Agenda and minutes

To elect a Chair of the Board for the period until the next Annual Council Meeting.

RESOLVED – That Councillor John Pantall be elected Chair of the Health & Wellbeing Board for the period until the next Annual Council Meeting.

To appoint a Vice-Chair of the Board for the period until the next Annual Council Meeting.

RESOLVED – That Jane Crombleholme be appointed Vice-Chair of the Health & Wellbeing Board for the period until the next Annual Council Meeting.

Members and officers in attendance to declare any interests they have in any of the items on the agenda for this meeting.

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 receive announcements from the Chair on matters relevant to the work of the Health & Wellbeing Board.

The Chair reported on the following activity that related to the work of the Health & Wellbeing Board:-

·         The Chair had recently taken part in a NICE Panel on local authority guidance. It was clear that there would be a particular challenge for NICE to prepare ‘softer’ guidance that did not have as the same clinical evidence base as guidance it had previously issued.

·         The Chair had attended an event organised by Tobacco Free Futures at which Newcastle City Council did a presentation on their tobacco control declaration, which he had subsequently shared with the Scrutiny Committee.

·         There had been a recent meeting of the Interim Greater Manchester Health & Wellbeing Board and a summary had been circulated to members of this Board.

To note the Minutes of the Shadow Health & Wellbeing Board held on 20 March 2013.

RESOLVED – That the Minutes of the last meeting of the Shadow Health & Wellbeing Board held on 20 March 2013 be noted.

To consider a presentation from representatives of the Clinical Commissioning Group (Nicola Alkemade) and Stockport Council (Joan Beresford)

The presentation will cover progress and challenges with implementing the objectives set out in Chapter 6, ‘Healthy Ageing and Quality of Life for Older People’ of the Joint Health and Wellbeing Strategy. The Chapter can be viewed online at http://www.stockport.gov.uk/2013/2996/41105/chapter6

Joan Beresford (Head of Integrated Commissioning, Adult Social Care), Stockport Council and Nicole Alkemade (Older People’s Joint Commissioning Manager), Stockport Clinical Commissioning Group, attended the meeting and made a presentation on the activity, successes and challenges in relation to Chapter 6 ‘Healthy Ageing’ of the Joint Health & Wellbeing Strategy.

The presentation focussed on the following:-

·         Key facts about older people

·         Aspects of Healthy Ageing – definitions and priorities for residents

·         Implementation of the chapter – examples of partnership working

·         ‘We wills’ & brief progress report – highlighting activity under each of the ‘we wills’

·         Discussion points & way forward – challenges and future activity

The following comments were made/ issues raised:-

·         There were important challenges around information sharing between agencies, but also providing and signposting information for older people.

·         Shifting the focus of delivery from secondary care to primary care will be challenging, but courage was needed to make this change. The work around Stockport One, whole budget settlements and Healthier Together should contribute to this.

·         People were generally no longer considered old at 65, but deprivation made a significant difference to the quality of life. It was important to maintain healthy life expectancy. The Adults & Communities Scrutiny Committee had recently completed a piece of work on social isolation and loneliness.

·         Efforts to reduce the number of older people reaching end of life in hospital was welcomed, as was the increased focus on prevention and care plans.

RESOLVED – (1) That Joan Beresford and Nicole Alkemade be thanked for their attendance and presentation.

(2) That the Service Director (Adult Social Care), Stockport Council and the Chief Operating Officer, Stockport Clinical Commissioning Group be requested to submit to a future Board Meeting an update on the effectiveness of the Rapid Response pilot project at reducing hospital admissions during the winter.

To consider a presentation from representatives of Stockport Council (Julie Farley) and Carers Voice /Carers Partnership Board (Dave Philips)

The presentation will cover the key issues for carers and how the Council and NHS are supporting them.

Julie Farley (Policy and Projects Manager, Adult Social Care) Stockport Council, and Dave Philips (Chair, Carers Voice) attended the meeting and made a presentation on the partnership working with carers, and the development of the Carers Strategy.

The presentation focused on the following areas:-

·         Carers Partnership – bringing together a range of voluntary and statutory partners

·         Caring for Our Future: Care and Support White Paper – key elements

·         Economic Impact of Carers in Stockport

·         Feedback from Carers – key messages and priorities

·         Key elements from the national Strategy

·         Reconfiguring local services – improvements to services offered and new ways of working

The following comments were made/ issues raised:-

·         The importance of information sharing and information provided to service users was again highlighted.

·         Important role for the GP in identifying and monitoring carers.

·         Continued engagement with young carers, including developing innovative approaches and “time banking”. Outreach work had been undertaken in local schools.

·         It was important to recognise the cost of breakdown of carers arrangements in terms of the both the financial cost and the impact on those being cared for.

RESOLVED – That Julie Farley and Dave Philips be thanked for their attendance and presentation.

To consider a report of the Director of Public Health.

The Director of Public Health submitted a report (copies of which had been circulated) providing an update to the Board on work being undertaken by the  Caldicott Guardians for the Council, Clinical Commissioning Group, Stockport and Pennine Care NHS Foundation Trusts to develop a common set out guidelines for the use and sharing of data, particularly in light of the move toward greater integration of health and social care services. The work had been informed by the national review of the Caldicott system, which had included the Council’s Service Director (Adult Social Care).

Members discussed potential obstacles to information sharing, including the danger of staff within health and social care organisations becoming too risk averse and this impeding useful information sharing for the benefit of patients/ service users.

It was commented that the NHS England Local Area Team were also involved in a review of its own Caldicott arrangements.

RESOLVED – That

·         the health service and social care organisations operating in Stockport be recommended to endorsed the Caldicott Guidelines developed for use in Stockport;

·         the further work set out in paragraph 14 of the report be endorsed as the way forward with a view to producing final Guidelines within six months;

·         the Chair and Vice Chair of the Board be authorised to consider and endorse the recommendations of the Caldicott Guardians as to the final guidelines, or to have these submitted to the Board for endorsement;

·         the proposal to develop arrangements whereby the Caldicott Guardians work together and can act for each other in emergency and inter-agency situations to be supported;

·         the principal of a safe haven for the secure use of identifiable information in preparation of non-identifiable and aggregate information relating to and for the use by the whole health and social care economy be supported, and that this should be based with the Public Health Service

·         the proposal to hold discussions with neighbouring authorities to identify opportunities for collaboration in the maintenance of such a safe haven be supported; and

·         the proposal to hold discussions with NHS Greater Manchester about mechanisms for involving local general practices in this process and about future responsibilities for coordinating and training Practice Caldicott Guardians be supported.

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

The Director of Public Health submitted a report (copies of which had been circulated) detailing a proposal to develop a pilot project for the delivery of intensive public health interventions in a defined geographical area. The pilot would be based on analysis which indicated that the public health interventions undertaken in the 1990s in Stockport had led to improvements in health inequalities during that period. If successful, the piloted interventions could then be adapted for use across the wider community to address the persistent polarisation present in the borough.

The following comments were made/ issues raised:-

·         Recently released figures from the 2011 Census indicated a slightly improved situation with respect to health inequalities compared to previous assumptions and this needed to be considered in developing these proposals.

·         The proposals needed to be considered in the context of the Neighbourhood Management arrangements.

RESOLVED – That the report be noted and the Director of Public Health be requested to continue to develop the proposals in relation to a Public Health pilot and to submit this to the Board for further consideration.

To consider a verbal update from the Service Director (Adult Social Care) and the Executive Councillor (Health & Wellbeing)

The Service Director (Adult Social Care), Stockport Council, updated the Board on developments with the integration of health and social care in Stockport.

In particular, the following issues were raised:-

·         Work was on-going to refine the Stockport One Service and related developments with a view to establishing the model across Stockport from April 2013.

·         Opportunities were being explored to better manage demand for hospital care through ‘Step Up’ approaches.

·         Positive working relationships between all partners was essential to delivering integration, and this was in place in Stockport.

·         Challenges remained in relation to the financial modelling of the services, but this was being refined. Delivering the changes, rather than planning them, may also be a challenge.

The Chair reported that the AGMA Executive would shortly be considering submissions from each of the Greater Manchester Local Authorities on their approaches to health and social care reform, as was considered at the Shadow Health & Wellbeing Board in March. Feedback from the discussions at AGMA would be circulated to the Board when available.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager be requested to circulate details of the report on health and social care reform being considered by the AGMA Executive when it was available.

To consider a report of the Head of Public Health Intelligence.

The Director of Public Health submitted a report (copies of which had been circulated) providing progress on the development of an Outcomes Framework for the Joint Health and Wellbeing Board.

Members discussed possible additional measures that could be included, such as additional Public Health measures drawn from the Public Health Observatory data; those relating to children’s safeguarding; measures relating to end of life and healthy ageing.

RESOLVED – That the report be noted and the approach to the Outcomes Framework identified in the report be endorsed as a starting point for further development, including further consideration of measures.

This item has been placed on the agenda at the request of Councillor John Pantall.

Further detail can be found online at http://www.workingtogetheronline.co.uk/documents/Working%20TogetherFINAL.pdf

The Corporate Director for People, Stockport Council, updated the Board on new guidance issued by the Department of Health that required vulnerable children to be considered as a distinct cohort within the Joint Strategy Needs Assessment. Further work was needed to identify the most appropriate mechanisms for accountability in respect of this duty as this could legitimately be seen to be the responsibility of a number of bodies, including this Board.

RESOLVED – That the report be noted and further report be submitted to the Board in relation to the Board’s responsibilities for vulnerable children and safeguarding.

This item has been placed on the agenda at the request of Councillor John Pantall.

Attached for information is a letter sent to all Health and Wellbeing Boards by the Department of Health in relation to the role Boards can play in relation to the Winterbourne View Concordat.

The Chair submitted a copy of a letter from Norman Lamb MP, Minister of State for Care and Support (copies of which had been circulated) sent to Health & Wellbeing Boards stressing the important role the Board had in providing leadership in delivering the commitments made in the Winterbourne View Concordat.

The Chair reported that the Council and Clinical Commissioning Group were developing a joint action plan to address the issues raised in the Concordat.

RESOLVED – That the letter from Norman Lamb MP be noted and the Democratic Services Manager be requested to circulate a copy of the Action Plan being developed in response to the Winterbourne View Concordat.

To consider a joint report of the Democratic Services Manager and the Health & Wellbeing Policy Manager.

The Chair submitted a report (copies of which had been circulated) setting out a forward plan of agenda items for future meetings of the Board.

RESOLVED – (1) That the report be noted

(2) That the Democratic Services Manager be requested to include the Health Scrutiny Committee’s final report on Mental Health Services on the agenda for the next meeting.