Agenda and minutes

Apologies were received from the following members of the Board:

·         Helen Child  - Third Sector Partnership

·         David Loughton  - The Royal Wolverhampton Hospitals NHS Trust

·         Cllr Val Gibson

·         Steven Marshall – Wolverhampton CCG

Ian Darch attended on behalf of Helen Child

There were no declarations of interest.

[To approve the minutes of the previous meeting as a correct record]

That the minutes of the meeting held on 30 November 2016 be confirmed as a correct record and signed by the Chair.

Councillor Sandra Samuels OBE briefed the Board that Wolverhampton has been shortlisted for the Dementia Friendly (City of the year award) and recognised for its work but did not win the award. The Board acknowledged the good dementia awareness work being done across the city.

[Ros Jervis, Service Director - Public Health and Wellbeing, to present Forward Plan]

Ros Jervis, Service Director Public Health and Wellbeing, introduced the report. The Board considered the items on the draft agenda for future meetings.  The Service Director advised the Board that a small executive group has been set to ensure items are presented in a timely way.

The Board suggested that NHS Capital Programme update report should be presented by a representative of Wolverhampton CCG.

Resolved:

            The Board approved the updates to the Forward Plan.

[Andrew Wolverson, Head of Early Intervention - Children & Young People,

, to present report]

Andrew Wolverson, Head of Early Intervention, gave a presentation about the aims of the Early Years Strategy. The Head of Early Intervention commented that 128 written responses had been received to the consultation and 50 people attended a public consultation event on 17 February 2017.

The Head of Early Intervention added that public feedback on the consultation had highlighted the issue of the need for the document to be more specific about what is needed at early year’s level. The Head of Early Intervention commented on the importance of underlying values listed in the report and in particular the role of parents as being first educators and the need to recognise their impact on their child’s development.

The Head of Early Intervention explained that the consultation ends on 17 February 2017 and the Board were encouraged to contribute to the discussion about the document.

The Board expressed concern that there was no reference to the issue of mental health and the need to align physical and mental development in early years. The Board supported this change and added the highlighted the importance of good maternal health and supporting mothers who are either depressed or diagnosed with other mental health issues. The Board commented on the link between post natal depression and a child developing mental health issues in later life.

The Board discussed the importance of strategy signposting people to the services and also raising awareness of the support available. The Head of Early Intervention commented on the support available at family hubs and the key role of GPs being part of engagement strategy.

The Board commented on the importance of the issue of keeping children safe as being part of the strategy. Alan Coe commented that he would welcome a specific reference in the strategy to the issue of safeguarding. The Board welcomed the reference to the importance of improving perinatal mental health. The Board suggested that the strategy should also include reference to supporting families where drug and alcohol misuse is an issue.

The Head of Early Intervention commented on the support available from the Family Nurse Partnerships to help families in this situation.

Resolved:

1.    The Board endorsed the principles and values of Early Years Strategy.

2.    The panel comments on the Early Years Strategy to be considered as part of the stakeholder consultation process.

[Peter McKenzie, Corporate Operations Manager,  to present report]

Dr Helen Hibbs, Chief Officer, Wolverhampton City Clinical Commissioning Group presented the report. The Chief Officer commented on the key priorities for delivery of the strategy and the six key objectives. The Chief Officer reaffirmed the commitment of the CCG to delivering the objectives in the Black Country Sustainability and Transformation Plan (STP) and the link to the CCG Operational Plan. The Chief Officer commented that the plan has been aligned to other strategic documents, for example, the Health and Wellbeing Board Strategy and the Joint Strategic Needs Assessment. 

The Chief Officer commented on the importance of working with partners to deliver the changes.

The Chief Officer added that the plan details risks to delivering the objectives but offered reassurance to the Board about the robustness of the plans.  The Board commented that the strategy needs to include reference to the issue of safeguarding children given the importance of the CCG role. The Board commented on the need for active engagement with partners.  The Chief Officer responded that the issue safeguarding is taken as a given but accepted the point and agreed to make the issue more explicit in the strategy.

Resolved:

1.    The Board comments on the CCG’s Operational Plan 2017-19 to be considered and the suggested changes included in a revised draft.

2.    The Board agreed to endorse CCG’s Operational Plan 2017-19.

[Alan Coe, Independent Chair, to present Wolverhampton Safeguarding Adults Board report]

Alan Coe, Independent Chair - Safeguarding Adults Board, introduced the report and explained that presenting the annual report about progress against priorities for 2014-15 to the Health and Wellbeing Board. The Independent Chair commented that it is statutory requirement to produce an annual report on behalf of the Wolverhampton Safeguarding Adults Board. The Independent Chair commented that safeguarding adults is different than when working with children, as adults are involved in making decisions and they can make unsafe choices.

The Independent Chair encouraged members of the Board to read the full report which details of the progress made and examples of safeguarding initiatives led by partner agencies.  The Independent Chair added that Board members are encouraged to say how they contribute to the aims of safeguarding adults and acknowledged the excellent work of West Midlands Fire Service.

The Independent Chair referred to the increase of 29 percent in the number of safeguarding concerns and added that this a reflection of the higher levels of public awareness and concern about the issue. The Independent Chair added that that changes in the remit of the MASH to include adults has also contributed to this increase. The Board is getting more direct referrals from the police. The Independent Chair commented that the more referrals is a good indicator of work done to raise awareness of the issue. 

The Independent Chair commented on that despite the progress made more work is needed to collect evidence about the extent to which people feel safer as a result of the intervention by a partner agency and their overall experience of the service.  The Independent Chair commented that the Council’s safeguarding is often underplayed and highlighted the excellent example of the trading standards service as partnership working in practice.

Cllr Samuels, Cabinet Member for Adults, welcomed the report and the progress made to improve adult safeguarding arrangements in Wolverhampton.

Resolved:

Those members of the Board who also represented on Wolverhampton Safeguarding Adult Board to provide assurance that the annual report 2015-16 findings are considered by their respective organisations.

[Ros Jervis, Service Director – Public Health and Wellbeing, to present report]

Ros Jervis, Service Director - Public Health and Wellbeing, introduced the report. The Service Director advised the Board that in future public health commissioning intentions will be integrated within the commissioning strategy for the People Directorate as a whole, and added that this is very welcome positive step.   The Board were advised that the ring fenced grant will end in 2018 to be replaced by local funding arrangements.

The Service Director commented on public health intentions 2017-18 and plans to redesign and retender health protection services to better deal with issues of tuberculosis and infection prevention in more joined up way.

The Board were advised that a wide range of stakeholders were represented on the multi-agency steering group. Paul Smith,Interim Manager for Commissioning, Older People added that a thematic approach is has been adopted to the taking the work forward. As a result it is easier for agencies to learn from each other.

The Board commented that the issue of FGM was not part of the commissioning intention. The Service Director responded that the issue of FGM was specifically part of this work and suggested that it should be picked up by safer partnership work.

Resolved:

            The Board agreed to endorse the commissioning intentions for Public Health and Wellbeing 2019.

[David Watts, Service Director – Adults Community and Steven Marshall, Programme Manager: Adult Social Care Transformation/Better Care Fund,

to jointly present a report]

Paul Smith, Interim Manager for Commissioning, Older People, introduced the update report on progress towards the planning process for 2017/18 Better Care Fund (BCF). The Manager for Commissioning advised the Board that work on the plan has been completed but awaiting Government guidance, which has been delayed. However, the necessary preparation work continues so that Government submission deadlines are met when the guidance has been issued.

The Manager for Commissioning advised the Board that the BCF plan is a two year programme. The BCF is still the delivery model and will complement and not replace existing CCG plans.

The Manager for Commissioning advised the Board that a ‘deep dive’ is planned for February which will involve partners.  The Board commented that the BCF plan needs to look how it will contribute to Strategic Transformation Programme (STP). The Board commented that work being done to review the estates that will support this work.

The Board discussed the use of local pooled budgets to support the achievements of the BCF plan and the challenges to being more productive.

The Board discussed the cost pressures on the health and social care sectors and acknowledged that there is no guaranteed funding and there was a need to look more radically create the space that can be used to support the transformation.

The Board commented that the plan is aimed at avoiding the need for people to go into hospital. The BCF should be used to transform services. The Board supported the transformation work. The Board commented on the challenges presented by BCF but also acknowledged the potential offered the CCG and the Council. The Cabinet Member for Public Health and Wellbeing commented on the findings of analysis done on published STPS by the Chartered Institute of Public Finance and Accountancy (CIPFA) which concluded that some do not provide a credible case about how the savings target will be achieved. The Cabinet Member expressed concern about the risk of having to make forced savings to meet the target. The Board commented on the delay in publishing guidance on the preparation of STP’s and how this has impacted on the work done to date.

The Manager for Commissioning commented on future demographics and the expected growth and the challenge in finding yearly savings. The Manager for Commissioning added that it was important to have policies aimed at reducing growth in demand for services.

Resolved:

            The Board agreed to note the progress towards to the planning process for the 2017/18 BCF programme.

[Jo Cadman, Strategy & Transformation Director, Black Country Partnership NHS Foundation Trust, to present report]

Jo Cadman, Strategy and Transformation Director, introduced the report and gave an overview of the process of the Transforming Care Together (TCT) partnership between the different organisations represented. The Strategy and Transformation Director commented that the partners are looking at ways of improving mental health and learning disability services provided in Wolverhampton.

The Strategy and Transformation Director commented on the work being done with partners in Dudley and Walsall about the benefits of working together.

The Strategy and Transformation Director outlined the next steps in the process and explained that the partners are aiming to have a combined organisation in place by 1 October 2017. The Strategy and Transformation Director added that there is an expectation that the savings will be achieved from combining current back office functions and clinical opportunities in the future.

The Strategy and Transformation Director explained that the proposal fits into the STP and is also aligned with the strategic plans of the CCG and the Council. The Board queried how the proposals fit with the findings of the Mental Health Commission and the specific health work streams. The Strategy and Transformation Director commented that each organisation was developing their individual transformational plans. The information will be shared across the different organisations to check that they meet the local needs.

The Board queried if the possibility of the impact of unintended consequences of the proposal changes have been considered. Alan Coe, Independent Chair - Safeguarding Adults Board, suggested that the impact of combining a number of mental health trusts may have an impact on safeguarding arrangements within the Trust. Alan Coe recommended that a report should go to those Boards that might be affected.

The Strategy and Transformation Director responded that a report on the work is presented to the respective board about the proposals to get a level of reassurance. The Strategy and Transformation Director commented on the current infrastructure and that it would be difficult to service each locality and agreed to look the impact of proposals on resources and current demand.

Resolved

            The Board comments on the planned integrations to be shared with partners during discussions about the Transforming Care Together partnership.

To pass the following resolution:

Resolved:

            That, in accordance with Section 100A (4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following item of business as it involved the likely disclosure of exempt information falling within paragraph 3 of Schedule 12A to the Act relating to the business affairs of a particular person.

[Paul Smith, Head of Commissioning – Older People, to present report]

Paul Smith, Interim Manager for Commissioning, Older People, introduced the draft report on the Black Country Transforming Care Partnership plan. The Board were invited to consider and approve the vision and workplan associated with its delivery.

The Board discussed the report and agreed to note the progress and current actions. The Board agreed to follow up on progress when the Government guidance is published.

Resolved:

1.    The Board agreed approve the vision and workplan associated with the delivery of the Black Country Transforming Care Partnership plan.

2.    The Board agreed to receive an update report when guidance issued by Government.