Agenda and minutes

Health and Wellbeing Board
Thursday, 6 December 2018 1.00 pm

Venue: Committee room C, County Hall, Kingston upon Thames, KT1 2DN

Contact: Sharmina Ullah 

Items
No. Item

4918.

APOLOGIES FOR ABSENCE

    To receive any apologies for absence and substitutions.

    Minutes:

    Apologies were received from Dave Hill, David Munro, Jason Gaskell, Councillor Mel Few, Councillor Clare Curran, Councillor Vivienne Michael, Dr Sian Jones and Dr Peter Bibawy.

     

    Mark Barratt substituted for Dave Hill, Craig Jones substituted for David Munro and Ruth Colburn Jackson substituted for Dr Peter Bibawy.

5018.

DECLARATIONS OF INTEREST

    All Members present are required to declare, at this point in the meeting or as soon as possible thereafter

     

    (i)      Any disclosable pecuniary interests and / or

    (ii)      Other interests arising under the Code of Conduct in respect of any item(s) of business being considered at this meeting

     

    NOTES:

     

            Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest

            As well as an interest of the Member, this includes any interest, of which the Member is aware, that relates to the Member’s spouse or civil partner (or any person with whom the Member is living as a spouse or civil partner)

            Members with a significant personal interest may participate in the discussion and vote on that matter unless that interest could be reasonably regarded as prejudicial.

     

    Minutes:

    There were none.

5118.

QUESTIONS AND PETITIONS

5118a

Members' Questions

5218.

Public Questions

5318.

Petitions

5418.

MINUTES OF THE PREVIOUS MEETING: 13 SEPTEMBER 2018 pdf icon PDF 100 KB

5518.

ACTION REVIEW pdf icon PDF 51 KB

    To review and agree the Board actions tracker.

    Minutes:

    Key points raised during the discussion:

     

    1. The Board received a presentation on young carers in Surrey at its previous meeting on 13 September 2018 and agreed to remove action A5/18 from the action tracker.

     

    1. It was highlighted that the Board would receive an update on older adults at Item 9 on the agenda and therefore action A35/17 was complete.

     

    1. It was noted that action A10/18, the Board to receive tableau data on target and outcomes relating to performance in Children’s Services, would be carried forward to 2019.

     

    Actions/ further information to be provided:

     

    None

     

    Resolved:

     

    The Board reviewed and noted its Action Tracker.

     

5618.

SURREY HEALTH AND WELLBEING BOARD MEMBERSHIP pdf icon PDF 88 KB

    Purpose of the report: To ask the Health and Wellbeing Board to endorse changes to its membership.

     

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Tim Oliver, Lead Cabinet Member for Place

     

    Key points raised during the discussion:

     

    1. It was noted that the Board’s membership was being reviewed to ensure it aligned with the Surrey 2030 vision, the NHS 10 year plan and Surrey’s 5-10 year plan on health and wellbeing and reflected the Board’s focus on prevention and the wider determinants of health.

     

    1. It was highlighted as part of the Council’s Transformation plans that partnership working was a key factor to improving outcomes and the proposed membership would support this.

     

    1. It was reported that once the appointments against the new membership proposals were confirmed, the Board would review the option to consider sub-groups to provide a focused approach in improving outcomes for residents.

     

    1. Members of the Board were supportive of the proposals however shared the view that consideration be given to including representation of Senior Responsible Officers from all Surrey sustainability transformation partnerships and integrated care systems into the new membership structure.

     

    1. It was highlighted that PricewaterhouseCoopers who were commissioned to develop the 10 year strategy for Surrey were in the process of delivering a final workshop on 24 January 2019 which would determine the health and wellbeing strategy for the Board.

     

    1. A member of the public asked the Board to consider providing terms of reference for the proposed new appointments, particularly for the housing lead role.

     

    Actions/ further information to be provided:

     

    A11/18 - The Board to consider providing terms of reference for the proposed new appointments.

     

    Resolved:

     

    The Health and Wellbeing Board:

     

    a)    Endorsed the new proposed new membership

     

    b)    Where named representatives have yet to be agreed, asked the co-chairs of the Board to work with relevant partner organisations to agree this ahead of the next meeting of the Board.

     

5718.

SYSTEM OPERATING PLANS FOR 2019/20 pdf icon PDF 110 KB

    Purpose of the report: This paper provides an update on the development of System Operating Plans for 2019/20 for Surrey Heartlands, East Surrey and Frimley Health and Care ICS.

    Minutes:

    Declarations of interest:

     

    None.

     

    Witnesses:

     

    Dr Russell Hills, Clinical Chair, Surrey Downs Clinical Commissioning Group

    Dr Andy Brooks, Chief Officer, Surrey Heath and East Berkshire Clinical Commissioning Group

    Dr Elango Vijaykumar, Clinical Chair, East Surrey Clinical Commissioning Group

     

    Key points raised during the discussion:

     

    1. The Co-Chairs agreed to take this item into Part 2, private.

     

    Resolved: That under Section 100(A) of the Local Government Act 1972, the public be excluded from the meeting for the following items of business on the grounds that they involve the likely disclosure of exempt information under the relevant paragraphs of Part 1 of Schedule 12A of the Act.

     

5818.

PREVENTION PRIORITY STATUS UPDATE pdf icon PDF 286 KB

    Purpose of the report:  To provide the Health and Wellbeing Board with an update on progress against the ‘Developing a Preventative Approach’ priority in the Joint Health and Wellbeing Strategy since the Board’s last update in April 2018, with a focus on:

     

    ·         Wider Determinants of Health Framework

    ·         Air Quality

    ·         Sexual Health

     

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Dr Rachel Gill, Public Health Consultant, Surrey County Council

     

    Key Points raised during the discussion:

     

    1. The Board received a presentation (attached as Annex 1).

     

    1. The Executive Director for Public Health and the Wider Determinants of Health informed the Board that acute trusts were exploring options for using Skype where possible for outpatient appointments to support reducing air pollution as 1 in 10 people drive to attend appointments.

     

    1. A Member highlighted that the report did not refer to public transport and suggested going forward to map public transport to centres to encourage less vehicles on Surrey roads.

     

    1. The Board noted that measuring air quality was a complex piece of work and the main aim was to deliver baseline to measure impact of interventions and provide an indication of local health impacts.

     

    1. The Executive Director for Public Health and the Wider Determinants of Health recognised concerns with the challenges around engagement for district and boroughs to find ways of delivering infrastructure and assured members of the public plans were in place to tackle this.

     

    Actions/ further information to be provided:

     

    None

     

    Resolved:

     

    The Health and Wellbeing Board:

     

    a)    Approved and supported the Wider Determinants of Health Framework and the three priority areas being taken forward.

     

    b)    Considered the contribution that partners could make to the air quality agenda in relation to the key priorities to improve local air quality.

    ·         Communication and awareness raising

    ·         Increase use of low emission vehicles

    ·         Increase use of active forms of travel

     

    c)    Noted progress on embedding the integrated model of sexual health and HIV treatment and care services in Surrey.

     

5918.

JOINT HEALTH AND WELLBEING STRATEGY PRIORITY UPDATE: IMPROVING OLDER ADULTS' HEALTH AND WELLBEING pdf icon PDF 129 KB

    Purpose of the report: Policy developemnet and review.

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Simon White, Executive Director for Adult Social Care

     

    Key points raised during the discussion:

     

    1. The Executive Director for Adult Social Care presented the report and informed the Board that a range of programmes had been undertaken across the partnership to improve the health and wellbeing of adults.

     

    1. It was noted that the report focused on integrated health and social care services (including Better Care Fund), transformation work around Adult Social Care and the development of Accommodation with Care and Support in Surrey.

     

    1. There was a discussion around emergency readmissions and it was highlighted that the rate has increased to 9%. The Executive Director for Adult Social Care noted concerns and agreed to review data on readmissions.

     

    Actions/ further information to be provided:

     

    None

     

    Resolved:

     

    The Health and Wellbeing Board:

     

    a)    Noted and supported the ongoing transformation work around Health and Social Care Integration, Adult Social Care Practice Improvement and Accommodation with Care and Support.

     

    b)    Noted the Better Care Fund returns for quarter one and two 2018/19.

     

    c)    Engaged with and supported the work to develop a Better Care Fund plan for 2019/20 once the Policy Framework and Planning Guidance for this is published by NHS England.

     

    d)    Noted that the Surrey Strategic Health and Care Collaborative Will Act on behalf of the Health and Wellbeing Board to oversee preparation of Better Care Funds returns going forward.

     

6018.

PROMOTING EMOTIONAL WELLBEING AND MENTAL HEALTH PRIORITY STATUS UPDATE - SUICIDE PREVENTION pdf icon PDF 184 KB

    Purpose of the report:

     

    1)    To provide the Board with an update on the development of Surrey Suicide Prevention Strategy.

    2)    To provide the Board with an update on the work of the Mental Health workstreams from the three Sustainability Transformation Partnerships (Frimley ICS, Sussex and East Sussex STP and Surrey Heartlands STP).

     

     

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Martyn Munro, Senior Public Health Lead, Surrey County Council

    Judi Mallalieu, Director of Transformation and Partnerships, Surrey and Border Partnership

     

    Key Points raised during the discussion:

     

    1. The Board received a presentation on the Suicide Prevention Strategy and the work of the Mental Health workstreams from the three sustainability transformation partnerships (attached as Annex 2).

     

    1. The Senior Public Health Lead clarified to the Board that the Suicide Prevention Strategy was still in draft stage and would be available in January 2019.

     

    1. It was highlighted that 72% of people who died by suicide were unknown to Mental Health Services and the Board asked what programmes were in place to work collaboratively and openly share information in this area to support prevention.

     

    1. It was noted that a mental health single point of access was being rolled out by Surrey and Borders across Surrey and North East Hampshire and Farnham (NEHF) for all adults. This would help ease access for people needing to seek routine or crisis mental health support and would also introduce increased resource with a rapid response service.

     

    1. It was further noted that lessons would be shared across the whole of Surrey and the NEHF footprint.

     

    1. The Senior Public Health Lead informed the Board that Public Health were working closely with other  sustainability and transformation partnership in the south east, who were successful in getting funding from NHS England and were supporting bids to support the Suicide Prevention funding.

     

    1. The Director of Transformation and Partnerships stated that the main challenge in relation to the data on the proportion of suicide deaths in Surrey, was the reporting of deaths by coroners. It was suggested that coroners were reluctant to record deaths as suicide and in order to improve this, the Board would need to review addressing the stigma that surrounds suicide reporting and strengthening the relationship between public health and coroners.

     

    1. The Board noted suggestions from members of the public to consider the review of coroner reports to help understand how future deaths can be avoided and the benefits of having an audit of these coroner reports.

     

    1. It was noted that the strategy was aligned to the national target of achieving a 10% reduction in suicide by 2021 through the coordinated actions of partner organisations. 

     

    Actions/ further information to be provided:

     

    None

     

    Resolved:

     

    The Health and Wellbeing Board:

     

    a)    Committed partners to joint delivery of the Suicide Prevention Strategy

     

    b)    Agreed to provide strategic oversight of the implementation of the strategy, holding partner organisations to account for their contributions to the delivery of the actions and recommendations contained within.

     

6118.

PROMOTING EMOTIONAL WELLBEING AND MENTAL HEALTH PRIORITY - SURREY CHILD AND ADOLESCENT MENTAL HEALTH INTERIM PLAN pdf icon PDF 238 KB

    Purpose of the report: The purpose of this report is to provide a summary of the outcomes of the CAMHS interim plan implemented in June 2018 to October 2018.

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Karina Ajayi, Head of Commissioning, Community Health Services, NHS Surrey Heartlands Clinical Commissioning Groups

     

    Key Points raised during the discussion:

     

    1. The Head of Commissioning introduced the report and provided a summary of the outcomes of the CAMHS Interim Plan implemented in June 2018 to October 2018, highlighting the improved ways of working.

     

    1. Members commented on waiting lists for assessments and asked the Head of Commissioning to report on the level of performance. It was noted that although significant improvement has been made in supporting children and young people to receive assessments, there were now delays in receiving the treatment required.

     

    1. To address data quality issues Surrey and Borders Partnership were working on a data plan and were working jointly to resolve issues which would be routinely reviewed going forward.

     

    Actions/ further information to be provided:

     

    None

     

    Resolved:

     

    The Health and Wellbeing Board noted the report.

     

6218.

SURREY CHILD AND ADOLESCENT MENTAL HEALTH UPDATE - TRANSFORMATION PLAN pdf icon PDF 83 KB

    Purpose of the report: The Surrey Child and Adolescent Mental Health (CAMHS) Whole System Transformation Plan, updated October 2018, is presented for approval by the Surrey Health and Wellbeing Board.

     

    Additional documents:

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Karina Ajayi, Head of Commissioning, Community Health Services, NHS Surrey Heartlands Clinical Commissioning Groups

     

    Key Points raised during the discussion:

     

    1. The Board received a summary of key points for the period 2018/19.

     

    1. It was noted that a number of new services had been put in place as a result of the plan. This includes four children and young people havens, an intensive support service for challenging behaviour, paediatric nurses working in children wards to increase awareness of mental health in acute settings, increased workforce for eating disorder services and Assistant Educational Psychologists training staff and parents in the principles of mindfulness.

     

    1. Members endorsed the report which gave a clear structure and understanding of the work to be undertaken but queried who was responsible for capturing the lessons learnt and providing assurances. The Head of Commissioning explained that the CAMHS Improvement Board reported to the Escalation Board, which reported to the Children’s and Women Workstreams and onto governing bodies. This would then go to Clinical Review meeting and the CAMHS review Board.

     

    Actions/ further information to be provided:

     

    The Head of Commissioning to share the revised governance structure.

     

    Resolved:

     

    The Health and Wellbeing Board:

     

    a)    Approved the refreshed Surrey CAMHS Whole System Transformation Plan (2018).

     

    b)    Noted the Summary written by Surrey’s young people and the impact of this transformational work demonstrated on the outcomes and experience for children and young people.

     

    c)    Asked Clinical Commissioning Groups to ensure that the refreshed Plan was published on their websites.

     

6318.

SURREY HEALTH AND WELLBEING BOARD COMMUNICATIONS AND ENGAGEMENT UPDATE pdf icon PDF 507 KB

    Purpose of the report: To update the Health and Wellbeing Board on activity and progress relating to communications and engagement since June 2018.

     

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Caroline Sargent, (Interim) Communications Manager, Surrey Downs Clinical Commissioning Group

    Helen Atkinson, Executive Director for Public Health and the Wider Determinants of Health

     

    Key points raised during the discussion:

     

    1. The Board received an update on activity and progress relating to communications and engagement.

     

    Actions/ further information to be requested

     

    None

     

    Resolved:

     

    The Health and Wellbeing Board:

     

    a)    Noted the progress made on the communications and engagement since June 2018.

     

    b)    Noted the new way of working for the Communications and Engagement group.

     

6418.

THE INDEPENDENT ANNUAL REPORT OF THE DIRECTOR OF PUBLIC HEALTH SURREY COUNTY 2018 pdf icon PDF 88 KB

    Purpose of the report: To present the Director of Public Health’s latest Annual Public Health Report (APHR), which focuses on the health and wellbeing of older people, to the Health and Wellbeing Board. 

     

     

     

    Additional documents:

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Helen Atkinson, Executive Director for Public Health and the Wider Determinants of Health.

     

    Key points raised during the discussion:

     

    1. The Executive Director for Public Health and the Wider Determinants of Health introduced the report and welcomed Board Members to share the Annual Public Health Report (APHR) across their demographic.

     

    1. Members were pleased with the APHR and asked how the Board could support maximising the opportunity to identify people who could benefit from the service.

     

    1. There was a discussion around social prescribing and the Executive Director for Public Health and the Wider Determinants of Health explained this involved a partnership approach. It was noted that the Surrey-Wide Voluntary Forum was a platform to encourage the progression of linking partnership working. 

     

    Actions/ further information to be provided:

     

    None

     

    Resolved

     

    The Health and Wellbeing Board:

     

    a)    Noted the findings and recommendations of the report

     

    b)    Considered where they can, as individual organisations or through joint actions described, improve the health and wellbeing of older people.

     

6518.

PRICEWATERHOUSECOOPERS UPDATE: 10 YEAR PLANNING

    The Board will receive a verbal update from PricewaterhouseCoopers.

     

    Minutes:

    Declaration of interests:

     

    None

     

    Witnesses:

     

    Viv Tong, Management Consultant, PricewaterhouseCoopers

     

    Key points raised during the discussion:

     

    1. The Board received a PowerPoint presentation (attached as Annex 3) providing an update of the progress made against the strategic planning.

     

    1. The Executive Director for Public Health and the Wider Determinants of Health clarified that data in relation to this work had been shared with the Board prior to this meeting.

     

    1. PricewaterhouseCoopers (PwC) explained that the Health and Wellbeing Strategy would be revisited to ensure it aligned with the anticipated NHS 10 year plan.

     

    1. It was explained that to ensure patient reporting was incorporated into the planning process, the timeline was amended to accommodate this work.

     

    1. The Lead Cabinet Member for Place informed the Board that the new 10 year strategic plan would involve the 11 district and boroughs councils sign off, however logistically this was a complex piece of work going forward.

     

    1. The Lead Cabinet Member for Place assured members of public that the role of local committees was advancing particularly as a number of local committees were moving to form as joint committees, making its roles more effective.

     

    1. The Board acknowledged the public’s concern with the lack of transparency regarding the PwC work and system ambitions for 2019/20.

     

    Tim Oliver left the meeting at 3.30pm

     

    Actions/ further information to be provided:

     

    None

     

    Resolved:

     

    The Board noted the update report.

     

6618.

PHARMACEUTICAL NEEDS ASSESSMENT (PNA) SUPPLEMENTARY STATEMENT pdf icon PDF 76 KB

    Purpose of the report:  To ask the Health and Wellbeing Board (HWB) to approve the Pharmaceutical Needs Assessment (PNA) supplementary statement (Annex one) for publishing following approval of a pharmacy merger by NHS England.

     

    Additional documents:

    Minutes:

    Declarations of interest:

     

    None

     

    Witnesses:

     

    Dr Rachel Gill, Public Health Consultant, Surrey County Council

     

    Key points raised during the discussion:

     

    1. It was noted after the approval of the pharmacy consolidation by NHS England in Merstham, for which the Board had already made representations, it was a statutory function for the Board to issue a supplementary statement.

     

    Resolved:

     

    The Board approved the supplementary statement, that must be issued in response to the approval of the pharmacy consolidation in Merstham by NHS England and agreed its publication on the basis that there was no gap in the pharmaceutical provision created as a result of the merger.

     

6718.

DATE OF THE NEXT MEETING