Meeting documents
Venue: Mezzanine Room 1, County Hall, Aylesbury. View directions
Contact: Sally Taylor
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Minutes of the Meeting held on 7 December 2017. PDF 165 KB The minutes of the meeting held on 7 December 2017 to be agreed as a correct record and signed by the Chairman. Additional documents: Minutes: The following actions were reviewed:
Mr Naylor had provided a declaration of interest form.
Ms Baker had sent the Healthwatch report on a joint project with Mind to Ms McDonald for circulation to the Board.
The Health and Wellbeing Governance Review paper had been amended to include that Mr G Peart would be the district council representative.
The action for a meeting to be arranged between Fiona Wise from the STP and the Chairman was carried forward. Action: Ms K McDonald
The Chairman followed up on the winter preparedness item (item 7 of previous minutes) and asked for an update on how the healthcare system had performed recently.
Mr N Macdonald, Chief Operating Officer, updated that the organisation had been under significant pressure due to the bad weather and higher demand, which was more than forecast. Buckinghamshire Healthcare Trust (BHT) had received good support from partners resulting in a reduced number of people waiting for transfer of care; down to the lowest levels of the year. A & E attendance had been up by 3.5% and ambulance attendance by 10%. There had been 31 admissions for patients with flu since the second week of January and four were in critical care. Extra domiciliary care had been provided but it had not been physically possible to use it all due to capacity; however, it had freed up medical staff. There had also been planned reduced out-patient work. The opening of the new space in A & E had to be delayed until 22 January. Mr Macdonald said that the figures compared to peers regionally and nationally. Mr Macdonald thanked all the staff in the care sector for their hard work over the last few weeks.
The Chairman asked for clarification on the four hour waiting time in A & E and was advised that the national standard was for 95% of patients to be treated or have left A & E within four hours. BHT had performed at 82% in December but was expecting a slightly higher figure for January. Mr Macdonald advised that nursing shortages, as highlighted in the media, was an issue for BHT.
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10:00 |
Welcome & Apologies Additional documents: Minutes: Apologies had been received from:
· Ms D Richards |
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Announcements from the Chairman Additional documents: Minutes: There were no announcements from the Chairman. |
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Declarations of Interest Additional documents: Minutes: There were no declarations of interest. |
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Public Questions Additional documents: Minutes: There were no public questions. |
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10:10 |
Presenter: Dr J O’Grady, Director of Public Health. Additional documents: Minutes: Dr J O’Grady, Director of Public Health, reminded the Board that the Dashboard had been reviewed at the meeting in November and members had requested more detail on how to understand the data. The Board had been provided with data for the Children’s Joint Health and Wellbeing Strategy Priority areas. Dr O’Grady briefly ran through the report and the following points were raised:
Action: Dr Sutton
Discussion followed on the red NHS Health Check indicator and Dr O’Grady agreed to provide a more detailed report for the next meeting. Action: Dr O’Grady
The Chairman steered the Board to the paper provided in the agenda pack. Dr O’Grady highlighted that a new 0-19 Service had been commissioned and that all babies were seen within two weeks of birth, at one year and two and a half years old. The Service provided a tiered offer i.e. if help was needed, more visits were made. The Health Visitor would ensure good engagement by visiting children in their own home if necessary.
The Chairman summarised as follows:
Action: Dr O’Grady
Action: Ms K McDonald RESOLVED: The Board NOTED the report.
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10:40 |
Children and Young People Update PDF 120 KB Presenter: Mr T Vouyioukas, Executive Director, Children’s Services. Additional documents: Minutes: Mr T Vouyioukas, Executive Director of Children’s Services provided a brief overview of the report and clarification was requested on the late notification of a child coming into care.
Mr Vouyioukas explained that the late notification was likely to be due to an emergency admission over the weekend which could result in a delay of 2-5 working days in getting the information from the emergency duty service to the day service. If the performance was not satisfactory there would be a discussion with colleagues to improve the issue.
RESOLVED: The Board NOTED the report. |
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10:55 |
Update on Health and Care System Planning Presenter: Mr R Majilton, Deputy Chief Officer, CCG (verbal update). Additional documents: Minutes: Mr R Majilton, Deputy Chief Officer, CCGs updated the group and made the following points:
Action: Mr R Majilton |
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11:10 |
Better Care Fund Presenters: Ms J Bowie, Director of Joint Commissioning, Buckinghamshire County Council and Ms D Richards, Director of Commissioning and Delivery, CCGs and Chair of the System A&E Delivery Board.
As agreed at the December meeting, the Better Care Fund leads will present a deep dive system overview of the BCF to stimulate Board discussion about the core challenges and solutions for forward planning.
Additional documents: Minutes: Ms J Bowie, Director Joint Commissioning, Buckinghamshire County Council introduced herself and said she would be presenting on behalf of herself and Ms D Richards, Director of Commissioning and Delivery, CCGs and Chair of the System A&E Delivery Board, who had sent her apologies.
Ms Bowie ran through the presentation and highlighted the following points:
The following points/questions were raised.
The Chairman asked if the metric was for Buckinghamshire hospitals or Buckinghamshire patients. Ms Bowie clarified it was for the Buckinghamshire patients.
The Chairman added that the funding of the (BCF) was linked to the performance of DToC; therefore there was a linkage to healthcare and social care.
Ms Bowie said Buckinghamshire had been meeting its targets for the social care area but not as a system. However, the trajectory had been going in the right direction.
The Chairman asked if there was a risk of financial penalty next year if the authority did not meet the targets. Ms Bowie said the financial penalties were aimed at social care and that the social care targets in Buckinghamshire had been met. Ms Bowie had not seen any evidence that there would be any penalties against local authorities.
In response to a question as to why the July figure was so high, Ms Bowie explained it was due to the way the data had been collected and analysed. The season also had an impact on figures; July was the start of the summer holidays which had placed a challenge on the home care providers.
Ms Bowie confirmed that the numbers did include children and acknowledged that often the focus was on the over 85’s but that there were other interesting aspects such as children and mental health patients which would be useful to consider and include in future updates.
Ms Baker asked if an evaluation was carried out from the patients’ perspective. Mr Macdonald said that there was a user group who focussed on the experience of the discharge process and that the Health and Social Care Select Committee had also ... view the full minutes text for item 9. |
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11:50 |
Buckinghamshire Safeguarding Adults Board Annual Report PDF 127 KB Presenter: Ms M Seaton, Independent Chair Additional documents: Minutes: Ms M Seaton, Independent Chair, took the Board through her presentation and highlighted the following points:
The following points/questions were raised:
In response to being asked what the area of greatest concern was for the Board; Ms Seaton said it was for practitioners and strategic leaders to develop awareness of the implications of the Care Act definition on self-neglect.
Ms Seaton advised that another major concern was the budget which had been very volatile over the last 5-6 years with no management control or monitoring of expenditure. This, however, was significantly improved in 2016/17. There was tight control over the budget during 16/17. The concern is that the Board was looking to set a lower budget in 2018/19 than in previous years, which would make it extremely challenging to deliver the priorities in the Strategic Plan.
RESOLVED: The Board NOTED and ENDORSED the report.
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12:10 |
Prevention at Scale Pilot Update PDF 181 KB Presenters: Dr J O’Grady, Director of Public Health and Mrs S Preston, Public Health Principal. Additional documents: Minutes:
Ms S Preston, Public Health Principal, provided an update on Prevention at Scale in Buckinghamshire. Ms Preston highlighted the following points:
The Chairman thanked Ms Preston for the presentation and asked who made the decision on the target area and which priority group would be focussed on.
Ms Preston said the insight work had been completely under local control and not guided by the LGA; the LGA were looking at how they will offer the expertise. It was well known that men and the BME groups were under-represented and needed to be engaged and would be a priority.
Ms Preston confirmed that there was no budget from the LGA so the pilot had to be run alongside an existing area. The LGA were providing an evaluator but the details were not yet known. Data would be collected from the new integrated lifestyle service and the Public Health team would be sharing best practice with the other 15 pilot areas. Ms Preston said she would circulate the list of the other areas involved in the pilot to the Board.
Action: Ms S Preston
RESOLVED: The Board NOTED the report and COMMITTED to support and participate in the Prevention at Scale pilot. |
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12:20 |
HEALTH AND WELLBEING BOARD WORK PROGRAMME PDF 310 KB Presenter: Ms K McDonald, Health and Wellbeing Lead Officer. Additional documents: Minutes: Ms K McDonald, Health and Wellbeing Lead Officer, advised that the agenda for the next Board meeting would contain the following:
Ms McDonald asked members to think about future items for the Board for the 2018 – 19 work programme.
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12:25 |
DATE OF NEXT MEETING 29 March 2018. Additional documents: Minutes: Thursday 29 March 2108. |