The Panel considered a draft Final Report into Children with Complex Needs a copy of which had previously been circulated to the Panel and representatives who had provided evidence on the review.
The Panel considered possible conclusions and recommendations which had been prepared in draft and circulated at the meeting.
The draft recommendations were as follows:-
1. The Health and Wellbeing Board should develop a new and redesigned stop smoking service, which has sufficient capacity and expertise to take on sizeable and difficult task ahead of it. The service's formulation and structure is a matter for management, after considering the evidence around need and necessary capacity. Nonetheless, from a political point of view, the Panel considers that the service should have the following aspects.
1.1 To be sufficiently assertive to target every pregnant woman in the Town and ascertain their smoking status.
1.2 If smoking status is confirmed, the expectant mother should be provided with a key worker, perhaps this could be their named community midwife, to offer support through the stop smoking services. The Panel considers having a key worker may reduce the numbers of those 'lost to follow up'.
1.3 The new Stop Smoking Service should make a specific, structured effort to work with the partners and families of pregnant women, in an attempt to alter the home environment to help the pregnant woman stop smoking.
1.4 For this to happen, need to have accessible clinics in the communities most affected by tobacco use in pregnancy, at times and locations that match local demand. It should certainly be the case that there should be an accessible service, both in terms and location, for every ward that is judged to need it.
1.5 If judged to be necessary, after considering all available evidence, smoking cessation classes should also provide a crèche facility, to eliminate a lack of childcare as a reason for expectant mothers not being able to attend.
1.6 Detailed consideration should also be given to the feasibility of the service including its remit, all harmful substances which can be consumed in pregnancy and potentially damage the unborn child.
1.7 The Panel would suggest that detailed social marketing is undertaken to understand local need, in terms of times and accessibility, to enable good access to this service.
2. That the local health and social care economy undertakes detailed analysis of all available evidence regarding the likely changes in population, aimed at producing a reliable set of data, regarding the number of children with complex needs in the future. This will be critical in planning educational, health and social care capacity in the future.
3. That the local Health and Social Care Economy, with a specific focus on the Clinical Commissioning Group, prepares a strategy as to how it will take on the timely and equitable funding responsibility for EHSCPs and how they will be marketed to parents.
4. That the Director of Public Health is supported in his efforts to increase the immunisation rates in Middlesbrough, by the full weight of the local authority. This should include the suggestion to schools that they provide assistance in offering facilities for immunisation programmes or associated catch up programmes. Evidence suggests that schools can be a very useful tool in reaching children requiring immunisations.
5. That the Directorate of Public Health takes on an area of work, aimed at understanding why there is such a divergence between rate of immunisations in Middlesbrough. This should have a focus on GP practice, as well as electoral wards.
6. That the Director of Public Health reassess how long term child patients at hospitals receive their immunisations. The Panel; considers it to be completely unacceptable that such a cohort is most at risk of not receiving their immunisations.
Confirmation was given of the information received and included in the Final Report following the Panel's request for clarification regarding the information available on a child's immunisation records by the South Tees Hospitals NHS Foundation Trust and from the Ministry of Defence in respect of children of Armed Forces families.
AGREED that the draft Final Report together with the conclusions and recommendations as outlined be approved subject to the following:-
(a) That recommendation 3 above includes a reference for the Panel's request to receive an update in the Autumn 2013.
(b) That recommendation 6 above includes a reference of the need for measures to be in place to ensure that long term child patients at JCUH receive immunisations if required.
(c) That an additional recommendation be included for further clarification to be sought from the Secretary of State for Defence regarding the support provided in respect of the immunisation of children of Armed Forces families.