Joint Health and Wellbeing Board Minutes

Joint Health and Wellbeing Board Minutes

Tuesday 11 July 2017
3:00 p.m.
Mandela Room, Town Hall, Middlesbrough

Attendance Details

Mr D Budd (Chair), Councillor M Carr, Councillor J Rostron, Councillor M Thompson, Councillor N J Walker, E Ioannides, T Parkinson, E Scollay, Mr M Davis, P Bateman, Mr B Clark, A Sinclair
N Mumtaz,
J McNally
P Stephens
Apologies for absence:
Ms S Picknett, Ms C Smith, Mr D Brown, Mr J Harwin, Ms A Hume, B Kilmurray, Ms S McArdle, R James, Dr P Crawshaw, Ms V Nanda, Councillor C M Rooney (Vice-Chair), E Kunonga, K Warnock
Declarations of interest:

There were no declarations of interest

Item Number Item/Resolution

The minutes of the Health & Wellbeing Board held on 22 March 2017 were agreed as a true and accurate record.

Tony Parkinson - Chief Executive - Middlesbrough Council

The Assurance Report from the Local Authority Chief Executive had been circulated to members prior to the meeting for information.


The Summary of recommendations from the report were that the Health and Wellbeing Board:

  • Notes the progress in refreshing the Joint Health & Wellbeing Strategy, and that a quarterly performance dashboard will be implemented for the next meeting of the Board.
  • Notes progress in refreshing the Middlesbrough Joint Strategic Needs Assessment, and continues to engage in the work as required to allow for the accurate identification of need.
  • Agrees the commencement of the process and associated timetable towards publication of its next revised Pharmaceutical Needs Assessment and the Statement of Intent that will be published to this effect.

AGREED as follows:-

  • The Board noted the submitted report
  • The Board agreed to the recommendations contained within the report
Alex Sinclair - Director of Programmes and Primary Care Development

The CCG Briefing had been circulated to members prior to the meeting for information.  The purpose of the briefing note is to update the Health & Wellbeing Board on the progress being made in a number of key areas by South Tees Clinical Commissioning Group (CCG) working in partnership with Middlesbrough Council and members of the NHS Provider community.


The Middlesbrough Health & Wellbeing Board were asked to:

  • Note the update on the May cyber-attack which impacted the NHS
  • Note the progress with delivery of the new urgent care model
  • Note the forthcoming CCG Annual General Meeting and Annual Report
  • Note the partnership working in relation to services for Children and Young People
  • Note the SEND inspection in Middlesbrough and commitment to improved joint working
  • Note the work underway to secure GP workforce
  • Note CCG involvement in the strategy to address the areas long standing challenges
  • Note the progress of Middlesbrough's Carers Partnership
  • Note the GP Education Time Out session for Mental Health & Learning Disabilities
  • Note the 360 stakeholder survey
  • Note the successful recruitment of six additional PPAG members and two new lay members
  • Note the appointment of the new PPG Chair
  • Note the refrshed CCG Communication and Engagement Strategy
  • Note the continuing work of the Integration Executive Group

AGREED as follows:

  • The Board noted the submitted report and agreed to the recommendations made
Kathryn Warnock - South Tees Integration Programme Manager

A report was tabled regarding the Integration and Better Care Fund planning requirements for 2017-19 were published on 3 July 2017.  There are new entries to the requirements that have placed a greater focus on reducing delays on moving patients out of hospital and into social care than expected.


The full implications of these changes need to be assessed in relation to the Better Care Fund and Improved Better Care Fund plans.  There is still a requirement that the Better Care Fund plan is approved by the Health & Wellbeing Board prior to submission on 11th September 2017 however the next planned meeting of the Health & Wellbeing Board is 13th September 2017, it was proposed to change the meeting to 6th September 2017.


AGREED as follows:-

  • The  report be noted
  • That the next Health & Wellbeing Board meeting will be held on Wednesday 6 September 2017
Eleni Ioannides - Executive Director of Children's Services

Eleni Ioannides, Executive Director of Children's Services delivered a presentation to the Board on Proposed Children's Trust Arrangements in Middlesbrough.


Following the recent Ofsted SEND Inspection the Ofsted inspections have highlighted the need for:

  • Strategic governance
  • Integrated business intelligence (data)
  • Improved joint commissioning

Partners have indicated support for a Children's Trust as an opportunity for better integration and collaborative working.

It is proposed a Children’s Trust Board is established with devolved powers from the HWBB.  The new Children’s Trust would be responsible for:


  • Joint planning and oversight of a coherent set of services;
  • Developing and consolidating changes and improvements already underway;
  • Supporting best practice across all agencies working with children’s and families in Middlesbrough;
  • Developing multi-agency teams and integrated services;
  • Stronger and more strategic multi-agency leadership;
  • Strengthening the voice of the child; and
  • Shared responsibility for achieving the best outcomes for all children and families and for reducing inequalities

The three key functions of the CTB will be to:


  • Develop an agreed integrated vision, strategy and set of common priorities laid out in a Children and Young People’s Plan
  • Provide inter-agency governance with regard to its implementation
  • Oversee the commissioning of integrated services for children, young people and their families

Membership will include the following organisations:

  • Executive Member for Children’s Services (Chair)
  • CCG
  • Cleveland Police
  • MVDA
  • Public Health
  • Schools
  • Foundation Trusts

Members of the Health & Wellbeing Board also suggested that there should be representation from Adult Social Care, DWP, Housing and TEWV.


Eleni informed the Board that a Children's Trust workshop will be held on 19 July and that the proposal to develop a Children's Trust will go to the Council Executive on 5 Deptember 2017 and will also be presented through the Clinical Commissioning Group's structures.

The Board were asked to approve the following recommendations:-

  • That the HWB approve and support the formation of the Children’s Trust Board
  • That the HWB delegate its Children’s functions to the Trust Board
  • That the HWB receive an annual report on progress from the CTB

SEND Inspection


Eleni also provided feedback from the recent Ofsted SEND Inspection the feedback from Ofsted included the lack of:

  • Joint planning and delivery
  • Joint commissioning
  • Joint working

As highlighted in the presentation given by Eleni work has already begun to address the issues that have been highlighted including the proposal of a Children's Trust and also the work that is being carried out to refresh the Joint Strategic Needs Assessment.  Eleni assured the Board that these messages have been heard and work is being carried out to address the concerns raised.

Paul Stephens - Head of Performance and Partnerships - Middlesbrough Council

Paul Stephens, Head of Performance and Partnerships delivered a presentation to the Health & Wellbeing Board on Shared Intelligence/JSNA Update.



  • Consensus that shared data and intelligence would benefit partners and partnership working within Middlesbrough.
  • Long-term debate at Health and Wellbeing Board and other partnerships on how this can be best achieved, with intermittent progress.
  • From MBC perspective, the need to deliver on this has become more pressing in recent months due to various peer reviews and inspections highlighting this as a key issue, particularly in relation to the Joint Strategic Needs Assessment.
  • Following discussion at last Board, first meeting held on 13 June, and was well-attended and well-received by partners. Anticipated that the group will meet monthly, initially, and update HWBB and other partnerships as the work progresses



Key discussion points

  • Vision for the group; how this is communicated to analysts; current arrangements; who will share what and when in future and in what format; and underpinning agreements and systems.

Outcome of discussion

  • Meet as a steering group initially, providing direction to analytical teams and considering opportunities for joint working as they emerge.
  • Purpose of group to jointly identify needs to inform strategy development and commissioning, and monitor performance - ToR to be developed.
  • Baselining of contacts, current arrangements, systems and information sharing agreements to be undertaken.
  • MBC has appointed a full-time resources to coordinate this group, and the JSNA work.



Key discussion points

  • Document structure and content (measures), and link to JHWBS and commissioning plans; current data gaps; methods of data disaggregation and prioritisation.

Outcome of discussion

  • Document to be structured around the life course, with additional sections on vulnerable groups - Ofsted has provided example of best practice.
  • JSNA will point up issues that will be prioritised by key partnerships looking at a range of factors including: prevalence, inequalities, trend, comparators and impact.
  • Sections of the JSNA need to evidence the above, adopting a standard approach to e.g. geographical disaggregation of data.
  • More information on the quality/impact of local service provision/assets and the views of children and families is required.
    The JSNA will result in 'intuitive' and 'counter-intuitive' findings, with the latter necessitating further research and informing the work plan of the intelligence group.


  • Draft CYP JSNA to be shared with Shared Intelligence Group this week.
  • Next meeting of the group at the end of July will consider:
  • Terms of Reference.
  • Initial baselining.
  • Working draft of CYP JSNA.
  • Steps to consult on/finalise the JSNA.
  • Future work and communication plans.
  • The next meeting of HWBB will consider findings from the CYP JSNA and agree how the document will be used.

AGREED as follows:-

  • The Health & Wellbeing Board noted the content in the presentation



Mark Davis, Chief Executive, MVDA

Mark Davis, Chief Executive at MVDA tabled the Healthwatch Middlesbrough Annual Report 2016/17 which has been prepared by Pioneering Care Partnership. 


Mark also tabled a briefing note which provided an updated on the development of Healthwatch South Tees.


AGREED as follows:-

  • That the briefing note be noted
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