Agenda and minutes

Health and Wellbeing Board
Thursday, 6 June 2019 1.00 pm

Venue: Ashcombe Suite, County Hall, Kingston upon Thames, Surrey KT1 2DN. View directions

Contact: Ben Cullimore  020 8213 2782

Items
No. Item

18/19

APOLOGIES FOR ABSENCE

    To receive any apologies for absence and substitutions.

    Minutes:

    Apologies were received from Ruth Colburn Jackson, Dave Hill, Siobhan Kennedy, Giles Mahoney and Simon White. Dr Peter Bibawy acted as a substitute for Ruth Colburn Jackson and Patricia Denney substituted for Dave Hill.

19/19

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:

    The Chairman informed the Board that he was the former chair of trustees for Shooting Star Children’s Hospices and current patron.

20/19

MINUTES OF PREVIOUS MEETING: 4 APRIL 2019 pdf icon PDF 66 KB

21/19

QUESTIONS AND PETITIONS

21/19a

Members' Questions

21/19b

Public Questions

21/19c

Petitions

22/19

IMPROVING HEALTHCARE TOGETHER 2020-2030 pdf icon PDF 309 KB

    The Improving Healthcare Together (IHT) 2020-2030 programme is led by experienced GPs from NHS Surrey Downs, Sutton and Merton Clinical Commissioning Groups (CCGs).

     

    We are working with Epsom and St Helier University Hospitals NHS Trust (ESTH) to address a series of long-standing challenges and improve healthcare for local people in the future.

     

    This reports outlines the progress to date with the programme of work and the next steps prior to any potential public consultation.

    Minutes:

    Witnesses:

     

    Andrew Demetriades, Joint Director of the Improving Healthcare Together 2020-2030 Programme, South West London Alliance

    Dr Charlotte Keeble, Senior Programme Manager for Acute Sustainability, South West London Alliance

     

    Key points raised during the discussion:

     

    1.    The Joint Director of the Improving Healthcare Together (IHT) 2020-2030 Programme presented a summary of the paper to the Board. He explained that it identified and analysed the challenges that had been recognised and the three options available. These were to locate major acute services at either Epsom, St Helier or Sutton Hospital whilst continuing to provide district hospital services at both Epsom and St Helier.

    2.    The Board heard that officers involved in the IHT 2020-2030 Programme were proposing to continue with an option process to make sure they followed the national and regional assurance process, and they were working closely with NHS Improvement and NHS England whilst their plans were undergoing assessment.

    3.    Discussing the next steps that would be taken, the Joint Director informed the Board that the Pre-Consultation Business Case would be updated before being subject to a national assurance process. CCGs would then consider the feedback from this process during Autumn 2019 before any consultation was undertaken on the options for future development.

    4.    A Member of the Board asked a question on behalf of the Surrey Coalition of Disabled People (SCDP), who wanted to know when an Equalities Impact Assessment would be completed for disabled people, as the IHT 2020-2030 Programme report analysed data from people living with “life limiting long-term illness” rather than disabilities. In response, the Senior Programme Manager for Acute Sustainability told the Member that a representative from the SCDP was on a consultation steering group and additional engagement was due to take place in June 2019.

    5.    The Joint Director was asked about the possibility of not successfully managing to gain capital funding. In response, he said that the case being put forward by the IHT 2020-2030 Programme was a strong one but they would re-evaluate at a later date if they were not successful. CCGs would not proceed to consultation unless support in principle had been achieved for available capital.

     

    Actions/ further information to be provided:

     

    None.

     

    Resolved:

     

    The Board:

     

    1.    Noted the update on progress with the Improving Healthcare Together Programme.

    2.    Considered any further information or updates it would like to receive in due course.

     

23/19

END OF LIFE CARE PARTNERSHIP PROJECT pdf icon PDF 168 KB

    The Health and Wellbeing Strategy identified ‘helping people in Surrey to lead healthy lives’ as one of three interconnected priorities for partners to work together to improve outcomes across the county. An agreed key focus area within this was to help people to live independently for as long as possible and to die well. The Health and Wellbeing Board has asked officers to scope out partnership opportunities to support work around End of Life Care.

     

    This paper sets out the current picture of End of Life Care commissioning priorities in Surrey, to enable the Board to scope a partnership project aimed at delivering an equitable, high quality End of Life Care service – to ensure Surrey residents and their families are able to access the care they need, as well as die with dignity in their preferred setting.

    Minutes:

    Witnesses:

     

    Sarah Brocklebank, Chief Executive of Phyllis Tuckwell Hospice Care

    Nigel Harding, Chief Executive of Shooting Star Children’s Hospices

     

    Key points raised during the discussion:

     

    1.    The Chairman informed the Board that officers had started to identify specific areas of work surrounding end of life care and introduced the two chief executives.

    2.    The Chief Executive of Shooting Star Children’s Hospices (SSCH) provided an overview of the services offered by his organisation and the challenges it faced. The two biggest were funding and recruitment, and these had resulted in the Surrey branch of SSHC being in deficit since 2012. The Board heard that SSHC was reliant on match funding with clinical commissioning groups (CCGs) and that more engagement was needed if it and similar organisations were to be able to continue to offer the services it provided.

    3.    The Board then heard from the Chief Executive of Phyllis Tuckwell Hospice Care (PTHC), who also spoke about the difficulty it has securing funding. She explained that it offered education and training as well as its three core services – in-patient unit care, care at home and living well services – and echoed the Chief Executive of Shooting Star Children’s Hospices’ view that more partnership working needed to take place.

    4.    After a discussion about the report, it was agreed that Dr Charlotte Canniff, Clinical Chair of North West Surrey CCG, would be the lead sponsor for the End of Life Care partnership approach.

    5.    A Member of the Board asked whether sufficient information had been collected from families and carers who had experienced end of life care. They went on to say they felt the report focused on what the systems did and how they worked but overlooked their users. The Board were told that Healthwatch Surrey were in correspondence with officers and would be able to support their efforts by gathering information and insight.

    6.    A discussion was had about the recruitment of staff after a Member of the Board asked how, given a free hand, the two chief executives would overcome the problem. Both spoke about the shortage of suitable recruits across the system as a whole and reiterated the need for closer collaboration between hospices and other health organisations.

     

    Actions/ further information to be provided:

     

    None.

     

    Resolved:

     

    The Board:

     

    1.    Noted the initial scoping that has taken place to map the End of Life commissioning priorities across Surrey.

    2.    Agreed to take forward an End of Life Care partnership project and support the next steps listed in the report.

    3.    Agreed to work with SODA to develop measures for End of Life Care, including preferred place of death.

24/19

PRIORITY ONE DRAFT IMPLEMENTATION PLAN pdf icon PDF 130 KB

    This paper introduces the draft implementation plan for ‘Priority One: Helping people to live healthy lives’. Following approval, we will begin engagement on the draft implementation plan with key stakeholders and partnerships.

     

    The Surrey Prevention and Wider Determinants of Health will sign off the final implementation plan in the autumn before the implementation plan is brought to the Health and Wellbeing Board for approval in December.

    Additional documents:

    Minutes:

    Witnesses:

     

    Ruth Hutchinson, Deputy Director for Public Health

     

    Key points raised during the discussion:

     

    1.    The Deputy Director for Public Health introduced the report and informed the Board of the work that had been done since its last meeting. Members were told that much of the engagement had already started with the five target population groups outlined in the Strategy, and that final plan would be presented to the Board for approval in December 2019.

    2.    A discussion was had about collaboration, with the Deputy Director for Public Health and Members agreeing that organisations and sectors from across Surrey needed to be included in the development process. Surrey Police, district and borough councils and the voluntary sector were all mentioned, as this would allow aims to align on a county-wide scale.

    3.    Members heard that there were plans to form a Surrey-wide Prevention and Determinants of Health Board, and this proposal went to the Surrey Heartlands board the day before the meeting of the Health and Wellbeing Board (5 June 2019). This, the Deputy Director for Public Health said, would provide greater assurance across the whole of the county and would sign off the final implementation plan in Autumn 2019 before being brought to the Health and Wellbeing Board.

    4.    It was agreed that Rod Brown, the Head of Housing and Community at Epsom and Ewell Borough Council, would be the Priority One lead sponsor.

    5.    After further discussion about collaboration and the importance of building on what already existed rather than duplicating, the Cabinet Member for Children, Young People and Families requested that the final implementation plan contains more mentions of children rather than just the elderly.

     

    Actions/further information to be provided:

     

    None.

     

    Resolved:

     

    The Board:

     

    1.    Approved the draft implementation plan, subject to any suggested changes.

    2.    Agreed to work in partnership to develop the final detailed implementation plan.

25/19

DEVELOPING THE COMMUNITY DEVELOPMENT SYSTEM CAPABILITY pdf icon PDF 525 KB

    Community development is identified as a system capability in order to deliver the Health and Wellbeing Strategy and the 2030 Community Vision for Surrey.

     

    The Health and Wellbeing Strategy proposes developing a community development workstream and a community engagement plan.

    Minutes:

    Witnesses:

     

    Rebecca Brooker, Communities and Prevention Lead

     

    Key points raised during the discussion:

     

    1.    The Board heard from the Communities and Prevention Lead, who introduced the report on community development and explained the way in which it was aiming to bring together elements of both the Health and Wellbeing Strategy and the 2030 Community Vision for Surrey. The report was a proposal on how this would be taken forward and put into action, and how those two strands would be combined to have a single clear approach.

    2.    The Communities and Prevention Lead explained that the proposal was made up of three phases. Firstly, partners would be brought together to scope and draft an initial proposal before those ideas would be prototyped and a period of engagement undertaken. Officers would then review the feedback gained and formulate a final plan. The Board heard that it would take a system leadership role throughout the process and after the plan’s implementation.

    3.    After discussing the community development and engagement plans, the Chairman invited the new Independent Chair of the Surrey Safeguarding Children Board to address Members. He spoke about working closely with the Board and sought clarity on what the formal relationship between the two boards would be moving forward. In response, the Chairman said that this would be confirmed and reported back to the Independent Chair in due course.

    4.    Members welcomed the idea of closer working between the Surrey Safeguarding Children Board and Health and Wellbeing Board and spoke about the need to make sure that all safeguarding protocols are as tightly aligned as possible.

     

    Actions/further information to be provided:

     

    The Board is to:

     

    1.    Provide an opportunity at a future Board meeting to shape the community development and engagement plans through an in-depth workshop.

    2.    Confirm the nature of the formal relationship between the Surrey Safeguarding Children Board and the Health and Wellbeing Board and inform the Independent Chair.

     

    Resolved:

     

    The Board:

     

    1.    Approved the proposed approach to establish a community development workstream and engagement plan.

    2.    Agreed to ensure that the activities within the community development and engagement plans are developed in partnership.

    3.    Agreed to provide an opportunity at a future Board meeting to shape the community development and engagement plans through an in-depth workshop.

26/19

DATE OF THE NEXT MEETING