Agenda and minutes

Apologies for absence were received from Councillor Doe, Dr Beach, Elliot Howard-Jones 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.

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 items.  However, the Chairman took the opportunity to welcome Dr Barnes, Dr Parks and Kim Carey, the Interim Deputy Director of Children and Adults to their first meeting of the Health and Wellbeing Board.  He also thanked David Quirke-Thornton for his contribution to the Board and wished him well in his new role.

At the invitation of the Chairman the Democratic Services Officer advised  there may be members of the press and public taking photographs, filming or audio-recording and reporting the proceedings. This was permitted under the Openness of Local Government Bodies Regulations 2014, which took effect on 6 August 2014. The Democratic Services Officer asked anyone exercising this right to do so in a way that did not disrupt the meeting and to ensure that any members of the public who were present to observe or participate in the proceedings were not filmed or recorded against their wishes. People wishing to make use of this new law were requested to move to the front row of the public gallery.

This report provides the information in relation to the Better Care Fund (BCF) Plan and its implications for Medway further to revised guidance issued by the Local Government Association (LGA) and NHS England on 25 July 2014.  The Board is being asked to support the Plan in its draft state recognising it will need to be revised prior to final submission on 19 September 2014.

Discussion:

The Assistant Director, Commissioning and Strategy gave a powerpoint presentation as an introduction to the Better Care Fund Plan and emphasised that the Plan had been judged by NHS England and the Local Government Association as good and she did not consider there would be major changes to the narrative.  She referred to a regional workshop held the previous day, which had been attended by officers of the Council and said that there would be changes up to the actual date of submission.

The Board were told that there were five new questions to answer in relation to the Better Care Fund Plan, as well as revisions to the four existing questions.  The new questions related to the following:

• Case for change
• Plan of action
• Risks and contingency
• Alignment
• Implications for acute providers

It was stated that the £1bn linked to pay for performance would be released proportionate to performance against the 3.5% target of reduction in non-elective activity (hospital admissions).

Details were given of the next steps, which were that the plan would be resubmitted on 19 September 2014, the assurance process should end on

13 October 2014 and the next seven months would be used to further the plan recognising that not everything goes ‘live’ by 1 April 2015.  During that period there would be continued engagement with professionals, existing users and potential users throughout the process.  A number of task and finish groups will be established on specific themes.

The Chairman stated that he had received a message from Dr Beach, the Healthwatch Medway representative, supporting the recommendations contained in the report.  Members of the Board generally were very supportive of the Better Care Fund Plan aims and the Acting Chief Executive of Medway NHS Foundation Trust stated that from an acute trust perspective the Plan presented a win/win situation.  He did state, however, there was a degree of scepticism about whether the aims could be achieved bearing in mind the increase in activity at the hospital.  As the target related to hospital admissions, rather than hospital attendance, he felt more optimistic. He felt it would be important to concentrate efforts on prevention and the improved management of long term conditions and social isolation.

The Director of Public Health queried the lack of detail about the impact of each scheme and asked whether the modelling would give the assurances about this.  The Assistant Director, Commissioning and Strategy explained that this would be apparent before April 2015.  The Chief Clinical Officer, NHS Medway CCG confirmed this and stated that the Plan needed to interrelate  with other work which the Council and CCG were undertaking and it would be difficult to decide which component would deliver which outcome.  The Chief Operating Officer,  NHS Medway CCG stated that the community redesign would also be an important factor in achieving the target.

The Deputy Director, Children and Adults referred to a nervousness in the system about the impact on and implications for acute providers but stated that the Medway Better  ...  view the full minutes text for item 289.

The report accompanies a protocol, which sets out the roles and responsibilities of the different strategic partnerships working across Medway Council in relation to safeguarding. It has been produced in response to recent Ofsted Inspections of children’s services in other local authorities, which have identified a need to have these responsibilities clearly defined and agreed by each Board. The Health and Wellbeing Board is asked to note the protocol and sign up to its implementation.

Discussion:

The Assistant Director, Commissioning and Strategy gave a brief introduction to the protocol setting out the relationship between key strategic boards in Medway.  She stated that it had been suggested, by the Children’s Safeguarding Board that the Corporate Parenting Board should also be added as a signatory to the protocol.  The Ofsted Inspection had stated that the local authority must be clear that safeguarding is everyone’s responsibility not just that of the Safeguarding Boards.  The other Boards referred to at the end of the document had already signed the protocol.

The Legal Officer present clarified that in relation to 8.3 of the protocol that this statement did not usurp the Council’s Overview and Scrutiny functions relating to this Board.  

The Deputy Director, Children and Adults stated that he had read that paragraph as referring to scrutiny as challenge which the Board would undertake when assessing whether commissioning plans were taking account of the Joint Strategic Needs Assessment and the Joint Health and Wellbeing Strategy.

A suggestion was made that the first bullet point on page 120 of the agenda could be widened to ‘other directly relevant strategies’ rather than just those connected with Public Health.  Clarification was also sought as to the penultimate bullet point to explain that performance management referred more to the co-ordinated approach that was needed.

Decision: 

A delegation was given to the Chairman, in conjunction with the relevant officers, to make the minor amendments to the protocol as set out above, (including adding the Corporate Parenting Board as an additional signatory).  The amended protocol should then be cleared by legal services and circulated to all Board Members before being signed by the Chairman on behalf of the Board.