Agenda and minutes

To receive any apologies for absence received.

Apologies were noted from the following:

·         Steve Crocker, Director of Children's Services. His Substitute Stuart Ashley, Deputy Director for Children and Families, also gave apologies

·         Dr Sarah Schofield, Chairman West Hampshire Clinical Commissioning Group. Her Substitute Heather Hauschild, Chief Officer, also gave apologies

·         Dr Andrew Whitfield, Chairman North East Hampshire and Farnham Clinical Commissioning Group. His Substitute Dr Peter Bibawy, Medical Director attended in his place

·         The main NHS England (Wessex) representative was a vacancy, and the Substitute Dr Liz Mearns, Medical Director gave apologies

·         The second District Councillor main representative was currently a vacancy, and the Substitute position was also a vacancy

·         Shantha Dickinson, Hampshire Fire and Rescue Service. Her Substitute Nigel Cooper, was unable to attend in her place

·         Michael Lane, Police and Crime Commissioner for Hampshire. The substitute position was currently a vacancy

·         Nick Tustian, Chief Executive Eastleigh Borough Council. His Substitute Patricia Hughes, Chief Executive of Hart District Council was unable to attend in his place

All Members who believe they have a Disclosable Pecuniary Interest in any matter to be considered at the meeting must declare that interest and, having regard to the circumstances described in Part 3 Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore all Members with a Non-Pecuniary interest in a matter being considered at the meeting should consider whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, consider whether it is appropriate to leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with the Code.

Members were mindful that where they believed they had a Disclosable Pecuniary Interest in any matter considered at the meeting they must declare that interest at the time of the relevant debate and, having regard to the circumstances described in Part 3, Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter was discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore Members were mindful that where they believed they had a Non-Pecuniary interest in a matter being considered at the meeting they considered whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, considered whether it was appropriate to leave the meeting whilst the matter was discussed, save for exercising any right to speak in accordance with the Code.

To confirm the minutes of the previous meeting

The minutes of the last meeting were reviewed and agreed, subject to an addition to Minute 42 to state that the Chairman agreed this would be done.

To receive any deputations notified under Standing Order 12.

No Deputations were received at this meeting.

To receive any announcements the Chairman may wish to make.

CQC Local System Review

The Chairman reminded Board Members that in March the Care Quality Commission undertook a Local System Review of the Hampshire Health and Care System. The Chairman announced that a Summit had been arranged for 20 June 2018 to discuss the findings of the review with system partners and stakeholders. Members of the Board had been sent an email invitation to this event.

The summit would be an opportunity for partners and stakeholders to hear the review outcomes directly from CQC and receive feedback from key system leaders on the actions that would be taken in response to the review.

Co-production

The Chairman informed Board Members, on behalf of the Chair of the Co-production Sub-group, that there would be a workshop on Co-production following the 11 October 2018 meeting of the Board. The Co-production Sub-group would be in touch with organisations on the Board in advance of the October workshop, to understand more about co-production in each of the organisations, and to help prepare for the workshop.

To receive a presentation providing an update on Special Educational Needs and Disabilities (SEND) Reforms.

The Board received a presentation from a representative from Children’s Services at Hampshire County Council and a representative of the Hampshire five Clinical Commissioning Groups (CCGs), providing an update regarding Special Educational Needs and Disabilities (SEND) Reforms (see Item 6 in the Minute Book).

Board Members heard that there was close working between the Local Authority and the NHS over implementing the reforms, including liaison with Adults Services at the County Council as the age range was extended to cover up to 25. 99.9% of Statements of Special Educational Needs had been transferred to Education Health and Care Plans (EHCPs) as required by 31 March 2018. The timescale for issuing new statements had been 26 weeks and the timescale for issuing new EHCP’s was 20 weeks. In March 2018 46% of EHCPs were being issued in this timeframe. It was noted that there had been a significant increase in demand for Statements/Plans from 5,000 in 2015 to 8,000 now, and the funding to provide them had not increased.

Board Members heard that there were a number of other developments underway including; the introduction of a digital EHC Hub; work to manage demand; work to reduce out of county placements; a post 16 preparation for adulthood strategy; capital place planning strategy.

The representative of the Community and Mental Health Trusts commented that the organisations represented on the Board were employers and could help provide employment opportunities as part of the preparation for adulthood work.

The importance of school nursing was discussed, and it was noted that a joint procurement was underway bringing together the nursing commissioned by public health and that commissioned by the CCGs. 

RESOLVED:

The update was noted.

For the Board to endorse the new Joint Carers’ Strategy.

The Board received a presentation from a representative from Adults Health and Care at Hampshire County Council and a representative from the Princess Royal Trust for Carers, regarding the Hampshire Joint Carers Strategy for 2018-2023 (see Item 7 in the Minute Book).

It was noted that the following week was Carers week, which provided opportunities to promote the new Strategy. National Government had published a Carers Action Plan which reflected similar themes to the Hampshire strategy. It was highlighted that the value of the time carers provide was equivalent to the whole NHS budget for a year.

A consultation had been undertaken on the draft Strategy, and feedback had been acted on to simplify and shorten the document. A Strategy Implementation Group was being established to follow up the actions.

The Executive Member for Children’s Services queried whether there were opportunities to use technology to support carers, especially young carers. It was responded that this was being considered, and feedback from young carers indicated that they would prefer digital support.

The Executive Member for Public Health highlighted the particular needs of rural carers who may be isolated, and the need to monitor the impact of the Strategy in future.

The Acute Hospitals representative offered that acute hospitals could do more to contribute, for example identifying carers through if they bring patients to appointments.

The HealthWatch Representative noted the Strategy was a good example of co-production, and offered HealthWatch support with reaching hard to reach carers.

RESOLVED:

The Health and Wellbeing Board agrees to:

·         Endorse and promote the Strategy

·         Use the Strategy as a reference document when planning services for the people of Hampshire

·         Think Carer! Promote carers’ issues and support them to continue in their caring roles

To receive a verbal update of work in progress.

The Board received a verbal update from the Assistant Director of Adults Health and Care at Hampshire County Council regarding the Improved and Integrated Better Care Fund and Delayed Transfers of Care.

Board Members heard that the Integrated Better Care Fund (BCF) began in 2015 and the funding was designed to support integration of health and social care, demographic pressures and person centred care. The value of the BCF was £88m in the last financial year (although this was not ‘new’ money). Of this, £11m was used to support district councils with disabled facilities grants, £22m to support adult social care pressures and £52m to invest in community services.

It was highlighted that the current BCF period ran to April 2019, and there was a national review of the BCF and disabled facilities grants underway. It was expected the outcomes of these reviews would inform any continuation of BCF in future years. There remained national support for the agenda of integration between health and social care.

It was noted that Delayed Transfers of Care (DToC) were a high profile issue for Hampshire, with a Care Quality Commission Review undertaken in March, from which a report was due to be received on 20 June 2018. Newton Europe had been providing external support to the Hampshire system on DToC issues. System partners were working on an action plan to respond to the CQC review and hoped to put measures in place in time to prepare for winter pressures.

RESOLVED:

The update was noted.

To consider a report from the District Forum providing an update on their work.

The Board received a report from the Chair of the District Forum providing an update from the Districts Health and Wellbeing Forum (see Item 9 in the Minute Book).

It was discussed that a whole systems approach was needed to tackle wider determinants of health for example inactivity. It was noted that investment in prevention could take time to deliver results. Board Members were supportive of taking a longer term view as a system.

RESOLVED:

That the Hampshire Health and Wellbeing Board notes the intention of the Hampshire Districts Health and Wellbeing Forum in focussing resources, for the next six months, to support the development of the new Health and Wellbeing Strategy.

To consider any other business Board Members wish to raise.

The HealthWatch representative highlighted that a letter had been received from the lead officer for the Hampshire and Isle of Wight Sustainability and Transformation Plan, inviting comments in relation to a session planned for 4 July 2018. This would be circulated for information to those members of the Board who had not seen it.

To note the next meeting of the Board is scheduled for 11 October 2018.

It was noted that the next meeting of the Health and Wellbeing Board was scheduled for 11 October 2018.