Agenda and minutes

Health and Wellbeing Board
Thursday, 10 September 2015 1.00 pm

Venue: County Hall, Kingston upon Thames, Surrey KT1 2DN

Contact: Andrew Baird or Joseph Jones 

Items
No. Item

127/15

APOLOGIES FOR ABSENCE

128/15

MINUTES OF PREVIOUS MEETING: 11 JUNE 2015 pdf icon PDF 137 KB

129/15

DECLARATIONS OF INTEREST

130/15

QUESTIONS AND PETITIONS

130/15a

Members' Questions

131/15

Public Questions

132/15

Petitions

133/15

BOARD BUSINESS

    To update the Board on any key issues relevant to its areas of work, membership and terms of reference.

     

    The Internal Audit team at Surrey County Council recently undertook an audit of the Health & Wellbeing Board, and the report and resulting Management Action Plan is attached, along with a copy of the Board’s Terms of Reference for information.

     

    Minutes:

    Terms of Reference

     

    ·           Members discussed the Health and Wellbeing Board’s Terms of Reference (ToR) to ensure that these reflected the functions and governance of the Board. It was suggested that amendments be made to the ‘key functions’ section of the ToR to remove reference to the role of the shadow Health and Wellbeing Board. Members agreed that the following  sections would be removed from the ToR:

    “Oversight of the commissioning expenditure across all health and social care organisations during its shadow period to ensure that the Board is in a position to take responsibility for this expenditure from April 2013.”

     

    “Oversight of the development of the JSNA and other commissioning strategies during the shadow period to ensure that the Board can take full ownership of these plans from April 2013.”

     

    ·           Attention was also drawn to a repetition contained within the ToR under the ‘Board Members’ section. It was subsequently agreed that the point below also be removed from the ToR:

    “All partners must share their commissioning plan and consult the Board as to whether it considers the commissioning plan to have taken proper account of the JSNA and JHWS.”

     

    ·           The removal of these sections was added to the actions tracker under reference number A1/15 and the updated ToR are attached to these minutes as Annex 1.

     

    ·           Concern was expressed in regard to substitution arrangements for Board meetings and it was suggested that members of the Board should be allowed to have more than one named substitute. It was agreed that an item would be added to the forward work programme in order to discuss the matter of substitutes and the issue of Board membership more widely. This has been added to the actions tracker under reference number A2/15.

    Forward work programme

     

    ·           A recommendations tracker would be added to the agenda for all future public meetings to ensure that progress of actions agreed by members could be tracked more effectively.

     

    ·           A request was made that the item entitled ‘Entry to the System’ which was scheduled for discussion at the meeting on 5 November 2015 be renamed to ‘Entry to the Health and Social Care System’. This has been added to the actions tracker as item A3/15.

     

    ·           The item entitled ‘Asset-based approaches to health and social care’ was moved to the meeting on 7 January 2016 and the Strategic Director for Adult Social Care was included as a sponsor for this item. This was been added to the actions tracker under reference A4/15.

    RESOLVED:

     

    a)    That the ToR be amended to reflect the changes agreed by the Board.

     

    b)    That an item on the membership and substitutions for the Health and Wellbeing Board be discussed at a future meeting.

     

134/15

JSNA AND COMMISSIONING INTENTIONS (2016/17) pdf icon PDF 132 KB

    The purpose of this item is to:

    ·         Share the plans for the future development of the Joint Strategic Needs Assessment (JSNA) and its use to inform commissioning intentions (see report 1 attached).

    ·         Share at a headline level the commissioning planning timeframes and key commissioning priorities of Board member organisations.

    ·         Outline how the commissioning intentions are aligned to Surrey’s Joint Health and Wellbeing Strategy.

    ·         This item is intended to allow for a discussion on the opportunities, gaps and challenges for the Board in implementing Surrey’s Joint Health and Wellbeing Strategy.

     

    Additional documents:

    Minutes:

    Witnesses:

     

    Rich Stockley, Senior Manager, Research & Intelligence, Surrey County Council

     

    Key points raised during the discussions:

     

    JSNA

    ·         The Board was provided with an overview of the amendments identified to further improve the accessibility and functionality of the Joint Strategic Needs Assessment (JSNA) as a resource for Surrey County Council (SCC) and its partners. These included introducing clearer and more succinct chapters which were easier to locate within the JSNA. Support was also sought for the revised JSNA to assume a life course approach in line with the outcomes of the Marmot Review.

     

    ·         The need for a JSNA Strategic Development Group was also stressed to the Board to ensure that there was an effective means of making decisions on the future strategic direction of the JSNA. Members of the Board were invited to join the Development Group to provide their input into the direction of the JSNA.

     

    ·         A member of the Board suggested that the final section in the proposed life course approach to the revised JSNA, ‘Aging Well’, be amended to 75 and over to align with the approach taken by the Clinical Commissioning Groups (CCGs). It was further suggested that a representative from Healthwatch Surrey be involved in the work undertaken to update the JSNA so that it also reflected the patients’ voice.

     

    ·         Members of the public present were invited to ask questions about the JSNA following which it was requested that the minutes of the meeting be circulated as widely as possible to help Surrey residents get a more comprehensive understanding of the work that the Board was doing to set the strategic direction of health and social care in the county.

     

    ·         The recommendations made in the report were agreed by the Board.

     

    Commissioning Intentions

     

    ·         Presentations detailing the commissioning planning timeframes, key commissioning priorities as well as highlighting potential challenges and opportunities were provided by each of the CCGs with members present, SCC, the districts and boroughs and NHS England.

     

    ·         It was felt that commissioning intentions should be presented jointly by Board member organisations to reflect the growing collaboration which was taking place between health and social care commissioners. The Board agreed that future presentations on commissioning intentions would be delivered collectively by member organisations. This has been added to the actions tracker as item A5/15.

     

    ·         The recruitment and retention of staff was highlighted as a particular challenge facing health and social care commissioners in Surrey particularly in light of the new living wage which was being introduced from April 2016 as well as a European Union judgement which required all mobile workers to be paid for time spent travelling between appointments. Given these challenges, it was agreed that the Health and Wellbeing Board would schedule an item on workforce recruitment and retention to be considered in 2016. As well as recruitment and retention of staff, it was suggested this item could also explore ways to flex the existing workforce more effectively and avoid the duplication of work by staff across organisations. This was included on the  ...  view the full minutes text for item 134/15

135/15

BETTER CARE FUND PLAN - STATUS UPDATE pdf icon PDF 131 KB

    The purpose of this item is to update the Board on progress in implementing the Better Care Fund plan (see attached position statement), following on from the update given at the March meeting and review the Better Care Fund Q4 14/15 and Q1 15/16 returns which are made to NHS England (attached). The Health and Wellbeing Board has delegated authority to sign off these returns to the Better Care Fund Joint Metrics Group. 

     

    Additional documents:

    Minutes:

    Witnesses:

     

    Dave Sargeant, Strategic Director of Adult Social Care, Surrey County Council

     

    Key points raised during the discussion:

     

    ·         The Strategic Director of Adult Social Care delivered a presentation to the Board on the Better Care Fund. The presentation is attached to these minutes as Annex 2.

     

    ·         Concerns were expressed regarding a rise in non-elective admissions to hospitals in Surrey, a key area that the Better Care Fund (BCF) was created to address and a metric which could also an impact on funding allocations. It was indicated that NHS England could provide some insights into ways of reducing non-elective admissions if they continued to rise.

     

    ·         The Board were informed that discussions were ongoing between SCC and the CCGs regarding the signing of Section 75 agreements but that it was hoped the discussions taking place around the legal elements of these agreements would be finalised within two weeks. It was indicated that NHS England had some concerns around why the S75 agreements had not been signed and whether this was the result of more widespread problems between SCC and the CCGs than the legal technicalities of the contracts. The Board agreed that the Strategic Director of Adult Social Care would circulate an update on the S75 agreements to Board members two weeks after the meeting. This was added to the actions tracker as reference number A8/15.

     

    ·         Discussions took place regarding the disparity in the way that partners were working together across the county to deliver health and social care services. It was highlighted that the way in which CCGs were collaborating or working with SCC or the district and borough councils was contingent on the needs of the local population and the health and social care landscape within each CCG area although there is a collective focus on delivering the same outcomes.

     

    RESOLVED:

     

    That the Strategic Director of Adult Social Care provide an update to Board members on the position of the Section 75 agreements two weeks after the meeting.

     

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IMPROVING OLDER ADULTS' HEALTH AND WELLBEING - ACTION PLAN REFRESH UPDATE pdf icon PDF 205 KB

    The purpose of this item is to update the Board on the proposed refresh of the ‘Improving older adults’ health and wellbeing action plan’ and performance metrics as requested at the Health and Wellbeing Board Meeting on 11 June 2015. 

     

    At the June 2015 meeting the Board felt that a refresh of the action plan would provide an opportunity to learn from the successes achieved so far and to develop meaningful metrics.  The board also highlighted a key opportunity for the district and borough councils to contribute to this process. 

     

    A working group has been established and has commenced the refresh process.

     

    The proposed refresh will:

    ·         Align with existing plans e.g. prevention plans, Better Care Fund, Surrey Dementia Strategy, Emotional Wellbeing and Mental Health, Living and Ageing Well.

    ·         Be based on evidence and need with actions updated to reflect this within the plan.

    ·         Produce a metrics dashboard with a simplified reporting template for the Board report. 

     

    There are no further papers attached with this report. 

     

    Minutes:

    Witnesses:

     

    Karen Thorburn, Stakeholder Engagement Manager, North West Surrey CCG

     

    Key points raised during the discussion:

     

    ·         An update was provided on the steps identified for refreshing the ‘Improving older adults’ health and wellbeing’ action plan. The Board were informed that the intention was to create a public-facing action plan which is accessible and uses plain English. A process of engagement would be undertaken with the district and borough councils to allow them to provide input into the revised action plan. It was agreed that a date would be identified for the Health and Wellbeing Board to review the revised action plan. This has been added to the action tracker under reference number A9/15.

     

    RESOLVED:

     

    That the Health and Wellbeing Board agreethe proposed approach to updating the Improving older adults’ health and wellbeing action plan.

     

     

137/15

DEVELOPING A PREVENTATIVE APPROACH/ TACKLING CHILDHOOD OBESITY IN SURREY pdf icon PDF 112 KB

    To provide an update on the Surrey Childhood Obesity event that took place on Tuesday 3 March 2015.

    Minutes:

    Witnesses:

     

    Helen Atkinson, Director of Public Health, Surrey County Council

    James Friend, Leader, Mole Valley District Council

     

     

     

    Key points raised during the discussion:

     

    ·         An update was provided on the Winter Communications Plan which was being coordinated by the Health and Wellbeing Board’s Communications Sub-group. The Board were informed that the Winter Communications Plan would be launched at the end of September 2015 and was aimed at old, young and vulnerable residents across Surrey to promote good health and wellbeing throughout the winter months as well as reminding residents of the appropriate use of health services. It was further highlighted that SCC, the CCGs and the Police would work collaboratively on the Winter Communications Plan to deliver a consistent message rather than running separate campaigns as had been the case in previous years. The co-chairs of the Health and Wellbeing Board agreed to be ambassadors for the Winter Communications Plan.

     

    ·         The role that the Health and Wellbeing Board could play in the outcomes from the childhood obesity event  was queried by members. It was agreed that this would be updated in future as part of the improving children’s health and wellbeing priority update.  . This has been included on the actions tracker under reference number A11/15.

     

    ·         Concerns were expressed regarding the role that partners involved in the obesity event could play in tackling childhood obesity in Surrey. It was stressed that a broad range of people from a variety of disciplines were involved in the event. Moreover, the event was also attended by children from deprived backgrounds who have a lower life expectancy than those from more affluent backgrounds. The Director of Public Health agreed to circulate an infographic to the Board which detailed how stakeholders can tackle obesity at a Surrey wide and local leveland this has been added to the actions tracker as item A12/15.

     

    ·         Members of the Board inquired about how the impact of the event on promoting healthy behaviours amongst young people in Surrey would be measured. It was indicated that there was a standard metric within data profiles which would provide accurate information on the impact of the event.

     

    RESOLVED:

     

    a)    The childhood obesity will be included in the update for the improving children’s health and wellbeing priority at future Health and Wellbeing Boards

     

    b)    The Director of Public to agree an infographic to Health and Wellbeing Board Members on how stakeholders can tackle obesity at a Surrey wide and local level.

     

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IMPROVING CHILDREN'S HEALTH AND WELLBEING - STATUS UPDATE pdf icon PDF 137 KB

    Following the previous Improving Children’s Health and Wellbeing status update in June 2015, the Health and Wellbeing Board asked for a further update including the 2015/16 Partnership Action Plan and an update following the publication of the Children’s Services Inspection Report.

    This item therefore includes:

    ·         The updated Children and Young People’s Partnership Action Plan 2015-16, which reflects certain areas for improvement as highlighted in the Ofsted report, alongside an updated status update (‘flash report’) showing the latest position against the ‘Improving Children’s Health and Wellbeing’ priority actions.

    ·         A presentation about the Surrey County Council Children’s Services Improvement Plan. (The Improvement Plan will not be finalised and published until after the Board’s papers are published however hard copies will be made available on the day of the meeting.)

    Whilst the action plan and status update reflect areas and actions as highlighted in the Ofsted Inspection report, things have and continue to move on quickly. Partners and the CYP Partnership will continue to work together to ensure there is appropriate alignment between the Improvement Plan and the work and priorities of Children and Young People’s Partnership.

    Following feedback at the last Health and Wellbeing Board meeting, work is also being undertaken to strengthen the outcome measures for each of the priority action areas.

    Additional documents:

    Minutes:

    Witnesses:

     

    Julie Fisher, Interim Strategic Director of Children, Schools and Families

     

    Key points raised during the discussion:

     

    ·         An update was provided on the Children’s Service Improvement Plan which had been produced by SCC in collaboration with partner organisations and had been submitted to the Department of Education (DfE) within the 70 day deadline following the publication of Ofsed’s Inspection report. The Improvement Plan is attached as Annex 3 to these minutes.

     

    ·         The Improvement Plan outlined the steps that SCC would take to institute sustainable cultural changes across Children’s Services. It was, however, emphasised that remedial action had already been taken to address the ‘priority’ and ‘immediate’ issues highlighted in the Ofsted report which included improving SCC and partner organisations’ response to Child Sexual Exploitation (CSE) through the development of a Multi-Agency Safeguarding Hub (MASH) and by establishing a one front door approach to safeguarding children in the county.

     

    ·         The Board was informed that representatives from Ofsted would come to Surrey on a monthly basis to review case files and ensure that the Improvement Plan was being successfully implemented. Moreover, the DfE had also sent an advisor to SCC who provided guidance on delivering the Improvement Plan and would continue to work with SCC and its partners until the concerns raised by Ofsted had been addressed.

     

    ·         Discussions took place regarding the role that CCGs could play in implementing the Improvement Plan and it was agreed that this would be considered at the meeting of the Health and Wellbeing Board on 10 March 2016. This has been added to the actions tracker under reference number A13/15.

     

    RESOLVED:

     

    That a further update on the 2015/16 action plan be given to the Health and Wellbeing Board on 10 March 2016. This should include discussion on how CCGs can be involved in implementing the Children’s Services Improvement Plan.

     

139/15

CHILDREN AND ADOLESCENT MENTAL HEALTH SERVICES TRANSFORMATION PLAN pdf icon PDF 132 KB

    Following the publication of Future in Mind and the guidance to introduce the waiting and access standards to mental health services NHS England has announced additional funding for children’s mental health services. This will be allocated to individual Clinical Commissioning Groups (CCGs) working in collaboration and will be released on the presentation of a Transformation Plan. The Health and Wellbeing Board is asked to support and approve the CAMHS Transformation Plan for Surrey developed by Guildford and Waverley CCG in order to access the additional funding made available by NHS England. The Transformation Plan will be provided to the Board upon publication

    Minutes:

    The Children and Adolescent Mental Health Services Transformation Plan was taken before item 8.

     

    Witnesses:

     

    Sarah Parker, Director of Children’s Commissioning (Surreywide),

    Diane McCormack, Head of children with complex and specialist health needs including CAMHS

     

    Key points raised during the discussion:

     

    ·         The witnesses delivered a presentation to the Board on the Children and Adolescent Mental Health Services (CAMHS) Transformation plan. During the presentation, it was emphasised that the additional funding made available by NHS England for commissioning CAMHS would be used to improve the availability of services in areas such as perinatal care, eating orders and psychiatric liaison in hospitals with the aim that these services would be in place from 1 April 2016. The Board were also informed that the Transformation Plan outlined efforts which would be made to tackle the stigma around mental health in young people. The presentation and CAMHS Transformation Plan are attached to these minutes as Annex 4 and Annex 5 respectively.

     

    ·         The Board highlighted the need for CAMHS to be closely linked with the work of schools and the Family Support Programme in Surrey to identify and address mental health issues in young people early. It was stressed that the Transformation plan placed a strong emphasis on partnership working. Members of the Board was also informed that a bid had been put in for further funding to train schools in Surrey on how to tackle the causes of mental health issues in young people. Although this bid had been unsuccessful it was indicated that the intention was that this training would still be given to schools.

     

    RESOLVED:

     

    The Health and Wellbeing Board approve the Children and Adolescent Mental Health Services (CAMHS) Transformation Plan.

     

140/15

PUBLIC ENGAGEMENT SESSION