Agenda and minutes

To approve the record of the meeting held on 21 October 2014.

The record of the meeting held on 21 October 2014 was agreed and signed by the Chairman as correct. 

Apologies for absence were received from Councillor Tolhurst, Alison Burchell, Heidi Butcher, the new Acting Manager, Healthwatch Medway and the Vice-Chairman, 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.

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 no urgent matters by reasons of special circumstances.  However, the Chairman took the opportunity to pass on the Board’s condolences to the Vice-Chairman.  He also welcomed Martin Riley, Managing Director, Medway Community Healthcare to his first meeting of the Board.

 This report updates the Board on Joint Health and Wellbeing Strategy JHWS) indicators.

Discussion:

The Consultant in Public Health Medicine introduced the monitoring report on the Joint Health and Wellbeing Strategy and responded to questions.

A request was made for consistent graphs to be provided on the basis that the scales gave scope for confusion whereby the gaps in performance on some of the graph appeared to be larger than they were.  In relation to the indicator on user experience of community mental health services the Chief Executive of Kent and Medway NHS and Social Care Partnership Trust was asked to provide a very short briefing note to update Board members on action taken to improve this indicator.

Discussion took place about breastfeeding initiation, indicator 104, and the point was made that it was the continuation of breastfeeding, which appeared to be more of an issue than the mothers starting breastfeeding.  On that basis additional support needed to be given to new mothers to encourage them to continue with breastfeeding.  The Senior Public Health Manager stated that part of the problem arose from repeating family behaviour in that often mothers copied what their own mother had done.  Work was ongoing to encourage breastfeeding at the hospital and in the community.  The Senior Public Health Manager assured the Board that there was good networking with other authorities to identify effective practice.

In response to a request, the Director of Public Health undertook to discuss Indicator 401 people using green spaces for exercise with the Deputy Director, Customer Contact, Leisure, Democracy and Governance to attempt to ascertain why people were not making the best use of large parks and green spaces in the area for health benefit and whether a different form of statistic is needed to measure physical activity.

Decision:

(a)     The Board noted the updates;

(b)     A short briefing note was requested from the Chief Executive, Kent and Medway NHS and Social Care Partnership Trust about action taken to improve experience of community mental health services; and

(c)     The Director of Public Health to discuss indicator 401 with the Deputy Director, Customer Contact, Leisure, Democracy and Governance to ascertain why Medway is under performing.

This report deals with the establishment of a pooled budget as part of the governance arrangements for the Better Care Fund and also updates Members on the approval process for the Better Care Fund plan. 

Discussion:

The Interim Head of Better Care introduced a report on the Better Care Fund and pooled budget and responded to questions.

Board Members expressed their thanks to the Interim Head of Better Care and to officers involved in the Better Care Fund programme.  In response to a question, the Chief Clinical Officer, NHS Medway Clinical Commissioning Group (CCG) and the Interim Head of Better Care confirmed that audit sections in the Council and in the CCG were aware of their responsibilities in respect of the section 75 agreement.  The Portfolio Holder for Adult Services confirmed that the Cabinet, on 13 January 2015, agreed that the Council would act as host for the pooled fund.

It was noted that the target for non-elective admissions could be reduced from 3.5% to 2.5%.

Decision: 

The Board noted progress on the development of the Better Care Fund and endorsed the draft Heads of Terms, set out in Appendix 2 to the report.

This report updates Members on the transfer and allocation of the 2014/15 Health Funding for Adult Social Care

Discussion:

The Interim Deputy Director, Children and Adult Services introduced the report on funding for health and social care setting out how the £4.5m from NHS England had been used to support a range of services.

Decision: 

The report was noted.

This report presents the Annual Public Health Report of the Director of PublicHealth for 2013/14 which focuses on the health of Medway’s older population andmakes recommendations for Medway Council and partners. An audit of progress against the Annual Public Health Report for 2012/13 is also included.

Discussion:

The Director of Public Health introduced her annual report, which focussed on the health of older people and four key issues affecting them: social isolation, falls, dementia and the quality of the living environment.  She offered to make a presentation to any partner of the Council should this be of assistance.

The Director of Public Health and her team were commended for producing a clear and comprehensive, easy read document.  The NHS and the rest of the Council were encouraged to support the recommendations in the report.

Reference was made to the challenge of social isolation and to the importance of keeping people involved and engaged in the community as it was felt that older people had a great deal to contribute in society and in the workplace in terms of experience and knowledge.  It was stated that older people should remain engaged and involved in as much as possible and not seen as ‘potential patients’ but rather as having a lot to offer and they should be given opportunity to keep well mentally and physically.

Decision: 

The Board noted the Annual Public Health Report 2013/2014 and the audit of progress against the recommendations in the Annual Public Health Report 2012/13.

This report updates Members on the recent work Public Health has undertaken in the area of alcohol licensing. It also outlines the work undertaken by Public Health to identify priority areas and the key workstreams being taken forward.

Discussion:

The Director of Public Health introduced the Public Health and Licensing update report, which set out the key workstreams being taken forward.  The closer working between Public Health and Licensing was welcomed and the benefits of the public health function transferring back into the local authority, thereby enabling public health to be embedded in everything the Council does, were pointed out. 

A suggestion was made on the Purple Flag initiative progresses more could be done to raise awareness of the award, maybe through Medway Matters.

A further suggestion was put forward that it could be helpful for there to be engagement with Caring Hands in the Community and with the Royal Engineers and Kent Military Partnership to discuss the issue of street drinking and alcohol abuse as a means of gathering further information about the impact of alcohol in Medway.

Reference was made to the event with licensees, which had been very positive.

Decision: 

The Board noted the report and the continued work progressing to reduce alcohol related harm through the use of licensing powers.

This report sets out proposals to develop a comprehensive Medway Emotional Wellbeing Strategy for children and young people, through the adoption of a strategic framework for the purpose of focussing attention on emotional wellbeing outcomes for children and young people and their families, across Education, Health and Social Care 

Discussion:

The Mental Health Social Care Commissioning Manager introduced a report setting out a proposal to develop a comprehensive Medway Emotional Wellbeing Strategy for children and young people through the adoption of a strategic framework across Education, Health and Social Care.

The Board welcomed the report and the point was made by a Board member that the document was as a result of the Council wanting children and young people to have the best start in life and it was stressed that it was also very important to keep young people out of the judicial system. Reference was made to the launch the previous evening of the partnership document entitled ‘Kent and Medway Joint Protocol on Criminal Justice - agency involvement with children in care’ in this regard.

It was stated that it was important for there to be simple, easily accessible information and guidance for all young people and in particular at points of transition in their lives aswell as more detailed specialist assistance and guidance/advice for young people with greater needs.

A simple blueprint to assist parents and those in regular contact with young people would be helpful to assist them in recognising the emotional state of young people and to know when to offer help.

Decision: 

The Board supported the development of the Medway Emotional Wellbeing Strategy for children and young people, in line with Option 2, taking account of the scope of the action plan set out in paragraph 6 of the report and the risks that require mitigation in four key areas set out in paragraph 5 of the report.

 This report updates Members on the findings of the LGA Peer Challenge on childhood obesity and on the Obesity Summit which took place during the summer and seeks the Board’s approval to develop a local framework for tackling obesity.

Discussion:

The Senior Public Health Manager introduced a report on the development a framework for tackling obesity and responded to questions.  He requested that all partner organisations continue to ensure representation at a senior level on the Obesity Network.

Reference was made to a successful bid to the Local Enterprise Partnership for £2.5m to enable cycle paths to be put in place across Medway and how this should assist cycle riders to ride more safely.  The success of the walking bus to encourage more parents to walk their children to school safely was referenced.

It was stated that the obesity summit had involved a wide range of partners and stakeholders who remained very enthusiastic in tackling obesity and were already taking forward new initiatives since the Obesity Summit.  The work of the Public Health team was commended.

The Chief Clinical Officer, NHS Medway CCG referred to the NHS 5 Year Forward View and that the CCG and Public Health were making an expression of interest to NHS England to be involved in the development of the national diabetes prevention programme which related to the Board’s aims in relation to tackling obesity.

Decision:

The Board noted the outcomes of the childhood obesity peer challenge and obesity summit and supported the development of a Tackling Obesity Framework for Medway.

This report updates Members on progress on preparation for the delivery of the Care Act 2014 in Medway.

Discussion:

The Interim Deputy Director, Children and Adults Services with the Programme Manager, Care Act introduced the report on the Care Act 2014.

The Programme Manager, Care Act explained that there were 74 days to go before the reforms take effect on 1 April and set out the delivery programme and work with partners that was required.

The Director of Children and Adults Services stated that there would be some nationally produced promotional literature to explain the Care Act to the public which could be adapted to be used locally.  However, this literature had not yet been received.  She also informed the Board that now the Programme Manager was in place he could make use of the regional networks, which were getting to grips with the implications of the Act.

Reference was made to a conference last year about the Care Act and the view was expressed that Medway was well placed already to take on board the new responsibilities and challenges.  The Portfolio Holder for Adult Services made a plea that young carers are included in the programme being put together by the Programme Manager, Care Act. 

Decision: 

The Board noted the report.

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 Chairman reminded the Board that the next formal meeting of the Health and Wellbeing Board would be held on 12 March at 4pm in meeting room 2. 

As there was now a development event on 12 February 2014 he suggested that the informal meeting scheduled for 11 February 2014 should be cancelled.

Decision:

The Board agreed to note the work programme and that the informal meeting scheduled for 11 February 2015 should be cancelled.