Agenda and minutes

Apologies for absence were received from Councillor J Allen, N Bailey, D Brown, R Chillery, J Gillon, J Illingworth, B Jackson, S Jacques Dr J Smith and S White

D Lowry for R Chillery, Dr L Murthy for B Jackson, L Buckley for J Gillon, J Carling for S White and R Turnbull for D Brown

There were no declarations of interest.

The minutes of the meeting held on 27 November 2019 were agreed as a correct record and signed by the Chair.

The Chair congratulated County Durham and Darlington NHS Foundation Trust for receiving a Care Quality Commission ‘good’ rating.

The Board received a report of the Director of Public Health, Durham County Council that presented an update on health protection assurance arrangements in County Durham (for copy see file of Minutes).

The Director of Public Health reported that the Health Protection Assurance and Development Group oversee five main strands of health protection activity and had given assurances that satisfactory arrangements were in place to protect the public on:

·        Screening programmes

·        Immunisation programmes

·        Outbreaks and communicable diseases

·        Strategic regulation interventions

·        Preparedness and response to incidents and emergencies

The Consultant at the Health Protection Agency, Public Health England advised that there had been an increase in mumps in younger adults and teens and that good work had been carried out in Aycliffe Young People’s Centre.  Work across the NHS had been taking place to increase the awareness and uptake of the MMR vaccination.

The Director of Public Health commented that flu continued to be a challenge especially for some groups such as pregnant women and children however the Flu Board would pick this up.

The Chief Clinical Officer, North Durham and Durham Dales, Easington and Sedgefield Clinical Commissioning Groups (ND/DDES CCG) asked what contingencies were in place should any cases of the Coronavirus present in County Durham.  The Consultant in Public Health explained that this was a rapidly evolving situation nationally and guidance keeps changing as the situation changes.  She assured the Board that there were contingencies in place and that support would be provided for those people returning from areas that were affected.  Website information was being used as advice changes so quickly and a lot of communication had taken place with the local authority, schools, prisons and messages to GPs and hospitals about what to do if someone presents with the virus.  The test results were taking approximately 24-48 hours to process and out of 97 UK nationals tested all had been negative so far.  Further to a question from the Chief Operating Officer, evidence had shown from China that testing was carried out when symptoms presented as they were looking for the virus within the respiratory system.

Councillor Gunn commented that the working group at Aycliffe Young People’s Centre was recently judged by Ofsted as outstanding in terms of the children and young people involvement.  The Director of Public Health assured the Board that the Public Health team work with Aycliffe Young People’s Centre and have identified a member of Children’s Services to become part of the Flu group to ensure that the health protection was part of every day business and that children had a voice.

Resolved:

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

(ii)          That local performance continues to be higher than England and regional averages and above target for most screening and immunisation programmes be noted.

(iii)         That the report provides broad assurance that effective processes are in place for each of the key strands of health protection activity be noted.

(iv)        That the need for further assurance in relation to flu immunisation  ...  view the full minutes text for item 5.

The Board considered a report of the Head of Partnerships and Community Engagement, Durham County Council that presented the current review of strategic partnership arrangements and requested views and opinions to influence the review (for copy see file of Minutes).

The Head of Partnerships and Community Engagement gave a detailed presentation that highlighted the following:-

·        Background

·        Moving from Good to Great

·        Number of Partnerships

·        County Durham Vision 2035

·        Health and Wellbeing Board development session November 2019

·        Health and Wellbeing Board Structure

·        Integrated Care Board/Integrated Steering Group for Children Structure

·        Benchmarking

·        Details on 4 options

·        Streamlining and restructuring current arrangements

The Chief Operating Officer, North Tees and Hartlepool NHS Foundation Trust commented that it was important that the strategic governance review was focussed on what is required within County Durham which in turn would feed up to the Integrated Care Partnership and Integrated Care Systems. . 

The Chief Operating Officer added that as the ICPs develop it was important to ensure that decisions made in Durham remain that way and that it was timely to look at the governance arrangements.  He went on to say that plans were evolving but as Durham was such as big county with a large population it was important that as many decisions as possible remained here rather than being made at a wider geography.  It was therefore important to have strong representation at the groups regional/sub-regional groups.

The Police, Crime and Victims’ Commissioner representative was wary of combining the County Durham Partnership with the Health and Wellbeing Board as the two already had large agendas.  He advocated to continue with a separate County Durham Partnership.

Further to a question from the Healthwatch representative, the Head of Partnerships and Community Engagement advised that there was no preferred option and feedback via the survey was important from the Health and Wellbeing Board.  He went on to say that there were strengths in all four options.

The Corporate Director of Children and Young People’s services said that the vision for County Durham was the starting point and agreed that joining the County Durham Partnership with this board would prevent a challenging agenda and he could not see how that would work.

Resolved:

(i)           That the presentation on the review of governance arrangements for County Durham’s Strategic Partnership arrangements be received.

(ii)          That the survey circulated following the meeting, to contribute to the review, be completed.

The Board received an update on health and social care integration from the Corporate Director of Adult and Health Services, Durham County Council.  She advised that Sarah Burns had been appointed to the Head of Integrated Commissioning post. The work to integrate commissioning arrangements was progressing with an operating model starting to evolve.  A launch event to celebrate the journey so far would take place in February/March and the system plan for County Durham would be reported to the Board in March.  The films shown before the commencement of the meeting would be shared with partners and would be used to support recruitment within County Durham.

Resolved:

That the update be noted.

The Board received a report of the Head of Commissioning, Durham County Council that gave an update on the work underway within the North East and Cumbria Integrated Care system (ICS), Integrated Care Partnerships (ICP), as well as activity within the County Durham Integrated Care Partnership (CDICP) in relation to digital projects (for copy see file of Minutes).

The Service Manager Operational Support, Adult and Health Services, Durham County Council gave a detailed presentation highlighting the following:-

·        A new regional digital strategy

·        Vision and Objectives

·        5 programme themes

·        20 programme activities

·        County Durham Integrated Care Partnership activity

·        Great North Care Record

In conclusion, the Service Manager explained that the digital strategy and action plan aligned to the five year system plan.

The Chair of North Durham CCG believed that patients would be empowered having full access to their medical records and asked if this would extend to hospital records.  The Service Manager explained that the Great North Care Record was focused around the consultation of what was willing to be shared for example.Durham County Council’s case management could open up a social care client portal.  She would take this back to ask for a full response.

The Healthwatch representative said that this would not be user friendly for some of the population and asked if efforts would be made to include those people who were not able to easily use the online route.  The Service Manager recognised that there was not solution for all and that the Digital Group had discussed what could be done around technology to provide a better offer for the individual.  This would be included in the action plan.

The Director of Integrated Community Services explained that the health call roll out would start in residential and nursing care homes followed by people living at home.

Further to a question from Councillor Gunn, the Service Manager explained that this was part of the five year plan and would link to communities and engagement.

The Chief Operating Officer, ND/DDES CCG said that he had been pushing this for a long time and there was a need for patients to look at their own records online.

Resolved:

That the report be noted.

The Board received a report of the Director of Public Health, Durham County Council that shared details of a case study in using the County Durham Approach to Wellbeing (for copy see file of Minutes).

The Director of Public Health and the Strategic Manager One Point/Think Family Services gave a detailed presentation that highlighted the following:-

·        County Durham’s Approach to Wellbeing – resilience and wellbeing, principles and commitments

·        Wellbeing approach – people and place and supporting systems

·        Project 1 – place based approach to early help

·        Project 2 – holiday activities with food

·        Principles to be adopted

·        Making a difference to place based approach to early help projects and holiday activities with food

Councillor Gunn said that there was a lot of good work taking place in the communities that share a lot of similarities but that also have noticeable differences.  Voluntary organisations, Children and Family workers and Area Action Partnership Co-ordinators work together to arrange essential holiday activities.  She asked what learning from that could be applied to other organisations and projects.  The Strategic Manager advised that for place based work it was essential to engage with the children, young people and families about issues that were important to them, including any services that were not currently accessible to them.  She added that this was in the early stages of development and would see improvements as services were developed.

Referring to the development of a Youth Council, Councillor Gunn commented that going forward the liaison with young people and communities would further enhance the current offer to children and young and would also be a valuable resource on which to draw to ensure their voice was heard.

The Chair said that the community were very capable and willing to take control and that this approach would help to empower them.  She was also pleased to hear how powerful it was to have the voice of the child being recognised.

Resolved:

That the use of the Approach to Wellbeing in this case study and the opportunity it has brought to encourage greater community engagement and co-production in the development of new services be noted.

The Board received a joint report of the Corporate Director of Adult and Health Services, Durham County Council, and Corporate Director of Children and Young People's Services, Durham County Council that gave an update as to progress following the launch of the all age ‘Think Autism’: Autism Strategy and Action Plan across County Durham (2018/19-2020/21) (for copy see file of Minutes).

The Strategic Commissioning Manager Learning Disability/ Mental Health and the Strategic Manager Specialist Inclusion Support, Durham County Council informed the Board of the progress made on the six priority areas of the strategy and action plan.

The Chair asked how partners could support Autism week and was advised that communications were already taking place and that partners were involved in the planning stages.

Councillor Gunn said that this had been a success last year.  She asked if there were any further details available on the action plan and strategy and was advised that the local offer platform had been shaped and was linked to the Autism Champion.

Resolved:

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

(ii)          That the next steps as outlined in the report be agreed.

(iii)         That support of the implementation of the All Age Autism Strategy be continued.

The Board received a report of the Director of Commissioning, Strategy and Delivery - Mental Health and Learning Disabilities, Clinical Commissioning Groups that outlined a number of key outcomes and deliverables against the Strategic Plan by the five workstreams (for copy see file of minutes).

Councillor Gunn was interested in Kooth, an online counselling programme, and how young people access that.  She was also pleased to see the successful trailblazer bid with just under £1m being secured for County Durham. Finally, she asked how we would encourage people to talk about mental health and how to raise awareness.  In terms of Kooth, the Director of Commissioning, Strategy and Delivery advised that there were routine reports available on uptake of the programme and he would circulate to the board.  The Director of Public Health confirmed that there were a range of activities planned across the County and links would be circulated for the Time to Change website.

Further to a question about the work being carried out in relation to suicides and the evidence of the impact of that, the Strategic Public Health Manager advised that there was a system wide approach on prevention that supported people who were in crisis and at risk of taking their own lives.  She added that full details could be found in the report and that there had been a slight reduction from last year.

As the County Council’s Mental Health Champion, the chair asked if the same good practice was being applied in other organisations.  She was advised that this was prevalent in many organisations such as the CCGs, Police and Fire.  There was also dedicated post in Business Durham.

Resolved:

(i)           That the progress made be noted.

(ii)          That to receive a further update relating to ambitions and priorities beyond 2020, linked to the developing new Joint Health & Wellbeing Strategy be agreed.

The Board received a report of the Director of Public Health, Durham County Council that gave an overview of the importance of housing and the home environment in improving health outcomes for the population of County Durham and provided an update on the work undertaken to address housing and health needs across the county (for copy see file of minutes).

The Strategic Public Health Manager and the Housing Solutions Manager highlighted the importance of housing on health and outlined the next steps for extending the action of the council and partners to promote a system-wide approach to this work.

Councillor Gunn thanked the officers for the detailed report that set out clearly the impact of poor housing and homelessness on people including children and young people.  The report also set out the costs to the NHS and she pointed out the great work taking place despite working to the confines of the Council’s financial envelope.

Resolved:

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

(ii)          That the options for Housing Partnership groups to work collaboratively to further explore opportunities to initiate a strategic Housing and Health Group which would include the council, NHS and housing provider partners be agreed.

The Board noted a presentation from the Director of Public Health, on the following public health campaigns (for copy of presentation see file of minutes):

·        Alcohol

·        Dry January

·        Tobacco

·        Mental Health

·        Breastfeeding

·        Flu