Agenda and minutes

Minutes of the meeting held on 8 June 2017.

RESOLVED that the minutes of the meeting held on 8 June 2017 be signed as a correct record.

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

There were no items requiring urgent attention, but the Chairman welcomed Mrs Mayes, Independent Member of the Standards Committee, who was attending in her capacity of monitoring the Council’s compliance with the ethical Governance framework.

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.

The appendix is attached, but also 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 four 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 four indicators below had all been updated since the last report to the Board;

·         Adult Smoking Prevalence, 2016 (latest figures suggests that 12.6% of the adult population in Devon smoke, which is below the South West (13.9%) and England rate (15.5%)):

·         Feel Supported to Manage Own Condition, 2016-17 (67.5% of those with a long-term condition felt they had enough support to manage their own condition, higher than the South West (65.2%) and England rates (63.3%));

·         Fuel poverty, 2015 (approx. one in eight households in Devon is in fuel poverty at 12.17%); and

·         Estimated Dementia Diagnosis Rate (65+), 2017 (recent data showed that Devon (60.6%) was lower than the South West (62.8%) and significantly lower than England (67.9%) rates).

Following approval at a previous meeting, a Red, Amber, Green (RAG) rating was included in the indicator list and a performance summary on page 12 of the full report. Areas with a red rating included fuel poverty, hospital admissions for self-harm (aged 10 – 24) and estimated dementia diagnosis rates (65+).

The report featured a table showing how Devon compared with the Local Authority Comparator Group (LACG) for all Health and Wellbeing outcome measures (September 2017). This included how Devon compared / performed against both the LACG and England and their rank position. A further table showed the Priority Area Summaries, which included progress against those priority areas including, inter alia, teenage conception rates, poverty, GCSE attainment and alcohol harm, smoking rates and deaths from preventable causes, levels of excess weight, fruit and vegetable consumption, deaths at home, healthy life expectancy, falls, dwelling hazards and rough sleeping levels. Also suicide rates, self-harm and the mental wellbeing of local service users.

Following discussion at the June 2017 Health and Wellbeing Board and as requested, the report included a further analysis of self-harm related admissions in 10 to 24 year olds, as the rates in Devon were significantly above South West, local authority comparator group and England levels. Table 4 of the report showed the total bed days per 100,000 population and revealed that Devon did not experience higher levels of zero day length of stay admissions and in fact had longer average lengths of stay than the South West, local authority comparator group and England. The Public Health England Local Knowledge and  ...  view the full minutes text for item 18.

Report of NEW Devon CCG and South Devon and Torbay CCG on Shaping Future Care - A Sustainability and Transformation Plan for Devon, attached.

A presentation will also be given at the meeting.

The Board received a covering report and presentation, circulated with the papers for the meeting, from NEW Devon CCG and South Devon and Torbay CCG on the Sustainability and Transformation Plan for Devon, presented by the Director of Strategy for both NEW Devon and South Devon and Torbay CCG.

The Board was being asked to note the update on progress of the Sustainability and Transformation Plan and suggest opportunities for increased alignment to support delivery of the Health and Wellbeing Strategy.

It was noted that the wider Devon Sustainability and Transformation Plan (initially published on 4^th November 2017), set the vision and strategic direction for health, wellbeing and care services across the areas covered by NEW Devon and South Devon and Torbay Clinical Commissioning Groups and the Plan had previously been presented to the Board.

The presented report provided an update on the current work and progress with the Plan and the development of a Sustainability and Transformation Partnership, including the aims and priorities of improving health and wellbeing, delivering safe and high quality care and providing cost-effective care. There were also local priorities of Prevention, Integrated care model, Primary care, Mental health and learning disability, Acute care, Children and young people and Productivity and the presentation provided further information in relation to each of the priority areas.

In terms of the next steps, across wider Devon, system working had resulted in real progress in addressing the financial challenges, improvements in services performance, and further steps towards integration of health and social care.

The Board noted that there were still significant challenges ahead and work was underway to step up the pace of progress with the plan in the context of wider changes in the health and care system.

Members asked questions and discussed the following.

·         the effectiveness of the communications strategy to date and the reassurance of the CCG in improving communications with communities and service users going forward;

·         how the CCG’s were collaborating with the purposeful systems work streams;

·         that the CCG needed to recognise the anxiety within communities regarding changes to service provision and the need to reassure those communities / users / patients with effective communication;

·         the ongoing workforce planning and that proposals would go to the Governing body in approximately two months time;

·         the synergies with the community and voluntary sector and whether their representation at a strategic level would improve both service provision and communication channels; and

·         the numbers of positive case studies that were becoming available and how these could be best used to provide public reassurance.  

It was MOVED by Councillor Leadbetter, SECONDED by Councillor Sanders, and

RESOLVED that the update be welcomed and the CCG’s be asked to note the Boards comments regarding public reassurance and improved communications moving forward.

Joint report of the Head of Adult Commissioning and Health (Devon County Council) and Director of Strategy (NEW Devon CCG and South Devon and Torbay CCG) on the Plan Submission for the BCF, in line with the Integrated and Better Care Fund Planning Requirements for 2017-2019 guidance from NHS England, Department of Communities and Local Government and the Department for Health.

The Plan will be made available at the meeting.

The Board considered a Joint report of the Head of Adult Commissioning and Health, NEW Devon CCG and South Devon and Torbay CCG on the Plan Submission for the BCF, in line with the Integrated and Better Care Fund Planning Requirements for 2017-2019 guidance from NHS England, Department of Communities and Local Government and Department for Health.

The final Plan was in the process of being finalised, due to the very tight timescales (requiring submission to NHS England by 11 September 2017), therefore the Board received a detailed presentation on the principles of the Plan, including the vision for integration (e.g. person centred care, joined-up services, maintaining independence and building wider support), the Integrated model of care (including a comprehensive assessment process, single point of access and rapid response), the national metrics required by the BCF plan as well as the national conditions.

The Board were reminded that the Better Care Fund was the only mandatory policy to facilitate integration, providing a framework for joint Health and Social Care planning and commissioning, bringing together ring fenced budgets from Clinical Commissioning Group (CCG) allocations, the Disabled Facilities Grant and, from 2017/18, funding paid to local government for adult social care services.

The BCF narrative plans must set out the joint vision and approach for integration, including how the work in the BCF plan complements the NHS Five Year Forward View, and with the aims and approach in Sustainability and Transformation Plans (STPs) and wider local government transformation.

In developing BCF plans for 2017-19, local partners were required to agree, through the Health and Wellbeing Board;

·         a short, jointly agreed narrative plan including details of how they were addressing the national conditions; including how plans would contribute to the local plan for integrating health and social care;

·         confirmed funding contributions from each partner organisation;

·         a scheme-level spending plan demonstrating how the fund will be spent; and

·         quarterly plan figures for the national metrics.

The Board noted the requirement for the BCF plan to be submitted to NHS England on 11th September and had been drafted using the nationally published template.

The Board asked questions and discussed the following.

·         whether there should be further investment in assisted technology;

·         clarification on the funding figures between localities in relation to iBCF spend;

·         the risks associated with not meeting the deadlines for submission of the Plan; and

·         that there would need to be further conversations regarding the detail of the Plan and further scrutiny in due course.

It was MOVED by Councillor McInnes, SECONDED by Mr Rogers, and

RESOLVED

a) that the principles of the 2017-2019 BCF plan, as outlined in detail in the presentation, appended to these minutes, be endorsed; and

b) that the Chairman of the Health and Wellbeing Board be authorised to proceed with approval of the final BCF Plan detail, on the basis of the principles endorsed above.

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/

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.

They further noted that a Scrutiny Task Group was being undertaken on the Better Care Fund.

i) to review and agree the Boards Forward Plan; and

ii) to note that that an officer has been assigned from the LGA to support an Integration Workshop. As such the Board will need to determine a suitable date (either prior to the Committee meeting on 14th December 2017 or 8th March 2018 or to look for an alternative date). In terms of this, there is no pre-work and Board Members only need to be part of the process.

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

Members further noted that an officer has been assigned from the LGA to support an Integration Workshop. There was no pre-work required and Board Members were only required to be part of the process.

RESOLVED that the Forward Plan be approved, including the items approved at the meeting and that the Integration Workshop take place on 14^th December 2017.

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 14^th December 2017 @ 2.15pm

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 14^th December 2017 @ 2.15pm

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