Agenda and minutes

The following Chairman’s Announcements will be made:

Health & Wellbeing Board Self Assessment Toolkit

Governance arrangements statement

The Chairman welcomed all to the meeting and drew the Board’s attention to Item 5 on the agenda (Whole System Approach to Better Care).  This item would be the main focus of discussion at the meeting, noting the guidance published by ministers on the Better Care Fund (formerly known as the Integration Transformation Fund) and taking into consideration the requirement for HWBs to submit a first cut of a completed Better Care Plan template by 14 February 2014.

Noting that the next meeting of the Board was not scheduled to take place until March, Board members would be asked at the end of the presentations being made under Item 5 to consider the most appropriate approach to approving the draft Better Care Plan.

Apologies for absence were received from:

Patrick Geenty (Wiltshire Police)

Debra Elliott (NHS England)

Carolyn Godfrey (Wiltshire Council)

To approve and sign the minutes of the meeting held on 21 November 2013.

The minutes of the previous meeting held on 21 November 2013 where approved and signed as a correct record.

To declare any personal or prejudicial interests or dispensations granted by the Standards Committee.

There were no declarations of Interest received.

A number of recent developments offer the Health and Wellbeing Board the opportunity to deliver the Joint Health and Wellbeing Strategy and develop a whole system approach to better care. One important element of this is the Better Care Fund (formerly known as the Integration Transformation Fund).   Guidance has been provided by Ministers on how this fund can be used to ensure health and social care work closely together.

Alongside this, NHS England has asked for CCGs to ‘develop bold and ambitious plans that look forward to the next 5 years’. The national timetable requires that CCG Boards have plans in place, shared with Health and Wellbeing Boards, by 31 March 2014 and that a ‘good first draft’ of the first 2 Years’ Operating Plan element be made available by 14 February 2014.

Understanding that a coordinated approach is required, the Board will receive presentations covering the following elements:

·         Better Care (Integration Transformation) Fund

·         CCG 5 Year Plan development

·         Children

·         NHS England

·         Finance

Feedback from a stakeholder event which took place on 14 January will also be provided.

In June 2013 the Department of Health announced £3.8billion worth of pooled budgets between health and social care for councils and local NHS organisations to jointly plan and deliver better integrated care and support services.  This is known as the Better Care Fund (formerly Integration Transformation Fund).. 

To further encourage this change in service delivery the Department of Health announced in December 2013 that a further £200m would be added to the pool for the transfer from health to social care in 2014/15, which is in addition to the transfer of £900m already planned from NHS to adult social care.  The Department of Health has called on all areas to start planning now, with a view to having draft plans in place by February 2014. 

Guidance on the preparation of these plans included that Health and Wellbeing Boards should provide the first cut of their completed Better Care Plan template (an integral part of the CCG’s Strategic and Operational Plan) by 14 February 2014, with a revised version to be submitted to NHS England by 4 April 2014.

To ensure a coordinated approach to the preparation of the Plan, the Board requested that presentations be made from key partners to start the Board thinking about how the draft Plan could be progressed.

The presentations relating to a whole system approach to Better Care can be found attached to these minutes and included the following.

An introduction to Better Care by the Leader of the Council and Chairman of the Board, Cllr Jane Scott.  This covered:

·         The need for an integrated care and support structure to be in place within the next 5 years.

·         That future care provision should be person centred co-ordinated care delivered locally where possible.

·         Challenges to be addressed included changing demographics within the local area (20% of the population were aged 65 and over and this was expected to increase to 22.5% by 2021); disjointed information sharing with health and social care professionals and a focus on intervention and treatment, rather than prevention.

·         The outcome of the Care Bill proceeding through parliament at present was awaited.

·         Changes that would be required to the current service, involved:

o   Services designed for the people who use them;

o   Joined up and streamlined services

o   Encouragement for people to take responsibility for their own health and wellbeing;

o   Local health services led by local GPs.

·         Next steps included a joint Plan agreed and signed by the Board.

·         25% of the Better Care fund would be subject to achieving performance outcomes, i.e. addressing delayed transfer of care, emergency admissions and admissions to residential and nursing homes.  It was likely that at least one local indicator would be provided by central government but further details on this were still awaited.

It was the desire of the Chairman that the resulting draft Plan include all the key requirements of partners with an aim for it to be one of the best Plans in the country.

Michael Hudson (Wiltshire Council) and Simon Truelove  ...  view the full minutes text for item 5.

An update will be provided to the Board on the work being undertaken to promote the Strategy including details of its launch within Wiltshire which is expected to take place on 12 February 2014.

The Associate Director for Communities and Communications, Laurie Bell, was in attendance to provide an update on the promotion of the Strategy, copies of which were available to Board members for final comment.

The strategy would be launched at the forthcoming Health Fayre to be held in the atrium of County Hall on 12 February. 

In noting the importance of the strategy the Chairman requested that it be disseminated to as wide an audience as possible to include through hospitals and surgeries and requested that Board members do what could be done to assist with highlighted the publication and availability of the document.

The Joint Business Agreement (JBA) is the overarching business agreement setting out the terms and conditions that apply to S75 and S256 Schedule arrangements which sit underneath it, both of which are made under the NHS Act 2006.

The Board will be asked to endorse the Joint Business Agreement report as agreed by the Joint Commissioning Board and CCG Governing Body and the use of the s256 agreement with NHS England to enable the Health Gains transfer to take place.

The Board were asked to endorse the Joint Business Agreement (JBA), agreed by the Joint Commissioning Board (JCB) and CCG Governing body, and the use of the S256 agreement with NHS England.

In presenting the joint report clarification was made that the arrangements set an excellent framework based on existing arrangements.  Deborah Fielding (CCG) gave thanks to all those involved in its preparation and acknowledged that the joint working arrangements were a good demonstration of the integration already taking place. 

The Chairman asked the Board to confirm their endorsement of the agreement and all were in agreement.

Resolved:

That the Board endorses:

1)    the Joint Business Agreement and asks relevant CCG and Council officers to implement the arrangements; and

2)    the use of the S256 agreement between the Council and NHS England to enable the Health Gains transfer to take place.

20 March 2014

22 May 2014

31 July 2014

25 September 2014

20 November 2014

As indicated earlier in the agenda, the Board agreed to hold an extraordinary meeting at the beginning of February to consider the draft Better Care Plan.

[Post meeting note: This meeting has now been agreed to take place at 5:30pm on Thursday 6 February 2014.]

Future meeting dates thereafter were:

20 March 2014

22 May 2014

31 July 2014

25 September 2014

20 November 2014

To allow for the consideration of any urgent items that the Chairman feels are necessary.

There were no urgent items for consideration.