Agenda and minutes

Venue: Training and Conference Suite, First Floor, Number One Riverside, Smith Street, Rochdale, OL16 1XU. View directions

Contact: John Addison  Senior Committee Services officer

Items
No. Item

41.

Apologies

    To receive any apologies for absence.

    Minutes:

    Apologies for absence were received from Councillor Rowbotham (RBC), Dr C. Duffy (HMR CCG).

42.

Minutes pdf icon PDF 71 KB

    Members are requested to approve the Minutes of the Meeting held on

    the 27th August 2019.

    Minutes:

    RESOLVED

     

    That the Minutes of the meeting of the Integrated Commissioning Board held on 27th August 2019 be approved as a correct record.

43.

Declarations of Interest

    Members are required to declare any disclosable pecuniary, personal or personal and prejudicial interests they may have and the nature of those interests relating to items on this agenda and/or indicate if S106 of the Local Government Finance Act 1992 applies to them.   

    Minutes:

    There were no declarations of interests.

44.

'Pop -up' Birthing Centre in Rochdale pdf icon PDF 124 KB

    Members will receive a report on a proposal for a 'Pop -up' Birthing Centre in Rochdale.

    Minutes:

    The Associate Director of Children’s Services reported that there had been an increased demand from the local community to have a facility for women to give birth in Rochdale. 

     

    In response to this and the recommendations of the 2016 maternity review ‘‘Better Births’ a proposal to open a ‘pop up’ birth centre in Rochdale has been developed.  This would provide the opportunity for low risk women to give birth in Rochdale, primarily supporting those women who may wish to choose a home delivery, but the home/social environment does not allow that choice.

     

    The campaign for the establishment of a birthing centre in Rochdale was being led by the “Friends of Rochdale Maternity Care” (FRMC). They had raised their wishes with local councillors, the Mayor of Greater Manchester and with the maternity services at Pennine Hospitals.

     

    Currently women in Rochdale have three options for birthing: the Consultant Led Unit (CLU) at Royal Oldham Hospital; the Alongside Midwifery Led Unit (AM at Royal Oldham Hospital; or at home.

     

    There was, reported, a fourth place of birth that providers were being encouraged to offer through the maternity contract and the recommendations of the 2016 maternity review “Better Births”. This was a Freestanding Midwifery Led Unit (FMU).

     

    Pennine Acute does currently offer all four places of birth however the FMU is located in Salford (Ingleside is a stand-alone birth centre run by Bolton Hospital) and works under an “in–reach” model of midwifery care staffed by midwives from North Manchester. Geographically this unit does not serve the women of Rochdale.

     

    RESOLVED

     

    That the Integrated Commissioning Board supports the opening of a pop up birth centre (without a birthing pool) on the Rochdale Infirmary Site for a twelve month pilot period.

45.

Locality Plan Refresh - Presentation

    The Director for Public Health will provide Members with a presentation on the Locality Plan Refresh.

    Minutes:

    The Director of Public Health provided Members with a presentation on the Locality Plan Refresh. The Director of Public Health advised that all 10 local authorities in Greater Manchester were refreshing their locality plans, by the end of November 2019 as part of the response to the NHS’s long term plan and Greater Manchester public service reform intentions.

     

    RESOLVED

     

    That the presentation be noted. 

46.

Children's Services Budget Strategy pdf icon PDF 221 KB

    Members will receive from the Assistant Director for Children’s Social care a report on the Children’s Budget Strategy.

    Minutes:

    The Board considered a report of the Director of Children’s Services, the purpose of which was to outline the end of year position in respect of Children’s Social Care and the innovations that were being progressed to address the current service pressures. The innovations, described in the report, would contribute to the services commitment to restoring the Children’s Social Care budget to a balanced position and returning to a steady state. 

     

    Children’s Social Care had reported a £6.7m overspend for the financial year 2018/19. The areas where funding pressures had been most prevalent were in respect of children’s care placements; in particular an increase in the use of external residential placements. Staffing costs had increased as a consequence of growth in the demand for social care services and instability in the work force leading to an increased use of agency staff. The current situation within Rochdale mirrored the situation across the country.

     

    The budgetary pressures were projected to continue for at least the next five years. This was largely attributable to the impact of the 2018/19 growth in cared for children numbers as they continue to be cared for in 2019/20 and beyond.

     

    As a means of addressing the budget gap and the associated demand led pressures, a five year Sustainability Strategy had been developed. The strategy had five key elements which are supported by a number of financial assumptions and an investment plan in order to achieve sustainable savings. The key elements are:

     

    ·                     Stabilisation of workforce

    ·                     Progressing agreed GM Innovations

    ·                     Restoring  foster care to growth

    ·                     Support for Children with Disabilities

    ·                     Effective Placement Commissioning and market management.

     

    These areas had been developed following detailed demand and financial mapping. A further element of the strategy is the continual review of the financial model and effectiveness of the approaches against agreed targets and reductions in spend. 

     

    Members of the Board sought assurances that the proposals would be kept within agreed spending limits, emphasising the need for balanced budgets to be set.

     

    RESOLVED

     

    1.    That the Integrated Commissioning Board supports the Greater Manchester Innovation Programme.

    2.    That the Integrated Commissioning Board funds the health posts required for the innovations.

    3.    That the Integrated Commissioning Board receive regular cost benefit analysis data to evidence the impact of the investment, at future meetings.

47.

Children's Community Services pdf icon PDF 120 KB

    The Assistant Director of Commissioning will present to the Board a report on Children’s Community Health Services.

     

    Minutes:

    The Associate Director of Children’s Services reported that following Pennine Care NHS Foundation Trust’s (PCFT) decision to divest itself of community health services, it was agreed that Children’s Community Health Services would be subject to a procurement process, with a new service provider to be in place from 1 October 2019.

     

    The procurement process was completed on 22nd August 2019 when the decision to award the contract to Salford Royal NHS Foundation Trust was published.

     

    The contract was let for a period of five years with the option to extend for a further 2 years.

     

    RESOLVED

     

    That the report be noted.

48.

Finance Monitoring Report - P6 pdf icon PDF 165 KB

    The Chief Finance Officer for Health & Social Care Integration will provide Members with a Finance Monitoring report covering period 6

    Minutes:

    The Integrated Commissioning Board (ICB) received a report of the Chief Finance Officer on the financial position of the pooled budget for the financial year 2019/20 as at the end of September 2019. The pooled budget excluded the Better Care Fund (BCF) and the Greater Manchester Transformation funding which were being reported separately to the ICB in 2019/20.The pooled budget had been amended to take into account savings proposals that had previously been reported to the ICB.

     

    The gap on the Health and Social Care (H&SC) Pool budget for 2019/20 was reported as being £11.4m as at the end of September 2019; this represented a reduction of £0.3m since the position as at the end of July 2019 of £11.7m. As at the end of September 2019 there is a forecast overspend of £3.0m against the pooled budgets, a reduction of £0.3m from the July 2019 position of £3.3m. The forecast overspend of £3.0m includes £1.8m of health-related pressures and £1.2m of Adult Social Care related pressures. Public Health was forecasting a nil variance.

     

    Members of the Board expressed their concern at the reported budget gap and in this regard it was requested that a report be submitted to the Board’s next meeting outlining proposed measures to reduce the reported funding gap.

     

    RESOLVED

     

    1.    That the report be noted.

    2.    That the Chief Finance Officer be requested to submit a report to the Boards next meeting detailing proposed measure that could be put into place to reduce the reported funding gap.

49.

Health and Social Care Better Care Fund Budget Monitoring Report - Quarter 2 2019/20 pdf icon PDF 203 KB

    The Chief Finance Officer for Health & Social Care Integration will present to the Board a report on Health and Social Care Better Care Fund Budget Monitoring - Quarter 2 2019/20.

    Minutes:

    The Chief Finance Officer presented a report which advised the Board on Health and Social Care Better Care Fund Budget Monitoring, for the Quarter 2 period (July – September) of 2019/20.

     

    The revised budget was set at the Board’s meeting on 26th March 2019, in line with the Better Care Fund Policy Framework and Planning Guidance for 2017-2019. The Council and the CCG (the partners) must have a Section 75 agreement to support the Better Care Fund budget and this was approved by the Board in September 2017 meeting and has been updated and formed part of the overall pooled Health and Social Care Section 75 agreement for 2019/20.

     

    It is a requirement of the NHSE guidance to produce a budget for 2019/20 which the ICB approved at its March 2019 meeting. The submitted report updated the monitoring against the 2019/20 budget which was a requirement of the Section 75 agreement.

     

    RESOLVED

     

    That the report be noted.

50.

Living Well Service Contract Extension pdf icon PDF 123 KB

    The ICB are asked to approve an extension of the Living Well Service contract by a period of six months.

    Minutes:

    The Director of Public Health reported that the current Living Well Service contract was due to expire on 31st March 2020. There was provision in the contract to extend up to a maximum of two years further, until 31st March 2022.

     

    The Director’s report sought the Integrated Commissioning Board’s approval of the extension to the Living Well Service contract for six months until 30th September 2020. This would allow sufficient time to remodel the Rochdale Borough prevention offer and deliver some financial efficiencies.

     

    The Living Well Service is delivered by The Big Life Group and is the current community and family prevention service in the Borough. It offers a wide range of services including support to stop smoking, oral health improvement, healthy weight and physical activity interventions for families along with wellbeing coaches to support people’s motivation and resilience to live a healthy life. The service also co-ordinates the Community Champions programme, along with a comprehensive volunteering offer which helps support improvements in health and wellbeing e.g. volunteer-led health walks across the Borough.

     

    RESOLVED

     

    1.    That the Integrated Commissioning Board approves the extension of the Living Well Service contract by a period of six months to 30th September 2020.

    2.    That the contract value for the service will remain £1,305,370 per annum for the extension period.

51.

Exclusion of Press and Public

    To consider that the press and public be excluded from the remaining part of the meeting pursuant to Section 100(A)4 of the Local Government Act 1972 on the grounds that discussions may involve the likely disclosure of exempt information as defined in the provisions of Part 1 of Schedule 12A to the Local Government Act 1972 and public interest would not be served in publishing the information.

    Minutes:

    Resolved:

    That the Press and Public be excluded from the meeting during consideration of the following five items of business, in accordance with the provisions of Section 100A (4) of the Local Government Act 1972, as amended.

     

    Reason for the Decision:

    Should the press and public remain during debate on these three items there may be a disclosure of information that is deemed to be exempt under Parts 1 and 4 of Schedule 12A of the Local Government Act 1972.

52.

Assisted Conception Contract Award

    For the Board to receive a report on the Greater Manchester Assisted Conception procurement process.

    Minutes:

    The Board considered a report of the Associate Director of Children’s Services, the purpose of which was to inform the meeting of the outcome of the Greater Manchester Assisted Conception procurement and to note see the contract award to successful bidders and HMR CCG’s participation in the procurement as an associate commissioner.

     

    RESOLVED

     

    That the report be noted.

53.

Transformation outlining the financial position against the plan

    The Committee will receive a report on Transformation position by the Strategic Commissioning Programme Director.

    Minutes:

    The Board considered a confidential report which reminded Members that the transformation programme expires on 31st March 2021. However, Greater Manchester Health and Social Care funding was due to cease on 31st March 2020. The continuation of the programme and its interventions was solely reliant on delivery of financial net benefit and the programme therefore being self-funding. Extensive work had been completed over the last few months to ensure that Rochdale Borough could continue to deliver the successful elements of the transformation programme by carrying out a programme of deep dives and reviews.

     

    RESOLVED

     

    1.    That the ICB agree to reduce the risk it is recommended that the transformation expenditure in 2020/21 is capped at a maximum of £4m in line with the growth that the Pennine Acute Trust would have received through the contract.

    2.    That the Pennine Acute Trust sign up to a contract that gives assurance that any growth can be contained by the schemes that are funded.

    3.    That the Board delegate authority to Mr. S. Rumbelow (HMR CCG Accountable Officer/RBC Chief Executive) supported by Councillor Brett (RBC Finance Portfolio holder), Ms. J. Newton (HMR CCG Board member with financial control responsibility), Dr A. York (Chair of CPAP) and S. Evans (HMR CCG – Chief Finance Officer) and that a progress report be submitted to the Board’s meeting scheduled or 28th January 2020.

54.

Children's community services risk management plan

    For Members to receive a report on Children’s Community Health Services- Risk Protection Framework.

     

    Minutes:

    The Board was informed that the procurement process for Children’s Community Health Services had been completed on 22nd August 2019 when the decision to award the contract to Salford Royal NHS Foundation Trust was published. The contract is let for a period of five years with the option to extend for a further two years.

     

    RESOLVED

     

    That the report be noted.

55.

Recovery and Reablement service

    For the Board to receive a report on the Development of a new service for vulnerable adults from the Assistant Director for Operations.

     

Minutes:

The Board considered a confidential report that informed the meeting of a service configuration review has been undertaken within Adult Social Care involving three current services. The services were reviewed together as it was recognised there was a number of service area overlaps and service interdependencies. The three services were: Community Restart Service; Renaissance Service; services for survivors of historic sexual abuse.

 

RESOLVED

 

1.     That following the consultation period the Board approves the implementation, as amended, following the consultation if necessary, the proposals detailed in the report and acts on the recommendations of the review and disestablishes Community Restart Team and Renaissance Service in their current forms.

2.     That the Board approves the establishment of the proposed “Recovery and Reablement” Service, as detailed in the submitted report.

56.

Pooled budget savings and efficiencies programme

    Members will receive a report on the Pooled budget savings and efficiencies programme.

Minutes:

The Board considered a confidential report that provided the meeting with recommendations regarding savings proposals to contribute to closing the budget gap for the Integrated Health and Social Care Pooled Fund for 2019/2020, 2020/2021 and 2021/2022. The savings proposals that were detailed in the submitted report reflected the first of two rounds of proposals. Further savings proposals will be submitted to a future meeting of the Board.

 

RESOLVED

 

1.          That the Integrated Commissioning Bard considers the savings proposals, detailed in the report and approves them for implementation or consultation as appropriate.

 

2.           That the following savings proposals are approved and the budgets are removed with no further monitoring requirements:

 

a.  S125. Admin Hub £34k (19/20)

b.  S132. Shared Lives Charging £60k (20/21)

c.  S137. Advocacy £44k (21/22)

 

3.   The following savings proposals are approved and the budgets are removed. In year monitoring will need to take place to mitigate against over performance:

 

a.  S130. Use of prepayment cards for cash budgets £26k recurrent, £140k non-recurrent (20/21)

b.  S129. Improved opportunities through person centred planning for people in supported living £500k (20/21 & 21/22)

c.  S134. DOLS Reduction in responsibilities £270k (21/22)

d.  S138. Financial Assessment Review £275k (20/21)

e.  S150. Capitalisation of Assistive Technology £150k (20/21)

 

4.       That the following savings proposals are approved for implementation:

 

a.  S94. Haematology Triage £88k (19/20 & 20/21)

b.  S70. Tocilizumab self-administration savings £328k (20/21)

 

5.       The following savings proposal is approved for further development prior to consultation:

 

a.  S.65 Prevention Contracts Supporting People £300,000 (2020/21 – 2021/22), this includes a six month extension to the current contract arrangements ahead of a full procurement exercise.

 

6.       The following savings proposals are approved for public consultation commencing 30th October 2019:

 

a.  S128. Charges to full cost payers £29k (20/21)

b.  S149. Shared Lives Management Costs £180k (20/21 & 21/22)

c.  S48. Moving On £50k (20/21)

d.  S49. Adult Care Commissioned Day Service £288k (20/21 & 21/22)