Agenda and minutes

The Chair welcomed all to the meeting.

Apologies were received from Catrinel Wright, Nerissa Vaughan, Angus McPherson, Terence Herbert, Christine Blanshard, Andy Hyett, Cllr Ben Anderson and Cllr Ian Thorn.

To confirm the minutes of the meeting held on 12 July 2018. (Copy attached)

The minutes of the previous meeting held on 12 July 2018, previously circulated, were considered.

Resolved:

To approve the minutes as correct.

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.

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 Wednesday 10 October 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 Friday 12 October 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.

There were no questions from the public.

The All Party Parliamentary Group on Arts and Health and Wellbeing recently wrote to Health and Wellbeing Boards to highlight the findings of its recent inquiry published here:

http://www.artshealthandwellbeing.org.uk/appg-inquiry/Publications/Creative_Health_The_Short_Report.pdf

The report includes a recommendation that:

We recommend that, at board or strategic level, in NHS England, Public Health England and each clinical commissioning group, NHS trust, local authority and health and wellbeing board, an individual is designated to take responsibility for the pursuit of institutional policy for arts, health and wellbeing.

Accordingly board members are requested to highlight a board member from their organisation to Meril.Morgan@wiltshire.gov.uk, Arts Lead for Wiltshire Council. The Cabinet Lead for Wiltshire Council is Cllr Richard Clewer.

This will enable closer working on arts and health to take place including where appropriate collaboration on funding applications and relevant events.

The report also highlights the value of arts through social prescribing, the importance of consideration within Sustainability and Transformation Partnerships and Healthwatch Wiltshire advocating for arts within health and care programmes.

Acute hospitals serving Wiltshire already have some provision for arts in place, alongside a number of care homes and GP surgeries. 

Dr Richard Sandford-Hill drew the meeting’s attention to the following information as set out in the agenda:

The All Party Parliamentary Group on Arts and Health and Wellbeing recently

wrote to Health and Wellbeing Boards to highlight the findings of its recent

inquiry published here:

http://www.artshealthandwellbeing.org.uk/appginquiry/Publications/Creative_Health_The_Short_Report.pdf

The report includes a recommendation that: We recommend that, at board or strategic level, in NHS England, Public Health England and each clinical commissioning group, NHS trust, local authority and health and wellbeing board, an individual is designated to take responsibility for the pursuit of institutional policy for arts, health and wellbeing. Accordingly board members are requested to highlight a board member from their organisation to Meril.Morgan@wiltshire.gov.uk, Arts Lead for Wiltshire Council. The Cabinet Lead for Wiltshire Council is Cllr Richard Clewer. This will enable closer working on arts and health to take place including where appropriate collaboration on funding applications and relevant events. The report also highlights the value of arts through social prescribing, the importance of consideration within Sustainability and Transformation Partnerships and Healthwatch Wiltshire advocating for arts within health and care programmes. Acute hospitals serving Wiltshire already have some provision for arts in places, alongside a number of care homes and GP surgeries.

To consider the implications of the areas highlighted in the WSCB annual report 2017/18 and early thoughts on future working arrangements following the removal of the statutory basis for the board in 2019. 

Responsible Officers: Mark Gurrey, Independent Chair

Mark Gurrey presented a report on the areas highlighted in the Wiltshire Safeguarding Children’s Board’s (WSCB) annual report 2017/18 and early thoughts on future working relations following the removal of a statutory basis for the board in 2019.

Matters raised during the presentation and discussion included: the timescale for implementation of the proposed arrangements; a desire to narrow the gap between the work of the board and the day-to-day life of children; the importance of continuing to value the WSBC’s key principles that were in place prior to the removal of its statutory basis; the opportunity to work collaboratively with practitioners and safeguarded children alike to explore the realities of its work.

In answer to a question from the Board, it was noted that both internal and external partners have been much more explicit about their performance than had previously been the case and the proposed arrangements, for example in Serious Case Reviews, would enable the WSCB to extract and apply the lessons learned much more quickly.

Resolved:

1.       To note the progress to date.

2.       To consider the early thoughts on future working arrangements following the removal of the statutory basis for the board in 2019.

To assess progress against the programme objectives to date and agree the next steps.

Responsible Officers: Terence Herbert

Report author: Lucy Townsend

Theresa Leavy presented a report assessing progress against the Families and Children’s Transformation Programme’s (FACT) objectives to date.

Matters raised during the presentation and discussion included: improvement to the case management system; the timescale in which this would be rolled out to partners; the establishment of an early support hub that will work alongside the MASH service; the High Frequencies Contact Project and its emphasis on service integration at a community level; a desire to focus on attachment and a singular approach to this regarding Best Start in Life.

In response to an issue raised by the Chairman, it was noted that an output framework had been developed which will measure the experience of those who have been through the programme and provide it with a benchmark for success.

In answer to a question from the Board, it was noted that the programme had tried to avoid rigid categorisation of services or issues but assured the board that exploitation of all kinds was at the forefront of its mind.

Resolved:

1.       To note the progress to date.

2.       To update progress in 6 months’ time.

To agree the Local Transformation Plan for Child and Adolescent Mental Health Services in Wiltshire.

Responsible Officer: Terence Herbert, Linda Prosser

Report author: Judy Edwards

Ted Wilson presented the outline of the Local Transformation Plan for Child and Adolescent Mental Health Services in Wiltshire.

Matters raised during the presentation and discussion included: interaction with children and young people to gauge the success of the programme; an emphasis from children and young people on the need for early intervention and access to services; the recommissioning of services from a tier based to a more holistic approach; the development of a wellbeing team embedded in schools and colleges; the improvement of the transition of people from CAMHS to adult services; working alongside B&NES in establishing a mental health support team and reducing referral time.

It was noted that more complete hard and soft metrics need to be put in place to measure the success of the Plan, and that the board would want to see this implemented and brought before them at a later date.

In response to an issue raised by the Board, it was recognised that more work needs to be done to promote what already exists through schools, in particular Kooth online counselling.

Resolved:

1.       To note the progress to date.

2.       To endorse the expanded plan for the Programme.

3.       To request a performance framework be developed and brought to the Board for consideration.

To receive a presentation regarding winter underway in the health services, public health and social care.

Responsible Officers: Linda Prosser, Carlton Brand

Report author: Jo Cullen, Tracy Daszkiewicz

Jo Cullen presented a report regarding the winter preparations underway in the health services, public health and social care.

Matters raised during the presentation and discussion included: working with partners to come together as a system to see what is driving demand in services; the specific feedback received including trusted assessment, choice policy and a clinically led external panel in regards to all long stay patients; Wiltshire LDB priorities in supporting reducing days Length of Stay (LOS) , in reducing Delayed Transfers of Care (DTOC) and ambulance handovers and in supporting 7-day working; the success of both the Wiltshire Primary Care Plan and Out of Hours and 111; flu vaccinations for children and over 65s; publicising the availability of flu jabs; the protocols and policy around outbreaks and the Communication Strategy in place.

In answer to a question from the Board, it was noted that the biggest risk this winter is to carers and workforces in general, although there have been discussions in relation to ways that they can be encouraged to be vaccinated against flu.

Resolved:

To note the progress to date.

To assess progress against the programme objectives to date and agree the next steps.

Responsible Officers: Carlton Brand

Report author: Emma Legg

It was decided by the Chairman to consider the Adult Social Care Transformation Programme report before that of the Better Care Plan to allow for a better flow at the meeting.

Emma Legg and Helen Jones presented a report assessing progress against the programme’s objectives.

Matters raised during the presentation and discussion included: the redesign of services so that they are focused on advice, early intervention, reablement and signposting; an online referral system to be used by both colleagues and partners; the development of a multi agency safeguarding hub for adults; following the Swindon model in developing a new in-house enablement service; improving the programme’s brokerage function; strengthening the partnership with VCS and micro-enterprises; the new H2LAH alliance; commissioning block Domiciliary Care providers in the south to add capacity over the winter months.

In answer to an issue raised by the Board, it was noted that work is underway to produce a Domiciliary Care capacity map to be broken down by area and hours needed vs hours available from providers.

In response to an issue raised by the Board, it was noted that the programme’s approach needs to be more focuses on the support that care leavers get throughout their lives and not just until they leave children’s services.

Resolved:

1.       To note the progress to date.

2.       To note the initial scoping of Phase 2.

Carlton Brand presented a report assessing progress on the implementation of the Better Care Plan schemes and a snapshot of the latest performance information (including DTOC).

Matters raised during the presentation and discussion included: DTOC delayed days trends through and past 2018/19; the strengthening of the Home First model as new service models are commissioned throughout 2018/19; a new Wiltshire Health and Social Care framework; a single overarching strategy to provide more effective prevention, health and social care outcomes; strengthening Strategic Commissioning across the system; unifying and developing whole system governance; developing an integrated workforce strategy; implementing digital opportunities and information sharing.

Resolved:

1.       To note the progress to date.

2.       To note the performance levels contained in the Integration and Better    Care Fun dashboard.

To assess progress in delivering the action plan developed in response to the CQC system review of health and wellbeing in Wiltshire.

Responsible Officers: Linda Prosser, Carlton Brand

Report author: Tony Marvell

Carlton Brand presented a report assessing progress in delivering the action plan developed in response to the CQC system review of health and wellbeing in Wiltshire.

Matters raised during the presentation and discussion included: the incorporation of the high impact model for delayed transfers of care and initiatives surrounding length of stay into the action plan structure; a new Wiltshire Health and Social Care framework; a single overarching strategy to provide more effective prevention, health and social care outcomes; strengthening Strategic Commissioning across the system; unifying and developing whole system governance; developing an integrated workforce strategy; implementing digital opportunities and information sharing.

Resolved:

1.       To note the progress to date.

2.       To note and comment on the content of the programme delivery plan.

To receive an update on:

a)     Performance on s136 detentions, and

b)     The Adult Mental Health Transformation plans in BSW. 

Responsible Officer: Linda Prosser, Ted Wilson, Nicola Hazle

Report author: Ted Wilson, Georgina Ruddle

Ted Wilson, Nicola Hazel and Linda Prosser gave an update on the performance on s136 detentions the Adult Mental Health Transformation plans in BSW. 

Matters raised during the presentation and discussion included: the Crisis Care Concordat; the Control Room Triage; the context of and centralisation plans for the East Place of Safety Pilot; the Wiltshire Resident’s Place of Calm and the collaborative bid that is being submitted through the Department of Health; the #makesomeonewelcome movement and the Tidworth Men’s Shed; plans for the future of the BSW Mental Health Transformation including adapting of programme structure and realigning resources.

In answer to an issue raised by the Board, it was noted that the means of conveyance should be a collaborative effort between police and ambulance services, although this is not the reality due to operational issues.

It was noted that the police would like to be more engaged with the Adult Mental Health Transformation plans going forward, and that discussions regarding this would take place at a later date.

Resolved:

To note the progress to date.

To note that the next meeting is due to be held on Friday 14 December 2018, starting at 2.30pm.

To note that the next meeting is due to be held on Friday 14 December 2018, starting at 2.30pm.

There were no urgent items.