Agenda and minutes

To receive any apologies for absence received.

Apologies were noted from the following:

·         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

·         Dr David Chilvers, Chairman Fareham & Gosport Clinical Commissioning Group. His Substitute Dr Paul Howden, Deputy Chair also gave apologies                   

·         Nick Tustian, Chief Executive, Eastleigh Borough Council. His Substitute Patricia Hughes, Chief Executive, Hart District Council also gave apologies

·         Cllr Dr Anne Crampton, Hart District Council. Her Substitute Cllr Philip Raffaelli also gave apologies

·         Phil Taverner, Test Valley Community Services (resigned position). His Substitute Carol Harrowell, Head of Client Services at the Home Group attended in his place

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

·         Dr Liz Mearns, Medical Director NHS England Wessex

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. Regarding minute 33 (key issues and financial challenges for the NHS and County Council in Hampshire) the Healthwatch representative requested that this topic be scheduled for further discussion. 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 welcomed those in attendance on behalf of the Care Quality Commission, who were observing the meeting as part of their review of the Hampshire Health and Care System. The purpose of the review was to better understand the pressures and challenges across the Hampshire system and identify any areas for improvement needed in health and social care services. The focus was on services for people over 65 and whether people using local services were provided with safe, timely and high quality care. Following the review, CQC would consider their findings and formulate a report. The report would be presented to the Hampshire Health and Wellbeing Board and published by CQC via their website.

Joint Health and Wellbeing Strategy

The Chairman noted that the Health and Wellbeing Board was responsible for the Joint Health and Wellbeing Strategy for Hampshire. The current Strategy period runs to 2018, and it would be a focus of the Board this year to review the Strategy. The business sub group would co-ordinate the strategy refresh, and Board Members would be involved in reviewing the priority areas under each theme through workshops. There would be a workshop following this meeting with a focus on the ‘living well’ and ‘ageing well’ areas of work. The revised Strategy would be brought back to a future meeting of the Board for approval.

To receive a report for information regarding the Improved and Integrated Better Care Fund 2017-2019.

The Board considered a report and supporting presentation on behalf of the Director of Adults’ Health and Care regarding the Integration and Better Care Fund and improved Better Care Fund.

Board Members commented that it would be good to have a report back in due course on what impact this funding has had, and how the benefits can be sustained beyond the short term funding. It was discussed that there were examples of both qualitative and quantitative benefits from the vanguard out of hospital care models.

RESOLVED:

The Health and Wellbeing Board:

·         Note the current position with regard to the Better Care Fund and improved Better care Fund policy.

·         Note the approach to the application of the IBCF.

·         Note that a Deed of Variation to the current Section 75 agreement was executed so that Hampshire meets expected National Conditions for a jointly agreed plan.

For the Board to approve the Hampshire Pharmaceutical Needs Assessment, and to delegate response to pharmacy consolidation plans. This Board is responsible for the PNA and responding regarding pharmacy changes under regulations.  

The Board considered a report from the Director of Public Health regarding the Hampshire Pharmaceutical Needs Assessment. The report also sought delegated authority to respond to consultations about pharmacy consolidation proposals, as a response was required within 45 days and there may not be a Board meeting in time. It was discussed that any proposals received could be reported to the Board annually.

RESOLVED:

The Health and Wellbeing Board:

·         Approve the Pharmaceutical Needs Assessment 2018 for Hampshire for publication.

·         Delegate authority to the Director of Public Health, to make representations to NHS England about pharmacy consolidation applications.

·         The Director of Public Health report annually to the Board regarding any consolidation applications received.

For the Board to approve the Suicide Prevention Strategy for Hampshire. The Board is responsible for this strategy under regulations.

The Board received a report and supporting presentation on behalf of the Director of Public Health regarding the Suicide Prevention Strategy.

Board Members discussed the issues. The Chief Executive of Southern Health commented that the target to reduce suicide by 10% was not ambitious enough. It was noted that evidence suggests a third of suicides had been to see their GP two weeks before their death. The Chair of North Hampshire Clinical Commissioning Group commented that it would be helpful if any warning signs could be flagged to GPs on a patients record, to help pick up on those cases. It was also discussed that targeted approaches were beneficial e.g. to support high risk groups like farmers.

RESOLVED:

The Health and Wellbeing Board approve the suicide prevention plan for Hampshire.

To receive an update from the Hampshire Districts Health and Wellbeing Forum (sub group of the Health and Wellbeing Board, leading on the Healthy Communities strand of the current Joint Health and Wellbeing Strategy).

The Board considered a report on behalf of the Chair of the District Forum, that had been deferred from the last meeting. The report highlighted the importance of open space for mental and physical health and wellbeing.

Board Members agreed this was an important factor in supporting a healthy lifestyle and addressing population health.  

RESOLVED:

That the Hampshire Health and Wellbeing Board recognises the value of access to open spaces in local areas and that the Board’s member organisations consider the measures in the report to encourage increased usage of open spaces for physical activity.

To receive an update from the Co-design, Co-Production and Community Participation Sub Group of the Board and consider their recommendations.

The Board considered a report from the Co-design, Co-production and Community Participation sub group, deferred from the last meeting. It was noted that at it’s meeting in February 2018 the group had decided to amend it’s name to simply ‘co production’ sub group.

The group had decided to focus on three priority areas initially, one of which was to provide information and guidance to the Board on good practice in engagement, co-design and co-production. The report made a number of recommendations to the Board on this topic.

The Chief Executive of Hampshire Hospitals NHS FT noted that provider organisations were not currently represented on the sub group, and offered to look into finding a representative, which was welcomed.

It was requested that co-production be discussed by the Health and Care Alliance and the Chairman agreed to follow this up.

RESOLVED:

·         That the Hampshire Health and Wellbeing Board use its influence to ensure that there is a commitment from the highest level in both local government and the NHS to effective co-production and engagement in the development of commissioning plans and services, including in the Sustainability and Transformation Partnership and Accountable Care Systems, across:

o  all stakeholders: health and care commissioners; the County Council; providers whether statutory, commercial or voluntary sector; service users current and future, and the community groups who work with them to make their views heard

o  the entire area of the STP, not just within Hampshire County Council’s borders

o  health and social care and well-being.

·         That the Board model good practice by involving public and/or service users in the Board’s own policy developments.

·         That the Board monitor co-design, co-production and community participation (see para 3.4 for how this should be done).

·         That the Board ensure that all have access to good practice guidance on co-design, co-production and community participation (see para 3.5).

·         That the Board agree that NHS and local authority colleagues need the

opportunity to learn by experience as well as being offered good practice guidance and explore ways to resource replication of the Empowering Engagement course successfully piloted in both North East Hants and the Isle of Wight (see para 3.6).

·      That the Board invite the STP to facilitate access to findings of previous

     participation work (see para 3.7).

To consider any other business Board Members wish to raise.

The Chairman invited Board Members to raise any other business. The Director of Public Health reported that a JSNA Steering Group had now been established.

The Healthwatch Chair highlighted that Hampshire Healthwatch were looking to recruit to Director and Associate roles (unpaid volunteer roles). Further details would be circulated to Board Members for distributing among their networks.

To note the next meeting of the Board is scheduled for 7 June 2018.

It was noted that the next meeting of the Health and Wellbeing Board was scheduled for 7 June 2018.