Agenda and draft minutes

Health and Wellbeing Board
Thursday, 6th June, 2019 3.00 pm

Venue: Trentham and Rudyard Suites - Staffordshire Place 1, Tipping Street, Stafford, ST16 2DH

Contact: Jon Topham  Email: StaffsHWBB@staffordshire.gov.uk

Items
No. Item

1.

Welcome and routine items

1a

Declarations of Interest

Minutes:

There were none at this meeting.

1b

Minutes of the H&WB Meeting held on 7 March 2019 pdf icon PDF 110 KB

Minutes:

RESOLVED - That the minutes of the Health and Wellbeing Board (H&WB) meeting held on 7 March 2019 be confirmed and signed by the Chairman.

2.

Questions from the public

Minutes:

There were none at this meeting.

3.

Health & Wellbeing Board: An Approach to Delivery pdf icon PDF 84 KB

Presentation by Jon Topham, Senior Commissioning Manager, & Andrew Donaldson, Head of Strategy

Minutes:

The H&WB received a copy of “Staffordshire H&WB Strategy – An Approach to Delivery” and “Public Health and Prevention Supportive Communities”. These documents suggested a key focus for the Board and outlined specific areas of activity around four delivery mechanisms:

·         Information: ensuring the IAG offer improved to support independence and to use and share data to target services effectively and intervene earlier;

·         Communities: connecting people to community activity and early help/facilitating new community activity to address gaps in demand;

·         Conversations: developing a programme of campaigns to promote healthy lifestyles and personal responsibility and connecting these to the H&WB public conversations; and

·         Decisions: ensuring that the Health in All Policies (HiAP) agenda influenced all decisions taken.

 

Members received details of work within the Supportive Communities agenda, which included proactively reducing demand for social and health care services through people helping people. Common themes were identified, with priority areas being: loneliness and social isolation; carer support; and, housing and home tasks. Measures of success around these key themes had been set, along with activity for the Board which would form the basis of the H&WB delivery plan.

 

Members noted the importance of the JSNA in measuring success within a time period and the more detailed information produced from the “deep dive” JSNAs. This information would also be used to help identify where early support was needed. Members highlighted the importance of: assessment data in the production of collaborative plans; base lining changes; and, using information from local communities earlier. The STP had an increasing emphasis around place, and work with the eight district and borough councils was important for co-design and co-implementation.

 

RESOLVED – That:

a)    the H&WB continue to provide system leadership in Staffordshire for the Families Strategic Partnership and seek an update at the September Board meeting;

b)    a clear line of sight to the STP Prevention Workstream be developed;

c)    the implementation of Supportive Communities be actively supported;

d)    the Board provide leadership for more targeted Joint Strategic Needs Assessment (JSNA), with the initial assessment around better targeting of people on the cusp of coming into health and care;

e)    a programme of public conversations be re-energised; and,

f)     leadership of the HiAP be provided.

4.

District Council Health and Wellbeing Board Update pdf icon PDF 527 KB

Tim Clegg, Chief Executive, Stafford Borough Council

Minutes:

The H&WB received an update and presentation from Tim Clegg, Chief Executive, Stafford Borough Council, outlining the work of district and borough councils with a range of partners to promote health in all they do. Specifically, Members heard how district and borough councils influence health through a range of activity, including:

·         housing, supply, support and reducing homelessness;

·         planning, leisure and green spaces;

·         community outreach and advice services;

·         economic development;

·         environmental health; and,

·         enabling and collaboration.

 

Examples of innovative projects were shared, such as the East Staffordshire “Pride of Place” project, the South Staffordshire “Good Life” project and Stafford Borough Council’s new garden community on the brown field site at Swynnerton.

 

District and Borough Council’s remained able to make a significant contribution to health and wellbeing through the HiAP agenda. They provided services that had a direct impact on the wider determinants of health, with their impact being enhanced when working in collaboration with partners.

 

RESOLVED – That:

a)    the content of the report and presentation be noted; and

b)    the H&WB show leadership in engaging key partners to work beyond organisational, sectorial, geographic and professional boundaries to work with communities to address the wider determinants of health.

5.

Changes to Governance of Physical Inactivity Sub Group pdf icon PDF 106 KB

Ben Hollands, Sports Across Staffordshire & Stoke-on-Trent (SASSOT) and Glynn Luznyj, Director of Prevention and Protection, Staffordshire Fire and Rescue Services

Minutes:

[Ben Hollands, Sport Across Staffordshire & Stoke-on-Trent, in attendance for this item.]

 

Board Member Glynn Luznyj reminded Members that in 2017 the H&WB had set up a physical inactivity sub-group to understand and address the issue of physical inactivity. The Board received details of the work of the sub-group and their relationship with Sport Across Staffordshire and Stoke-on-Trent (SASSOT).

 

Over time the work of the sub-group had become closely aligned to that of SASSOT, its strategy and the resources associated with this. Inactivity remained a public health priority. However the sub-group’s membership was no longer active as its work had been mainstreamed through SASSOT. It was proposed that SASSOT’s governance structures should provide future oversight of the work programme through either the SASSOT Board or their Strategy Advisory Group. A link back to the H&WB could be maintained through Tim Clegg, who was a member of both the H&WB and SASSOT. Members were aware that SASSOT met quarterly and thought would be needed as to how their work was reported back to the H&WB.

 

RESOLVED – That:

a)    SASSOT be recognised as the lead agency for physical activity;

b)    the new governance structure for the physical activity work strand that utilised existing meeting networks and governance structures managed by SASSOT and its Executive Board be endorsed; and

c)    thought be given to how the work of SASSOT be reported back to the H&WB.

6.

Stoke-on-Trent and Staffordshire Safeguarding Children Board pdf icon PDF 79 KB

Kate Sharratt, Head of Performance and Development

Additional documents:

Minutes:

[Kate Sharratt, Head of Performance & Development, Families & Communities, SCC, in attendance for this item.]

 

Members received a presentation which set out the new arrangements for the Stoke-on-Trent & Staffordshire Safeguarding Children’s Board. Following the Wood Review, Local Safeguarding Children’s Boards (LSCBs) were being reviewed. This had presented an opportunity to design a new partnership infrastructure, with the new arrangements being implemented from 1 April 2019.

 

Details of the statutory safeguarding partners on the new board were shared, with Members noting that the elected member with responsibility for children’s services from both SCC and Stoke-on-Trent City Council were also included on the Board as non-voting members.

 

The new Board would focus on scrutiny and assurance across the landscape of provision. In future it was suggested that the H&WB may wish to report annually to Staffordshire’s new LSCB evidencing their work in holding to account those involved in health and well-being improvement.

 

RESOLVED – That the new arrangements for the Stoke-on-Trent and Staffordshire Safeguarding Children’s Board be noted.

7.

Draft Carers Strategy pdf icon PDF 103 KB

Andy Marriot, Lead Commissioner, All Age Disabilities and Mental Health

Additional documents:

Minutes:

[Gill Smith, Commissioning Manager, in attendance for this item.]

 

Staffordshire County Council (SCC) and the five Staffordshire Clinical Commissioning groups (CCGs) had produced a draft all age carers strategy “All Together for Carers”.  The Strategy set out the statutory duties of the Council and the NHS towards Carers under the Care Act 2014 and to Young Carers and those approaching adulthood under the Children and Families Act 2014, and under the NHS Constitution. It set out the following seven proposed priorities:

·         identifying carers;

·         improving information, advice and guidance,

·         staying healthy;

·         a life outside of caring;

·         assessment and support;

·         crisis management;

·         recognition and value.

 

A period of public consultation on the draft Strategy had begun on 29 April 2019 and would run for 12 weeks, closing on 22 July 2019. Consultation findings would help to develop the Strategy, which would be brought back to the H&WB for approval, along with a delivery plan giving key milestones and metrics to monitor implementation and progress.

 

Some concerns were shared around the current commissioned services. The contract was currently in its first year extension with the possibility of a further year extension from September. Concern was expressed that a contract that had received negative feedback looked likely to have a further extension due to time scale restrictions.

 

RESOLVED – That:

a)    the draft carers strategy “All Together for Carers” be noted; and

b)    members provide feedback on the Strategy as part of the consultation process.

8.

Staffordshire Better Care Fund Plan 2019/20 pdf icon PDF 111 KB

Richard Harling, Director for Health and Care

Minutes:

At their meeting of 7 March 2019 the H&WB noted the progress of the Staffordshire BCF during 2017-2019, agreed the extension of the current BCF schemes into 2019/2020 and approved the delegation of the final sign-off of the 2019/2020 plan to the Board Co-Chairs, with minimal change anticipated. On 10 April 2019 the Government published the 2019/2020 BCF Policy Framework which confirmed their ongoing commitment to supporting the integration of health and care. It confirmed the anticipated minimal change throughout 2019/2020, with the only notable alteration being a simplified planning and submission process.

 

At their March meeting Members received indicative funding for the Staffordshire BCF. As outlined in the BCF Policy Framework, the BCF National Conditions required an NHS contribution to adult social care. This involved a cash transfer from CCGs to local authorities. In Staffordshire the CCG cash transfer was anticipated to be in the region of £20.271m in 2019/2020, depending on the inflationary uplift. In addition the BCF mandates a minimum contribution from CCGs into the BCF pooled fund, which for Staffordshire in 2019/2020 was anticipated to be £42.927m.

 

The BCF Plan approval process would be assured and moderated regionally. Those deemed compliant would be put forward for approval by NHS England. Permission to spend from the CCG ringfenced contribution would be made by NHS England only after BCF Plan approval. This approval process presented risk in relation to both CCG cash transfers and to SCC and CCG minimum contribution to the BCF pooled fund. As planning templates and timescales had not yet been issued by NHS England, BCF approval was unlikely to be secured until late summer 2019. This meant that both SCC and CCGs were currently funding BCF schemes “at risk” and would have to do so until the plan was approved enabling the release of CCG funding. Members agreed this was unsatisfactory and requested the Co-Chairs escalate the Board’s concerns to the Secretary of State for Health and Social Care.

 

RESOLVED – That:

a)    the recent publication of the BCF Policy Framework be noted;

b)    the financial risk in relation to the funding of some services funded via CCG cash transfers be noted; and,

c)    the Co-Chair’s escalate the Board’s concerns to the Secretary of State for Health and Social Care.

9.

Director of Public Health Annual Report pdf icon PDF 89 KB

Richard Harling, Director for Health and Care

Minutes:

Members received a presentation on the Director of Public Health’s draft Annual Report “Live Long and Prosper: Digital Technologies for Health and Wellbeing”. The report considered the use of digital technologies in health and care and the opportunities their use presented, enabling individuals to take more control of their health and wellbeing and reduce dependence on health and care services, as well as transforming the way health and care services were organised and managed.

 

The report looked at the range of digital technologies in health and care, considering the evidence and benefit for:

·         digital information, advice and guidance;

·         consumer wearables;

·         biometric monitoring and implantable drug delivery;

·         linking electronic records;

·         telemedicine;

·         telecare/assistive technology;

·         artificial intelligence; and

·         care robots.

 

In considering these new technologies the Report made 17 recommendations around future use and developments. Members were asked to forward any comments on the draft report to the Director of Health and Care, with the finalised report being brought to the September H&WB.

 

Members asked that the use of new technology considered carefully any impact on the whole system, giving an example of missing people resulting in increasing referrals to the Police, often unnecessarily. It was important to ensure the right training went to the people sitting behind the technology.

 

Members also felt that one of the biggest challenges was around effective data sharing.

 

RESOLVED – That:

a)    the draft report be noted;

b)    the 17 recommendations be noted and any comments be forwarded to the Director for Health and Care;

c)    consideration be given to how the health and care system might deliver the key recommendations, these being shared at the September meeting.

10.

Air Quality Project 2018 -2020 pdf icon PDF 82 KB

Mike Calverley, Health, Protection and EPR Lead

Additional documents:

Minutes:

[Mike Calverley, Health Protection and EPR Lead, and Matt Pringle, Connectivity Support Team, and Catherine Stephenson, Connectivity Manager, in attendance for this item.]

 

The Staffordshire and Stoke-on-Trent Air Quality Project had been launched in July 2018 after a successful bid to Defra under their Air Quality Grant Scheme.  The successful bid saw a grant of £208.000 in April 2018. The bid had four elements, including: business and school engagement; EV scoping and communication/behaviour change. The project partnership included all eight district and borough councils, Stoke-on-Trent City Council and SCC. A project board had been established, meeting quarterly, and a detailed project plan, with quarterly milestones, had been produced.

 

Members received details of progress to date and noted improving air quality would require significant behavioural changes. 20 June 2019 was clean air day, promoting the issues, and Members were referred to the Clean Air website which had useful information on this event.

 

RESOLVED – That the progress made be noted.

11.

Mental Health Update pdf icon PDF 89 KB

Minutes:

The Board were updated on work around parental mental health and suicide prevention.  Work had been undertaken to better understand the issue of parental mental health, specifically the challenges, gaps and potential improvements that could be made in identifying and supporting adults who are parents with emotional wellbeing and mental health needs. A number of recommendations were made which included: appropriate data sharing; utilising the Place Based Approach and a focus on whole family solutions; improved intelligence gathering; cultural changes across adult and children’s services; governance; and a Children’s Safeguarding Compact considered as part of every commissioning/procurement activity for adult health or social care. These recommendations were supported by the Staffordshire Safeguarding Children’s Board (SSCB) and would be overseen by the Families Strategic Partnership Board.

 

Members also received details of a £300k funding bid to NHS England to support delivery of local suicide prevention plans, with a specific focus on prevention beyond secondary services and reduction within services via quality improvement.

 

Board Member ACC Jennie Sims asked that work be undertaken with partners to access funding for implementing environmental measures to prevent suicides in identified hotspot areas. Board Members Philip White and Craig Porter agree to take this issue back on behalf of SCC and the CCGs.

 

RESOLVED – That;

a)     the report be noted; and

b)    the issue of funding for environmental measures to prevent suicides in identified hotspot areas be raised with SCC and the CCGs.

12.

Items for Information pdf icon PDF 9 MB

Additional documents:

Minutes:

The H&WB received the following reports for information only:

a)    Creation of a Single Strategic Commissioning Organisation (sSCO) for NHS Services in Staffordshire and Stoke-on-Trent; and

b)    SCC Offer to the Integrated Care System.

13.

STP

Minutes:

Members were informed that a 12 week consultation on the STP was currently underway. Members received copies of the consultation documents, which included details of ways to feed back views to inform the consultation.

 

14.

Forward Plan pdf icon PDF 148 KB

Minutes:

The H&WB noted their forward plan, and the addition of the following items for their September meeting:

·         Family Strategic Partnership Board Annual Report;

·         the H&WB Strategy;

·         consultation follow-up; and

·         CCG Commissioning intentions.