Agenda and minutes

There were none at this meeting.

RESOLVED – That the minutes of the Health and Wellbeing Board meeting held on 8 December 2016 be confirmed and signed by the Chairman.

There were no questions from the public.

Becky Wilkinson, Programme Manager

The Staffordshire Better Care Fund (BCF) had undergone scrutiny at national and regional level, with assessors reaching a consensus that the Plan should be approved with no remaining unmet Key Lines of Enquiry (KLOEs) and the Board received detail of the assessor feedback. Whilst national guidance and templates had been delayed the County Council was working closely with CCG counterparts and the regional BCF Manager in planning for 2017/19. Once the guidance was released there would be a maximum of six weeks in which to complete and return Staffordshire’s BCF.

National conditions had been reduced from eight to three:

·         a requirement for a jointly agreed plan, approved by the H&WB;

·         real terms maintenance of transfer of funding from health to support adult social care; and

·         a requirement to ring-fence a portion of the CCG minimum to invest in Out of Hospital services.

Plans would also be required to set out the area’s vision for integrated health and social care by 2020. The 2017-19 BCF would be expected to align to wider integration in the H&WB economy and align to the Staffordshire Transformation Plan (STP).

Members raised the following:

·         the need for a greater level of understanding of the STP once specifics were available, whilst acknowledging that the H&WB has had two workshop session on the STP to date and that public debate was currently around agreeing the broad concepts and direction of travel;

·         future Disabled Facilities Grants (DFCs), with an expectation that the  pass through will be the same as the previous year;

·         fully supporting developing one narrative and aligning the BCF and STP to help reduce complexity and ensure a stronger focus;

·         a request for a development session around the STP and BCF, showing how these are aligned.

RESOLVED – That, with the caveat that a H&WB development session be arranged prior to their June meeting around the STP, BCF and how these are aligned:

a)    the report, and the link between the BCF and the STP, be noted;

b)    use of the BCF as a local delivery mechanism for the STP be agreed;

c)    the scope for the 2017-19 BCF be agreed;

d)    the Board delegate agreement for the final BCF submission to the joint H&WB Co-Chairs (to enable agreement to be reached prior to the next H&WB meeting in June);

e)    scope outlining the use of BCF as a local delivery mechanism for the STP be approved; and,

f)     the use of one narrative for both the STP and BCF be agreed.

Jon Topham, Senior Commissioning Manager, Public Health

The Board received details of the H&WB Strategy beyond 2018, which built upon previous Board discussions around the Living Well Strategy and outlined a direction of travel for the new strategy. The Board considered current activity and noted that the Local Government Association (LGA) session of 7 July 2016 and the Development Session of 12 January 2017, both reflected the importance of the H&WB and laid the foundations for a new way of working. The Board had also suggested that the current strategy should evolve rather than a brand new strategy being developed with a focus on what the H&WB will do as a system leader and a recognition of the democratic legitimacy provided by elected members on the Board.

The Board intended to focus on three key principles, these being:

·         prevention, early intervention and personal responsibility as the primary driver for their work;

·         promoting integration and co-operation;

·         enabling effective navigation of systems (agencies and public) to create the right environment for prevention.

The rationale for separate Stoke and Staffordshire H&WBs was raised, with concern over duplication, frustrations at the time commitment to non councillor board members in attending two H&WBs and the advantages of a more joined up approach. Members suggested working together to develop the new Strategy could be a starting point towards greater co-operation.

RESOLVED – That the H&WB:

a)    approach the Stoke H&WB to suggest working together on developing the new Strategy;

b)    promotes better “join up” around money and resources;

c)    supports the development of a place based approach focusing on key priority neighbourhoods, developing community assets and engagement;

d)    develops a proactive communication and public engagement function;

e)    develops the policy environment Health in All Policies (HiAP);

f)     continues to provide the right data and information for Joint Strategic Needs Assessments (JSNA);

g)    agree the following governance issues:

·         Board Members role will be clarified;

·         broader membership should be considered;

·         a greater emphasis on democratic legitimacy;

h)   the following timeline be agreed.

Jon Topham, Senior Commissioning Manager, Public Health

HiAP was a collaborative, evidence-based approach to improving the health of all people by incorporating health considerations into decision-making across a range of organisational sectors and policy areas. Whilst there had been some consideration of an HiAP type approach locally within licensing and fast food, there had been no co-ordinated approach to embed health in all policies.

Members strongly supported the HiAP approach. They noted the HiAP Licensing paper at Appendix D which recommended identifying champions for both licensing and fast food, and agreed to this as an approach. Members shared examples of work already taking place within their organisations around these issues. A workshop for Board Members and Partners was suggested, with District and Borough colleagues agreeing to host and lead on this event. Champions for both fast food and licensing would be identified after the workshop session.

RESOLVED – That the H&WB:

a)    champions the HiAP approach, with Board members becoming HiAP Champions, advocating the HiAP approach within their own organisations and beyond;

b)    builds HiAP into the new H&WB Strategy and Action Plan for 2018 onwards;

c)    monitors progress on HiAP through the H&WB Strategy and Action Plan;

d)    District and Borough Board Members host a workshop for Board members and partners on the HiAP approach in Staffordshire; and

e)    reflects the corporate approach to HiAP by ensuring all organisations involved in the H&WB embed Health Impact Assessments into their decision-making processes.

Jude Taylor, Sportshire Co-ordinator

As part of their new investment strategy Sport England had recently launched the Local Delivery Fund (LDF). The LDF made up to £10m available to ten geographical areas for projects to tackle physical inactivity. Staffordshire SCC was working with partners to develop a Staffordshire Physical Activity Strategy which would form the basis of a bid to Sport England and the Board were asked to support the proposed leadership and governance of this work.

RESOLVED – That the H&WB:

a)    takes the leadership role for the development of a Staffordshire Physical Activity Strategy and sponsors the bid submission;

b)    provides governance to the bid and adopts the working group as a sub-group of the Board;

c)    supports a focus on inactive people in the 55-68 age group; and

d)    receives regular updates on the bid’s progress.

Presentation by Richard Harling - Director of Public Health

The Director of Public Health produces an annual report on a topic of his choosing, and Members now received a presentation outlining the focus of this year’s report on End of Life (EOL). Life expectancy continued to increase, however the number of years spent in ill-health was not reducing. There was a need to focus on improving the quality of life and on the quality of death, with EOL experiences improved if these were discussed and planned.

The report will consider key barriers to raising the issue of death and the benefits of effective planning to the individual, their families and friends and to the wider health economy. It will consider ambitions for palliative and EOL care, the importance of talking with family and professionals about EOL and the current reality of EOL care, making recommendations to address the issues identified.

Members shared details of work undertaken in their organisation around EOL. They also stressed the sensitive nature of this issue whilst supporting the suggestion that EOL be considered as the topic for the next H&WB debate.

It was anticipated that the report would be published during the summer.

RESOLVED – That the presentation be received.

Presentation by CCG and SCC representatives

The Board received a presentation from Jonathan Bletcher, Stafford and Surround CCG, on Staffordshire CCGs commissioning intentions for 2017-2019, which were detailed in their Operational Plan. The Operational Plan aligned CCG finance and activity planning whilst demonstrating delivery of the NHS constitutional standards and was aligned to the STP. Three operational plans had been developed to reflect specific geographical areas of North, South and East Staffordshire.

The presentation explained the relationship between the STP and Operational Plan. It supported Quality, Innovation, Productivity and Prevention (QIPP) whilst moving to the transformational changes of the STP. The Board also heard details of the twelve areas for action from the H&WB Strategy and examples of CCG Operational plan actions and alignments to these.

It was suggested that once the plans became more detailed specific areas may be brought to the H&WB on a more regular basis for discussion.

The Director of Health and Care then gave a presentation outlining the commissioning intentions of the County Council which set out the vision to:

·         Build a healthy Staffordshire;

·         Help people to help themselves;

·         Grow communities to support people;

·         Offer extra help for those who need it;

·         Be honest about the options available; and

·         Maintain long term care services.

Members received details of the delivery plan for health and care and considered detail of the: universal and targeted intervention services around public health and prevention; adult social care and safeguarding services; and care commissioning.

RESOLVED – That the presentations on both CCG and SCC commissioning intentions be received.

Verbal update by Ruth Goldstein, Public Health

The first H&WB debate had taken place on 1 March. The debate had been on obesity and had involved wider communications engagement and social media prior to the event. There had been a good attendance on the day, with 72 members of the public attending and participating in the debate, with a team of 6 professionals on the debate panel.

A detailed evaluation of the event would be brought to a future H&WB meeting.

Those Board Members who had attended felt it had been very successful, although they felt there should have been more awareness that this had been a H&WB event.   

RESOLVED – That the update on the obesity debate be noted.

In future items for information will be included on Pinipa for Members information/comment prior to each Board meeting. Pinipa training will be available to Board Members at the conclusion of this meeting.

For this meeting “for information” items have been included in the agenda pack on the following areas:

Members were aware that in the future items for information would be included on Pinipa for Board Members information and comment prior to each Board meeting. Detail on how to use Pinipa would be circulated to Board Members after the meeting and training would be made available should Members request this. On this occasion however the following documents had been included in the agenda pack for information only:

·         Children’s Safeguarding Board Annual Report;

·         Update on CAMHS funding; and

·         JSNA/Intelligence

The Forward Plan sets out the work of the Board and is reviewed at each meeting.

Recommendation: Members are asked to agree their next meeting agenda based on their discussions during this meeting and the work outlined in the Forward Plan. 

In considering their Forward Plan the Board noted the following items scheduled for their June meeting:

·         Items for decision –

Children & Families

·         Items for Debate –  

H&WN Strategy, first draft

          Obesity conversation following the 1 March   debate

HiAP, neighbourhood/place based approach

BCF

·         Items for information –      

Personal Health Budgets

JSNA/intelligence

Members also requested an item on the STP for their June meeting.

The Board had also agreed workshop sessions:

·         on the STP/BCF prior to their June meeting,

·         on HiAP to focus on licensing and fast food, with District and Borough colleagues hosting this event.

RESOLVED – That the additions to the Forward Plan be agreed.