Agenda and minutes

Venue: Committee Suite - County Hall

Contact: Stephanie Lewis 01392 382486  Email: stephanie.lewis@devon.gov.uk

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Items
Note No. Item

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83.

Minutes pdf icon PDF 121 KB

Minutes of the meeting held on 13 September 2018, attached.

Additional documents:

Minutes:

RESOLVED that the minutes of the meeting held on 13 September 2018 be signed as a correct record.

           

 

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84.

Items Requiring Urgent Attention

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

Additional documents:

Minutes:

(An item taken under Section 100B (4) of the Local Government Act 1972)

 

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

 

The Committee received the Annual Report of the Devon Safeguarding Adults Board charting progress within Devon of national expectations and safeguarding activity. This included the 2017/18 priorities of improving people’s experience of safeguarding and delivery of “Making Safeguarding Personal” across all partners, the prevention of harm and neglect in care and

health services and improving awareness and application of the Mental Capacity Act (MCA) and Best Interests for people.

 

It also reported on the work of the DSAB sub groups such as the Mental Capacity Act, the Safeguarding Adults Review Core Group, the Learning and Improvement Group, Operational Delivery and Community Reference Group.  Furthermore, the Report outlined the 2018-19 Business Priorities which included ensuring that people in Devon felt safer, protecting people from harm by proactively identifying people at risk, whilst promoting independence and increasing the legal literacy of practitioners in respect of the MCA.

 

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

 

RESOLVED that the Report be welcomed and the Committee place on record its thanks to the Chair and those involved in the production of the Report.

 

[NB: The Safeguarding Board Annual Report will also be available, alongside other documentation, such as Safeguarding reviews at: https://new.devon.gov.uk/devonsafeguardingadultsboard/

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85.

Devon Joint Health and Wellbeing Strategy: Priorities and Outcomes Monitoring pdf icon PDF 61 KB

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

Additional documents:

Minutes:

The Board considered a Report from the Chief Officer for Communities, 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 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:

 

·         Mortality rate from preventable causes, 2015-2017 – the age-standardised mortality rate in Devon (161.03 per 100,000) was below the South West and significantly lower than the comparator group and England rates. However, the rate of decline had slowed in recent years.

·         Reablement Services (Effectiveness), 2016-17 – In Devon, 82.6% of older people were still at home 91 days after discharge from hospital into reablement services, which was similar to the South West, comparator group and national rates.

·         Reablement Services (Coverage), 2017-18 – In 2017-18, 1.8% of older people discharged from hospital in Devon were offered reablement services which was significantly lower than the South West, comparator group and national rates.

·         Stable and Appropriate Accommodation (Learning Disabilities), 2017-18 – 76.0% of adults with a learning disability in Devon were living in their own home or with family, which was above the South West and comparator group rate but below the national rates

·         Stable and Appropriate Accommodation (Mental Health Clients), 2017-18 – 60.0% of adults in contact with a secondary mental health service were living in stable and appropriate accommodation, which was significantly below the South West, but significantly above the comparator group and national rates.

·         Suicide Rate, 2015-2017 – There were around 70 suicides per annum in Devon, with rates remaining around or slightly above the national average.  Rates were significantly higher in males.

·         Social Contentedness, 2017-18 – 42.8% of social care users reported being satisfied with their social situation, which was below the South West, comparator group and national rates, but not statistically significantly lower.

 

A Red, Amber, Green (RAG) rating was included in the indicator list and performance summary with areas of red ratings including alcohol-Specific Admissions in under 18s, *Re-ablement Services (Coverage), Hospital Admissions for Self-Harm, aged 10 to 24, Gap in employment rate (mental health clients) and Estimated Dementia Diagnosis Rate (65+).

 

The outcomes Report was also available on the Devon Health and Wellbeing website www.devonhealthandwellbeing.org.uk/jsna/health-and-wellbeing-outcomes-report

 

RESOLVED that the performance Report be noted and accepted.

 

 

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86.

Acuity Audit Presentation pdf icon PDF 289 KB

Presentation of the Assistant Director in Public Health on the Acuity Audit of Hospital Bed Occupancy in Devon.  Please see below link to the full Acuity Audit Report:

 

http://www.devonhealthandwellbeing.org.uk/library/annual-reports/acuity-audit-2018


 

 

 

Additional documents:

Minutes:

The Board received a Presentation from the Assistant Director in Public Health on the Acuity Audit of Hospital Bed Occupancy in Devon. 

 

The Presentation highlighted this was the fifth Audit to take place, including all four acute hospitals in the Devon STP area, analysing bed occupancy to identify and define the care needs of the inpatient population across the STP footprint on the audit date on 15 May 2018.  The number of patients who were fit to leave a hospital setting had decreased from 38.6% in 2010 to 23.4% in 2018.

 

Particular attention was given to indicators which correlated to patients remaining in a hospital bed when they could be cared for in an alternative setting, such as:

·         older age;

·         unplanned admission;

·         identifying patients experiencing dementia or cognitive impairment; and

·         receiving care prior to admission.

 

The audit identified some areas that required further analysis which included:

·         end of life care;

·         admission from care homes; and

·         dementia diagnosis.

 

The full Acuity Audit Report could be found at:

http://www.devonhealthandwellbeing.org.uk/library/annual-reports/acuity-audit-2018

 

[The Presentation was attached to the minutes]

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87.

Joint Commissioning in Devon, the Better Care Fund and Governance Arrangements pdf icon PDF 139 KB

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 on the BCF, Quarter Return, Performance Report and Performance Summary

Additional documents:

Minutes:

The Board considered a joint Report of the Head of Adult Commissioning and Health DCC, and the Deputy Chief Executive Officer / Director of Commissioning NEW Devon CCG and South Devon and Torbay CCG on the Better Care Fund (BCF), Q2 2018/19 submission to NHS England and the Ministry of Housing, Communities and Local Government reporting on performance against a core set of metrics relating to the Better Care Fund. The Health and Wellbeing Board was required to formally endorse the returns.

 

The Report informed Members that the BCF had met each of the four national conditions, as well as confirmation of a s75 pooled budget.  The Council was on track to meet three of the four metrics which included:

 

·         reduction in non-elective admissions;

·         the rate of permanent admissions to residential care per 100,000 (65yrs+), and

·         the proportion of older people still at home 91 days after discharge from hospital into reablement / rehabilitation services.

 

However, the BCF declared it was not on track to meet the target for delayed transfers of care.  Daily monitoring of delays had been established to identify prevailing issues, alongside an implementation of the system wide plan to tackle delayed transfers of care, which was overseen by the A&E Delivery Boards.

 

RESOLVED that the Report on the Better Care Fund Q2 be endorsed.

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88.

Learning Disability Partnership Board

Update from the Chair of the Learning Disability Partnership Board.

Additional documents:

Minutes:

The Board received a Presentation from the Chair of the Learning Disability Partnership Board who highlighted the role of the Partnership Board, its achievements, areas to develop and how to improve the reach of the Board.  The key areas of the Presentation included:

 

·         the Learning Disability Partnership’s Board membership included people with a learning disability, their families and carers and representatives from Health, Social Care and Community services;

·         the Board had good support from the Council and the NHS;

·         Board Members said they wanted an accessible web site with easy read content, so they could find information for themselves instead of relying on other people;

·         increasing employment opportunities, through discussions with representatives from Job Centre Plus, the Employment / Skills team and Learn Devon and a media and marketing campaign to encourage businesses to become Disability Confident, making it easier for people to get a job in Devon; and

·         NHS Improvement Standards – looking to improve the experience of people with a learning disability in hospitals.

 

Members’ discussion points included:

 

·         encouraging businesses to become Disability Confident and make reasonable adjustments for people with a learning disability to work;

·         tackling health inequalities through learning disability medicals;

·         publicising the new website through GPs and community partners;

·         quality checkers around learning disability services and whether the Partnership Board was involved in this process – the Chair of the Board would confirm whether this was the case;

·         friendship groups and how to promote the scheme with Devon Councillors;

·         Members requested updates from the Learning Disability Partnership Board at future Committees, and

·         the Chair of the Health and Wellbeing Board agreed to attend a future meeting of the Learning Disability Partnership Board.

 

The Committee thanked the Chair of the Learning Disability Partnership Board for his attendance and speaking to Members.  

 

 

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89.

Devon's Charter to End Loneliness pdf icon PDF 95 KB

That Devon’s Charter to end Loneliness (attached) be approved by the Board and signed by the signatories.

Additional documents:

Minutes:

RESOLVED that Devon’s Charter to end Loneliness be approved by the Board and signed by the signatories.

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90.

Progress Report on the development of the Devon Health and Wellbeing Board pdf icon PDF 57 KB

Report of the Chief Officer for Communities, Public Health, Environment And Prosperity on the development of the Board, attached.

Additional documents:

Minutes:

The Board considered a Progress Report regarding the development of the Devon Health and Wellbeing Board which outlined work undertaken against the six objectives established by the Task Group which included:

 

1.     establishing alignment with other partnerships focused on the wider determinants of health;

2.     establish a wider Health and Wellbeing Network to support, inform and disseminate the work of the Health and Wellbeing Board;

3.     utilise a tiered approach to geography with democratic accountability at all levels and a two-way information flow to inform local priority setting;

4.     strengthen and formalise the role of the Board in providing assurance that the commissioning plans of local organisations reflect Boards priorities;

5.     establish the Board’s role in the strategic planning of health, care and wellbeing; and

6.     increase collaboration between Devon, Plymouth and Torbay Health and Wellbeing Boards.

 

A new Devon Joint Health and Wellbeing Strategy would be developed and published later in 2019 which would provide a vehicle for addressing these objectives and driving the longer-term development of the Board and local health, care and wellbeing system.

 

RESOLVED that the Board support ongoing work on the objectives and actions from the Task Group Report on board development and progress to date be noted.

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91.

Health Protection Committee Assurance Report pdf icon PDF 1 MB

Report of the Chief Officer for Community, Public Health, Environment and Prosperity, attached.

Additional documents:

Minutes:

The Board received the Health Protection Committee Assurance Report which provided a summary of the assurance functions of the Devon and Cornwall Health Protection Committee and reviewed performance for the period from 1 April 2017 to 31 March 2018, for the Health and Wellbeing Boards of Devon County Council, Plymouth City Council, Torbay Council, Cornwall Council and the Council of the Isles of Scilly.

 

The Report considered the following domains of health protection:

 

       communicable disease control and environmental hazards;

       immunisation and screening; and

       health care associated infections and anti-microbial resistance.

 

The Report set out the structures and arrangements in place to assure performance; the performance and activity in all key areas during 2017-18; the actions taken to date against the programme of health protection work priorities established by the Committee for the period 2017 to 2018 and the priorities for the work programme for 2018/19.

 

RESOLVED that the Health Protection Committee Assurance Report be noted.

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92.

CCG Updates

An update by the Chairs of NEW Devon and South Devon & Torbay Clinical Commissioning Groups.

Additional documents:

Minutes:

The Chair of the South Devon & Torbay Clinical Commissioning Group (CCG) provided an update to the Board on progress within the Devon health and care system and the planning for delivery of integrated care.  This included a change in Leadership Team, specifically at the Accountable Officer level.  Other upcoming changes also included the merging of Northern, Eastern and Western (NEW) Devon CCG and South Devon and Torbay CCG to form one CCG covering the whole of the geographical area of Devon.  NHS England confirmed its approval of the merger on 14 December 2018.  This was an important step in creating a single strategic commissioner for Devon as part of the ambition to better integrate health and care services to benefit local communities.

 

 

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93.

References from Committees

NIL

Additional documents:

Minutes:

Nil

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94.

Scrutiny Work Programme

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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95.

Forward Plan pdf icon PDF 47 KB

To review and agree the Boards Forward Plan.

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 11 April 2019 @2.15pm

Performance / Themed Items

Health & Wellbeing Strategy Priorities and Outcomes Monitoring

Theme Based Item (TBC)

 

Business / Matters for Decision

Better Care Fund

Loneliness Campaign Update Report (to include risk profiling and heat maps)

STP Update and feedback of involvement of Devon HWBBs

Dementia Update report

CCG Updates

 

Other Matters

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

 

Thursday 11 July 2019 @2.15pm

Performance / Themed Items

Health & Wellbeing Strategy Priorities and Outcomes Monitoring

Theme Based Item (TBC)

 

Business / Matters for Decision

Better Care Fund

JSNA / Strategy Refresh

Learning Disability Partnership Board – Update from Chair

CCG Updates

 

Other Matters

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

 

Thursday 10 October 2019 @2.15pm

Performance / Themed Items

Health & Wellbeing Strategy Priorities and Outcomes Monitoring

Theme Based Item (TBC)

 

Business / Matters for Decision

Better Care Fund

Homelessness Report -12 month update

Children’s Safeguarding annual report

CCG Updates

 

Other Matters

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

 

Thursday 16 January 2020 @2.15pm

Performance / Themed Items

Health & Wellbeing Strategy Priorities and Outcomes Monitoring

Theme Based Item (TBC)

 

Business / Matters for Decision

Better Care Fund - frequency of reporting TBC

Adults Safeguarding annual report

CCG Updates

 

Other Matters

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

 

Thursday 9 April 2020 @2.15pm

Performance / Themed Items

Health & Wellbeing Strategy Priorities and Outcomes Monitoring

Theme Based Item (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 / December)

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

JSNA / Strategy Refresh – (June)

 

Other Issues

Equality & protected characteristics outcomes framework

 

 

 

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

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96.

Briefing Papers, Updates & Matters for Information

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/

 

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

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97.

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 11 April 2019 @ 2.15pm

Thursday 11 July 2019 @ 2.15pm

Thursday 10 October 2019 @ 2.15pm

Thursday 16 January 2020 @ 2.15pm

Thursday 9 April 2020 @ 2.15pm

 

Annual Conference

 

Thursday 11 July 2019 @ 9.30am

Additional documents:

Minutes:

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

 

Meetings

Thursday 11 April 2019 @ 2.15pm

Thursday 11 July 2019 @ 2.15pm

Thursday 10 October 2019 @ 2.15pm

Thursday 16 January 2020 @ 2.15pm

Thursday 9 April 2020 @ 2.15pm

 

Annual Conference

Thursday 11 July 2019 @ 9.30am