Agenda and minutes

Apologies for absence were received from Martin Barkley, Alan Foster and Sue Jacques.

Paul Newton substituted for Martin Barkley and Edmund Lovell substituted for Sue Jacques.

There were no declarations of interest.

The Minutes of the meeting held on 21 June 2013 were confirmed by the Board as a correct record and signed by the Chairman.

The Board considered a joint report of the Chief Clinical Officer, Durham Dales, Easington and Sedgefield Clinical Commissioning Group and Chief Operating Officer, North Durham which provided an update on urgent care in County Durham and specific plans in both Clinical Commissioning Groups (for copy see file of Minutes).

Dr Findlay informed the Board that a review of urgent care centres and walk in centres was currently being undertaken and added that the implications of new contract changes for GP’s which came into effect from April 2014 were, as yet, unknown.

The Corporate Director, Children and Adults Services, informed the Board that all partners were conscious of the pressures on urgent care and the need to re-engineer and re-think the service.  An Urgent Care Board had been established which met outside of these Board meetings, and this a sub-group which supported the system wide Clinical Programme Board.  Also, a national review of the future of urgent and emergency care services was being undertaken by Professor Keith Willett.

In reply to a question from Councillor Nicholls regarding weekend GP provision, Dr Findlay informed the Board that there were currently GP practices in North Durham CCG which were open at weekends, and would be practices within DDES CCG open from this weekend.  Nicola Bailey confirmed that all GP practices in North Durham would be open on weekends until April 2014.  The Corporate Director, Children and Adults Services suggested that publicity for this could be placed on the County Council’s web site if information was provided.

Resolved:

That the report be noted.

The Board considered a report of the Director of Public Health which provided details of the County Durham Tobacco Control Alliance Action Plan and sought support of the Board for the Plan (for copy see file of Minutes).

The Director of Public Health informed the Board that smoking was the highest cause of preventable death in County Durham and had an annual cost of nearly £28m in the County.  £21m of this was a cost to the NHS.  The Tobacco Control Alliance Action Plan set an ambitious target to reduce smoking prevalence in County Durham to 5%, and to 10% amongst routine and manual groups, by 2030.

Councillor Hovvels informed the Board that the target set by the Action Plan was quite challenging, particularly taking into account the current economic climate and welfare reform programme.

Resolved:

That the report be noted and the Tobacco Control Alliance Action Plan be endorsed.

The Board considered a report of the Director of Public Health which presented the Public Mental Health Strategy (for copy see file of Minutes).

C Sullivan, Public Health Consultant, informed the Board that the primary purpose of the strategy was to reduce the number of people developing mental health problems through promotion of mental health, prevention of mental ill-health and improving the quality of life for those with poor mental health through early identification and recovery.  The strategy formed a key strand of the County Durham Mental Health Framework which would be brought to a future meeting of the Board

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A key action of the Public Mental Health strategy was to reduce social isolation and loneliness. There were a number of population groups vulnerable to social isolation and loneliness, such as young care-leavers, refugees and those with mental health problems.  Older people, as individuals as well as carers, had specific vulnerabilities owing to loss of friends and family, loss of mobility or loss of income.  Social isolation and loneliness impacted on quality of life and wellbeing, with demonstrable negative health effects including lonely individuals having higher blood pressure than their less lonely peers.

Durham County Council had a key role in implementing No Health Without Mental Health and improving the mental health and wellbeing within local communities.  Part of this commitment included the recent identification of an elected member, Councillor Hovvels, as mental health champion whose role would include promoting wellbeing and initiating and supporting action on public mental health.

P Appleton, Head of Planning and Service Strategy, Children and Adults Services referred to social isolation in older people and the need for partnership work to address this, adding that there were currently some very successful schemes operating within County Durham.  The Corporate Director of Children and Adults Services suggested that a future meeting of the Board be presented with details of some work and activity currently taking place.

Resolved:

(i)              That the current and projected mental health needs within County Durham be noted;

(ii)             That the County Durham Joint Health and Wellbeing Strategy specified a specific action to develop and implement a multi-agency Public Mental Health Strategy, including suicide prevention, for County Durham be noted;

(iii)            That the Public Mental Health Strategy would form a key strand on the Mental Health Framework for County Durham be noted;

(iv)           That the Public Mental Health Strategy had been developed by a multi-agency group that involved stakeholders, service users and carers be noted;

(v)            That the County Durham Public Mental Health Strategy be endorsed;

(vi)           That there was a detailed action plan, with timescales and named leads to ensure implementation of the strategy be noted.

(vii)          That further work be presented to the Health and Wellbeing Board in relation to work and activity taking place as part of the Public Mental Health Strategy.

The Board considered a report of the Head of Planning and Service Strategy, Children and Adults Services, which presented the first performance report to the board which described the progress being made against the priorities and outcomes set within the County Durham Joint Health and Wellbeing Strategy 2013-17 (for copy see file of Minutes).

The Head of Planning and Service Strategy outlined details of performance to the Board.  Referring to paragraph 27 of the report, the Board was informed that there were significantly higher alcohol specific admissions for under-18’s per 100,000 population in County Durham than the north east and this was more than double the national rate, although the number was decreasing.  The Director of Public Health informed the Board that the County Council was currently carrying out consultation on its Licensing Policy and the Board should make a representation to this consultation. 

The Head of Planning and Service Strategy referred to paragraph 32 of the report and informed the Board that take up of the NHS Health Check programme had increased during Quarter 1 in comparison to the same period of last year but the uptake of Health Checks was below target and not expected to exceed the 2012/13 total.  A further report would be brought to a future meeting of the Board to consider whether a blanket approach to Health Checks should continue or whether a more targeted approach should be adopted.  The Director of Public Health informed the Board that GP practices and Local Medical Committees believed a targeted approach should be considered and undertook to share this information with CCG Boards.

Resolved:.

(i)              That the performance highlights and areas for improvements identified throughout the report be noted

(ii)             That the actions taking place to improve performance be noted

The Board considered a joint report of the Corporate Director of Children and Adults Services, Chief Clinical Officer DDES CCG and the Chief Operating Officer, North Durham CCG which sought agreement and ratification from the Board of the proposed use of the 2013/14 allocations of social care funding and content for the associated Section 256 agreement (for copy see file of Minutes).

Resolved:

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

(ii)             That the proposed options for the use of the Social Care Funds be approved;

(iii)            That the Section 256 agreement be ratified.

The Board considered a report of the Head of Commissioning, Children and Adults Services which provided details of progress in relation to the Winterbourne Review Concordat and Action Plan implementation in County Durham (for copy see file of Minutes).

Resolved:

(i)              That the Board note the update and assurance that plans were in place to work collaboratively between DCC and Clinical Commissioning Groups to develop long-term solutions for identified individuals;

(ii)             That further progress updates be received in 2014, including a detailed action plan in relation to any significant ‘resource shifts’ from hospital to community-based services.

The Board considered a report of the Head of Commissioning, Children and Adults Services which provided an update on progress in relation to the Autism Strategy implementation and completion of the self-assessment framework and sought approval for the development of a local action plan for submission to the Board in January 2014 (for copy see file of Minutes).

Resolved:

That the report be noted and a detailed report and action plan be brought to the Board meeting in January 2014.

The Board considered a joint report of the Chief Clinical Officer, DDES CCG and Chief Operating Officer, North Durham CCG which outlined the planning process which fed into the 2014/15 planning round for both North Durham CCG and DDES CCG (for copy see file of Minutes).

The report articulated how the activity fitted into the North Durham CCG and DDES CCG ‘Clear and Credible Plan’ development and the strategic challenges faced by both organisations and included include activity that had been undertaken to date and forthcoming work that would be required.

The Corporate Director of Children and Adults Services informed the Board that development of the Commissioning Plan could not be seen in isolation from Integrated Transformation Funding which would drive changes in existing contractual arrangements.

Resolved:

That the report be noted.

The Chairman was of the opinion that the following item of business was of sufficient urgency to warrant consideration to provide Board Members with an update on key reforms related to the new Children’s and Families Bill.

The Corporate Director of Children and Adults Services referred the Board to the implementation of key reforms related to the new Children’s and Families Bill.  The changes would have an impact on the nature and way in which services for children and young people with special educational needs and disabilities (SEND) were delivered and suggested that the Board may wish to include these reforms on their Forward Plan.

In response to a request from Councillor Nicholls, Mr Bedlington provided the Board with a brief update on the progress of Healthwatch in County Durham.

Resolved:

That a report on Special Educational Needs and Disabilities be included on the Health and Wellbeing Board forward work plan.

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 Schedule 12A to the said Act.

The Board considered a report of the Director of Public Health which provided a summary of Pharmacy Relocation Applications 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 June 2013 (for copy see file of Minutes).

Resolved:

That the Board make no representations in relation to the application for relocation.