Related Documents:
agenda for these minutes
Present:-
Devon County Council
Councillors Barker, Davis (Chairman), Clatworthy and McInnes.
Dr V Pearson (Director of Public Health)
District Council Representative
Councillor Sanders
Environmental Health
Mr R Norley
Northern, Eastern Western (NEW) Devon Clinical Commissioning Group (CCG)
Dr T Burke
Joint Engagement Board
Ms C Brown
Health Watch
Mr D Rogers
Apologies:
Mr T Hogg (Police and Crime Commissioner)
Ms J Stephens (Devon County Council)
Dr D Greatorex (South Devon and Torbay Devon Clinical Commissioning Group (CCG)
Mr J Wiseman ( Probation Service)
Ms L Scott (NHS England)
*181 Minutes
It was MOVED by Councillor Clatworthy, SECONDED by Councillor, and
RESOLVED that the minutes of the meeting held on 11 June 2015 be signed as a correct record.
PERFORMANCE AND THEME MONITORING
*182 Devon Joint Health and Wellbeing Strategy: Priorities and Outcomes Monitoring
The Board considered a report from the Director of Public Health, presented by Mr S Chant (Public Health Specialist Intelligence), on the performance for the Board, which monitored the priorities identified in the Joint Health and Wellbeing Strategy for Devon 2013-2016.
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, and a Devon, South West and England comparison chart for benchmarking purposes.
The Board received an updates only version of the Health and Wellbeing Outcomes Report. The report was themed around the four Joint Health and Wellbeing Strategy 2013-16 priorities and included breakdowns by local authority, district, clinical commissioning group, inequalities characteristics and trends over time. The indicators relating to Teenage Conception Rate, 2014 Q1, Hospital Admissions for Self-Harm, Aged 10 to 24, 2013-14, Proportion of Physically Active Adults, 2014, Alcohol-Related Admissions, 2014-15 (narrow and broad definitions), Incidence of Clostridium Difficile, 2014-15 and Feel Supported to Manage Own Condition, 2014-15 Q3-Q4 had all been updated since the last report to the Board.
Following approval at a previous meeting, a Red, Amber, Green (RAG) rating was included in the indicator list and a performance summary on page 2 of the full report. Areas with a red rating included hospital admissions for self-harm, aged 10-24.
The report also highlighted that, in due course, it would contain a summary of emerging themes from the Devon Child Sexual Exploitation (CSE) scorecard. The scorecard was being developed by the CSE sub-group of the Devon Safeguarding Children Board (DSCB), with input from relevant partners. A senior information analyst from the Public Health Intelligence Team had been seconded to act as lead analyst for CSE data. The first version of the scorecard had just been drafted and would be available in late September and produced thereafter on a quarterly basis.
The outcomes report was also available on the Devon Health and Wellbeing website www.devonhealthandwellbeing.org.uk/jsna/health-and-wellbeing-outcomes-report
The Board, in discussion,
clarified reasons for the lower level of dementia diagnosis rates;
noted that the measures for dementia diagnosis rates were under national review;
considered the importance of appropriate care and support, post diagnosis, which was critical;
questioned the gender disparities in relation to hospital admissions for self harm and whether any further breakdowns were available; and
whether there were any plans by commissioners to address the gender differences highlighted by the figures.
It was MOVED by Councillor Davis, SECONDED by Dr Pearson, and
RESOLVED
(a) that the performance report be noted and progress with the Child Sexual Exploitation scorecard be welcomed; and
(b) that Members of the Board be sent a further breakdown of statistics in relation to the gender figures and self harm hospital admissions.
*183 Theme Based Report Good Health in Older Age
The Board considered a report from the Director of Public Health on the promoting good health and wellbeing in older age priority, as detailed in the Joint Health and Wellbeing Strategy.
The importance of promoting good health and wellbeing in older age is well known and of particular importance in Devon due to the higher proportion of older people living and working in Devon. The Devon Joint Strategic Needs Assessment (2015) highlighted forward projections of future growth in the older population and the reduction in the younger working age population. This had major implications for care and support.
Analysis of the Joint Strategic Needs Assessment identified the priorities of reducing falls and fractures in older people, raising awareness of dementia in communities and identifying hidden carers. In addition, the Joint Health and Wellbeing Strategy update in 2013 added the additional priority of end of life care and the following additional actions of, producing an end-of-life care integrated pathway, promoting healthy lifestyle advice for people with dementia, implementation of the carers strategy and the undertaking of a sight loss/ visual impairment health needs assessment.
In terms of progress against outcomes, the report contained an analysis of relevant outcomes measures from the Devon health and wellbeing outcomes report and was set out in table form and included performance measures of incidences of clostridium difficile, injuries due to falls, dementia diagnosis rate, feeling supported to manage own condition, reablement services (effectiveness), reablement services (coverage) and re-admissions to hospital within 30 days.
In summary, the report outlined that Devon was expected to experience the greatest population growth in the older age groups and for this reason Good Health and Wellbeing in Older Age was an important priority locally. There were approximately 181,600 people aged 65 and over in Devon, of which 15,600 were supported by social care (JSNA 2015).
The focus of prevention in older age was around healthy active ageing and supporting independence so that older people were able to enjoy longer healthy lives, felt safe in their homes and were connected to their community.
The Board also viewed a short film, produced by Teignbridge District Council, which highlighted the emotional and psychological effects of falls, spoken by those in the film, outlining impacts on confidence levels and general wellbeing.
The Board discussed the following in terms of
the role of the new Prevention Board, being chaired by Dr Norrey (Chief Executive of Devon County Council);
the work being done to avoid admissions to hospital;
the role of care plans and understanding patient / people preferences to help avoid admissions;
clarification on the systems that paramedics had access to (for example patient preferences) and whether this was appropriately joined up ;
whether any analysis had been conducted on the correlation between slips, trips and falls and poor housing conditions and / or areas of deprivation;
the current work by Healthwatch, with hospices and in conjunction with Cornwall, on end of life care;
whether there was a role in Devon with regard to Admiral nurses for dementia;
the current pilot with Devon Fire and Rescue, combining fire advice with a home check, particularly focusing on those issues that could cause falls and slips; and
the key themes arising from the discussion that pointed towards investment in community services, reablement and demand management (to help people help themselves) and the transparency of records;
It was MOVED by Councillor Davis, SECONDED by Councillor Clatworthy, and
RESOLVED
(a) that the future format of themed reports be discussed at the Health and Wellbeing Board Development Day on 8 October 2015; and
(b) that further information be brought to the Board in respect of any work or analysis on the correlation between housing, deprivation and slips, trips and falls.
BOARD BUSINESS - MATTERS FOR DECISION
*184 Joint Commissioning in Devon, the Better Care Fund (BCF) and Governance Arrangements)
The Board considered a joint report from Mr T Golby (Head of Social Care Commissioning, Devon County Council) and Mr P O Sullivan (Director of Partnerships, NEW Devon CCG) on current progress with the Better Care Fund.
The purpose of this fund was a drive towards integration and a seamless service user / patient experience being at the forefront of developments around health and social care. The key areas of focus were prevention and independence, crisis response and regaining independence.
The report outlined that the Better Care Fund 2015 /16 First Quarter Return had been submitted to the national BCF programme. The return built on the previous return that the Board had agreed at its last meeting. It provided data and details in relation to a number of items including the National conditions, Performance information regarding Non Elective Admissions and the Pay for Performance target, an update on how Income and Expenditure was being handled and a progress report on Dementia Diagnosis.
The quarterly data collection also required submission of a written narrative that contained any additional information regarding progress against the plan. The narrative was included as part of the Board papers.
In addition, each month a summary performance report was produced for the whole of Devon and the latest version was also attached to the papers.
The Board was asked to note that the BCF Delivery Group had open actions in place intended to address the issues related to delayed transfers of care and non-elective admissions. both of which were supported by the current operational plans of both NEW Devon and South Devon Torbay CCG.
The Board was further asked to endorse the Chairs recent delegated decision to sign off the latest data validation return for Better Care Fund (Min 168b).
In signing off the return the Board agreed to the use of NHS Monthly Activity Report (known as MAR), that no Quarter 4 payment was due, that no Quarter 4 Payment was made and the difference between the CCG Operational Plans including QIPP savings and the BCF Performance Target was less than 2% and, as such, national guidance states that the original BCF performance target of 3.5% should not be changed.
The Board discussed and asked questions on the following;
whether delays in TTA s were still happening (medication to take away on discharge from hospital) and what actions were being taken to address this, for example delays in dispensing by hospital pharmacies etc;
the work of the Strategic Resilience Group in assuring internal processes were operating as they should, including the issues raised with TTA s; and
the role out of the computerisation programme within the NHS which should see improvements, especially with electronic prescribing.
It was MOVED by Councillor Sanders, SECONDED by Councillor McInnes, and
RESOLVED
(a) that recent delegated decision made by the Chairman to sign off the latest data validation return for Better Care Fund (Min 168b), be endorsed; and
(b) that the quarterly reports, required by the Board, be welcomed.
*185 Annual Health Protection Report
The Board considered a report from the Director of Public Health which provided a summary of the assurance functions of the Health Protection Committee and also the actions taken in relation to the programme of health protection work priorities for 2014 to 2015.
The report considered the following domains of health protection:
Communicable Disease Control and Environmental Hazards (which included information and actions around organisational roles/responsibilities, surveillance arrangements, outbreak of E.coli VTEC, tuberculosis incident in a Devon School, norovirus 2013-14, scarlet fever 2014-15 and seasonal influenza);
Immunisation and Screening (considering organisational roles/responsibilities, surveillance arrangements, immunisation activity and changes to the National Immunisation Programme 2014-15, screening, information sharing and seasonal influenza); and
Health Care Associated Infections (including the work of the Health Care Associated Infection Programme Group, clostridium difficile infection (CDI), MRSA, other outbreaks, other bacteraemias, exercise Cygnus and also national issues such as the Ebola virus disease).
The report concluded with an outline of the Work Programme for 2015-16, which included a Tuberculosis strategy, Influenza immunisation, Hepatitis C strategy review, Screening, Bacteraemias and Emergency planning including a further pandemic flu exercise in the autumn, Exercise Mallard.
The Board discussed and asked questions on the following;
the welcome news that Local Authorities had been working with Public Health England to produce guidance for the hospitality industry (following a recent norovirus investigation);
the low take up of the flu vaccination for pregnant women and the forthcoming campaign to address this issue; and
the need to recognise the large scale co-ordination required by GP s surgeries to conduct immunisation programmes to all eligible people, including newer vaccinations such as the one for shingles.
It was MOVED by Councillor Davis, SECONDED by Councillor McInnes, and
RESOLVED that the report and forthcoming work programme be welcomed.
*186 Adult Safeguarding - Vulnerable Adults Mental Health Crisis Care
The Board considered a report from the Head of the Adults Safeguarding Board which outlined a summary and key learning points in relation to the recent thematic review into vulnerably adults mental health crisis care.
The review was commissioned by the Safeguarding Adults Board to consider any underlying or cross cutting themes that existed within three cases that had occurred within six months of each other but were otherwise unrelated (a suicide, a murder and a dispute on arranging safe transport).
A number of themes were identified during the review which included the quality and timeliness of assessment at the point of crisis, inter-agency communication, sharing of risk information, co-location and informal information exchange, mental health services discharge processes, joint agency training and understanding, multi agency participation in root cause analyses and duty of candour and clarity of RCA reports for service users and families.
Since the review (and during the progress) some of the identified issues had started to be addressed by developments in national or local policy and practice. The report then outlined the further progress since the review, linked to each of the themes identified above.
The Board discussed
that feedback from the review raised information governance issues with regard information sharing and the need for pro-active sharing of information across agencies and professionals; and
the huge human impact of the cases, demonstrating the need to get it right .
It was MOVED by Councillor Davis, SECONDED by Councillor Sanders, and
RESOLVED that the review, learning points and subsequent action plan be welcomed.
*187 Transformation Plans (CAMHS)
The Board received a joint presentation from NEW Devon CCG and South Devon and Torbay CCG in relation to the CAMHS Transformation Plans. All the CCGs, local authorities and service providers were adopting a system wide approach to transformation and, in doing so, were recognising current services and needs would be different in different parts of the geography, whilst also looking to achieve a consistent system vision and outcomes over the course of the plans.
The presentation outlined the key messages received from children and young people which raised consistent themes around spanning information, preventing crisis, help in a crises, easy access services and a workforce that listened and treated people with respect. It also presented the Board with the needs and considerations locally, outlining the geographical issues in delivering services. In the last year, there had been 3709 referrals to CAMHS and there were approximately 115 young people with eating disorders.
The CAMHS agenda was reported as very important as a local agenda and there was much good practice to build upon. However, the presentation outlined the aspirations for the future which included evidence based models designed around children, a whole systems approach, the wider workforce as a focal point for transformation, clear outcomes and the use of interventions that were both effective and evidence based.
The presentation then outlined the main priorities, highlighted as:
Early intervention (working with partners and peers, early intervention with support at Tier 1 and 2 and working with adult providers for all age pathways)
Crisis response (implement the requirement of MH Crisis Concordat, timely front door response in acute crisis 24/7 and assertive outreach over extended hours)
Children in care (remodelling the CiC (Children in Care) pathway, enhanced evidence based therapeutic interventions and multi-agency support for children on the edge of care); and
Specific services (embed the self harm evidence pathway and extending eating disorders model across Devon and Plymouth in line with the evidence base)
The presentation concluded with the Governance Plans and expectations of what young people should expect in terms of timely access, choice over support, control over the services received, integrated support, services in line with best practice, involvement in planning and the opportunity to influence.
(a) South Devon and Torbay CCG
The Board considered a report from South Devon and Torbay CCG outlining that Clinical Commissioning Groups had been given funding allocations by NHS England to support transformational change in local CAMHS services.
The SDT CCG had been working with CAMHS providers, patients/ parents and NEW Devon CCG to outline the changes needed. Plans were for 5 years and had to show a distinct service for eating disorders as well as looking to meet the priorities outlined within Future In Mind . As part of the assurance process, the support of the Board was sought to confirm agreement to the proposed priorities and also the anticipated outcomes.
The report outlined the ambitions of the CCG which were;
reduce the number of presentations to AE for those in crisis (would be predominately those with significant self harm);
reduce the number of admissions to secondary care for eating disorders and for those in crisis (would be predominately those with significant self harm);
reduce and maintain shorter treatment times for those with eating disorders by increasing dietetic and paediatric support, building on the existing nationally recognised good practice pathway;
reduce the number of admissions to Tier 4 beds for all conditions;
support core CAMHS services with recognition that transformational change had already taken place by drawing on core funding; and
work with schools to build resilience, to more effectively support children between the ages of 2-5 years and look at more robust autism assessment services (dependent on financial capacity and resources)
The report also outlined further plans in relation to eating disorders and the existing hub and spoke model, the crisis and intensive home intervention service and how resilience might be provided through a peer support service (via Young Devon) and also to improve the offer to Looked After Children in line with the new NHSE guidance.
The Board expressed concern over the potential development of a peer support service and increasing online counselling through Young Devon, given the Council had just co-commissioned a new service with schools which was needs- and evidence-based and had been developed with a considerable amount of work over the last 18 months. The Board requested this was reconsidered as there could be potential duplication and also result in inequality in service provision across Devon. It was also noted that of the existing CAMH service provision, there was still a gap at tier 2/3 level (Primary Mental Health Workers) which should be addressed by the additional NHS funding and which would consequently reduce the pressure on tier 3 and 4 (specialist) CAMH services.
It was MOVED by Councillor Davis, SECONDED by Councillor Clatworthy, and
RESOLVED that, subject to reconsideration of the peer support proposal, the Board endorse the outline priorities, as outlined in the report, and also give delegated authority to the Chair of the Board to approve the final plan, which was required to be signed off by 16th October 2015.
(b) NEW Devon CCG
The Board considered a report from NEW Devon CCG which, firstly, outlined the initial objectives, by NHS England, of the transformation programme which included developing eating disorder services for children and young people, rolling out the Children and Young People s Improve Access to Psychological Therapies Programme (IAPT) and improving access to perinatal care. As part of the programme, local Transformation Plans for each Clinical Commissioning Group (CCG) area had to be developed.
The local Transformation Plans had to be underpinned by the input of children and young people themselves and also partnership working across the system which included the completed plans being signed off by Health and Wellbeing Boards.
The report described the planning requirements, including assurance processes, set out the scope, design features and resource framework, outlined the local process for developing the Transformation Plan and proposed an approach for Health and Wellbeing Board engagement and sign off.
There were a whole host of criteria which CCG s needed to demonstrate in terms of producing their plans. These were outlined in detail in the report and included, inter alia, having been built around the needs and mental health needs of children and young people, evidence of effective joint working, reference to other improvement initiatives, promoting collaborative commissioning approaches within and between sectors, include spending and investment by all partners, publication of the plans on relevant websites, demonstrate how health inequalities would be addressed, include workforce information, have measurable KPI s and must have been costed and aligned to the funding allocation.
It was noted by the Board that both NEW Devon and Southern Devon and Torbay CCG s had to submit local Transformation Plans and they were looking at areas within the plans where there were benefits of working together.
It was MOVED by Councillor Davis, SECONDED by Dr Pearson, and
RESOLVED that the proposed priorities, framework and assurance mechanisms be endorsed and the Board agree that delegated authority be given to the Chair to authorise the final sign off in order to meet the submission date of 16 October 2015 (noting that the plan is a living document and would continue to be updated).
*188 NEW Devon CCG Update (including Transforming Community Services)
The Board received a presentation from NEW Devon CCG which updated Members on the following issues:
the Monitor investigation and the findings of the CCG s Eastern Locality community services procurement (Monitor launched its investigation in January 2015, following a complaint by Northern Devon Healthcare NHS Trust (NDHT) over the CCG s decision to name the Royal Devon and Exeter NHS Foundation Trust (RDEFT) as its preferred provider);
Sidwell Street (Exeter) Walk in Centre and Urgent Care review (whilst the public support for walk-in centre in Exeter was acknowledged, the review was on hold pending national guidance);
Improving Quality, Innovation and Productivity (there were 29 active projects within the 2015/16 Quality, Innovation, Productivity and Prevention (QIPP) programme and also an update on the Right Care initiative major initiative for continuous service review and improvement);
Success Regime (preparatory work was under way for the start of the Success Regime and the CCG were one of three health systems involved in the first wave of SRs);
NHS England directions (the directions were issued following the quarter three review in 2014/15 and came into effect on 10 August 2015, giving NHS England a greater support / monitoring role over the CCG s performance and financial recovery. The majority of the actions in the directions had been completed)
Accessing patient information at the point of care (the CCG had 73 GP practices signed up to share records digitally which meant GPs could electronically share information with fellow clinicians outside their surgery, which avoided time consuming phone calls and paper chases).
There was also an open invitation for members of the Board to attend the annual general meeting of the CCG, on Wednesday 30 September 2015 at the Westpoint Centre in Clyst St Mary.
The Board discussed
how potential links could be made with medical providers and personal care providers;
how public health and the social care sector would be involved in the success regime; and
whether clarification could be given in relation to the current position with North Devon, the Community Hospitals Consultation and provision in other parts of the County.
It was MOVED by Councillor Davis, SECONDED by Dr Pearson, and
RESOLVED that Dr Burke be thanked for his presentation and that a copy be made available to Board Members.
OTHER MATTERS
*189 References from Committees
Nil
*190 Scrutiny Work Programme
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.
*191 Forward Plan
The Board considered the contents of the Forward Plan, as outlined below (which included the additional items agreed at the meeting).
| Date | Matter for Consideration |
| Thursday 12 November 2015 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Theme Based Report (Strong and Supportive Communities) Business / Matters for Decision Better Care Fund Care Act Implications CCG Updates Joint Commissioning Strategies Actions Plans (Annual Report) Prevention Strategy Update (Minute 169) Children s Safeguarding annual report (Annually September moved from Sept) Child Sexual Exploitation Multi-Agency Working (DT / JS) Adults Safeguarding Annual Report NEW Devon CCG Personal Medical Services Other Matters Scrutiny Work Programme / References Board Forward Plan Briefing Papers, Updates Matters for Information |
| Thursday 14 January 2016 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Theme Based Report (Children, Young People and Families) Business / Matters for Decision Better Care Fund CCG Updates Delivering Integrated Care Exeter (ICE) Project Annual Update Other Matters Scrutiny Work Programme / References Board Forward Plan Briefing Papers, Updates Matters for Information |
| Thursday 10 March 2016 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Theme Based Report (Healthy Lifestyle Choices)
Business / Matters for Decision Better Care Fund CCG Updates
Other Matters Scrutiny Work Programme / References Board Forward Plan Briefing Papers, Updates Matters for Information
|
| Thursday 9 June 2016 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Theme Based Report (Review / Joint Health and Wellbeing Strategy / JSNA) Business / Matters for Decision Better Care Fund CCG Updates Other Matters Scrutiny Work Programme / References Board Forward Plan Briefing Papers, Updates Matters for Information
|
| Thursday 8 September 2016 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Theme Based Report (TBC) Business / Matters for Decision Better Care Fund CCG Updates Other Matters Scrutiny Work Programme / References Board Forward Plan Briefing Papers, Updates Matters for Information
|
| Thursday 10 November 2016 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Theme Based Report (TBC) Business / Matters for Decision Better Care Fund CCG Updates Other Matters Scrutiny Work Programme / References Board Forward Plan Briefing Papers, Updates Matters for Information
|
| Thursday 12 January 2017 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Theme Based Report (TBC) Business / Matters for Decision Better Care Fund CCG Updates Other Matters Scrutiny Work Programme / References Board Forward Plan Briefing Papers, Updates Matters for Information
|
| Thursday 9 March 2017 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Theme Based Report (TBC) Business / Matters for Decision Better Care Fund CCG Updates Other Matters Scrutiny Work Programme / References Board Forward Plan Briefing Papers, Updates Matters for Information
|
|
Items to Add | Equality protected characteristics outcomes framework Winterbourne View (Exception reporting) |
RESOLVED that the Forward Plan be approved, including the items approved at the meeting.
*192 Briefing Papers, Updates and Matters for Information
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/
Items of interest included;
(a) a briefing note regarding the All the Moor Butterflies project, on Dartmoor, by Butterfly Conservation, which highlighted links between the project and the Health and Wellbeing Strategy and identified the Board as a consultee for the work; and
(b) a letter from Torridge District Council's External Overview Scrutiny Committee meeting which had included a recent resolution from that Committee to contact all those involved in providing the 'care closer to home' service including third sector and other providers; to seek assurance that the 'care' element be put in place as a complete health care package; and to recommend that all sections of care and health providers work closely together to provide a holistic integrated seamless service
RESOLVED that the items of correspondence be noted.
*193 Dates of Future Meetings
RESOLVED that future meetings of the Board will be held on
Thursday 12th November 2015 @ 2.00pm
Thursday 14th January 2016 @ 2.00pm
Thursday 10th March 2016 @ 2.00pm
Thursday 9th June 2016 @ 2.00pm
Thursday 8th September 2016 @ 2.00pm
Thursday 10th November 2016 @ 2.00pm
Thursday 12th January 2017 @ 2.00pm
Thursday 9th March 2017 @ 2.00pm
*194 Dates of Future Seminars
Thursday 8th October 2015 @ 1.30pm 4.00pm (Note revised start time)
Thursday 11th February 2016 @ 10.30am 4.00pm
Thursday 13th October 2016 @ 10.30am 4.00pm
Thursday 9th February 2017 @ 10.30am 4.00pm
The Chairman reminded the Board that an LGA facilitator would be attending the Development Session on 8th October 2015.
*DENOTES DELEGATED MATTER WITH POWER TO ACT
The meeting started at 2.00pm and finished at 4.47pm.
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NOTES: 1. Minutes should be read in association with any Reports or documents referred to therein, for a complete record. 2.The Minutes of the Board are published on the County Council s website at http://www.devon.gov.uk/index/councildemocracy/decision_making/cma/index_hwb.htm 3. A recording of the webcast of this meeting will also available to view for up to six months from the date of the meeting, at http://www.devoncc.public-i.tv/core/portal/home |