Agenda item

Report of the Joint Head of Integrated Strategic Commissioning for the North East and North Cumbria Integrated Care Board and Durham County Council.

The Board received an update report from the Joint Head of Integrated Strategic Commissioning in respect of the Transforming Care Programme,

incorporating an update on the Joint Health and Social Care

Learning Disability Commissioning Strategy and the Think Autism Strategy for County Durham, presented by the Strategic Commissioning Manager, Tricia Reed (for copy see file of minutes).

The Strategic Commissioning Manager updated the Board, noting work in terms of helping those with learning difficulties and/or autism to enable them to live in the community, so that fewer people would need to go into hospital for their care.

Councillor R Bell asked as regards reference within the report to ‘inappropriate hospital occupancy’.  The Strategic Commissioning Manager noted there were some cases where individuals had been admitted before advances in diagnosis and medication, and now with improvements in those areas, some could be supported within the community.  She noted that some issues in respect of learning difficulties and/or autism were not treatable like mental health issues, noting some admissions under the Mental Health Act.

The Corporate Director of Children and Young People, John Pearce noted that it was clear that the issues involved were very complex, and noted he felt the principle was positive and along with national policy, it was also the right thing to do.  He noted concern in terms of roll out and targets that appeared to be arbitrary.  He added that while he agreed that if the current settings were inappropriate there should be alternatives offered, however, he believed their needed to be a clear understanding of what was appropriate and to have that in place ready, with appropriate resources unlocked.  He asked if the community resources were the ready and in place, adding that if not, there was a risk.  The Joint Head of Integrated Strategic Commissioning, Sarah Burns noted the targets were fixed and explained that she had spoken with colleagues from Tees, Esk and Wear Valley (TEWV) NHS Foundation Trust as regards how their teams would work with the in house ICB and community teams, and to ensure there were the skills to meet the needs within the community, once those people were moved into communities.  The Corporate Director of Children and Young People reiterated he felt it was critical to ensure there was capacity first.  J Todd noted it was clear there would not be a ‘turning off of the tap’ and that there would be work to look to intervene early.  He noted his experience in respect of Hawthorn House and the step-up/down beds as an alternative to hospital.

The Corporate Director of Children and Young People noted his frustration in terms of the national process and funding and agreed that the work and mitigation that was being undertaken in our area was very good.

Resolved:

That the Health and Wellbeing Board:

(a) note the progress made with plans for new community services for people with the most complex needs including the use of the Community Discharge Grant, which will support the Transforming Care objectives over the next year and in the longer term.

(b) receive further regular updates to retain oversight of the Transforming Care agenda.