Agenda and minutes

Apologies for absence were received from  N Bailey, M Barkley, J Chandy, Dr S Findlay and A Foster

J Smith as substitute for Dr S Findlay and P Smith as substitute for M Barkley

There were no declarations of interest.

The Minutes of the meeting held on 3 November  2015 were confirmed by the Board as a correct record and signed by the Chairman.

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 Quarter 2 2015/16  Better Care Fund (for copy see file of Minutes).

The Board were advised that 5 out of 6 performance indicators had been met in Quarter 2.  The indicator still to achieve the target was regarding permanent admissions of older people to residential/ nursing homes per 100,000 population, however the Strategic Programme Manager – Care Act Implementation and Integration advised of contributing factors to the non-achievement.

Resolved:

(i)         That the report be noted.

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

The Board considered a joint report of the Chief Clinical Officer, Durham Dales, Easington and Sedgefield (DDES) Clinical Commissioning Group (CCG) and Chief Operating Officer, DDES and North Durham CCG that provided an update on the refresh of the North Durham Clinical Commissioning Group and Durham Dales Easington and Sedgefield Clinical Commissioning Groups potential commissioning intentions for 2016/17 and that provided an overview of the national planning requirements (for copy see file of Minutes).

The Commissioning Manager, North East Commissioning Support (NECS) advised that the process was similar across both CCGs.  National planning guidance was received in late December 2015 and the NHS was required to produce two separate plans, a Sustainability and Transformation Plan and a one year Operational Plan.  The Board were informed of the planning timetable.

The Commissioning Manager advised of the wider footprint for the Sustainability and Transformation Plan (STP) across Durham, Darlington and Tees, however it was reiterated that a locality focus needs to be retained, which will align to the STP.  The Network and Senate Associate Director, NHS England stated that there was a standard format planning template and he would circulate this for information. The Chief Executive of County Durham and Darlington NHS Foundation Trust (CDD NHS FT) added that each statutory organisation were still required to have individual plans. 

The Commissioning Manager outlined the “must dos” for 2016/17 and the Head of Planning and Service Strategy, Children and Adults Services, Durham County Council, commented on the scale of challenge presented.  The Board agreed the introduction of mental health access targets were an important step forward towards parity of esteem between mental and physical health.

The Corporate Director of Children and Adults Services, Durham County Council stated that it was important to ensure the Local Government Association were involved in developing the guidance for plans, where they impacted on local authorities.  The Network and Senate Associate Director agreed to feed this back to NHS England Sub-Regional Team. Further guidance is expected at the end of January 2016 and the Network and Senate Associate Director agreed to circulate this to the Health and Wellbeing Board.

Resolved:

(i)         That the Planning Progress Update and Draft Commissioning Intentions 2016/17 be received.

(ii)        That the planning timetable be noted.

(iii)         That the power of authority to the Corporate Director, Children and Adult Services, Durham County Council, the Chief Clinical Officer, DDES CCG and the Chief Operating Officer, ND CCG & DDES CCG in consultation with the Chair of the Health and Wellbeing Board to sign off the local premium indicators for 2016/17 be delegated.

The Board considered a report of the Chief Clinical Officer, Durham Dales, Easington and Sedgefield Clinical Commissioning Group (DDES CCG)  that provided an update on DDES CCG’s review of urgent care services and proposed new service models (for copy see file of Minutes).

The Clinical Chair, DDES CCG advised that the report had been considered at Adults, Wellbeing and Health Overview and Scrutiny Committee earlier in the week.  He advised that it had been necessary to look at and review urgent care as at present there was a complex system.  It had been found that a lot of people visited urgent care as they were unaware that they could get an appointment with a GP.  The Clinical Chair advised that the 111 service would be able to access and make appointments at GP surgeries.  He said that every general practice had been involved and highlighted the proposed models.  He added that although there was a lot of public anxiety, no decisions had been made in relation to urgent care services in DDES and any future system would look at the better use of public money.  

The Chairman suggested that the consultation be spread out as far and wide as possible to include Town and Parish Councils.  It was also agreed that it was important to consult with Area Action Partnerships.

With regards to the residents of North Durham CCG, the Clinical Chair advised they were looking at urgent care together with out of hours provision and consultation would take place with GPs to look at the most appropriate models.  The principles would be the same as outlined within this report by having a system for people to navigate more easily.

Councillor J Allen asked that the consultation be meaningful and that dates be circulated as soon as possible through county councillors and town and parish councillors to ensure everyone has an opportunity to have their say.

The Director of Public Health County Durham, Children and Adults Services, Durham County council asked what the plans were at Darlington as we do have patient flow into that area from County Durham.  The Chief Executive CDD NHS FT advised that this was co-located within A&E at Darlington and plans for hubs would go out for consultation.

In terms of the consultation, the Interim Chief Executive of Healthwatch County Durham and the Head of Planning and Service Strategy said that timing was of the essence and that messages to the public need to be clear and easy to understand.

Resolved:

(i)            That the report be noted.

(ii)          That an update at a future meeting be received.

The Board considered a report of the Director of Public Health County Durham, Children and Adults Services, Durham County Council which  gave an update on the County Council’s Cold Weather Plan which sought to reduce excess winter deaths and cold related ill health (for copy see file of Minutes).

The Director of Public Health advised that the plan was about keeping people healthier at home as we do have excess winter deaths in County Durham.  Early sight of the figures from last winter had shown a substantial increase.  The Director of Public Health was looking further into the figures and will look at the links to those who are socially isolated.

The Director of Public Health will join the System Resilience Group to be sighted on the wider system winter planning issues.  The Director of Public Health will also present the Plan to the Community Wellbeing Partnership.

Resolved:

(i)            That the report be noted.

(ii)          That the Cold Weather Plan incorporates the new NICE guidance and is exploring the interface with the NHS system resilience plan be noted.

The Board considered a report of the Director of Public Health County Durham, Children and Adults Services, Durham County Council that provided a summary of the County Durham Health Profile 2015 and that compared indicators against the previous profile of 2014 (for copy see file of Minutes).

The Board discussed hip fractures and falls and the Director of Public Health agreed to ask the Frail Elderly group to carry out further investigations into this data to bring further information to a future Board meeting.

Resolved:

(i)            That the report be noted.

(ii)          That the findings are utilised and inform the planning of services provided for people living in County Durham by DCC and partners and also those services that were commissioned be noted.

(iii)         That the poor outcomes identified in the profile were being addressed by the relevant strategies and plans developed by partners including the Joint Health & Wellbeing strategy, mental health strategies, tobacco control plan, health weight framework be noted.

The Board considered a report of the Director of Public Health County Durham, Children and Adults Services, Durham County Council that provided a summary of the County Durham Child Health Profile 2015 and compared indicators to the previous profile of 2014  (for copy see file of Minutes).

The Director of Public Health agreed to provide a report to a future Board meeting looking into unintentional injuries of children and young people.

Resolved:

(i)            That the report be noted.

(ii)          That the health profile is used in the planning of services provided for children and young people living in County Durham by Durham County Council and partners and also those services that were commissioned be noted.

(iii)         That the poor outcomes identified in the profile were being addressed by the relevant strategies and plans including the Children and Young People’s Mental Health, the Joint Health & Wellbeing Strategy, Children and Young People Mental Health and Emotional Wellbeing Resilience Plan, Alcohol Harm Reduction Strategy, Healthy Weight Framework be noted.

The Board considered a report of the Director of Public Health County Durham, Children and Adults Services, Durham County Council that gave progress for the County Durham Drug Strategy Action Plan for 2014-2017 (for copy see file of Minutes).

The Director of Public Health advised that there was a time lag in the data available but it was hoped to see some improvements as services from the new provider, Lifeline, were embedded.  The Director of Public Health reported that there was a special Overview & Scrutiny session looking at the performance outcomes of the Lifeline services. 

In relation to substance misuse treatment a new policy would ensure that a recovery contract was in place with the service user, that would monitor, support and help them to secure employment, housing, training and education.  The Director of Public Health advised that 1400 people were currently receiving treatment and that this could be a big concern for elected members and the wider community.

Resolved:

That the action plan and current performance be noted.

The Board considered a report of the Independent Chair of the Durham Local Safeguarding Children Board (LSCB) which provided information in respect of the Annual Report of the County Durham Local Safeguarding Children Board (LCSB) (for copy see file of Minutes).

The Independent Chair highlighted the achievements in 2014/15 and priorities and challenges for 2015/16.  The Board were advised that the vision had been amended slightly, that there was a focus on child sexual exploitation and joint working with the Police, and that self-harm was a LSCB priority following feedback from young people expressing that it was an important issue.

The Head of Planning and Service Strategy referred to the launch of a new website by a multi-agency ERASE team.  The Board were advised that this would be a source for help and information for children, parents and the wider community to help them stay safe, in a bid to end child sexual exploitation.   He suggested that the LSCB work with AAPs to promote the website and to work with partners to help send out the materials for it. 

Resolved:

(i)            That the content of the report to ensure it remains sighted on the LSCB’s effectiveness and interfaces be noted.

(ii)          That the range of work that has taken place to safeguard children in county Durham, and the continued challenges, developments and achievements in this critical area of work be noted.

The Board considered a report of the Report of Independent Chair, County Durham Safeguarding Adults Board which provided information about the current position of the County Durham Safeguarding Adults Board (SAB) achievements on 2014/15 and plans for 2015/16 (for copy see file of Minutes).

The Independent Chair advised that a lot of work had been carried out in relation to the Care Act and that awareness raising had been effective in increased the number of adult safeguarding referrals, and that the number of multi-agency investigations had reduced.

Resolved:

(i)            That the content of the report to ensure it remains sighted on the SAB’s effectiveness and interfaces be noted.

(ii)          That the achievements during 2014/15 and the progress of actions during 2015/16 be noted.

The Board considered a report of the Head of Children’s Services, Children and Adults Services, Durham County Council that provided an update on the national and local developments in relation to children’s social care services (for copy see file of Minutes).

The Head of Planning and Service Strategy highlighted the key points within the report, including the two successful bids to the Children’s Social Care Innovation Fund and the improvements in performance across a range of key indicators.

The Chairman said that there was a lot of positive work progressing and congratulated the Youth Offending Service for winning an award for the work carried out.

Resolved:

(i)            That the report be noted.

(ii)          That further updates in relation to the transformation of Children’s Services on a six monthly basis be received.

The Board considered a report of the Interim Chief Executive, Healthwatch County Durham that gave an update on the strategic direction, structural changes, activities and outcomes of Healthwatch County Durham during the period April to September 2015 (for copy see file of Minutes).

The Interim Chief Executive of Healthwatch highlighted the changes during the period and advised of the high turnover of staff due to maternity leave.  She advised of her appointment as Interim Chief Executive and a new Interim Chair.  The volunteer programme had been developed with 6 new defined roles created.

The Board were advised that a named link for each AAP had been identified and would help to spread the available resources as widely as possible.

The Director of Public Health enquired as to where information is directed when received.  The Interim Chief Executive advised that issues were directed as appropriate, for example, to the CCGs, Foundation Trusts and was informed that it was important to feed back to people to let them know what had been done and what responses had been received.

Resolved:

(i)            That the activities and outcomes of Healthwatch County Durham’s work in gathering views, advising people and speaking up for health and social care service users be noted.

(ii)          That Healthwatch County Durham Community Interest Company is now operating as an independent social enterprise be noted.

The Board considered a report of the Area Action Partnership Coordinator, Assistant Chief Executive, 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 highlighted the achievements and developments and advised that developing dementia friendly communities and tackling holiday hunger were emerging issues that had been identified.

The Head of Planning and Service Strategy said that it was important for all agencies to understand the value of the AAPs and the benefits that could be achieved for small funding grants and projects.

The Corporate Director of Children and Adult Services queried how the AAPs would scale up the holiday hunger issue. The AAP Co-ordinator agreed to take this issue forward and will report into the Children and Families Partnership.

Resolved:

(i)            That the work that was taking place be noted.

(ii)          That the improved alignment of work of the AAP’s to the Health and Wellbeing Board be noted.

(iii)         That work will progress through the Community Wellbeing Partnership.

(iv)         That the AAP/public health supported projects in 2015/16.

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 paragraphs 1 & 2 of Schedule 12A to the said Act.

The Board considered a report of the Director of Public Health County Durham, Children and Adults Services, Durham County Council 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 November 2015 (for copy see file of Minutes).

Resolved:

That the Board note the Pharmacy Relocation Applications received.