Agenda item

The Committee received a report and presentation from the Chief Officer, Durham and Durham Dales Easington & Sedgefield, and North Durham Clinical Commissioning Groups, and Chair of the County Durham Integrated Board that presented part B (Children and Young People) of the Durham Health and Wellbeing System Plan 2019/20 (for copy see file of Minutes).

The Director of Commissioning, Strategy and Delivery, North Durham and DDES CCG highlighted the key areas of the plan which had been developed under the leadership of the Integrated Steering Group for Children, which included:

·        Children and Young People’s Strategy

·        The Integrated Steering Group for Children governance and work programme

·        Integrated commissioning approach for children and the priorities linked to the inspection regimes in children’s services

·        Therapy services

·        Development of place based 0-19 services

The Director of Commissioning Strategy and Delivery informed the committee of a joint development session that was held on 13 June with the Adults, Wellbeing and Health Overview and Scrutiny Committee and the Health and Wellbeing Board that discussed the development of the longer term plan.  Information from this session would be shared with this committee.

The committee were informed that there would be a focus on how services would work together to ensure that every child had the best start in life with a focus on:-

·        Smoking in Pregnancy

·        Healthy Weight

There would also be a focus on the transition to adult services and the need for improvements for:-

·        Review of Looked After Children

·        Review of SEND

Ms Evans commented on the inclusion of the community and voluntary sector and service users for the co-production of the plan.  She asked how young people would independently access services in the Dales when out of hours services were being removed.  The Director of Commissioning, Strategy and Development explained that the community and voluntary sector has been involved as a partner and they were helping to make improvements.  Training in teams and working with partners would make the overall experience a better one for service users.  With regards to delivering services at a local level she advised that not all services could be delivered in this way.  She added that targeted work was being carried out for out of hours services and that transport and outreach services were being looked at.

The Deputy Director of Public Health advised that the Local Authority was further ahead in terms of planning and were working together with partners on how to include residents in the process.  With regards to access she added that they were also looking at online support via social media, including access to counselling services.  She also reminded members about the role of the pharmacy and the self support opportunities.

Councillor Jewell referred to cuts in services and thought there was a mis match in terms of the strategic vision and the operational side of services, referring in particular to Villa Real Special School.

The Director of Commissioning, Strategy and Development explained that there was a requirement to meet therapy needs of children however there had been challenges in terms of staffing.  She assured members that the service had an obligation to meet the needs of the SEND population although it should be noted that the needs had increased and the service was stretched.

The Chair appreciated that the plans for transitions were difficult and that neurodisability and SEND required specialist teams that had no equivalent in adult care, resulting in the care being fragmented. She said that changes in service delivery needed to change to ensure that young people could continue their care.

In response the Associate Director of Operations, CDDFT said that provider organisations did recognise the issues around transitions and he highlighted a concern in paediatrics when young people were discharged at a certain age.  Services were looking at how to deal on a case by case basis so that care could be managed in a better way.  He informed the committee that discussions had been taking place with the current 0-19 provider, Harrogate and District NHS FT, about extending the service to 0-25 year olds.  He added that this was about co-production and ensuring we moved forward with partners.

The Deputy Director of Public Health advised the committee that Head of Early Help, Inclusion and Vulnerable Children was leading on a transition group for 14-15 year olds, with a focus in particular on mental health and autism.  An update would be given at a later date.

Further to a query from Councillor Crute about bringing Part A for Adults and Part B for Children together, the Director of Commissioning, Strategy and Delivery explained that many services span age ranges including A&E and NEAS however she assured members that an individual or a groups needs were always met.  She said that this would span both Adults, Wellbeing and Health and Children and Young People’s Overview and Scrutiny Committees going forward.

Resolved:

(i)           That the report and plan were noted.

(ii)          That the approach to the development of the long term Durham System Health and Wellbeing Plan outlined in the report be noted.