Agenda and minutes

There were no declarations of interest.

The minutes of the meeting held on 21^st November, 2017 were signed as a true record. There were no matters arising.

Joint report

The following representatives have been invited to the meeting for the consideration of this item:

Simon Gilby, Coventry and Warwickshire Partnership Trust (CWPT)

Matt Gilks, Coventry and Rugby Clinical Commissioning Group (CCG)

Jed Francique, CWPT

A request has been received from a member of the public concerning the Adult Neurodevelopment Diagnostic Pathway, Briefing Notes of the Scrutiny Co-ordinator and Catherine Rigney, Coventry and Rugby CCG are attached

The Board considered a joint report which highlighted the progress made during the last twelve months with the Child and Adolescent Mental Health Services (CAMHS) Transformation Plan. The report detailed both the achievements and the challenges during this period and the ongoing work to improve the CAMHS system of support for children and young people. Matt Gilks, Coventry and Rugby CCG and Simon Gilby and Jed Francique, Coventry and Warwickshire Partnership Trust (CWPT) attended the meeting for the consideration of this item. The Board also received briefing notes of the Scrutiny Co-ordinator and Coventry and Rugby CCG concerning a request from a member of the public concerning the Adult Neurodevelopment Diagnostic Pathway.

The report also provided a reminder of the tiers of the CAMHS system; provided an update on the national and local policy context; highlighted the findings of the recent CQC inspection and detailed the action being taken in response; and set out the priorities for Year 3 of the transformation programme. 

The Board were informed that over the last twelve months progress had been made in the following areas:

·  Implementing the new ASD pathway for school-aged children, including the ongoing development of the Dimensions Tool;

·  Delivery of support in schools particularly through the enhanced Primary Mental Health offer and the positive outcomes that this has delivered. 

·  Ongoing development of the community Eating Disorders service;

·  Maintaining referral to treatment waiting times, with strengthened arrangements to reduce follow-up waits;

·  Procuring additional clinical capacity via an independent provider to offset recruitment challenges, which reflect the national picture;

·  Launch of the new, integrated CAMHS LAC  service, with consultation & advice to Social Workers;

·  Launch of a new website;

·  Positive feedback from service users, e.g. reflected in many areas of the Experience of Service User Questionnaires.

The key next steps for the CAMHS programme were:

·  Monitoring the specific action already taken to address the issues raised in the Care Quality Commission inspection;

·  Ongoing waiting list management action to address all key waits, particularly CAMHS follow-up waits and ASD  assessment waits;

·  Ongoing work to make “early help” available through a range of means, including online support, telephone advice & consultation and pre-assessment groups;

·  Workforce planning and development, including ongoing recruitment and retention work;

·  Developing a tier 3.5 service business case, to provide additional, integrated support for young people presenting in crisis situations;

·  Further developing the service for Looked After Children;

The Board questioned the officers and representatives on a number of issues and responses were provided, matters raised included:

·  The frustrations from Head Teachers and teachers regarding their dealings with CAMHS

·  Clarification about the issues raised by the CQC inspection including the safeguarding policy; the lack of key performance indicators; the mixed staff morale; and governance of the service

·  Reference to the establishment of a joint Scrutiny Boards (2) and (5) Task and Finish Group on CAMHS providing opportunities to work with the partner representatives

·  Reference to the Green Paper and the future proposals for schools including having a trained  ...  view the full minutes text for item 38.

Presentation from Simon Gilby, Coventry and Warwickshire Partnership Trust (CWPT) 

The Board received a presentation from Simon Gilby, Coventry and Warwickshire Partnership Trust (CWPT) on the CQC Inspection Report of CWPT which was published in November, 2017. CWPT was rated as ‘requires improvement’ with the report indicated that although some progress had been made since the previous inspection, insufficient progress had been made to enable a higher rating to be awarded overall. Lisa Cummins, CWPT was also in attendance. 

The presentation highlighted the key issues for 2016/17 along with some background information on the employees at CWPT. An overview of the inspection found that the report was positive; CWPT were a learning organisation; immediate actions and improvements had been made; and the organisation was committed to excellence.

Detailed information was provided on the inspection ratings under the headings of Safe, Effective, Caring, Responsive and Well-led. Caring was rated as ‘good’ with the other areas ‘requires improvement’. A breakdown for the individual ratings for Community Health and Mental Health was set out. Four areas within mental health were rated as ‘inadequate’ and the Board were informed of the immediate actions which had been undertaken to improve this situation. Three of these areas had now moved to ‘requires improvement’. 

The presentation drew attention to the work that CWPT was particularly proud of and the areas for improvement under the inspection rating headings. 

Regarding the key issue of the Child and Adolescent Mental Health Services (CAMHS) waiting list, in particular the waiting times for children and young people to access mental health treatment and referrals that required triage and availability of staff to complete the task, the Board were informed that the new CAMHS Navigation Hub was being implemented with strengthened arrangements as follows:

·  All referrals clinically screened within 2 days, with all referrals screened as urgent being prioritised

·  Clinical staff numbers increased from 1.5 to 3 WTE and admin support from 5 to 8.5 WTE

·  Standard Operating Procedure updated

·  Strengthened CAMHS waiting list review arrangements

·  Fully engaged with partners in a joint approach.

Attention was drawn to the warning notice that had been issued in respect of the physical health care and treatment provided to patients on the older people mental health wards. The Board were informed of the immediate action which had been undertaken as follows:

·  Multi-disciplinary team case review of every patient undertaken and process embedded in practice

·  Nursing staff received refresh physical health skills training and had been assessed as fully compliant

·  Standardised process developed for management of physical health care, reviewed and strengthened

·  Governance embedded, process to monitor and ensure oversight in place

The Board noted that the CQC, NHS Improvement, and the CCG were all supportive of the plans and approached taken.

The presentation concluded with progress which included an action plan being developed with a focus on outcomes and tangible assurance. Many improvements had already been completed and full completion was anticipated by July 2018. Progress was monitored by the Trust Board.

The Board questioned the representatives on a  ...  view the full minutes text for item 39.

Report of the Task and Finish Group

The Board considered a briefing note of the Scrutiny Co-ordinator detailing the outcomes of Task and Finish Group on Improving the Quality of Housing and the Health and Wellbeing of Coventry Residents. Approval for the establishment of the Task Group was given by the Board at their meeting on 19^th July, 2017.

The briefing note highlighted that the Task and Finish Group had wanted to investigate and draw attention to the link between health and housing; to look at the existing work being undertaken by organisations across the City to support people in developing and maintaining healthy homes; and to consider how the Council could improve the quality of private rented sector housing. The Group were joined by representatives from Coventry Citizens Advice who were able to provide an insight into the housing challenges faced by Coventry residents. Members also heard evidence from West Midlands Fire Service, Whitefriars Housing, the Council’s Housing Enforcement Team and Public Health. A call for evidence was also put out electronically to enable private landlords to give their views. The Group met on five occasions.

The briefing note detailed the outcomes of the Task and Finish Group sessions on the following subjects:

Public Health and setting the scene

Citizens Advice Coventry

West Midlands Fire Service

Whitefriars Housing

Housing Enforcement.

The recommendations from the Task and Finish Group were to be submitted to Cabinet at their meeting on 6^th March, 2018.

Members discussed the recommendations to be submitted to Cabinet and suggested the inclusion of the work of other advice agencies. The issue of limited resources was highlighted.

RESOLVED that:

(1) Having considered the recommendations from the Task and Finish Group as set out in the briefing note and having taken account of the comments from members, the recommendations be amended to read as follows:

i. That the Coventry and Rugby Clinical Commissioning Group are asked to look at hosting advice outreach in GP surgeries (Cllr Caan)

ii. To endorse the work of Citizens’ Advice Frontline Network and other advice agencies to look at the co-ordination of grant and charity resources to assist tenants to create easier access to funds for tenants in need of support (Cllr Bigham)

iii. To support the continued work of the West Midlands Fire Service on the Health Agenda, including working with partners to evaluate the impact andthen, if appropriate, explore funding options for the Back Home Safe and Well initiative (Cllr Caan/Cllr Abbott)

iv. To endorse work with city partners to consider opportunities for information sharing, which could lead to the identification of vulnerable people who may benefit from services or support through community resources, such as from Citizen’s Advice, Coventry Independent Advice Services and the Fire Service Safe and Well check. (Cllr Abbott/Cllr Bigham)

v. That work is undertaken to define and promote Healthy Homes (Cllr Caan)

vi. To support the proposal to continue to develop Selective Licensing in the City (Cllr Bigham)

(2) The recommendations for Cabinet, as amended above, be supported.

(3)  ...  view the full minutes text for item 40.

Report of the Scrutiny Co-ordinator

The Board noted their work programme for the current municipal year.

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

The Scrutiny Co-ordinator reported that the next meeting of the Coventry and Warwickshire Health Overview and Scrutiny Committee was due to be held at 2.00 pm on Tuesday, 27^th February, 2018.