Agenda and minutes

To elect a Chairman of the Health and Wellbeing Board from among the Councillors appointed to the board for the forthcoming year. 

Councillor Andrew Mackness was elected Chairman of the Health and Wellbeing Board for the forthcoming year.

To elect a Vice-Chairman of the Health and Wellbeing Board for the forthcoming year. 

Dr Gill Fargher was elected Vice-Chairman of the Health and Wellbeing Board for the forthcoming year.

Apologies for absence were received from Councillor Howard Doe and the Very Reverend Dr Mark Beach (Healthwatch nominee).

A Member of the Board need only disclose at any meeting the existence of a disclosable pecuniary interest (DPI) in a matter to be considered at that meeting if that DPI has not been entered on the disclosable pecuniary interests register maintained by the Monitoring Officer.

A Member of the Board disclosing a DPI at a meeting must thereafter notify the Monitoring Officer in writing of that interest within 28 days from the date of disclosure at the meeting.

A Member of the Board may not participate in a discussion of or vote on any matter in which he or she has a DPI (both those already registered and those disclosed at the meeting) and must withdraw from the room during such discussion/vote.

Board Members may choose to voluntarily disclose a DPI at a meeting even if it is registered on the council’s register of disclosable pecuniary interests but there is no legal requirement to do so.

Members should also ensure they disclose any other interests which may give rise to a conflict under the council’s code of conduct.

In line with the training provided by the Monitoring Officer members will also need to consider bias and pre-determination in certain circumstances and whether they have a conflict of interest or should otherwise leave the room for Code reasons. 

There were none.

This report will explain the background to the setting up of the Health and Wellbeing Board, introduce the individual members of the Board, recap on what has taken place during the shadow year and will give a brief introduction to the communications and engagement strategy which is being compiled. 

This item will culminate in a short film illustrating the potential impact of Health and Wellbeing Boards.

Discussion:

The Director of Public Health introduced this report setting out the progress made by the Shadow Health and Wellbeing Board during 2012/2013.

This included the development of the Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy 2012-2015, after a well-attended stakeholder event, and a review of commissioning plans.

It was reported that, as a committee of Medway Council, the Council had agreed the Board’s Terms of Reference on 25 April 2013 and a copy was attached to the report at Appendix 1.

The Director of Public Health gave details of the priorities for the 2013/2014 work programme, which reflected both the Board’s statutory duties and local priorities. This included a refresh of the Joint Strategic Needs Assessment and a review of the Joint Health and Wellbeing Strategy. The Board was also required to complete a pharmaceutical needs assessment and all organisations on the Board would need to support this significant piece of work. Furthermore, a report on the implications arising from the review by Sir Bruce Keogh into the quality of care and treatment at 14 Trusts nationally, including Medway NHS Foundation Trust, would be presented to the Board for consideration. It was also noted that a stock take of progress against the commitments made in the Winterbourne View Concordat needed to be submitted by 5 July 2013. This would be shared with Board members prior to submission, with a full report presented on 22 October 2013.

The Director of Public Health highlighted that a key objective for 2013/2014 would be the integration of commissioning arrangements between the Council and the NHS for children and adult services. The Board would have oversight of these arrangements and will receive a report at the October meeting.

A video clip demonstrating the potential impact of the Health and Wellbeing Board was shown at the meeting.

Decisions:

(a)               The Board noted the Terms of Reference for the Health and Wellbeing Board.

(b)               The Board noted the priorities for 2013/2014, as set out in the report.

This will be an opportunity for the theme leads for the Joint Health and Wellbeing Strategy priorities, which were agreed last year following stakeholder engagement, to update on progress.

This item was considered in conjunction with agenda item 7 (Joint Health and Wellbeing Strategy delivery plans and outcomes framework) and is therefore set out below.

This report contains progress updates of the delivery plans for the Joint HWBS priority actions for 2013/2014 and the monitoring and outcomes framework for the JHWBS and the Board is asked to consider and comment on progress made.

Discussion:

The Consultant in Public Health introduced a report setting out progress against each of the delivery plans for the five priority actions within the Medway Joint Health and Wellbeing Strategy 2012-2017.

The theme leads for the priority actions updated the Board on progress and a summary is set out below under the 5 themes:

• Theme 1: Give every child a good start

It was noted that the overarching action was to support mothers to have good physical and emotional health in pregnancy and in the early months of life; focusing on increasing levels of breastfeeding and reducing smoking in pregnancy.

Action included the work by Medway Community Healthcare to address recruitment targets for the health visiting expansion; how health visitors were supporting smoking cessation and increasing breastfeeding rates; initiatives to support pregnant women to quit smoking at an early stage of pregnancy, such as the introduction of expired-air carbon monoxide monitoring; and, the peer supporter network, supported by Medway Community Health Care, of mothers who had breastfed their babies and were keen to help other mothers do the same. 

During the discussion of this item Board Members reflected on the role of the Family Nurse Partnership and the importance of making every contact count to address issues such as smoking.

• Theme 2: Enable older people to live independently and well

The priority action was to improve early diagnosis treatment and care for people with dementia in line with increasing population need.

Board members were advised of a number of actions/outputs, including four successful bids to the Prime Minister’s Dementia Challenge Fund; a campaign to encourage memory assessments; a community engagement event run by the Clinical Commissioning Group; and, the exploration of interactive technology to support identification and assessment.

The positive impact that a reduction in the use of anticholinesterase inhibitors could have was reported to the Board and it was requested that lead officers work to make delivery plans more accessible to the public by the removal of jargon.

• Theme 3 Prevent early death and increase years of healthy life

The priority action was to reduce death rates from cardiovascular disease.

The Board were advised of the proactive approach being taken, such as the early identification and management of patients with familial hypercholesterolaemia and diabetes. Details of the PACT campaign that encouraged people to check their pulse once a year was given, together with information as to how it was being publicised in order to maximise the campaigns effectiveness. It was noted that around one in five strokes were due to atrial fibrillation and of these three quarters may be prevented by people taking their pulse.

• Theme 4 Improve physical and mental health and wellbeing

It was reported that the priority action was promoting healthy eating and physical activity.

The Board were advised as to progress with developing a cross-departmental approach on planning and licensing, which sought to create healthy environments conducive to preventing and reducing existing levels of obesity. Further collaborative work would be undertaken with Greenspaces concerning  ...  view the full minutes text for item 66.

The Board is being asked to comment on the NHS Medway Clinical Commissioning Group’s (CCG) prospectus.  The prospectus is designed, with input from stakeholders and the public, to introduce the CCG to all.  It is intended to help the public and patients to understand who the CCG are, why they exist and how they will work to make Medway a happier and healthier place to be.

Discussion:

The Chief Operating Officer at NHS Medway Clinical Commissioning Group (CCG) introduced a report that provided the Board with a copy of the CCG Prospectus. It was noted that the Prospectus had been published on 28 May 2013 and a copy was attached to the report.

Board members were advised that the purpose of the prospectus was to help the public and patients understand who the CCG were, why they exist and how they will work to make Medway a happier and healthier place to be.

The draft Prospectus had been shared for comment with the CCG Governing Body and Patient Council, as well as the Shadow Health and Wellbeing Board. It was also noted that it took into account the principles required by NHS England.

The Board supported the Prospectus and welcomed the inclusion of details relating to the Health and Wellbeing Board and Joint Health and Wellbeing Strategy. During the discussion of this item it was also reported that an easy-read version would be made available shortly.

Board Members noted that the Prospectus was currently a web based document and suggested that further consideration is given to enhancing accessibility to it; such as utilising Medway Matters – the council produced magazine published and delivered to every household in Medway.

Decision:

(a)               The Board noted the Prospectus, the consultation undertaken and approved the final version which had been published within the required timeframe.

(b)               The Board suggested that further consideration be given to a means to enhance the accessibility of the Prospectus.

Following on from a development session on health inequalities earlier in the day the Board is asked to consider making recommendations on matters which could be added to the scope of the forthcoming in-depth scrutiny review on health inequalities and to consider what matters the Board may wish to concentrate on in the future. 

Discussion:

The Consultant in Public Health gave a presentation providing an overview and summary information about health inequalities in Medway. Potential areas for action were also identified. The Board were advised that reducing health inequalities in Medway would be the subject of a Health and Adult Social Care Overview and Scrutiny review in 2013/2014 and were asked to consider areas that could be proposed to the Overview and Scrutiny Committee for inclusion within the review.

The Board were provided information explaining why action was needed to tackle health inequalities; this included the difference in life expectancy between the 10% most and least deprived in the population, which was 9.3 years for men and 4 years for women. The challenge of reducing health inequalities was also explored, with reference made to the gestation times for interventions and the 6 key policy recommendations arising from the recent publication of ‘Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England post 2010’ (Marmot Review).

It was noted that a revised version of the report had been tabled at the meeting and that the Health and Wellbeing Board had attended a development session earlier in the day facilitated by Peter Goldblatt from the University College London, Institute of Health Equity.

The Board considered and discussed potential areas for inclusion within the Overview and Scrutiny review. This included a number of areas that had been identified within the development session, such as active travel, asset mapping and creating healthy environments, and other areas including housing, debt and proportionate universalism/targeting services according to need.

The Board was mindful of the need to make recommendations that were focussed and meaningful and requested that a report be brought back to the next meeting of the Board to enable further discussion on proposals for the scope of the review.

Decision:

The Board agreed that this report be resubmitted to the next meeting of the Health and Wellbeing Board to enable further consideration.

This report sets out items for the future work programme to allow Board members to put forward suggestions and/or additions. 

Discussion:

The Democratic Services Officer introduced a report on the work programme, which was based on activity over the shadow year.

It was noted that following discussion earlier in the meeting that items concerning the monitoring and review of the Joint Health and Wellbeing Strategy, the mapping of community assets and reviewing health inequalities in Medway would needed to be included within the work programme.

Decision:

The Board agreed that

(a)               the monitoring and review of the Joint Health and Wellbeing Strategy, as set out in agenda item 7, be added to the Board’s work programme;

(b)               a report exploring the mapping of community assets be added to the agenda on 22 October 2013;

(c)               the scope for the in-depth scrutiny review on health inequalities be reported to the next meeting of the Board.