Joint Health and Wellbeing Board Minutes

Joint Health and Wellbeing Board Minutes

Wednesday 22 March 2017
10:00 a.m.
The Live Well Centre, Dundas Arcade

Attendance Details

Councillor J Rostron, Councillor E Ioannides, E Kunonga, E Scollay, Ms V Nanda, Mr M Davis, Mr C Irvine, Mr J O'Connell, Ms N Judge, Ms A Sinclair, Ms A Baxter, Mr M Braithwaite
Apologies for absence:
Mr D Budd (Chair), Councillor C M Rooney (Vice-Chair), M Thompson, Councillor N J Walker, T Parkinson, Dr P Crawshaw, Ms A Hullick, R James, Ms C Smith, Mr D Brown, Ms A Hume, B Kilmurray, Ms S McArdle
Declarations of interest:

There were no declarations of interest.

Item Number Item/Resolution

A formal notice had been issued to all concerned of a meeting of the Health & Wellbeing Board to be held on 22 March 2017.


At the appointed time of 10.00 am the following were present:-


Councillor J Rostron 


Apologies for absence: Mayor D Budd, Councillor C Rooney, Councillor M Carr, Councillor N Walker, Councillor M Thompson


In the absence of a quorum and given the business to be transacted, it was agreed by those present to proceed with the items on the agenda on an informal basis. Any items requiring ratification would be considered at the next meeting of the Committee



The minutes of the Health & Wellbeing Board held on 14 December 2016 were agreed as a true and accurate record.


Alex Sinclair pointed out some typing errors which will be amended

Tony Parkinson - Chief Executive - Middlesbrough Council

Erik Scollay presented the Chief Executive Assurance Report in the absence of Tony Parkinson.


The purpose of the report is to provide the Middlesbrough Health & Wellbeing Board with assurance that the Board is fulfilling its statutory obligations and provide a summary of progress in implementing the Joint Health & Wellbeing Strategy.

The Middlesbrough Heath & Wellbeing Board were asked to:


  1. Note the draft refreshed JHWBS and provide comments to the author of this report by 30 April to allow the document to be finalised and published.
  2. Agree the template for future quarterly performance reporting to the Board, and that this is implemented from the next Board meeting, replacing the current Chief Executive’s Assurance Report.
  3. Note the commencement of the JSNA refresh programme and engages in the work as required to allow the accurate identification of need to the Board.
  4. Note that the Licensing Policy Statement and Alcohol Harm Reduction Strategy will proceed to Council for approval, following consideration at Executive.
  5. Supports the implementation of the Alcohol Harm Reduction Strategy.
  6. Supports the proposal for the Council to sign up to the Local Government Alcohol Declaration.

Eleni Ioannides asked that the emerging findings from the recent Ofsted Inspection on the SEND Reforms be presented to the Health & Wellbeing Board, Eleni stated that the overarching message from the inspection team was there was a lack of strategic partnership working and strategic leadership to provide clear direction. It was also made clear that the JSNA is not helpful enough for good joint commissioning.


The Board noted the report and agreed to the recommendations made.

Mark Braithwaite - Independent Chair - Middlesbrough Safeguarding Children Board

Mark Braithwaite Independent Chair of Middlesbrough Safeguarding Children’s Board provided an update to the Health & Wellbeing Board.


The Annual Report highlighted the key achievements for last year and a new report will be published in the Autumn.

The board monitors its core safeguarding business through its sub-group structure both locally, on a South Tees basis and across the four LA's pan-tees. It scrutinises the work of the Child Death Overview Panel and retains a responsibility for commissioning Serious Case Reviews where considered necessary


The past twelve months has seen the revision of the Tees eSafety structure with chairing arrangements aligned with the Tees Strategic VEMT group. The Tees Performance Management Framework has been introduced though in its infancy.


A successful section 11 audit process evidenced progress on all counts for the majority of organisations involved in safeguarding across the town.


Refresh updates to the web based Safeguarding Policies and Procedures web-site and implementation of the threshold document across the South Tees patch have also been significant steps forward.


The MSCB have held well received safeguarding events for professionals and young people alike and have evidenced the progress that continues to be made. One such example has been the live drama production 'Chelsea's Choice' raising awareness on child sexual exploitation which has been seen by over 1,500 young people across all Middlesbrough secondary schools.


Mark also provided an update on the recommendations of the Ofsted Inspection/Review in December 2015. There were 6 recommendations for the LSCB to address with significant progress made in all areas.


Integration with all agencies (particularly schools and diverse communities).

  • Schools are now represented on the board and links to the Middlesbrough Achievement Partnership strengthened. Safeguarding briefing note sent to all schools and colleges across Middlesbrough. MBC in the process of appointing to a key interface role.


Understanding of thresholds across front line professionals.

  • Threshold document agreed across Middlesbrough and Redcar & Cleveland with a program of sessions for professionals.

 Working arrangements/coordination with H&WBB, the C&YP Delivery Partnership and MAP.

  • A schedule of meetings and presentations with all key partnerships agreed and delivered

Further development of performance monitoring arrangements.

  • The Tees Performance Management Framework making progress with quarter 3 data presented to all boards across Tees. Work now in train re thematic (deep dive) reports.

Improved coordination of Section 11 audits across the Tees patch.

  • Agreed Tees format and schedule for roll out planned for later this year, all key partners will be obliged to participate in the audit.

Introduction of Rapid Response Arrangements following child death events

  • Rapid response arrangements are now in place providing a well received and needed service.

Mark also informed the Board that the Department for Education sponsored review of the role and functions of Local Safeguarding Children Boards undertaken by Alan Wood CBE was published on Thursday 26th May 2016. The review makes 34 recommendations covering governance, accountability, inspection and the central commissioning of serious case reviews and child death overview processes.


Ann Baxter - Independent Chair - Teeswide Safeguarding Adults Board

Ann Baxter Chair of the Teeswide Safeguarding Adults Board provided an update to the Board. Ann stated it had been a significant year for the Board and they faced challenges such as the place of safeguarding adults in our society, the availability and provision in nursing homes, reduction in bed numbers in care homes, an increase of deprivation of liberty, increase in domestic abuse and dermographic needs.


Ann stated there has been increased engagement through their website which has engaged a range of people. A key priority of the Board is raising awareness of what safeguarding is and how to protect themselves and others. A lot of training has taken place including e-learning and bespoke events. An event around Domestic Abuse will take place in May 2017. A development day has also taken place to look at the strategic overview and how we continue to work together and focus on preventative strategies.


A discussion took place on the ESEN System, which is being used in the Anti Social Behaviour Team, Erik Scollay sits on the steering group and will feed in information from this group to the Health & Wellbeing Board.

Kathryn Warnock - South Tees Integration Programme Manager

Kathryn Warnock, South Tees Integration Programme Manager presented a report on the Better Care Fund and Integration. Kathryn stated that the BCF allocation for 2017/18 had not yet been published.


The purpose of the report is to provide Middlesbrough Health & Wellbeing Board with a summary of:

  • The Better Care Fund for quarter 3 - 2016/17
  •  Integration in Action - South Tees System Wide Health and Social Care Plan
  • BCF Planning for 2017/18

A summary of the recommendations for the Board were set out in the report, the Board was asked to:


  • Note the Quarter 3 BCF Monitoring template that was submitted to NHS England in March 2017
  • Agree to hold a joint Health & Wellbeing Board session with Redcar & Cleveland Health & Wellbeing Board in May to consider the development of a South Tees System wide Health and Social Care plan to support the graduation from BCF
  • Consider the most appropriate mechanism to sign off the BCF plan for 2017/18

The Board noted the recommendations in the report and agreed that the BCF would come through Paul Stephens to be circulated to the Board for sign off.

Alex Sinclair - Head of Programmes and Delivery - NHS South Tees CCG

Alex Sinclair, Director of Programmes and Primary Care Development asked the Health & Wellbeing Board to agree a statement on the CCG's role in contributing to the delivery of the Health & Wellbeing Strategy for Inclusion in the CCG's 2016/17 annual report.

The statement read:


"The CCG is an active member of the local Health & Wellbeing Boards and contributes to the delivery of Joint Health and Wellbeing strategies in both Middlesbrough and Redcar & Cleveland".


The Board agreed to the statement and that it should be included in the CCG Annual Report for 2016/17



Alex Sinclair, Director of Programmes and Primary Care Development provided a CCG update, Alex informed the Board that the new Urgent Care Model will be implemented on 1 April 2017, ELM Alliance will be operating as the extended hours provider at the four community hubs and the Out of Hours Service will be provided collaboratively between ELM, North East Ambulance Services (NEAS) and South Tees Hospitals NHS Foundation Trust.


Alex stated that work has continued with NHS England to ensure the increased pharmacy cover in line with the revised extended GP opening hours.


The CCG in collaboration with Public Health have commissioned an Open Access Chest X Ray service which allows members of the public to self refer for a chest X Ray without seeing their GP first provided that they meet certain clinical criteria. The clinics are operating in the TS1, TS3 and TS6 areas.


Alex also informed the group that the CCG are currently reviewing welfare rights service provision to ensure there is the most effective use of combined resources across health and the local authorities to deliver the best value service for local people.

Edward Kunonga - Director of Public Health

Edward Kunonga, Director of Public Health delivered a presentation on the draft Prevention Strategy for Adults and Older People 2016-2020.


The key principles of the Strategy are:


  • Addressing social detriments of health
  • Effective partnership working
  • System, scale and consistency
  •  Speed of impact and gestation periods for activity
  •  Asset based approaches
  •  Co-production

Key areas for action


  • Addressing social determinants
  • Roll out of Extra Life
  • Standardise Making Every Contact Count
  • Coordinated information, advice and advocacy
  • Building resilient communities
  • Integrated approaches to addressing risk factors - Live Well Centre and community offer
  • Targeted approaches to services
  • Management of long term conditions
  • Targeted work with vulnerable groups
  • Coordinated low level interventions

A consultation event had taken place on 12 January and was attend by a range of partners were there was good buy in and engagement. An online questionnaire has also generated further feedback.


The next steps are for the strategy to be signed off in April 2017 and then the strategy will be launched in May 2017.


Mark Davis, Chief Executive of MVDA gave a presentation to the Board on Healthwatch South Tees.


The aim of Healthwatch South Tees is to:


"Give citizens and communities a stronger voice to influence and challenge how health and social care services are provided across Middlesbrough and Redcar & Cleveland".


Mark described to the Board the proposed governance arrangements:


  • New HWST Board
  • Young people’s shadow board
  • Existing LHW Board = Locality Committees
  • Leadership and Delivery Group
  • Ad hoc task and finish groups
  • Enter and View panel
  • Partnership development group (time limited)

Mark stated that they are currently:


  • Planning for TUPE
  • Discussions with existing LHW Boards
  • Discussions with LA colleagues and others
  • Initiating the communications and engagement plan
  • Initial prep for HWST: consultation, policies, procedures and strategies
  • Communications and branding
  • ICT arrangements

Mark asked the Health & Wellbeing Board to consider:


  • Identifying a senior representative to be a primary contact for HWST
  • Identifying a representative to sit on partnership development group to shape planning etc
  • Thoughts on what priorities might feature in the initial plan
  • Support initial presentations to teams/services about new arrangements.
Paul Stephens - Head of Performance and Partnerships - Middlesbrough Council

Paul Stephens, Head of Performance and Partnerships presented the Forward Work Plan for Information. The Forward Work Plan will be updated and will include:


  • Update on Healthwatch
  • Ofsted Inspection feedback
  • JSNA
  • Looking Ahead
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