Agenda and minutes

There were none at this meeting.

RESOLVED – That the minutes of the Health and Wellbeing Board meeting held on 6 July 2017 be confirmed and signed by the Chairman.

There were no questions from the public.

Verbal update by Allan Reid, Consultant in Public Health

The Steering Group developing the end of life care debate had met twice to date. They proposed that the debate should be based on the title used nationally, being called “Dying Matters in Staffordshire” rather than the previous suggestion of “Dying to Chat”. It was also suggested that a dedicated website would enable a more public facing approach to the work of the Board and the debate.

RESOLVED – That:

a)    the verbal update be noted;

b)    “Dying Matters in Staffordshire” be the name of the debate; and

c)    Work towards a dedicated web site be progressed giving consideration to costings.

Richard Harling, Director for Health and Care

The Pharmaceutical Needs Assessment (PNA) considers the current provision of pharmaceutical services across a defined area, making an assessment as to whether population needs are met. The H&WB has a statutory duty to update their PNA every three years, keep a current map of provision in its area and publish any supplementary statements where changes have been made.

The Board received the draft consultation report which would form the second comprehensive PNA for Staffordshire. The report highlighted that:

·         there are sufficient numbers and a good choice of pharmacy contractors to meet Staffordshire’s pharmaceutical needs;

·         there are a number of advanced and locally commissioned services that pharmacies currently provide to support the health and wellbeing needs of Staffordshire residents;

·         there are opportunities for pharmacies to further complement primary and secondary care services and play a part in improving health and reducing inequalities.

The Board were aware of the funding reductions and consequent contracting services of pharmacies and the STP consideration of the use of pharmacies for primary care.

RESOLVED – That:

a)    further consideration should be given to how pharmacies can support delivery of health and wellbeing priorities and particularly focus on the contribution pharmacies can make to the STP;

b)    a consultation period of 60 days between September and December 2017 be agreed; and

c)    further feedback from H&WB Members and their organisation be given to the report authors to help shape the final PNA as part of the consultation process.

Gavin Boyle, Chief Executive, Derby Teaching Hospital NHS Foundation Trust

Helen Scott-South, Chief Executive, Burton Hospitals NHS Foundation Trust

Magnus Harrison, Medical Director, Burton Hospitals NHS Foundation Trust

[Gavin Boyle, Chief Executive, Derby Teaching Hospital NHS Foundation Trust, Helen Scott-South, Chief Executive and Magnus Harrison, Medical Director, Burton Hospitals NHS Foundation Trust, and John Rivers, Chairman of both Derby and Burton Hospital Trusts attended to present this item]

The Boards of Burton Hospitals NHS Foundation Trust and Derby Teaching Hospitals NHS Foundation Trust had now approved an outline business case for a proposed merger between the two organisations. The merger would see Burton Hospitals retaining a vibrant district general hospital, including Accident and Emergency (A&E) services, with a commitment to improving  services in Burton. For Derby Hospitals the proposed collaboration would give access to a wider population base, enabling the organisation to sustain and expand specialist services.

With regard to the community hospitals in Lichfield, Tamworth and London Road, Derby, the Trusts intended to maximise their use by focusing on new models of care which centred on the local “place” people live, developed as part of the Sustainability and Transformation Plans (STP) in Derbyshire and Staffordshire. The partnership also offered opportunities to develop shared corporate and non-clinical services.

Board Members raised the following issues:

·         the importance of ensuring the proposed merger’s fit with the STP;

·         the importance of maintaining patient choice and the current use of Good Hope Hospital by many Staffordshire patients;

·         that the business case includes a growth in acute activity and income that risks further increasing the proportion of NHS funding going into acute services at the expensive of investment in prevention and community services, unless this can come from a reduction in acute activity and expenditure at other Acute Trusts;

·         that the business case should therefore be checked against the assumptions made by neighbouring Acute Trusts to determine whether they are in fact expecting a shift of activity and funding to BHFT/DTHFT.

The commissioner for Burton, East Staffs CCG was strongly in support of the collaborative work which was seen as essential to ensure sustainable and high quality services for the public currently served by Burton hospitals.

RESOLVED – That:

a)     the continued commitment and progress made towards the proposed merger of Burton Hospitals NHS Foundation Trust and Derby Teaching Hospitals NHS Foundation Trust be noted, along with their commitment to the goals of the Staffordshire STP; and

a)    the business case be checked by the STP against the assumptions about activity and funding at other Acute Trusts to determine whether collectively they are affordable.

Helen Riley, Deputy Chief Executive and Director for Families and Communities

The H&WB received an overview of the activity undertaken by the Families Strategic Partnership Board (FSPB), supported by the Families Partnership Executive Group (FPEG). The report highlighted the Partnership Board’s aim to deliver sustainable long-term solutions to effectively manage demand of services and ensure help is provided at the earliest opportunity.

RESOLVED – That:

a)    the report be noted;

b)    the work undertaken by the FSPB and the FPEG and the direction of travel for partnership activity be endorsed;

c)    the activity plan and outcomes framework be approved;

d)    the priority of mental health and wellbeing (across the life course, focusing on the lower end of the spectrum and centring on root cause) be endorsed; and,

e)    the successful delivery of FSPB initiatives is acknowledged as requiring a “whole family” holistic approach.

Simon Whitehouse, Programme Director

The H&WB received detail of the STP’s three priorities for 2017/18: bringing the finances under control; improving performance; and managing winter better. Progress was shared on the five key programmes within the Together We’re Better (TWB) Staffordshire STP and Members also received details on a review of governance and stakeholder engagement. A re-deployment team had been set up to match existing staff with vacancies across Staffordshire and Stoke-on-Trent and details of this were also discussed.

RESOLVED – That:

a)    the H&WB support the three priorities;

b)    the co-chairs of the H&WB attend a Health and Care Transformation Board governance workshop to explore and shape how the system moves into delivery mode; and

c)    Board Members give consideration to enabling their respective organisational vacancies to be accessible to displaced health and care staff through the re-deployment team.

Ben Hollands, Sports Across Staffordshire & Stoke-on-Trent (SASSOT)

At their meeting of 9 March 2017 the H&WB had adopted a sub-group of the Board to lead an application for a consortia bid to the Sport England Local Delivery Fund. The premise of the bid had been to tackle physical inactivity in older adults within six geographical areas across Staffordshire. In June Sport England had made the decisions that whilst Staffordshire’s application should be commended for its strong sense of place, logical approach and clarity of purpose, they would not be taking it through to the final stage of assessment. This was partly because they needed stronger evidence of H&WB strategic leadership.

Through the bid process it had become apparent that there was an urgent need for a collaborative approach to tackle inactivity and the sub-group was now developing a clear vision, priority outcomes and associated work programme, evaluating what could be delivered without the significant investment of the Local delivery Fund. A further application had been made to Sport England by Sport Across Staffordshire and Stoke-on-Trent for a dedicated staff resource to support the work of the sub-group.

RESOLVED – That:

a)    the work of the sub-group to date be endorsed;

b)    the H&WB continue to take a leadership role in the development of a collaborative approach to physical inactivity in Staffordshire;

c)    physical activity is a priority for the H&WB going forward; and

d)    help to ensure physical activity is embedded into local policy.

Helen Riley, Deputy Chief Executive and Director for Families and Communities

The H&WB received a summary of the partnership discussions and an overview of the Place Based Approach (PBA) concept and how this was being developed at a local level by the Families Strategic Partnership. The partnership brought together strategic and operational system leadership at both a County and District/Borough level whilst ensuring best use of public sector and community assets within localities. Agreement had been reached to pilot the PBA concept initially in Newcastle-under-Lyme and Tamworth, with the intention that the learning from these pilots support the Districts/Boroughs when the PBA is rolled out across Staffordshire. This is currently being aligned with the adults prevention workstream.

RESOLVED – That:

a)    the report, and particularly the concept, definition and principles of the PBA, be noted;

b)    the core approach across Staffordshire and the local flexibility dependent on local need a resource availability be noted;

c)    provision by the H&WB of the strategic direction be agreed;

d)    the successful delivery of PBA is acknowledged as requiring a “whole family” approach.

Karen Bryson, Assistant Director, Public Health and Prevention

The H&WB considered the approach to their new Strategy “Prevention through Wellness – our People and Place based approach”. The new Strategy had much on common with the STP Prevention Work stream. It was therefore suggested that the Strategy be adopted as the strategic framework for the Prevention Workstream, with a single delivery plan overseen by a Prevention Steering Group established as a sub group of the H&WB.

The Strategy would focus on three themes:

·         Lifestyle factors – obesity, physical inactivity, smoking, drugs and alcohol

·         Mental well-being – social isolation, dementia, suicide prevention

·         Long term conditions – diabetes, heart disease and stroke, respiratory disease, end of life

RESOLVED – That

a)    the overlap between the H&WB Strategy and the STP Prevention Work stream be noted, and the Strategy’s adoption as the strategic framework for the STP Prevention Work stream be agreed;

b)    the establishment of a Prevention Steering Group sub-group of the H&WB be agreed to develop and implement the Delivery Plan. Membership of the sub-group drawn from key partners and report to the H&WB and the STP Board;

c)    the key Strategy themes be agreed; and

d)    the proposed approach to prevention be supported.

The following items were included on the H&WB Agenda for information only:

·         Better Care Fund Update

·         JSNA Outcomes - August 2017

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

Items for debate –

1.    Annual Report of the Director of Public Health

2.    HIAP

3.    Public Conversation

4.    Commissioning Intentions

5.    Suicide Prevention

6.    Ofsted report of Children’s Services

Items for information –

1.    Air Quality Report

2.    Anti-Microbial Resistance (AMR)

3.    H&WB Strategy

4.    Staffs & Stoke-on-Trent Adult Safeguarding Partnership Board Annual Report

RESOLVED – That the Forward Plan be agreed.