Meeting documents

It was agreed that Mr M Tett would continue as Chairman and Dr K West would continue as Vice-Chairman of the Health and Wellbeing Board for the 2019/2020 municipal year.

RESOLVED:  The Board NOTED the confirmation of the Chairman and Vice-Chairman.

Apologies were received from Ms A Macpherson, Mr S Bell, Mr M Tett, Ms G Quinton and Ms L Patten

Mr R Nash attended in place of Mr T Vouyioukas.

The meeting was chaired by Dr K West in Mr Tett’s absence.

There were no announcements from the Chairman.

There were no declarations of interest.

To agree the minutes of the meeting held on 28 March 2019.

The minutes of the meeting held on 28 March 2019 were reviewed and the following points were noted:

• Item 1, Welcome and Apologies – Mr R Bajwa should read Dr R Bajwa.
• Member’s Present – Mr S Bell was listed as the Chief Executive, Oxford Health NHS; it should read Oxford Health NHS Foundation Trust.
• Item 7 – Update on Health and Care System Planning:  Dr Roberts requested the second bullet point on page 4 of the minutes be amended to read "approximately 25% of patients in hospital over 65 years would be likely to suffer from dementia".
• Item 9 – JSNA Update and Proposed Way Forward – 5^th bullet point.  It was noted that an action to change the title of the JSNA on the web page had not been captured.  It was agreed that the Joint Strategic Needs Assessment (JSNA) title itself could not be changed but Ms McDonald and Dr O’Grady would discuss.

RESOLVED:  Subject to the amendments noted above the minutes of the meeting held on 28 March 2019 were AGREED as an accurate record and were signed by the Chairman.

There were no public questions.

To be presented by MsJ Hoare , Managing Director, Buckinghamshire Integrated Care System, Mr N MacDonald, Chief Executive, Buckinghamshire Healthcare NHS Trust, Ms L Patten Accountable Office Buckinghamshire and Oxfordshire CCG and Ms G Quinton, Executive Director, Communities, Health and Adult Social Care.

Mr N Macdonald, Chief Executive, Buckinghamshire Healthcare Trust, welcomed Ms J Hoare, Managing Director, Integrated Care System (ICS).  Mr Macdonald provided the following update on the history of the Sustainable Transformation Partnerships (STPs) and the ICS:

• The 44 STPs were created approximately three years ago.  The STP for this area covered Buckinghamshire, Oxfordshire and Berkshire and was known as ‘BOB’. 
• Buckinghamshire was designated as an ICS approximately two years ago.  Buckinghamshire was one of the only ICS’ which was not co-terminus with the boundary of the STP; there were two ICSs in the BOB. 
• There was a national policy to move all the STPs into the ICS by April 2020 or 2021.
• There was an application process and the BOB STP had been successful in becoming a Wave Three Integrated Care System.

Mr Macdonald provided the presentation which was included in the agenda pack and highlighted the following:

• The system priorities for 2019/20.
• BOB had refreshed its Strategy and the work plan showed a desire to be working at a regional level. 

The following points were noted in discussion and in answer to member’s questions:

• A member of the board commented that, at present, the ICS/STP did not have statutory status but this could change.
• Mr Macdonald stated an Independent Chair of the ICS had been appointed and would commence in October 2019.
• In response to a member of the board asking how communications would be managed; Mr Macdonald stated that a monthly briefing was issued which could be circulated to the Health and Wellbeing Board members for cascade.  NHS England had provided presentation slides on the recent changes which would be circulated.

ACTION:  Ms McDonald

Ms Hoare continued with the presentation and highlighted the following points:

• The local Buckinghamshire ICS would become the ICP; many things would remain the same as it would build on the existing work programme and provision in the local area would continue to work at place level and adopt a population health approach.
• The ICP would be a partnership with the providers and commissioners working together to utilise the skills and abilities across the system.

• The ICP would continue its relationship with the Health and Wellbeing Board and the Health and Adult Social Care Select Committee.
• The realignment of Clinical Commissioning Group functions.
• The development of the Primary Care Networks (PCN); there would be 12 PCNs each covering a population of approximately 30,000-50,000 – the details would be confirmed by the end of June 2019. 
• The system was working together to understand population health needs and making intelligent decisions to deliver the services.
• Going forward, the aim was for people to avoid hospital admissions.
• Professionals were working together to co-ordinate the needs of the public and discharge people from hospital more quickly.  
• It would be important to develop care plans which worked across all services and optimised the use of digital capability which could be shared.
• A clear, single point of access and direct booking services were being developed.
• An improvement in the children’s  ...  view the full minutes text for item 7.

To be presented by Mr T Vouyioukas, Executive Director, Children’s Services.

Mr W Whyte, Cabinet Member for Children’s Services introduced Mr R Nash, Service Director, Children’s Social Care. 

Mr Nash highlighted the following points from the report contained in the agenda pack:

Report to DfE by the Improvement Adviser – Mr Coughlan’s report provided an update on progress in relation to improvement; the key message was that progress was ‘as well as could be expected’.

Ofsted Monitoring Visit - The monitoring visit on 22 and 23 May had looked at the three statutory children’s services; i.e. the multi-agency safeguarding hub (MASH), the effectiveness and impact of assessments and the  arrangements in place for missing children who were at risk of exploitation.  The key findings were listed in the report.

Special Educational Needs and Disability (SEND) – the report provided an update on the improvement plan and outlined the immediate priorities. 

RESOLVED:  The Board NOTED the update.

To be presented by Dr J O’Grady, Director of Public Health.

Dr J O’Grady, Director of Public Health, reminded the board that a number of partners across Buckinghamshire had signed up to a shared approach to prevention and agreed to work together to help tackle social isolation.   Dr O’Grady requested members of the board report back to their organisations to ensure the correct stakeholders attended the two day workshop on 25 and 26 September 2019.

Ms McDonald, Health and Wellbeing Lead Officer, highlighted the following key points:

·         The Healthy Communities Partnership (HCP) Board would have oversight of the project. 

·         Work had been initiated with the Design Council who had good experience of working with the public and private sector in identifying and implementing high impact changes.  The Design Council was collaborating with partners to explore social isolation in Buckinghamshire. 

·         A ‘challenge statement’ would be agreed before the two day workshop. 

·         A range of possibilities would be explored; suitable options were required which all partners could contribute to. 

·         The next stage would be facilitated by the Design Council, a two-day workshop was scheduled for 25 and 26 September and participants would benefit from working through Design Council processes. 

·         Task and finish groups would be set up and an evaluation of the project would be undertaken in 2020.

·         Ms McDonald requested members of the board provided their support to the project and to make sure Health and Wellbeing Board organisations were engaged.

The following points were noted in discussion and in answer to member’s questions:

• In response to a question on how socially isolated people would be identified; Dr O’Grady acknowledged that this was a challenge and that the communities and local area forums would be able to help.  Work would also be undertaken with the voluntary sector and information would be available from the primary care data.  Young people often felt socially isolated and work would be undertaken in businesses to provide help to people on retirement; it would be seen as a whole system approach.
• A member of the forum asked if, and how, the project would link with Prevention Matters.  Dr O’Grady stated that the Community Links Officers (Prevention Matters) were part of the Public Health and Communities team.  Ms K Leney, Community Engagement Team Manager, was working on a ‘Bucks Online Directory’.
• The need to include those with mental health issues was highlighted.
• A member of the board asked whether the data would include future projections and how this would be incorporated into future plans such as the Garden Town project.  Dr O’Grady acknowledged it would be difficult to spread the message to all parts of the system and highlighted that last year’s Director of Public Health Annual Report entitled ‘Healthy places, healthy futures: growing great communities’ emphasised the need to include places for people to meet within new housing developments.
• It was agreed that primary care was part of the solution but a whole system approach was needed.  An agreement to share information would build up a comprehensive picture of the numbers and complexity of those who were  ...  view the full minutes text for item 9.

To be presented by Dr J O’Grady, Director of Public Health and Ms L Smith, Public Health Principal.

Dr J O’Grady, Director of Public Health, stated the draft version of the Tobacco Control Strategy was included in the agenda pack and advised that all partners had a part to play in achieving a smoke free generation.

The aim of the strategy was to provide a clear vision and framework for partners to work towards. It continued to focus on reducing smoking prevalence rates and inequalities caused by smoking for both adults and young people, reducing the harms associated with second hand smoke and reducing the supply and demand of illicit tobacco

 It aimed to deliver against four overarching areas

·         Prevention first

·         Supporting smokers to quit

·         Eliminating variations in smoking rates

·         Effective enforcement

It was expected that those organisations who had signed up to the shared approach to prevention would be required to deliver specific actions in the plans under the four overarching areas, this would include national incentives for the NHS to support smokers to quit and submission of inequality plans by September. There would be opportunity to discuss this further when the strategy was launched at the Buckinghamshire Tobacco Alliance on 9 July 2019.  

The board discussed the wider implications of smoking including issues of littering and the health impacts of vaping.  A member asked whether it was possible to engage young people on the environmental and climate change impact of carbon emissions caused by smoking. Dr Jane O’Grady agreed that the environment could be a useful way to engage with young people and it would be interesting if this could be picked up by national campaigns. Public Health England was responsible for looking at the health impacts of vaping and research was on-going and Public Health colleagues would continue to review locally. 

RESOLVED: The Health and Wellbeing Board APPROVED and AGREED to adopt the Buckinghamshire Tobacco Control Strategy and support the development and delivery of the strategy action plan.

To be presented by Ms K McDonald, Health and Wellbeing Lead Officer.

Ms K McDonald, Health and Wellbeing Lead Officer, listed the agenda items for the meeting on 5 September 2019.  Ms McDonald stated she had added more items to the work programme for the meeting in December 2019 and March 2020 and asked members of the board to advise her of any additional items. 

The following items were suggested:

• Winter planning preparations.

·         The Healthwatch annual report.

Thursday 5 September 2019 in Mezzanine Rooms 1 and 2, County Hall, Aylesbury.

Thursday 5 September 2019.