Agenda and minutes

Minutes of the meeting held on 7 September 2017, attached.

RESOLVED that the minutes of the meeting held on 7 September 2017 be signed as a correct record.

Items which in the opinion of the Chair should be considered at the meeting as matters of urgency.

There were no items requiring urgent attention.

Report of the Chief Officer for Community, Public Health, Environment and Prosperity, which reviews progress against the overarching priorities identified in the Joint Health and Wellbeing Strategy for Devon 2016-2019, attached.

The appendix is available at http://www.devonhealthandwellbeing.org.uk/jsna/health-and-wellbeing-outcomes-report/

The Board considered a report from the Chief Officer for Community, Public Health, Environment and Prosperity on the performance for the Board, which monitored the priorities identified in the Joint Health and Wellbeing Strategy for Devon 2016-2019.

The indicator list and performance summary within the full report set out the priorities, indicators and indicator types, and included a trend line, highlighting change over time.

The Board received an ‘updates only’ version of the Health and Wellbeing Outcomes Report.  The report was themed around the five Joint Health and Wellbeing Strategy 2016-19 priorities and included breakdowns by South West benchmarking, local authority district and local authority comparator group, clinical commissioning group, and locality comparison, trend and future trajectories and inequalities characteristics.

The indicators below had all been updated since the last report to the Board:

·         Excess Weight in Four / Five Year Olds, 2016-17 – Levels of excess weight in reception year children (22.8%) were similar to the South West comparator group and national rates;

·         Excess Weight in 10 / 11 Year Olds, 2016-17 – Levels of excess weight in year six (29.3%) were below South West comparator group and national rates;

·         Teenage Conception Rate, Q2 2016 – Conceptions to under 18s had fallen in Devon and were similar to South West and comparator group rates;

·         Excess Weight in Adults, 2015-16 – According to the Active People Survey, 61.6% of the adult population in Devon were overweight or obese (broadly similar to South West comparator group and national rates);

·         Proportion of Physically Active Adults, 2015-16 – revealed that 69.9% of the Devon adult population were active for at least 150 minutes per week, which was above regional and national rates;

·         Diet – Fruit and Veg ‘5-a-day’, 2015-16 – 64.3% of the adult population in Devon consumed five or more portions of fruit and vegetables per day (significantly above South West comparator group and national rates);

·         Mortality rate from preventable causes, 2014-2016 – the age-standardised mortality rate in Devon (159.7 per 100,000) was significantly below South West comparator group and England rates. However, the rate of decline had slowed in recent years and inequalities persisted;

·         Reablement Services (Effectiveness), 2016-17 – in Devon, 86.8% of older people were still at home 91 days after discharge from hospital into Reablement services, (significantly above the South West comparator group and national rates);

·         Reablement Services (Coverage), 2016-17 – In 2016-17, 1.8% of older people discharged from hospital in Devon were offered Reablement services (significantly lower than South West comparator group and national rates);

·         Deaths in Usual Place of Residence, 2016 – 54.9% of Devon residents dying in 2016 did so in their usual place of residence, which was significantly above South West, comparator group and national rates; 

·         Stable and Appropriate Accommodation (Learning Disabilities), 2016-17 – 78.4% of adults with a learning disability in Devon were living in their own home or with family, which was above South West comparator group and national rates;

·         Stable and Appropriate Accommodation (Mental Health Clients), 2016-17 – 60.0% of adults in  ...  view the full minutes text for item 28.

Expert Panel on the theme of ‘Children, Young People and Families, as outlined as a priority in the Joint Health and Wellbeing Strategy.

A presentation will be given at the meeting.

The Board received a presentation from the Head of Education and Learning on the ‘Children, Young People and Families’ priority, as detailed in the Joint Health and Wellbeing Strategy, which was centred on Special Educational Needs and Disability (SEND) and working together around transitions.

The Presentation focussed on SEND and transitions including primary to secondary and secondary to adulthood; transition to adulthood for disabled young people; the emotional health and wellbeing of young people; Children in Care and Looked After Children and Safeguarding children and young people.

The Board discussed and asked questions on the following:

·       the difficulties for some children transitioning from primary to secondary school and the dramatic change in environment, structure and expectation;

·       concerns over speech and language development of young people;

·       the development of a ‘transition book’ for primary and secondary school to help support young people and their families; and

·       the aim to build the confidence of parents around transition stages.

Joint report of the Head of Adult Commissioning and Health, NEW Devon CCG and South Devon and Torbay CCG on the BCF, Quarter Return, Performance Report and Performance Summary, attached.

The Board considered the Joint Report and presentation of the Head of Adult Commissioning and Health, NEW Devon CCG and South Devon and Torbay CCG on the Devon Better Care Fund Q2 submission to NHS England, submitted on 17 November 2017.

Regular reports were provided on the progress of the Devon Better Care Fund Plan to enable monitoring by the Health and Wellbeing Board.  Performance and progress was reviewed monthly by the Joint Coordinating Commissioning Group through the high level metrics reports and progress overview. 

The Report noted that all four national conditions had been met and that three out of four performance against national metrics were on target, including non-elective admissions, admission to residential and care homes and effectiveness of reablement.  It was noted that, despite positive improvement within the wider system, it had not been possible to meet targets for Delayed Transfers of Care (DTOC) due to reductions across the NHS Trusts.  Daily monitoring of delays had been established to identify any prevailing issues and it was noted that activity in November was close to target; however increased activity in the system during early winter would remain a challenge.

The trajectory of DTOC was still slightly over target, however significant improvements had been made in Devon, which had halved in the last six months, from 156.1 in June 2017 to 77.9 in November 2017.  This had required significant management and staff focus which would be challenging to maintain during the winter period.

RESOLVED that the Better Care fund Q2 submission be noted and endorsed. 

Annual Report of the Devon Safeguarding Adults Board charting progress within Devon of national expectations and safeguarding activity, attached.

Ms Sian Walker, Independent Chair of the Devon Safeguarding Adults Board to attend the meeting.

Ms Sian Walker, Independent Chair of the Devon Safeguarding Adults Board, attended and spoke at the Committee to present the Board’s Annual Report.

The Board received the Annual Report of the Devon Safeguarding Adults Board charting progress within Devon of national expectations and safeguarding activity. This included the work of the Devon Safeguarding Adults Board sub groups, including the Operational Delivery Group, Mental Capacity Act (MCA) Group, Safeguarding Adults Review Core Group, Learning and Improvement Group, Themed Workshops and also the launch of the Community Reference Group.

Furthermore, the report outlined the 2017-18 Business Priorities which included improving people’s experiences of safeguarding, promoting independence, awareness and application of MCA, protecting people from harm, awareness of self-neglect, reducing financial abuse and scams, support for families, reducing prevalence of modern slavery & human trafficking and the Prevent agenda.

The Report concluded with the key achievements that had been made with partner agencies including the Police, HM Prison, Clinical Commissioning Groups, Devon, Dorset and Cornwall Community Rehabilitation Company, Probation, NHS and Ambulance etc.

RESOLVED that the report be noted.

Report of the Chief Officer for Communities, Public Health, Environment and Prosperity on a summary of the assurance functions of the Devon and Cornwall Health Protection Committee and reviews performance for the period from 1 April 2016 to 31 March 2017, attached.

The Board received the Annual Health Protection Report of the Chief Officer for Communities, Public Health, Environment and Prosperity for the Health and Wellbeing Boards of Devon, Plymouth, Torbay and Cornwall and the Isles of Scilly.

It provided a summary of the assurance functions of the Health Protection Committee (of the five Health and Wellbeing Boards) on behalf of the five local authorities for the period from 1st April 2016 to the 31st March 2017, considering the domains of health protection, including communicable disease control and environmental hazards, immunisation and screening, health care associated infections and anti-microbial resistance.

The Report summarised the action taken to date against the programme of health protection work priorities established by the committee for the period 2016 to 2017.

Report of the Chief Officer for Communities, Public Health, Environment and Prosperity on the consultation of the Pharmaceutical Needs Assessment 2018 to 2021, attached, which can also be found on the Council’s website at:

http://www.devonhealthandwellbeing.org.uk/board/pharmaceutical-need-assessment/

https://new.devon.gov.uk/haveyoursay/categories/health/

The Board considered a report from the Chief Officer for Communities, Public Health, Environment and Prosperity on the production of the Pharmaceutical Needs Assessment (PNA) which was a comprehensive assessment of the current and future pharmaceutical needs of the local population.

The PNA would be used by NHS England to inform:

• decisions regarding which NHS funded services need to be provided by community pharmacies and dispensing appliance contractors in Devon;
• whether new pharmacies or services are needed;
• decision-making about the relocation of existing pharmaceutical premises in response to applications by providers of pharmaceutical services; and
• the commissioning of locally Enhanced services from pharmacies.

Prior to publication, the PNA must go through a 60-day consultation period.  Consultation on the Devon PNA started on Monday 4th December 2017 via the Devon County Council Have Your Say website and would run until Friday 2 February 2018.

Once the consultation period had ended, a consultation report would be produced and changes to the PNA would be considered.  The final version of the PNA would then be presented and discussed at the Health and Wellbeing Board meeting scheduled for 8 March 2018.  This would enable the 2018-21 PNA to be published on or before the April 1st 2018 deadline.

The Devon PNA and consultation could be found at:

http://www.devonhealthandwellbeing.org.uk/board/pharmaceutical-need-assessment/

https://new.devon.gov.uk/haveyoursay/categories/health/

Joint report of the NEW Devon CCG and South Devon and Torbay CCG on the Local Transformation Plan for supporting the emotional health and wellbeing of children and young people, attached.

The Board received a Report from NEW Devon CCG and South Devon and Torbay CCG on the Local Transformation Plan for supporting the emotional health and wellbeing of children and young people in Devon, presented by the Head of Mental Health Services for both NEW Devon and South Devon and Torbay CCG’s.

NHS England required CCGs to refresh and republish their original plans which were previously considered by the Health and Wellbeing Board.   The Report outlined the planned style and content of the Plan, which was aimed at children and young people, in order to be submitted to NHS England. It had been developed in consultation with 6,000 children and young people across South Devon and Torbay and also 6,000 children and young people across Devon.

The Plan would also be presented to the Plymouth and Torbay Health and Wellbeing Boards.

Members’ questions and discussion points included:

·         the positive work undertaken with young people across the whole county;

·         liaison with the Children and Families Partnership in Devon;

·         work to address mental health problems in children at primary school level; and

·         the need to promote the Plan to all agencies, organisations and young people in Devon.

It was MOVED by Councillor Sanders, SECONDED by Dr Pearson, and

RESOLVED that

(a)  the final version of the Plan be circulated to Members of the Committee next week, and

(b) delegated authority be given to the Chair to endorse the final version of the Plan in order for it to be published by 8 January 2018.

Nil

There were no references from Committee.

In order to prevent duplication, the Board will review the Council’s Scrutiny Committee’s Work Programmes. The latest round of Scrutiny Committees confirmed their work programmes and the plan can be accessed at; http://new.devon.gov.uk/democracy/committee-meetings/scrutiny-committees/scrutiny-work-programme/ , attached.

The Board received a copy of Council’s Scrutiny Committee work programme in order that it could review the items being considered and avoid any potential duplications.

To review and agree the Boards Forward Plan, attached.

The Board considered the contents of the Forward Plan, as outlined below (which included the additional items agreed at the meeting).

RESOLVED that the Forward Plan be approved, including the items approved at the meeting.

No items circulated since the last meeting.

Members of the Board received regular email bulletins directing them to items of interest, including research reports, policy documents, details of national / regional meetings, events, consultations, campaigns and other correspondence. Details were available at; http://www.devonhealthandwellbeing.org.uk/

No items of correspondence had been received since the last meeting.

Please note that dates of future meetings and conferences will be included in the Devon County Council meetings calendar. All will take place at County Hall, unless otherwise stated.

Meetings

Thursday 8^th March 2018 @ 2.15pm

Thursday 14^th June 2018 @ 2.15pm

Thursday 13^th September 2018 @ 2.15pm

Thursday 13^th December 2018 @ 2.15pm

Annual Conference

Thursday 14^th June 2018 @ 9.30am

RESOLVED that future meetings and conferences of the Board will be held on:

Meetings

Thursday 8^th March 2018@ 2.15pm

Thursday 14^th June 2018 @ 2.15pm

Thursday 13^th September 2018 @ 2.15pm

Thursday 13^th December 2018 @ 2.15pm

Annual Conference

Thursday 14^th June 2018 @ 9.30am