Agenda and minutes

The Chairman will welcome those present to the meeting and provide the following announcement:

·       The Veteran’s Covenant Healthcare Alliance (VCHA)

The Veterans Covenant Healthcare Alliance (VCHA) has launched its new website (www.veteranaware.nhs.uk). This website is to provide all with information, news and how to accredit as an NHS Trust organisation along with resources to assist and guide trusts through the accreditation process. The VCHA welcomes any feedback or suggestions to ensure that they are able to provide the correct levels of communication and information to all visiting the site. Comments can be sent to: rnoh.vcha@nhs.net.

·       Health and Wellbeing Board Strategy

Please find attached to the agenda the Health and Wellbeing Board Strategy, for reference.

Councillor Richard Clewer, Co-Chair of the Board welcomed everybody to the meeting.

Before the meeting began each Member of the Board, other Councillors and

officers who would be contributing to the meeting were given the opportunity to

confirm their attendance for those watching the live stream of the meeting.

Councillor Clewer provided the following Chairman’s Announcements:

·       The Veterans Covenant Healthcare Alliance (VCHA)

·       Health and Wellbeing Board Strategy

To receive any apologies for absence.

Apologies for absence were received from:

Kieran Kilgallen, Cllr Simon Jacobs, Kate Blackburn, Terence Herbert, Stacey Hunter, Emma Legg, Stephanie Elsy, Tracey Cox, Nicola Hazle, Dr Andy Smith and Douglas Blair.

To confirm the minutes of the meeting held on 28 January 2021.

The minutes of the meeting held on 28 January 2021 were presented for consideration.

Decision - The minutes of the meeting held on 28 January 2021 were agreed as a correct record.

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

There were no declarations of interest.

The Council welcomes contributions from members of the public. During the ongoing Covid-19 situation the Council is operating revised procedures and the

public are able participate in meetings online after registering with the officer named on this agenda, and in accordance with the deadlines below.

Guidance on how to participate in this meeting online.

Statements

Members of the public who wish to submit a statement in relation to an item on this agenda should submit this is electronically to the officer named on this agenda no later than 5pm on Monday 5 July 2021. State whom the statement is from (including if representing another person or organisation), state points clearly and be readable aloud in approximately 3 minutes. Up to three speakers are allowed for each item on the agenda.

Questions

Those wishing to ask questions are required to give notice of any such questions

electronically to the officer named on the front of this agenda no later than 5pm on 1 July 2021 in order to be guaranteed of a written response. In order to

receive a verbal response questions must be submitted no later than 5pm on 6 July 2021.

Please contact the officer named on the front of this agenda for further advice.

Questions may be asked without notice if the Chairman decides that the matter is

urgent. Details of any questions received will be circulated to members prior to the meeting and made available at the meeting and on the Council’s website; they will be taken as read at the meeting.

There were no questions raised by members of the Public to be answered at this meeting.

To receive a presentation Elizabeth Disney (Wiltshire COO, BSW CCG), Lucy Townsend (Corporate Director of People, Wiltshire Council), Jo Cullen (Primary and Urgent Care, BSW CCG), Lucy Baker (Service Delivery, BSW CCG), Myfanwy Champness (Children’s Commissioning BSW CCG), Robert Holman (Head of Commissioning Specialist Services, Wiltshire Council), Emma Legg (Director of Access and Reablement, Wiltshire Council) and Helen Jones (Director of Joint Commissioning, Wiltshire Council).

The Board received a presentation which focused on Covid and planning for the future. Elizabeth Disney (Wiltshire COO, BSW CCG) introduced the presentation and updated that the NHS had identified the following national priority areas for recovery:

1.     Supporting the Health and Wellbeing of staff

2.     Delivering the NHS Covid vaccination programme

3.     Building on what has been learned during the pandemic to transform the delivery of services

4.     Expanding primary care capacity

5.     Transforming community and urgent and emergency care

6.     Working collaboratively across systems to deliver these priorities.

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

• It was queried whether reduced collective NHS demand and improved community wellbeing was embedded within a priority. It was clarified that these areas are embedded throughout the nature of the work that is being undertaken to respond, for example expanding primary care.
• The importance of prevention was stressed and that through a population health management approach data can be used to target areas.

Primary Care – Jo Cullen (Primary and Urgent Care, BSW CCG). The presentation covered the following areas:

·       BSW Covid Response Primary Care Offer was approved by the CCG last summer with a confirmed contract and funding for GPs. There is a commitment for Primary Care practices to deliver the most appropriate care to patients until September to provide stability.

·       The National Standard operating procedures for GPs was updated in May to support restoration of services in line with the roadmap out of lockdown.

·       May 2021 saw a 76% increase in the number of appointments compared to May 2020. Reports show that in May 2021 59% of appointments were face to face compared to 38% in May 2020.

·       Key messages from primary care were outlined including the perception that practices were not open; backlogs are starting to be caught up on; GPs are busy due to the total triage system; there is aconcern not to miss seeing patients who need to be seen, for example cancer patients.

·       A vaccination summary was provided with half of staff working in primary care delivering vaccinations. So far 1,114,001 vaccines have been delivered as of June 2021 with staff working to a deadline of 19 July for ages down to 18.

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

·       It was queried how patient anger and frustration is being manifested. A number of individual practice complaints have been seen as well as comments on social media and patients going to MPs. A briefing has been sent out regarding this.

·       There is concern regarding the implications of restrictions easing on 19 July and how the public will react to this. GPs will still be under different restrictions to other places such as supermarkets.

·       GPs have been busier than any time before in the past 5 years, for example on one day there was 4,000 calls to a practice. As a rough estimate, 50% of the calls received in primary care are related to low level anxiety in the general public,  ...  view the full minutes text for item 17.

To receive an update on governance and work programme, incorporating feedback from the previous Health and Wellbeing Board workshop. To be presented by Elizabeth Disney (Wiltshire COO, BSW CCG) and Lucy Townsend (Corporate Director of People, Wiltshire Council).

The Board received an update from Elizabeth Disney (Wiltshire COO, BSW CCG) about the Wiltshire Alliance. The update covered the following matters:

• A Nested Model of the ICS was presented which involved System, Place and Neighbourhood levels. It was highlighted that operating partnerships would be at Place and Neighbourhood levels. The Model is an opportunity for all organisations to create strength and common purposes which will allow work in the same direction.
• An overview of what the ICS is made up of, as well as its purpose and the regulatory role that NHS England will play regarding the ICS.
• All current CCG function will transfer into the NHS ICS body including commissioning and safeguarding duties.
• The ICS NHS will have a Unitary Board as well as sub-committees, which will be responsible for ensuring the ICS NHS body achieves its purposes. Minimum expectations for membership were outlined consisting of Independent non-executives; Executives and Partners.
• Partnership work will be integral to the ICS and will be facilitated through the ICS Partnership Forum as well as Place-based partnerships (ICAs) and Provider Collaboratives.
• The governance structure of the Wiltshire Alliance was outlined as well as its relationship to BSW ICS and the Health and Wellbeing Board.
• The development process that the Wiltshire Alliance has undertaken was outlined, including Wiltshire Professional Leadership Network, Workshops, Delivery Group and Leadership Team.
• The Wilshire Alliance contribution to the BSW ICS vision was detailed including aims and enablers all contributing to empower people.
• The Wiltshire Alliance Principles were outlined as follows with the themes and principles integrating into the workplan:

1)    Work as one

2)    Be led by our communities

3)    Improve health and wellbeing

4)    Reduce inequalities

5)    Join up our services

6)    Enable our volunteers and staff to thrive.

• The role of the Wiltshire Health and Wellbeing Board was outlined, including the development of the Joint Strategic Needs Assessment and the Joint Health and Wellbeing Strategy,

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

• It was stressed that the Wiltshire Alliance is an opportunity for all involved to empower the Wiltshire ICA and provide a strong voice for Wiltshire within the wider ICS.
• It would be useful to target some areas to demonstrate the benefits of the new system quickly, whilst also looking at bigger issues which might cause later problems through a preventative scope.

Decision - That the Wiltshire Health and Wellbeing Board continues to consider the evolving relationship between itself, the Alliance and the ICS.

To receive a report from Melanie Nicolau (Programme Lead for Adult Commissioning, Wiltshire Council).

The Board received a report from Melanie Nicolau (Programme Lead for Adult Commissioning, Wiltshire Council). It was noted that though the Better Care Fund weren’t required to submit plans for 2020/2021 to the national team, there was a requirement to understand the financial position and whether national conditions had been met along with being an enabler for work in Wiltshire. An anomaly was noted within the report, that the Better Care Fund did not underspend by £5million and a corrected version would be circulated

Decision – The Wiltshire Health and Wellbeing Board noted the end of year Better Care Fund submission for 2020/2021.

To receive a report from Stacey Sims (Manager).

The Board received a report from Stacey Sims (Manager) and a young Healthwatch volunteer. The report covered the following matters:

• Highlights of the past year, including the publication of 12 reports which made 36 recommendations; 36 volunteers providing 1,134 hours of time; engagements with 520 people about experiences of services during the pandemic as well as hearing from 1,753 people about experiences of health and care services.
• The creation of the Wiltshire Mental Health Open Forum in July 2020.
• Work conducted by Young Healthwatch, including mystery shopping services and then presenting findings to the Mental Health Network.
• Mental Health work including 32 in depth phone calls with people who had been taken to the Bluebell Place of safety during the pandemic.
• Response to Covid included setting up Covid advice and information webpages which were viewed more than 8,200 times; highlighted good practice in care homes and signposted community support.
• Outlined priorities for 2021/2022 which included finishing off paused work before the pandemic; mental health; primary care; children and young people; hospital discharge pathways.

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

• Though the Mental Health Network for children is run by Wiltshire Council, the priorities are essentially the same as the Mental Health Forum for adults.
• It was clarified that the priorities in the work programme are set from feedback provided by local people, as well as communicating with commissioners at Wiltshire Council and the CCG to see if they link together.

Decision – The Wiltshire Health and Wellbeing Board noted the key messages from the report. The Wiltshire Health and Wellbeing Board noted the contribution made by Healthwatch volunteers. The Wiltshire Health and Wellbeing Board confirmed its commitment to listening to the voice of Healthwatch.

To receive a report from Helen Jones (Director Joint Commissioning, Wiltshire Council).

The Board received a report from Helen Jones (Director Joint Commissioning, Wiltshire Council). The report covered the following matters:

• Whole Life Commissioning was the first of three chapters that will have Market Positions Statements, with the other two areas being adults and children.
• The report aimed to state what the current position is, what is wanted to be reached as well as how commissioners will work with partners to get there.
• The report noted that 70% of providers who responded to the survey did not feel confident in supporting those with complex needs. High levels of placements out of the county were also highlighted, which is a trend that is aimed to be reduced.
• It was highlighted that there has been increased complexity as well as an increase in prices within the residential and nursing parts of the market. Many residential places are purchased by other local authorities and there are significant gaps in crisis services.
• There is an aim to commission less restrictive placements and to grow the Shared Lives programme, as well as developing the market so that fewer placements are out of county.
• Aims also include for all providers to promote independent support and progression to less restrictive options, as well as commissioning services that both prevent and respond to crisis.

Decision - The Wiltshire Health and Wellbeing Board noted the work undertaken on the Market Position Statements and that commissioners and providers consider the implications for their work.

The next meeting is being held on 30 September 2021 starting at 9.30am.

The date of the next meeting is 30 September 2021 at 9:30 am.

Any other items of business which the Chairman agrees to consider as a matter of urgency,

There were no urgent items.