Agenda and minutes

To approve the record of the meeting held on 18 June 2013.

The record of the meeting held on 18 June 2013 was agreed and signed by the Chairman as correct.

The Chairman welcomed Dr Beach from Healthwatch Medway to his first meeting of the Board. 

Apologies for absence were received from Councillor Carr, Barbara Peacock and Dr Fargher. 

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 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 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. 

 http://www.youtube.com/watch?feature=player_embedded&v=rnlmdkufaT8

A video from the Local Government Association was shown which illustrated a case study and the potential impact of a Health and Wellbeing Board on an individual person.  The Board felt the video clip was useful and could be used in officer training and if, more members of the public attend, could be shown again in the future.  It was also agreed that it should be added to the Council web site under the Health and Wellbeing Board section.

The purpose of this report is to advise the Board of the key points arising from the consultation event on the Joint Health and Wellbeing Strategy held on 18 September 2013.

Discussion:

The Director of Public Health introduced the report on the feedback from the stakeholder event held on 18 September 2013 which she stated was well attended.  The event had been about sharing progress, consulting and refreshing and renewing the priorities.  There had been no dissent about the existing priorities that stakeholders felt should be kept but there were some additional suggested priorities put forward.

In addition to the stakeholder event an online consultation had taken place and 56 responses received which were being analysed.  A scoring template, with the long list of priorities, would be sent to Board members outside of the meeting with the aim of them being completed and brought to the next meeting of the Board for short listing.  She emphasised that action would still take place if a priority was not short listed but the intention was that the short list would contain those areas which lent themselves to collaborative working to achieve a better outcome.

The Director of Public Health then stated that stakeholders at the event had supported the proposal to remain engaged through the theme groups during the year rather than just consulting once a year.

The following points were made during debate:

• On Theme 1 it was emphasised that communication skills were important in improving school readiness

• In relation to social isolation a number of Board members acknowledged this to be a very significant problem.  The point was made that the issue did not fit solely under the heading of Theme 2 – in that young people and those with disabilities could also be isolated.  Linking people with the voluntary sector was important, as, while it was a good thing to encourage independent living, a side effect may be that people living independently became isolated.

• Consideration should be given to increasing the use of social media to connect with people.  A briefing for Healthwatch Medway on the use of the prioritisation matrix was requested.

• The comment was made that under Theme 5 – the topic of ‘Welfare reforms and their impact on neighbourhoods/individuals” may be outside of the remit of the Board.  Board members acknowledged that to be the case insofar as influencing the reforms were concerned but felt that the impact of such reforms on people’s health and mental wellbeing was something, which the Board would have an interest in addressing.

• Reference was made to the local and national position with regards to cancer screening and the fact that uptake on screening for bowel cancer, particularly in men was lower than it should be.  The point was made that even national targets may not be ambitious enough and that the Board should be ambitious.

• The priorities relating to mental health were welcomed and a request made that the focus should be on mental health rather than mental ill health. The general public were generally not as familiar with the concept of five a day in good mental health terms as they were with the concept of five a day in  ...  view the full minutes text for item 486.

This paper aims to define the methodology for undertaking a mapping of Medway-wide assets, which relate to the promotion of physical activity and healthy eating as part of a wider approach to improving community health and wellbeing in Medway.

This asset-based approach is intended to complement Medway’s Joint Strategic Needs Assessment and significantly enhance understanding of the strengths and assets, as well as the deficits, which exist within Medway’s communities.

Discussion:

The Acting Consultant in Public Health introduced an item on mapping local assets and explained that the following had been agreed as a way forward:

• Phase 1: A Medway-wide mapping of organisational/institutional assets, physical assets and assets of associations which promote physical activity and healthy eating
• Phase 2: Using information from Phase 1 to identify one or more communities/neighbourhoods of interest, an in depth mapping of assets at an individual and community level, which promote physical activity and healthy eating.

Responding to a question as to whether, as part of the exercise, any assessment would be undertaken around value for money on what was invested in the community it was stated that this was not currently built in to the work, however, it could be given consideration particularly for services commissioned by HWB Members.

Following a request it was agreed that as far as stakeholder engagement was concerned there would be one event during the day and another in the evening to ensure better coverage.

Healthwatch Medway asked to be involved in the steering group.  It was also confirmed that the voluntary sector would be included as key stakeholders in the project.

It was suggested that it would be very helpful if the utilisation of assets could be included in the project, along with details around capacity, so that it was possible to see where there were areas of low take up and areas of high demand etc.

The Deputy Director, Children and Adults offered to share information gathered in Children and Adults directorate in the compilation of various social care directories.  Councillor O’Brien also referred to information gathered in the same directorate relating to 14-18 commissioning which could also be shared. Members of the Board felt that, to avoid duplication of effort, a trawl of what was already taking place across the various agencies would be helpful at the outset.  The Council for Voluntary Services, Volunteer Bureaux and Citizen’s Advice Bureaux for example would have their own maps of assets.

Board Members agreed to be consulted as part of that process in order that their knowledge/contacts could be shared.  The point was made that it should be made clear to the community the reasons behind the asset mapping so that the benefits of contributing to it could be explained.

Decision: 

(a)   The proposed methodology set out in the report was agreed along with the comments as shown above;

(b)   It was agreed that a verbal update should be provided for the January 2014 meeting.

This report introduces the draft communications plan for the Medway Health and Wellbeing Board.

Discussion:

The Head of Communications and Marketing introduced a report setting out the draft communications plan to support the work of the Health and Wellbeing Board.  He explained that in relation to the concept of the three key messages for the Board flowing from each Board meeting and the responsibility of Board Members to feedback on the outcome at the next meeting.

The following points were made:

• In relation to page 49 of the report, the third key message should be amended to reflect the fact that the Health and Wellbeing Board was not a decision making body and that any decisions would need to be taken by the Cabinet and Clinical Commissioning Group.

• As far as page 53 of the report was concerned it was felt that the key messages on this occasion did not reflect the key themes of the Joint Health and Wellbeing Strategy.  In relation to key message 3 – delivering work to map people, places and organisations it needed to be a wider message.  It was also important for colleagues across the local authority to be aware of the aims of the Joint Health and Wellbeing Strategy in their work in planning, housing etc.

• In relation to page 49 it was stated that it was important to consider how the voluntary sector could make their contribution.

• In relation to page 51 consideration could be given to other methods of making information more accessible, voice enabled pdfs, podcasts etc.

• A request was made for logos of the Clinical Commissioning Group, Healthwatch/NHS England etc to be added to the Communications Plan to endorse the fact that all parties are working together.

• It was requested that the Communications Plan and key messages should be shared with the Board by email over the next week.

Decision: 

(a)   The draft Communications Plan was approved subject to the addition of the above comments/amendments and should be emailed to the Board members over the next week;

(b)   It was agreed that the Director of Public Health is given delegated authority to approve materials, wording and designs on behalf of the Board, in consultation with the Chairman.

This report is for information and gives details of the current position following the establishment of Healthwatch in Medway.

Discussion:

Dr Beach introduced the update report and requested that in all future paperwork Healthwatch should be referred to as Healthway Medway to avoid confusion.

Since the production of the report a number of promotional engagement events had taken place in Lordswood, Strood, Rainham Shopping Centre, the Hospital and the Pentagon Centre, which had been very successful.  A number of Board members confirmed this and stated that they had attended the events.  Over 100 comments had been received and were being analysed.  A further event around NHS England’s GP Call to Action had taken place on the same day as a Healthwatch meeting.  A report would be sent to the next Healthwatch Medway Board.

He then stated that the Healthwatch England annual report was now available through Healthwatch Medway.   

A number of Board Members mentioned that they had been contacted by former Members of the Local Involvement Network (LINk) as being interested in being part of the new arrangements but not having heard back from Healthwatch Medway.    Dr Beach expressed the hope that, following the recent engagement events such interested persons would join Healthwatch Medway.

Reference was made to the model adopted by Medway for Healthwatch involving five separate respected organisations, which it was felt added strength to the model.  Reference was also made to ongoing communication and co-ordinated events with the Clinical Commissioning Group, which was welcomed.

Decision:

The update report was noted.

The following video gives an explanation of the role of the Health and Wellbeing Board from The Kings Fund:

 http://vimeo.com/69224754

Discussion:

A video from the Kings Fund was shown illustrating the NHS reforms, which led to the setting up of Health and Wellbeing Boards across the country.

The following points were put forward:

• The video was generally found to be informative but a number of Board members felt the political references were unhelpful.  The option to play the video without sound was suggested
• The breadth of the role of public health in local authorities had been underplayed in the video
• There was a feeling that the video painted a rather negative picture rather than a positive view of how Health and Wellbeing Boards could bring the system together
• The use of an artist to capture events was thought to be helpful and may be useful in future depending on the needs of the audience
• Since the production of the video a number of key changes had taken place

Decision:

It was suggested that the Head of Communications and Marketing should investigate with the Kings Fund whether the video could be adapted and report to the next meeting.

Medway Clinical Commissioning Group (CCG) and Medway Council have established a Partnership Commissioning team to commission seamless health and social care services that achieve the best outcomes for residents and their families and best value for the public purse.  The report, which will be supplemented by a presentation to the Health and Wellbeing Board, outlines key areas of work and priorities. 

Discussion:

The Deputy Director, Children and Adults introduced a powerpoint presentation explaining the progress made in partnership commissioning.  He stated that the purpose was for the Council and Medway Clinical Commissioning Group (CCG) to work together with a commitment to deliver easily accessible and seamless health and social care services for the people of Medway that achieve the best outcomes for residents and their families and best value for the public purse.

The Board were informed of the composition of the CCG Commissioning team and the areas it covers and the Partnership Commissioning Team, which had been set up with jointly funded posts under the direction of the Assistant Director, Partnership Commissioning.  

It was stated that the intention was for integrated commissioning to lead to integrated services and the Deputy Director, Children and Adults referred to the setting up of section 256 agreements for pooled funding.  £3.8bn nationally had also been set up for an Integration Transformation Fund although it was emphasised that this would not be new money.  A plan for this would need to be in place by March 2014 and the Health and Wellbeing Board would have a role in commenting on it.  The Director, Kent and Medway, NHS England, explained that £1.9bn of that money would be from money currently spent in acute hospital trusts and £1bn would be dependent on successful delivery of the plan in the next year.

Decision: 

The Board noted the report.

This report briefs the Board on the “A Better Start” Big Lottery bid, which Medway is making with Family Action to improve outcomes for children.  Medway has been successful in reaching the final round of the bidding process which, if successful, would bring circa £40m over 10 years to enable a systematic change to services to provide a preventative approach in pregnancy and early years and reduce the incidence of health and social problems later in life.

Discussion:

The Portfolio Holder for Children’s Services and the Director of Public Health introduced a report setting out progress with the “A Better Start” Big Lottery bid that fitted with the Board’s strategic objective of ‘every child getting the best start in life’.

Medway was one of 15 areas across England to have been awarded a development grant of £264,500, which enabled the development of the phase two application.  An Area Partnership Board had been set up, chaired by the Chief Executive of Medway Council and members of the Board included the Portfolio Holder for Children’s Services, Director of Public Health, Director of Children and Adults, Chief Executive of Family Action, Medway CCG GP Member of Governing Body and Director, Kent and Medway, NHS England. 

The deadline for submission had recently been extended to 28 February.  The Director of Public Health explained that the Health and Wellbeing Board would have oversight of the bid but that decision-making would rest with the Cabinet and CCG.

Decision: 

The report was noted.

The Minister of State for Care Services has requested that Health and Wellbeing Boards consider the Winterbourne View Joint Improvement Programme – Local Stocktake, in order that Board members are apprised of progress locally against the commitments made in the Winterbourne View Concordat. 

Discussion:

The Deputy Director, Children and Adults introduced a report outlining the Winterbourne View Joint Improvement Programme – Local Stock take and the Winterbourne View Concordat issued in December 2012.  He explained that this followed physical and psychological abuse suffered by people with learning disabilities and challenging behaviour at Winterbourne View hospital, which had been exposed in a Panorama investigation in 2011.

The Deputy Director, Children and Adults explained that for Medway there were only four adults who had learning disabilities and complex/challenging behaviour who were currently in-patients in specialist learning disability hospitals.  Discussions were underway and plans being developed to support them to move to community (less restrictive) settings, noting the complexity of their needs and bespoke care and support arrangements required.

Dr Beach stated that Healthwatch Medway had a number of observations on the matter and would circulate a list for ongoing discussion.  He asked whether it would be possible for Healthwatch Medway to be included in the ongoing discussions about future plans for the four adults.

Dr Green, on behalf of the CCG, stated that he felt that, in view of the small number of people involved who would be easily identifiable; it may not be appropriate for Healthwatch Medway involvement in the planning of their care.

A further anonymised summary update could, however, be considered by the Board on a date to be agreed once discussions had taken place with the families involved.

Decision: 

(a)   the Winterbourne View Joint Improvement Plan – Local Stock take was noted;

(b)   a further anonymised summary update to be provided to the Board either for the January meeting or April meeting.

This report allows the Board to consider any additions or changes it wishes to make to the work programme. The report also contains an update on the setting up of the health inequalities scrutiny task group. 

Discussion:

The Democratic Services Officer stated that she would include in the work programme items, which had been added during the meeting.  She also stated that the Health Inequalities Task Group had met recently to discuss the scope of the review but had decided to wait until after a policy briefing to finalise the details.

Dr Beach asked whether it would be possible for a Healthwatch Medway representative to join the Task Group.  The Democratic Services Officer stated that the membership of the Task Group had already been set by Health and Adult Social Care Overview and Scrutiny Committee but undertook to put forward the request and report back to Healthwatch Medway.  She stated that it was likely that Healthwatch Medway would have a role in the work of the Task Group in some form.

The Chief Operating Officer, Medway CCG, explained that the commissioning plans would need to come to the January meeting as the April meeting would be too late.  She also felt that the priority action plans should be reviewed at the same meeting.  The Director of Public Health stated that the CCG commissioning timetable did not accord with the Council’s but would look at how this could be programmed in possibly by using an informal Board meeting.  It was agreed there would need to be a report on the Integrated Transformation Fund in January.

Decision: 

(a)   It was agreed that consideration would be given to the involvement of Healthwatch Medway in the work of the Health Inequalities Task Group;

(b)   Reports referred to during the meeting to be added to the work programme including a report on the Integrated Transformation Fund and priority action plans in January 2014 as referred to above;

(c)   Consideration be given to amending the programming of the review of commissioning plans following discussion between the relevant parties and the Chairman.