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Agenda and minutes

Venue: Kennet Room, County Hall, Trowbridge, BA14 8JN

Contact: Craig Player  Email: craig.player@wiltshire.gov.uk

Items
No. Item

1.

Chairman's Welcome

The Chairman will welcome those present to the meeting.

Minutes:

The Chairman welcomed all to the meeting.

 

It was noted that this would be Ted Wilson and James Scott’s last Health & Wellbeing Board meeting ahead of their retirements. They were thanked for their hard work.

 

It was noted that the Chairs had received a letter from Avenue Surgery Patient Group regarding the potential closure of a pharmacy linked to the GP surgery in Warminster and potential reduction of services in the town.

 

The issue had been raised with NHS England which is responsible for pharmaceutical licensing and commissioning and they have been asked to address the concerns of the patient group.

2.

Apologies for Absence

To receive any apologies or substitutions for the meeting.

Minutes:

Apologies were received from Cllr Ben Anderson, Toby Davies; Christine Blanshard, Kevin McNamara, Lucy Baker, Andy Hyett and Cara Charles Barks.

 

Ian Jeary was substituted by Greg Izon.

 

3.

Minutes

To confirm the minutes of the meeting held on 26 September 2019.

Supporting documents:

Minutes:

The minutes of the previous meeting held on 26 September 2019, previously circulated, were considered.

 

Resolved

 

To approve the minutes as correct.

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.

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 23 January 2020 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 27 January 2020.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 questions from the public.

6.

Maternity Consultation

To consider the outcome of the consultation on maternity services and the outcome of the rapid scrutiny by the Health Select Committee on the consultation.

 

Responsible Officer: Tracey Cox

Report author: Lucy Baker

Supporting documents:

Minutes:

Sarah Merritt presented a report on the outcome of the consultation on maternity services and the outcome of the rapid scrutiny by the Health Select Committee on the consultation.

 

Matters raised during the presentation included: the Local Maternity Services future vision; the transformation process so far; consultation with the public and partners; the assurance process; the case for change; staff experience and satisfaction; independent analysis of the public consultation; consultation feedback themes; the decision making process; the recommendations for change; the risks and mitigations; postnatal care; the implementation plan and the sign off and governance process.

 

In answer to a question raised by the Board it was noted that the post-natal beds in Chippenham and Paulton will remain open for a 12-month period. After this period they would be closed.

 

In response to a question from the Chairman it was noted that communications and public engagement will continue throughout the process ensuring the public are well informed and involved.

 

It was noted that the Health Select Committee had been fairly content with the outcome of the consultation. While there were concerns over the outcome of the public consultation, and in particular the experiences of the mothers, it agrees that the correct decision had ultimately been made. It was also happy to note that there would be a continuity of services and that no services were closing before their replacement was opened.

 

Resolved

 

1.    To note the update.

2.    To note the final decision and next steps.

7.

Families and Children Transformation Programme

To consider the progress made in the Families and Children Transformation (FACT) programme and the associated development of a whole life pathway with Adult Social Care.

 

Responsible Officers: Terence Herbert and Tracey Cox

Report authors: Lucy Townsend and Claire Edgar

Supporting documents:

Minutes:

Lucy Townsend and Claire Edgar presented a report on the progress made in the Families and Children Transformation (FACT) programme and the associated development of a whole life pathway with Adult Social Care.

 

Matters raised during the update included: the relevance to the Health and Wellbeing Strategy; the background of the programme; the new governance structure; recruitment to new posts; Community Safety for Young People; A Good Education for All; Best Start in Life; Integrated Multi-Professional Early Support; the Partnership Strategy; the Whole Life Pathway; the CAMHS Local Transformation Plan; Core Skills and Single Approach and the next steps.

 

In answer to a question raised by the Board it was noted that women on the PAUSE Project did have access to family planning advice and contraception formed part of the programme. All women that were part of the first cohort had chosen to remain on the contraception following the programme.

 

It was noted that while the PAUSE Project was 100% funded by Wiltshire Council, the programme has a wider impact on the rest of the system. In light of this, it was suggested that Wiltshire Council work with other partners to review the programme’s funding.

 

In response to a query from the Board it was noted that the Inclusive Approach Across Schools programme was available to everyone. However, it accepts that some parents chose to home educate their children and some children have specific educational needs and, in such cases, education needs to be ensured by a whole system approach.

 

It was noted that the A Good Education for All workstream monitors students who had been excluded, or are at risk of exclusion, to ensure they are adequately supported by the system.

 

The Board raised its concerns over ensuring the voice of both the children and families that had been through the system. Indeed, it is often very hard for parents that had been through the system too and there were challenges in managing their expectations. The FACT programme was committed to being aspirational and ambitious for Wiltshire’s residents and recognised the importance in communicating this to parents.

 

The Board asked for the reasons for the decrease in the flagging of those that are at risk of exploitation under the Young People’s Service Contextual Safeguarding approach. The Board was assured that an analyst team at Wiltshire Council were looking into this trend but were confident that the response to these situations remained very strong.

 

In response to a question from the Board it was noted that housing provision did form part of the Whole Life Pathway workstream, but that more work needed to be done to consolidate this link. The Chairman assured the Board that the Whole Pathway was important in allowing Wiltshire Council to identify vulnerable people in need of housing much earlier.

 

Resolved

 

1.    To note the updates since the last report.

2.    To agree the outline of work moving into 2020.

 

8.

Joint Targeted Area Inspection of Children's Mental Health

To consider readiness for a potential Joint Targeted Area Inspection (JTAI) on Children’s Mental Health, noting the Child and Adolescent Mental Health Service (CAMHS) transformation plan as recently agreed.

 

Responsible Officers: Terence Herbert and Tracey Cox

Report authors: Lucy Townsend and Martin Davis

Supporting documents:

Minutes:

Lucy Townsend and Martin Davis presented a report on readiness for a potential Joint Targeted Area Inspection (JTAI) on Children’s Mental Health, noting the Child and Adolescent Mental Health Service (CAMHS) transformation plan as recently agreed.

 

Matters raised during the presentation included: Single Point of Access; a mental health early intervention service; Mental Health Support Teams in Wiltshire; the Mental Health Liaison service; 24/7 crisis support services; the Mental Health Services Data Set; the SOMEHOW and Harbour projects; embedded CAHMS staff within families and children’s teams; the Wiltshire Healthy Schools Programme and the BSW Mental Health Strategy.

 

The Board raised its concerns over whether the current staffing numbers were sufficient to meet demand. It was assured that Oxford Health was providing CAMHS workers in schools and training teaching staff in observation and support/ signposting skills.

 

Resolved

 

To note and endorse the report and methodology used in preparation for a potential JTAI.

 

9.

Multi Agency Safeguarding Hub for Adults

To consider the impact of Multi Agency Safeguarding Hub (MASH) for adults since its inception and the next steps for its development.

 

Responsible Officers: Emma Legg and Ted Wilson

Report authors: Emma Townsend, James Dunne and Simon Childe

Supporting documents:

Minutes:

Emma Townsend and Simon Childe presented a report on the impact of Multi Agency Safeguarding Hub (MASH) for adults since its inception and the next steps for its development.

 

Matters raised during the presentation included: the Adult MASH staffing structure; the monthly Quality Assurance Panel; the Virtual Partners Network; why the MASH is so valuable; training and support; the Wiltshire Care Partnership; working with partners and the next steps including the availability of further feedback from Healthwatch Wiltshire later in the year.

 

Resolved

 

To note the report.

 

10.

Bath and NE Somerset, Swindon and Wiltshire Sustainability and Transformation Plan

To receive an update on recent activity in the Bath and NE Somerset, Swindon and Wiltshire Sustainability and Transformation Plan (BSW STP).

 

Responsible Officers: Tracey Cox

Minutes:

Tracey Cox gave an update on recent activity in the Bath and NE Somerset, Swindon and Wiltshire Sustainability and Transformation Plan (BSW STP), including the development of a long-term plan.

 

Matters raised during the update included: who BSW works with; engaging with people in BSW; the BSW vision; promoting health and wellbeing; developing sustainable communities; sustainable secondary care services; transforming care across BSW; creating strong networks of health and care professionals to deliver the NHS Long Term Plan and BSW’s operational plan and the BSW’s next steps. It is expected that the BSW Long Term Plan would be published shortly, including a public facing document.

 

Resolved

 

To note the recent activity in the Bath and NE Somerset, Swindon and Wiltshire Sustainability and Transformation Plan (BSW STP).

 

11.

Workforce Strategy

To receive a presentation on the emerging Wiltshire Workforce Strategy.

 

Responsible Officers: Ted Wilson and Emma Legg

Report author: Maureen Holas

Supporting documents:

Minutes:

Ted Wilson and Emma Legg presented a report on the emerging Wiltshire People Strategy and the next steps for development.

 

Matters raised during the update included: stakeholder engagement; the purpose of the strategy; expected outcomes; the current picture; the key drivers for change; the current workforce; the key priorities going forward; risks that may prevent full achievement of the strategy and the next steps for the strategy.

 

It was recognised that there was a need to develop the view of the workforce challenges. It was noted that the strategy was yet to have input from Great Western Hospital and Royal United Hospital and this could be important, given that something like 28% of RUH staff live in Wiltshire.

 

It was noted that the data presented was the best data available at the time of time and there were gaps in terms of databases. It was recognised that there was a need to develop this to ensure an accurate, broad perspective.

 

In answer to a question from the Board it was noted that the strategy does not yet include provision for looking after children and that the strategy was in its early stages and would look at this in due course.

 

The Board raised its concerns over workplace flexibility as this was a consideration for those looking to get into the profession. It was noted that while Wiltshire Council offered flexible workplace policies, it was difficult for this to be implemented across the system as it would require the commitment of and collaboration with a range of partners.

 

 

 

 

Resolved

 

To approve the emerging strategy and note the costs associated with implementing the strategy.

12.

Strategic Estates Plan

To receive a presentation on the emerging Strategic Estates Plan.

 

Responsible Officers: Tracey Cox and Ted Wilson

Report author: Simon Yeo

Supporting documents:

Minutes:

This item was deferred to the next meeting of the Health and Wellbeing Board because the presenter had been unable to attend at short notice.

13.

GP Improved Access Scheme

To consider the findings of Healthwatch Wiltshire’s research into people’s views of the GP Improved Access Scheme.

 

Responsible Officer: Stacey Sims

Supporting documents:

Minutes:

Stacey Sims presented a report on Healthwatch Wiltshire’s research into people’s views of the GP Improved Access Scheme.

 

Matters raised during the update included: how the research was undertaken; who was spoken to; what patients thought about the service; what surgeries thought about the service; what staff thought about the service and the key recommendations drawn from the research.

 

In answer to a question from the Board it was noted that the demographics of the patients spoken to was captured in the research and a further breakdown of this and how it may affect views and experiences can be shared with Health and Wellbeing Board members.

 

Resolved

 

1.    To note the key messages from the report.

2.    To confirm the Board’s commitment to listening to the voice of local people to influence commissioning and service provision.

 

14.

Primary Care Network

To consider the progress made in primary care networks and the next steps.

 

Responsible Officer: Tracey Cox

Report author: Jo Cullen

 

Supporting documents:

Minutes:

Ted Wilson presented a report on the progress made in Primary Care Networks (PCNs) and the next steps.

 

Matters raised during the update included: the background of PCNs in Wiltshire; its link to the NHS Longterm Plan; nationally allocated funding for PCNs and how it would be used; Social Prescribers; the Additional Roles Reimbursement Scheme and the next steps.

 

Resolved

 

To note the report and its next steps.

 

15.

Better Care Plan for Wiltshire Update

To receive an update on recent activity.

 

Responsible Officers: Ted Wilson and Helen Jones

Report author: James Corrigan

Supporting documents:

Minutes:

James Corrigan presented a report on the BCP’s recent activity.

 

Matters raised during the update included: overall performance trends; Non-Elective admissions (and that the rate for those 65+ is lower than the overall population); length of stay is now below plan levels; rates of Delayed Transfers of Care; local performance reporting; financial reporting; and the Improved Better Care Fund and the Winter Plan.

 

 

Resolved

 

To note the Better Care Performance and Finance Report for Q3 of 2019/20.

 

16.

Date of Next Meeting

The next meeting will be held on Thursday 02 April 2020 at 9.00 am.

Minutes:

17.

Urgent Items

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

Minutes:

The Chairman and Director of Public Health gave an update on the Coronavirus outbreak. It was noted that relevant departments and partners were meeting on a weekly basis to monitor its spread.

 

Residents were encouraged to contact 111 if they had any concerns. More detailed advice can be found via the following link: https://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public