Agenda and minutes

To remind Members of the need to record the existence and nature of any personal, disclosable pecuniary or other registrable interests in items on the agenda, in accordance with the Members’ Code of Conduct.

There were no declarations of interest received.

To inform the Health and Wellbeing Board of the refreshed Local Transformation Plan for Children and Young People’s Emotional Health and Wellbeing

The Board considered a report (Agenda Item 4) which provided an early descriptive indication of the changes to the children and young people’s mental health system following the implementation of Local Transformation Plans.

The report of the government's Children and Young People’s Mental Health Taskforce, “Future in Mind – promoting, protecting and improving our children and young people’s mental health and wellbeing”, was launched on 17 March 2015 with the requirement for system wide transformation by 2020.

West Berkshire’s Health and Wellbeing Board approved the local plans in October 2015 which has enabled additional recurrent funding to be released from NHS England to the West of Berkshire Clinical Commissioning Group (CCG).

There was insufficient consistency in national or regional comparator information, to enable reliable benchmarking of local performance however service managers were pleased with the direction of travel indicated by performance data.

Berkshire Adolescent Unit (BHFT) was now a 7 day, 24 hour a day service that was also a registered tier 4 provision in Berkshire. The number of beds had increased from 7 to 9 and so fewer children requiring this level of intervention needed to be placed outside of Berkshire.

The Common Point of Entry (CPE) was now open 8am until 8pm Monday to Friday. The current average waiting time for referrals to CPE was 5 weeks. National indications suggest that the national waiting time for a first CAMHs appointment was approximately 9 weeks.

Initial indications suggested a reduction in waiting times, with more children and young people receiving timely evidence based treatment across all 5 care pathways. The indications from the data also suggested that the number of children waiting for help had also reduced.

The Child and Adolescent Mental Health Service (CAMHS) Urgent Response Pilot ran throughout 16/17 and had been commissioned for 17/18. Short term intensive interventions in the community were provided to young people who had experienced a mental health crisis with the aim of reducing the number of children and young people who had a second or subsequent crisis. The service also provided wrap around support when there were delays in sourcing a Tier 4 in CAMHS patient bed.  Response time to assessment has reduced and length of stay in both A&E and the paediatric wards had reduced with improved facilitation of admission to Tier 4 units when required. Current information suggested a reduction in use of agency Registered Mental Nurses at Royal Berkshire Hospital. There had also been a reduction in the number of minors admitted to the Place of Safety at Prospect Park Hospital.

Information suggested that Berkshire West waiting times for autism assessment i.e. 40 weeks was lower than the national average. However waits remained longer than both the commissioner and provider wanted locally. The current local target was to reduce waiting times for autism assessment to a maximum of 12 weeks by October 2017. The Children’s Delivery Group would be running a conference in May to check that schools were making appropriate referrals.

Sally Murray concluded by informing  ...  view the full minutes text for item 46.

That the Health and Wellbeing Board approves the draft plan and delegates authority to the Head of Adult Social Care, in consultation with the Chairman and Vice-Chairman of the Health and Wellbeing Board, to approve the final plans for the Better Care Fund 2017/19.

The Board considered a report (Agenda Item 3) which sought the Health and Wellbeing Board’s approval for the draft BCF plan for 2017/19, subject to the Head of Adult Social Care, in consultation with the Chairman and Vice-Chairman of the Health and Wellbeing Board, ensuring the plan aligned with the BCF National Guidance once it is published. Due to the announcement of the General Election to be held on 8 June 2017, Tandra Forster reported that it was unlikely that the plan could be submitted until mid to late June. Officers were confident that they had a mature plan.

Shairoz Claridge advised that the vision for the original Better Care Fund had been to improve outcomes in the delivery of care and Newbury and District and North and West Reading Clinical Commissioning Groups had performance in the top quartile for non-elective admissions. The focus for the next Better Care Fund plan would be using step down beds to improve performance on delayed transfers of care and supporting self funders.

Tandra Forster commented that plan had an increased focus on support for mental health and learning disability services so that they had parity with physical health. Proposals included a link worker in Prospect Park to support discharges and Birchwood Care Home step down beds would include  support for older people with mental health issues and dementia.

Cathy Winfield commended the plan and endorsed the strength of the joint working. She noted that the plan targeted the pressure points in the system and expressed her full support.

Andrew Sharp enquired whether there would be any flexibility in the plan to include other projects, for example improved community nursing might prevent non elective admissions. Shairoz Claridge advised that work was ongoing to develop integrated care teams to include social workers and community nurses.

Councillor Rick Jones stated that one advantage to the delay in the publication of the guidance was that he had been able to meet with Tandra several times to discuss the plan. He endorsed the good work presented tot he Board.

Councillor Quentin Webb queried whether there would be sufficient resources to support the Getting Home Project. Tandra Forster advised that phase one effected internal processes and was sufficiently resourced. The primary issue but the main issue in relation to delayed transfers of care continued to be capacity in effecting resourcing was the care market.

RESOLVED that the Health and Wellbeing Board approves the draft plan and delegates authority to the Head of Adult Social Care, in consultation with the Chairman and Vice-Chairman of the Health and Wellbeing Board, to approve the final plans for the Better Care Fund 2017/19.