Agenda and minutes

Health and Wellbeing Board
Monday, 16 December 2019 11.30 am

Venue: Committee Room B, County Hall, Penrhyn Road, Kingston upon Thames, KT1 2DN

Contact: Amelia Christopher  Email: amelia.christopher@surreycc.gov.uk

Items
No. Item

53/19

APOLOGIES FOR ABSENCE

    To receive any apologies for absence and substitutions.

    Minutes:

    Apologies were received from Joanna Killian, Dr Elango Vijaykumar, Dr Charlotte Caniff - Suzanne Rankin as substitute, Dr Claire Fuller, David Munro - Sarah Haywood as substitute, Mary Lewis, Borough Councillor John Ward - Borough Councillor David Beaman as substitute, Kate Scribbins - Peter Gordon as substitute, Dr Andy Brooks - Nicola Airey as substitute, Dr Russell Hills, Robert Moran, Sinead Mooney, Borough Councillor Caroline Reeves and Helen Griffiths.

     

54/19

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:

    There were none.

55/19

QUESTIONS AND PETITIONS

55/19a

Members' Questions

56/19

Public Questions

57/19

Petitions

58/19

SURREY HEARTLANDS ICS 5 YEAR STRATEGIC DELIVERY PLAN 2019-2024 pdf icon PDF 140 KB

    This paper presents the Health and Wellbeing Board with the near final draft of the Surrey Heartlands Integrated Care System 5 Year Strategic Delivery Plan (2019-2024) for approval.

     

     

    Additional documents:

    Minutes:

    Witnesses:

     

    Karen Thorburn - Director of Performance at Surrey Heartlands Health and Care Partnership Clinical Commissioning Groups (CCGs)

    Karen McDowell - Chief Finance Officer at Surrey Heartlands Health and Care Partnership Clinical Commissioning Groups (CCGs)

     

    Key points raised during the discussion:

     

    1.    After an introduction on the close collaboration between Surrey County Council and Surrey Heartlands Health and Care Partnership by the Chairman, the Director of Performance at Surrey Heartlands stated that the 5 Year Strategic Delivery Plan aligned with the NHS Long-term Plan and the Surrey 10 Year Health and Wellbeing Strategy.

    2.    The Director of Performance at Surrey Heartlands:

    ·         Reported Surrey Heartland’s strategic ambition of having ‘out-of-hospital’ care equity across community health crisis response within two hours of referral and within two days for reablement.

    ·         Stressed the importance of access to General Practice Improved Access (GPIA) seven days a week.

    ·         Stated the targets in the Plan to achieve the ‘best in class’ rates in a number of areas including: increasing citizen’s use of outdoor areas for exercise and health reasons, reducing smoking rates, providing adequate housing and in particular ensuring specialist accommodation for individuals with Special Educational Needs and Disabilities (SEND), the commitment to increased screening and immunisations - particularly childhood vaccination rates.

    ·         Highlighted the importance to all in society of having a strong start in life for the first 1,000 days for new-borns.

    ·         That 35 out of 36 measures were compliant with the NHS Long Term Plan metrics, compliance had subsequently been achieved in ambulance conveyance rates but non-compliance remained in Cancer Early Diagnosis as assessed by Cancer Alliance.

    ·         That the Plan involved significant partnership work which was led by ‘Surrey 500’ who were a group of 100 delegates from the System wide Children’s and Families workforce to ensure effective partnership working.

    ·         That a key challenge to the Plan was to ensure complete digitalisation of personal care plans and records, which would be shared locally and across the association. That would be facilitated through triangulation workshops in the New Year with key partners, aided by Surrey County Council.

     

    Simon White arrived at 11.38am

    3.    The Chief Finance Officer at Surrey Heartlands Health and Care Partnership noted that a barrier to returning the NHS into overall financial balance by 2023/24, was the 2020/2021 £50.1 million deficit, but was being addressed by increasing system efficiencies through incorporating new system partners such as East Surrey CCG and Surrey & Sussex Healthcare.

    4.    She explained the challenging ‘system control total’ set in 2019/20 which indicated a £62.4 million deficit in 2020/21. Further non-recurrent measures were being explored in conjunction with the 2019/20 Financial Recovery Plans to address accumulated pressures from previous years. Key areas of focus included outpatient transformation through digitalisation and an integrated transformation unit led by Surrey County Council.

    5.    Fundamental to facilitating the 2019/20 Financial Recovery Plans was collaboration across all Commissioning and Provider organisations through ensuring place-based leadership teams and high quality care facilities. A revised document on addressing the financial pressures had been submitted to  ...  view the full minutes text for item 58/19

59/19

FRIMLEY ICS 5 YEAR STRATEGIC DELIVERY PLAN pdf icon PDF 369 KB

    This paper presents the Health and Wellbeing Board with the final narrative version of the Frimley Integrated Care System (ICS) 5 year Strategy (2019-2024) for sign-off.

    Additional documents:

    Minutes:

    Witnesses:

     

    Nicola Airey - Executive Place Managing Director at Surrey Heath Frimley Collaborative

    Key points raised during the discussion:

     

    1.    The Executive Place Managing Director at Surrey Heath Frimley Collaborative outlined the report and stated that it was established in consultation across key stakeholders and organisations, ensuring continued engagement with local authorities was crucial.

    2.    She reported that the Plan was closely aligned to the NHS Long Term Plan and expressed whether it would be beneficial for the Board to focus on monitoring the Surrey 10 Year Health and Wellbeing Strategy rather than multiple Plans - as both Surrey Heartlands’ and Frimley’s 5 Year Strategic Delivery Plans were heavily aligned to it.

    3.    She highlighted:

    ·         The move of Frimley’s Plan into its delivery phase which was focused on a place-based approach across three providers, driven by a committed group of leaders including Surrey County Council and borough and district councils.

    ·         The challenge of the six Strategic Ambitions necessary to facilitate the Plan, which included: the cultural change needed in the workforce to facilitate the Plan through recruiting and working in new and innovative ways and the proactive approach to creating a link between local communities and service providers to promote personal responsibility for health and wellbeing.

    ·         That the finances were expected to be balanced at the end of the financial year despite a £2-3 million deficit. The forecast of a £60 million deficit next year was a challenge, but Frimley were on track to locate £30 million and close the remaining gap.

    ·         The need for greater alignment between Frimley and Surrey Heartlands on their respective Plans.

    4.    The Chairman acknowledged the rollout of the pilot local partnership boards in two boroughs in Surrey, those would allow greater integration on health and wellbeing at a more local level.

    5.    The Executive Place Managing Director at Surrey Heath Frimley Collaborative noted the importance of building on local structures across key stakeholders in order to have a unitary approach to health and wellbeing. She informed the Board that the review of local partnership structures within the Frimley Health and Care Integrated Care System (ICS) would be reported back to the Board once completed.

    6.    Members praised the presentation of the Plan as its infographics were public friendly and accessible.

     

    RESOLVED:

     

    The Health and Wellbeing Board:

    (a) Noted the alignment between the Surrey and Frimley ICS strategies.

    (b) Signed-off the Frimley Health and Care ICS Narrative Strategy.

     

     

    Actions/further information to be provided:

     

    The Executive Place Managing Director at Surrey Heath Frimley Collaborative will provide the Board with the results of the review of local partnership structures within the Frimley Health and Care Integrated Care System (ICS) once completed.

     

60/19

REVISED SURREY CHILD AND ADOLESCENT MENTAL HEALTH (CAMHS) WHOLE SYSTEM TRANSFORMATION PLAN pdf icon PDF 145 KB

    In response to member feedback received at the Board’s meeting on the 5 December 2019, changes have been made to the “Open Letter to Children and Young People” and additional detail that members requested is provided in this report.

     

    The updated October 2019 version of the plan was the fourth annual plan presented for approval by the Surrey Health and Wellbeing Board at its meeting on 5 December 2019.

     

    Additional documents:

    Minutes:

    Witnesses:

     

    Sue Robertson - Associate Director of Strategic Commissioning at Surrey Heartlands Clinical Commissioning Groups (CCGs)

    Key points raised during the discussion:

     

    1.    The Associate Director of Strategic Commissioning at Surrey Heartlands informed the Board that the revised report incorporated member feedback obtained at the meeting of the Health and Wellbeing Board on 5 December 2019.

    2.    She explained that to ensure a more balanced report, the ‘Open Letter to Children and Young People’ had been rewritten, the changes to paragraphs two and three acknowledged that there was more work ahead in Child and Adolescent Mental Health (CAMHS). The revised Open Letter highlighted that no one in the system was complacent as they recognised the future challenges and what needed to be improved; but that it was also important to credit staff in areas of good achievement.

    3.    A Member queried whether the Open Letter had been piloted with any children in order to understand how well it would resonate with them.

    In response, the Associate Director of Strategic Commissioning at Surrey Heartlands explained that the CAMHS youth advisors worked closely with children such as ‘Freya’s Story’ in the CAMHS Whole System Transformation Plan. The Chairman noted logistical problems with testing the Open Letter as the CAMHS Whole System Transformation Plan had been delayed from October and stated that it addressed member comments by being more balanced and honest.

    4.    The Associate Director of Strategic Commissioning at Surrey Heartlands stated that she would take on board member feedback for next year and noted that there was a complete child friendly version of the entire CAMHS Whole System Transformation Plan. She acknowledged the Chairman’s suggestion for a future more child friendly version of the Open Letter.

    RESOLVED:

    The Health and Wellbeing Board:

    a.    Approved the refreshed Surrey CAMHS Whole System Transformation Plan (2019), noting the changes made to the “Open Letter to Children and Young People” in response to member feedback received 5 December 2019.

     

    b.    Noted the actions and initiatives being undertaken to transform services and make improvements to the outcomes and experience for children and young people.

    Actions/further information to be provided:

     

    The Associate Director of Strategic Commissioning at Surrey Heartlands will take on board member feedback including piloting the ‘Open Letter’ with children, in order to complement the children’s version of the CAMHS Whole System Transformation Plan.

     

61/19

DATE OF THE NEXT MEETING