My report to Council

Posted By: Dale Mulgrew
Date Posted: 19/10/2009

Thank you Mr Mayor for the opportunity to report to the Council the latest developments on various matters relating to the health and social care Portfolio.

Adult care

Learning Disabilities strategic review:

The Learning Disabilities agenda for the borough is proving to be an increasingly challenging proposition, as the financial pressures continue to mount. This is a complex area and involves many overlapping facets; two examples being out of area placements, and the transition arrangements into adulthood.

What also is not known is the impact personal budgets will have on this client group, although we are certain that the population base is growing and will continue to grow due to increased life expectancy.

Currently there are two important developments taking place at the moment within this arena which together form the pretext to the review.

The first involves a negotiation process with the PCT over continuing health care costs and associated matters. Secondly, the decoupling of the pooled budget arrangement, which has been place for the last eight or so years, is impending, due to a change in legislation.

This will mean that for individuals with learning disabilities, health related costs will be borne by the PCT, whilst social care costs will be borne by the local authority.

Thus, this is a crucial juncture and, at this moment, there is now the need for the local authority to establish what the best model of support is for the learning disability needs of this borough.

A new direction is required to enable better planning for this agenda. This will ensure that the necessary support for our learning disability populace is maintained in the future, but will also importantly reflect the Council’s ability to financially support this area of adult care going forward.

As chair of the learning disabilities partnership I have been pressing for a careful examination of the learning disabilities agenda for some time, and so this strategic review is in response to the ongoing challenges that are being faced by the service and the corresponding budgets.

This review comes on the back of a number of projects that were set up eighteen months ago, for which I express my mild disquiet that they did not deliver more substantial results than anticipated.

Discussions are underway to ensure the resource is being properly resourced, and will have a dedicated project officer leading the work. I am confident that we will get some firm conclusions, which will influence the future planning and how services are shaped in the future.

I believe there is the need for some fundamental changes as the current configuration will continue to prove financially challenging if there are no innovations introduced, or shifts in provision, or recalibrating of resources.


Domiciliary Care retender

Over the summer there has been an incredible amount of work gone into a process of re-tendering all the Council’s homesupport business. The outcome of the tender would see the award of new contracts to providers who met the quality grade as part of the creation of a new ‘preferred providers list.’
Members will be aware of the need to drive a higher quality through the homecare sector in the borough, and the re-tendering process has been robust, full of rigour and has followed corporate procurement guidelines.
At the beginning of the process I was made aware that there were a number of expressions of interest. However a quality threshold was set, so that only tenders which matched the strict criteria and were adjudged to have made this high watermark were invited to participate in the interview stage.
In the end a number of local providers did not manage to either make the final selection that would form the ‘preferred providers list,’ nor did they even make the interview stage.

The providers who have been assessed through the tender process have well trained and committed staff, who will put the people they care for at the centre of all they do, and provide this care whenever and wherever it is needed in the borough.
Adult Care will ensure that the transition over to the new providers will have minimum disruption, and will be handled in a coordinated and sensitive manner. Staff working for providers who did not make this final list can transfer to the Council’s preferred providers without putting their pay or conditions at risk.

Green Paper on future of social care
The Government over the summer launched a green paper entitled ‘Shaping the future of care together’, which is primarily charged with looking at how social care is to be provided and funded in the future.
The big idea is the setting up of a National Care service, which would guarantee a level of support that would be standardised across the country.
The other big aim of the National Care Service would see the elimination of the deeply unpopular trap of being punished for having a level of lifelong savings that are then plundered in old age for social care costs.
This policy paper sets out ideas around national assessments and proposals on different frameworks. It also identifies several options that could lead to a fairer future funding system under the umbrella of a national care service, which can be developed further.
I encourage fellow members to take part in the consultation and to express their views on what potentially will be a radical shake up of social care.
Personalisation focus on carers
As reported to Council in July, Adult Care are at present conducting trials with service users to ensure the process is robust and user friendly. I will feedback to Council next time on how this nascent system is faring.
One of the other developments on personal budgets is the formation over the summer of a carers steering group that will ensure carers are not ignored during the inception of self directed support for Rochdale.
It is easy to get carried away and fixated on the service user’s needs when talking about personal budgets, but carers are inextricably linked to any new system which involves the individual that they care for. It is due to this integral role that I am pleased it has been recognised through the setting up of this new group.

Health

Impending changes to health leadership

The HMR PCT has made the decision that they will actively seek to find a replacement swiftly for the leadership of their organisation, after their previous chief executive, Mr Trevor Purt, moved on at the end of last month.

The recruitment process will conclude before Christmas, and I am pleased that an invitation has been extended so that I will be participating in the interview stage, which will see shortlisted candidates questioned by deputations from partner organisations.



Start of unpopular changes to the Infirmary

In August the walk in centre was relocated from a stand alone building opposite the Infirmary Hospital, and re-stationed inside the A&E building as part of a co-located service. These changes are the start of inexorable plans under the ‘health futures’ reconfiguration of services.

As a Council we will strive to continue to work with our two major health partners responsible for providing acute services (HMR PCT as the commissioner, and the Acute trust as the provider) to ensure that the Rochdale Infirmary is not treated as some distant relative, in order for decisions on the hospital to be constructively challenged and to be held account.

As a Council we continue to be concerned about the downgrading of the Infirmary and the resultant decamping of services. There is also a need to really begin to consider what will happen to the Infirmary building when the lights are turned off for the services whose existence are now dictated by the clock and will be moved out imminently.


Middleton mental health re-tender

There is good news for mental health provision in the Middleton area as the HMR PCT are now nearing the completion of their tendering exercise for a new contract to provide community and crisis mental health services for this township.

Previously there had been an unacceptable and historical blur around mental health provision in Middleton, as often Middleton service users where left perilously betwixt and between referrals to the Birch Hill Site, or referred to central Manchester.

This new contract will see Middleton provided with its own services, bringing provision nearer to home and the community, with the added benefit that they will be more responsive to local needs. This is all together a vast improvement on the previous situation.