Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 19 October 2017.

The Minutes (copies of which had been circulated) of the meeting held on 19 October 2017 were approved as a correct record and signed by the Chair.

Board Members and officers were invited to declare any interests they had in any of the items on the agenda for the meeting.

No declarations of interest were made.

To achieve any announcements from the Chair on matters related to the activity of the Board.

No announcements were made.

To consider a report of the Chief Finance Officer (CCG) and Borough Treasurer (Council)

The report contains the Better Care Fund (BCF) Quarter 3 Monitoring Returns and provides an update on the finance performance of the BCF as at 31st December 2017 (Quarter 3).

The Board is recommended to:

·         Approve the Q3 and Q2 BCF monitoring returns.

·         To note the finance performance of the BCF as at 31st December 2017 (Quarter 3).

Officer contact: Alison Johnson, alison.johnson4@nhs.net

A joint report of the Chief Finance Officer (Stockport Clinical Commissioning Group) and the Borough Treasurer (Stockport Council) was submitted (copies of which had been circulated) providing the Quarter 3 2017/18 Data Collection Return for the Better Care Fund that was required for submission to NHS England. The report also included the Quarter 2 Return.

RESOLVED – (1) That the Quarter 2 and Quarter 3 Better Care Fund Monitoring Returns be approved for submission to NHS England.

(2) That the financial performance of the Better Care Fund as at 31 December 2017 (Quarter 3) be noted.

To consider a report of the Deputy Director of Public Health.

A review was commissioned from the Cheshire and Mersey Public Health Commissioning and Greater Manchester Health and Social Care Partnership in response to the change in arrangements for screening women registered at Heald Green practices in spring of 2017. The report details the key issues arising from that work.

The Board is invited to note the report.

Officer contact: Eleanor Banister/ Dr Vicci Owen-Smith, 0161 474 2447/ 07810045578, eleanor.banister@stockport.gov.uk / vicci@nhs.net

The Deputy Director for Public Health submitted a report (copies of which had been circulated) providing the Board with a summary of a review commissioned from the Cheshire and Mersey Public Health Commissioning and Greater Manchester Health and Social Care Partnership in response to the change in arrangements for breast screening women registered at Heald Green practices in spring of 2017. The report detailed the key issues arising from that work.

Carol Bailey, (Screening and Immunisations Manager, Greater Manchester Health and Social Care Partnership) and Marie Coughlin (Screening & Immunisation Manager, Cheshire and Merseyside Public Health Network) also attended the meeting to respond to questions from the Board.

The following comments were made/ issues raised:-

Drop off rates a concern in Cheadle. Have suggested Massey Street as a possible location, but despite supportive local businesses this not happened. Still offer of ward funds to help with that.

·           Concerns were expressed about a reduction in screening rates in the Cheadle area. The removal of the screen facility in Heald Green was acknowledged and the possible impact of patients being called for screening in Macclesfield identified as a possible contributing factor in the reduction given the difficulties of accessing the site.

·           Concerns were expressed that the performance against the 3 year round target was just above 50%, meaning that levels of uptake in Heald Green were below the England average. In response it was clarified that there was a difference between uptake and round length, with the reduce performance due to mergers of practices leading to higher than expected invitations. Current levels of round length were now back to within the 90% target. The statistics may also be misleading as the round length may people 3 years and 1 week but the performance indicator gave a worse impression of the situation. It was commented that the decline in uptake was part of a national trend, with reductions higher in more affluent communities. This may be in part due to the increased awareness and information provided by the NHS when communicating with people being called.

·           It was queried whether the public felt better able to access information and thereby make informed choices, meaning they may perceive their risk to be lower. In response it was stated that there was insufficient evidence available to say for certain, but that the Stockport Together model was designed to ensure that conversations were had with service users whenever possible to highlight where there were outstanding tests or screenings. As part of a GM wide review of cancer screening the reasons the public had for taking up, or not, screenings would be explored.

·           Concerns were expressed that despite falling uptake rates there was no indication of the steps being taken to address whether changes in delivery of screenings were needed, such as changing the sites where screening was offered. The John Lewis Department Store and Massey Street Car Park in Cheadle were suggested as possible alternatives. In response it was stated that these alternatives and others were being explored but that there were often significant practical challenges to overcome. It was also commented that there was not one simple answer to improving uptake and a range of options needed to be considered, including time of appointments as well as location.

·           Surprise was expressed that there was not higher rates of uptake for free screening services. In response it was stated that there was evidence that people’s perception of screening, such as potential painfulness, had an impact, but that it was also noticed that uptake reduction when the NHS information leaflet changed to give patients a more informed choice.

·           It was commented that the particular challenges being experienced in Heald Green highlighted the need to ensure that the whole screening system was able to adapt to changing arrangements on the ground, in particular the move to larger GP practices.

RESOLVED – That in relation to the review of Breast Screening  ...  view the full minutes text for item 5.

To consider a joint report of the Deputy Director of Public Health and the Corporate Director for Place Management & Regeneration.

To provide a report to the Health and Well Being Board on the GM Working Well Early Help Service that is currently being developed.  To secure the support of the Health and Well Being Board in taking forward this initiative with Stockport GPs and the Local Authority.

The Health and Well Being Board is invited to:

•        Note the strategic importance of work for health and the contribution this cross-cutting programme will make for the delivery of the Greater Manchester Strategy and Population Health Plan within Stockport;

•        Approve Stockport’s participation in the programme;

•        Support the Health & Work Task & Finish Group set up in Stockport to drive forward this work locally.

Officer contact: Dr Donna Sager/ Nick Hill, 0161-474-3928 / 07800 618203, donna.sager@stockport.gov.uk / nick.hill@stockport.gov.uk

A joint report of the Deputy Director of Public Health and Corporate Director for Place Management & Regeneration was submitted (copies of which had been circulated) providing the Board with an update on the Greater Manchester Working Well Early Help Service that was currently being developed. The Service being piloted would be available to all residents in work in Stockport who became ill and were at risk of falling out of the labour market, or who are newly unemployed due to health issues. The aim was to support people to remain or transition back into work; improve their overall wellbeing and reduce demand on primary care and other services. 

Nick Hill (Work & Skills Lead, Stockport Council) attended the meeting to respond to questions.

Clarification was sought on how GPs would be engaged with this process as concern was expressed that the success of the project was contingent on support from already overstretched practices. In response it was stated that the programme would targeted to the Brinnington and Victoria locality in the first instance.

RESOLVED – That in relation to the Working Well Early Help Programme:-

•      the strategic importance of work for health and the contribution this cross-cutting programme will make for the delivery of the Greater Manchester Strategy and Population Health Plan within Stockport be noted;

•      Stockport’s participation in the programme be approved;

•      the Health & Work Task & Finish Group set up in Stockport to drive forward this work locally be supported.

To consider a report of the Director of Public Health.

This document sets out the expectations of the relationship and collaborative working arrangements between Safer Stockport Partnership (SSP), Stockport Safeguarding Children Board (SSCB), Stockport Safeguarding Adults Board (SSAB), Health and Wellbeing Board and the Children’s Trust.

It covers their respective roles and functions, accountability and governance arrangements, lead board responsibilities, membership of the boards, arrangements for challenge, oversight and scrutiny, performance management and reporting.

The chairs of the Safer Stockport Partnership and the independent chair of the SSCB and the SSAB, the chair of the Health and Wellbeing Board and the chair of the Children’s Trust have formally agreed to the arrangements set out in this document, which will be subject to bi- annual review (from the date of initial agreement) or immediately following legislative change.

The Board is asked to note the content of the MOU and endorse the document.

Officer contact: Dr Donna Sager 0161-474-3928, donna.sager@stockport.gov.uk

A report of Director of Public Health was submitted (copies of which had been circulated) inviting the Board to consider a Memorandum of Understanding setting out the expectations of the relationship and collaborative working arrangements between this Board and the Safer Stockport Partnership, Stockport Safeguarding Children Board, Stockport Safeguarding Adults Board and the Children’s Trust.

The Memorandum covered each body’s respective roles and functions, accountability and governance arrangements, lead board responsibilities, membership of the boards, arrangements for challenge, oversight and scrutiny, performance management and reporting. The Chairs of the bodies had given their endorsement to the document which would be subject to bi- annual review or immediately following legislative change.

Clarity was sought on who had responsibility for monitoring and coordinating activity. In response it was stated that the Council’s Head of Service Safeguarding & Learning would fulfil this role, although it was stressed that all partners had responsibility for safeguarding.

RESOLVED – That the content of the Memorandum of Understanding between the Safer Stockport Partnership, Stockport Safeguarding Children Board, Stockport Safeguarding Adults Board and the Children’s Trust be noted and the document endorsed.

To consider a report of the Deputy Director of Public Health.

Stockport has a population that is older than most places in the UK, and one that is also growing older.  This presents a fantastic opportunity to embrace and adopt a strategy to make the borough a place where people can age, really well.

This strategy presents an overview of work already ongoing to promote healthy, positive ageing in Stockport, highlighting the areas where a difference can be made to ageing well, and posing a challenge to think more broadly and collectively, and to take forward the key actions that will make a difference.

The Health and Wellbeing Board is invited to consider and adopt Healthy Ageing Strategy.

Officer contact: Dr Donna Sager, 0161-474-3928, donna.sager@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) inviting the Board to consider a Stockport Health Ageing Strategy, developed in recognition that the population of Stockport was one of the oldest in the UK, and was getting older. The Strategy aimed to ensure the borough was a place where people can age well.

The Strategy also needed to be understood in the context of the Greater Manchester Ageing Hub that linked with the Centre for Ageing Better, to take opportunities to undertake activity could be more appropriately delivered on a wider footprint.

It was clarified that the Stockport Clinical Commissioning Group had yet to consider the Strategy.

The following comments were made/ issues raised:-

·         This Strategy drew on the out ‘Aging Well’ elements of Health & Wellbeing Strategy that already had broad support from partners and stakeholders.

·         Ensuring unpaid carers were given smart support and care was vital as they were going to become ever more important.

·         Ensuring active older people would begin with encouraging active children, so how was that going to be encouraged? In response it was stated that the Strategy had no age parameters to reflect this. There was also a physical activity strategy, and the Schools Sports Partnership that had proved very successful and active.

·         What support was available for encouraging community groups and youth groups in getting people active? In response it was stated that Public Health had good links with community groups but many were self-sustaining and required little intervention. In many cases it was better to allow them to 'get on with it’. It was further commented that physical activity did not have to be sport.

RESOLVED – (1) That the draft Healthy Ageing Strategy and the ’direction of travel’ set out within it be endorsed.

(2) That the Deputy Director of Public Health be requested to submit a report to a future meeting in relation to the Stockport School Sports Partnership.

To consider a report of the Deputy Director of Public Health.

The Stockport Health and Wellbeing Board has a duty to prepare and publish a regular Pharmaceutical Needs Assessment (PNA).

We are undertaking a full review of the Stockport PNA in 2017-18, so that we can update our understanding of the priority needs of our population and meet our statutory duty to publish an update in April 2018.

The Stockport PNA 2018 required by law to undergo a 60 day consultation period.

This report presents the draft Stockport PNA 2018 for consideration and comment by the Stockport Health and Wellbeing Board.

The Board is asked to give comments for each of the consultation questions as follows:

·         The document sets out the draft results of the pharmaceutical needs assessment for Stockport. Does it achieve this?

·         Do you know of any relevant information that has not been included which could affect the statements or conclusions in this document? If yes, then please provide the additional information.

·         This document shows that pharmaceutical provision within Stockport is satisfactory with limited identified gaps. Do you agree with this statement? If you do not agree, what else should be considered?

·         Following the conclusion of the consultation period an updated Stockport PNA 2018 will be published in April 2018, a copy of the final report will be shared with the board.

Officer contact: Eleanor Banister, 0161 474 2447, eleanor.banister@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) inviting the Board to consider the draft Pharmaceutical Needs Assessment (PNA) for 2018 that was current subject to consultation with stakeholders and the public. The Board had a duty to prepare and publish a regular PNA that provided a comprehensive assessment of the current and anticipated pharmaceutical needs of the community to assist local commissioners and service providers by giving an evidence base for how best to plan and commission pharmacy services to meet the needs of the population.

The Board was invited to comment on the document and respond to a series of consultation questions set out in the report.

RESOLVED – (1) That the Draft Pharmaceutical Needs Assessment be noted.

(2) That in response to the consultation questions:-

·         the Board agrees that the document achieves the aim of setting out the draft results of the pharmaceutical needs assessment for Stockport;

·         further consideration is needed in respect of pharmacy provision for the expanding community in Woodford.

At the request of Board, this is a standing item on the agenda.

Members and officers presented are invited to update the Board on developments with the Stockport Together Programme.

The Chair invited partners present to update the Board on Stockport Together.

The following update was provided:-

·         The Clinical Commissioning Group Governing Body had met earlier in the day and had approved the finalised Business Cases of the New Models of Care, subject to a number of caveats. The Council’s Cabinet was due to consider the documents on 6 February 2018.

·         Caroline Drysdale, the new Managing Director of the managed care organisation, was not in post and this was part of the change from planning improvements to delivery of those improvements.

·         In response to a question about whether the programme was on time it was stated that the original timescales had been changed, and the programme had been adapted. Discussions were ongoing about how 7-day working at the neighbourhood level would operate, as the work of GPs, district nursing and social work needed to be synchronised. There was no indication that targets would not be met. In relation to the realisation of benefits, the modelling suggested a number of risks that would need to be managed and monitored closely to understand the effect. It was further commented that the Board had a role in shaping what featured in the monitoring of Stockport Together.

RESOLVED – (1) That the update be noted.

(2) That the Democratic Services Manager be requested to include an item on the next agenda in relation to Board Membership.

At the request of the Board, this is a standing item on the agenda.

Members and officers presented are invited to update the Board on developments with the transformation of health and social care services in Stockport and Greater Manchester.

The Chair invited partners present to update the Board on developments with the transformation of health and social care services in Greater Manchester.

Andrew Webb reported that the Transformation Fund resources for Stockport would cease at the end of the current year. Local partners were currently in dispute with the Greater Manchester Health and Social Care Partnership about £3m of ICT allocation that had been committed in expectation of the resources being made available. Other resources had been used to cover the shortfall and were the matter to be resolved to the satisfaction of Stockport partners this would reduce the pressure on budgets in 2018/19.

RESOLVED – That the update be noted.

To consider the Forward Plan of agenda items for future meetings of the Health & Wellbeing Board.

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) setting out a forward plan of agenda items for future meeting of the Board.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager be requested to include items on future agendas in relation to:-

·         Stockport Sports Partnership

·         Board Membership

The Chair reported that this meeting would be the last attended by Andrew Webb as he was shortly to retire from his post as Corporate Director for People at Stockport Council.

On behalf of the Board the Chair thanked Andrew for this service to the residents of Stockport and wished him the best for the future.