Agenda item

To receive an update on the Integrated Care System (ICS) and to discuss proposals regarding a new meeting format.

The Board received an update and report from Lucy Townsend (Corporate Director of People, Wiltshire Council). The update covered the following matters:

·       It was explained that the reason for bringing the report to the Health and Wellbeing Board was due to the changing governance across BSW regarding developments of the ICS and ICA. Therefore a series of activities have taken place, which included consideration of how the Health and Wellbeing Board should operate in the future.

·       The report featured a number of recommendations with consideration of how the Health and Wellbeing Board would link to the placed based partnership, the Alliance. Additionally, there is an MOU and Terms of Reference agreement of the proposed statutory structures, which will be submitted to the NHS Partnership Board as well as the Wiltshire Council Cabinet in December; once signed off from both it will be suitable to go live in April 2022.

·       Regarding main considerations, there is emphasis on the new system, that the Health and Wellbeing Board will be the owner of the strategy for the all age population of health for those in Wiltshire. With a collective delivery and accountability, rather than solely individual accountability.

·       Regarding the workshops that have taken place, there have been positive statements regarding the values and behaviours that would be expected from partners with Terms of Reference taking in to account emerging membership on other place boards.

·       It was also noted that Healthwatch Wiltshire engages with the wider VCS in undertaking of this work, with an awareness that this may not be sufficient on its own, with consideration required on other mechanisms used to engage with partners.

·       Regarding meetings, there is a desire for less of a “show and tell” approach, with papers published in advanced to allow adequate time for challenge and support. Papers must also have a clear link to the joint Health and Wellbeing Strategy priorities.

In addition, the Board noted comments on the following matters:

·       It was queried what was meant by Healthwatch engaging with the wider VCS, as it was stated that this something that is already taking place and could result in resource implications if different is expected. It was clarified that the report was aware of what Healthwatch is currently doing regarding engagement with the wider VCS, and wanted to formalise links with the voluntary and community sectors.

·       It was queried whether the report is solely linking the public voice to the VCS rather than the wider care system. Clarity was provided that the intention is for public voice to be linked broader than solely the community sector and that public voice will be maximised to develop and deliver priorities.

·       It was stated that the Joint Strategic Needs Assessment needs to be refreshed and though the Public Health Team lead on this, active participation will be required from partners in order to make the end product more valuable.

·       It was queried within the proposal what was meant by “Informal meetings should focus on professional development”. Clarity was provided that this related to feedback provided in workshops and the principles of operating as a collective approach rather than as individual organisations. It was acknowledged that working together in a complex way isn’t simple and therefore continual professional development must be recognised from relationships and the way the Health and Wellbeing Board works together. Understanding is required in order to achieve being able to successfully work together, which can be described as professional development.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals:

i) 3 formal meetings are scheduled for next year as well as three informal meetings.

ii) Formal meetings should focus on agreeing the JSNA and PNA, JHWS refresh as well as the safeguarding, safety and Healthwatch Wiltshire annual reports.

iii) Formal meetings should also provide opportunities for enquiry on the collective delivery of JHWS priorities that form the relevant part of the Alliance Work Programme (which will also include required programmes from NHSE and government); receive periodic progress reports on the relevant parts of the Alliance Work Programme; be consulted on the Healthwatch Wiltshire work programme and have the opportunity to influence through the Chair of the Alliance any ICS system developments with implications for Wiltshire.

iv) Healthwatch Wiltshire be asked to engage with the wider VCS in undertaking its activity and periodically present findings from its work to Wiltshire partners, with the Alliance tasked to formally report back in response to any Healthwatch findings. The Professional Leadership Network offers an additional vehicle for wider community and professional engagement in strategy and delivery.

v) Informal meetings should focus on professional development and single topics of population need and how they can be addressed, with wider input from other partners as appropriate and clear commitment to action emerging, with Alliance reports to formal meetings to follow.

vi) New terms of reference for the HWB be considered for recommendation and ratification by full council (in line with any new statutory obligations) in the new year.

vii) The JSNA be refreshed and a new JHWS be developed on the back of that, taking into account and informing emerging ICS strategy.