Meeting documents

The Chairman welcomed members of the board to the meeting. 

Apologies were received from Mr Tolis Vouyioukas, Executive Director, Children’s Services; Mr Graham Peart, Wycombe District Council; Mr Patrick Hogan, South Bucks District Council; Dr Jane O’Grady, Director of Public Health; Mrs Gill Quinton, Executive Director, Communities, Health and Adult Social Care and Mr Neil Macdonald, Chief Executive, Buckinghamshire Healthcare NHS Trust.

Ms Julie Davies, Head of Children's Quality Standards and Performance, Children’s Social Care, attended in place of Mr T Vouyioukas.

Mrs Tracey Ironmonger, Acting Director, Public Health attended in place of Dr O’Grady and Mrs Quinton.

Mr David Williams, Director of Strategy and Business Development, Buckinghamshire Healthcare Trust attended in place of Mr Neil Macdonald.

The Chairman reminded members that Buckinghamshire County Council was following Purdah requirements in light of the general election on 12 December 2019.  The Chairman read the following statement:

‘As this meeting is being webcast, can I remind members to observe purdah requirements as we are in the pre-election period for the forthcoming general election.

 For the Council, it still remains very much business as usual, which is why our formal meetings are continuing. However can I ask members to ensure that any comments made during our discussions relate directly to our agenda items and are not seen as, or could be perceived to be, political in nature.

 I hope you understand and will adhere to this requirement during this period of heightened sensitivity. If there are any questions on this issue, please raise them now before we begin the formal agenda.’

There were none.

Outstanding actions:

• The Director of Public Health Annual Report on Alcohol- a detailed action plan would be brought to the board to be reviewed.
• Drinks industry promoting safe drinking- a briefing had been drafted to be shared with the board.
• Poster campaigns had been shared with partners.
• Stickers on recycling bins - the concept had been discussed with Buckinghamshire County Council (BCC’s) communications team.  The cost would be significant but could potentially be considered in 2020.  Members needed to be mindful of the level of impact the stickers would have and if this would justify the cost.  It could be an option for residents to purchase them.
• A briefing session on the long term plan had taken place on 16 October 2019. 
• The Leader would write to the Prime Minister and Secretary of State regarding improved long term care plans.  The board would take this forward following the general election.

RESOLVED:  The minutes of the meeting held on 5 September 2019 were AGREED as an accurate record and signed by the Chairman.

There were none received.

1. Update on NHS Long Term Plan and Integrated Care Partnership – to be presented by Mr D Williams, Director of Strategy and Business Development, Buckinghamshire Healthcare Trust and Ms J Hoare, Managing Director, Integrated Care Partnership (ICP).

2. Future arrangements for NHS Commissioning - to be presented by Mr R Majilton, Deputy Chief Officer, Buckinghamshire CCG.

3. Service Design and Engagement Framework – Ms K Parfitt, Head of Communications, Communities, Health and Adult Social Care, Buckinghamshire Clinical Commissioning Group and Buckinghamshire Integrated Care Partnership.

4. Better Care Fund – to be presented byMs J Bowie, Service Director, Integrated Commissioning.

1. Update on NHS Long Term Plan and Integrated Care Partnership 

Ms J Hoare, Managing Director, Integrated Care Partnership highlighted the following:

• Work by the Integrated Care Partnership continued and the approach had been streamlined to ensure effectiveness.
• There were three work streams; children and young people, primary care networks (integrating physical and mental health) and social care teams.  The mental health work stream had been established for a period of time with a focus placed on easy access to services. 

• All groups were multiagency and used population data to locate the areas where they would have the most impact.
• A focus was placed on respiratory problems and coronary disease. 
• Clinics were established within the community to allow residents quick access to services.  Available services included help with physical and mental health and were a good example of services coming together.

Mr D Williams, Buckinghamshire Health Care NHS Trust highlighted the following:

• Two briefing sessions were held with Health and Wellbeing Board members in 2019.  Focus was placed on the detail of the NHS long term plan and how it would affect the Buckinghamshire area.

A number of key themes were highlighted at the last session in October:

·         A focus on prevention and health inequalities.

·         A focus on quality of estates to ensure patients felt welcome in health and care settings.

• Communication and engagement with patients. This would help to ensure that members of the public were aware of their own care responsibilities and how they could access emergency care. 
• The plan had been submitted on 1 November 2019 and would be published at the start of 2020.  The plan would set a strong template for refreshing the health and wellbeing strategy.
• Thanks were given to members of the board for their commitment and support.

The following points were highlighted in response to questions raised by members of the board:

• A key priority needed to be ensuring that patients had their views represented.
• Communication with members of the public required improvement. 
• The publication of the plan would be an opportunity to open up conversations on what public expectations should be; how they would take responsibility for their own care and how to properly access care.
• One of the main priorities for the service was to make every contact count.  Discussions had taken place with patients to highlight the support available in order for them to improve their own health.
• It would be useful to have further clarity for members of the public on the definitions of "a partnership" and "a system."

2. Future arrangements for NHS Commissioning

Mr R Bajwa, Clinical Chair, Buckinghamshire Clinical Commissioning Group (Bucks CCG) provided an introduction to the presentation circulated with the agenda and highlighted the following:

• A number of changes had been made in recent years.  The most notable was the establishment of Sustainability and Transformation Partnerships (STPs).  The role of the STPs was formalised in the long term plan with a drive towards more effective integration, now known as Integrated Care Systems (ICS).  ...  view the full minutes text for item 6.

To be presented by Ms T Ironmonger, Assistant Director of Public Health.

Ms T Ironmonger, Director of Public Health presented the report and highlighted the following:

·         Organisations in Buckinghamshire had signed up to a shared approach to prevention to deliver more impactful prevention work.

·         The issue of social isolation had been selected as a priority.  The design council ran a workshop in September 2019 to identify areas of work to focus on. Two transformation projects had been identified: The first project was the development of an assessment tool to identify trigger events for an individual in order to reduce the risk of being socially isolated. The second project was a solution to social connectedness within communities.  It would identify joint hot spots across organisations and then pilot work in small geographical areas to get greater local insight into the problem and then co-design solutions with local communities.

·         Public health would need support from partner organisations to attend task and finish groups and workshops with communities.

The following points were highlighted in response to questions raised by members of the board:

·         Social isolation in rural areas was more difficult to tackle than urban areas.   Rural isolation was a theme that needed to be focused on as part of the project.

·         Intelligence from prevention matters would feed into the project.

·         A key focus would be to collaborate with the emergency services to capture intelligence on high intensity users. 

·         Concerns were expressed over the capacity to use the toolkit once it was in place.  Consideration would be taken over how the assessments would be put into practise.

·         Without insight it was difficult to tell if there were individuals not being reached through Street Associations or similar projects.

·         Discussions could take place with members of the community to decide if various initiatives such as Timebanks would be beneficial.

·         The first task and finish groups would take place in late January/early February 2020.

RESOLVED:  Members of the board APPROVED the proposal.

To be presented by Mr R Nash, Service Director, Children’s Social Care.

Ms J Davies, Head of Children's Quality Standards and Performance presented the report and highlighted the following:

• The family support service went live in September 2019.
• The National Mental Health programme was providing specialist support with reduced waiting time for young people.
• 32 primary and secondary schools had participated in training.
• Academic results continued to improve and were above national average
• SEND- A well-attended conference was held in November 2019 attended by young people.  The information gathered would inform the 2020 strategy.  The service acknowledged that although improvements had been made, there was still further work to do.

The following points were highlighted in response to questions raised by members of the board:

• It was too early to be able to compare the effectiveness of delivery with previous services.  A smoother transition was already seen between front door services.
• Educational Health Care Plans (EHCPs) were not yet being issued within the 20 week target but were improving.  There had been some instances of children waiting over a year to be issued an EHCP.
• A member of the board requested that the data around school achievements was broken down to examine whether primary school data was having an impact on secondary school data.  The data would be shared following the meeting.

ACTION: Ms Davies

RESOLVED: Members of the board NOTED the update.

To be presented by Mr R Nash, Service Director, Children’s Social Care, Buckinghamshire County Council.

Ms Davies, Head of Children's Quality Standards and Performance presented the report and highlighted the following:

• The service had transitioned to the new arrangements and was more engaged with the three main partners:  police, health and the local authority. Buckinghamshire had transitioned within the set deadline and the Department of Education was satisfied that required standards had been met.
• Subgroups continued to deliver the main business of board and statutory requirements of recording serious incidences and deaths involving local children.

The following points were highlighted in response to questions raised by members of the board:

• Improvements had been seen in the attendance levels of education representatives at sub-groups.
• It would be beneficial to gain the perspective of young people at sub-groups. This was an area for consideration and development. 
• Buckinghamshire Healthcare NHS Trust (BHT) had completed a significant amount of work involving children.  The responses and views had shaped the service nationally.

RESOLVED: Members of the board NOTED the update.

To be presented by Ms K McDonald, Health and Wellbeing Lead, Buckinghamshire County Council.

Ms K McDonald, Health And Wellbeing Lead Officer presented the report and highlighted the following:

• A private meeting would be held on 30 January 2020 to plan the future agendas for the Board.
• The Health Watch Annual Report had been pushed back to March 2020.
• The meeting in March 2020 would include items covering social isolation and physical exercise.

RESOLVED: Members of the board NOTED the update.

19 March 2020.

19 March 2020, 10:00am, Mezzanine 1 and 2.