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Agenda item

Health and Social Care Dashboard (Shairoz Claridge/Tandra Forster/Rachael Wardell)

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

Minutes:

Tandra Forster introduced agenda item eight to Members of the Health and Wellbeing Board with the purpose of highlighting any emerging issues. Tandra Forster drew the Board’s attention to the Adult Social Care section and reported that some of the latest data reported was from quarter two due to submission deadlines.

ASC1: Proportion of older people who were still at home 91 days after discharge from hospital to reablement/rehabilitation service: The target was 92% and performance was 90% and therefore was highlighted red. Tandra Forster explained that the indicator referred to a small cohort of people. The Better Care Fund (BCF) Joint Care Provider (JCP) Project would help improve performance for this indicator.

Regarding Delayed Transfers of Care, performance was green with regards to all delays and performance in relation to those attributable to social care was amber. There was a good relationship with the Royal Berkshire Hospital (RBH) however, it was acknowledged that there were still areas that needed improving.  Focus was being given to extending the JCP and increasing seven day working. Home care in rural areas was also a challenge and would be incorporated into the BCF for 2016/17.

Shairoz Claridge introduced the Acute section of the Dashboard.

AS1: 4 hour A&E target – total time spent in Accident and Emergency (A&E) department: The RBH were currently the only hospital trust achieving this target. It was expected that with the approach to winter the number of people using A&E would increase. Hampshire Hospitals and Great Western Hospital were struggling to meet the target. Shairoz Claridge highlighted that the Newbury and District Clinical Commissioning Group were not the commissioners for these two Foundation Trusts however, efforts were being made to obtain narrative around the target. Year to date information showed that 70% of those accessing urgent care from West Berkshire flow towards the RBH, 14% go to Hampshire Hospitals and 8% to Great Western Hospital.

There was a great deal of work taking place regarding urgent care services. Vanguards were redesigning the Urgent Care system and details on this could be found within the document ‘Safer, Better, Faster’. Urgent Care was being looked at locally on a Thames Valley basis. A paper was being brought to the next Board meeting on the 111 service, which formed part of the Urgent Care system.

Tandra Forster reported that Adult Social Care was currently developing its winter plan. Performance in West Berkshire was very good with only a few spikes throughout the year. Different ways to manage performance were being explored.

AS5: Ambulance Clinical Quality – Category A 8 Minute Response Time: Shairoz Claridge reported that the provider was the key to turning performance around on this target, which was currently red. There were currently challenges being faced in recruiting and retaining staff.

(Cathy Winfield joined the meeting at 9.15am)

Rachael Wardell introduced the Children’s Social Care section of the Dashboard.

CSC1: the number of Looked After Children (LAC) per 10,000 population: the volume of LAC in West Berkshire was still above the national rate. Rachael Wardell explained that the figure of 48 did not mean than there were 48 LAC in West Berkshire but that there were 48 per 10 000 population.

CSC2: the number of child protection plans per 10 000 population: this remained stable in West Berkshire however, was above the national average. Rachael Wardell stated that recent data showed this number was starting to reduce slightly and this was as a result of the way cases were being managed.

CSC3: the number of Section 47 enquiries per 10 000 population: there had been a significant increase in the number of Section 47 enquiries according to the data for quarter two. As a result of this increase thresholds had been reviewed and conclusions made that the necessary Section 47 enquiries were being applied. It was not yet clear why an increase was being witnessed.

CSC4 and CSC5: to maintain a high percentage of (single) assessments being completed within 45 working days and LAC cases reviewed within required timescales: both of these indicators were green and performing within the target however, Rachael Wardell felt that all LAC should expect to be reviewed on time.

CSC6: Child Protection Cases which were reviewed within required timescales: although amber, performance against this target was very strong and only one percent away from being rated green.

CSC7: percentage of LAC with Health Assessment completed on time: Performance was currently red at 73% (target 90%) and Rachael Wardell had requested that the indicator be added to the Dashboard due to under performance in this area. All LAC received a Health Assessment when brought into care and therefore it was felt that the target for this should be 100%. 73% was a significant improvement and October data showed further improvement over 80%. It was hoped that at least 90% would be achieved by December.

Councillor Graham Jones stated that he was pleased to see the indicator on Health Checks incorporated as part of the Dashboard. He was questioned the arrow symbol for those indicators showing volume, in particular the number of LAC. Rachael Wardell explained that numbers were compared to the normal range nationally. LAC within the system were those children who could not be safely protected at home. There was no right or wrong in terms of these figures however increased numbers, or a number of LAC higher than the normal range, indicated significant pressure on the system. Councillor Roger Croft queried what the ‘normal range’ referred to and Rachael Wardell confirmed that it was the ‘England normal range’ that was used. Given the prosperity of the District Councillor Croft queried if West Berkshire should expect to fall into the lower part of the ‘normal range’ and Rachael Wardell confirmed that this was correct.

Leila Ferguson was concerned that the number of LAC could rise significantly if money for Short Breaks was reduced or removed. It was hoped that the necessary conversations were taking place on this. Rachael Wardell explained to ensure all Board Members were clear, that Short Breaks provided respite care for families with children with disabilities. It was possible that some families might feel unable to care for their child at home if this service was removed.

RESOLVED that the Health and Wellbeing Board noted the Dashboard.

Supporting documents: