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Agenda and minutes

Venue: Kennet Room - County Hall, Bythesea Road, Trowbridge, BA14 8JN. View directions

Contact: Will Oulton  Email: william.oulton@wiltshire.gov.uk

Items
No. Item

1.

Chairman's Welcome and Introduction

Supporting documents:

Minutes:

The Chair welcomed all to the meeting.

2.

Apologies for Absence

Minutes:

Apologies were received from Chief Insp. Mike Veale, Nerissa Vaughan, Dr Andy Smith, and Dr Bill Bruce-Jones, James Scott and Cara Charles-Barks.

 

3.

Minutes

To confirm the minutes of the meeting held on 9 November 2017.

Supporting documents:

Minutes:

The meeting considered theminutes ofthemeetingheld on 9November 2017.

 

Resolved

 

To approve as  correct record for signing by the Chair the minutes of the meeting held on 9 November 2017.

4.

Declarations of Interest

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

Minutes:

There were no declarations of interest.

5.

Chairman's Announcements

·       CQC inspection in March

·       Progress on integration

 

Supporting documents:

Minutes:

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

 

·       CQC inspection in March

·       Mention the Ofsted inspection of SEND

·       Progress on integration

 

6.

Public Participation

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 Monday 22 January 2018 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 Wednesday 24 January 2018. 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.

Minutes:

There were no public questions or statements received.

7.

Sustainability and Transformation Partnership Update

A presentation inform the current priorities for collaborative working, and to introduce the board to the new senior responsible officer for the STP.

 

Responsible Officers: Chris Bown

Minutes:

Chris Bown gave a presentation, appended to these minutes, regarding the current priorities for collaborative working, and to introduce the board to the new senior responsible officer for the Sustainability and Transformation Partnership (STP).

 

Matters highlighted in the course of the presentation and discussion included: the overview of the national picture and the context in which the STP had been drawn up; the need for better engagement with local government; that a plan was established in 2016 and focused on the 5 year forward view; the 44 STPs in England and the desire to become accountable care systems (now retitled as integrated care systems); the focus on improving health outcomes for the population, particularly narrowing the gap on life expectancy between those living in more deprived areas; that there are 20 plus partners involved in delivering the aspirations; the desire to reduce duplication and variation with the intention of making the system more efficient and less confusing to the individual; the five key focuses of the plan: proactive and preventative care, planned/consistent care; acute collaboration; digital and workforce issues; the key role of the Health & Wellbeing Boards in providing strategic leadership along with the STP; the key areas for future work: mental health  and well-being, a greater emphasis on self and community care; and better integration with social care; that some services should be commissioned or transformed at  STP level where appropriate; the desirability of an update on maternity at a future meeting, the need to address the financial challenge of a projected deficit of £110m (without savings across the STP); how cost improvement programmes are developed; the importance of developing a workforce and estates strategy; the complexities of the geography in Wiltshire; the work to provide greater emphasis on children’s services; the piloted approaches in areas of deprivation; and the further discussion required on governance.

The Chairman thanked Mr Bown for his presentation, and welcomed the opportunity to continue discussions.

8.

Winter Pressures - Update

A presentation on the implementation of winter planning measures, the additional funding announced in the budget and to consider the current situation across the system.

 

Responsible Officers: Linda Prosser, Graham Wilkin

Report author: Jo Cullen

Minutes:

Jo Cullen gave a presentation, appended to these minutes, on theimplementationofwinterplanning measures,theadditionalfunding announcedin thebudgetand toconsiderthecurrentsituationacross the system.

 

Matters highlighted in the course of the presentation and discussion included: that this was an interim update which presented some of the lessons learnt from experiences so far this winter; the increase in ambulance demand compared to the previous year; the variance in attendances at the three acute centres and the reasons for this; the impact of Christmas events on demand; how actual demand matched with predicted demand on 111 services; the symptoms of people presenting at 111 and how they can be appropriately diverted to self-care and pharmacy when routine services aren’t available; the volume of calls for out of hours services; how extra demand was managed with additional resources; that care homes that had been seeking repeat prescriptions over weekends had been identified and were targeted for action; the services provided by walk-in centres; that average length of stay in acute settings had reduced; the integrated control centre in Wiltshire, supported by partners, to enable capacity can be managed; and the lessons learnt and the interim actions already taking place.

 

The Chairman asked the thanks of the Board to all staff supporting the system be recorded.

 

9.

Delayed Discharges

To receive an update on the latest figures for delayed discharges.

 

Responsible Officers: Linda Prosser, Graham Wilkin

Report author: Sue Shelbourn-Barrow

Supporting documents:

Minutes:

Jeremy Hooper presented an update on the latest figures for delayed discharges (DTOC).

 

Matters highlighted in the course of the presentation and discussion included: that DTOC numbers were being brought down; that some further work was required including regarding mental health partners; the greater focus on increasing weekend working to facilitate 7 days a week discharges; the work of the JCB, the discussion of equipment provision and the implementation of the choice policy and the further work required; that further work on the efficacy for dementia strategy was required; and the thanks to the teams for their continued hard work.

 

Resolved

 

i)             To note performance, variation for DTOC trajectory and actions interwoven in the delivery of the 8 High Impact Actions

 

ii)            To note the delivery and actions to support winter pressures capacity

 

iii)          To note the establishment of the Better Care Fund DTOC sub group

 

10.

Better Care Plan

To receive an update on the delivery of the Better Care Plan for Wiltshire and emerging plans for 2018/19.

 

Responsible Officers: Linda Prosser, Graham Wilkin

Report author: Sue Shelbourn-Barrow

Supporting documents:

Minutes:

Jeremy Hooper presented an update, appended to these minutes,on thedeliveryof theBetter CarePlanfor Wiltshireandemerging plansfor 2018/19.

 

Matters highlighted in the course of the presentation and discussion included: that non-elective admissions were higher than last year across all age bands; the changes to the model of home care; the activity on intermediate care beds; the new governance arrangements, and the changes made to better manage the number of projects that need to be delivered; and that the project board would be meeting the following month and establishing a deliver group.

Resolved

 

1.          To note the new Better Care Fund Dashboard

 

2.          To note the Better Care Fund Risk Register 2017/18

 

3.          To consider the emerging plan for 2018/19

 

4.          To give strategic approval to the proposed draft BCF Section 75 Agreement 2017/2019 between Wiltshire Council and NHS Wiltshire CCG which will continue to provide the legal framework for the Better Care Fund and underpin the Better Care Plan (delegating any future minor amendments to the Chair and Vice Chair).

 

11.

Pharmaceutical Needs Assessment

To agree the final Pharmaceutical Needs Assessment, following recent consultation.

 

Responsible Officers: Tracy Daszkiewicz

Report author: Steve Maddern

Supporting documents:

Minutes:

 

Steve Maddern presented the report which asked the Board to  agree  the  final  Pharmaceutical  Needs  Assessment (PNA),  following  recentconsultation.

 

Matters highlighted in the course of the presentation and discussion included: that the draft was considered at a previous meeting; that issues raised in the consultation had been addressed in the revised draft; that young peoples needs have been highlighted; and that officers had been providing response to the PNAs from neighbouring areas.

The Chairman thanked Steve and his team for their hard work.

 

Resolved

 

1.          To note the public consultation feedback in the draft PNA document.

 

2.          To approve the final PNA 2018 document to come into effect as of 01 April 2018.

 

12.

CCG Local Transformation Plan (CAMHS) Refresh

To approve the refresh of the CCG’s local transformation plan for child adolescent mental health services in 2018/19.

 

Responsible Officer: Ted Wilson

Report author: James Fortune

Supporting documents:

Minutes:

Ted Wilson presented the report which asked the Board to approve the refresh  of  the  CCG’s  local  transformation  plan  for  child adolescent mental health services in 2018/19.

 

Matters highlighted in the course of the presentation and discussion included: that the plans expanded upon the plan from 2015; the relevance of the green paper of 2017 from DoE and DfH and the links to those ambitions; the improved resources available to schools; that twelve secondary schools now had dedicated workers; how officers were leading on STP-wide work looking at the reprocurement of CAMHS services; that there is now a single point of access for self-referral and for professionals; the welcome expansion of online counselling service, and that 2000 individuals had accessed this service; the work of Healthwatch and the training of Young Listeners, the increasing levels of self-harm and the aim increase early intervention; that work was ongoing to reduce relatively high waiting times; and that officers were pleased with the progress made so far.

 

Councillor Laura Mayes expressed her thanks for the progress made, and gave examples of the positive feedback received from young people.

 

In response to a question from Angus MacPherson, it was noted that all secondary schools had welcomed the offer of new services, but there was a concern that those with school nurses may see the expanding service as a way how making cut backs to their own provision. It was also hoped to expand the offer of services to primary settings.

 

Dr Toby Davis gave an example from his practice which showed a marked improvement in the services available.

 

In response to a question raised by Christine Graves, it was noted that further training to be given to all teachers so that they are confident in signposting children to support.

 

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;

 

  1. To endorse the refreshed and expanded plan including its commissioning intentions, local priorities and updated budget proposals;

 

  1. To encourage partner agencies to consider contributing their views to the green paper on improving mental health support for children and young people.

 

13.

Wiltshire CCG Care Operating Model

A presentation outlining the proposed care operating model for Wiltshire.

 

Responsible Officers: Linda Prosser

Report author: Mark Harris

Minutes:

Mark Harris gave a presentation, appended to these minutes, regarding the proposed care operatingmodelfor Wiltshire.

Matters highlighted in the course of the presentation and discussion included: the services included in the model; the basis on how the capital investment is made; the different groups within each geographical footprint and what can be expected in which footprint; and the vision of having GP practices working together at hubs.

 

The Chairman thanked the officers for the presentation and requested that a further discussion take place at a future meeting.

 

 

14.

Domestic Abuse

To receive an update on domestic abuse strategy, needs assessment and contract award. 

 

Responsible Officer: Graham Wilkin

Report author: Tracy Daszkiewicz

Supporting documents:

Minutes:

TracyDaszkiewicz presented the report which gave an update on domestic abusestrategy, theneeds assessmentand contractaward.

 

Matters highlighted in the course of the presentation and discussion included: how the needs assessment was undertaken and published; the procurement process undertaken; that the new strategy had been developed in line with the national strategy; that there were approximately 15,000 people at risk or suffering from domestic abuse; that addressing this was a key priority; and that about 50% of children in contact with children’s services are affected by domestic abuse; how support can be integrated with housing policies; that services are available to all victims so that there is no discrimination based on gender; the links to substance abuse and how the work is partnered; and the work with police and fire service partners.

 

Resolved

 

To note the report

 

15.

Adult Social Care Transformation Programme

An update on the delivery of the programme.

 

Responsible Officers: Graham Wilkin

Report author: Catherine Dixon

Supporting documents:

Minutes:

Catherine Dixon presented the report which provided an update on the delivery of the programme.

 

Matters highlighted in the course of the presentation and discussion included: how the funding had been used to develop the model of prevention; the work to promote reablement and increasing capacity in the market; that the project had looked at local area co-ordination; the proposed links to the STP and how this might be reflected in the CCG plans; the desire to include partners in steering group; the commissioning intentions and developing strategies for services for adults with learning difficulties; that there would be further work on co-production to bring partners; that an innovation grant was awarded to look at workforce capacity; the changes to staffing structures and setting up own reablelment services; that the project would be continuing to look at services and looking at elderly and mental health in stage two; and how the project is monitored through transformation board.

 

Resolved

 

To note the progress made

 

16.

Health and Wellbeing Board progress report 2017

To receive an update on progress in delivering the joint health and wellbeing strategy.

 

Responsible Officer: Linda Prosser, Graham Wilkin

Report author: David Bowater

Supporting documents:

Minutes:

David Bowater presented the report that provided anupdateon progressin deliveringthe jointhealthandwellbeingstrategy. Matters highlighted included: the importance of highlighting the progress made against the public strategy; that some issues could be looked at in the future e.g. personal health budgets; and the effectiveness of taking a partnership approach to shared problems.

 

Resolved

 

To note the progress made in delivering key objectives over the last year.

 

 

17.

Date of Next Meeting

The next meeting will be 29 March 2018

Minutes:

It was noted that the date of the next meeting would be the 29March 2018.

18.

Urgent Items

Minutes:

There were no urgent items.