Agenda and minutes

The Chairman welcomed everyone to the meeting.

Apologies were received from Chief Constable Mike Veale; Peter Hill from Salisbury, represented by Dr Nick Marsden; Ken Wenman from SWAST, represented by Nick Wilson; Cllr Laura Mayes; Dr Richard Sandford-Hill and Dr Toby Sutcliffe.

To confirm the minutes of the meeting held on 22 September 2016.

The minutes of the meeting held on the 24 September 2015, previously circulated, were considered.

Resolved

To approve and sign the minutes of the previous meeting held on

24 September 2015.

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

There were no declarations of interest made.

·       Letters from the Home Secretary and Secretary of State for Health regarding health and police collaboration.

·       Letter from David Mowat MP, Department of Health on Primary Care

·       Letter from DH/ DCLG regarding Winter Planning

Baroness Scott drew the meeting’s attentions to the following information set out in the agenda:

·       Letters from the Home Secretary and Secretary of State for Health regarding health and police collaboration.

·       Letter from David Mowat MP, Department of Health on Primary Care

·       Letter from DH/ DCLG regarding Winter Planning

The Council welcomes contributions from members of the public.

Statements:

If you would like to make a statement at this meeting on any item on this agenda, please register to do so at least 10 minutes prior to the meeting. Up to 3 speakers are permitted to speak for up to 3 minutes each on any agenda item. Please contact the officer named above for any further clarification.

Questions:

To receive any questions from members of the public or members of the Council received in accordance with the constitution. Those wishing to ask questions are required to give notice of any such questions in writing to the officer named above, no later than 5pm on Thursday 8 December 2016. Please contact the officer named on the first page 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 Board members prior to the meeting and made available at the meeting and on the Council’s website.

There were no questions or statements under this item.

To outline to commissioners and providers the annual report of the Wiltshire Safeguarding Children Board; with emerging priorities for 2017.

Responsible Officers: Mark Gurrey, Independent Chair

Mark Gurrey, Independent Chair, attended the meeting to present the annual report of the Wiltshire Children Safeguarding Board.

Issues highlighted in the course of the presentation and discussion included: the activities of the board; the results of recent Ofsted inspections; the recent change to the Chair and the governance arrangements; the priorities for the Board; the upcoming results from review into domestic violence; the Wood review, commissioned by the DfE, that reviewed all Boards nationally and serious case reviews, and the recommendations arising; the implications for the existing Board and how regulations will allow greater flexibility to set up a system and governance arrangement that better suit local needs; that whatever arrangement is put in place, the culture has to be effective to protect vulnerable children.

Baroness Scott thanked Mr Gurrey for attending the meeting to present the report.

Resolved

To note the report and give the content consideration when commissioning or providing services for children and young people across the partnership.

Reason for Decision:

It is the requirement of all Safeguarding Children Boards to produce an Annual Report on the effectiveness of safeguarding in their local area. The Board will submit a copy of this report to the Health and Wellbeing Board, who will be expected to respond by giving consideration when commissioning or providing services for children and young people across the partnership.

To update the Board on the Sustainability and Transformation Plan for Bath and NE Somerset, Swindon and Wiltshire and the implications for partners in Wiltshire in light of the latest NHS Planning Guidance.

Responsible Officers: James Scott, SRO for the STP.

Report author: David McClay, Programme Director for the STP

The meeting received a report which provided an update on the Sustainability and Transformation Plan (STP) for Bath and NE Somerset, Swindon and Wiltshire including the implications for partners in Wiltshire in light of the latest NHS Planning Guidance. The report outlines the progress made since the last update to the Board in September 2016.  It provided an overview of the key elements within the emerging STP for Bath & North East Somerset, Swindon and Wiltshire areas. It was noted that the full plan was published and circulated to Board members on the 14^thDecember. The plan set out the key early priorities within the STP but also identified that significant public and workforce engagement would take place over the next 5 months to finalise the future design of our health and social care services.

Issues highlighted in the course of the presentation and discussion included:

that a broader coalition of partners had been working together to work on the emerging plan; that the intention was to start working with partners and the public on co-designing services in response to the plan; that the financial gap would be around £217m if no changes were to be made; how the plan had focused on areas that need action and to which the plan can effect change; the opportunities to share property, personnel and back office issues; how a small minority of complex cases take up a large amount of resources; the implications of the geography in the area; how certain specialisms can work better across the STP area; how the STP board will move to become a partnership responsible for implementing plan; the opportunities for joining up digital programmes particularly the Single View of the customer which is piloting in the a Bradford-on-Avon GP surgery; the positive attitudes between partners; the involvement of AWP and the prominence of mental health in the STP; and the key to making sure communication is clear.

Recommendation:

To note the update on the emerging STP.

Reason for Decision:

To allow Health & Wellbeing stakeholders the opportunity to comment on the emerging plan and for members to identify gaps and overlaps with the Board’s H&WB programme

A presentation outlining the future opportunities for primary care in Wiltshire in light of NHS Planning Guidance and the potential for close working to address these, including preventative and proactive working.

Responsible Officers: Tracey Cox

Report Author: Jo Cullen

The meeting received a presentation, circulated on the 14 December, which outlined the future opportunities for primary care in Wiltshire and the potential for close working including preventative and proactive working.

Issues highlighted in the course of the presentation and discussion included:

the issues of recruitment in a number of practices; the contribution of primary care to support the whole system; how integration with other teams can be prioritised, and the impact that it can make on patients; the vision for improving access to care; the engagement work with patients and the public; how the examples of successful pilots can be expanded into other areas; the work to link the management of property and technology across practices;  and the support given to vulnerable practices.

Baroness Scott thanked officers for the report and asked that further updates, focusing on specific areas, be brought to future meetings of the Board. She also asked officers to consider what extra support Wiltshire Council could give to address any issues e.g. recruitment.

Resolved

To note the update.

Report Author:  Frances Chinemana, Ted Wilson 

The meeting received the report which provided an update on the delivery of Wiltshire’s Joint Mental Health Strategy in the context of the Mental Health Five Year Forward View and latest NHS Planning Guidance. Following approval of the Wiltshire Mental Health and Wellbeing Strategy in 2015 and its implementation plan in 2016, it was agreed at the Health and Wellbeing Board that an annual report on progress would be provided to highlight some of the achievements across the priority areas for the first year.

Issues highlighted in the course of the presentation and discussion included: That Wiltshire CCG and Wiltshire Council Public Health teams co-chaired the board that managed the strategy; that progress reports had also been provided to the CCG Board and the Health Select Committee; that a key priority had been to build a partnership approach across the first year; that there was an intention to improve user involvement on the Board; that improvements to data and information gathering may lead to changes in the strategy; the links to other plans; that some projects had had successful funding bids approved; and the improvements that had been made already, and the priorities for improvement.

Baroness Scott thanked officers for the report and asked that further update report, focusing on performance, be brought back to the Board in 6 months.

Resolved

To note the information and recommendations within the annual report.

Reason for Decision:

The Wiltshire Mental Health and Wellbeing Strategy and implementation plan aims to create environments and communities by 2021 that will keep people well across their lifetime. This annual report on progress gives an update on action towards this aim

An update on the the Child and Adolescent Mental Health Services Transformation Plan in the context of the latest NHS funding and procurement plans. 

Responsible Officers: Tracey Cox, Carolyn Godfrey

Report Author: Julia Cramp

The meeting received a report which provided an update on the Child and Adolescent Mental Health Services Transformation Plan in the context of the latest NHS funding and procurement plans.

Issues highlighted in the course of the presentation and discussion included: the national increase in demand for mental health services for children and young people; the additional resources that have been identified; the actions achieved and priorities for improvement in the plan; how the health messages are communicated accessibly for children and young people; the hope that helping young people now will prevent future mental health problems in the future; that young people, themselves, see mental health as a key issue; the plans to hold a youth summit, along with  key partners, to discuss mental health issues; and how the young listeners project has included services users.

Dr Gareth Bryant stated that he felt that activities around the plan were a good example of were partners joining together to help take pressure off GPs.

Resolved

1.     To note the progress to date on the implementation of the CCG local transformation plan for children and young people’s mental health and wellbeing;

2.     To endorse the refreshed and expanded plan including its commissioning intentions, local priorities and updated budget proposals for 2016/17 and 2017/18.

Reason for Decision:

NHS England requires Wiltshire CCG to work with key partners (including schools, the voluntary and community sector and importantly children, young people and those who care for them) to review the local transformation plan and ensure it is reflective of local needs and is delivering improvements.

To ask the Board to approve the Year 2 Action Plan for the Concordat and receive an update on the latest performance information against key indicators. 

Responsible Officers: Ted Wilson, MHCCC Action Group Chair 

Report Author: Georgina Ruddle, Sgt Mike Hughes, David Bowater

The meeting considered the report which asked the Board to consider progress on the Action Plan for the Concordat and provided an update on the latest performance information against key indicators. The report followed a previous update report received in September.

Issues highlighted in the course of the presentation and discussion included: that report follows a discussion hosted at the police offices; that street triage services is not currently operating around the clock, but that there is an agreement to move forward with this; the continued need to get timely assessment of cases; the impact of the Police and Crime Bill, especially regarding longer-term solutions; and the issue of prioritising resources for Wiltshire residents in a larger, more regional system.

Baroness Scott thanked the Police and Crime Commissioner for hosting the conference, and encouraged Board Members to visit the street triage team to see it in operation.

Resolved

1.     To note the outcomes of the mental health summit in October;

2.     To agree to receive an updated and combined action plan for the new Wiltshire and Swindon Mental Health Crisis Care Concordat Action Group in the new year; and

3.     To considers the latest available data against key indicators at Appendix 1, and agrees to a further update in the New Year.

Reason for Decision:

At the last meeting the Board agreed to receive a further update on the delivery of the Mental Health Crisis Care Concordat Action Plan, following a meeting of lead chief executives, together with an update on the delivery of the Mental Health and Wellbeing Strategy.

It also considered appropriate indicators for monitoring the implementation of the Action Plan and an update is provided against these.

A paper for information presenting the Public Health Annual Report

Responsible Officers: Carolyn Godfrey

Report author: Frances Chinemana

The meeting received the Annual Report for Public Health which informed the Health and Wellbeing Board members of activity on public health in Wiltshire during 2015-16. It was noted that the report could be brought back to the Board if there were any substantive questions raised by the members of the Board.

Resolved

To note the publication of the Annual Report

Reason for decision:

Work on Public Health has implications for all health care providers and commissioners.

To receive a presentation updating the Board on the Better Care Plan for 2016/17 and emerging priorities for 2017/18.

Responsible Officers: Tracey Cox, Carolyn Godfrey

Report author: James Roach

The meeting received presentation, circulated on the 14 December, which provided a mid-year review of the Better Care Plan delivery together with information on our approach to winter planning.

Issues highlighted in the course of the presentation and discussion included: the demographic growth and the impact on demand; that there had been a reduction in admissions compared to projections, and the impact on the length of stay; the increase in the level of complexity of cases presenting to acute hospital services; the change in performance of Delayed Transfers of Care (DTOC), and that the average number of days had reduced; how to address the over-prescription of care; that there had been a reduction in permanent care replacements; the impact of Brexit on workforce planning, and whether this could be reported to a future meeting; that this had not resulted in a financial saving, but outcomes for residents is better; and that the 2017/18 commissioning plan would be brought to the February meeting of the Health & Wellbeing Board.

Resolved

That the update be noted.

The meeting noted that the next meeting would take place at 10am on the February 2017.

There were no urgent items.