Venue: Trentham Room - No.1 Staffordshire Place. View directions
Contact: Jon Topham Email: StaffsHWBB@staffordshire.gov.uk
Declarations of Interest
There were none at this meeting.
RESOLVED – That the minutes of the Health and Wellbeing Board meeting held on 6 September 2018 be confirmed and signed by the Chairman.
Questions from the public
There were no questions from the public at this meeting.
Liz Mellor, Children’s Commissioning Development Manager and Jill Mogg, Commissioning Manager
(Liz Mellor, SCC Children’s Commissioning Development Manager and Nicola Bromage, CCG Commissioning Manager in attendance for this item.)
Staffordshire’s Emotional Wellbeing and Mental Health Strategy for children and young people was due to expire at the end of the year. A review of the Strategy was timely to enable alignment to the proposed transformational changes in the development of the clear vision and priorities. It also enabled account to be taken of the new approaches and ways of working set out in the Government’s Green paper “Transforming Children and Young People’s Mental Health Provision”.
Members received a copy of the new Strategy which proposed a partnership approach to addressing the mental health and emotional wellbeing needs of children and young people across Staffordshire and Stoke-on-Trent. A collaborative approach to delivering a shared vision and priorities was seen as fundamental to delivering effective and sustainable transformation. The focus was on prevention and early intervention and set out aspirations for the next five years.
The Strategy would be followed by the development of district delivery plans which would allow a locally directed focus on how the Strategy would be implemented. Details of the extent and type of engagement and consultation were shared with the Board, including an explanation of the information shared at the SCC Corporate Review Committee held that morning.
RESOLVED – That:
a) comments from the H&WB Members be noted;
b) the governance arrangements designed to give leadership and accountability, enabling positive change, be noted; and,
c) the Strategy and Local Transformation Plan (LTP) be endorsed for wider circulation and publication.
Tilly Flanagan, Head of Child Health and Wellbeing
(Alexandra Birch, Stafford & Surround CCG, in attendance for this item)
In February 2016 the National Maternity Review “Better Births” had been published. This set out a vision for safe and efficient models of maternity care and identified five objectives:
· improved quality and safety of maternity and new born services;
· engagement and co-production with women and their families;
· configuration of maternity services;
· improved health and wellbeing of women and babies; and
· improved access to perinatal mental health services.
The H&WB received details of the Local Maternity System (LMS) across Staffordshire and Stoke-on-Trent, known as the Pan Staffordshire Maternity Transformation Programme. CCGs were required to establish a LMS that was coterminous with Sustainability and Transformation Partnerships (STP). An operational plan had been developed which detailed how Staffordshire would meet the recommendations from “Better Births”. This Plan had been developed by a range of partners, including Staffordshire’s Early Years Advisory Board, which was a sub-group of the Staffordshire Family Strategic Partnership Board.
a) the report and governance arrangements for delivering the plan be noted; and
b) the Local Maternity Transformation Plan be endorsed.
ACC Jennie Sims
( Diane Malkin, Vulnerability Manager, Staffordshire Police, in attendance for this item.)
The Crisis Care Concordat had been implemented in 2014 and had been the main driver in enabling change in the delivery of services to communities throughout Staffordshire and Stoke-on-Trent. The Concordat provided a joint declaration and action plan to give a response and commitment to the needs of those experiencing mental health issues within our communities and promoted partnership working.
Whilst the Concordat had seen a number of achievements, such as the reduction in numbers of individuals in custody detained under Section 136, there was now a need to review and refresh it to ensure it met the needs of the communities and to reflect changes to delivery organisations. Areas for change within the Concordat were shared with the H&WB.
It was intended that the two H&WBs (Staffordshire and Stoke-on-Trent) should have final “sign off” for the Concordant and would monitor its delivery. H&WB members were asked to nominate a representative to take part in the review and timescales would be clearer once the membership had been agreed.
RESOLVED – That:
a) the review and refresh of the Crisis Care Concordat Declaration, Action Plan and Governance Structure be supported;
b) each representative organisation on the H&WB nominate an individual to take part in the review;
c) that the H&WB have the responsibility for sign off on the Concordat and for monitoring its delivery; and
d) the requirement for the Concordat declaration and action plan to be responsive to current need, well prepared for future need, and have clear direction in responding to such need through service provision be supported.
CQC Local System Review
Oral Update from Richard Harling, Director for Health and Care
Richard Harling, SCC Director for Health and Care, gave an oral report on the CQC local system review. The CQC had undertaken a review in October and had produced a draft report for comment. On Tuesday 11 December a meeting will be held with the CQC where they will present their draft report and the comments made, with thought given at this time to developing the action plan. The final CQC report was expected to be published in January 2019.
RESOLVED – That the oral report be noted.
Karen Bryson, Assistant Director, Public Health and Prevention
(Emma Sandbach, Consultant in Public Health, in attendance for this item.)
Flu was a key factor in NHS winter pressures each year. The national flu campaign began on 8 October. Locally Staffordshire County Council and the CCGs had developed a detailed joint communications plan which began on 13 September and would continue until January. Positive feedback had been received from NHSE for Staffordshire’s pro-active approach. Initial figures indicated an increase in the requests for flu vaccination vouchers from staff within school settings and County Council front line staff in comparison to last year. However, as flu vaccines were distributed by GP practices no clear figures of uptake will be available until nearer Christmas 2018.
As part of the Staffordshire campaign the Care Market Development Team had included a range of resources on their Staffordshire Connects website. A partnership was also being developed between Staffordshire Public Health Team, Stoke City and Burton Albion football clubs. The aim was to produce a short video on the importance of the flu vaccination that could be played on the big screens at stadiums. There might also be an opportunity to promote the vaccination on local radio using members of the football clubs.
Details of early figures were shared with Members. Concerns were raised over difficulties with supplies this year, with only one supplier providing the vaccine and with limited supply available initially. In particular Members were concerned that the lack of vaccine availability early on could result in a reduction of take up this year despite Staffordshire’s proactive campaign approach. Board Members asked that their concerns be shared with NHS England who were responsible for coordinating vaccine supplies.
RESOLVED – That:
a) Staffordshire County Council’s seasonal flu campaign for 2018/19 be noted;
b) the development of the detailed seasonal flu plan and communications plan running from 13 September 2018 to 1 January 2019 be noted, it further being noted that the campaign was jointly developed between Health and Care, the Health, Safety and Wellbeing Team and the Council’s Communications Team;
c) the campaign’s development in partnership with Public Health England, Staffordshire CCGs and the pharmaceutical industry (Sanofi Pasteur) be noted; and
d) a letter setting out the H&WB concerns over vaccine supplies this year be sent to NHS England.
Karen Bryson, Assistant Director, Public Health and Prevention
In Staffordshire 44,452 households were living in fuel poverty. The risk of cold homes and from cold related illness translated to an increase in service use and the related costs for health and care. In Staffordshire 21.5% of the annual cost of excess winter deaths was attributed to cold homes, whilst the cost of cold related illness to the NHS and Social Care was around £5.2m annually.
Staffordshire County Council had been successful in their bid to the Warmer Home Fund, securing £1.8m to address fuel poverty in Staffordshire (including match funding from E.On, the delivery partner). This had been a Staffordshire wide partnership bid that provided an innovative approach combining measures to address fuel poverty and the wellbeing, mobility and health risks commonly associated with living on cold homes.
Pro-active targeting of funds would be through the new Community (Frailty) Hubs being established as part of the STP’s Enhanced Primary and Community Care workstream. Both Staffordshire Police and Staffordshire Fire Service were well placed to help with referrals for those most in need. Referral pathways and programme delivery would be developed in the New Year.
RESOLVED – That the successful bid to the Warmer Homes Fund (WHF) that secured £1.8m to address fuel poverty in Staffordshire, and the associated WHF programme, be noted.
Emma Hodges, CEO, St. Giles Hospice
(Emma Hodges, CEO, St Giles Hospice, in attendance for this item.)
Following discussions between members of the voluntary sector, supported by Support Staffordshire, consideration was given to providing a mechanism for engagement both within the voluntary sector, and between the voluntary sector and the statutory agencies, on end of life care. As a result the End of Life Care Action Alliance was formed, with seventeen different agencies involved to date. A representative from the CCG and from Public Health also attend those meetings.
NHS England became aware of the End of Life Care Action Alliance and felt the model would fit their project focusing on voluntary, community and social enterprise engagement with the STP. The Alliance were asked to submit a paper for funding that would enable benefits to be fast tracked through building capacity and momentum. The H&WB received details of the NHS England approved action plan with details of funding. A key element of the funding was to provide a different approach to Care Planning.
Seventeen different member organisations were currently involved in the Alliance. A key element of development was to enable front line staff to have the confidence to talk about death and dying, with training on this being part of the work undertaken. Work was also being considered around care plans, with a proposal to develop bottom up care plans. Impact of these developments could be monitored through the number of people with an advanced care plan in place as well as the number of individuals dying in hospital.
RESOLVED – That the actions proposed by the End of Life Care Action Alliance, particularly in relation to the funding from NHS England, and the action plan be supported.
Glynn Luznyj, Director of Prevention and Protection, Staffordshire Fire and Rescue Services
The H&WB received details of Staffordshire Fire and Rescue Services’ Preventing Fire and Improving Health and Wellbeing from Glynn Luznyj, Director of Prevention and Protection.
The Fire and Rescue Service vision and priorities were shared with Members, as well as performance details. In particular the changing role of the Fire and Rescue Service was noted. As fires became less common the role of the Service had become more about engaging with communities and working on fire prevention whilst building relationships with other blue light services and health and social care partners on prevention and health and wellbeing. Examples of Staffordshire achievements were shared, including:
· a reduction in fire related incidents by 40% (locally and nationally);
· 3 million plus smoke alarms fitted; and
· Early intervention and long term prevention rapidly evolving to encompass wider health issues;10,000 interactions, engagements and training of children and young people per year.
Other examples of Fire Service best practice was shared with Board Members, including:
· Atrial Fibrillation in Halton CCG;
· work to tackle social isolation and loneliness; and
· Lancashire dementia support.
Members received details of the extensive work undertaken within the community. Details were also shared around the challenges faced around funding and demand shunting. There was ongoing development at a national level around the role of the Fire Service in health interventions and emergency medical response.
The work of the Fire and Rescue Service was commended by Members. Possible involvement of the Service with equipment installation for vulnerable residents was suggested and it was suggested that this could be considered by the Joint Commissioning Board, with the BCF being asked to consider possible funding.
RESOLVED – That:
a) the presentation be noted;
b) the Director for Health and Care raise the possibility of Fire and Rescue Service involvement in equipment installation at the Joint Commissioning Board.
John Wood, Chairman of the Staffordshire and Stoke-on-Trent Adult Safeguarding Partnership Board
(John Wood, SSASPB Independent Chairman, and Helen Jones, Adult Safeguarding Partnership Board Manager, in attendance for this item.)
The Care Act 2014 states that each local Safeguarding Adult Board must share their Annual Report with the H&WB in their area. Members now received a copy of the Staffordshire and Stoke-on-Trent Adult Safeguarding Partnership Board (SSASPB) Annual Report for the period 1 April 2017 to 31 March 2018. The Report outlined progress of sub-groups that support the SSASPB and its delivery of their Strategic Priorities and objectives.
Whilst the SSASPB didn’t consider details of individual cases, they did receive data which enabled them to identify spikes of concern and address these. Individual case information which enabled any links to be made would be addressed through the MASH or the Adult Social Care Teams and through QSISM (Quality Safeguarding Information Sharing Meeting).
Members noted that the Children’s Safeguarding Board had reviewed its membership and reduced the number attending. The SSASPB retained its large membership but felt that there was good engagement. In some instances members would be part of review groups rather than the main Board but would still have the opportunity to inform work undertaken.
RESOLVED – That the SSASPB Annual Report 2017/18 be received in accordance with the requirements of the Care Act 2014 Statutory Guidance (2016’para 160).
The Staffordshire Better Care Fund (BCF) plan had received full approval on 22 March 2018 and was currently in the second year of a two year programme. Planning guidance was expected in December for the financial year 2019/20. Members heard that continuing from Quarter 1, the County Council and the CCGs were progressing and extending Joint Commissioning arrangements. There was an agreed programme of work underway for 2018/19 overseen by the BCF Joint Commissioning Board and progress was being made, including Stoke-on-Trent City Council joining the joint commissioning arrangements.
RESOLVED – That:
a) the Quarter 2 BCF performance in 2018/19 be noted;
b) the indicative BCF budget for 2019/20 be noted; and
c) progress with developments towards joint commissioning by the County Council and CCGs be noted; and
d) the BCF Plan 2019/20 be brought to the March Board for agreement if submission date is after the 8th, otherwise the Chairs be given delegated authority to agree the Plan if submission is required prior to the next meeting.
Members noted the following areas of ongoing work for the Board:
· the Autism Self Assessment had been completed and would be signed off by the Co-Chairs on the Board’s behalf, and circulated to Members;
· currently there was no independent H&WB website and consideration was ongoing as to how to address this, with Members indicating that they were happy for the Board to have a page on the SCC web site;
· Members noted that the H&WB membership had been amended following the September Board meeting, with representatives from support Staffordshire and SCVYS now included;
· the SEND Strategy was currently out for consultation and Board Members were encouraged to respond; and
· the Burton/Derby hospital merger and whether an update should be brought to the Board.
Proposed items for the next Board meeting were agreed as follows:
· Commissioning Plans
· DPH report
· Physical activity
· Air Quality update
· Children’s Safeguarding and Governance
· District Council & Health and Wellbeing from Tim Clegg
· details of all H&WB statutory duties and monitoring of these
Members also reiterated again the desire to have one joint Staffordshire and Stoke-on-Trent H&WB and asked that the Co-Chairs approach the Stoke-on-Trent Board again on this issue.
RESOLVED – That:
a) an update on the Burton/Derby hospital merger was not required at present;
b) a web page for the H&WB should be included on the SCC website rather than an independent H&WB site;
c) the items listed above be included on the Forward Plan for the next H&WB meeting.