Agenda and minutes

There were none at this meeting.

RESOLVED: That, with an amendment at minute 6 from Sharon Young to Sally Young, Director of Corporate Services, Governance and Communications as in attendance for that item, the minutes of the Health and Wellbeing Board held on 5 September 2019 be confirmed and signed by the Co-Chair.

Members noted that the launch date for the Concordat had not been finalised but was expected to take place in February.

There were none at this meeting.

Emma Hodges, Group Chief Executive – St Giles Hospice

(Emma Hodges, CEO, St Giles Hospice, in attendance for this item.)

At the H&WB meeting of 6 December 2018, Members received details of the South Staffordshire End of Life Voluntary Action Alliance (VAL). The VAL supported priorities identified via the Director of Public Health’s report on End of Life in 2017 and the work of the End of Life STP Board. Members now received an oral update from Emma Hodges, outlining that:

·         the South Staffordshire End of Life VAL comprised 17 agencies aiming to unite around a community-based vision for end of life care;

·         the voluntary sector was an essential part of this work, in particular in working towards achieving the ambitious framework developed by the National Palliative and End of Life Care Partnership;

·         the VAL had been accepted as an accelerator site by NHS England, allocating £70,000 for the project, which had been used to fund a conference, training needs analysis and training delivery over the past 12 months;

·         a live pilot study was underway to test appetite towards care planning and advanced care planning, with a further £25,000 funding allocation from NHS England to support this work. This funding had been match funded by the CCGs.

RESOLVED – That the work of the South Staffordshire End of Life Voluntary Action Alliance in developing a complementary community model for end of life care in Staffordshire be supported.

Simon Whitehouse, STP Director

[Jonathan Bletcher, Director, Planning & Strategy, and Tracey Shewan, Communication & Corporate Services, in attendance for this item.]

Together We’re Better, the five year plan, was required to publish its refreshed system during winter 2019/20. The Plan was submitted to NHS England in November 2019, although this was an iterating process, with the latest iteration submitted on 8 January 2020 and awaiting regional sign off.

The H&WB received a presentation on the Plan’s:

·         Strategic framework;

·         how the Plan dovetailed/supported the Health and Wellbeing Strategy;

·         the place based approach;

·         financial overview;

·         workforce challenges within health and social care;

·         an update on progress with the system transformation around: urgent and emergency care; integrated community services in South and East Staffordshire; mental health services; maternity services; and planned care; and,

·         developing the system architecture and interim arrangements.

A key ambition nationally was the development of Integrated Care Systems by 2021. The Together We’re Better Board drove this strategic partnership in Staffordshire, with work underway with system leaders to redesign local approaches. This included the need to establish Integrated Care Partnerships.

Members queried the increasing number of priorities within the Plan, what role the West Midlands Ambulance Service had in supporting delivery of the Plan’s priorities and how effective communication was with them, and whether NHS England believed Staffordshire had credible plans for delivery. They also queried the listening exercise which had appeared to be North Staffordshire centric and the health infrastructure implications around housing developments.

RESOLVED – That:

a)    the information provided and the progress with implementing the priorities set out in the Five Year Plan for Staffordshire and Stoke-on-Trent be noted; and

b)    the development of the Integrated Care System be supported.

Presentation by Craig Porter, Managing Director (South), CCGs

Craig Porter, Board Member and CCG Managing Director of South West Division, tabled details of Staffordshire CCG’s commissioning intentions 2020/21.  Commissioning intentions had been co-developed with providers and clinicians, and reflected:

·         strategic developments – including development of an Integrated Care System (ICS) and strategic commissioning capability, as well as place-based developments which included Primary Care Networks (PCNs) and ultimately Integrated Care Providers (ICPs);

·         productivity, efficiency and delivery – this included intra-STP (Staffordshire Transformation Plan) Intelligent Fixed Payment (IFP) arrangements and an intention to develop a payment mechanism for out-of-STP providers that would ensure equitable risk and resource allocation; and

·         key service/pathway developments – giving key priorities that underpinned wider system transformation and care quality improvements, including: population health management; out of hospital redesign; system redesign; frailty; mental health; learning disabilities and autism; planned care; personalised care; cancer; children and young people’s services board; urgent care transformation; and digital.

Members queried the split between spend on acute and preventative services, with long term ambitions for the balance of spend to move more towards  preventative services. The possibility of combining commissioning intentions across SCC and CCGs was also raised.

RESOLVED – That Staffordshire CCG’s commissioning intentions 2020/21 be noted.

Presentation by Richard Harling, Director for Health and Care, SCC

The H&WB received a presentation on the commissioning intentions of SCC, setting out the outcomes, priorities and working principles of the vision for Staffordshire.

Major transformation programmes were shared around:

·         supportive communities (including information, advice and guidance, and building and signposting to community assets)

·         all age disability (including developing an autism strategy, recommissioning mental health recovery services and carers services)

·         modernising adult social care (including the development and implementation of E-self assessment and a project around preparation for adulthood that ensured children with disabilities had the right support as they reached 18)

·         care in the home (including home care and targeted reviews)

·         accommodation based care

·         urgent care

The commissioning intentions would enable savings of £25m over five years and improvement in service provision.

RESOLVED – That the SCC commissioning intentions for 2020/21 be noted.

Jenny Pierpoint, Portfolio Manager

The 2019/20 Better Care Fund (BCF) Plan had been drafted, agreed and submitted in accordance with required timescales. At their meeting of 5 September 2019, the H&WB had agreed the extension of the current BCF schemes and approved the delegated sign-off of the 2019/20 plan to the Co-Chair’s.

Member’s received details of the BCF Pooled Funding. Confirmation of the Plan’s approval had been received that afternoon.

Following submission of the Staffordshire BCF Plan, the County Council and the CCGs had made a request to re-baseline the CCG minimum contribution to social care to ensure that Staffordshire had the resource required to sustain essential services going forward around support for carers and the Care Act. Positive informal feedback had been received that suggested this request would be approved.

RESOLVED – That:

a)    the approval of the 2019/20 BCF Plan by the H&WB Co-Chairs and its submission to the regional team on 27 September 2019 be noted;

b)    the request for re-baselining made in order to correct historic issues with BCF funding in Staffordshire be noted; and,

c)    timescales for BCF Plan approval be noted.

Jon Topham, Senior Commissioning Manager, Public Health

At the H&WB meeting of 5 September it was resolved that a report would be brought to the next Board meeting updating Members on progress with the Director of Public Health’s Annual Report recommendations and identifying timescales for any outstanding actions. Members now considered a table summarising responses from key organisations to the Annual Report’s recommendations.

An assistive technology workshop was suggested to help raise awareness and to include representation from the media and general public.

RESOLVED  - That:

a)    a presentation on the Together We’re Better Digital Programme be brought to the March Board meeting;

b)    updates on Broadband and Digital Infrastructure Strategy from SCC be brought to the December 2020 H&WB meeting;

c)    joined up approaches across the Public Sector be supported; and,

d)    an assistive technologies workshop be held, with arrangements for this considered at the March Board meeting.

Kate Sharratt, Assistant Director for Intelligence, Improvement and Development

[Kate Sharratt, Head of Intelligence, Improvement and Development, in attendance for this item.]

The H&WB received the Families Strategic Partnership (FSP) Annual Report 2018/19 which helped monitor progress in delivering Staffordshire’s Children, Young People and Families Strategy. The Annual Report detailed FSP activities during 2018/19 and provided an overview of key activities to be undertaken during 2019/20.

During 2019/20, the FSP had expanded to include the Special Educational Needs and Disability (SEND) partnership and Education Strategy Forum. In addition a request had been made for the Children and Young People’s JSNA to be updated to enable the Partnership to be intelligence led. On completion of the JSNA, work would be undertaken to review existing arrangements, with a view to updating the FSP Strategy, priorities, work programme and governance arrangements. The intention was to share the revised strategy and governance arrangements with the H&WB at their summer 2020 meeting in place of a 2019/20 annual report.

RESOLVED – That:

a)    the FSP Annual Report 2018/19 be endorsed and the contributions to delivering the H&WB Strategy be acknowledged; and

b)    a revised FSP strategy and governance structure be brought to the H&WB summer meeting in place of a FSP annual report.

John Wood, Independent Chairman

[John Wood, SSASPB Independent Chairman, and Helen Jones, Adult Safeguarding Partnership Board Manager, in attendance for this item.]

The Care Act 2014 stated 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 2018 to 31 March 2019.  The Report outlined progress of sub-groups that support the SSASPB and its delivery of their Strategic Priorities and objectives.

Cllr Alan White, Co-Chair, wished to place on record his thanks for the work undertaken by the SSASPB and his confidence that any issues raised with them were dealt with in an appropriate, professional and timely manner. Dr Alison Bradley, Co-Chair, endorsed this thanks from the CCG perspective.

RESOLVED – That the SSASPB Annual Report 2018/19 be received in accordance with the requirements of the Care Act 2014 Statutory Guidance (2016’para 160).

Tim Moss, Assistant Director for Education Strategy and Improvement

In November 2018, Ofsted/CQC had inspected Staffordshire’s effectiveness in implementing the special educational needs and disability (SEND) reforms (as set out in the Children and Families Act 2014). The inspection outcome was that a Written Statement of Action (WSoA) was required to address the significant areas of weakness identified in the published report letter.  H&WB Members received a copy of the WSoA, which had been submitted to Ofsted in April 2019. The document set out how SCC and NHS Staffordshire CCGs would work together with partners, parents/carers, young people and school leaders, to improve outcomes for children and young people with SEND.

A key element of the WSoA was the formation of seven task and finish sub groups as follows:

a)    leadership and governance

b)    joint commissioning

c)    Early Years

d)    graduated response

e)    assessment and planning

f)     local offer and engagement group

g)    eight district governing body groups

The Chairs of each sub group would meet monthly prior to the SEND Partnership Group to highlight progress with their actions plans, the associated risks and interdependencies.

Details of next steps were shared with Members, including:

a)    the co-production with key stakeholders of the SEND Strategy which will inform future multi-agency direction of travel regarding send in Staffordshire;

b)    the SEND strategy will contain a set of principles to underpin the way key partners work with children, young people and families, communities and partners to meet the needs of people with SEND;

c)    following the production of the SEND strategy a range of activities developed to ensure effective delivery;

d)    key elements of the SEND model to include: SEND locality hubs; educating children with moderate learning difficulties in mainstream schooling where ever possible; outreach support for mainstream schools provided by special schools; and special schools to provide for those in greatest need; and

e)    at a local level the SEND model will be aligned to other locality models.

RESOLVED – That:

a)    the content of the report and the status of the Local Area Written Statement of Action be noted;

b)    the direction of travel to improve the SEND service be endorsed; and

c)    that the SEND Strategy be brought to the H&WB in September 2020 for review and sign-off.

The H&WB noted their Forward Plan, and the addition of the following items for their next meetings:

·         JSNA

·         digital programme

It was hoped that CCG colleagues would attend the March meeting to share their views on the JSNA.

RESOLVED – That the additions to the work programme be noted.