Agenda item

Purpose: To present the Dashboard and highlight any emerging issues.

(Rachael Wardell and Councillor Lynne Doherty joined the meeting at 9.15am)

Tandra Forster introduced the item to Members of the Health and Wellbeing Board. She reported that the target had been exceeded regarding the number of people (65+) who were still at home 91 days after discharge from hospital to reablement/rehabilitation services. Tandra Forster reminded the Board that this indicator reflected the enablement service and only consisted of a small number of people and therefore it fluctuated easily.

Rachael Wardell briefed the Board on the Children’s Social Care section of the Dashboard. Due to processes being undertaken as a response to the Ofsted Inspection the number of Looked After Children (LAC) was not expected to decrease. Children who were in care were there because they needed to be. Therefore it was likely that the target would remain red. Rachael Wardell reminded the Board that numbers were being compared against a normal range and therefore should not be considered as a target.

Rachael Wardell drew attention to CSC5 regarding looked after children cases, which were reviewed within the required timescales. Performance was currently at 97% and was getting closer to the target (99%).

Dr Bal Bahia asked when General Practitioners (GPs) were notified when a child was brought into care. Rachael Wardell confirmed that they were not notified as a matter of course however, it should be flagged up as part of the Healthcheck process. Dr Bahia referred to a case where he had only become aware that a child was looked after, when he had requested their notes. Rachael Wardell acknowledged Dr Bahia’s point in that it would be helpful for GPs to be informed as part of the process.

Dr Lise Llewellyn queried why the number of LAC in West Berkshire was outside of the normal range. Rachael Wardell stated that Ofsted had felt that there were further children in West Berkshire who should be looked after by the authority and therefore it was likely that the number of LAC in West Berkshire would increase. Each LAC case was decided on by the courts. Ofsted had not found any children who they had considered unsafe and their criticism had been that sometimes children were not brought into care fast enough.

Dr Lewellyn further queried what it was about the locality that drove more children into care. Rachael Wardell stated that she was sceptical about where the normal range data came from. West Berkshire was within the normal range for the South East. The normal range being measured against was a nationally defined measure and did not truly reflect the area.

Councillor Graham Jones asked if numbers could be linked to the number of Asylum Seekers entering the district as a result of the two service stations. Rachael Wardell explained that child abuse was often linked to poverty however, this was not always the case. The Legal Team would be of the view that there were unusual cases that might be the result of a cluster.  There was nothing obvious that could be pinpointed as the cause. Rachael Wardell continued by explaining that thresholds had been set well within West Berkshire and children were moved into permanency efficiently.  Focus needed to be placed on taking legal advice earlier in the process and if care proceedings were required, then these would be implemented. Thresholds also needed to be set earlier.

Dr Bal Bahia stated that there was a Hot Focus Session for LAC taking place on 11^th June, which would be a good opportunity to explore the issues. Dr Llewellyn stated that her question had not been in reference to processes but rather what the characteristics were that caused West Berkshire to fall outside of the normal range.

Rachael Wardell reported that two years ago the levels of LAC had been slightly below the normal range and now they were slightly over. There was nothing special or unique about West Berkshire. She also added that the Hot Focus Session on 11^th June would address what services were in place for children coming into care but would not address the health and wellbeing of children in the district generally and what led them into care.

Fiona Slevin-Brown drew attention to the Acute Sector section of the Dashboard. It was an improving position regarding the four hour Accident and Emergency Target. Although performance (94%) was red against the target (95%), April data showed that performance in this area had improved further and the target had only marginally been missed.

Councillor Hilary Cole queried how AS3; DTOC attributable to social care (Total West Berkshire) was calculated and whether it should be an average or total figure.

RESOLVED that Tandra Forster would check with her team and report back.

In response to a question from Dr Llewellyn regarding the Accident and Emergency indicator, Fiona Slevin-Brown reported that attendees fluctuated however, growth that led to increased admission had not been seen.

Tandra Forster referred to AS3 regarding the number of Delayed Transfers of Care, which were attributable to social care per 100,000 population. Although the target was not being met, there had still been a significant improvement in performance. Focus was required around hospital pathways. Tandra Forster added that some money had been received through the winter resilience project and further funding could be expected through the Better Care Fund and therefore further improvement was anticipated.