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Agenda and minutes

Venue: County Hall, Topsham Road, Exeter, EX2 4QD

Contact: Karen Strahan 01392 382264  Email: karen.strahan@devon.gov.uk

Media

Items
Note No. Item

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1.

Election of Chairman

Additional documents:

Minutes:

RESOLVED that Councillor Davis be elected Chairman for the ensuing year.

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2.

Election of Vice Chairman

Additional documents:

Minutes:

RESOLVED that Dr T Burke be elected Vice Chairman for the ensuing year.

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3.

Minutes pdf icon PDF 105 KB

Minutes of the meeting held on 10 March 2016, attached.

Additional documents:

Minutes:

It was MOVED by Councillor Clatworthy, SECONDED by Mr Norley and

 

RESOLVED that the minutes of the meeting held on 10 March 2016 be signed as a correct record.

           

 

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4.

Items Requiring Urgent Attention

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

Additional documents:

Minutes:

There were no items requiring urgent attention.

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5.

Devon Joint Health and Wellbeing Strategy: Priorities and Outcomes Monitoring

Report of the Director of Public Health (PH/16/23), which reviews progress against the overarching priorities identified in the Joint Health and Wellbeing Strategy for Devon 2013-2016.

 

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

Additional documents:

Minutes:

The Board considered a report from the Director of Public Health (PH/16/23) 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.

 

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 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;

 

·         Smoking at Time of Delivery, 2015-16;

·         Teenage Conception Rate, Q2 2015;

·         Proportion of Physically Active Adults, 2015;

·         Alcohol-Related Admissions, 2015-16 provisional (narrow and broad definitions);

·         Adult Smoking Prevalence 2015;

·         Incidence of Clostridium Difficile, 2015-16; and

·         Percentage who feel supported to manage condition, 2015-16.

 

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, again demonstrating the importance of investing in services that supported emotional wellbeing.

 

The report also featured a table showing how Devon compared with the Local Authority Comparator Group (LACG) for all Health and Wellbeing outcome measures (September  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;

 

  • clarification of the recording of self harm incidents, particularly in acute units and also the recording of self harm in young people, with the reference in the JSNA and the Councils responsibilities to children in care;
  • alcohol admissions and whether there was any evidence of where alcohol was being purchased and / or consumed and that further work would be undertaken on this;
  • concern over the waiting times for CAMHS services, particularly counselling services and that an update report was being presented to the Peoples Scrutiny Committee in November 2016; and
  • what actions were being taken to address the ‘red’ rated outcomes measures.

 

The Board further noted that a report would be presented to the Board in December in relation to mental health services, which would include social isolation issues and suicide rates.

 

In addition, a refresh of the Childrens and Young Peoples Strategy which included the Childrens Alliance Strategy was being undertaken and the Board would consider the content of this in due course.

 

RESOLVED that the performance report be noted and accepted.

 

 

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6.

Review of Joint Strategic Needs Assessment

Report of the Director of Public Health on the refresh of the Joint Strategic Needs Assessment (JSNA) (PH/16/24), attached.

 

The full JSNA can be found at http://www.devonhealthandwellbeing.org.uk/jsna/overview/draft-2016/, but a copy is attached for Board Members.

 

Additional documents:

Minutes:

The Board considered a report from the Director of Public Health (PH/16/24) on the updated Joint Strategic Needs Assessment (JSNA) Devon Overview for 2016.

 

This Devon overview looked at the overall pattern of health and care needs in the county, including the impact of population change, deprivation and economic conditions.

 

The draft 2016 JSNA Devon Overview was also available at:

http://www.devonhealthandwellbeing.org.uk/jsna/overview/draft-2016/

 

JSNA Devon Overview 2016 used the same document structure as the 2015 overview and

Included updates to text, tables and figures. Although new information added in 2016 included:

 

·         a population overview for the new town of Cranbrook;

·         further breakdowns of outcomes measures by equality and diversity characteristics;

·         maps and deprivation analyses drawn from the 2016 JSNA area profiles;

·         an expanded deprivation section drawing on the Indices of Deprivation 2015;

·         further information in the Children, Young People and Families section on education, healthy lifestyles, disability, and children in care;

·         more information in the Older People section relating to healthy life expectancy, frailty, visual impairment, social isolation and loneliness, and end of life care; and

·         the main health and wellbeing challenges in Devon.

 

The document concluded with a summary of the main health and wellbeing challenges in Devon.  The challenges highlighted in the 2015 assessment remained, but there were an additional four challenges relating to new towns/developments, housing, loneliness and frailty.

 

It was important that the Board noted the importance of the outcomes work, as it drew together priorities from the Joint Health and Wellbeing Strategy and evidence from the Joint

Strategic Needs Assessment.

 

The Board noted the headline finding of the JSNA which showed a need to focus on mental health and associated services.

 

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

 

RESOLVED that the draft Joint Strategic Needs Assessment (JSNA) Devon Overview 2016 be noted.

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7.

Joint Health and Wellbeing Strategy pdf icon PDF 63 KB

Report of the Director of Public Health on the refresh of the Joint Health and Wellbeing Strategy (PH/16/25), attached.

 

A copy of the draft Strategy is also included in the papers.

Additional documents:

Minutes:

The Board considered a report from the Director of Public Health (PH/16/25) on the revised Joint Health and Wellbeing Strategy for 2016-2020.

 

The Board noted the statutory requirement to have a Joint Health and Wellbeing Strategy for the Local Authority area based on the need identified in the Joint Strategic Needs Assessment.

 

The report outlined that the first Strategy was widely consulted upon in 2012/13 and two updates were produced in September 2013 and again in June 2015. The strategy needed to be updated due to both its expiry date and the need to be consolidated into one document, reflecting current health and wellbeing issues.

 

The four original themes of the 2013 Strategy (a focus on children and families, healthy lifestyle choices, good health and wellbeing in older age and strong and supportive communities) have remained valid and provided a focus on health inequalities across the life-course in line with Marmot principles.

 

In terms of the Joint Health and Wellbeing Strategy 2016-2020, the Board has continually reflected on its priorities, including development and stakeholder sessions with a wide range of groups, organisations and individuals with different perspectives. From such feedback, future priorities needed to focus on early intervention, mental health, housing and connectedness and enabling communities with an underpinning focus on health inequalities.

 

 

The proposed new strategy was high level, seeking to reflect progress that the wider system has made as separate organisations and collectively over the last three years. It has a set of interconnecting themes supporting health and wellbeing through the life course underpinned by strong and supportive communities and living with lifelong mental health:

 

·         A focus on Children, Young People and Families – this remained important to ensure the best start in life and a focus on prevention / early help when need was identified;

·         Living well – renamed ‘Living Well’ to reflect the importance of looking after oneself in mid / later life to reduce risk of disability and frailty. Prevention / management of long-term conditions / reducing multi-morbidity was critical and lifestyle changes could help support this;

·         Good Health and Wellbeing in Older Age – remained important;

·         Strong and Supportive Communities – a focus on strengthening community resilience, addressing social isolation and the importance of place based health (for example the importance of housing, fuel poverty etc); and

·         Lifelong Mental Health – to reflect the importance of mental health and the Five Year Forward View for Mental Health, this has been added as a new priority area.

 

The Board discussed and asked questions on the following;

 

·         the value of strong social connectedness and how people could be kept healthier for longer;

·         support for carers was another important area and the Strategy made particular reference to this;

·         the importance of the Domestic and Sexual Violence Strategy / work being given full focus within the H&W Strategy and whether it should be a priority in its own right and that a specific reference to the D&SVS should be made within priority 1;

·         the role  ...  view the full minutes text for item 7.

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8.

Joint Commissioning in Devon, the Better Care Fund and Governance Arrangements pdf icon PDF 58 KB

Joint report of the Head of Social Care Commissioning and Managing Director Partnerships (NEW Devon CCG) on the BCF, Annual Return, Performance Report and Performance Summary

Additional documents:

Minutes:

The Board considered a joint report from Mr T Golby (Head of Social Care Commissioning, Devon County Council), Mr P O’Sullivan (Director of Partnerships, NEW Devon CCG) and Mr S Tapley (South Devon and Torbay CCG).

 

Regular reports were provided on the progress of the Devon Better Care Fund (BCF) 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.

 

Quarterly, the Board is required to formally endorse the template supplied by the central Better Care Fund Programme support team, which had been included with the agenda.

 

In terms of the ongoing Better Care Fund activity and performance monitoring, considerable effort had been made throughout 2015/16 to address the BCF National Conditions requirements. These had all been met and were reflected in the BCF 2016 /2017 First Quarter Return. There were also performance targets for a number of system wide measures, monitored by the Better Care Management Group on behalf of JCCG.

 

In terms of ‘Outcome measures’, there had been agreement on local action plan to reduce delayed transfers of care as well as a system wide action plan to reduce them. Furthermore, the BCF schemes that were focused on reduction of non-elective admissions were developed, implemented and monitored via the Urgent Care Control Centre under the Success Regime programme.

 

The local metric for dementia had been changed. Whilst it still monitored support for people with dementia (instead of monitoring diagnosis rates), the length of stay in hospital for those with dementia was also recorded.

 

The Board further noted that the rates of admission to residential and nursing care homes was 601.8 per 100,000 for over 65 population, significantly below the South West average of 678.2 and the England rate of 668.8. In addition, re-ablement services were effective for around 88% of older people in receipt of those services, significantly higher than the South West (84%), the local authority comparator group (82.8%) and England (82.1%).

 

The Board asked whether there was any information on the future of the Better Care Fund, particularly in light of Sustainability and Transformation Plans (STP), the overall regulation of the Fund by NHS England and whether the Board could lend any further support.

 

It was MOVED by Councillor Clatworthy, SECONDED by Mr Norley, and

 

RESOLVED that the first quarter return, as circulated, be endorsed and the Chairman be authorised to sign the return on the Boards behalf.

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9.

Updates from Clinical Commissioning Groups

An opportunity for Clinical Commissioning Groups to give short verbal update on any pertinent issues of interest or importance to the Board.

Additional documents:

Minutes:

The Board received a verbal update from Dr D’Arcy (South Devon & Torbay CCG) advising that a consultation had been launched on the re-shaping of community based health services.  The consultation would be live between Thursday 1 September and Wednesday 23 November 2016.

 

The new model of care was looking to switch funding from hospital to community care and ensuring any new services were in place before changing current provision.

 

There would be investment in community services, fewer community hospital beds, stronger minor injuries units (MIUs) (a reduction to three in Newton Abbot, Totnes and Dawlish, but open from 8am to 8pm, seven days a week, with x-ray diagnostic services), Intermediate and domiciliary care and reduced pressure on Torbay hospital.

 

The outcomes of the consultation would be reported to the Board in due course.

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10.

Scrutiny Work Programme pdf icon PDF 106 KB

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/

Additional documents:

Minutes:

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.

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11.

Forward Plan pdf icon PDF 48 KB

To review and agree the Boards Forward Plan, attached.

Additional documents:

Minutes:

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 15 December 2016 @ 2.00pm

Performance / Themed Reporting

Health & Wellbeing Strategy Priorities and Outcomes Monitoring

Theme Based Report (Mental Health)…. to include Mental Health & Young People / Survey and New Service (Min 218)

 

Business / Matters for Decision

Better Care Fund - frequency of reporting TBC

Integrated Personal Commissioning (minute 231)

Sustainability & Transformation Plan – if required

Devon Adults Safeguarding Annual Report

DVSA Strategy

CCG Updates – SD&Torbay CCG Consultation - Community Services.

 

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

Childrens and Young Peoples Strategy (including Childrens Alliance Strategy) Refresh.

 

Other Matters

Scrutiny Work Programme / References, Board Forward Plan, Briefing Papers, Updates & Matters for Information

 

Thursday 8 June 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

Delivering Integrated Care Exeter (ICE) Project – Annual Update (March)

Children’s Safeguarding annual report (September / November)

Adults Safeguarding annual report (December)

Joint Commissioning Strategies – Actions Plans (Annual Report – December)

 

 

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.

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12.

Briefing Papers, Updates & Matters for Information

·         Digital Roadmap 2020 – circulated via email 28/06/2016

·         Heart of the South West Devolution documentation – all reports, newsletters and important briefings can be found here - https://new.devon.gov.uk/democracy/how-the-council-works/devolution/ The latest newsletter and FAQ can be obtained from the Clerk.

·         LGA briefing paper on devolution (July 2016) - http://www.local.gov.uk/documents/10180/7632544/3.5+What+next+for+devolution+-+final+WEB.pdf/77125fcd-4035-443c-b98c-2da62c644548  Copies can be obtained from the Clerk.

Additional documents:

Minutes:

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 correspondence received or of interest to Board Members since the last meeting included

 

·         Digital Roadmap 2020 – circulated via email 28/06/2016

·         Heart of the South West Devolution documentation – all reports, newsletters and important briefings could be found at - https://new.devon.gov.uk/democracy/how-the-council-works/devolution/

·         LGA briefing paper on devolution (July 2016) - http://www.local.gov.uk/documents/10180/7632544/3.5+What+next+for+devolution+-+final+WEB.pdf/77125fcd-4035-443c-b98c-2da62c644548 

 

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13.

Dates of Future Meetings

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 15th December 2016 @ 2.00pm

Thursday 9th March 2017 @ 2.00pm

Thursday 8th June 2017 @ 2.00pm

 

Annual Conference

Thursday 8th June 2017 @ 10.00am

 

(Board dates for 10th November 2016 and 12th January 2017 are cancelled)

(Seminars dates for 13th October 2016 and 9th February 2017 are also cancelled)

Additional documents:

Minutes:

RESOLVED that future meetings and seminars of the Board will be held on………

 

Meetings

Thursday 15th December 2016 @ 2.00pm

Thursday 9th March 2017 @ 2.00pm

Thursday 8th June 2017 @ 2.00pm

 

Annual Conference

Thursday 8th June 2017 @ 10.00am

 

(Board dates for 10th November 2016 and 12th January 2017 are cancelled)

(Seminars dates for 13th October 2016 and 9th February 2017 are also cancelled)


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