Agenda and minutes

The Chairman will welcome those present to the meeting.

·       Procurement of Community Health Services

Cllr Richard Clewer, Chairman of the Board and Leader of the Council, welcomed all attendees to the meeting.

Before the meeting began, each Member of the Board, other Councillors and

officers who would be contributing to the meeting were given the opportunity to

introduce themselves.

Cllr Clewer, through a chairman’s announcement, informed members of a Briefing Note in relation to the Procurement of Community Health Services.

Fiona Slevin-Brown wanted to assure the board that efforts to procure services are making progress.

To receive any apologies for absence.

·       Jane dTerence Herbert (CEO)

·       Gina Sergeant

·       Jo Madeley

·       Dr Nick Ware

·       Cllr Laura Mayes

·       Cllr Jane Davies

·       Philip Wilkinson (Police and Crime Commissioner)

·       Claire Thompson

·       Judith Sellers

To confirm the minutes of the meeting held on 25 May 2023.

The minutes of the previous meeting of the Board held on 25 May 2023
were presented for consideration. After which, it was:

Decision - The Wiltshire Health and Wellbeing Board approved and signed the minutes of the previousmeeting of the Health and Wellbeing Board held on 30 March 2023 as atrue and correct record.

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 (4 clear working days, e.g. Wednesday of week before a Wednesday meeting) 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 (2 clear working days, eg Friday of week before a Wednesday meeting). 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.

No questions were received.

To receive an update from David Jobbins regarding the implementation plan of the BSW Integrated Care Strategy.

The Board received a verbal update from David Jobbins regarding the implementation plan of the BSW Integrated Care Strategy. Following engagement, the 2023/24 Plan has been finalised and is brought to the HWB to note. The main changes are noted in the report and slides which can be found in the agenda pack.

The report was very long, in excess of 200 pages, which has seen significant editing down and its design altered to make it more user friendly. A refresh process was described as a means to reduce the page number further. The process of putting the plan together showed more work is needed and many actions are process based not delivery based.

One significant difference is that the part of the plan relating to youth has been pulled together into one themed section rather than being spread out across multiple areas of the report which made it harder to understand.

It was noted that there was a requirement for each regional HWB to state their opinion on the plan. However, due to the need to publish the plan at the end of June before the meeting, opinions were expressed through Chair’s action, and it is part of the recommendations to note those.

During the debate the following points and clarifications were made:

The Board complimented numerous positive changes to the plan, and it was described as far more focused, easier to read and understand and as expressing good aspirations.

However, concern was raised that the resources to deliver these aspirations have not been detailed. What impacts on the 5-year plan from a workforce shortage, and organisational stability from numerous institutional changes were also identified as an area to investigate.

It was raised that GP’s would need to understand how the plan would affect their role, as would managing the expectations of local residents and illustrating what differences this plan would make to their daily lives.

It was clarified that means to monitor against commitments made in the plan would come into place within the next few months. It was understood that there are risks and challenges to the plan, but recognizing how we are delivering against our aims will mean success even if changes have to be made.

The process of writing the plan is almost more beneficial than what is in the plan as it has brought the whole ICB working together. Some of the diagrams and schematics are extremely useful to understanding what the ICB is and what the plan is.

Resolved

i)               note the finalised the 2023/24 BSW Implementation Plan; and

ii)             note the opinion the HWB has provided that the plan takes proper account of the Wiltshire JLHWS.

To receive an update from Bina Kakad on the ICB Capital Plan.

The Board received a verbal update from Bina Kakad on the ICB Capital Plan. The full report can be found in the agenda pack.

Within the plan the priorities for 2023/24 had been highlighted This had been broken down into what’s contained within these priorities including local and national schemes. The aim is to produce a capital strategy framework and to integrate the community and primary care network into our objectives.

During debate, the following points and clarifications were made:

That it would be useful to understand how the capital application links to the five-year plan and there is work still taking place to align this under a single overall strategy and how it underlines what the Capital Plan is aiming to achieve.

Each of our objectives and strategies will have risk analysis and contingencies in place.

The development of the broader structure of the plan is still in progress but using estates available to deliver objectives is at the forefront.

Resolved

i)               Notes the Joint Capital Resource Use Plan at Appendix 1;

ii)             considers how the capital plan interrelates with other relevant plans for system infrastructure and estates; and how it will support delivery of the Integrated Care Partnership strategy and the priorities of the Health and Wellbeing Board

To receive an update from Jo Cullen on the transfer of pharmacy, optometry and dental services to the BSW.

The Board received a verbal update from Jo Cullen on the transfer of pharmacy, optometry and dental services to the BSW. The full report can be found in the agenda pack.

The paper set out the context as to why these areas have been delegated to the BSW. Although only a few months into the process, local committees and lead personnel for each of these areas had already been established. A discussion with the Health Select Committee had taken place regarding dental services. The main priority across all areas was stressed as access, especially given the news coverage on difficulties accessing services. The workforce was also noted as a serious priority given shortages.

During debate, the following points and clarifications were made:

It was clarified that the priority was not just access but also affordability, with many dentist surgeries moving away from providing NHS Care and with the cost-of-living crisis the knock-on effects are clear. A focus on good education on oral hygiene is something that can be focussed on. The importance of sugar tax as a preventative measure was indicated.

The lack of pharmaceutical provisions that are currently available in Wiltshire was accepted as a serious concern. Mapping of dentists for the area was shown at the recent Health Select Committee meeting and the creation of one for what pharmacies are currently available across the county was suggested as a means of assistance for residents.

Resolved

i)      To note the report

To receive an update from Sadie Hall regarding the CYP Strategy.

The Board received a verbal update from Sadie Hall regarding the CYP Strategy. The full report and PowerPoint can be found in the agenda pack.

As discussed in the previous agenda item covering the BSW Integrated Care Strategy, all work with children and vulnerable adults (0-25 years old) was undertaken together under the CYP Strategy.

Reference to “CORE20PLUS5” was made:

CORE20 – Targeting the most deprived 20% of the national population as identified by the Index of Multiple Deprivation.

PLUS – Informed by Integrated Care Systems, population groups experiencing poorer-than-average health access, experience and/or outcomes, who may not be captured within the CORE20 alone and would benefit from a tailored healthcare approach.

5 – The five key clinical areas of health inequalities. Asthma, Diabetes, Epilepsy, Oral Health, and Mental Health.

During debate, the following points and clarifications were made:

Some of the CYP Strategy sits within SEND and the MIND Board plays a big part in recognising links within Schools. Asthma support is delivered through the Healthy Schools programme to help schools be asthma friendly.

Whilst funding allows testing processes and investment, the CYP Strategy’s work is not wholly dependant on it. This was seen as a major positive by the Board.

Integration within Wiltshire’s sectors including secondary schools and housing isn’t at a detailed level yet, but progress is being made.

Resolved

i)               Note the role and function of the BSW CYP Programme Board as set out in Appendix 1.

To receive an update on developments relating to the implementation of the Better Care Plan.

The Board received a verbal update from Helen Mullinger on developments relating to the implementation of the Better Care Plan. The full report and PowerPoint can be found in the agenda pack.

The Better Care Fund (BCF) programme supports local systems to successfully deliver the integration of health and social care in a way that supports person-centred care, sustainability and better outcomes for people and carers.

It was shared that a total pooled fund of £69,511,569 in 2023-24 was spent across 66 schemes.

The BCF is underpinned by 2 core objectives to:

• Enable people to stay well, safe, and independent at home for longer.

• Provide people with the right care, at the right place, at the right time.

The BCF’s Themes were also shared:

Reducing Inequalities – linking to Core20PLUS5.

Hospital Discharge – Focussing on improving flow across services and reducing unnecessary hospital admissions and delayed discharges.

Avoidable Admissions - Work aims to deliver improvement in 2hr Rapid Response times and expand same-day emergency care to support a reduction in avoidable admissions.

Support for Mental Health, LD and Autism – support through BCF funded schemes such as the Intensive Enablement Service. Additional funding for Shared Lives through the Winter Discharge funding.

Use of the Voluntary Sector – both to provide services (Home from Hospital) but also so support existing services (e.g meal deliveries to support reablement service – funded through the Winter Discharge.

During debate, the following points and clarifications were made:

The Board praised the successes that the BCF was reporting, however highlighted the need to give the Board information that can be shared with residents in a way they can appreciate.

The need to coordinate more with partners was stressed, as was the risk workforce issues could have on the plans.

To receive an annual report from Stacey Sims for Healthwatch Wiltshire.

The Board received an annual report from Stacey Sims on behalf of Healthwatch Wiltshire. The full report and PowerPoint can be found in the agenda pack.

Healthwatch Wiltshire was specified as a local health and social care champion, that listened to local resident’s experiences and had the power to hold NHS Leaders to account over local feedback and ensure standards of care were improved. Healthwatch helped inform other areas of society including in schools, dental hygiene etc and could monitor efforts at prevention, including through their own workshops.

The report highlighted the statistics for the year in Wiltshire:

637 people shared their experiences of health and care.

4,125 people approached Healthwatch for information and advice.

7 reports were published that made 31 recommendations.

21 volunteers gave up over 680 hours of their time. 

The priorities for 2023-2024 were included:

• Mental health and Autism
• The wellbeing of children and young people
• Hospital discharge and virtual wards
• Access to GP services

Resolved

i) Notes the key messages?from the report.

ii) Notes the contribution made by Healthwatch volunteers.

iii) Confirms its commitment to listening to the voice of local people to influence commissioning and service provision.

The date of the next meeting is 28 September 2023.

The date of the next meeting is 28 September 2023.

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

There were no urgent items.