Agenda item

Following an introductory presentation to consider a report of the Executive Director Core Services and Barnsley CCG (Item 4a attached) in respect of Barnsley CCG’s Intermediate Care Service Specification (Item 4b attached).

The following witnesses were welcomed to the meeting:

·         Brigid Reid, Chief Nurse Barnsley Clinical Commissioning Group (CCG), Chair of the Alliance Management Team

·         Jayne Sivakumar, Head of Commissioning and Transformation, Barnsley CCG

·         Sean Rayner, District Director-Barnsley & Wakefield, South West Yorkshire Partnership NHS Foundation Trust (SWYPFT)

·         James Barker, Director of Business Development and Strategy, Barnsley Healthcare Federation

·         Diane Edwards, Associate Director of Nursing, Barnsley Hospital NHS Foundation Trust (BHNFT)

·         Jacqui Howarth, Service Manager-Right Care Barnsley, BHNFT

·         Rachel Dickinson, Executive Director-People, Barnsley MBC

·         Lennie Sahota, Service Director-Adult Assessment and Care Management, Barnsley MBC

·         Cllr Margaret Bruff, Cabinet Spokesperson, People (Safeguarding)

In introducing the item, the meeting was informed that the definition of intermediate care used in Barnsley was “active rehabilitation following an acute illness or early therapeutic intervention to prevent hospitalisation”.

The Committee received a presentation which provided information of the work which was undertaken through an Alliance Contract between SWYPFT, BHNFT, Barnsley Healthcare Federation, Barnsley MBC and Barnsley CCG to provide intermediate care. The main principles of the specification was to provide:

·         Patient-centred care (ensuring that treatment meets the needs of the patient, rather than patients being treated in line with the needs of the service);

·         effective clinical leadership;

·         strong system knowledge (ensuring that the right service is provided at the right time);

·         a partnership focus; and

·         an increased role for early therapeutic intervention (as intermediate care was currently focused on rehabilitation following hospitalisation, rather than preventing hospitalisation).

The meeting was informed that RightCare Barnsley (the core and origin of the Alliance Contract set up between SWYPFT, BHNFT and Barnsley CCG) served as the single point of entry and exit to the intermediate care service. This approach sought to reduce the amount of communication required between different organisations, ensuring that patients were progressed through care appropriately.

The meeting was also informed that performance measurements regarding quality of life were being established, to ensure that rehabilitation and therapeutic intervention was enabling patients to be as independent as possible. This approach was being embedded in the service through the therapeutic staff being requested to upskill colleagues in therapeutic approaches, with the aim of staff being able to enable patients to be more independent.

It was explained to the meeting that hospitalisation could often lead to “deconditioning” of patients, where patients lost muscle mass and mobility, reducing their ability to rehabilitate and act independently.

Questions were asked in response to the presentation and report submitted, and the following matters were highlighted:-

·         In relation to the history of RightCare Barnsley, it was explained that there had previously been an unplanned care board, led by the CCG. At that time, the default option for GPs had been to refer patients to hospital for unplanned care, which typically created pressure in the system. Therefore, a care co-ordination centre approach was sought, to provide a brokerage service by phone to GPs. This allowed GPs to ensure that patients were directed to the most appropriate place.

·         Mount Vernon Hospital was expected to close, with some of the capacity being provided through care homes. These would be procured in line with a strict service agreement, to ensure that the required standards were met. This would ensure that patients were cared for closer to home and would allow patients to be directed to homes which best met their treatment needs. It was explained that, in relation to the planned Transition Unit NHS inpatient beds there were currently vacant wards at Barnsley Hospital where this would be established (with an aim of a capacity of 24 beds).

·         The staff currently employed on the wards at Mount Vernon Hospital would be at risk of redundancy, but it was expected that it was likely that these staff would be able to redeployed within the Alliance. Staff had been kept informed of the proposals for the future of Mount Vernon Hospital over the last 12 months, but formal consultation had not yet started. SWYPFT was the owner of the Mount Vernon Hospital site, which was expected to be sold following the closure. Proceeds from the sale would be handled in accordance with Department of Health guidance.

·         Prevention of falls at care homes, while ensuring that patients retained mobility to prevent deconditioning, was an area of work which RightCare Barnsley would be undertaking in the coming year.

·         Patient information systems were shared by all partners to the Alliance Contract (with due regard for patient confidentiality) to ensure that information was shared effectively, ensuring the best care for patients. There did remain some issues in ensuring compatibility of IT systems, but this would not put any patients at risk.

·         If Members wished to support the intermediate care service in Barnsley, they were recommended to contact the Alliance Contract Management Team, through the Scrutiny Officer, as there was a range of public representative roles which Members could fill. In addition, Members were advised that the Alliance Contract team could provide them with the most up to date information regarding any proposals for the service, so that this information could be accurately transmitted to the public.

The Chair thanked the witnesses for their contribution to the discussion.

RESOLVED:

1. That Members who wish to support and contribute to the development of the intermediate care service should express their interest via the Scrutiny Officer.
2. That the witnesses be thanked for their attendance and contribution.