reported to Scrutiny recently. The Minister for Health and Social Services has announced that recurrent funding of £20 million will be used to continue Intermediate Care Fund projects which have shown themselves to be of positive advantage to our community. The funding is being made available through the University Health Board budget and proposals have to be agreed by the IHSC Governance Board. We are preparing final evaluation reports to review the impact of the schemes undertaken in 2014/2015 and to scope out the delivery phase for key components of the new programme, which will be implemented across the Cardiff and Vale Health Board partnership footprint. These include:
· development of a single point of access for citizens and health and social care professionals;
· an accommodation solutions/resettlement project, providing a co-ordinator to work with patients and professionals to fast track discharge from hospital where an accommodation issue is preventing this;
· Community Resource Team Reablement Plus which involves the provision of support by a multi-disciplinary team through step-down facilities leading to active recovery and reablement;
· preventative interventions/services, to maximise opportunities to enable people to live independently for as long as possible.
9. A full report on the proposals will be provided to Scrutiny following completion of the final evaluation and further discussion within the IHSC Partnership.
Regional Collaborative Fund:
10. This three year (April 2013 - March 2016) funding stream continues to provide positive benefit for Learning Disability services reform and for broader adult services change through support for elements of the Vale Community Resource Team. The IHSC Governance Board approved the most recent quarter 3 report for RCF in April 2015 and initial discussions are already underway to identify ways in which funding for these services might be sustained in the long term.
Social Care and Well-being (Wales) Act 2014:
11. Welsh Government requires that each Region should reflect the National Partnership Forum arrangements, to include representatives from other organisations such as the Care Council and the Independent Sectors.
12. In April, 2015, the IHSC Governance Board endorsed the Regional Delivery Plan and agreed that its Terms of Reference should be amended to reflect the needs of the new Act, taking on the role of the Regional Partnership Forum for Health and Social Care and overseeing implementation of the Act. The resulting amendments to the Terms of Reference are provided at Appendix 1. These matters may need to be reviewed again in response to Welsh Government Guidance in respect of Part 9 of the Act, which deals with co-operation and partnership. Draft guidance is likely to be available for consultation in May.
Interim Carer's Strategy 2015-2016:
13. The IHSC Governance Board has approved that the Partnership should support delivery of this Strategy and it has endorsed the Action Plan for 2015 - 2016. Regular performance reports will now be brought to the Strategic Implementation Group.
Delivering Transformation Fund:
14. The Partnership is currently preparing its bid for £414,648 to support the ongoing development of integration and attainment of all aspects of the Social Services and Well-being (Wales) Act 2014 across Cardiff and the Vale of Glamorgan.
Community Care Information System:
15. Following completion of a national tendering exercise to secure a new electronic case management and information system for social care, mental health and community health care, the IHSC is undertaking a baseline assessment to inform how implementation of this new system might be achieved across the Cardiff and Vale of Glamorgan community. Further information will be provided to Scrutiny following completion of this process.
Older People Framework:
16. Work is underway to ensure appropriate links between this strategic document and the Ageing Well Delivery Plans currently being developed by the Local Authority.
Public Health and Well-being Programme
17. Following recent proposals to develop a joint Local Service Board between the Vale of Glamorgan and Cardiff, work has started to identify a model to improve public health and well-being across both areas which allows for increased collaboration and joint working whilst respecting the specific needs of individual communities and the roles and responsibilities of statutory organisations.
18. The Public Health and Well-being Board has now been replaced with a joint structure including both the Vale of Glamorgan and Cardiff Local Authorities. The new structure incorporates the following elements.
Health and Well-being Performance Management Group:
19. Membership comprises Senior Managers from across partner organisations, meeting every four months with the aim of:
· ensuring delivery of existing action plans and that business 'as usual' continues at a local level on tobacco, food and physical activity;
· ensuring links with ongoing work by the Area Planning Board, Healthy Schools and the Cardiff and Vale Immunisation Steering Group;
· scrutiny of Highlight Reports on the above;
· reporting to the Cardiff and Vale Joint Local Service Board' (C&VJLSB)
· inform work of the Task Force, as set out below.
Health and Well-being Development Task Force:
20. Despite concerted efforts across the Vale of Glamorgan, it is clear that significant work remains to reach the objectives set out within the Food and Physical Activity action plan. It has been agreed that obesity is now the key topic which will be prioritised, to introduce a renewed approach for prevention across the Vale of Glamorgan and Cardiff. On completion of an initial scoping phase, a full proposal will be brought to the Cardiff and Vale Joint Local Service Board for approval.
21. A Task Force is being initiated to develop an ambitious, aspirational and innovative approach to tackling obesity and two pieces of work have been commissioned to inform the process:
· a review of best practice internationally;
· establishing a series of conversations with the general population (to include professionals, communities and individuals) to develop the vision of what should be achieved.
Resource Implications (Financial and Employment)
22. To date, the Partnership has been successful in securing time-limited grants for implementing parts of the programme from a number of Welsh Government funding streams, including the Regional Collaboration Fund and the Intermediate Care Fund which are being used to remodel adult social services. These grants, together the Sustainable Social Services Wales: Delivering Transformation Grant, are being used to produce service improvements and to increase management capacity to support the programmes of change. The recent announcement to fund effective schemes from the 2014/15 Intermediate Care Fund recurrently is very welcome.
23. In the longer-term, there are likely to be significant workforce implications arising from plans for changes to current service models and for reviewing options for further service integration. In these circumstances, the Council's policies in respect of workforce changes will apply.
24. In relation to Public Health and Well-being, grant funding for programme management is no longer available. Future support for the new Joint Board and to take forward existing work programmes within the Vale of Glamorgan will require further discussion with partners.
Sustainability and Climate Change Implications
25. 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)
26. 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.
Crime and Disorder Implications
27. There are no crime and disorder implications as a direct result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
28. There are no equal opportunities implications arising directly from this report.
29. 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
30. The report is in accordance with the Council's Policy Framework and Budget.
Consultation (including Ward Member Consultation)
31. There are no matters in this report which relate only to an individual Ward.
Relevant Scrutiny Committee
32. Social Care and Health.
Scrutiny Committee (Social Care and Health): 15th April, 2013 - The Vale of Glamorgan Health, Social Care and Well-being Partnership.
Scrutiny Committee (Social Care and Health): 6th October, 2014 - Update on the Regional Collaboration Fund and Intermediate Care Fund programmes.
Scrutiny Committee (Social Care and Health): 19th May, 2014 - Collaborative Planning for Older People's Services.
Scrutiny Committee (Social Care and Health): 3rd November, 2014 - The Vale of Glamorgan Health Social Care and Well-being Partnership.
Meredith Gardiner, Programme Manager, Health, Social Care and Well-being
Officers attending the joint Local Service Board and the LSB Implementation Group.
Philip Evans, Director of Social Services