Agenda and minutes

Moved by Councillor Johnson, Seconded by R Shimmin 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 Dr D Smart, Seconded by R Shimmin 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, C Martin and Dr J Smith.

J Chandy for Dr Smith, J Parkes for A Foster and P Scott for C Martin.

There were no declarations of interest.

The minutes of the special meeting held on 8 March 2016 were agreed as a correct record and signed by the Chairman.

The Board considered a report of the Head of Legal and Democratic Services, Resources, Durham County Council that sought views on inviting Harrogate and District NHS Foundation Trust (NHS FT) to become an additional voting member and that advised of additional changes to the membership of the Board (for copy see file of Minutes).

The Strategic Manager – Policy, Planning and Partnerships, Children and Adults Services, Durham County Council informed the members that Harrogate and District NHS FT were successful in securing the 0-19 contract and as such it would be appropriate to join the Board.

She also advised of changes to the structure within Durham County Council as there would be a Corporate Director of Adult and Health Services and a Corporate Director of Children and Young People’s Services.  Interim appointments had been made, together with an interim appointment to the Director of Public Health post.

Resolved:

(i)            That Harrogate and District NHS Foundation Trust becoming an additional voting member of the Health and Wellbeing Board be agreed;

(ii)          That the post of Corporate Director, Children and Adults Services, Durham County Council will be replaced by a Corporate Director of Adult and Health Services and a Corporate Director of Children and Young People’s Services be noted.

The Chairman welcomed Suzanne Lamb from Harrogate and District NHS Foundation Trust and the interim Directors to the meeting.

The Board considered a report and presentation of the Programme Director for the Better Health Programme, NHS North of England Commissioning Support that gave an update on the progress of the Better Health Programme (for copy see file of Minutes).

The Programme Director for the Better Health Programme gave a presentation that explained the vision and the key elements of the programme.  Members were shown a video as part of the presentation.

The Board noted that a Regional Joint Overview & Scrutiny Committee meeting had taken place which had included additional slides providing further detail of the options available as part of the Better Health Programme.  The Chairman added that there had been a lot of questions raised at the Joint Overview & Scrutiny meeting and said that it was important to keep the Health and Wellbeing Board updated.  The Programme Director agreed to share the options and agreed that there needs to be a clear process between the Regional Scrutiny meetings  and Health and Wellbeing Boards.  She advised that the process would be open and transparent.

The Board agreed that as this was a moving piece of work, it was important to receive regular updates on progress at each Health and Wellbeing Board meeting.

Resolved:

(i)            That the presentation be noted.

(ii)          That further updates in relation to the Better Health Programme at future meetings be received.

The Board considered a report of the Strategic Programme Manager – Care Act Implementation and Integration, Children and Adults Services, Durham County Council that gave an update on the 2015/16 year end performance targets for the Better Care Fund (BCF) and the financial position relating to the plan (for copy see file of Minutes).

The Head of Planning and Service Strategy informed the Board that permanent admissions of older people to residential/ nursing homes had reduced but that the target was not met.  He noted there was an improvement on last year’s figures and advised that £2.5m performance grant award had been received.

Resolved:

(i)       That the performance highlights be noted.

(ii)     That further updates in relation to the Better Care Fund be received.

The Board considered a report of the Head of Education, Children and Adults Services, Durham County Council that provided an overview of the Strategy for Children and Young People with Special Educational Needs and/or Disabilities (SEND) aged 0-25 2016/18 (for copy see file of Minutes).

The Head of Education informed the Board that the Strategy covered the following key strategic aspects:-

·      Shared vision

·      Areas for action consideration

·      Outcomes

·      Recommendations

The Head of Planning and Service Strategy referred to mental health in young people with special educational needs as a priority group. The Head of Education confirmed that mental health needs are included within the Strategy and agreed to seek the view of the Mental Health Partnership in relation to further progressing this work.

Resolved:

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

(ii)          That the Strategy for Children and Young People with SEND aged 0-25 2016/18 be endorsed.

The Board considered a report of the Head of Children’s Services, Children and Adults Services, Durham County Council that shared the refreshed County Durham Domestic Abuse and Sexual Violence Strategy 2015/18 (for copy see file of Minutes).

On behalf of the Board, the Chairman thanked those involved in the work carried out on this very important strategy.

Resolved:

That the refresh of the County Durham Domestic Abuse and Sexual Violence Strategy 2015/18 be noted.

The Board considered a report of the Interim Director of Public Health County Durham, Children and Adults Services, Durham County Council that presented the draft Oral Health Strategy for agreement prior to wider public consultation (for copy see file of Minutes).

Councillor O Johnson was pleased that the Board had driven this initiative forward.  He was shocked at the inequalities statistics within County Durham and fully supported the report.  Councillor J Allen endorsed Councillor Johnson’s comments and would welcome the involvement of AAPs in the consultation process.  C Gaskarth representing Healthwatch County Durham also offered support in the process.

The Chairman stated that the Board would release a press statement outlining the start of the consultation process.

Resolved:

That the wider consultation of the Draft Oral Health Strategy be agreed.  

The Board considered a report of the Strategic Manager – Policy, Planning and Partnerships, Children and Adults Services, Durham County Council that  presented details of the Big Tent Engagement Event 2016 (for copy see file of Minutes).

Members were informed that there would be a number of keynote speakers and workshops taking place throughout the event including a focus on a Macmillan partnership project, integration, oral health and mental health.

Resolved:

(i)            That the proposed programme for the Big Tent Event 2016 be agreed;

(ii)          That any comments on the themes for workshops be agreed;

(iii)         That any comments on proposed organisations / groups to be invited to the Big Tent Event be agreed;

The Board considered a report of the Interim Director of Public Health County Durham, Children and Adults Services, Durham County Council that gave an update about the performance of the Health Checks service, benchmarking against other areas and ways in which coverage may be improved (for copy of report see file of Minutes).

The Head of Planning and Service Strategy said that as the strategy had changed to target certain groups, it was important for information to come back to the Board to show if the changes were working.

The Chief Clinical Officer said that it was positive to see the prevalence of CVD coming down and felt it important to compare how Durham were doing compared to the national average.  The Interim Director of Public Health suggested that a tighter indicator was needed to look at the trend over time.

The Chief Clinical Officer advised that GP practices produce a vast amount of detailed information and that it would be a benefit to look at mortality rates.

Referring to the eligible group and the two different population figures quoted in the report, Councillor Allen asked what the implications would be for County Durham.  She was advised that it would be more challenging to reach the centrally based figures.  The Interim Director advised that she would provide figures for a future meeting to explain this in more detail. 

Resolved:

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

(ii)          That the impact that differences between centrally and locally estimated eligible populations have on performance outcomes be noted;

(iii)         That the impact of quality control measures on reported numbers of Health Checks be noted;

(iv)         That the outcomes from the Health Check review and agree that the new delivery model will be presented to a future HWB meeting be noted;

(v)          That the programme was subject to procurement and that the current contractual arrangements end 31 March 2017 be noted.

The Board considered a report of the Interim Director of Public Health County Durham, Children and Adults Services, Durham County Council that presented the Teenage Pregnancy Action Plan for County Durham 2016 – 2018 for endorsement (for copy of report see file of Minutes).

The Interim Director of Public Health explained that there had been a steady decline in the teenage pregnancy figures over the last 15 years and extensive consultation had been carried out with regards to the plan.  She commented that it was aimed at a group of vulnerable people with the aim on prevention.  It was acknowledged that when young people become pregnant the vulnerable parent pathway will be available to provide additional support to those who need it.

Resolved:

That the Teenage Pregnancy Action Plan for County Durham be endorsed, whilst noting the need to reflect changes identified by DurhamWorks when their plans were finalised.

The Board considered a report of the Interim Director of Public Health County Durham, Children and Adults Services, Durham County Council which presented the 2015 annual report focused on tackling obesity (for copy of report see file of Minutes).

The Interim Director advised that the Council were leading by example as better promotion and healthier options were now available in the canteen.

The Board agreed it would be interesting to hear from younger people and those people who had managed to bring their weight back under control, including what support they had received.  It was also agreed that it would be useful to see what has worked well in other areas across the North East. 

Discussion took place about how body image scales have changed over time and that some parents do not identify their child as being overweight or obese.

The Interim Director advised that the FISCH project had a family oriented weight challenge and that the AAPs had a healthy cooking programme available.  With the addition of active walking and cycling activities the aim is to see a behaviour change for the family as a whole.

The Chief Executive of County Durham and Darlington NHS Foundation Trust suggested that as the smoking and alcohol cessation projects had shown improvements, then the same methods could be used to combat obesity.  The Interim Director referred to a 3 year programme being carried out by Leeds Beckett University with Durham and that this was an area being discussed.

It was agreed that an update on the Healthy Weight Framework would be provided to the Health and Wellbeing Board at a future meeting.

Resolved:

(i)            That the 2015 Annual Report of the Director of Public Health, County Durham and note the key messages and recommendations, be received.

(ii)          That the report is used to inform commissioning plans, service developments and assessment of need to support a range of funding bids, particularly by third sector organisations be noted.

The Board considered a report of the Strategic Manager – Policy, Planning  and Partnerships, Children and Adults Services, Durham County Council that presented the Health and Wellbeing Board Annual Report 2015/16 for agreement (for copy of report see file of Minutes).

The achievements of the board were highlighted, together with the local project work carried out through Area Action Partnerships and the future work programme for the Board.

The Corporate Director of Children and Adults Services stated that the report shows the system working together and the depth of work taking place with all organisations involved.

It was agreed that members of the Board should share the annual report in respective organisations.

Resolved:

(i)       That the Health and Wellbeing Board Annual Report 2015/16 be agreed.

(ii)     That the timeline and next steps outlined in the report be noted.

The Board considered a Joint 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 provided final Commissioning Intentions for 2016-17 and progress on the Sustainability and Transformation Plan (STP) (for copy see file of Minutes).

The Corporate Director of Children and Adults Services stated that there was alignment with the Joint Health and Wellbeing Strategy and showed a clear vision and priorities.

The Board agreed it was important to receive regular updates on the Sustainability and Transformation Plan which would be provided at each meeting.

The Chief Clinical Officer highlighted that the work of the Better Health Programme and the Sustainability and Transformation Plan would look to be integrated, moving forward.  There is a need to focus on financial balance and constitutional issues.

The Board agreed that the voluntary and community sector are a key sector in the prevention agenda.

Resolved:

(i)            That the Planning Progress Update be noted.

(ii)          That the final CCG Commissioning Intentions be noted.

(iii)         That the Sustainability and Transformation Plan progress and update be noted.

The Board considered a Joint report of the Director of Corporate Programmes, Operations and Delivery, NHS North Durham CCG, and Director of Primary Care, Partnerships and Engagement, NHS North Durham and Durham Dales, Easington and Sedgefield CCGs that informed of the development of the County Durham and Darlington (CDD) Local Digital Roadmap (for copy see file of Minutes).

The Head of Planning and Service Strategy explained that digitalising NHS records had been ongoing for a number of years and that it was important that different organisational systems can fully “talk” to one another.

The Director of Primary Care, Partnerships and Engagement, ND & DDES CCGs advised that a system had been adopted and one that recognises that all systems could link together.

Resolved:

(i)         That the report be noted.

(ii)        That the requirement to form a County Durham and Darlington Digital        Steering Group be noted.

The Board considered a Report of the Director of Primary Care, Partnerships and Engagement, NHS North Durham and Durham Dales, Easington and Sedgefield CCGs that provided Durham Dales, Easington and Sedgefield CCG Primary Care Strategy and the North Durham CCG Primary Care Strategy and Implementation Plan (for copy see file of Minutes).

The Director of Primary Care, Partnerships and Engagement highlighted that both Strategies align to the General Practice Five Year Forward View.

Resolved:

Members of the Board to provide comments on the Durham Dales, Easington and Sedgefield CCG Primary Care Strategy and the North Durham CCG Primary Care Strategy and Implementation Plan.

The Board considered a report of the Interim Director of Public Health County Durham, Children and Adults Services, Durham County Council that notified of a flagship partnership project between Durham County Council and Macmillan Cancer Support and that sought support for the development and future implementation of the project (for copy see file of Minutes).

The Interim Director advised that the £1m investment would help and support the long term conditions of people living with and beyond cancer.

The Chairman was delighted to be part of this project and commended the service for the partnership working with Macmillan.

The Corporate Director of Children and Adult Services said that this was a fantastic piece of work with the public sector and charity organisation working well and developing a mature relationship.

Resolved:

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

(ii)          That to support the project be agreed;

(iii)         That updates on the progress of the project at a future meeting be received.

The Board considered a report of the Head of Planning and Service Strategy, Children and Adults Services, Durham County Council that described the progress being made against the priorities and outcomes set within the County Durham Joint Health and Wellbeing Strategy (JHWS) 2015-18 (for copy see file of Minutes).

The Chief Clinical Officer said that the cancer wait target was difficult to influence in parts of DDES as there were different patient flows.  He outlined there was a push from NHS Foundation Trusts to work with patients to encourage ownership of attending appointments.

The Corporate Director of Children and Adults Services referred to excess winter deaths and felt there should be a focus on ensuring that people are referred for benefit checks and fire safety checks to help them receive the support they need.

Councillor Allen referred to the lag on drug and alcohol data.  She had visited excellent facilities in Bishop Auckland and Durham and felt that the quality of care made a difference when looking at successful outcomes.  She felt that a drill down and look at localities would improve the outcomes.

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 and agree any additional actions, where relevant, be noted.

(iii)         That the delivery plan actions where revised dates have been agreed by partners be noted.

(iv)         That performance against the 2015/16 Quality Premium Indicators be noted.

The Board considered a report of the Strategic Manager – Policy, Planning  and Partnerships, Children and Adults Services, Durham County Council that presented the Joint Health and Wellbeing Strategy Delivery Plan 2016-2019 for agreement (for copy see file of Minutes).

The Strategic Manager agreed to check with respective organisations to ensure timescales are realistic in the delivery plan.

Resolved:

(i)            That the Joint Health and Wellbeing Strategy Delivery Plan 2016-19 be agreed.

(ii)          That the performance monitoring arrangements for the JHWS Delivery Plan be noted.

The Chairman informed the Board that this was the last meeting for the Corporate Director of Children and Adults Services and she placed on record her thanks for what she had achieved for the authority and with partner agencies. She wished her well for the future.