Agenda item

Purpose: To present and seek comments on the proposed dashboard for Health and Social Care.

Tandra Forster presented a slide to the Board, which featured a first attempt at a performance dashboard for the Health and Wellbeing Board.

The dashboard was split into three areas including Adult Social Care, Children’s Social Care, Primary Care and the Acute sector. Each area would then contain up to three indicators. Those for Adult Social Care included two indicators around the delayed transfer of care. This included delays due to reasons such as housing or access into the West Berkshire community hospital. Tandra Forster explained that data represented a  very vulnerable set of people.  The third indicator was around the proportion of older people who were still at home 91 days after discharge from hospital into reablement/rehabilitation services. In essence this was about working with people to help keep then independent. Tandra Forster asked the Board to note that the threshold was currently at critical and therefore reablement was often a challenge.

Tandra Forster sought comments from the Board to gauge if they were satisfied with the information that was proposed for the dashboard or if there was other information they wanted included.

Phil McNamara further explained that Officers had begun looking at the dashboard a few weeks ago, with a view to identifying the key indicators. Many of the metrics identified were currently placed in the wrong areas, for example Clinical Commissioning Groups did not commission Primary Care. However it was reiterated that what the slide showed was an initial attempt and was very much work in progress. Once comments had been sought from the Board the next step would be to draft a further mock up of the dashboard. At one stage a more sophisticated version of the dashboard had been submitted however, the view had been formed that the simpler model was required. Tandra Forster  reported that Health and Wellbeing Board’s across the country were looking at doing something similar. The aim of the dashboard was to flag up immediate issues across the system that could help to indicate system resilience.

Rachael Wardell stated that it was important to look at what was already regularly reported on, along with that reported on by partner organisations. Rachael Wardell welcomed the idea of presenting the dashboard on one page however, felt that the Board also needed access to the context behind the data.

Cathy Winfield stated that the Better Care Fund (BSF) criteria were very important for the Board to keep an eye on. Tandra Forster further highlighted that there were other providers apart from the Royal Berkshire Hospital who needed to be included.

Cathy Winfield reported that the NHS had an Alamac system for monitoring purposes. This was a live information system that was currently under a lot of pressure. Cathy Winfield stressed that the BCF needed to be included as part of the dashboard.

Rachael Wardell gave further explanation on the Alamac system for those who were not familiar with it. The system had been introduced due to the pressure on hospitals to move people through the system. It included Officers meeting to talk about how issues could be moved forwards. Alamac collected information for example on how many beds were taken up. It flagged issues at the Royal Berkshire Hospital and helped in the identification of these issues so that work could begin to resolve them.

Councillor Graham Pask felt that it was critical that the Health and Wellbeing Board could access the information behind the dashboard. It was confirmed that the dashboard would only go to the Health and Wellbeing Board. Rachael Wardell highlighted that although the dashboard would only be presented to the Board, the indicators were shard more widely.

Phil McNamara stated that a completed version of the dashboard that took account of the comments made by the Board, would be brought the next meeting of the Board in September.

Adrian Barker felt that finance data and feedback from service users would indicate if there were problems within the system however, was sceptical as to whether there were currently any indicators on this. Cathy Winfield reported that some data was collected, which captured patient experience. Tandra Forster added that Adult Social Care carried out an annual survey however, this would be difficult to feed into the dashboard given it was annual and the dashboard would be reported on regularly. Tandra Forster suggested that she could bring the result from the annual survey to the end of year meeting.

Councillor Marcus Franks felt that what had been presented was a good start in developing the dashboard. He acknowledged that the BCF criteria were important however, felt that this could be reported on in the integration section of the agenda. 

It was noted that the Children’s Social Care section was currently blank. Rachael Wardell agreed that this was a very important area for the Board to view. The Children and Young People’s Partnership had recently been disbanded and in doing so Rachael Wardell stated that issues would now come to the Health and Wellbeing Board and therefore there would certainly be a set of indicators for inclusion in the Dashboard.

Dr Bal Bahia stated that the Board only needed to see top level data, which was the aspiration for the dashboard. He stated that it was also about understanding the landscape and being clear on where it should go moving forward.

Lesley Wyman felt that the dashboard as it currently stood would be particularly difficult for the public to understand as it was very complex. Tandra Forster agreed with this and reiterated that the Board was only being presented with a first attempt. Councillor Franks felt that the Primary Care section should include something on quality and also access. The idea of the dashboard was to measure performance and if something was flagged as amber or red, the reasons behind the data could be investigated.

It was agreed that the dashboard needed to be in a completed state before being circulated to the Board. Tandra Forster reported that Jess Bailiss would be responsible for coordinating the dashboard and keeping it up to date.

Phil McNamara suggested that the dashboard go to the Integration Steering Group for discussion before going back to the Board. Tandra Forster stated that the next step was to obtain information from Children’s Services, Primary Care and the acute sector.

David Seward noted the title ‘System Resilience’ and felt that the dashboard was only capturing reactive data rather than taking preventative measure approach. Tandra Forster reported that the idea was the data would generate discussion, the Board could then put actions in place to help resolve the issue.

Councillor Quentin Webb queried how low numbers would be dealt with as these could generate high percentages. Phil McNamara confirmed that if there were low numbers this would be explained within the narrative.

Cathy Winfield confirmed that the CCG did look at the number of elective admissions. It was also suggested that Primary Care capacity could be looked at. Serious thought was currently being given to how Primary Care needed to change to meet current health needs.

Lesley Wyman reassured all that the preventative agenda and the wider determinants of health would form part of the Health and Wellbeing Strategy and underpinning performance framework.

RESOLVED that a completed version of the dashboard would be brought back to the next Health and Wellbeing Board in September, which took account of the comments made by members of the Board.