Joint Health and Wellbeing Board Minutes

Joint Health and Wellbeing Board Minutes

Date:
Wednesday 14 March 2018
Time:
10:00 a.m.
Place:
Mandela Room, Town Hall, Middlesbrough
 

Attendance Details

Present:
Mr D Budd (Chair), Councillor C M Rooney (Vice-Chair), Councillor M Carr, Councillor J Rostron, Councillor M Thompson, Councillor N J Walker, E Kunonga, T Parkinson, E Scollay, H Watson, Ms V Nanda, Mr M Davis, Mr A Downey, Mr D Gardner, Ms A Sinclair, Mr A Simpson
Officers:
J McNally, K Warnock
Apologies for absence:
Dr P Crawshaw, Mr J Harwin, Ms C Smith, Ms A Hume, Ms S McArdle,
Declarations of interest:

There were no declarations of interest made at this point of the meeting.

Item Number Item/Resolution
PUBLIC
17/26 MINUTES OF THE HEALTH AND WELLBEING BOARD - 6 DECEMBER 2017

The minutes of the Health and Wellbeing Board held on 6 December were agreed as a true and accurate record.

Alex Sinclair - Director of Programmes and Primary Care Development
17/27 CCG UPDATE - A FOCUS ON MIDDLESBROUGH

Alex Sinclair, Director of Programmes and Primary Care Development provided an update to the Health and Well-being Board on the progress being made in a number of key areas by South Tees Clinical Commissioning Group (the CCG), working in partnership with Middlesbrough Borough Council and members of the NHS Provider community.

 

The Health and Wellbeing Board were asked to::

  • Note the work underway to attract and recruit more GPs to the area
  •  Note the proposed development of a workforce framework for health and social care in the North East and Cumbria
  • Note the new hospital-based carers' information support service providing support to Middlesbrough carers
  • Note the work progressing with the joint commissioning of children’s services
  • Note the engagement with children, young people and their carers and families
  • Note the introduction of the paediatric telephone triage pilot at South Tees Foundation Trust
  • Note the decision to make changes to respite services for adults with a learning disability, complex needs and/or autism whilst retaining the currently available facilities.
  • Note the continuing work with partners to support vulnerable people to get to the right place of safety
  • Note the work with partners to minimise the impact of winter pressures
  • Note the financial challenge facing the CCG and the plans in place to address this

Agreed as follows: -

  • The Health and Wellbeing Board noted the progress being made
17/28 STATEMENT ON SOUTH TEES CCG'S ROLE IN CONTRIBUTING TO THE DELIVERY OF THE HEALTH AND WELLBEING STRATEGY

Alex Sinclair, Director of Programme and Primary Care Development presented a statement outlining the CCG’s role in contributing to the delivery of the Health and Wellbeing Strategy for inclusion in the CCG's 2017/18 annual report.

 

Board members were asked to note that a single statement had been developed, reflecting the strategies and activities in both Middlesbrough and Redcar and Cleveland in order to align with the South Tees focus of the CCG report.

 

The statement would read as:

 

The CCG is an active member of the local Health and Wellbeing Boards and contributes to the delivery of joint health and wellbeing strategies in both Middlesbrough and Redcar and Cleveland.

 

Agreed as follows: -

  • The Health and Wellbeing Board supported the proposed statement for inclusion in the report.
17/29 CCG FINANCIAL UPDATE - PRESENTATION

Simon Gregory, Director of Finance and Governance at South Tees CCG delivered a financial update presentation to Members of the Health and Wellbeing Board.  Following the presentation it was agreed that the Health and Wellbeing should provide whole system representation.

17/30 PRIMARY CARE UPDATE - PRESENTATION BY ANDREW MCMINN

Andrew McMinn, Senior Commissioning and Delivery Manager at South Tees CCG attended the meeting to deliver a presentation to the Health and Wellbeing Board on the GP Five Year Forward View. 

 

The main points to note in the presentation:

  • Net increase of 5000 GPs (1/3 retiring in next 5 years)
  • Increase training places (3250)
  • Return of the 'golden hello' for GP trainees in hard to recruit areas (£20K)
  • Overseas recruitment
  • 3000 new fully funded mental health therapists
  • 1 per 20,000 patients (3 average practices)
  • 1500 co-funded practice clinical pharmacists
  • 1 per 30,000 patients
  • Support for practice managers & practice nurses
  • 1000 associate physicians
  • New Carr-Hill - deprivation / age to reflect workload
  • Initiatives to reduce GP workload
  • 10 HiA
  • Care Navigation
  • New consultation types
  • Estates & Technology funding
  • Investment to Primary Care
  • 7 day GP access

South Tees - GP Forward View Local Scheme (LIS)

 

The GP Forward View LIS was launched on the 16th March 2017 in response to the national Forward View.  The LIS sees increased investment in to General Practice over the next 5 years.

 

The LIS invests in practices in order to -

  • Meet patient need
  • Sustain General Practice
  • Meet the CCG and member practice needs
  • Help achieve the GP Five Year Forward

It was advised that to date:

  • All South Tees practices have signed up to the LIS
  • Practices have submitted their implementation plans by the 30th April
  • The implementation plans detail what schemes practices will be implementing over the next 12 months
  • How can this scheme support practices?
  • Funding
  • Evidence based projects that will reduce pressure in Primary care but maintain and improve patient care

The Health and Wellbeing Board were informed that the following schemes would be taking place across South Tees:

  • Clinical support system
  • Improved routes to General Practice
  • Care Navigation
  • Development of teams
  • Education and support
     


 

Kathryn Warnock - South Tees Integration Programme Manager
17/31 SOUTH TEES INTEGRATION UPDATE

Kathryn Warnock, South Tees Integration Manager provided the Health and Wellbeing Board with a summary of progress on current integration work.

 

The Health and Wellbeing Board heard that the Redcar and Cleveland and Middlesbrough Better Care Fund (BCF) plans 2017-2019 were submitted to NHS England 11 September.
 

It was advised that the BCF quarterly monitoring template was used to ensure that Health and Wellbeing Board areas continued to meet the requirements of the BCF over the lifetime of their plan and enabled areas to provide insight on health and social integration.


The completed BCF Q3 2017/18 reporting templates were submitted to NHS England on 19 January 2018.
 

The Board was advised that work is ongoing through the BCF Monitoring and Implementation Group to evaluate all current BCF projects and schemes to ensure they are effectively contributing to the BCF requirements and are having the greatest impact. The output from these evaluations will be reported to Integration Executive Group to assess the feasibility on continuing the schemes.

The Board heard that the Integration Executive Group had agreed to reallocate uncommitted funds and slippage (approximately £1million across both plans) to schemes the CCG can invest to support the delivery of BCF metrics this will support the CCG.

 

The Health and Wellbeing Board were advised that during the first three quarters of 2017/18 there was a decrease of 1.4% in overall non-elective admissions in Middlesbrough and Redcar & Cleveland Local Authorities, compared to the previous year.  For Middlesbrough LA, there was a decrease of 1.6% and for Redcar and Cleveland LA, there was a decrease of 2.6%.


It was advised that whilst year to date figures remained lower than the previous year, during the third quarter (October-December) non-elective admissions had started to increase compared to the same period last year.
 

The Health and Wellbeing Board were also asked to note that whilst activity is down on the year, costs are increasing significantly due to changes in the tariff for non-elective admissions.

 

The Health and Wellbeing Board were advised that the local authority had maintained performance over the start of winter through October, November and December in meeting the targets set by NHS England for the number of bed days attributable to adult social care.  Therefore the local authority had received confirmation that their improved BCF allocations for 2018/19 would not be reviewed and plans can carry forward.

 

Mark Davis, Chief Executive of MVDA informed the Health and Wellbeing Board that a bid for a NHS England Health and wellbeing grant that had been submitted via the Voluntary Development Agencies to support the expansion of care coordination across South Tees had been unsuccessful. The Board were advised that there had been no feedback given on why the bid was unsuccessful.

 

Agreed as follows: -

  • The Health and Wellbeing Board noted the progress on current integration work
Edward Kunonga - Director of Public Health
17/32 PHARMACEUTICAL NEEDS ASSESSMENT UPDATE

Edward Kunonga, Director of Public Health presented the responses to the statutory 60-day consultation and the final version of the Pharmaceutical Needs Assessment (PNA) for the Health and Wellbeing Board's approval for publication by 25 March 2018.

 

The Director of Public Heath stated that the Health and Well Being Board had a statutory responsibility to develop and update the PNA.  The PNA included a description of all the pharmaceutical services currently available from local community pharmacies, and other providers, and identified any potential for gaps and improvement or better access currently and in the future.

 

In December 2017 the board approved the Director of Public Health to proceed to statutory 60-day consultation on the draft PNA. 

 

The Board were informed that the preparation of the second Middlesbrough HWB PNA for publication on or before 25 March 2018 was now complete. The PNA had been produced in accordance with the NHS (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013 and alongside the corresponding PNA for Redcar and Cleveland.

 

The Director of Public Health advised that responses had generated valuable insight regarding current and future provision of pharmaceutical services. There were 9 responses to the consultation.

 

Agreed as follows: -

  • The Health and Wellbeing Board approved the Director of Public Health to proceed to publish the PNA by 25 March 2018
Helen Watson, Executive Director of Children's Services
17/33 CHILDREN'S TRUST UPDATE - PRESENTATION

Helen Watson, Executive Director of Children's Services delivered a presentation to the Health and Wellbeing Board to update on the work of the Children's Trust.

 

The presentation provided an update on the Children and Young People's Plan.

 

IMPERATIVE 1

  • Increase the number of families we work with at an Early Intervention threshold, for which ACEs feature in the household.

The Board was advised that the following progress had been made in relation to Imperative 1:

  • Pilot areas (Thorntree and Ayresome primary schools) selected to identify children in Year 2 who are living with ACES
  • Early intervention by co-located multi agency 'team around the family' targeted to improve outcomes and monitor long-term impact
  • Increase awareness of ACEs for parents through a marketing and information campaign

IMPERATIVE 2

  • Strengthen families to support a reduction in children becoming looked after.

The Board was advised that the following progress had been made in relation to Imperative 2:

  • Multi-agency project group launched
  • Work streams identified

The Health and Wellbeing Board were advised of the following challenges:

  • Support from HWBB for practical and uninhibited data sharing in accordance with sound information governance principles
  • Support from HWBB for joint commissioning at macro level i.e. pooled budgeting
  • Coordinated work with HWBB in communities with greatest need
    Development of benefit realisation / ROI
  • Joint commissioning protocol in development

 


 


 

Edward Kunonga - Director of Public Health
17/34 PROPOSAL FOR JOINT HEALTH AND WELLBEING BOARD WITH REDCAR AND CLEVELAND BOROUGH COUNCIL

The report was presented to the Health and Wellbeing Board for information only.  The report recommends the establishment of a single health and well-being board between Middlesbrough Borough Council and Redcar & Cleveland Borough Council.  Edward Kunonga, Director of Public Health informed the Health and Wellbeing Board that the report will be presented to Middlesbrough Council's Executive on 20 March 2018 and will also be presented to Redcar and Cleveland's Executive.  If approval is gained by both Executives the joint Health and Wellbeing Board will meet in June 2018.

 

Agreed as follows: -

  • The Health and Wellbeing Board noted the report
Mark Davis, Chief Executive, MVDA
17/35 HEALTHWATCH SOUTH TEES UPDATE

Mark Davis, Chief Executive of MVDA provided the Board with an update on Healthwatch South Tees.  The Board was informed that the work programme was progressing well.  The Board were advised that community intelligence reports had highlighted work to be carried out with the BME community and older people.

 

Mark advised that the Enter and View policy had been refreshed and five enter and view visits would be taking place within the Audiology department and four extended GP practices.

 

The Board were advised that the Star Award which is a recognition award of people or services had been awarded to an eye clinic liaison officer and more awards were planned.

 

Mark informed the Board that Healthwatch South Tees are facing a 30% reduction in funding, work is currently being undertaken to look at the implications of the funding cut, the Board was advised that the cut is one of the highest in the country.

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