Agenda and minutes

The Chairman welcomed all to the meeting, and introduced Cara Charles-Barks the new Chief Executive of Salisbury NHS Foundation Trust.

Apologies were noted from:

• Tracey Cox (Wiltshire CCH) – represented by Mark Harris
• Dr Toby Davies and Dr Anna Collings
• Chris Graves (Wiltshire Healthwatch) –  represented by Emma Cooper
• Nikki Luffingham (NHS England)

To confirm the minutes of the meeting held on 15 December 2016.

The minutes of the previous meeting were considered.

Resolved

That the minutes of the meeting held on 15 December 2016 be approved as a correct record for signing by the Chairman.

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

There were no declarations of interest.

·        Outcomes Based Commissioning Peer Challenge

·        Shingles Vaccination rates

The Chairman drew the meeting’s attention to the following announcements:

·      Commissioning for Better Outcomes Peer Challenge

It was noted that this would be the subject of a future report to the Board.

·      Shingles

Dr Ardiana Gjini attended to present a further verbal update on the steps to promote the uptake of this vaccine, particularly the support offered to practices with low uptake.

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 on the front of the agenda 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 on the front of this agenda no later than 5pm on Thursday 2 February 2017 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 Monday 6 February 2017. 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 Committee members prior to the meeting and made available at the meeting and on the Council’s website.

There were no questions or representations made under this item.

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

Responsible Officers: Richard Crompton, Independent Chair

Richard Crompton, Independent Chair, presented the annual report of the Wiltshire Safeguarding Adults Board.

Issues highlighted in the course of the presentation and discussion included: that the report had previously been considered by the Health Select Committee; the picture based on previous the year and the issues arising for the coming year; how the Care Act, placing Adult Safeguarding on a similar statutory footing to Children’s Safeguarding, had brought the work into greater focus; the different partners and agencies involved in the Board; the impact of demographic and financial pressures on the issues of adult safeguarding and on Deprivation of Liberty Safeguards; the three main areas of focus; the development and publication of staff guidance; the information sharing protocol; the  high-risk behaviour policy which identifies preventative work; efforts to enhance training; auditing case files to enhance self-assessment; the increased officer support to the Board; increasing the profile of the Board through better visibility; the funding made available from Health and Police, along with the Council; the need to review performance data from a range of partners; the links to Healthwatch; how the adult and children safeguarding boards can work together to identify transition issues; how boards look at family issues not just at individuals; the potential to develop a hub based approach; that statistics show an increase in number of referrals, but is not uncommon, as a reflection of an increasing awareness and increased reporting overall; that four out of five reports are screened out in triage as not warranting further action; that  45% of referrals come from Care Home sector

The Chairman thanked Mr Crompton for the update and, noting the multi-agency hub approach had been a success in children’s services, that she would welcome a future more detailed discussion on widening of the model at a future meeting.

Resolved

1. To note the publication of the Wiltshire Safeguarding Adults Board Annual Report;

2. To agree to support the work of the Wiltshire Safeguarding Adults Board

3. To receive a further report, in 6 months, updating on progress including the MASH and the emerging business plan.

To provide an update on the findings of the recent Joint Targeted Area Inspection on domestic abuse, together with proposals for procurement of the service and the future development of strategy in this area.

Responsible Officers: Carolyn Godfrey

Report author: Hayley Mortimer, Lucy Townsend

Carolyn Godfrey, Wiltshire Council, presented the report which provided an update on the findings of the recent Joint Targeted Area Inspection on domestic abuse, together with proposals for procurement of the service and the future development of strategy in this area.

Issues highlighted in the course of the presentation and discussion included: the priority placed on abuse by all agencies; the opportunity to combine different contracts into one procurement exercise; the multi-agency approach to assess needs and develop the strategy; and that an action plan would be reported to the Board at a future date.

Resolved

To note the report and the implications for partners in the delivery of their services.

a)    A verbal update from the chair of the new Wiltshire and Swindon Mental Health Crisis Care Action Group, Ted Wilson.

b)    A presentation outlining work to date on a review of AWP s136 pathways.

Keith Pople, Alexander Group

The meeting received a verbal update from the chair of the new Wiltshire and Swindon Mental Health Crisis Care Action Group, Ted Wilson. The action group is currently working to develop a revised action plan and progress agreement on Approved mental health professionals (AMHPs) and the places of safety.

Issues highlighted in the course of the presentation and discussion included: that a  joint action plan for Wiltshire and Swindon was being developed; the implications of the Police & Crime Act; the investment to provide street triage 24/7 from April; the opening of places of safety in Devizes to be complete by March; the availability of s12 doctors across the Avon and Wiltshire footprint (and a named doctor in each of the CCG locality groups); the desire to make sure Wiltshire issues are picked up in the concordat.

The meeting also received a presentation from Keith Pople, outlining work to date on a review of s136 pathways.

Issues highlighted in the course of the presentation and discussion included: that the review was discussed at the recent Mental Health Summit convened by Mike Veale; the approach taken to the review; how better benefits can be gained from widening the review across the Avon and Wiltshire footprint; how different views of the 23 organisations and service users fed into the review; how the system has been mapped and how a increased focus on preventative work should be done; the results seen already in street triage; the other best practice examples from around the country; the specific issues for Wiltshire: the pressures on the AMHPs system; the need to take volume out of the pathway, including getting hold of s12 doctors; how a reciprocal arrangement for AMHPs could be introduced to reduce travel time; and whether increasing facilities may increase referrals to them.

Resolved

To note the updates and to receive a further update at the next meeting.

The CCG’s proposed Operational Plan for 17/18 in the context of the emerging Sustainability and Transformation Plan.

Responsible Officers: Tracey Cox

Report Author: David Noyes

Mark Harris, from the Wiltshire Clinical Commissioning Group (CCG), presented the Operational Plan for 2017 to 2019 which set out how Wiltshire CCG would work with its partners in Wiltshire Council and the wider care system across Bath & NE Somerset and Swindon to transform care for people in Wiltshire and beyond.

Issues highlighted in the course of the presentation and discussion included: that NHS England receives the plan to get reassurance that the CCG is covering the areas it needs to; the statutory responsibilities and priorities covered in the plan; the links to the Sustainability Transformation Plan (STP) and the work underway on a system control total; the financial assumptions outlined in the plan; how coherence is established, in the plans, with other neighbouring CCGs; the areas for improvement included in the plan; how the Operational Plan will translate into a business plan in six months time, and how performance and delivery will be reported to the Board.

Resolved

To note the strong alignment with the objectives of Wiltshire’s Joint Health and Wellbeing Strategy as well as the objectives of the emergent Sustainability and Transformation Plan and those of NHS planning.

An update, to follow, on scheme implementation and consideration of the findings of the BCP task group.

Responsible Officers: Tracey Cox, Carolyn Godfrey

Report author: James Roach

The meeting considered the report, circulated on the 8 February, which: provided an update on current performance against the key Better Care Plan indicators; an overview of the key conclusions and recommendations of the Better Care Plan Task Group and actions being taken; and a summary update on the proposed Better Care Fund budget for 2017/18 and the key commissioning intentions.

Issues highlighted in the course of the presentation and discussion included: that the commissioning intentions would be finalised in more detail by the end of February and would be presented to the next meeting; the significant pressures being felt locally; and the children’s emergency admissions in Wiltshire.

The Chairman stated that James Roach was not at the meeting, as she wanted to thank him in person for his work on the Better Care Plan. She asked for a letter to be drafted.

Resolved

1.    To note the current performance of the Better Care Plan in Wiltshire and the key operational risks

2.    To support and endorse the key recommendations from the Better Care Plan Task Group

3.    To approve the next steps in relation to finalising the Better Care Plan Commissioning priorities for 2017/18

A verbal update on the changing ambulance service and the Ambulance Response Programme.

Responsible Officers: Andy Smith, Executive Medical Director, SWAST

Andy Smith, from the South Western Ambulance Service NHS Foundation Trust, provided a verbal update on the changing ambulance service and the Ambulance Response Programme.

Issues highlighted in the course of the presentation and discussion included: the areas for improvement, and how quality can be monitored; identifying needs and establishing best practice pathways; how pre-triage questions can establish what resources should be sent to a call-out; how requests are categorised and prioritised; how to encourage the public to contact the right person in the system; how to address the future challenge of integrating better with social care to meet the needs of frail elderly patients e.g. in Hertfordshire a social worker is sent out on some calls; and the need to capture patient reported experience.

Resolved

To note the verbal update and to request a written update at later stage.

An update on the latest improvements to complaints processes within Wiltshire as part of Healthwatch Wiltshire’s work.

Responsible Officers: Christine Graves 

Report Author: Sara Nelson

Emma Cooper and Sara Nelson presented the report which provided an update on the latest improvements to complaints processes within Wiltshire as part of Healthwatch Wiltshire’s work.

Issues highlighted in the course of the presentation and discussion included: the follow-up work undertaken regarding the recommendations previously reported to the board; how the scope was expanded from NHS complaints to include social care complaints too; how the complaint liaison group was formed from Patient Advice & Liaison (PALs) and customer care officers; that this group would continue to meet quarterly and discuss issues and best practice; how advocacy services have been included along with an increasing range of agencies and partners; that PALs managers have formed a sub-group along with their other staff; how future workshops would continue to focus on learning outcomes; the increased demand from people with mental health issues; that social care complaints appear to have less scrutiny nationally; how improvements can be made on accessing information about social care complaints; the links to national work aimed at supporting this work; and the next steps for the programme.

The Chairman thanked Healthwatch for their work in this area.

Resolved

a)    To recognise the commitment of Healthwatch Wiltshire, the acute hospital trusts, and mental health trust, NHS Wiltshire Clinical Commissioning Group (CCG), Wiltshire Council and SeAP Advocacy to continue to work together and share good practice on complaints handling.

b)   To note the work that Healthwatch Wiltshire have done in this area of social care complaints and consider the recommendations for possible improvements in the system.

c)    To note Healthwatch Wiltshire’s continued involvement in the national work on complaints that has been carried out alongside Healthwatch England.

The annual report deferred from the last meeting.

Responsible Officers: Frances Chinemana

Frances Chinemana, presented the Annual Report for Public Health which informed the Health and Wellbeing Board members of activity on public health in Wiltshire during 2016-17.

Issues highlighted in the course of the presentation and discussion included: the key areas of success including the increase in life expectancy; that obesity in children had reduced, the increase in leisure centre visitors; the numbers of children going into A&E; the public health issues benefited from links to the Clinical Commissioning Group, Sustainability and Transformation Plans and Better Care Plan work; that the public health team was part of an integrated Council department; the impact of local events to consider JSA data and how it was informing local priorities.

Resolved

To note the publication of the Annual Report.

The next meeting will be 18 May 2017.

The date of the next meeting, 18 May 2017, was noted.

There were no urgent items.