Agenda and minutes

Moved by Councillor O Gunn, Seconded by Dr S Findlay and

Resolved:

That Councillor L Hovvels of be elected Chairman of the Board for the ensuing year.

Councillor L Hovvels in the Chair

Moved by A Healey, Seconded by J Robinson and

Resolved:

That of Dr S Findlay be appointed Vice-Chairman of the Board for the ensuing year.

Apologies for absence were received from A Foster, S Jacques, S Lamb, C Martin, Councillor M Nicholls, Dr J Smith and M Whellans.

G O’Neill for M Whellans, J Parkes for A Foster and J Birtley for S Lamb.

There were no declarations of interest.

The minutes of the meeting held on 16 March 2017 were agreed as a correct record and signed by the Chairman.

The Board considered a report of the Corporate Director Adult and Health Services, Durham County Council that gave background information on the additional £2 billion funding for adult social care announced in the spring budget 2017 (for copy see file of Minutes).

The Head of Adult Care gave a presentation that highlighted the following:-

·         Adult Social Care Challenges

·         Improved Better Care Fund (iBCF) & the allocation for Durham

o   2017/18 £13m, 2018/19 £8m & 2019/20 £4m = Total of £25m

·         iBCF Spending Plans – Working Groups established to take forward the Emerging Themes

o   Meeting Social Care Needs

o   Reducing Pressure on the NHS

o   Supporting the Local Provider Market

o   System Development

The Chief Operating Officer, North Durham and Durham Dales, Easington and Sedgefield (DDES) Clinical Commissioning Group (CCG) acknowledged that this was short term funding and not a sustainable solution for social care.

The Corporate Director Adult and Health Services, Durham County Council agreed with this.  She stated that further information was awaited, including what the Care Quality Commission’s “Appreciative Reviews” would involve.  Notification of a review would be through the Chair of the Health and Wellbeing Board.  She further advised that County Durham did not have the same issues in relation to delayed transfers of care as there was nationally. 

The Head of Planning & Service Strategy, Adult and Health Services, Durham County Council identified that it was important to have an element of innovation as part of the Improved Better Care Fund.

Resolved:

(i)            That the Local Authority and CCG’s would progress plans to spend this funding as per the guidance set out in the grant conditions be noted.

(ii)          That oversight would be provided by the Integration Board and reported back to the Health and Wellbeing Board as part of the BCF monitoring process be agreed.

The Board considered a joint report of the Director of Commissioning and Development, North Durham Clinical Commissioning Group and the Chief Clinical Officer, Durham Dales, Easington and Sedgefield Clinical Commissioning Group that gave an update on the Northumberland, Tyne and Wear and North Durham and Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby Draft Sustainability and Transformation Plan (STP) (for copy see file of Minutes).

The Corporate Director Adults and Health Services commented that the plans were building on what had been happening locally. 

The Strategic Manager, Policy, Planning and Partnerships, DCC asked how the local plans flowing from the STPs would align with the Joint Health and Wellbeing Strategy (JHWS) and was advised by the Chief Clinical Officer, North Durham and Durham Dales, Easington and Sedgefield CCGs,  that these plans would link to the JHWS.

The Chief Clinical Officer DDES CCG said that it was complex with two STPs and 13 workstreams developing the plan and that a lot of work was happening locally, regionally and nationally.   The Chief Operating Officer added that the language in the STPs was to be a focus, to ensure they were accessible to members of the public.

The Head of Planning and Service Strategy queried why the priorities were different in the two STPs and commented that it was good to see a focus on mental health.  The Chief Operating Officer added that the mental health workstream as part of the South STP was making sure that the Five Year Forward View was being implemented.  The focus for the Northern STP was looking at where clinical development could be developed further.  

Councillor Gunn asked how the STP would link into children and young people’s services.  The Chief Operating Officer advised that a recent presentation had been provided to the Children and Families Partnership to outline work that was taking place at scale for children, young people and families.  The Consultant in Public Health County Durham added that the prevention workstream had a focus on the best start in life and that children were very much a part of that.

The Chief Operating Officer outlined she was keen for Healthwatch County Durham’s support in relation to engagement activities and she will be taking advice from Healthwatch as to the best way to carry this out.

The Director of Public Health County Durham stated that prevention starts at a community level in terms of self-help. An update on the regional Prevention Workstream as part of the STPs will be shared with the Board at a future meeting.

The Corporate Director, Adults and Health Services referred to Sunderland and South Tyneside STP and requested an update on progress.  She was advised that as part of the work on Pathways to Excellence there would be a public consultation starting on 5 July 2017 with a County Durham meeting taking place at the Glebe Centre, Murton.  This would look at Stroke Services, Maternity Services, Specialist Baby Care and Women’s Services.  The Chief Operating Officer said she would circulate a  ...  view the full minutes text for item 8.

The Board considered a report of the Director of Integration, North Durham and Durham Dales, Easington and Sedgefield Clinical Commissioning Groups and Durham County Council that provided progress with regard to Community Hubs/Teams Around Practices (TAP) (for copy see file of Minutes).

The Director of Integration advised that a memorandum of understanding had been developed and a brand for the County Durham Accountable Care Network had been agreed.  She went on to explain that DDES CCG was part of the Primary Care Home joint project to shape the way primary care services were delivered and to support the avoidance of hospital admissions. 

The TAPs will focus on the top 2% of people in need and there would be a better plan and co-ordinated care for them.  The Board were informed that in order to include the voluntary sector, a delivery plan was being implemented.

The Director of Integration said that there was a lot of work ongoing and that the model had been embraced locally.  The work would be reviewed regularly including the work with the voluntary sector.

Councillor Gunn asked how the work with the voluntary sector was being taken forward. The Director of Integration outlined a contract had been awarded to a VCS organisation to work with others in the sector.  Workshops would also take place and a list of performance outcomes would be monitored.

Councillor Gunn went on to say that there were so many voluntary and community organisations that were doing a lot of really important work on the ground, and who were reliant on funding.  She said that she would be interested to see how the relationship developed and said that it was important for councillors to be kept up to date with any developments.

The Head of Planning and Service Strategy commented that a lot of work had been undertaken in such a short space of time and that it was important to hear from patients and service users so that stories were brought to life for the public and the board.

The Director of Integration confirmed there would be a review in 6 months’ time with a report back to this board.

It was agreed it was important that Area Action Partnerships were appraised of the work taking place.

Resolved:

(i)            That this report for information be received.

(ii)          That the direction of travel and note progress made be supported.

(iii)         To encourage further engagement of the VCS and request that Durham Community Action present to the County Durham Partnership a summary of its engagement to date and plans to enhance VCS involvement in primary care in the future.

(iv)         That to receive a further update report at a future Health and Wellbeing Board meeting be agreed.

The Board considered a report of the  Head of Planning and Service Strategy, Adult and Health Services, Durham County Council that presented the Health and Wellbeing Board Annual Report 2016/17 for agreement (for copy of report see file of Minutes).

The achievements of the board were highlighted, together with the details of locality health and wellbeing projects which supported the priorities of the Health and Wellbeing Board, as well as details of the future work moving forward.

The board agreed that a press release be issued on the work carried out over the last year.

Resolved:

(i)       That the Health and Wellbeing Board Annual Report 2016/17 be approved.

(ii)     That the future areas of work outlined in the report be agreed.

The Board received a report of the Director of Nursing, Durham Dales, Easington and Sedgefield and North Durham Clinical Commissioning Groups that provided an overview of recommendations from the Care Quality Commission (CQC) review of health services for children and looked after and safeguarding in County Durham (for copy see file of Minutes).

The Chief Operating Officer, North Durham and DDES CCG highlighted the key recommendations from the CQC and advised that an action plan had been developed which would be closely monitored.

The Director of Public Health County Durham outlined the change of provider to the Drug and Alcohol Treatment service.

Resolved:

That the report be received.

The Board considered a report of the Director of Public Health County Durham, Durham County Council that gave an update on the development of the County Durham Healthy Child Programme Board and its proposed aim and vision for future collaborative frontline working from conception to 19 years (24 year for Special Educational Needs and Disability (SEND)) (for copy see file of Minutes).

The Consultant in Public Health presented the report and advised the board that approval had been given in November 2016 to set up a Healthy Child Programme Board to discuss collaborative improvements to the health and social care offer to children, young people and families.  The Board would look to develop a seamless service at the point of contact, including maternity services, paediatrics, early help, early years and support services.  Three workshops had been held to date with the fourth meeting planned for June.

The Consultant in Public Health explained that parents and children would be involved as the work progresses and that the draft HCP charter would be signed off by respective organisations.   Ante-natal care was identified as a “quick win” area to focus on initially.

Resolved:

(i)            That information regarding the early formulation of the Healthy Child Programme Board be received.

(ii)          That the HCP board progressing with the intentions of co-designing and co-producing a collaborative model of front line delivery from conception to 19 years (24 years for SEND) over the coming two years and beyond be agreed.

(iii)         That to receive regular updates on progress to retain oversight of developments be agreed.

The Board considered a report of the Director of Public Health County Durham, Children and Adults Services, Durham County Council which presented the 2016/17 annual report focused on the importance of good work with a specific emphasis on our mid-life population (age 40 -70 years) (for copy of report see file of Minutes).

The Consultant in Public Health presented the report and outlined that there had been an emphasis on physical and mental wellbeing in the workplace. The report was aimed at small to medium enterprises.

The Consultant in Public Health outlined that Durham County Council were now working towards the Better Health at Work Award. 

In relation to a question from the Chief Clinical Officer, DDES CCG, the Director of Public Health outlined that the Healthy Living Pharmacy approach has been implemented in County Durham and they receive brief interventions training in relation to alcohol harm reduction.

The Chairman welcomed the report and was encouraged that the Council were doing more with healthier choices in the canteen and exercise opportunities for employees. 

The Director of Public Health commended the work outlined in the report and referred the board to a campaigns calendar and outlined the importance of organisations signing up, as well as Area Action Partnerships, to ensure key messages were spread across the population about the importance of supporting the health and wellbeing agenda.

Resolved:

(i)            That the 2016/17 annual report of the Director of Public Health, County Durham be received.

(ii)          That the Annual Report be shared with other relevant partners to incorporate, where appropriate into future work programmes

(iii)         That to receive an update on the recommendations in this report as part of next DPH annual report be agreed.

(iv)         That to receive a separate update on the outcomes from the last DPH annual report on obesity be agreed.

The Board considered a report of the Area Action Partnership Coordinator, Transformation and Partnerships, Durham County Council that provided an update in relation to the work taking place to enhance the interface between Area Action Partnerships (AAPs) and the Health and Wellbeing Board to improve the alignment of AAP developments and investments and the priorities of the Partnerships (for copy see file of Minutes).

The Area Action Partnership Coordinator advised of the review of the structure for the Community Wellbeing Partnership and the work by County Durham and Darlington Fire and Rescue Service with the County Durham Dementia Action Alliance (CDDAA).  He went on to inform the board that the priority theme voting results for the general and schools surveys showed that Children, Young People and Families was ranked number one, this was followed by Older People and Health and Wellbeing.  The Board were advised that mental health was a top priority for 10 of the AAPs.

Councillor Gunn referred to localised support for the development of funding bids. The AAP Co-ordinator outlined that Area Action Partnerships have localised profiles and also access information on the Integrated Needs Assessment which is the evidence base. 

The Chairman referred to defibrillators and the training required for community wardens and others.  The Area Action Partnership Coordinator said that he could map this information from the AAP perspective.

Resolved:

(i)            That the alignment of work of the AAP’s to the Health and Wellbeing Board be supported.

(ii)          That details of the AAP priorities for 2017/18 be received.

(iii)         That information about the shared work that the AAP’s and partners were currently working on be received.

(iv)         That to receive future update reports be agreed.

The Board considered a report of Director of Public Health County Durham, Adult and Health Services Durham County Council that presented a revised delivery framework for the prevention of unintentional injuries in children and young people (0-19 years) in County Durham 2014-2017, requiring further consultation and approval (for copy see file of Minutes).

The Director of Public Health informed the board that there had been significant challenges in County Durham with the different social backgrounds and that a multi-agency plan had been developed to tackle this.  She went on to highlight the key issues and advised that there would be a focus on the 0-5 year olds.  The board were asked to agree a framework for wider consultation with a further report to come back in September 2017.

Resolved:

That the Unintentional Injuries Delivery Framework for wider consultation as set out in the timeline be agreed.

Resolved:

That under Section 100(a)(4) of the Local Government Act 1972, the public be excluded from the meeting for the following item of business on the grounds that it involves the likely disclosure of exempt information as defined in paragraph 3 of Part 1 of the Local Government Act 1972.

The Board considered a report of the Director of Public Health County Durham which provided a summary of a Pharmacy Relocation Application received from NHS England in accordance with the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 since the last formal meeting of the Board in March 2017 (for copy see file of Minutes).

Resolved:

That the report be noted.