Agenda and minutes

Moved by Councillor O Gunn, Seconded by J Robinson 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 Councillor J Allen, Seconded by M Whellans and

Resolved:

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

Apologies for absence were received from  Dr S Findlay, C Bage, N Bailey, J Gillon, S Jacques, A Healy, S Lamb, C Martin, Dr D Smart and Dr J Smith

D Brown for C Bage, M Houghton for N Bailey, S Findlay, D Smart & J Smith, G O’Neill for A Healy, L Hunter for J Gillon and S Clegg for S Jacques

There were no declarations of interest.

The mintues of the meeting held on 20 March 2018 were agreed as a correct record and signed by the Chairman.

The Board received a presentation of the Strategic Manager, Partnerships, Durham County Council that provided a refresh of the role and responsibilities of the Health and Wellbeing Board.

The presentation highlighted functions and membership of the Board (for copy see file of Minutes).

Resolved:

That the presentation be received.

The Board received a verbal update of the Director of Commissioning and Development, North Durham Clinical Commissioning Group that gave an update of the Sustainability and Transformation Plans Update: Northumberland, Tyne and Wear and North Durham and Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby Draft Sustainability and Transformation Plans.

The Director of Commissioning and Development explained that guidance had been received from NHS England asking STPs to consider as a region progress towards an integrated system.    This regional work was being led by Alan Forster and would involve partners and the voluntary and community sector.

He went on to advise that a lot of work was ongoing in other areas such as prevention, pathology, mental health and transforming care with an emphasis on place based working. 

The Chairman commented that it would be beneficial to have a simplified process.

The Director of Integration was advised that the region refers to North Cumbria and the North East  and that discussions on funding were in the main related to NHS services.

The Corporate Director of Adult and Health Services, DCC said that it was helpful to hear the progress being made and that for County Durham we would focus on what was required for our population.

Referring to the allocation of funding, Councillor Gunn commented that this was a positive way forward rather than having to bid for funding.

Resolved:

That the update be noted.

The Board considered a joint report of the Corporate Director Adult and Health Services, Durham County Council, the Chief Operating Officer, North Durham and Durham Dales, Easington and Sedgefield Clinical Commissioning Groups, and the Director of Integration, NHS County Durham and Durham County Council that provided an update on the integration of health and social care services in County Durham (for copy see file of Minutes).

The Chairman was advised following a question about how people would find out how they were affected, that there would be the avoidance of duplication and processes would be simpler.  This had already been seen through Teams Around the Patient (TAPs) which were now all operational.

The Director of Integration further explained that members of public would see a better service that was not as complex to navigate as the current system.

The Chief of Staff, Office of the Police, Crime and Victim’s Commissioner asked how the practicalities of a pooled budget would work.  The Corporate Director of Adult and Health Services, DCC explained that we would be building on what we do now through the Better Care Fund.  She explained a new community services contract had been agreed and that there would be a joined up strategic approach to commissioning to cover children and adults, moving forward. She added that good relationships existed between public service partners and there was a formal budget arrangement that would be developed going forward together with risk sharing and a clear strategy that would cover budgets / finances.  This would be covered by the joint commissioning steering group.  It was agreed the future integration model would come back for further discussion, including revised governance arrangements.

Resolved:

(i)            That the content of the report and the work to date on Integration of Health and Social Care Services be noted.

(ii)          That the report, presented to Cabinet, and CCG Executive and Governing Bodies, be noted.

(iii)         That the intention to develop a Health and Social Care Plan for County Durham through the development of a Joint Strategic Commissioning Function and Integrated Governance arrangements be supported.

(iv)         That further updates be received.

The Board considered a report of Chief Operating Officer, North Durham and Durham Dales Easington and Sedgefield Clinical Commissioning Groups and Chief Clinical Officer, Durham Dales, Easington and Sedgefield Clinical Commissioning Group that presented a refresh of the Durham Dales, Easington and Sedgefield (DDES) and North Durham CCGs Operational Plans 2017-19 (for copy see file of Minutes).

The Director of Commissioning and Development, North Durham CCG explained that the operational plans from each of the CCGs in County Durham had been refreshed for year two.  The steer from NHS England was to grow activity. Some of the key areas had been refreshed to reflect the health & care plan, the importance of the children agenda, integration work and teams around the patient and the wider regional workstreams. 

The Corporate Director of Children and Young People’s Services said that there was an opportunity to target key issues for the children’s agenda.

The Director of Corporate Affairs and Legal/Trust Secretary, City Hospitals Sunderland NHS Foundation Trust suggested a key area for the CCGs would be in relation to cyber security/digital care and the Director of Commissioning and Development agreed to take this back to the Clinical Commissioning Groups.

Resolved:

(i)            That the contents of these refreshed reports for North Durham and DDES CCGs be noted.

(ii)          That the plans submitted to NHS England by 30th April 2018 deadline be noted.

The Board received a presentation from the Chief Officer and the Chair of  County Durham and Darlington Local Pharmaceutical Committee describing the role community pharmacies play in improving the health and wellbeing of the residents of County Durham (for copy see file of Minutes).

The presentation highlighted the following:-

·         Community Pharmacy – background

·         3 strands of shared local government/community pharmacy agenda

o   Public Health

o   Support for independent living

o   Social capital

·         Community Pharmacy Forward View

·         Supporting people to manage their Long Term Conditions

·         First port of call for healthcare advice and treatment

·         Neighbourhood health and wellbeing hubs

·         Support for the aims of the Joint Health & Wellbeing Strategy 2016-19

·         Health and Wellbeing hubs

o   screening services

o   health promotion

·         Pharmaceutical Needs Assessment Action Plan – Collaborative Working

·         Opportunities for future service developments

·         Pharmacy services North East – looking to expand to County Durham and Darlington

The Chairman of Healthwatch County Durham expressed some concern about care navigation for minor ailments in that GPs would not get to see a patient if this system navigates away from them.  The Chief Officer of the LPC advised that a lot of discussions had taken place with the CCGs about care navigation and it had been stressed to have a referral back to the GPs mechanism built in to the process, as required.

The Chairman said that pharmacies played a very important role and thanked the Chief Officer and Chair of the LPC for their presentation.

Councillor Allen commented that there were a lot of services available to communities and advocated for pharmacies to raise awareness and promote what was being carried out.

With reference to charging for prescription deliveries for vulnerable patients, Councillor Gunn asked what the views were of the LPC.  The Chair of the LPC was aware that some pharmacies did charge and highlighted that pharmacies did not receive a budget for deliveries and that funding from government to pharmacies had been cut and that some pharmacies were looking at sustainability.  He said that pharmacies would look to continue free delivery of prescriptions for vulnerable groups.  Feedback that had been received so far was very positive and many people said that they would come in to collect their prescriptions in future.

In relation to the capacity in pharmacy service, the Corporate Director of Adult and Health Services asked if there were any vacancies and if demand could be sustained.  The Chair of the LPC advised that funding cuts had resulted in staffing levels being looked at.  She added that current levels could be maintained and the situation would be monitored, with the option to increase staffing based on demand.

The Chief Officer of the LPC informed the Board that they supported care navigation and had asked the CCG to provide information about care navigation to send out to pharmacists.  A meeting had been arranged for 19 June 2018 and would be up to each pharmacist if they would take part. 

The Corporate Director of Children and Young People’s Services  ...  view the full minutes text for item 11.

The Board received a report of the Director of Public Health County Durham that gave an update on Public Health links to housing and examples of developments that have been implemented 2016-2018 (for copy see file of Minutes).

The Deputy Director of Public Health County Durham reported that a Healthy and Housing group was established and had agreed five priority areas, as follows:-

(a)  Addressing poverty including welfare reform and fuel poverty

(b)  Early years including identification of neglect and injury prevention

(c)  Older people with issues such as dementia and age friendly community initiatives, reducing social isolation and falls reduction

(d)  Vulnerable groups such as those with learning disabilities, a mental illness, and those exposed to domestic abuse

(e)  Workforce development such as Making Every Contact Count.

With regards to the wider health and housing implications she suggested that a detailed presentation be provided at a future meeting.

She explained the work taking place with CCGs and GPs including warm and healthy homes would be further developed.

The Corporate Director of Children and Young People’s Services referred to priority (d) and commented that there was a risk of poverty and social isolation for care leavers.

Councillor Gunn asked how the needs of children and young people were going to be met in terms of their health and housing, linked to education.  The Deputy Director of Public Health advised that interventions were put in place to reduce accidents occurring in the home for under five year olds and that the housing environment was looked at in terms of enabling homework to happen.

The Assistant Chief Fire Officer, County Durham and Darlington Fire and Rescue Service said that it was useful to understand when tenants had issues with private landlords in terms of being at risk of fire.  Hoarding was also mentioned as a risk factor.  The Deputy Director of Public Health advised that the safe and wellbeing visits to would tie in to this work of the group.

The Chairman said that a lot of work was taking place via the AAPs.

Councillor Gunn said that it was often the simple things that made a huge difference to people’s lives and it was important to talk to families about their housing needs.  For example, providing adaptations to people and dropping a kerb to allow access to the home.

Resolved:

(i)            That the contents of the report be noted.

(ii)          That the five priority areas as outlined in paragraph 5 of the report ne endorsed.

(iii)         That a presentation at a future meeting outlining the work taking place between housing and health to address these priority areas be agreed.

(iv)         That the strong links between housing and health be acknowledged.