Third Sector Assembly. Health and Social Care Network. Notes from the Health and Social Care Network meeting held on 30 th November 2009.

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1 Third Sector Assembly Health and Social Care Network Notes from the Health and Social Care Network meeting held on 30 th November Organisations present: Ashram Housing Association Bethel Health and Healing Network Birmingham Council of Faiths Bordesley Green Forum BVSC, the Centre for Voluntary Action Castle Vale Community Regeneration Services Cornerstone Pohwer SIFA Fireside Welcome and Introduction Cath Gilliver welcomed everyone to the network meeting and invited the organisations present to introduce themselves. Heart of Birmingham tpct & Sandwell & West Birmingham Hospitals NHS Trust Proposed changes to Maternity Services from 2010 to 2015 in Sandwell and West Birmingham Amanda Smith, Patient Public Involvement Officer, Heart of Birmingham tpct Jessamy Kinghorn, Head of Communications and Engagement, Sandwell and West Birmingham Hospitals NHS Trust (SWBH) Amanda addressed the network and explained that they are working with SWBH on the maternity review in Sandwell and West Birmingham. Merida Associates are working with both Trusts on the consultation and requested that the Trusts get feedback from the Third Sector Assembly. Jessamy presented the consultation to the network and explained that the proposed changes will be implemented across Sandwell and West Birmingham between now and when the new hospital is opened in 2015 in Smethwick. Why is there a need for improving maternity services? In recent years, independent reviews of maternity services in Sandwell and the Heart of Birmingham have raised some concerns about quality and safety. The Government has also introduced new national standards for the care of women during and after pregnancy and childbirth, so there are areas for improvement. 1

2 The Trust has found it difficult to recruit doctors and midwives, as there is a lot of competition in the area. The Trust also needs to provide more choice for women with normal pregnancies. What is currently provided? Sandwell General Hospital: Consultant-led delivery suite with labour ward One theatre for operations e.g. caesarean sections Consultant-led antenatal clinics Special baby care for babies over 34 weeks. Women in labour who are less than 34 weeks pregnant must be transferred to a unit offering more complex care City Hospital: Consultant-led delivery suite with labour ward Two theatres for operations with 24hour staffing Consultant-led antenatal clinics Special baby care unit for premature babies from 26 weeks and for babies needing very complex baby care What are the proposals? There are three options for future services until the opening of the new hospital. All three options state that maternity services will no longer be offered at Sandwell, this is because of a case that was put forward by clinicians, that it would not be viable to have the services at Sandwell when City Hospital is a larger hospital with specialist services; space to cope with more births and more physical space to move in to. Option 1 All births, except for home births, will take place at City Hospital: Low risk births in the midwife-led Birth Centre at City Hospital No births or in-patient maternity care at Sandwell Hospital Some antenatal clinics, including routine scans, run by midwives at Sandwell Hospital Special baby care provided at City Hospital Option 2 All births, except for home births, will take place at City Hospital. Some women with complicated pregnancies, who need specialist antenatal care, will be able to get it at Sandwell Hospital. Low risk births in the midwife-led Birth Centre at City Hospital. There would be both consultant-led antenatal care clinics and routine antenatal clinics including scans, run by midwives at City Hospital No births or in-patient care at Sandwell Hospital 2

3 Some antenatal clinics, including routine scans, run by midwives and also a small number of specialist/consultant-run antenatal clinics at City Hospital Option 3 Temporarily relocate all births (normal and complicated) to City Hospital, and then set up a Community Birth Centre in Sandwell that is not attached to a hospital site: Routine antenatal clinics for women with normal pregnancy will continue at Sandwell Hospital Once the Birth Centre is open, women with normal pregnancies will have the additional choice of having their babies in a midwife-led Birth Centre in Sandwell Consultant antenatal clinics and births for women with complications will all be at City Hospital All specialist baby care would be provided at City Hospital The formal consultation runs from 12 th October th January Question and Answer Session Q. Have you consulted midwives separately to obstetricians? A. Yes Q. Have you consulted the Sandwell Local Involvement Network? A. Yes, we have had correspondence with them and they produced a response to the consultation Q. There are significant health inequalities in South West Birmingham. There is also a significant BME community. Have the Trust had any difficulties with communication? Can midwives speak community languages? Perhaps this is why it has been difficult to recruit midwives. A. It seems that part of the problem with recruiting midwives is because of the Trust s reputation and the size of the maternity unit. Midwives would prefer to work in bigger teams and at Trusts such as Birmingham Women s Hospital. However, there have been problems recruiting midwives across the NHS. Midwives have to use an independent translator; the Trust cannot use staff to translate for patients when consent is involved. Q. You need to work with third sector organisations to provide a better service for these communities third sector organisations work with these communities everyday. A. Heart of Birmingham tpct is the Commissioning PCT for South West Birmingham, and they are looking to recruit and employ a third sector commissioner. Attendees requested that the PCT provides the Assembly with an update regarding this post. Cath thanked Jessamy and Amanda for attending the meeting. If organisations are interested in responding to the consultation, they can complete the feedback form online at: 3

4 or or Personalisation an Outline for the Future: Elizabeth Ross, Programme Manager, Adults and Communities Transformation Programme By 2011, the government requires all 150 councils to have made significant steps towards redesign and reshaping of their adult social care services. The overall aim is to provide better care and support to all service users. In Birmingham, change is needed. Adult Care Services costs are rising. Demographic projections indicate that the council will need to increase spend by between 270million and 500million to deliver equivalent services over the next 10 years. The Transformation Programme has been established to: Make sure people have control over their lives Help people to be more independent by developing preventative activities Provide accessible, quality information so people can make informed choices about their lives Support people to identify their own needs through self assessment Make sure people have prompt access to services Change the skills of the workforce to meet personalisation agenda Deliver change in a managed way The programme delivers the following three sub programmes: Understanding future needs: predicting, planning, getting hold of relevant data from sources and managing and sharing data, we will be able to understand what people s future needs might be Supporting the citizen: by making sure that individual outcomes are achieved, with a citizen journey supported by the Council and underpinned by principles of self directed care and the promotion of independence. Self directed support refers to support that is determined and controlled by the citizen, based on an assessment of need and ability Shaping the market place: by working together with people who use services, the public, and with the third sector, we will be able to support individuals and tailor make quality services to meet their needs. These services will offer more choice and control; be cost effective; and support the whole community Q. Third sector organisations will be bidding to deliver services. Is this the cheap option and is Personalisation just a cost cutting exercise? Business transformation means cost avoidance serving more people for the same amount of money. 4

5 A. We will free up resources to give an individual budget. The Local Authority will undertake the assessment and through a brokerage system, ensure their budgets help individuals to meet their needs. The commissioners will be the individuals. The model is already in place with regards to learning disabilities and there will be a transition period to the new model. Q. With regards to service provision, third sector organisations still have overheads to cover and there is no way to generate money to meet these overheads if people with individual budgets are only paying 12/ 13 for a service. A. This is why the transformation team wants to engage with the third sector Q. People can t always self manage there needs to be a statutory responsibility for safeguarding. As time goes on, how will individuals be assessed? A. Central government haven t provided any extra funding. However, qualified senior social workers will still be present and will sign off support package. Shaping the market place will be developed within a managed framework and will be monitored regularly to ensure that outcomes are being met. The impact of individual budgets: Movement of funding to the citizen via individual budgets. This will influence and change how the market provides services Individual budgets will stimulate the markets capacity for delivering services to individuals Opportunities for new user-led organisations to develop new, and improve existing services BCC will need to rethink the role of its own internal services Commissioners will need to become more involved in shaping market activities rather than being dominated with buying and contracting issues Existing suppliers will need to move away from block contracts with the council and move towards individual contracts with the people using the services In other areas, third sector organisations have come together as a consortium to deliver a brokerage service. Next steps: Sharing a supplier sourcing model with providers at constituency based meetings over the next few months It is not limited want to design this with the sector. It needs to be in detailed form by February It will be based on achieving outcomes for individuals and openness of cost and quality standards It will encourage innovation and not focus purely on cost and volume Transformation team want to hear from some suppliers now who have an interest in supplying new innovative services and testing the model 5

6 Contact: Feedback from Birmingham City Council s Third Sector Commissioning Group Cath Gilliver provided an update from the Third Sector Commissioning Group. Cath explained that Birmingham City Council has created this new group to look at commissioning with a view to implementing a simpler and more standardised model across the Council. The first meeting was attended by two of the Assembly Champions, along with Brian Carr and Tracey O Brien from BVSC, and representatives from each Directorate of the Council. The Champions highlighted the impact of the recent commissioning processes on third sector groups in terms of both the administrative burden and the apparent failure to look at the consequences of funding losses and relate them to the care landscape across Birmingham. A second meeting will be held in January, if anyone would like to feed into the meeting, then they can Cath with their comments: cathgilliver@sifafireside.co.uk Discussion: Personalisation Discussion led by Cath Gilliver Attendees agreed that it was not too late to have an impact with regards to personalisation. Cath informed attendees that the Health and Social Care Network of the Third Sector Assembly will be hosting a summit on Personalisation on 22 nd February This event would be the ideal opportunity for the sector to influence the agenda. A suggestion was made to look into the possibility of taking on the Korean work experience Social Policy postgraduate to lead on personalisation for the Network. The student is looking to undertake a placement within the voluntary sector, and this could be the perfect opportunity. Cath agreed to pursue this possibility further with the University of Birmingham. Peter Rookes and Jean Rookes (Birmingham Council of Faiths) informed the group that they sit on the Core Group of the Birmingham Local Involvement Network (LINk). The LINk has a Mental Health Working Group and some of the members of that group are using individual budgets. Cath suggested it would be useful if Peter and Jean could get some feedback from these individuals on their experiences of individual budgets. Peter and Jean agreed to do so. Jen Wells (Cornerstone) was interested in finding out a bit more about the cash flows relating to personalisation it would be interesting to find out how they worked it out. Cath suggested that this could perhaps be included in the personalisation event in February as a workshop. 6

7 Cath thanked everyone for attending the meeting and informed members that the next meeting will be taking place on Monday 22 nd February, venue to be confirmed. 7