Agenda and minutes

To elect a Vice-Chairman for the Health and Wellbeing Board for the 2013/14

Dr Bal Bahia was elected as Vice-Chairman of the Health and Wellbeing Board.

To approve as a correct record the Minutes of the meeting of the Board held on 25 July 2013.

The Minutes of the meeting held on 25 July 2013 were approved as a true and correct record and signed by the Chairman.

To receive any Declarations of Interest from Members.

Councillor Graham Jones declared an interest in all agenda items by virtue of the fact that he was a pharmacist in Lambourn as well as a member of the Public Health and Pharmacy Forum but reported that, as his interest was personal and not prejudicial or a disclosable pecuniary interest, he determined to remain to take part in the debate and vote on the matters where appropriate.

There were no public questions submitted relating to items on this agenda.

Councillor Graham Jones reported that a question had been submitted by Mrs Carol Trower, Chief Officer of the Berkshire Local Pharmaceutical Committee. However, as Mrs Trower was unable to attend the meeting a written response would be sent to her.

Councillor Graham Jones declared a personal and prejudicial interest in the subject matter of the question.

Purpose: The Royal Berkshire NHS Foundation Trust has completed its draft five year Integrated Business Plan (IBP) and are now seeking views and feedback from stakeholders.

This item was deferred.

Purpose: To inform the Health and Wellbeing Board of how the 2013-14 funding transfer from the NHS is being used by West Berkshire Council.

Jan Evans introduced her report which set out how the 2013-14 funding transfer from the NHS was being used by West Berkshire Council. The report was seeking approval from the Health and Wellbeing Board for the use of the 2013-14 transferred monies.

Jan Evans stated that for 2013-14 an additional £0.519m had been provided to West Berkshire Council by the NHS. The report stated that this increased the total NHS funding to £1.782m in 2013/14 however, Jan Evans confirmed that this needed amending to £1.793m.

Agreement had been reached between the NHS England Area Team and the Council. The report along with the appended Section 256 agreement identified those areas of spend, which had been protected as a result of the funding. Protecting the most vulnerable citizens remained a Council priority and therefore additional funding from the NHS had been used to protect Adult Social Care as far as possible from the full level of cuts faced by other Council services.

Paragraph four of the report looked at future years funding. In 2014/15 £400k of additional funding would be transferred to the Council and would be used to support Adult Social Care services in 2015.  The Council and NHS would need to draw up plans which showed how this money would be utilised. The plans would need to demonstrate how care and support services would be protected and how the plans met specific criteria including seven day working in health and social care, better data sharing and a joint approach to assessment and care planning.

There would also be performance monitoring in place in respect of the 2015/16 funding, with the second half of the money being released half way through the financial year. Further guidance from the Department of Health was expected in the autumn of 2013. A governance structure was also being agreed.

Jan Evans requested that the Health and Wellbeing Board note the information within the report and approve plans set out for 2015/16. Councillor Graham Jones remarked how the area of work demonstrated that the collaborative agenda was continuing to move forward.

Adrian Barker commented that the item linked to the integration work taking place and the Call to Action item later on the agenda. Jan Evans continued that the integrated transfer fund underpinned how the NHS and Council would move forward.

RESOLVED that the Health and Wellbeing Board approved the use of the 2013/14 NHS transfer funds. The Section 256 Memorandum would be signed by Councillor Jones and circulated to the relevant persons.

An update on behalf of Kakoli Choudhury (Health Protection Consultant, Bracknell).

Lesley Wyman introduced her report, which aimed to brief the Board on the Measles Mumps and Rubella (MMR) vaccination catch up programme and the progress that the Thames Valley Area Team were making in delivering the national target.

There was a national target to immunise 95% of children with one dose of the vaccine by the age of two and a second dose of the vaccine by the age of five. Although the rate of those completing the course of vaccinations was good in West Berkshire, improvement was required as the 95% target was not being reached.

There had been a rise in the incidences of Measles in 2011/12, which had carried on through until 2013. There was a higher rate of cases in teenagers, which had never before been an issue. The 10 – 16 year old age group was the one most affected by the adverse publicity relating to the MMR vaccine between 1998 and 2003 and therefore there were larger numbers of children of this age unimmunised or partially immunised against measles. 

Lesley Wyman drew the Boards attention to the section of the report which detailed what was being done to increase the immunisation rate and formed part of the MMR catch-up campaign. Phase one of the campaign in Berkshire included communications to encourage parents or guardians of unvaccinated and partially vaccinated young people to take them to their General Practice and the targeting of vulnerable groups such as Gypsy, Roma and Traveller families.

The proposed outcome for West Berkshire was for 95% of young people aged 10 – 16 years to have received at least one dose of the MMR by September 2013.

Lesley Wyman reported that there was difficulty in obtaining data showing which young people had received one or both of the doses. Regarding phase two of the campaign, there would be a meeting of the Thames Valley Steering Group including Directors of Public Health to agree the actions, which would be taken locally. Three from the six unitary authorities had achieved or almost achieve the 95% target for the first MMR immunisation and all apart from Slough were above 90%.

Percentages included within the report as part of Sentinel Survey, showed West Berkshire was achieving positively however, the caveat was added that the percentages did not take all GP practices into account and therefore were not a total representation. Following an audit it had been found that a number of GP Practices were under reporting on the particular age group of concern, therefore is was possible that more 10 – 16 year olds had received the MMR than indicated by the data.

Lesley Wyman reported that it was about encouraging parents and schools to identify children who had not received immunisation. General practices were paid to identify children, encourage them into surgeries and give them the MMR through a Locally Enhance Service.

There was intention to provide extra vaccinations within schools however, only within South Reading and Slough where the number of  ...  view the full minutes text for item 46.

Purpose: To draw to the attention of the Health and Wellbeing Board a new requirement to undertake a Joint Health and Social Care Assessment for Learning Disability.

Rachael Wardell introduced her report to the Board which presented the new Joint Health and Social Care Learning Disability Self Assessment Framework. All local authority areas had been asked to complete the self-assessment, working with local partners including Clinical Commissioning Groups (CCGs) by the end of November 2013.

Rachael Wardell gave a presentation to the Board which had been written for the broader public and therefore simplified the process. In summary:

·        The Joint Self- Assessment (JSA) was a way of checking how good services were working for people with learning disabilities and their family members.

·        In the past this had been carried out through the Health Self Assessment Framework and the Learning Disability Partnership Board. In essence the JSA brought these two things together.

·        The three measures for the JSA were Staying Healthy, Being Safe and Living Well.

·        Areas were being checked against these measures through their compliance to relevant policy; data showing how many people were using particular services and through sharing case studies.

·        Local partners shared the responsibility for ensuring the framework was a success and this would be overseen by Learning Disability Partnership Boards, Clinical Commissioning Groups and Health and Wellbeing Boards.

Rachael Wardell reported that the work was in hand and she would report back to the Health and Wellbeing Board with the result of the self assessment at a later date.

RESOLVED that Rachael Wardell would inform the Board of when the self assessment would be completed as soon as she was made aware.

Purpose: To make the Health and Wellbeing Board aware of an early strand of Health and Social Care integration being undertaken in the West of Berkshire.

Rachael Wardell introduced her report which aimed to make the Health and Wellbeing Board aware of an early strand of Health and Social Care integration being undertaken in the West of Berkshire.

Berkshire West Health and Social Care partners had committed to working more closely together to ensure effective provision of quality services to the population, using their collective resources to achieve the best outcomes for service users and their families.

Locality groups had been set up in each Council area to develop Health and Social Care integration. The West of Berkshire group consisted of ten partners including CCGs and the Ambulance Trust. These partners had always collaborated loosely however, working relationships were now more defined due to the Pioneer Project.

Approval was not required from the Board as there was capital funding designated for the project.

Councillor Graham Jones referred to the Governance section of the report where it stated that the steering group for the project would be the Berkshire West Partnership. Rachael Wardell confirmed that the Health and Wellbeing Board sat above the Berkshire West Partnership. Councillor Jones questioned Member involvement and Rachael Wardell acknowledged that in the future she might need to seek permission from the Executive Portfolio Holder for Children and Young People, Youth Service and Education.

Cathy Winfield reported that she would like to see care pathways redesigned around outcomes and as a result reduced placements in care homes. The next step was to create a business plan for the future state, which assessed where additional funding was needed and where the gaps were in the Social Care system. If the system was changed it needed to be done collectively both in terms of resources and results. Cathy Winfeld suggested that a presentation be brought to the next Board meeting, which detailed the strands and governance of the project.

RESOLVED that Cathy Winfeld coordinate a presentation for the next H&WB Board meeting which gave an update on the project.

Councillor Jones noted that the target was red for the number of elected admissions and questioned whether this was measurable. Cathy Winfield confirmed that there were a variety of metrics including some patient experience measures. The number of people going through hospital doors needed to be reduced.

Adrian Barker commended the project and asked whether there would be an opportunity for the public to input their experiences. Rachael Wardell confirmed that this would be considered, she still needed to draft a response on the methodology.

Cathy Winfield reported that a plan would be in place by March 2014 and it was hoped that they would have a future state by February 2014. A high level plan would be required, which could then be fine tuned accordingly. The delivery in West Berkshire would be different to that of Reading.

Purpose: To provide information on the local implementation of the Department for Communities and Local Government’s Troubled Families Programme: 2012-2013.

Rachael Wardell introduced the Turnaround Families Programme to Members of the H&WB Board, which was being managed by the Department of Communities and Local Government. The Programme had been initiated as a result of the riots which had taken place in London during 2011. There were specific areas that were taken into account when families were referred onto the programme and these included work related benefit dependency, anti-social behaviour, youth offending and school attendance. A cohort of families had been identified. Payment by result was the method being used for the programme.

West Berkshire was considered advanced as it already had the Family Intervention Programme (FIP) and a Family Intervention Team (FIT). The first year of the Turnaround Families Programme had largely been foundation laying and planning.

Rachael Wardell handed over to Satdeep Grewel (Development Officer – Turnaround Families) and Ruth Adams (Turnaround Families Referral Coordinator) to give a presentation to the Board giving more detail on the programme.

In summary:

• There were ten families on programme so far for whom payment was being sought;
• The programme promoted a whole family approach;
• Participation by the families was voluntary and the aim was to move the families towards economic independence.
• Research had been carried out on the families using data from RAISE, which showed that 70.1% had mental health issues and 69% had experienced domestic abuse.
• The local Turnaround Families Programme aimed to turn around services delivery; turn around the lives of 145 families and turn around aspects of strategic funding and partnerships.
• The Department of Health would carry out a re-evaluation of the service.

Cathy Winfield questioned how the programme fit with health visiting and secondly how FIP sat with Family Nursing Partnerships. Rachael Wardell confirmed that this highlighted a weakness of the programme as families were not eligible until their children came of school age whereas Health Visiting supported birth to 5 years.

Lesley Wyman stated that the Turnaround Families Programme overlapped with the Public Health agenda in a number of success indicators. A number of common issues, which had been raised, formed part of the Public Health Action Plan. It was vital that joint working took place to avoid duplication.

RESOLVED that the Turnaround families Team meet with Public Health to discuss collaborative working.

Adrian Barker questioned how the Police were involved in the Programme and secondly asked if plans were in place to try and sustain the programme.

RESOLVED that: Rachael Wardell would look into the latter part of Adrian Barker’s question regarding sustainability.

Regarding the involvement of the Police force it was reported that Susan Powell and Police representatives sat on the Safer Communities Partnership, which was aware of the Turnaround Families work. The Police were able to make referrals to the Turnaround Families Programme and close working also took place with the Youth Offending Team.

Leila Ferguson reported that Empowering West Berkshire (EWB) were the umbrella organisation for voluntary organisations. Leila Ferguson noted that 70% of the families had disabilities, of which it was  ...  view the full minutes text for item 49.

Purpose: To inform the Health and Well Being Board of the national Call To Action that will engage stakeholders in the design of a renewed and revitalised NHS. To advise the Board of its role in this process.

Cathy Winfield introduced her report which sought to inform the H&WB Board of the national Call to Action that would engage stakeholders in the design of a renewed and revitalised NHS.

NHS England had published the Call to Action document ‘The NHS Belongs to the People’ to engage with NHS staff, stakeholders, patients and the public about the future of the NHS in the light of challenges faced by the service. The aim of the document was to build a case for change and address pressures faced by the NHS. The normal financial allocation within the NHS was annual however, in 2014 funding would be allocated for two years.

The three options which had been ruled out regarding the future of the NHS were:

• Do nothing;
• Assume increased NHS funding;
• Charge for fundamental services or ‘privatise’ the NHS.

The engagement process would allow the opportunity to gather ideas and solutions. The NHS was facing workforce challenge and demand pressures. A workshop was taking place on 7^th November 2013 to begin looking at challenges faced.

RESOLVED that Cathy Winfield would report back to the Board regarding the workshop on 7^th November.

Councillor Graham Jones identified that there was a direction of travel away from a national illness service towards prevention. Prevention was an easy concept to buy into however, he could foresee political issues arising. Councillor Jones asked what was expected from West Berkshire Council by the Call to Action initiative. Cathy Winfield confirmed that scheduled strategic meetings and the event planned for November, were relevant for the H&WB Board.

Lesley Wyman pointed out the importance of Public Health in leading on the prevention agenda and supporting the CCGs in this work.

Rachael Wardell referred to page 197 of the agenda (page 21 of the NHS belongs to the People document) and pleaded that a one model approach was not taken, as this often caused an area of work to collapse. What worked well in West Berkshire needed to be held onto and its rural nature kept in mind.

Cathy Winfield confirmed that there was opportunity for localism. And it was expected that there would be variation across the models of delivery.

RESOLVED that the H&WB Board noted the national Call to Action and its role in the engagement process.

There were no Member questions submitted relating to items on this agenda.

There were no Member questions submitted relating to items on this agenda.

28November 2013 – Committee Room 1

23January 2014 – Committee Room 1

27 March 2014 – Committee Room 1

22 May 2014 – Committee Room 1

The date of the next meeting was 28 November 2013 in the Council Chamber (Market Street Offices)