Meeting documents

Apologies were received from Mr T Boyd, Mr D Johnston, Mrs J Baker OBE, Mr S Bell, Dr S Roberts and Ms L Patten.

Ms T Jervis attended in place of Mrs Baker.  Ms D Wolfson attended in place of Mr Boyd and Mr Johnston.

The Chairman congratulated Ms Lou Patten on her recent appointment as the Accountable Officer for the federated Clinical Commissioning Groups and Mr Neil Dardis on his permanent appointment as Chief Executive of Bucks Healthcare Trust.

Ms A Macpherson had replaced Ms S Jenkins as a District Council representative on the Board.

There were no declarations of interest.

To confirm the minutes of the meeting held on Tuesday 7 June 2016.

The minutes of the meeting held on 7 June 2016 were agreed.

The Chairman referred Members to the list of actions included in the agenda pack.  It was agreed to invite Tracey Ironmonger to a future meeting and to re-invite David Smith, the local Senior Responsible Officer for the Sustainability and Transformation Plan to the December meeting.

ACTION:

·         Ms K McDonald to invite Tracey Ironmonger to a future meeting.

·         Mr R Majilton to follow-up on the invitation for David Smith to attend the December board meeting.

The District Council representatives provided the Board with feedback on how the Active Bucks programme had been working within their Districts.

There were no public questions.

Presentation of the Joint Strategic Needs Assessment Development Group.

Presented by Dr Emily Youngman

The Chairman welcomed Dr Emily Youngman, Consultant in Public Health Medicine.

The following main points were made during the presentation:-

·         Local authorities and clinical commissioning groups had equal and joint duties to prepare Joint Strategic Needs Assessments (JSNAs), through the Health & Wellbeing Board.

·         The JSNA assessed the current and future health, care and wellbeing needs of the local community to inform commissioning decisions.

·         The Buckinghamshire Health & Wellbeing Board was in the process of refreshing the JSNA for 2016-2021.

·         A JSNA development group was established in June 2015 and a stakeholder event took place in July.

·         The population in Buckinghamshire had increased by 3.3% since 2011 and it was estimated to increase by 7.7% (40,400 people) to 562,600 in 2025.  The non-white population increased from 7.9% in 2001 to 13.6% in 2011.

·         Buckinghamshire was the 5^th least deprived local authority out of 152 in 2015 (compared to being 8^th out of 149 in 2010).

·         Buckinghamshire had one of the highest employment rates in the country and there had been a shift in working patterns with more people working part-time.  42% of residents work outside the county.

The Board noted the presentation and it was agreed to receive an update on each section of the JSNA at future meetings.

ACTION:  Ms K McDonald, Health & Wellbeing Lead Officer, to update the work programme to include regular updates on the JSNA.

Report of the Health & Wellbeing Board Planning Group.

Presented by Katie McDonald, Health & Wellbeing Officer

Ms K McDonald, Health & Wellbeing Lead Officer, presented the proposal for the refresh of the Joint Health and Wellbeing Strategy (JHWS) and the following main points were made during the presentation:-

·         The Strategy should set out the Health & Wellbeing’s shared vision for Health & Wellbeing across the whole county and present the high level priorities and outcomes to be used as a basis to shape commissioning across the health and care system and co-ordinate action to work towards better health and wellbeing for the whole population.

·         The Board was asked to agree the proposed timeline for publication of a refreshed strategy for Buckinghamshire. 

·         Key dates:-

o   Board Members to submit comments to Ms McDonald by 23 September.

o   A six week online consultation to commence on 10 October and finish by 18 November.

o   A private Health & Wellbeing Board meeting to be held on 22 November to include feedback from the consultation and agreement on a draft of the refreshed JHW strategy.

·         A Board Member asked whether the outcomes from the last strategy had been measured and whether there were any lessons learned.

·         There was a suggestion that the "sponsor/champion" of the strategy should be someone from outside of the delivery area so that they could be a "critical friend".

·         It was agreed that each priority area would be discussed in turn at future Health & Wellbeing Board meetings.

ACTIONS:

·         Board Members to send comments to Ms McDonald by Friday 23 September.

·         Ms McDonald to send the online consultation link to Board Members once the six week consultation started (w/c 10 October).

RESOLVED:

Board Members agreed the key dates outlined above and agreed, in principle to a sponsor/champion for each priority area and a ‘job description’ for every member of the Health & Wellbeing Board to play a role in making the delivery of the strategy a success.

Presented by Devora Wolfson, Director of Joint Commissioning.

Ms D Wolfson presented an update on the Better Care Fund (BCF) and made the following main points:-

·         The Better Care Fund Section 75 Agreement had been signed.

·         Agreement had been reached with the District Councils on the Disabled Facilities Grant and partners were working together closely to ensure the maximum benefit from these resources.

·         A Dashboard had been developed to provide the Board with an assessment of performance against the BCF objectives and targets.

·         The latest data showed that Buckinghamshire was performing well in terms of the reduction in non-elective admissions and permanent admissions to care homes.  The performance for delayed transfers of care required improvement.  This was being overseen by a multi-agency working group – the Discharge Project Group.

·         A Member expressed concern about the ‘snapshot’ approach to measuring delayed transfers of care figures.

·         Following a discussion around the specific metrics, it was agreed that the Board should continue to monitor the BCF metrics but would also carry out a deep dive on a specific metric at each meeting.  A Member suggested liaising with the Integrated Care Boards to avoid duplication of work.

·         In response to a comment about the trends, it was agreed to add an axis to help analyse the trend lines.

ACTIONS:

·         Ms Wolfson to update the Better Care Fund Metric Dashboard to include an axis on the trend chart.

·         It was agreed to review the BCF metrics at each meeting as well as undertaking a "deep-dive" into one specific metric.  This approach would be trialled at future meetings and it would be monitored to avoid duplication of work. 

RESOLVED:

The Board noted the performance of the Better Care Fund plan.

Robert Majilton, Director of Sustainability and Transformation, will provide an update.

The Chairman welcomed Mr R Majilton, Director of Sustainability and Transformation.  The following main points were made during the presentation:-

·         44 STP ‘footprints’ across England largely based on patient flows into tertiary acute hospitals.

·         Buckinghamshire was part of a Buckinghamshire, Oxfordshire, Berkshire West ‘footprint’ (BOBW) with a population of 1.8m, £2.5bn place based allocation, 7 Clinical Commissioning Groups, 16 Foundation Trust & NHS Trust providers and 14 Local authorities.

·         BOBW STP covered four key programmes and two enabling work streams.

·         The main plan was being developed locally across the health and care system – the Bucks ‘chapter’, which built on the 5 year system plan and which was presented to the Health & Wellbeing Board in June 2014 and the primary care strategy was presented to the Board in March 2015.

·         Healthy Bucks Leaders’ Group was continuing to drive this work with a focus on aligning resources, reducing duplication and giving clear programme leadership and programme management.

·         The national deadline for submitting the STP was mid-October 2016.  The first cut of the operational system and organisations’ plans would be ready by mid-November.

RESOLVED:

Board Members noted the progress to date.

a)    Update from David Johnston, Managing Director of Children’s Social Care and Learning;

b)   Governance arrangements for the oversight of tackling Female Genital Mutilation in Buckinghamshire 

Presented by Katie McDonald, Health & Wellbeing Lead 

Report attached.

c)    Buckinghamshire Transformation Plan for Children and Young People’s Emotional Wellbeing Update for 2016/17 

Presented by Juliet Sutton, Clinical Director of Children’s Services Report attached.

Buckinghamshire’s Transformation Plan for Children and Young People’s Mental Health and Emotional Wellbeing

Dr J Sutton, Clinical Director for Children’s Services, presented an update on Buckinghamshire’s Transformation Plan for Children and Young People’s Mental Health and Emotional Wellbeing 2016/17. 

The following main points were made during the update:-

·         A single point of access (SPA) had been established in Aylesbury and operated between 8am-6pm Monday to Friday.  The SPA accepted referrals and queries from families, young people and professionals and feedback had been very positive. 

·         The Barnados team within CAMHS operate the SPA and provided brief, evidence-based interventions.

·         16 and 17 year olds could self-refer.

·         A new website had been developed and launched (http://www.oxfordhealth.nhs.uk/fresh/services/)

·         All primary, secondary and special schools in Bucks had a CAMHS link worker who provided a direct link for schools to the CAMHS service.

·         A specialist eating disorder service had been developed in accordance with national guidance that providers assess within 2 weeks of referral.

·         The waiting times for assessments for autism were currently too long within the paediatric and CAMHS services and would be a priority for 2016/17 along with providing training and support to staff supporting young people with learning disabilities in college who also presented with mental health concerns.

RESOLVED:

Board Members discussed and noted the update.

Children and Young People

Ms D Wolfson, Director of Joint Commissioning, provided an update on behalf of Mr D Johnston, Managing Director of Children’s Social Care and Learning.  She explained that a monitoring letter had been received from Ofsted which reported a positive direction of travel.  The letter would be made available on the OFSTED website from Friday 16 September.

Governance arrangements for the oversight of tackling Female Genital Mutilation (FGM) in Buckinghamshire

 Ms K McDonald, Health & Wellbeing Lead, reported the following:-

·         Following a joint meeting with the Chairs of the Health & Wellbeing Board, Safer and Stronger Bucks Partnership Board, Buckinghamshire Safeguarding Children Board and Buckinghamshire Safeguarding Adult Board, it was recognised that all Boards had a part to play in effectively tackling FGM.

·         It was agreed that the overall governance and monitoring should sit with one of the Boards and that the HWB, with both local and NHS membership, would be best placed to take the overall strategic lead on this issue.

·         Agencies in Buckinghamshire were committed to eradicating FGM by developing a co-ordinated multi-agency approach that placed the woman and child at the centre.

·         A draft multi-agency action plan had been drawn up which focused on:

o   Drafting a Bucks wide strategy for tackling FGM;

o   Updating the guidance for frontline practitioners on FGM and the local procedure for responding to incidences of FGM (publication due shortly);

o   Awareness raising with practitioners and members of the public.

ACTION:

·         Board Members to provide comments on the strategy and action plan to Ms McDonald by Friday 23 September.

RESOLVED:

Board Members confirmed their position as strategic lead for FGM and agreed the proposals for monitoring the effectiveness of the local approach to tackling FGM.

Board  ...  view the full minutes text for item 10.

For Board Members to discuss the Health & Wellbeing’s work programme.

Board Members were asked to note the work programme.

ACTIONS:

·         It was agreed to adopt a themed approach for the Joint Health & Wellbeing Strategy so that each priority would be discussed in turn at future meetings.  Ms McDonald to include the priorities in the work programme – starting with mental health and wellbeing.

·         The Better Care Fund metrics would be discussed at every meeting with a trial of a deep-dive look at a specific metric.  Ms McDonald to add the specific metrics into the work programme for future meetings.

The next Health & Wellbeing Board meeting will take place on Thursday 15 December 2016 from 2.30-4.30pm (pre-meeting for Board Members only between 1.30-2.30pm) in Mezz Room 2, County Hall, Aylesbury.

There will be an agenda planning session on Tuesday 22 November 2016 from 10am-1pm which will be held in private.

There will be a private agenda planning meeting for Board Members only on Tuesday 22 November from 10am-1pm.

The next formal Board meeting will take place on Thursday 15 December from 2.30-4.30pm in Mezz Room 2 (there will be a private pre-meeting for Board Members only between 1.30-2.30pm).