Agenda and minutes

To elect a Chairman of the Health and Wellbeing Board for the forthcoming year.

Councillor David Brake was elected as Chairman for the forthcoming year.

To elect a Vice-Chairman of the Health and Wellbeing Board for the forthcoming year.

Dr Peter Green was elected as Vice-Chairman for the forthcoming year.

The Chairman informed the Board that a notice of resignation had been received from Sally Allum, the named substitute for NHS England on the Board. He also informed the Board that Dr Mike Parks, Medical Secretary for the Kent Local Medical Committee (LMC) had retired and confirmed that Dr Caroline Rickard would now represent the LMC as invited attendee to the Board. The Board wished Dr Mike Parks a very happy retirement and thanked him for his longstanding efforts on the Board.

Apologies for absence were received from Board Members, Councillors Doe, Maple and Potter and the NHS Medway Clinical Commissioning Group representatives Ian Ayres, Dr Peter Green (Vice-Chairman) and Dr Antonia Moore.

Apologies for absence were also received from invited attendees James Devine (Chief Executive, Medway NHS Foundation Trust), Helen Greatorex (Chief Executive, Kent and Medway NHS and Social Care Partnership Trust) and Dr Caroline Rickard (Medical Secretary, Kent Local Medical Committee).

To approve the record of the meeting held on 16 April 2019.

The record of the meeting held on 16 April 2019 was agreed and signed by the Chairman as correct.

There were none.

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct.  Guidance on this is set out in agenda item 4.

Disclosable pecuniary interests

In relation to agenda item 8 (Suicide Prevention Update) Ian Sutherland, the Director of People – Children’s and Adults Services explained that he had a Disclosable Pecuniary Interest (DPI) in relation to the national charity Samaritans as his wife was the Chief Executive of this organisation. He explained that having taken advice, it was considered that although the Samaritans was referenced within the report, the DPI was not closely aligned to the business within the agenda item and therefore on this occasion it did not give rise to the need to take any further action.

Other significant interests (OSIs)

There were none.

Other interests

There were none.

As a Medway, North and West Kent footprint system, we have developed a single operating plan for 2019/20. This has helped deliver the consistency in planning aspired to in the Medway, North and West Kent (MNWK) Planning Approach (submitted to February 2019 Governing Body at Medway CCG).

The attached document has been adjusted to reflect local feedback from across Kent and Medway and national feedback from regulatory partners. Formal feedback is still to be received following 4 April 2019 submission and thus in-year amendment may be required. 

The plan documents the key developments for 2019/20: Local Care, Outpatient Transformation and the development of Primary Care Networks, Integrated Care Partnerships and Integrated Care Systems.

The Health and Adult Social Care Overview and Scrutiny Committee considered the operating plan on 18 June 2019. The comments of this Committee are set out in section 3 of the report.

Discussion:

The Deputy Managing Director, NHS Medway Clinical Commissioning Group (CCG) acknowledged that there were a significant number of acronyms and technical terms included within the Operating Plan ‘the Plan’ and undertook to consider this when producing future Plans.

It was explained that as well as Medway, the Plan also covered the areas of Dartford, Swale and West Kent. There were three core areas within the Plan which were particularly relevant to Medway, including:

1.  System changes: The Plan provided information on the introduction of Primary Care Networks (PCNs). There were 7 PCNs emerging in Medway which covered populations of between 30,000 to 50,000 people. These PCNs were similar to Local Care Hubs established under the Local Care Model except Strood had been split to reflect probable developments on the Peninsula. The PCNs were aligned to existing Healthy Living Centres.

With respect to the Healthy Living Centres, it was explained that 4 had already been established and another 3 were needed. The Plan also reflected the work being undertaken with partners and providers across Medway and Swale to develop the Integrated Care Partnership (ICP) which covered this footprint.

2.  Outpatient transformation: In line with the Medway Model, the Plan anticipated that some services would be relocated to enable them to be provided at community level, closer to the home of patients. The Plan aimed to improve care pathways and increase the number of ways patients could access clinical advice and clinicians.

3.  Progressing Local Care: The Plan also set out proposals to: embed extended access to GPs, increasing the number of appointments available to patients; embed care home support; and complete integrated local reviews.

Other areas detailed within the Plan included: developing the 111 Service to ensure clinicians such as GPs and mental health nurses were available to consult with patients calling the service; reducing waiting times for planned care; and strengthening mental health provision which included increasing physical health checks for patients with serious mental illness and loearning disabilities.

A Board Member commented that as this was an annual plan, it was out of context with other NHS Plans such as the Long Term Plan, the Five Year Plan and the Sustainability and Transformation Plan. It was suggested that the Operating Plan should include narrative on how it interacts with the priorities of other NHS Plans and include timescales for implementation, budget, workforce requirements etc. Without this context it was difficult for Members to fully understand the Operating Plan.

In response to this and questions regarding the complexity of the Plan, it was explained that the Long Term Plan was published in January 2019 and was the basis for the Operating Plan. The Plan was constructed to meet the requirements and priorities mandated by NHS England, which was the target audience. A shorter, more user friendly, public facing version was being created. A Member asked that going forward the Health and Wellbeing Board and relevant Overview and Scrutiny Committee receive an informative presentation on the Plan  ...  view the full minutes text for item 121.

This report updates Members of Health and Wellbeing Board on the suicide prevention programme. In Medway, the Public Health team provide strategic leadership for suicide prevention, including the Suicide Prevention Strategy and Steering Group.

In 2018, new funding of £667,978 was secured from NHS England for suicide prevention work across the Kent and Medway Sustainability and Transformation Partnership (STP) area in 2018/19. STPs bring together a range of stakeholders including the NHS and local government. Kent and Medway was one of eight areas nationally to receive funding.

This report provides an overview of suicide prevention work that has taken place during 2018/19 and plans for 2019/20. The programme was agreed by the multi-agency Suicide Prevention Steering Group that supports this work in Kent and Medway. The proposed interventions are based on the best evidence available to inform suicide prevention.

This report was considered by the Health and Adult and Social Care Overview and Scrutiny Committee on 18 June 2019 and the comments of this Committee are set out in section 5 of the report.

Discussion:

It was recognised that suicide was a tragic event that could have a devastating impact for family and friends of the person and on the community as whole. In Medway, as nationally, men, particularly middle aged men, were at a greater risk of suicide than women. In the year before a suicide, a third of people had contact with secondary mental health services, a third had contact with their GP and a third had no contact with health services. This suggested that there was a need to look at community interventions as well interventions relating directly to health services. In 2018, new funding was secured from the NHS for the suicide prevention across the Kent and Medway Sustainability and Transformation Partnership (STP). Kent and Medway was one of eight areas nationally to have been awarded additional funding for the programme.

This was an evidenced based programme which through the Suicide Prevention Steering Group engaged with a wide range of partners, including transport and education providers, the voluntary sector and had representation from families who had been bereaved by suicide. The programme delivered over the last year had consisted of nine strands of work set out in detail in Table 2 of the report. Four areas were highlighted in particular, as follows:

1.  The ‘Release the Pressure’ social media campaign. This campaign had been extended significantly over the last year to reach more men and encourage them to seek help. The campaign signposted them to a 24 hour / 7 day a week helpline staffed by trained counsellors. 4,500 calls from Medway residents had been made to the helpline during the previous year.

2.  The ‘Saving Lives Innovation Fund’ was launched which provided grants to community organisations to undertake innovative projects to prevent suicides. 29 such projects had been undertaken in the year, with over 1,000 people benefitting from these. An example project was a mentoring programme to support men going through family breakdown.

3.  Suicide prevention training for professionals and the public. One programme had trained over 100 adults. E-learning had also been launched. 

4.  The Kent and Medway NHS and Social Care Partnership Trust (KMPT) had also developed a Zero Suicide Plan.

Each suicide prevention workstream was assessed for impact, for example data on the number of calls to the helpline had been collected. The programme had also been externally evaluated, although this data was not yet available. Qualitative data was set out at paragraph 3.6 of the report. Feedback from the national team responsible for funding the programme suggested that work in Medway was well advanced compared to the other seven areas awarded funding. 

Funding had also been secured for 2019/20 to further develop the programme. Table 3 of the report outlined the plans for the forthcoming year. This included a new workstream on system leadership which would focus on reviewing care pathways. The Kent and Medway Suicide Prevention Strategy would also be refreshed for 2020.

A Board Member said tackling suicide had to be holistic and  ...  view the full minutes text for item 122.

This discussion paper outlines a summary of the Health and Wellbeing Board’s existing communications and engagement activities, and identifies opportunities for the Board to further develop its approach to communications and engagement.

The summary of existing communication and engagement activities of the Board, includes communications relating to the Board’s Joint Strategic Needs Assessment (JSNA) and Joint Health and Wellbeing Strategy (JHWBS).

Following interviews with communications leads from both the Council and the Clinical Commissioning Group (as key organisations represented on the Board), the paper also makes a number of recommendations about opportunities for further developing the Board’s approach to communications and engagement in future, for consideration by the Board.

Discussion:

This report provided a summary of the existing communications and engagement activities relating to the Health and Wellbeing Board, including those relating to the Joint Strategic Needs Assessment (JSNA) and the Joint Health and Wellbeing Strategy (JHWS). These were set out in detail at paragraphs 3.6 to 3.10 of the report. Having evaluated existing arrangements and following liaison with communications representatives from Medway Council and Medway NHS Clinical Commissioning Group (as two of the key partners on the Health and Wellbeing Board), the Consultant in Public Health proposed areas of further action as set out in paragraphs 3.12 to 3.18 of the report. The proposed recommendations would increase awareness of the Board and further develop the Board’s understanding of and engagement with local people on health and wellbeing topics.

Board Members expressed support for the proposals set out within the report and welcomed this as a starting point. A number of further suggestions were made, including:

·           publishing information on the Health and Wellbeing Board, including contact points and its work programme within the ‘Medway Matters’ magazine at least twice a year. It was noted that this could be shared with local schools and universities to include within their own publications.

·           seeking information on health and wellbeing topics from key target groups by for example consulting with organisations such as the Medway Parents and Carers Forum who represent the views of parents of children with disabilities and Medway’s Children and Young People Council who represent the views of young people in care and care leavers; and

·           with respect to the upcoming formation of Integrated Care Partnerships (ICPs), developing a single engagement plan across providers to work in parallel with the proposals within the report.

In response to the latter point, the Director of Communications, Medway NHS Foundation Trust explained that there were already good communication networks among providers and these would be built in to the ICP going forward.

Decision:

The Health and Wellbeing Board agreed to:

a)    nominate a named communications lead for the Health and Wellbeing Board and request the lead to explore ways of promoting the role of the Board to the public, e.g. using partners’ websites and e-bulletins;

b)    add an update on the “Involving Medway” programme to the Board’s Work Programme;

c)    add an update on the work of the Patient Experience and Public and Patient Engagement (PEPPE) group to the Board’s Work Programme;

d)    consider if there are any health and wellbeing topics which the Board would like to ask the PEPPE group to consider engaging with the public about;

e)    delegate authority to the Director of Public Health in consultation with the Chairman of the Health and Wellbeing Board to review patient experience case studies developed by the PEPPE and include them in the JSNA as appropriate;

f)     request that the citizens’ panel is used to gather information about health and wellbeing topics, and receive an update on this and the results of the health and wellbeing survey when it is complete in  ...  view the full minutes text for item 123.

The report advises the Health and Wellbeing 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 introduced the work programme report and drew the Board’s attention to the recommended amendments to the work programme set out at paragraphs 2.2 to 2.5.1 of the report. These amendments had been reflected in the work programme set out at Appendix 1 of the report.

It was explained that following the pre-agenda meeting, officers had proposed a scope for the research in relation to food justice, set out at paragraph 2.5.2 of the report and had recommended that the report be presented to the Board at their meeting on 10 September 2019.

Having reviewed the items listed on the work programme with dates to be determined, a Member expressed a view that the reports regarding the evaluation of the Suicide Prevention Programme and the update on the outcome of the section 136 ‘deep dive’ should be prioritised. The Democratic Services Officer undertook to review with officers how soon these reports could be brought forward and schedule them accordingly.

The Board considered the start time of their meetings and it was proposed that start time be brought forward to 3pm.

Decision:

The Health and Wellbeing Board:

a)    noted the comments and actions regarding prioritisation set out within the minute and agreed the work programme attached at Appendix 1 to the report, subject to adding the Reference from Full Council – Food Justice report to the agenda for 10 September 2019.

b)    agreed the scope of the Reference from Full Council – Food Justice report set out paragraphs 2.5.2 of the report; and

c)    agreed to bring forward the start time for Health and Wellbeing Board meetings to 3pm, subject to the clinical representatives of NHS Medway Clinical Commissioning Group (CCG) being able to attend.