Agenda and minutes

To approve the record of the meeting held on 25 February 2014 and the record of the special meeting held on 2 April 2014.

The record of the meeting held on 25 February 2014 and the record of the special meeting held on 2 April 2014 were agreed and signed by the Chairman. 

Apologies for absence were received from the Director of Children and Adults and the Deputy Director, Children and Adults. 

A councillor 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 councillor 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 councillor 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.

Councillors 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.

Councillors 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 to members 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. 

For those board members who are not councillors they should also declare any pecuniary interests at this point.

There were none. 

There were no urgent matters.  However, the Chairman took the opportunity to welcome the Acting Director of the Kent and Medway Local Area Team to his first meeting.  He also advised that, in order to clarify a number of matters with Democratic Services, the report scheduled as 5d on the agenda relating to Working effectively with local providers would be deferred to the next meeting.  The Healthwatch Medway representative asked whether, when the report comes back, consideration could be given to including a housing provider to the Board membership.

The purpose of this report is to provide information on progress made by the Health and Wellbeing Board within its first year and to provide a forward look for 2014/15. 

Discussion:

The Director of Public Health introduced the report setting out the review of progress of the Health and Wellbeing Board with a forward look for 2014/2015 and responded to Board Members’ questions.

It was noted that Cllr Wicks’ name needed to be added to the list of membership on page 30 of the agenda.

The point was made by the Healthwatch Medway representative that social housing was integral to the work of the Health and Wellbeing Board and as such could possibly be invited to join the Board.  The Portfolio Holder for Housing and Community Services stated that he was a member of the Strategic Housing Partnership and as such he agreed to promote the dialogue about health and wellbeing there.

The report was welcomed as a useful summary of what the Board had achieved in its first year.   Discussion took place as to the suggestion of a specific area of focus for the Board and there was concern that the topic of focus did not detract from or duplicate work already ongoing, particularly that on the Better Care Fund and redesign of community services.  It was agreed that there were different interpretations of words such as ‘primary care services’ and the Board wanted to ensure that not only was the choice of topic clear, but that it was important for there to be clarify as to what success would look like and of how all partners at the Board can contribute to achieving it.  It was also suggested that the topic might be better as a three year medium term focus rather than one for a year.

The general area put forward was the integration of out of hospital health and social care services, possibly linked with supported housing.  It was agreed that the actual title of the focus topic would be determined outside of the meeting, by consultation among the Board, in order that a scoping paper would be produced for the next meeting.

Decision: 

(a)   The Board noted the information in the report;

(b)   The Board supported the proposal of an area of specific focus for the Board in 2014/2015 and agreed that a scoping paper on this work would be brought back to the next meeting.

In line with the requirement under The National Health Service Act 2006 (as amended) at Section 14Z15 this report summarises the CCG contribution to the delivery of the Joint Health and Wellbeing Strategy.

Discussion:

The Chief Operating Officer and Chief Clinical Officer introduced the NHS Medway Clinical Commissioning Group (CCG) Annual Report and responded to questions.

The view was expressed that the comment in the report about co-operation with the local authority was understated and that there was a very healthy working relationship had been established.  This view was reinforced by positive comments from the Healthwatch Medway representative who commended the engagement of the CCG with Healthwatch Medway and for their appointment of a Communications and Engagement Officer who was already building a good relationship with them.

Decision: 

The Health and Wellbeing Board confirmed agreement with the review summary for inclusion in the CCG Annual Report, taking into account the additional comments made during the meeting.

This report asks the Board to consider the final report of the Review of Health Inequalities in Medway in-depth Task Group set up by the Health and Adult Social Care Overview and Scrutiny Committee and agree the findings and recommendations of the Task Group for referral to the Cabinet on 13 May 2014.

Discussion:

The Chairman of the Task Group, Councillor Wildey, introduced the findings and recommendations of the health inequalities review and explained the background to it taking place, which was the wide difference in life expectancy across Medway.

Board Members supported and commended the review document and the comment was made that it was an outstanding report, with very powerful evidence. 

A number of Board Members agreed that the pace of change in relation to licensing working with public health had been a lot slower than they would have liked and they hoped that recommendation 3 would bring about speedier changes.

The Chief Clinical Officer, NHS Medway CCG advised that the paragraph relating to commissioning on page 114 of the agenda needed clarification and it was agreed that this would be done prior to submission to the Cabinet.  An explanation was also requested for the reason the word inequity was used in recommendation 4 rather than inequality.

A suggestion was made that access to social care should be included to recommendation 7.  The Chairman of the Task Group however explained that the remit of the Task Group had focussed on the two topics of smoking cessation and access to primary care.

The Director of Public Health suggested that it would also be appropriate to request officers, in recommendation 9, to undertake equity audits in respect of access to social care.

The Board also felt that recommendation 11 Principle 2 should be expanded to all significant decisions but were keen to ensure that this should be a meaningful exercise and not delay decision making.

The Healthwatch Medway representative requested that the volunteer role description should be circulated to all participants in the stakeholder event and undertook to supply the document to Public Health.

Decision: 

The Board then commended the recommendations set out in the review document to the Cabinet with the following additional suggestions:

• In relation to recommendation 4 an explanation be given as to the use of the word inequity as opposed to inequality
• The suggestion was made that as well as considering access to primary care that barriers to accessing social care should also be included in recommendation 7a
• For recommendation 11 Principle 2 it was suggested that this should be amended to read ‘assess the impact of all significant decisions on health inequalities before decisions are made.

This report sets out a proposal to invite several key providers to attend the formal meetings of the Health and Wellbeing Board (which are held in public) on a regular basis and to participate fully in the discussion of items of business on the agenda. 

This item was deferred to the next meeting. 

This report advises the Board of the forward work programme for discussion in the light of latest priorities, issues and circumstances.  It gives the Board an opportunity to shape and direct the Board’s activities. 

Discussion:

The Democratic Services Officer pointed out that, as set out in the report, the August 2014 meeting had been cancelled.  She also clarified with the Acting Director, Kent and Medway Local Area Team thathe would bring the report on pharmacy services to the next meeting.  The Chairman requested that the report should be a short, simple report to explain the background to the Pharmaceutical Needs Assessment and how it is used to allow all Board members to understand its significance.

The Healthwatch Medway representative stated that the report on engagement listed for the next meeting would actually be the annual report from Healthwatch Medway.

Decision: 

The Board noted that the provisional date of 14 August 2014 will be deleted from the programme of Board meetings.