Agenda and minutes

To approve the record of the meeting held on 9 September 2014.

The records of the meeting held on 17 June 2014 and 9 September 2014 were agreed and signed by the Chairman.

It was noted that the record of the meeting held on 17 June 2014 was included in Supplementary Agenda No.2 and was tabled at the meeting.

Apologies for absence were received from the following Board Members: The Very Reverend Dr Mark Beach, Councillor Brake, Elliot Howard-Jones, David Quirke-Thornton, Barbara Peacock and Councillor Tolhurst.

Other apologies for absence were also received from Helen Jones (Medway Council), Dr Mike Parks (Kent Local Medical Committee) and Martin Riley (Medway Community Healthcare).

Board Members paid tribute to the work that David Quirke-Thornton (Deputy Director, Children and Adults Services) had undertaken during his time at Medway Council and wished him well at his new role at Southwark Council. It was agreed that a letter of thanks be sent to him.

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.

Disclosable pecuniary interests

There were none.

Other interests

There were none.

The Chairman will announce any late items which do not appear on the main agenda but which he/she has agreed should be considered by reason of special circumstances to be specified in the report. 

There were none.  

Social isolation is a key priority of the Medway Health and Wellbeing Board and the strategy has been developed to tackle the issue across Medway.  A draft of the strategy is being brought to Medway Health and Wellbeing Board for approval prior to being sent to the Cabinet.

Discussion:

The Consultant in Public Health introduced this report which provided details of the Strategy to Reduce Social Isolation 2014/2018. He informed Board Members that this was an opportunity to provide any final views on the draft Strategy prior to consideration and final approval at Cabinet on 25 November 2014.

He provided details as to the background to the issue of social isolation and how this was different to loneliness and could be measured objectively. He referred Board Members to page 7 of the draft Strategy which set out two maps that showed an index of relative social isolation per household at lower super output area level of persons aged under 65 and over 65 which had been developed to identify areas where residents may be more likely to be socially isolated.

He informed Board Members of the consultation that had been carried out on the draft Strategy including focus groups and key stakeholders. He stated that three key strategic themes had been identified: raising awareness, action for individuals and community action. It was noted that there would be a range of targeted actions for each of the themes and he gave some examples of pilot projects in support of the issue.

Board Members welcomed the strategy and discussed a number of issues including:

• The extent to which geographical and financial factors could have an impact on social isolation with Board Members providing examples of potential geographical factors in Rainham and Gillingham/Chatham.
• The need to raise awareness of front line staff and the community about social isolation and to find ways of engaging people with the range of opportunities available in Medway.
• The need to improve communication channels to better highlight the availability of resources/services.
• The need to promote and increase volunteering to assist in reducing social isolation
• The “men in sheds” pilot scheme was seen as an excellent initiative to tackle social isolation and Board Members were keen to see this programme extended. It was confirmed that this scheme would be delivered by the Sunlight Development Trust, however, the number of schemes would be subject to the level of available funding.
• The need to develop an Action Plan to ensure that the Strategy would be delivered and to report back to the Board on key actions. The Director of Public Health informed Board Members that she would need to identify an officer to undertake this work because the current Consultant would shortly be leaving the Council’s employment.
• To ensure appropriate reference was made to the De Jong loneliness scale.

It was confirmed that the NHS Medway Clinical Commissioning Group would also be considering the Strategy at its November Governing Body meeting to consider its role in taking the Strategy forward.

Decision:

a)     The Health and Wellbeing Board noted the draft Strategy and noted that the Strategy would be submitted to Cabinet for formal approval and adoption on 25 November 2014.

b)     The Health and Wellbeing Board agreed that an Action Plan be referred back to the Board for consideration  ...  view the full minutes text for item 469.

This item will be a presentation from Colin Guest, Project Co-ordinator from MCCH, a voluntary organisation which has been working with a variety of organisations on a project called ‘Jigsaw’ to support people with learning disabilities and autism in Strood and Gillingham.

Discussion:

Colin Guest, Project Coordinator, MCCH, a provider of social care services (learning disabilities, autism or mental health needs), attended the meeting to provide the Board with an update on the Jigsaw Project, in which MCCH had been working with a number of organisations to support people with learning disabilities and autism in Medway.

He gave the Board a detailed background which had led to the development of the project including support for learning disabled adults in independent living and the issues which faced those adults including various forms of harassment and abuse. He referred Board Members to two major incidents in the previous decade (the murder of Steven Hoskin in 2006 and the Pilkington family deaths in 2007) and the impact these had had on various agencies.

He stated that MCCH had conducted a three and a half year investigation into crimes against learning disabled persons and that one of the outcomes was that a third of those living in the Medway area had been attacked/victimised and that it was recognised that there was a lack of specialist support for both victims and the police. This had led to the development of the Jigsaw project which aimed to reduce victimisation and improve responses to reports of victimisation. He also stated that this project aimed to raise awareness of autism and learning disabilities through visits to workplaces, schools, colleges and community centres, and to produce guidance for GPs and social workers who carried out health checks and fair access care services assessments respectively, to better identify mental health and victimisation concerns. He also stated that further funding would be required from partners to continue with the project.

Board Members discussed a number of issues including:

• That personal, social, health and economic education (PSHE) had a role to play in raising awareness of the issues and the need to work with schools on this issue.
• That the NHS Medway Clinical Commissiong Group (CCG) would review the draft guidance for GPs being produced by MCCH but that it was not a matter for which the CCG had formal commissioning responsibility for (this sat with NHS England)
• The need to build upon healthchecks to ensure a full picture of individuals would be developed.
• The need to work with other providers on the project including transport and housing providers.

Decision:

The Health and Wellbeing Board noted the presentation of the Jigsaw project and the offers of help and support to develop the project.

The Health and Wellbeing Board has a statutory duty to produce a pharmaceutical needs assessment.  This report presents the draft Pharmaceutical Needs Assessment and a proposal to consult on the draft for 60 days.

Discussion:

The Director of Public Health introduced this report and informed Board Members that the Board had a statutory requirement to produce a Pharmaceutical Needs Assessment (PNA) by April 2015 and that there was a requirement for formal consultation on the document.

Cheryl Clennett, Consultant for Kent Public Health, had developed the draft PNA and provided details on the basis on which it could be considered that access to these services was considered adequate in both urban and rural areas. She highlighted a number of issues in Medway with particular reference to rural areas such as the Hoo Peninsula where there were a number of dispensing doctors in the absence of pharmacies. She referred Board Members to the updated maps in relation to the draft PNA, as set out in Supplementary Agenda No.1.

Board Members discussed a number of issues including:

• That reference to Peter’s Park in paragraph 5.1.3 of the covering report should have read “Peter’s Pitt”.
• That it be noted that the Lodge Hill development was a contentious issue and this would likely be reflected in consultation responses.
• That concern regarding the lack of pharmaceutical services on the Isle of Grain would likely be reflected in the consultation responses.
• That whilst access to pharmaceutical services had been measured on proximity, could other factors such as quality of services be included? The Consultant for Kent Public Health stated that “other” factors were not part of the PNA, however, issues such as quality of services were  a matter for NHS England. She informed Board Members that residents would have a degree of choice in accessing pharmaceutical services in Medway.
• That pharmacies had to be viable as a business which would be a factor in explaining the lack of services on the Isle of Grain. In such cases, there would be an increase in the provision of dispensing doctors.

The Board also discussed the findings arising from the draft PNA and expressed concern that the conclusions of the steering group set out in paragraphs 5.1.1 and 5.1.2 of the covering report were included prior to consultation.

Decisions

a)     The Health and Wellbeing Board noted the finding that there are proposed major housing developments in Medway, the main one being Lodge Hill.  There is also a proposed development in Peter’s Pitt which is in Kent but close to the Medway border in Wouldham. This will mean that these areas will need to be reviewed on a regular basis to identify any increases in pharmaceutical need.

b)     The Health and Wellbeing Board noted the finding that the current provision of “standard 40 hour” pharmacies should be maintained especially in rural villages and areas such as the Hoo peninsula.

c)      The Health and Wellbeing Board noted the finding that the current provision of “100 hour” pharmacies should be maintained.

d)     The Health and Wellbeing Board agreed that the current draft PNA should be used as the consultation document for the purposes of the statutory consultation and to approve a consultation on the  ...  view the full minutes text for item 471.

This report sets out a briefing for the Health and Wellbeing Board from NHS England, Kent and Medway in relation to national changes being proposed relating to the Organisation Alignment and Capability programme.

Discussion:

This report provided details of national changes being proposed to the organisation alignment and capability programme in relation to NHS England, Kent and Medway. It was confirmed that this review did not change the roles and responsibilities for NHS England.  

Decision:

The Health and Wellbeing Board agreed that the Chairman write to Eliot Howard-Jones asking for a more detailed explanation of NHS England’s proposals.

The Health and Wellbeing Board (HWB) has a statutory duty to publish the Joint Strategic Needs Assessment (JSNA), which informs the development of the Joint Health and Wellbeing Strategy. This paper provides the HWB with information relating to new or updated JSNA content.

Discussion:

The Director of Public Health introduced this report which provided information relating to new or updated Joint Strategic Needs Assessment (JSNA) content. This included an updated version of the executive summary, an updated version of the Health Inequalities section of the summary, an updated dementia background chapter and a new domestic abuse chapter.

She reminded Board Members as to the next steps as to the development of the JSNA and that the new JSNA content would be circulated to Board Members for comment prior to publication.

Decision:

The Health and Wellbeing Board noted the information in this report.

The purpose of this report is to provide an update to the Board on Joint Health and Wellbeing Strategy (JHWS) indicators, to update the HWB on progress against 2014/15 delivery plans and to provide the HWB with the JHWS 2014/15 summary document for consideration. 

Discussion:

The Director of Public Health introduced this report which provided an update on the Joint Health and Wellbeing Strategy (JHWS) indicators and referred to updated delivery plans in Appendix 2 to the report as well as a revised summary version of the JHWS in Appendix 3 to the report.  

Decision:

The Health and Wellbeing Board noted the progress updates and progress to the successful implementation of the priority action delivery plans.

The Health and Adult Social Care Overview and Scrutiny Committee Task Group review of Health Inequalities in Medway contained 11 recommendations. This report provides an update on progress on recommendations that are related to the Health and Wellbeing Board.

Discussion:

The Senior Public Health Intelligence Manager introduced this report which updated the Board on progress on relevant decisions which were made as part of the Task Group Review of Health Inequalities in Medway (Cabinet decisions 86/2014, 89/2014 and 91/2014).

He informed Board Members that he had received an update on Cabinet decision 86/2014 (inequity in access and outcomes at GP practices) just prior to the meeting and the Board asked for this information to be circulated via email.

Decision:

The Health and Wellbeing Board noted the contents of this report and agreed to the proposal that a health equity audit is undertaken on access to maternity care.

Healthwatch Medway CIC was established in April 2013 when Medway Council awarded the contract for delivery of two Healthwatch functions (citizen engagement, information and signposting) to Medway Citizens Advice Bureau.

This annual report covers the initial operational period April 2013 - March 2014.

Discussion:

Sarah Russell, Operations Manager, Healthwatch Medway, introduced this report which covered the initial operational period April 2013-March 2014. She explained, in introducing this report, that she had only been in post for 8 weeks, however, she highlighted the key areas of focus in the past year (for example, citizen engagement and acting in an information and signposting capacity), feedback on performance (for example, identifying improvements in response to feedback) and how Healthwatch Medway would move forward in the forthcoming year (for example, the introduction of a new administrative support post, the improvement in data collection and focussing on specific marginalised groups such as older people).

Board Members discussed a number of issues including a request for a Briefing Note on the following:

• Clarification of the salaries as set out in the statement of activities
• Clarification of the rents that Healthwatch Medway were paying in relation to office space at Kingsley House and the Sunlight Development Trust
• Clarification of Healthwatch Medway’s banking arrangements
• How the costs of Healthwatch Medway compared to the costs of Healthwatch operating in other similarly sized Local Authority areas, for example, Brighton.

Board Members explained that the request for this information was in the context of ensuring that Healthwatch Medway was providing its services on a value for money basis.

Decisions:

a)     The Health and Wellbeing Board noted the Annual Report.

b)     The Health and Wellbeing Board requested a Briefing Note from the Interim Deputy Director, Children and Adults Services, and the Assistant Director, Partnership Commissioning on the following matters in relation to Healthwatch Medway:

·        Clarification of the salaries as set out in the statement of activities.

·        Clarification of the rents that Healthwatch Medway were paying in relation to office space at Kingsley House and the Sunlight Development Trust.

·        Clarification of Healthwatch Medway’s banking arrangements.

·        How the costs of Healthwatch Medway compared to the costs of Healthwatch operating in other similarly sized Local Authority areas, for example, Brighton.

This report provides the Health and Wellbeing Board with an update on progress on the Better Care Fund plan for Medway. This includes feedback through the assurance process following the revised submission on the 19 September 2014.

Discussion:

The Interim Deputy Director, Children and Adults Services, introduced this report which provided an update on progress on the Better Care Fund (BCF) plan for Medway. She informed the Board that an assurance review had taken place on Medway’s submission, however, the Council awaited the outcome of the review.

She also informed the Board that the Assistant Director, Partnership Commissioning, intended to submit a report to a future meeting of the Board on the governance structure for the BCF programme of projects.

Decision:

The Health and Wellbeing Board noted the report.

This report sets out revisions to the Medway Protocol for working across key strategic boards for information. 

Discussion:

The Head of Legal Services informed the Board that the amended protocol had been reviewed by Legal Services as requested at the last meeting of the Board.

Decision:

The Health and Wellbeing Board agreed the revised protocol and asked the Chairman to sign to evidence acceptance.

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 Director of Public Health informed the Board that the Workshop on out of hospital care arranged for 13 October 2014 had been postponed and sought Board Members’ flexibility in being available when it was rearranged, which was most likely to be in the new year.

It was confirmed that the Better Care Fund would be considered at every Board Meeting for the time being.

Board Members also considered the issue of priority actions and how these would be reflected over time, given that some actions would be taken forward, for example, social isolation.

Decision:

The Health and Wellbeing Board noted the report.