Related Documents:
agenda for these minutes
Present:-
Devon County Council
Councillors Barker, Clatworthy, Davis (Chairman) and McInnes
Dr V Pearson (Director of Public Health) and Ms J Stephens (Strategic Director People)
Environmental Health
Mr R Norley
South Devon and Torbay Devon Clinical Commissioning Group (CCG)
Dr D Greatorex (items 5 10)
Northern, Eastern Western (NEW) Devon Clinical Commissioning Group (CCG)
Dr T Burke
Joint Engagement Board
Mrs C McCormack Hole (representing Mrs C Brown)
Health Watch Devon
Mr D Rogers
District Council Representative
Councillor Sanders
Apologies:
Ms L Scott (NHS England), Mr T Hogg (Police and Crime Commissioner), Mrs C Brown (Joint Engagement Board) and Mr J Wiseman (Probation Service)
*228 Minutes
It was MOVED by Councillor Sanders SECONDED by Councillor Clatworthy, and
RESOLVED that the minutes of the meeting held on 14 January 2016 be signed as a correct record.
PERFORMANCE AND THEME MONITORING
*229 Devon Joint Health and Wellbeing Strategy: Priorities and Outcomes Monitoring
The Board considered a report from the Director of Public Health 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. In terms of benchmarking, the local authority comparator group had been updated to reflect the latest designations, with Cambridgeshire and Hampshire being removed and Staffordshire and Suffolk added.
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 below had all been updated since the last report to the Board;
Alcohol-Related Admissions, 2015-16 Q2 (narrow and broad definitions);
Injuries Due to Falls, 2014-15;
Feel Supported to Manage Own Condition, 2015-16 Q1-Q2;
Male Life Expectancy Gap (2012-2014); and
Female Life Expectancy Gap (2012-2014)
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 (Figure 1) of the full report. Areas with a red rating included hospital admissions for self-harm aged 10-24.
Furthermore, figure 2, summarised the outcomes against the four themes of the Devon Joint Health and Wellbeing Strategy, including highlighting the current position with trends on child poverty levels, recorded levels of child development, smoking at delivery, conception rates and self-harm admissions in younger people, levels of physical activity, levels of excess weight, alcohol-related admissions rate, adult smoking rates, mortality rates, clostridium difficile incidents, detection of dementia, injuries due to falls, re-ablement service effectiveness, re-admission rates, suicide rates, life expectancy, quality of life for carers and mental health issues.
The report also featured a table (figure 3) showing how Devon compared with the Local Authority Comparator Group (LACG) for all Health and Wellbeing outcome measures (January 2016). This included how Devon compared / performed against both the LACG and England and their rank position.
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, highlighted and asked questions on;
the re-ablement data and clarification on the variation in figures, including the impact (if any) of rurality and the ongoing work to extend the service, including recruitment and redeployment to progress the initiative;
whether any analysis could be undertaken on the use of the service in areas both with and without community hospitals to consider any impact;
clarification on what commissioners were doing regarding the priorities marked as red including commissioning intentions, mental health services and the associated plan for 2017 and the work within the success regime which put mental health services as a core strand within other services (e.g. acute care), rather than a stand alone provision;
the life expectancy gap of both males and females, the volatility associated with the male figures and also the spikes in numbers for both Exeter and North Devon;
the low prevalence of falls in the North Devon / Torridge area and the work of a dedicated team in this area, including in reach into care homes; and
the work of the filo project and the great benefits that were being realised from this model.
It was MOVED by Councillor Davis, SECONDED by Dr Pearson, and
RESOLVED that the performance report be noted and accepted.
*230 Theme Based Report Healthy Lifestyle Choices
The Board received a report from the Director of Public Health on the Healthy Lifestyle Choices priority, as detailed in the Joint Health and Wellbeing Strategy, which was centred on informing, enabling and supporting people to take responsibility for their own health and health of their family (and people in their care), through addressing any lifestyle choices which were likely to be detrimental to current and/or future health, for example, eating healthy food, moving more every day, not smoking, not drinking alcohol excessively and being mindful of mental health and wellbeing.
The report highlighted that non-communicable diseases such as coronary heart disease, lung cancer, stroke and liver disease were the leading cause of premature mortality and ill-health, therefore individual, community and service provided preventive action was important.
In addition, health inequalities accounted for huge variation in both mortality and morbidity rates (e.g. multi-morbidity in the most deprived areas could be experienced 10-15 years earlier than the least deprived areas). Figure 1 in the report highlighted the relationship between deprivation and health-related behaviours and health and social outcomes.
Analysis of the Joint Strategic Needs Assessment identified the priorities for this overarching objective as alcohol misuse, contraception and sexual health, screening, physical activity, healthy eating and smoking cessation and also high blood pressure.
The report set out an analysis of relevant outcomes measures from the Devon Health and Wellbeing Outcomes Report, covering all the relevant indicators under the priority healthy lifestyle choices and giving a more detailed analysis of those indicators below;
Physically Active Adults;
Excess Weight in Children aged Four or Five;
Alcohol-Related Admissions;
Adult Smoking Prevalence;
Under 75 Mortality: All Cancers; and
Under 75 Mortality: Circulatory Diseases
In summary, the report outlined that Healthy lifestyle choices was a broad theme requiring long-term and sustained action. It also reported on the new ways of informing, enabling and supporting people to make changes such as the new Healthy Lifestyle Offer, the work with the Local Nature Partnership and further work on Naturally Healthy Week during May. Lastly, the Public Health England, One You campaign was launched on Monday 7th March 2016.
The Board also watched Kath s Story , which focused upon improvements in health and life through quitting smoking, the clip could be found at;
https://www.youtube.com/watch?v=HFwNLOJ5Ldgfeature=youtu.be
The Board discussed and asked questions on the health inequalities, as outlined in the report, the role of alcohol as a big future issue for the Board (alcohol abuse being a problem for the more affluent in society as well as in areas of great deprivation), that future priorities would feature mental health far more prevalently than was currently the case, based on stakeholder feedback and the launch of the recent quiz how are you which the Chairman extolled Members of the Board to undertake.
BOARD BUSINESS - MATTERS FOR DECISION
*231 Integrated Personal Commissioning
The Board considered a report from NEW Devon CCG which highlighted that the CCG, the County Council, Plymouth City Council along with a number of local voluntary and community sector organisations, had formed part of the only successful regional demonstrator site for Integrated Personal Commissioning (IPC) in England. The report gave an overview of the IPC from a national, regional and local perspective.
The Board was being asked to review and agree the recommended local and regional governance relationships proposal of the programme and also consider the outlined proposals regarding its role in providing leadership, engagement and input into the development and progress of the programme from both a strategic and cross organisational viewpoint.
By way of a background, the IPC programme was first outlined in June 2014 and was in addition to the Better Care Fund, year of care NHS commissioning, personal health budgets, social care personal budgets and the early experience of fourteen integrated care pioneers. The programme provided a delivery vehicle for integration and personalisation, sitting alongside new models of care vanguards amongst other change programmes (e.g. Transforming Care, Special Education Needs) that the Five Year Forward View introduced.
The goals of the programme were;
people with complex needs and their carers to have a better quality of life, allowing them to achieve outcomes important to them / their families through greater involvement in their care, designed around their needs;
prevention of crises (that led to unplanned hospital visits and institutional care) by keeping people well and supporting self-management; and
better integration and quality of care, including better user and family experiences of care.
The programme was therefore aimed at groups of individuals who had high levels of need (usually health and social care needs), such as children / young people with complex needs, those with multiple long-term conditions (including frailty), learning disabilities and also people with significant mental health needs.
Then Board received a supporting presentation outlining the key aspects of the programme including the care and financial models, progress at implementation sites, governance frameworks, various work streams (e.g the Right Skills Group, Person Led Care and Support Workstream, Finance and Commissioning Workstream), the work to involve others, management and evaluation and also how personal budgets could help with learning disability, continuing healthcare, children and young people, long term and mental health conditions.
A short film was also shown, Johnathans Story , which could be seen at; https://www.youtube.com/watch?v=9xw6pWJV0kQ which demonstrated moving from institutionalised care towards a personal health budget.
The Board asked that a number of factual amendments be made to the report, including, inter alia, the reference to publically funded adult social care support and personal budgets (P.20), the reference to the Joint Health and Wellbeing Strategy (P.21) and the reference to NEW Devon Health and Wellbeing Board.
Furthermore, the Board recorded their concerns over the lack of clarity regarding Governance structures and also the Boards role within those structures, including the suggestion of the appointment of an IPC senior officer in each appropriate organisation.
It was MOVED by Councillor Davis, SECONDED by Councillor Sanders, and
RESOLVED that whilst the key aims and ambitions of the project were, in the main, supported, further work was required on the role of the Board in the Governance Structures currently proposed, therefore a further report be brought back to the Board on 8 September 2016.
*232 South Devon and Torbay CCG Activities and Progress
The Board received a verbal update from Dr Greatorex (South Devon and Torbay CCG) on the various activities, projects and programmes that had been happening within the locality.
This included an update on the sustainability and transformation footprint (as part of the five year forward view). As part of that forward view, the CCG were participating in the right care programme (which looked at how services were delivered, including comparisons with other areas and learning good practice to improve service delivery).
Work was also underway on Community Development, which involved working across organisations (including the new integrated trust) and looking at new models of care, from a community perspective, including the work of multi-agency teams.
Further updates included looking at the development of urgent care centres (essentially Minor Injuries Units with increased facilities such as extended periods and diagnostic services), the use of Community Medical Beds, work to improve Intermediate Care including the merge of rapid and crisis response teams and a focus on the concept of wellbeing co-ordination services.
The Board noted that a series of public consultations would take place on the changes (starting in May 2016 over a twelve week period).
OTHER MATTERS
*233 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.
*234 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 8 September 2016 @ 2.00pm | Performance / Themed Reporting Health Wellbeing Strategy Priorities and Outcomes Monitoring Review / Refresh of Joint Health and Wellbeing Strategy / JSNA) Survey / New Service (MH / emotional wellbeing in young people) Business / Matters for Decision Better Care Fund frequency of reporting TBC Integrated Personal Commissioning (minute 231) 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) Mental Health and Young People (Min 218) Business / Matters for Decision Better Care Fund - frequency of reporting TBC 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 - frequency of reporting TBC 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 - frequency of reporting TBC CCG Updates Other Matters Scrutiny Work Programme / References, Board Forward Plan, Briefing Papers, Updates Matters for Information |
| Annual Reporting | Children s Safeguarding annual report (September / November) Adults Safeguarding annual report (September / November) Joint Commissioning Strategies Actions Plans (Annual Report - November) |
|
Other Issues | Equality protected characteristics outcomes framework Winterbourne View (Exception reporting) |
RESOLVED that the Forward Plan be approved, including the items approved at the meeting.
*235 Dates of Future Meetings and Seminars
RESOLVED that future meetings of the Board will be held on
Board Meetings
Thursday 8th September 2016 @ 2.00pm
Thursday 10th November 2016 @ 2.00pm
Thursday 12th January 2017 @ 2.00pm
Thursday 9th March 2017 @ 2.00pm
Board Seminars
Thursday 9th June 2016 @ 2.00pm
Thursday 13th October 2016 @ 10.30am 4.00pm
Thursday 9th February 2017 @ 10.30am 4.00pm
*DENOTES DELEGATED MATTER WITH POWER TO ACT
The meeting started at 2.00pm and finished at 3.50pm.
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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. 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 |