Agenda item

Attendees:

-       Emily Warren (Regional Partnership Board Regional Team

-       Chris Humphrey (Head of Adult and Community Services)

-       James Harris  (Strategic Director - People)

The Head of Service presented a brief overview to the Committee and highlighted the key areas for consideration. It was explained that this is another Welsh Government funding stream and is fairly new. The Head of Service has worked collaboratively and Newport are the host authority for Home First, which are a part of the hospital discharge team. They work at two sites: Royal Gwent Hospital and Neville Hall. This scheme is making sure that people being admitted to A&E are the ones that realty need to be.

The Officer gave context to the committee, and advised that the Head of Planning in ABHB wanted to work towards a more seamless system in care. The Healthier Wales policy was published in June 2018 and was cost neutral. £100million was gathered over a period of two years of delivering transportation. The sooner you put in an offer the sooner you can get the funding. Some of the questions Welsh Government ask include “Do you work in partnership?”  A small leadership Group was set up to see what could be delivered in 14 months that benefits social care and health and in which they had confidence.

Consultations had been taken with CIT representatives in four challenge support sessions, and discussed networking, what is out there in the committee, what you might go to a GP for and to access Mental Health services. Five well-being co-ordinators have been funded in areas so they can signpost people for advice.

During the sessions there had been some great suggestions. Examples were given such as transformation of primary care services, training and supporting GPs, and also putting in a multi-disciplinary team to make sure when patients access primary care services they can be navigated. They are trying to test the principles, if this work is how we should deliver, and where can we bring in additional people? The Home First model was then advised, where families can access adult mental health services. The whole school approach also equips schools to signpost and identify work with families.

A significant portion of the money had gone into training staff. In terms of outcomes, this is very early programme, which had only started in January 2019. There had been 792 calls as of the end of June so it can be seen how it could make a difference, which is already being seen to struggling families. Home First has had over 1000 assessments, and 30% for admissions.

Members asked the following:

·      Members praised the programme as impressive and exciting. It was then asked in what context would Brexit effect the programme. Members were advised about an underspend in two projects which are being funded from the sustainable funding stream. This was planned so it could be rolled over it next year, and the projects are ready to be delivered in April 2020. Often you cannot roll over, but any underspent funds are in risk of being taken from the Brexit war chest. Partners are putting in a second offer in.

·      Would this cause an internal disruption? It was advised that it could disrupt GP services generally. Lots of people feel they don’t get the support needed because things are rushed. Members were then advised of an element of support being offered via compassionate communities exchange service being held in surgeries. Sometimes seeing a GP is only one point. In the new model of primary care if you can free up GP time a service user could have more time with them. If a GP was visited for anxiety, further information could be given to the patient, as the GP is not the right person to see.

It was added that 40% of people seeing a GP did not need to seem them, so it is important to make sure resources are being used in the best way. Phone conferences had been used as a pilot, trying to work in collaboration in a joint was to manage some people with challenging problems

·      Comment was made that some doctors just give patient drugs to combat mental health problems and offer no extra support. There has to be other routes open to patients that are not medicine based. It was advised that partners need to support GPs to give them knowledge to signpost. There is a real challenge from the health board to better equip GPs. There is a lot of work to change culture.

·      Members commented that we have to make sure services are in place, and voiced concerns about hospital discharges that families aren’t being consulted well enough, with some people going home with severe mental health problems which haven’t been identified. It needs to make sure that the right support services are there and carers are receiving integrative services as well as been seen as part of the service.

·      How many agencies are currently on board? A definite number could not be advised however there are 100s. There is an appointed lead in each authority area whose job is to work with teams and third sector agencies. There is a big challenge to get information out to the public and accessing it. The Neighbourhood Care Network in Blaenau Gwent was mentioned, with lots of activities taking place such was walks and events in libraries.

The Strategic Director then advised that all carers wish to be involved in the decision-making process, but they need the information. It would be useful if they knew where to go and had a responsible person to go to and get signposted. It works really well as a model. Not all carers wanted to have a carer’s assessment.

·      Comment was made that people should have access to bereavement services to give them access and information to what happens next. Members were advised that there is an initiative from the National Dementia Project and Cruise support families in grieving. There are also support networks that can be tapped into so carers who have previous lost someone can help others.

·      Members commented on the various cultures in Wales and how the harmonising approach across Wales must be challenging, with the border between England and Wales. It was when asked how much divergence was between Wales and England. Members advised that there were lots; Wales have a different funding arrangements, thresholds and different structures. Wales is more generous in many ways with social care. Welsh Government want partnership working,

The officer advised that Wales do not commission like England, who are driven by commissioning and contracting. It seems easier in Wales with block budgets, resource sharing. Our job drive is to improve outcomes, which is challenging but very much outcome focussed.

The Chair thanked the Invitees for attending.