Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 6 November 2013 

The Minutes (copies of which had been circulated) of the meeting held on 6 November 2013 were approved as a correct record and signed by the Chair.

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

The following interest was declared:-

Personal Interest

To consider a report of the Corporate Director for People.

The report has been prepared in response to the publication of the findings of an LGA/ NHS England national evaluation or stocktake of progress by local authorities in implementing the Winterbourne View Concordat, and updates the Board on the local situation and the main implications of the evaluation for Stockport.  The report also provides an update on the Learning Disability Self Assessment Outcome

The Executive Summary of the Stocktake has been included in the agenda papers, but a full copy can be found on the LGA Website at http://www.local.gov.uk/documents/10180/12137/Winterbourne+View+Joint+Improvement+Programme+-+stocktake+of+progress+-+version+7/27f58b23-3fd1-4115-8ae2-89226a23d7fa

The Board is asked to comment upon the summaries above with a view to advising the Learning Disability Joint Strategic Commissioning Group of any actions to be undertaken.

Officer contact: Mark Warren, 0161 474 5364, mark.warren@stockport.gov.uk

A representative of the Service Director (Adult Social Care) (Stockport Council) submitted a report (copies of which had been circulated) providing the Board with an update on progress with the implementation of the Winterbourne View Action Plan and the undertaking of ‘stocktakes’ of services for those with learning disabilities. The report also provided an update on the outcomes of the Learning Disability Self-Assessment.

It was highlighted that while local performance was ‘red’ in some areas, this reflected the national situation and that Stockport’s performance was broadly in line with the national average. Nonetheless, local partners were committed to improving performance and outcomes wherever possible.

The Chair welcomed the report and the hard work being undertaken that demonstrated the commitment of partners to this serious area of work.

RESOLVED – That the report be noted and officers involved be thanked for their hard work.

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

(i)            The Chair reported on a recent meeting with a representative of the Healthier Together Service Transformation Team to discuss the preparations for the consultation on the programme. The Chair stressed that partners in Stockport had been committed to the integration of health, social care and primary care for some time. The importance of the sector-led reform work involving the Foundation Trusts, CCGs and Local Authorities in the south of Greater Manchester and Cheshire East was also stressed.

(ii)          The Chair reported that he had been provided with an analysis of excess winter deaths (EWD) undertaken by the Public Health Team.

RESOLVED – That the Democratic Services Manager be requested to circulate to all Board members a summary of the Excess Winter Deaths analysis produce by the Public Health Team.

To consider Stockport’s draft bid to the Better Care Fund/ Integration Transformation Fund prior to its consideration by the Council’s Executive on 11 February and the CCG Board on 12 February 2014 and to delegate the final sign-off of the submission to the Chair and Vice Chair for completion before the 15 February 2014 deadline.

Officer contact: Terry Dafter, 0161 474 4401, terry.dafter@stockport.gov.uk

A joint report of the Service Director (Adult Social Care) (Stockport Council) and the Chief Operating Officer (Stockport Clinical Commissioning Group) was submitted (copies of which had been circulated) containing a draft of the joint Council/ CCG bid to the Department of Health for the Better Care Fund (previously known as the Integration Transformation Fund) that would form the basis of local plans to further integrate health and social care services. The Bid would be submitted to the Council’s Executive and CCG Board in early February before sign-off from this Board.

A diagram setting out the services within scope of the new integrated system was also provided (copies of which were circulated).

It was reported that since the last meeting of the Board, the Department of Health had requested that in addition to the Bid in February 2014, a further detailed plan be submitted in early April. It was anticipated that as a result of the February bid the Department of Health would flag-up an areas of concern, clarification or further work before the final submission in April.

It was emphasised that work was ongoing to develop the Bid and more importantly the model of service delivery. The challenge of the model would be to change the culture of those working in the new system to work differently. The Marple & Werneth Pathfinder was due to begin shortly. This would provide invaluable evidence of the impact of these new ways of working before the model was rolled out.

The following comments were made/ issues raised:-

·         Further detail should be included in the narrative of the bid to emphasis the level of collaboration and joint working already taking place in Stockport.

·         Members acknowledged the work that had been done to develop the model and the bid and welcomed the joint leadership shown by both organisations.

·         This area of work was very much embedded within the plans of the CCG and was not seen simply as an ‘add-on’. Similarly, it needed to be seen in the context of other work streams at both regional and national level, such as out of hospital standards and 7 day working.

·         Work was ongoing to develop a ‘joined-up’ ICT solution that would allow all partners to share data where needed from their own systems, rather than to seek a new system that would be costly and that currently was not available on the market. Staff regularly highlighted ICT as a concern about service change. This area of work was being overseen by a multi-agency group that was looking at ICT issues across the economy. Stockport had attracted funding from a national group to support the development of a solution, in recognition of the progress already made locally.

·         Producing a ‘case study’ of a patient’s journey through the health and social care system before integration and afterward, from the perspective of the service user, would be a useful means to demonstrate the impact of the proposals.

RESOLVED – (1) That progress with the development of the Better Care Fund bid be noted.

(2) That the Chair and Vice-Chair be authorised to sign-off the first draft Plan submission of the Bid on behalf of the Board following its consideration by the Council Executive and the CCG Board on 11 and 12 February respectively.

(3) That the Service Director (Adult Social Care) (Stockport Council) and Chief Operating Officer (Stockport Clinical Commissioning Group) be requested to submit a copy of the Interim Better Care Fund Plan to the next meeting on 12 March 2013.

(4) That members of the Board be encouraged to contact officers directly if they had any queries or suggestions about the Plan.

To consider a recent developments from NHS Greater Manchester, Greater Manchester Combined Authority and AGMA on possible arrangements for the locality-led stakeholder and public conversation and on sector led approaches.

The views of the Board are sought.

A report of NHS Greater Manchester was submitted (copies of which had been circulated) setting out a proposed framework for the locality-led stakeholder and public consultations on health and social care reform. The report had been produced following the agreement to the overall consultation process by the CCG Committee In Common and AGMA.

The following comments were made/ issues raised:-

·         There was a danger that the work being co-ordinated through Greater Manchester on Healthier Together, health and social care integration and primary care reform would be at odds with the work taking place within the South Sector, particularly since all these streams were moving at varying pace. Assurances had been provided that the Greater Manchester work would not conflict with the sector-led work but there remained a role for the Council and CCG to ensure these work streams were not pulling in different directions.

·         Feedback from the Patient Liaison Groups would be welcomed.

·         The structure of the document appeared to give precedence to consultation with professional and organisational stakeholders before patients and the public.

RESOLVED – (1) That the report be noted.

(2) That the Chief Operating Officer (Stockport CCG) and the Chief Executive (Stockport Council) be requested to ensure that in so far as possible, the South Sector led reform proposals compliments the Greater Manchester and locality-led proposals.

(3) That the Democratic Services Manager be requested to circulate a copy of the Clinical Commissioning Group plan for the locality-led consultation on health and social care reform.

To consider an update on progress with the ‘We Will’s’ in the Health & Wellbeing Strategy Chapter 4 on Alcohol and outlines the proposed framework for development of a new integrated drug and alcohol Strategy.

The Board is recommended to:

i)       Note and comment on progress in relation to the implementation of the Alcohol Chapter.

ii)     Note and comment on the proposed framework for a new integrated Drug and Alcohol Strategy.

Officer contact: Simon Armour, 0161 474 2454, simon.armour@stockport.gov.uk

Simon Armour (Public Health Specialist) submitted a report (copies of which had been circulated) providing an update to the Board on progress against the ‘We Wills’ in Chapter 4 of the Health & Wellbeing Strategy related to alcohol, and also outlining a proposed framework for the development of a new integrated drug and alcohol strategy.

The following comments were made/ issues raised:-

·         There were a range of early interventions in place to address alcohol related harm, such as a dedicated nurse at Stepping Hill Hospital, outreach workers and volunteers providing support to misusers. This activity appeared to be yielding good results, but for relatively small numbers. It was hoped that more thorough analysis would be available in the future.

·         Members discussed the link between preventative work and the emerging integrated care model. It was suggested that greater priority being given to prevention would reduce demand for services more generally. Further consideration was needed to ensure it was embedded within the model.

·         There had been changes in the approach taken within children and young people services through the review of integrated prevention services and the bringing together of services to address risky behaviours.

·         There seemed to be greater scope for partners to address the underlying mental health issues of substances misusers.

RESOLVED – (1) That Simon Armour be thanked for his attendance.

(2) That the report and proposed framework for the new integrated Drug and Alcohol Strategy be noted.

To consider a report of the Director of Public Health.

Included with the agenda are the overview and key messages (Levels One and Two respectively) of the 21^st Annual Public Health Report for Stockport for 2013/14.

The full analyses report (Level Three) has not been included in the agenda due to its size, but can be viewed online at http://democracy.stockport.gov.uk/documents/s35926/21st%20PH%20Report%20-%20Level%203%20-%20Full%20Analyses.pdf

Officer contact: Dr Steve Watkins, 0161 474 2436, stephen.watkins@stockport.gov.uk

The Director of Public Health submitted a report (copies of which had been circulated) providing an overview and the key messages from the 21st Annual Report of the Director of Public Health.

The Director highlighted that the health of the population of Stockport was broadly in line with national averages, although there remained significant inequalities.

The following comments were made/ issues were raised:-

·         The report very much accorded with the thinking of partners about the pertinent issues affecting the health of the Borough, although opinions may differ on the response to them and the priority they were given.

·         Previous reports had been taken account of by partners when developing other strategies and plans which demonstrated the value of the reports.

·         The effectiveness of children ‘nagging’ their parents to change their behaviour, particularly in relation to smoking, had been recognised. It was suggested that this technique also be employed for encouraging physical activity.

·         It was suggested that the development of healthy ageing programmes would be welcomed in the context of the integrated care model.

RESOLVED – That report be noted.

To consider a report of the Corporate Director for People.

The report summarises the key findings of a self assessment carried out on the implementation of the national Adult Autism Strategy, and how this has informed the development of a local Strategy.

The Health Wellbeing Board is asked to:

·      Note progress to date and discuss any issues that require further attention or inclusion.

·      Recommend any further actions to address any issues raised in the self-assessment.

·      Comment and any recommendations in light of the draft Autism Strategy.

Officer contact: Vince Fraga, 0161 474 4401, Vincent.fraga@stockport.gov.uk

A representative of the Service Director (Adult Social Care) (Stockport Council) submitted a report (copies of which had been circulated) summarising the key findings of the self-assessment carried out on the implementation of the national Adult Autism Strategy and how this had informed the development of a local Strategy. A copy of the draft Strategy, which had been the subjection of consultation with stakeholders, was also submitted for consideration by the Board.

The following comments were made/ issues raised:-

·         Responding to the needs of residents with autism should be the concern of all agencies, not just the Council. It was important that the positive multi-agency work taking place continue, even though agencies were having to cope with reducing resources. Although a local strategy had been developed, it was important that the issues considered as part of the planning of mainstream services rather than being seen as a specialist service.

·         The transition from children to adult services was a concern for parents and carers, and this was included within the scope of the review of Disability Services. The Children and Families Bill, once enacted, would place new requirements on local authorities in relation to those with learning disabilities, particularly around the review and planning of services. The Council was developing a new approach to meet these requirements which would also encompass those with autism.

·         Although the Autism Partnership had ceased to meet, there remained a commitment from partners to engage with stakeholders but to do so in a constructive and effective way.

RESOLVED – (1) That the report and draft Autism Strategy be noted.

(2) That the progress made to date in responding to the requirements of the Autism Act and the National Autism Strategy be noted.

(3) That Karen Kime and colleagues be thanked for their hard work in preparing the self-assessment and draft Strategy.

(4) That the Corporate Director for People (Stockport Council) be requested to submit a report to a future Board meeting on the local response to the likely requirements of the Children and Families Bill.

(5) That the Democratic Services Manager be requested to circulate details to members of the Board on the Joint Strategic Needs Assessment analysis of autism.

To consider a report of the Council Solicitor.

The report invites the Board to consider changes required to the ‘Terms of Reference’ as set out in Article 9 of the Council Constitution. The changes are neede to take account of changes to the Code of Conduct for Councillors and Co-opted Members.

The Board is requested to give consideration to the content of the report and consider the arrangements for substitute members of the Board.

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) inviting the Board to consider governance issues arising from the operation of the Board since its establishment in April 2013, namely the arrangements for substitute members and proposed additions to the Board’s general role in light of guidance issued by Department of Health.

RESOLVED – That consideration of the report be deferred to allow for further consideration by partners of the issues raised in the report.

To agree dates for meetings of the Board in 2014/15.

(All Wednesdays, starting at 2pm)

9 April 2014 – additional meeting proposed by the Chair if needed

4 June 2014 – date already agreed

16 July 2014

3 September 2014

5 November 2014

14 January 2015

11 March 2015

22 April 2015

10 June 2015

The Board were invited to consider dates for meetings in 2014/15.

RESOLVED – That the following dates for future meetings be approved:-

(All Wednesdays, commencing at 2pm)

9 April 2014 (subject to need)

4 June 2014 – date already agreed

16 July 2014

3 September 2014

5 November 2014

14 January 2015

11 March 2015

22 April 2015

10 June 2015

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

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 – That the report be noted.