Kelham  Hall  Newark  

Nottinghamshire  NG23  5QX  

 Tel:  01636  650000  

www.newark-­‐sherwooddc.gov.uk      

Chairman:  Councillor  P.  Handley  Vice-­‐Chairman:  Councillor  D.  Staples    Members  of  the  Committee:    Councillor  N.R.  Allsopp     Councillor  J.E.  Hamilton     Councillor  M.  Shaw  Councillor  Mrs.  B.M.  Brooks     Councillor  G.S.  Merry       Councillor  D.  Thompson  Councillor  Mrs  M.  Dobson     Councillor  J.  Middleton        Councillor  Mrs  T.  Gurney     Councillor  J.L.  Osborne         MEETING:   External  Relations  and  Partnerships  Overview  and  Scrutiny  Committee    

  DATE:     Wednesday,  5th  September  2012  at  5.30pm    

  VENUE:   Lady  Chapel,  Kelham  Hall    

You  are  hereby  requested  to  attend  the  above  Meeting  to  be  held  at  the  time/place    and  on  the  date  mentioned  above  for  the  purpose  of  transacting  the    

business  on  the  Agenda  as  overleaf.       NOTES       Tea,  coffee,  water  and  biscuits  will  be  available  for  Overview  and  Scrutiny  Committee  Members  

in  the  Dining  Room  at  4.30  p.m.       If  you  have  any  queries  please  contact  Catharine  Saxton  on  01636  655247.    

AGENDA    

    Page  Nos.    1.  

 Apologies  for  Absence  

 

2.   Minutes    To  receive  the  minutes  of  the  meeting  held  on  4th  July  2012.    

1  -­‐  4  

3.   Declarations  of  Interest  by  Members  and  Officers      Declarations   of   interest   by   party  members   and   officers   and   as   to   the   party  whip.    

 

4.    

Newark  and  Sherwood  Clinical  Commissioning  Group  Presentation   Verbal  

INFORMING  FUTURE  CABINET  DECISIONS    

5.   Work  Programme  2012/13   5  -­‐  6  

PERFORMANCE  MANAGEMENT    

6.   Newark  and  Sherwood  Homes  Monitoring  Report    

To  Follow  

7.   Newark  and  Sherwood  Homes  Quarterly  Report   7  -­‐  12  

ADDITIONAL  ITEMS  

8.   East  Midlands  Ambulance  Consultation   13  -­‐  22  

9.   Family  Intervention  Project  Worker  Update   23  -­‐  38  

CONFIDENTIAL  AND  EXEMPT  ITEMS  None.    

 

DATE  OF  NEXT  MEETING    The  next  scheduled  meeting  of  the  Committee  is  to  take  place  at  5.30  pm  on  Wednesday,  24th  October  2012.    

NEWARK AND SHERWOOD DISTRICT COUNCIL Minutes of the meeting of the EXTERNAL RELATIONS AND PARTNERSHIPS OVERVIEW AND SCRUTINY COMMITTEE of Newark & Sherwood District Council held in the Lady Chapel, Kelham Hall, Newark on Wednesday, 4th July 2012 at 5.30 pm. PRESENT: Councillor D. Staples (Vice-Chairman)

Councillors: Mrs B.M. Brooks, Mrs M. Dobson, Mrs T. Gurney, J.E. Hamilton, G.S. Merry, J.L. Osborne, M. Shaw and D. Thompson.

ALSO IN ATTENDANCE: Councillors: Mrs N.A. Armstrong, T.S. Bickley and R.J. Jackson. Councillor D. Staples – Vice-Chairman, chaired the meeting due to the apology for absence from the Chairman - Councillor P Handley. 9. APOLOGIES FOR ABSENCE

Apologies for absence were submitted from Councillors N. R. Allsopp, P. Handley and J. Middleton.

10.

MINUTES

AGREED that the Minutes of the meeting held on 30th May 2012 be approved as a correct record and signed by the Chairman.

11. DECLARATION OF INTERESTS BY MEMBERS AND OFFICERS NOTED: that no Member or Officer declared any interest pursuant to any statutory requirement in any matter discussed or voted upon at the meeting.

INFORMING FUTURE CABINET DECISIONS 12.

PROPOSED WORK PROGRAMME The Committee considered the report of the Director – Customers, which provided Members with information to form their workplan for the forthcoming year. The report reminded Members of the national financial and policy content Newark and Sherwood District Council was operating in and of its response to it through the setting of new priorities and moving to a commissioning approach. The report linked a suggested work plan for Members to the Council’s priorities, which could be used to directly influence future commissioning activity, whilst also including feedback from Committee Members about issues they may want to see scrutinised. Members agreed to establish a Task and Finish Group to consider the Health Agenda, the first meeting to commence as soon as practicable after the Clinical Commissioning Group’s presentation to the 5th September 2012 meeting of the Committee. Members felt that due to confidentiality issues the Task and Finish Group should convene in camera.

1

Members also requested that the Deputy Leader of the Council be invited to a future meeting to provide an update of the work of the Health and Wellbeing Board.

AGREED that: (a) the content of the report be noted; (b) the Deputy Leader of the Council be invited to a future meeting of the

Committee to provide an update regarding the work of the Health and Wellbeing Board;

(c) the 2012-2013 Workplan as appended to the Minutes be approved; (d) the Committee establish a Task and Finish Group to consider the

Health Agenda; and (e) the remit and membership of the Health Task and Finish Group as

follows:

(i) Remit for the Health Task and Finish Group

• What are the Clinical Commissioning Groups (CCG) commissioning plans and themes?

• What are the Housing Working Board (HWB) commissioning plans?

• To what extent will they meet the needs of local communities and what gaps will exist?

• What can be done from a social health prospective to prevent people becoming patients in the first place?

• What are the opportunities for mapping joint outcomes with the Council around specific priorities and developing joint commissioning?

• Could this lead to the External Relations and Partnership Overview and Scrutiny Committee making recommendations to Cabinet in phase two of the Council’s commissioning projects?

(ii) Membership

Councillors: Mrs B. M. Brooks, Mrs M. Dobson, Mrs T. Gurney, J. E. Hamilton, P. Handley and D. Staples.

(ii) the Health Task and Finish Group would be considered in camera.

PERFORMANCE MANAGEMENT 13.

HOUSING REVENUE ACCOUNT PERFORMANCE REPORT TO 31ST MARCH 2012 The Committee considered the report of the Director – Resources, which compared the actual expenditure and income within the Housing Revenue Account for the period ending 31st March 2012 with the profiled budget for that period. Variances were detailed in the report, although the outturn was broadly in line with budgets.

2

AGREED that Members and Officers continue to monitor the Housing Revenue Account income and expenditure and officers work with Newark and Sherwood Homes to provide further detailed information on expenditure to the Committee to allow additional scrutiny of the Housing Revenue Account (HRA) business plan.

ADDITIONAL ITEMS 14.

SHERWOOD FOREST HOSPITALS NHS FOUNDATION TRUST The Director – Customers informed Members that the follow up report from Sherwood Forest Hospitals NHS Foundation Trust should have been presented to the meeting by the Chief Executive Martin Wakely. Contact had been made with Sherwood Forest Hospitals to try to secure a report for the meeting, but unfortunately nothing had been forthcoming. The Chairman suggested that a letter be forwarded to the Chairman of the Sherwood Forest NHS Foundation Trust raising the Committees concern regarding the high turnover in Chief Executives, as Mr Wakely was the fourth Chief Executive in three years, and to express disappointment that the report was not forwarded to the July meeting of the Committee as agreed at the 29th February 2012 meeting. A report was requested for the 5th September 2012 meeting of the Committee.

AGREED that a letter be sent on behalf of the Committee from the Chairman of the Committee to the Chairman of the Sherwood Forest NHS Foundation Trust, raising the Committee’s concerns regarding the high turnover in Chief Executives and asking why a report was not forwarded to the July meeting of the Committee with a representative as agreed at the 29th February 2012 meeting of the Committee. An invitation be extended to the Trust Chairman to attend the 5th September 2012 meeting of the Committee.

15. SOCIAL JUSTICE: TRANSFORMING LIVES – UPDATE The Committee considered the report of the Business Manager – Policy and Commissioning, which informed Members on the Council’s activities to address the Government’s Social Justice strategy. The report considered the key themes of the Social Justice Strategy and how improvements to people’s lives could be achieved at a local level. Appendix A to the report provided an update on the types of activities provided by the Council to contribute towards the Social Justice Strategy, information which Members had requested at the 18 April 2012 meeting of the Committee. In answer to a Members request as to whether the Social Justice Strategy could be summarised it was confirmed that this would be undertaken. A Member sought clarification as to whether there were any significant gaps or issues within the Social Justice Strategy. It was confirmed that under the current economic climate the Authority was constrained in what could be achieved. Children/families in

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poverty were considered as an area, which would increase. It was felt that the next few years would be a challenge due to shrinking resources.

AGREED that: (a) the report be noted; and (b) a summary of the Social Justice Strategy be compiled for Members.

(Councillor D. Thompson left during consideration of the above Minute) The meeting closed at 6.32 pm Chairman

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6

EXTERNAL RELATIONS AND PARTNERSHIPS AGENDA ITEM NO. 7 OVERVIEW AND SCRUTINY COMMITTEE 5TH SEPTEMBER 2012 NEWARK AND SHERWOOD HOMES REPORT PRESENTED BY: Stephen Feast – Director, Newark and Sherwood Homes EXECUTIVE SUMMARY To provide the Committee with information on Newark and Sherwood Homes income recovery performance for the first quarter of 2012/13, and the work being progressed to manage the impacts of Welfare Reform. RECOMMENDATION The Company’s strong performance in arrears recovery and costs within its peer group and the proactive work Newark and Sherwood Homes is undertaking to prepare for and to mitigate the risks associated with Welfare Reforms be noted. 1.0 Background 1.1 At its meeting on 30th May 2012, the External Relations and Partnerships Overview and

Scrutiny Committee received a report which updated Members on the actions within Newark and Sherwood Homes Business Plan 2012-17 to support the priorities identified by members of the Committee.

1.2 The report also provided information on the outturn income recovery figures for 2011/12.

As part of the Committee’s considerations, Members raised concerns about the tenant’s welfare and requested that a three monthly report highlighting the arrears figures be presented to the Committee, in order that Members could be involved as soon as possible to resolve any problems.

1.3 This report provides arrears performance information as required and a summary of the

proactive work Newark and Sherwood Homes is progressing seeking to minimise the financial impacts of the Government Welfare Reform changes.

2.0 Performance Information 2.1 2012/13 Quarter one income management performance information is provided below: Percentage of rent collected (Upper Quartile 2010/11 = 99.13%) 2011/12: Out-turn: 99.18% 2012/13: Q1 Out-turn 97.78% 2012/13: Q1 Target 96.0% Amount of arrears as a percentage of debt (Upper Quartile 2010/11 = 1.46%)

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2011/12: Out-turn: 1.07% 2012/13: Q1 Out-turn 1.35% 2012/13: Q1 Target 1.40% 2.2 In both instances, the Company’s performance is in line with the profiled monthly target.

The annual targets set for 2012/13 are based on continual improvement and exceed upper quartile performance when compared to other similar sized ALMOs who are acknowledged to be the highest performers in the housing sector.

Housing Quality Network (HQN) – Analysis of local authority housing

management performance 2009/10 “While councils with ALMOs account for only just over a third of all

stockholding local authorities, ALMOs form two thirds of those landlords classed as ‘top performers’ in 2009/10. This appears to support the case that this form of management is particularly effective.”

- Hal Pawson, January 2011 2.3 2012/13 Quarter One performance is particularly pleasing given the challenging economic

circumstances, which clearly impacts on the personal finances of tenants and their ability to pay their rent and other charges.

2.4 The Company’s approach has, for some years, focussed on proactive support in addition to

appropriate interventions to deliver excelled levels of rent recovery. This approach has been enhanced through Newark and Sherwood Homes revising their Financial Inclusion Policy in November 2011. This Policy sets out how the Company will support tenants, signpost to money and debt advice and help to reduce fuel poverty amongst the most vulnerable groups.

2.5 Increasing numbers of tenant households are requiring financial inclusion support to

enable them to sustain their tenancies through meeting financial obligations. This situation is expected to increase further following the Welfare Reforms being implemented from April 2013.

3.0 Cost Performance Information 3.1 In delivering this performance, the Company has maintained low cost compared to its

peers. This is demonstrated by the HouseMark dashboard at Appendix A, which identifies low cost, high performance services in rent arrears. This information is collated by HouseMark and independently validated.

3.2 This information gives the Committee independent validated information providing

assurance of efficiency and high performance by Newark and Sherwood Homes in delivering landlord services for the Council.

4.0 Preparing for Welfare Reforms 4.1 The Company’s approach to income management continues to be enhanced to meet the

forthcoming challenges of Welfare Reform to ensure income levels are maintained in line with the Company’s Financial Business Plan and the Council’s Self Financing Housing Revenue Account Business Plan.

8

4.2 The Welfare Reforms are anticipated to make the collection of income more challenging in the future and to have a detrimental impact on arrears performance. In particular the introduction of the Under Occupation scheme for Housing benefit, the Housing benefit cap and the implementation of Universal credit are key challenges. The Company is working with Council colleagues within Revenues and Benefits to coordinate work and share information as required.

4.3 The Company is seeking to minimise the risks of Welfare Reforms and a range of tasks are

being progress aimed at communicating what the changes are, the likely impact on household finances and what actions are required now to prepare for the changes. As part of this work, Members were invited to a briefing session in May 2012 on Welfare Reforms to support understanding of the changes and the potential impact to the Company and the Council.

4.4 A focus on the collection of income has always been a priority for Newark and Sherwood, however this is even more business critical now following the implementation of the Self Financing Housing Revenue Account in April 2012. As part of the Self Financing implementation consideration was given to the Welfare Reforms and financial modelling was undertaken to demonstrate the impact to the Financial Business Plan of increasing rent arrears. The standard inputs and future assumptions in the base financial business plan include increases in rent arrears which relate directly to the Welfare Reform changes.

5.0 Onward Management 5.1 A new suite of financial performance data focused on the key risks to the Self Financing

Business Plan has been developed and is included elsewhere on this agenda. This suite of data includes performance of income recovery and has been developed to provide a strategic focus on the key risks associated with Self Financing.

6.0 RECOMMENDATION Members are asked to:

(a) Note the Company’s strong performance in arrears recovery and costs within its peer group; and

(b) Note the proactive work Newark and Sherwood Homes is undertaking to prepare for and to mitigate the risks associated with Welfare Reforms.

Background Papers

Nil.

For further information please contact Stephen Feast, Director, Newark and Sherwood Homes.

Stephen Feast Director, Newark and Sherwood Homes

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10

Appendix A

TSA Standard Summary for Newark and Sherwood Homes

TSA Standard Cost KPI Cost KPI Quartile

Quality KPI

Quality KPI Quartile

Newark & Sherwood Homes (2010/2011)

Newark & Sherwood Homes (2010/2011)

Quality of Accommodation

Direct CPP of Major Works & Cyclical Maintenance

Percentage of tenants satisfied with overall quality of home (GN)

Percentage of dwellings failing to meet the Decent Homes Standard

Repairs and Maintenance

Direct CPP of Responsive Repairs & Void Works

Percentage of tenants satisfied with the repairs and maintenance service (GN)

Repairs completed ‘right first time’

Average time in days to re-let empty properties

Tenant choice and customer service

Direct CPP of Housing Management

Percentage of tenants satisfied with overall services provided (GN)

Percentage of respondents who felt staff were able to deal with their problem (GN)

Current tenant rent arrears as % of rent due

Percentage of tenants satisfied with complaints handling

Neighbourhood and estate management

Direct CPP of Estate Services

Percentage of tenants satisfied with their neighbourhood as a place to live (GN)

Anti Social Behaviour and security

Direct costs per case of Anti social behaviour

Percentage of respondents satisfied with anti-social behaviour case handling

Tenant Empowerment Direct CPP of Resident Involvement

Percentage of tenants satisfied that views are being taken into account (GN)

Care and Support Needs

Direct SH & SP costs as % adjusted operating costs

Percentage of supported housing tenants satisfied with the services provided by their landlord

Quartile Key Upper

Quartile Middle Upper

Median Middle Lower

Lower Quartile

N/A No Data

Valid dataset Small dataset Key CPP Costs Per Property KPI Key Performance Indicators GN General Needs SH and SP Supported Housing and Supporting People Services

11

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EXTERNAL RELATIONS AND PARTNERSHIPS AGENDA ITEM NO. 8 OVERVIEW AND SCRUTINY COMMITTEE 5TH SEPTEMBER 2012 EAST MIDLANDS AMBULANCE CONSULTATION REPORT PRESENTED BY: GED GREAVES, BUSINESS MANAGER - POLICY AND COMMISSIONING Executive Summary To improve performance and respond to financial challenges, East Midlands Ambulance Service has developed proposals for a review of its estate and operations. Consultation is underway and this report sets out the proposals and seeks the Committee’s comments. Recommendation That the Committee’s views are forwarded to East Midlands Ambulance Service. 1.0 Background 1.1 East Midlands Ambulance Service (EMAS) has not been achieving its response time targets,

these are:

• A8, to provide an emergency response to 75% of patients with life threatening emergency conditions within 8 minutes of the call

• A19, to provide an ambulance to 95% of patients with the most life threatening conditions within 19 minutes of the call

1.2 Despite the response times, EMAS has been able to demonstrate appropriate clinical care evidenced by the number of compliments received and reasonable performance against its peers.

1.3 In order to improve performance, EMAS has been reviewing its response approach. It has

already made some improvements which include:

• Investment in the Clinical Assessment Team (to increase the number of calls resolved by telephone)

• Removing the ‘ring fence’ on Emergency Care Practitioners. • Piloting urgent care vehicles, Police/Ambulance cars and hospital liaison officers

1.4 However, these have been possible only with additional non-recurrent funds and transformational support.

1.5 EMAS, in addition to delivering a high quality clinical service and meeting the performance

standards is also required to work within the funds available. For the next few years, it is required to achieve efficiencies of £29.6m.

1.6 A review has been undertaken to see how EMAS can not only meet the challenge of national

targets but also achieve local targets and improve the support provided to its staff. The programme has included: • A review of its Estate and how it is used

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• A review of the ‘Service Model’, i.e. the nature of the response that EMAS give when it receives a 999 call

• An independent review, jointly commissioned with the Primary Care Trust Clusters that provide NHS funding to EMAS.

1.7 Each of these reviews have been supported by an expert modelling company using EMAS

activity data. 1.8 To continue to implement its quality strategy and to meet current and future performance

standards, EMAS has to change. If it chooses not to implement change, it will be unable to meet patients’ needs (as defined by response times), nor its financial challenges.

1.9 An Estates Plan and Service Model have been developed to show how it can achieve current

performance standards, using current resources. The independent review will indicate whether the Trust can achieve even more within its current resource or whether further change and/or funding is needed to meet the new national standards and performance at county level.

1.10 EMAS anticipate that any funding gap will require the Trust to find further innovations to

help performance to improve. 1.11 The EMAS briefing paper at Appendix 1 describes current operations and the need to

change. Appendix 2 lists, for postcodes within Newark and Sherwood, performance against the two measures detailed in paragraph 1.1 above. It is evident that, for some postcodes, response rates consistently underperform.

2.0 Estate Plan 2.1 The Estate Plan describes the current estate, identifies a £13m backlog maintenance deficit

and confirms that the estate undermines the ability to respond quickly to calls. 2.2 The strategy proposes the establishment of ‘hubs’, which would be larger stations, which are

strategically placed to support crews based at Tactical Deployment Points (‘standby points’) when they are not with patients.

2.3 This arrangement will not only lead to improved performance (by up to 5% A8 target), but

also give the opportunity for the Trust to give better support to its clinical staff. Hubs will have the staff and facilities for clinicians to be provided with serviced, clean and stocked vehicles at the beginning of each shift. They will also provide more opportunity for clinicians to meet with their team leaders, improving communications and early resolution of any issues.

2.4 Combining the best of external advice and internal knowledge EMAS propose, subject to

consultation, to move from a model of 66 ambulance stations and 153 “standby points” to a model consisting of 13 new build hubs (see Table 1) and 131 tactical deployment points (see Table 2 for proposed Nottinghamshire/Lincolnshire points) of which most will be facilitated either with a modular unit or with a partner organisation.

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Table 1 – Proposed hubs

Derby Loughborough Algarkirk Chesterfield Northampton Elsham Nottingham Kettering Skegness Kings Mill Lincoln Sleaford Leicester

Table 2 – Tactical deployment points in Nottinghamshire/Lincolnshire

Nottinghamshire Lincolnshire Arnold Beechdale Carlton Eastwood Hucknall Kings Mill

Newark Retford Stapleford West Bridgford Wilford Worksop

Lincoln Barton Scunthorpe Brigg Grimsby Gainsborough Market Rasen Louth Mablethorpe

Horncastle Skegness Sleaford Boston Grantham Holbeach Spalding Bourne Stamford

2.5 The proposed configuration will support its ambitions for providing better support to its clinical staff. The proposed thirteen hubs will provide an environment where: • Staff and team leaders will have the opportunity to meet regularly at the beginning

and end of shifts, gaining access to support from colleagues and better communication more generally.

• EMAS will be able to considerably improve the way in which it cleans, services and re-stocks vehicles ready for staff to use at the beginning of each shift.

2.6 EMAS will provide training facilities to enable local provision of training, education and

development reducing the need for staff to travel long distances to the three existing training sites.

2.7 It has considered the economics of reconfiguring its estate and outlines how over a five year

programme the proposed model can be funded through capital receipts and how it will provide lower running costs and a considerable reduction of backlog maintenance.

2.8 EMAS will also maintain a presence in all of the towns where it currently has stations. 3.0 EMAS Service Model 3.1 This sets out how EMAS will ensure that it provides patients with the right response when a

999 call is made. 3.2 Some patients will be offered advice over the telephone, by an expanded Clinical

Assessment team, based in the call centres. The Trust aims to increase the number of calls

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resolved in this way, in doing so it ensures that its ambulance crews are reserved for those patients that need that service.

3.3 When EMAS send an ambulance crew, it will respond at one of three levels:

• A Paramedic response, where there is an emergency needing a fast response • An Emergency Care Practitioner, where nurses or paramedics with extra skills can

help a patient to access other services and/or to stay at home • An urgent care response, where there is not a life threatening emergency, the

patient has been assessed by a healthcare professional and a journey to a hospital or other healthcare facility by ambulance is needed.

3.4 The model allows the Trust to identify how many staff of each skill level are needed, the hours of work that need to be covered (shift patterns) and what type of vehicle should be used (e.g. double crew ambulance, fast response vehicle or urgent care vehicle).

4.0 Independent Review 4.1 EMAS and its Commissioners have set up an independent review of funding levels. The

review to be published in September 2012 will identify whether EMAS can achieve current performance standards within the existing funding structure.

4.2 However, the modelling work supporting the service model and estate strategy has

identified that the Trust is not able to achieve current or future performance standards unless it changes the way it works and/or has additional funds.

4.3 The review shows that the Trust can achieve the national performance targets, at Trust level,

with current resources but with limited ability to implement the efficiency programme. 4.4 The review also shows that the Trust could, if it implemented an optimisation programme

(including the shift changes, estates strategy and service model) achieve the national targets and make a contribution to the efficiency requirements.

4.5 However, the review also shows that achieving consistent performance across all divisions

would not be possible. 4.6 Should these findings be confirmed in the independent review, then the Trust will need to

negotiate additional funds and/or identify further innovations to address the performance gaps. A number of new approaches are currently being trialled in readiness for discussions with commissioners for 2013/4 e.g.

• The Police/Ambulance pilots (POLAMB) in town and city centres – ensuring the ability to provide a fast response in areas where crime, violence or aggression is probable.

• Cycle Response Unit, in Leicester City Centre, allowing faster response where heavy traffic is often a hindrance to four wheeled vehicles.

• Mobile treatment centres, providing support where crowds gather (e.g. night time city centres) and where ‘drying out’ facilities will help to prevent the need for a journey to hospital.

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• Community First Responders and Fire Service Co-responders, where volunteers can help to provide immediate assistance whilst the ambulance is dispatched.

5.0 Issues for Consideration 5.1 The Committee will note from Table 1 and Table 2 that the district will not include a “hub”.

The nearest hubs will be located in Sleaford, Lincoln and Nottingham. The district is earmarked for three tactical deployment points; Newark, Newark North and New Ollerton. The Committee may wish to consider whether on balance this may provide an improvement on current provision, particularly given the tactical deployment point proposed for New Ollerton.

5.2 A range of proposed tactical deployment points are on the periphery of the district including:

Arnold, West Bridgford, Mansfield, Bingham, Retford and Worksop in Nottinghamshire and Sleaford and Grantham in Lincolnshire.

5.3 The Committee may be concerned by the findings of the modelling work which suggests that

there may be a risk that, despite the proposed changes, performance standards may still prove to be challenging and particularly so for rural areas. This may be an issue that members wish to explore with EMAS at the Committee’s next meeting on 24 October 2012.

5.4 Members may recall that a presentation on the First Responder service was given by Mr. Fox

representing Lives (Helping Save Lives in Lincolnshire) to the Committee on 14 September 2011. The presentation highlighted the important and growing role played by volunteers when responding to emergencies. The Committee may wish to consider raising this type of volunteering with Parish Council’s and local residents to encourage further people to volunteer and help fund-raise. Schemes currently operate in Southwell, Farndon, Farnsfield, Ollerton and North Muskham.

6.0 RECOMMENDATION

That the Committee’s views are forwarded to East Midlands Ambulance Service to inform the consultation.

Background Papers Media release: Better response, better performance and better care, 17 July 2012 EMAS Board report: Being There for Patients – Our Programme to Improve Response Times, 23 July 2012 For further information please contact Ged Greaves on extension 5231 Kirsty Cole Deputy Chief Executive

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APPENDIX 1

EMAS’ Being the Best change programme Briefing paper

Present operations East Midlands Ambulance Service operates 66 ambulance stations and 153 standby points (these are lay-bys, car parks, or other areas where our crews can be strategically placed to respond quickly to the next 999 call received). We respond to 999 calls in double crewed ambulances or fast response cars, and can request support from the air ambulance. An ambulance station is simply a garage with accommodation and provision for a small store of consumables; they are a base where crews coming on duty change over with crews at the end of their duty and to take a meal break at some point during the shift. Our treatment centres are at the scene i.e. we treat people who have been involved in a road traffic collision in their vehicle, in the layby where they have been thrown, and in our ambulance vehicles. No patient care is delivered from any of our ambulance stations. At the start of their shift, the crew check their vehicle (providing there is not an emergency call to attend immediately) to ensure it is clean, stocked and ready to go – this includes checking tyre pressure, that the lights and it is fully fuelled. Having checked the vehicle it is very likely the crew will be asked to go to a standby point or to respond to an emergency 999 call (on average we receive a new 999 call every 45 seconds). We have used standby points for several years and the location where crews ‘standby’ is determined by our Emergency Operations Centre (EOC) which uses historic activity, predicted demand and refers to the number of available resources we have to prioritise where our crews need to be. The pattern of demand changes throughout the day and night, and so our standby points change to reflect that. Once the crew are sent to an emergency, they will attend the location and deal with the needs of the patient. This may result in a journey to hospital, referring the patient to a more appropriate health service, or treating the patient at the scene. When treatment is provided at the scene, having given the patient the necessary care and advice, completed the paper work and made themselves ready, the crew will be available in that location to respond to the next emergency call. If the patient’s condition requires further assessment or treatment at hospital the crew assess which hospital the patient should go to, take them there and provide a clinical handover to the medical staff at the chosen hospital. Having done this, cleaned the vehicle and restocked any items needed, the crew are available again for the next 999 call, or to be sent to a new standby point. As each emergency call is processed in EOC the nearest available crew is identified and tasked to attend that call. For example purposes only and to help put this into context, a crew from location A may attend their first call in location A and take the patient to the nearest major trauma centre, location B. When this call is complete, the crew now being available in location B can be tasked to the next emergency or be deployed to a standby point, location C. This is not happening to this vehicle alone but to all the crews across the East Midlands and to help us cover the region, our EOC maintain a kaleidoscope of activity matching calls by type and priority to available resources by crew grade and type. So the vehicle that you may see sat on standby waiting for the next call in your local town may not be your town’s vehicle, but it is a highly skilled clinician in an emergency vehicle with life-saving equipment and drugs ready to a call.

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The perception of crews sitting in ambulance stations waiting for the next call is simply not possible and has not been the case for over twenty years or more. Why we need to change The present system described above has considerable inefficiencies that impact on our ability to get to people quickly, to meet the national performance standards and on staff welfare. Empty, outdated and in the wrong place: Many of our stations were built several years ago and clearly communities have grown and road networks changed resulting in several of our stations no longer being in a place where we can respond to people quickly. Many of them are dated which means we need to spend c. £13 million investment to get them to a good standard. Better cover for staff shortages: The inefficiencies arise from having many small stations where only one or two vehicles are based; this leaves us vulnerable to crew shortage if one member of staff fails to present for duty (i.e. sickness) and can leave the area without adequate cover while alternative arrangements are made. By having fewer stations covering shortages caused by sickness or injury, will be much more effectively managed. Better staff welfare: We presently operate from 153 standby points and most are not facilitated i.e. they are a road layby or car park where the crew member sits in the vehicle until the next emergency call is allocated to them. The 131 tactical deployment points (TDPs) will be facilitated meaning crews will have access to toilet facilities, a kitchen and somewhere to eat and rest while waiting for their next call. Crews will be sent to the TDPs as they are currently sent to standby by EOC prioritising their use as explained previously in this document. When not on meal break it is anticipated that these TDPs will be like the stations are now, for most part unoccupied because our crews will be busy out on the road responding to calls. The benefit to EMAS is that a TDP is significantly smaller than the traditional ambulance station thus incurring significantly less running costs and maintenance. We have proposed that the there should be a TDP within the immediate area (i.e. within 1 ½ mile) of the current station’s locations, and in some cases the TDP will be exactly where the ambulance station is, it will simply be a smaller premises. Infection prevention and control: The cleaning cycles required for prevention of infection transmission are very challenging with a large number of small sites, as considerable time is wasted by the cleaning crews travelling between sites to clean only one or two vehicles. Fewer larger sites enable effective cleaning performance. Clinicians can be clinicians: Multiple sites result in staff having to check and prepare their own vehicles; on a larger site this could be efficiently undertaken by a specialist ‘make ready team’, thus resulting in ambulance crews being able to operate as a clinician at the start of their shift rather than spending time making basic vehicle checks. Management support: Staff on smaller stations can go for days not seeing their line manager because of the shift systems currently in operation and because some managers have responsibility for several stations. With 13 hub sites there will be a line manager available 24/7, allowing better communication and staff engagement and support. It is important to note that no decisions have been taken, we have made proposals and we want to consult on those. Our consultation will launch in September and run for three months. Views expressed during that time will be considered and final plans are due to go to our January 2013 Trust Board. It is envisaged that the overall programme will take four years to complete from the time commencement.

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APPENDIX 2 Performance against A8 standard to provide an emergency response to 75% of patients with life threatening emergency conditions within 8 minutes of the call

Performance against A19, to provide an ambulance to 95% of patients with the most life threatening conditions within 19 minutes of the call

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

Performance against A8 target

Target NG21 NG22 NG23 NG24 NG25 Total

60.00%

65.00%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

100.00%

Performance against A19 target

Target NG21 NG22 NG23 NG24 NG25 Total

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EXTERNAL RELATIONS AND PARTNERSHIPS AGENDA ITEM NO. 9 OVERVIEW & SCRUTINY COMMITTEE 5TH SEPTEMBER 2012 FAMILY INTERVENTION AND TROUBLED FAMILIES UPDATE REPORT PRESENTED BY: Lisa Lancaster - Community Safety Business Manager Executive Summary At its meeting in January 2012, a report came to ERPOS to discuss the Family Intervention Project. As a result, members of the committee asked for further investigation into expanding the project in Newark and Sherwood. This investigation was delayed due to the finalisation of the Governments ‘Troubled Families’ Scheme which it was anticipated would allow for an increase in staffing for this type of work. The ‘Troubled Families’ Scheme has now been finalised for Nottinghamshire and this report is to make members aware of how the roll out will work in Newark and Sherwood. Recommendation That the report is noted

1.0 Background 1.1 In 2010 Newark and Sherwood District Council invested funding in a Family Intervention

Officer and due to the success, invested further funding in a second post in 2012 (the County Council also mainstreamed the first post in 2012). Newark and Sherwood District Council strongly supported the project but with the current economic situation, even though there is evidence to say that in the long term these officers can dramatically reduce cost to the public sector, there was little chance at this project expanding further.

1.2 However as a result of the riots seen in England in 2011, the Government decided that further

investment was needed nationally in reducing the social issues linked with Troubled Families and the Troubled Families Programme was launched in December 2011. The aim was to provide more targeted support, with families getting one dedicated worker rather than a “string of well-meaning, disconnected officials” – which was the core element of Family Intervention Work. David Cameron spoke of “turning around the lives of 120,000 families”.

1.3 As a result of this the government pledged a total of £448 million over 3 years to a ‘Troubled

Families’ project to specifically support families with worklessness, children who were not attending school, and children and young people causing anti-social behaviour and crime. Although a large amount of money, the government were also expecting a substantial amount of match funding from local services, however this could be made up by existing services. The money also had some elements of ‘Payment By Results’, weighted most heavily on getting people back into employment.

1.4 Earlier in the year as part of this program, each County Council were asked to identify, with

partners, likely families who hit the specific triggers. Initial figures from the Government

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suggest that there would be around 1580 such families in Nottinghamshire. It is estimated that out of the 1580 families in Nottinghamshire to target over the three year period, 228 (just under 15%) are from our district.

1.5 The County Council, with support from the districts, indentified 439 families spread across the

county who hit the triggers, which it would work with in the first year, however it is not yet clear how many of these are from Newark and Sherwood. The Department for Communities and Local Government have then issued funding to the county to roll out the program. This included £3200 per family ‘attachment fee’ and £175,000 to support the set up of the program.

2.0 Impact for Newark and Sherwood 2.1 Although the funding has been issued to the County Council, there has been very close

working with the Districts, with an executive steering group comprising of District Chief Executives, and an operational group comprising of District Community Safety Leads. The program will also be rolled out at a district level with teams based locally.

2.2 For Newark and Sherwood the Project – re-named ‘Supporting Families’ does mean the

recruitment of an additional Family Intervention Worker by the county council to work solely for in our area – taking our total up to 3 FTE’s. There will also be 1.5 FTE posts for District Co-ordinators. These posts are similar to Family Intervention Officers but carry a higher workload of less intense cases. There will also be 0.5FTE team leader, to assist in the management of the team.

2.3 These staff will be based within Kelham Hall, and funding has been provided through the

County Council from the DCLG funds to support the officers at the building and cover adhoc costs associated with administration, management and overheads from the team.

2.4 At the current time, recruitment is ongoing for these new posts, and it is hoped that the team

will start to be put in place in September 2012. District representatives have been involved in the recruitment process and the team will be fully integrated with our district services, although the criteria set out by the scheme is quite precise and cannot be altered to radically locally to ensure the Payment By Results element is met.

2.5 The full business case from the County Council for the project is attached at appendix A. The

project is still in its early stages but further updates will be available to councillors should they request as the project continues.

3.0 Recommendation That the report is noted. Background Papers NA For further information please contact Lisa Lancaster on ext 5232. Lisa Lancaster – Business Manager Community Safety

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June 2012

Children, Families and Cultural Services

Troubled Families

Business Plan 012/13

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1

Contents

1. Introduction Pg 2 2. The Work of The Programme Pg 2 3. Governance of the Programme Pg 6 4. Delivery of the Programme Pg 6 5. Partnership Delivery in Districts Pg 7 6. Service-User Involvement Pg 7 7. Time Period of This Plan Pg 8 8. Equality & Diversity Pg 8 9. Budget Pg 9 10. Risks to This Plan Pg 11 11. How Will We Monitor Our Progress Pg 11 12. Action Plans Pg 12

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2

1. Introduction The Troubled Families Programme was launched in December 2011 with the stated aim of providing more targeted support, with families getting one dedicated worker rather than a “string of well-meaning, disconnected officials”, and with the stated aim of “turing around the lives of 120,000 families”. (David Cameron, speech 15th December 2011). The Government identified 1580 families in Nottinghamshire using Poverty indices estimating that these families cost Nottinghamshire £118.5 million. This plan will describe Nottinghamshire’s response to the ‘Troubled Families’ agenda, based on the data collected in the first two months of the Programme, the funding agreed to support the Programme and the priority groups of families identified to be worked with in the first year ( 2012/13). Nottinghamshire County Council is committed to making Nottinghamshire a place where children are safe and happy, where everyone enjoys a good quality of life, and where everyone can achieve their potential. The Troubled Families Programme aims to ‘Transform Lives’ by engaging with children and young people involved in Crime and Anti-Social behaviour, who are not attending school and who have parents who are not in work. 2. The Work of the Programme The Troubled Families Programme is a national 3 year programme which is targeted at the most difficult to engage children, young people and their families. In Nottinghamshire we will be describing this as the ‘Supporting Families Programme’. The Programme is funded by central government on a payment by results basis which is focussed on three outcomes:

• reducing criminal activity and anti-social behaviour in children and young people

• improving school attendance in children and young people • encouraging parents into work.

In addition Local Authorities have been asked to identify ‘Local Eligibilty Criteria’ which can be used in combination with either the criminal justice or education outcome criteria to determine which families might benefit most from this Programme. The Programme recognises that the causes of these behaviours are complex and multi-layered and thus will engage with a range of partners to deliver the work across the County. It will also link into National and Local strategies on reducing Poverty and the European Social Fund Programme for Families with multiple problems. (East Midlands Services contract has been awarded to ‘Working Links’).

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3

The Programme will also be shaped by local policies in relation to reducing crime, anti-social behaviour and improving school attendance. Over the next three years additional families will be identified using similar criteria, with the Government yet to specify how frequently they will require revision of the ‘Troubled Families’ data. The Troubled Families Programme will also be evaluated on its ability to reduce overall County and District Council spending on individual families and will be using a range of local and Government-led cost-benefit analysis tools to demonstrate its efficiency. Chart 1 – Breakdown of Child Records (c.2,349) identified in initial data collection for the Troubled Families programme.

Data set: 13/06/2012 (Awaiting benefits status from DWP)

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4

Chart 2 – Breakdown of Child Records (428) identified in initial data collection for the Troubled Families programme.

Data set: 13/06/2012 (Awaiting benefits status from DWP)

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5

Map 1 – The 385 Nottinghamshire Troubled Families identified by unique address (mapped at postcode level) for those children meeting the ASB & Crime and/or the

Education criteria and who are known to Social Care (428 child records).

Data set: 13/06/2012 (Awaiting benefits status from DWP)

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6

3. Governance of the Programme

Governance for the Programme will come from the Troubled Families Executive Group, who will report to both the Safer Nottinghamshire Board and the Health and Wellbeing Board. The Governance will therefore reflect that the Programme is a partnership between the County and District Councils and Strategic Partners including Probation, Police and Health. 4. Delivery of the Programme

• Troubled Families Co-ordinator: The Programme will be managed by the

Troubled Families Co-ordinator, whose role is to manage delivery of the Programme, identify cohort of families to be worked with, and be responsible for all financial and performance management of the programme.

The Troubled Families Co-ordinator will directly line manage three Troubled Families teams based in each Community Safety partnership area. The Managers will be drawn from the existing F.I.P. Team managers plus an additional post.

• Team Managers: The Teams will be led by qualified Supporting Families

Team Managers, who will also report to their local Community Safety Partnership and District Early Intervention Manager for local steer and guidance.

• District Co-ordinators: Each Troubled Families Team (To be known as

‘Supporting Families Teams) will contain District Family Support Co-ordinators who will care plan and manage provision of Services for Troubled Families . The District Co-ordinators will be responsible for ensuring that each Family has a relevant CAF plan which is being reviewed and progressed, and that all relevant professionals are delivering a consistent service, which meet the needs of all members of the family. These will be entirely new posts.

• Family Intervention Workers: The most complex families will have a FIP

worker who will undertake intensive interventions to support families to make positive changes. These Team members will comprise the existing F.I.P. plus additional staff.

Therefore the staffing will be as follows:

Broxtowe

1 Co-ordinator 1 Family Intervention Worker

Gedling

1 Co-ordinator 1 Family Intervention Worker

1 P/T Team Manager

Rushcliffe 1 P/T Co-ordinator 1 Family Intervention Worker

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7

Newark & Sherwood

1 F/T & 1P/T Co-ordinator 2 Family Intervention Workers

1 F/T Team Manager

Bassetlaw 2 Co-ordinators 3 Family Intervention Workers

Mansfield 2 Co-ordinators

3 Family Intervention Workers

1 F/T Team Manager

Ashfield 3 Co-ordinators 4 Family Intervention workers.

There will be an overall recruitment of 1 FTE Team Manager 11 FTE District Co-ordinators 7 FTE FIP Workers 5. Partnership Delivery in Districts It is proposed that the Teams will be co-located in District Council offices based with other district council employees and partnership agencies who deliver community safety interventions and family support work, and will be in addition to and based alongside Targeted Youth Support Services who are also moving to District delivery models. It is anticipated that this model will ensure ‘joined-up’ delivery, sharing of local intelligence and consistent services to children, young people and families with complex needs. The Programme will also aim to reduce and stream-line the overall number of professionals working with a family by ensuring that each family have an up-to-date CAF with a named key worker, who leads on the agreed interventions with the family. Moreover as part of the Community Budget agenda ‘Supporting Families’ teams will offer an opportunity for increased targeting of joint funding and delivery of projects aimed at families with multiple problems (e.g.promotion of healthy lifestyle choices, fire safety, parenting courses) across partnership boundaries, using local needs analysis and local delivery models. Money will be given to District Councils to provide a local infra-structure to enable delivery, for example to cover admin costs etc. In addition to this there will be a budget for each District to deliver training/ parenting programmes and anti-poverty projects, which will be tailored to local need and agreed by the Community Safety partnerships. 6. Service-user involvement District Co-ordinators, led by the Team Managers in their areas, will develop Service user involvement groups which will actively listen to and promote the views of the families who are receiving Family Support Services.

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8

These Service-user groups will work towards the goal of families becoming actively involved in the Programmes, specifically in relation to recruiting staff, mentoring other families and advising the Troubled Families Teams about evaluating interventions. Structure Chart for the Programme

7. Time period of this plan This plan describes action planned for the period April 1st 2012 to March 31st 2013. The Troubled Families Programme is a three year programme and as such this business plan will be updated annually to reflect outcomes achieved, data collected in relation to numbers of Troubled Families and any other relevant strategic plans.. 8. Equality and Diversity The aim of the Programme is to improve significantly the life-chances of the most vulnerable children, young people and their families and to measure these improvements. The Programme is part of the Children, Families and Cultural Services Division and as such is included within the equality impact assessments for the Division.

1 FTE Team Manager (Newark/Sherwood &

Bassetlaw)

Troubled Families Co-ordinator

1 FTE Team Manager (Mansfield & Ashfield)

P/T Team Manager (BGR)

2.5 Co-ordinators 3 Family Intervention

Project Workers

3.5 Co-ordinators 5 Family Intervention

Project Workers

5 Co-ordinators 7 Family Intervention

Project Workers

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9

9. Budget The Troubled Families Programme is funded by the Department for Communities and Local Government. The DCLG have made available a payment of £175,000 to cover the co-ordination of the Programme. This money has been allocated to pay for Nottinghamshire’s Troubled Families Co-ordinator, the provision of a temporary Systems Analyst and to provide on-going support to the Programme by paying for additional support from the County Council’s Data Management Team. Additional monies from this start-up fund will pay for training and specialist supervision for the workers in the Programme. In addition to this money the DCLG have paid Nottinghamshire County Council £3,200 per family, for the estimated 439 Families which we indicated to The Troubled Families Team that we would be working with (527 Families to be engaged with via the Troubled Families Programme plus an additional 86 to be worked with via the European Social Fund Programme – ‘Working Links’) Therefore £1,404,800 was paid to the County Council on 1st June 2012 as the first Up-front Grant. The 60% match funding from the County Council and partnership agencies is demonstrable from existing Services which are already being provided to these families (Family Intervention Programme and Criminal Justice Interventions, Anti-Social Behaviour Intervention, Targeted Youth support and Behaviour and Attendance Services for example). The Programme also aims to address the ‘high local costs’ of Families with multiple problems and therefore alongside the Payment by results outcome measures the Nottinghamshire troubled Families Programme will use the ‘Think Family’ Calculator. CHART 3 – Funding Breakdown for Nottinghamshire Troubled Families programme

Note: Based upon matched funding for 1,317 places on programme with remaining funding for 263 families to be provided through existing ESF funded programme and Work programme.

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10

CHARTS 4a & 4b – Breakdown of £10,000 per family (40% DCLG – 60% Local partnership matched funding) for each place on the Troubled Families Programme. CHART 4a - Payment by Results (PbR) model based upon improvements is ASB & Crime, Education and progress to work.

CHART 4b – Payment by Results (PbR) model based at least one adult in family moved off out-of-work benefits and into work.

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10. Risks to this Plan Risks to delivery of the Programme include:

1. Non- achievement of Payment by results outcomes- Steps taken to reduce this include careful mapping of families prior to interventions taking place.

2. Non-compliance of Families- Steps to be taken to reduce this include consideration of use of statutory powers (Parenting Orders and Contracts)

3. Staffing- recruitment and selection of staff needs to be prioritised within the department and timed to ensure maximisation of re-deployment of experience staff from County Council Services at risk of redundancy

4. Unknown/ Undeclared performance measures from DCLG/ Troubled Families Team- Need to establish efficient data collection, management and recording of base-lines to ensure that data can be collected as and when required.

5. Data-sharing and Collection: - Need to ensure legal guidance is obtained and all data is stored in compliance with data protection legislation.

Risks to be regularly reviewed at Executive Board Meeting and action plans developed in relation to each area of identified risk.

11. How will we monitor our progress? Performance of the Troubled Families Programme will be monitored by the Troubled Families Executive Group which will report to the Safer Nottinghamshire Board and the Health and Wellbeing Board. Monthly Reports will be collected evidencing the families who are being worked with, plans for these families and identifying any local barriers to successful outcomes. Data collection will be reviewed monthly and delivery modified in accordance with management information received. Data collection will be reviewed monthly and delivery modified in accordance with management information received. Service-user feedback will also be built into the delivery of the Programme and will be used to inform subsequent Business Plans. Therefore the next cohort of identified ‘Troubled Families’ should be explicit by early 2013, and the Troubled Families Business plan can be up-dated accordingly.

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12

12. Action Plans

Service Objectives Establish a ‘Supporting Families’ Team, infrastructure and delivery model.

Expected outcomes (results)

• Reduce anti-social behaviour • Reduce criminal activity in young people aged

under 18 • Reduce school exclusions • Improve school attendance • Encourage adults and young people in families into

employment.

Expected improvements (benefits)

• Reduction in County and District Council’s spend on Families with multiple problems

• Improve information and Service delivery to Families with complex needs

• Improve data sharing and communication about families with multiple problems.

Service Group Troubled Families Programme

Responsible Lead Officer Dawn Godfrey/ Mary Jarrett

Key Actions Lead Officer

Complete by (date)

1. Establish and recruit to Supporting Families Teams, creating links with District partners.

Mary Jarrett

September 2012

2.

Develop Management information Systems to inform Programme and measure outcomes using existing systems.

Mary Jarrett/ Andree Mitchell

July 2012

3. Develop Service-user consultation model (possibly in partnership with local schools)

Mary Jarrett

September 2012

4. Measure base-lines for Family Interventions. Mary Jarrett

September 2012

Action plan to be re-vised when the plan becomes operational projected to be September 2012

Key Performance Indicators

Target Performance Indicator Baseline 12/13 13/14 14/15

Successful receipt of Payment by Results 20% 40% 60%

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