Agenda and minutes

To approve the record of the meeting held on  15 September 2015.

The record of the meeting held on 15 September 2015 was agreed and signed by the Chairman as correct.

Apologies for absence were received from Dr Peter Green, NHS Medway CCG, Barbara Peacock, Director of Children and Adult Services, Ian Sutherland, Deputy Director of Children and Adult Services, Lesley Dwyer, Chief Executive, Medway NHS Foundation Trust and Dr Mike Parks, Kent Local Medical Committee.

In the absence of Dr Green, it was agreed that Dr Barnett act as Vice-Chairman for the duration of the meeting.

Disclosable pecuniary interests

There were none.

Other interests

There were none.  

There were none.

The Chairman welcomed Dr Antonia Moore, NHS Medway Clinical Commissioning Group, to her first meeting of the Board. He also welcomed Detective Supt. Andy Pritchard, Vice Chair of the Medway Safeguarding Children Board, who was attending the meeting to present the Board’s Annual Report. 

The Chairman advised the Board that, in line with the protocol setting out the relationship between key strategic boards in Medway, the agenda included reports from the Medway Safeguarding Children’s Board, Medway Children’s Action Network and Medway’s Corporate Parenting Board.  The Health and Wellbeing Board therefore had the opportunity to hold these Boards to account, challenge their performance and identify key issues which needed to be included in the Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy.  The protocol also required the Health and Wellbeing Board to share with the Boards the review of the JSNA and the Joint Health and Wellbeing Strategy and a report was included on the agenda which would be the basis of that report to the other Boards.   

This report seeks the Board’s comments on Medway’s Local Transformation Plan.

Discussion:

The Partnership Commissioning Programme Lead – Disabilities and Mental Health introduced a report on the final version of the Medway Local Transformation Plan (LTP) for Children and Young People’s Mental Health and Wellbeing. This developed the principles set out in the Medway Children and Young People’s Emotional Wellbeing Strategy and translated them into short and medium term actions to be taken forward by the CCG and partner agencies in Medway. The LTP had been developed in response to, and in accordance with, Government guidance and additional recurrent funding of £516K was available to Medway CCG and partners to take forward plans and actions within the LTP. This funding was due to be released on 6 November 2015. The Emotional Wellbeing Task Group would be responsible for taking the LTP forward and regular updates would be made to the Health and Wellbeing Board.

The following points were made:

·         The Director of Public Health suggested that Public Health be represented on the LTP Project Board.

·         The additional funding was welcomed and there was a need for all partner agencies to fully commit to the actions within the plan in order for aspirations to be achieved.

·         It was important that service users who were struggling within the system saw movement and progress.

·         Service users generally had interactions with a range of services and improved data sharing between services would reduce the need for them to explain their situation each time they contacted a different service.

·         The financial implications of developing and delivering a new model of services needed to be fully considered to ensure that expectations were managed and achievable.  This may require a transitional budget.

Decision:

The Board noted the update report and:

(a)         welcomed the Local Transformation Plan and the associated additional resources;

(b)         noted the challenges for partner agencies in delivering the Plan, recognising the need for close monitoring; and

(c)         requested that Public Health be represented on the LTP Project Board.

This report seeks the Board’s approval of recommendations for commissioning for recently published chapters of the JSNA.

Discussion:

The Director of Public Health introduced a report on the annual review of the outcomes indicators which contributed to the Joint Health and Wellbeing Strategy (JHWS) and a review of updates to the Joint Strategic Needs Assessment (JSNA).  The outcomes of these reviews would inform partners commissioning plans for the next year.

The report highlighted new chapters of the JSNA which had been finalised, approved and published through the agreed governance mechanisms since the last commissioning cycle.

In response to a question on the statistical significance of percentage changes, for example in smoking prevalence, the Director of Public Health explained that it was necessary to examine the underlying figures from which the percentages were derived in order to determine statistical significance.

Members of the Board discussed a range of issues including:

·         The Pearl Project aimed at increasing bowel cancer screening uptake through patients receiving letters from their own GP rather than the screening service;

·         improving cancer screening uptake, diagnosis and waiting times. The Director of Public Health agreed to bring a briefing paper on cancer to the Health and Wellbeing Board;

·         indicator 106, smoking at the time of delivery, which exceeded the national rate;

·         mental health;

·         the reduction in the gap in life expectancy for men within Medway which was welcomed;

·         the inclusion of a chapter on dementia within the JSNA;

·         increasing the use of green spaces, one suggestion being to advertise them in GP surgeries.

Decision:

The Board approved the report and :

(a)       asked that relevant partner organisations take note of any relevant updates in the next commissioning cycle; and

(b)       noted that the report would be presented to other appropriate partnerships as outlined in the protocol for joint working with other boards approved at the last meeting of the Health and Wellbeing Board.

This report informs the Board of activities of the Medway Children’s Action Network and the early help action plan for 2016.

Discussion:

The Programme Lead, Early Help introduced a report informing Board members of the activities of Medway’s Children Action Network (CAN) and the Early Years Action Plan for 2016. The network incorporated key leaders of services for children, young people and families and it’s role was to develop and implement improvements to services for children. Since December 2014 Medway CAN had refreshed the early help strategy; consulted with managers and practitioners; undertaken detailed work on 4 priority areas (domestic abuse, emotional health and wellbeing, language and discourse and raising aspirations); and agreed an Action Plan for 2016.  The key priority for the 2016 was to make a substantial and lasting difference to outcomes around emotional health and wellbeing in Medway.

The following points were made:

·         The membership of the CAN would benefit from a Housing representative. It was noted that Housing was involved at the operational level.

·         The Common Assurance Framework (CAF) process needed strengthened. The number of CAF co-ordinators to deal with interventions had increased from 1 to 4.

Decision:

The Board:

(a)        noted the Action Plan for Early Help and Medway CAN’s role in it; and

(b)       noted that CAN’s priorities were closely aligned to the Health and Wellbeing Board’s first key priority, to give every child a good start.

This report seeks the Board’s comments on the Medway Safeguarding Children Board Annual Report.

Discussion:

The Vice Chair of the Medway Safeguarding Children Board (MSCB) introduced a report on the Board’s Annual Report for 2014/15. He reported that the Board’s primary role was to keep children safe from harm, abuse or neglect. The report included an overview of the Board’s governance and accountability arrangements; an analysis of the key achievements for the year against the six priorities; an overview of the quality assurance arrangements and performance in key statutory functions; a summary of MSCB accounts for 2014-15; and priorities for the year ahead.

The following points were made:

·         Where possible, the involvement of children in the Board’s processes should be sought. It was noted that a there was a presentation involving children at every meeting.  A Young People’s Panel had been established and some items were introduced by children.

·         Medway was working closely with Kent to identify foster carers for unaccompanied asylum seeking children.  Safeguarding policies were in place for vulnerable children at risk of trafficking and exploitation.

Decision:

The Board:

(a)       noted the MSCB’s Annual Report and commented on the effectiveness of local services in keeping children safe; and

(b)       encouraged the involvement of children in the MSCB’s processes.

This report seeks the Board’s comments on the Corporate Parenting Board Annual Report.

Discussion:

The Chair of the Corporate Parenting Board introduced a report on the Corporate Parenting Board Annual Report for 2014/15.  The report set out the core purpose of the Board, the structure of the Board and its achievements.  Provisional feedback from the recent inspection by Ofsted was that the Corporate Parenting Board was an active advocate for, and scrutiniser of, children in care with good engagement with looked after children and care leavers, promoted by a strong Children in Care Council.

Decision:

The Board:

(a)      noted the annual report of the Corporate Parenting Board and commented on the effectiveness of the Board; and

(b)      noted how the continued efforts of partners was helping to secure improved outcomes for Looked after Children, including coordination of the early help agenda to prevent unnecessary escalation of needs into the care system.

This report updates the Board on the Concordat and its implementation for Medway and seeks the Board’s continued support.

Discussion:

The Head of Mental Health Social Work and Deprivation of Liberty Safeguards introduced a report that updated the Board on the Mental Health Crisis Care Concordat and it’s implementation for Medway. Since the last update report in March 2015, good progress had been made by the Kent and Medway Crisis Care Concordat Steering Group in working towards ensuring that there was urgent and emergency access to crisis care for people experiencing mental health crisis. A number of achievements were set out in the report.

The following points were made:

·         Steps were being taken with the Police to develop a model to replace the street triage initiative.

·         With regard to people detained by the police under S136 of the Mental Health Act 1983, there was a need for an acute mental health facility within Medway to prevent people being held in a police cell.

·         S136 detention enabled people to be placed in a temporary place of safety. They would not all have a mental health need and many would be discharged to return home.

·         The Mental Health Crisis Care Concordat has enabled much improved multi agency working.

Decision:

The Board:

(a)       noted the progress made by the Kent and Medway Crisis Care Concordat Steering Group; and

(b)       agreed to continue to support the Concordat.

This report seeks the Board’s comments on the future work programme for the Board.

Discussion:

The Director of Public Health referred to the Board’s informal meeting held on 29 October 2015 which considered how the new Local Plan could be developed to ensure that Medway is developed to improve health and wellbeing. This would need to be further considered by the Board as the plan progressed.  The Chairman stated that there had been some very productive discussions at the informal meeting about embedding health in planning policies and also the need to ensure health and social care facilities were able to meet the needs of the population.  Members of the Board had been keen to continue to engage in the production of the plan and also support consultation with local people through their networks. 

It was suggested that, as part of the Board’s consideration of the Local Plan, it should consider the use of S106 planning obligations under the Town and Country Planning Act 1990.  It was also suggested that the Board consider a report examining mental health including preventative measures . This could be incorporated into the next update report on the Mental Health Crisis Care Concordat. 

Decision:

The Board agreed the following changes to the work programme:

(a)      to include engagement with the development of the Local Plan, with dates to be confirmed, including consideration of the use of S106 planning obligations; and

(b)      to include within the next report on the Mental Health Crisis Care Concordat, an examination of mental health including preventative measures.