Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 14 January 2015.

The Minutes (copies of which had been circulated) of the meeting held on 14 January 2015 were approved as a correct record and signed by the Chair.

Board members and officers to declare any interests which they have 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.

The Chair updated the Board on the following issues:-

(i)            He had attended a recent launch event for the NHS Statement on Tobacco control and would be encouraging all local NHS partners to endorse the statement (see Minute 7 below).

(ii)          There had been a recent announcement of the devolution of £6 billion of NHS resources to Greater Manchester. The announcement had lacked detail on the mechanisms for how this would work in practice, but Simon Stevens, Chief Executive of NHS England, had emphasised the importance of tackling health inequalities and promoting health improvement.

(iii)         He and the Vice Chair would be attending a Local Government Association event on 25 March seeking to assess the impact of Health & Wellbeing Boards and discussing possible options for their future.

To consider a presentation from the Stockport Clinical Commissioning Group on the development of a Strategic Vision for health and social care partners in the borough.

Ann Schenk (Director of Strategic Partnerships, Stockport NHS Foundation Trust) attended the meeting and made a presentation, with Terry Dafter and Gaynor Mullins, on behalf of key partners about their work in ‘Developing a Single Vision and Strategy for Health and Care Services in Stockport’.

The presentation outlined the key drivers for this work, including

·         health inequalities in Stockport - those in the most deprived areas living 11 years less than those in the least deprived;

·         increasing prevalence of major disease groups and the need to tackle the lifestyle factors underlying these increases;

·         the challenge of managing long-term conditions that account for an increasing percentage of NHS and social care spend and resources;

·         an aging population in Stockport that will be older than the England average; and

·         the significant financial shortfall for the health and social care economy by 2018/19 in the event that action is not taken to reduce or manage demand and improve capacity.

The presentation went on to highlight the work of partners to address these challenges, focussed around four key areas:-

·         Prevention and equipping people to manage.

·         “Proactive” care for people who already have a known need.

·         Planned care for people needing some kind of intervention.

·         Urgent care for people who need help today (including emergency care for people with immediate needs).

The presentation then covered some of the key elements of the projects to redesign services to meet these objectives, including indicative milestones for taking the project forward.

A draft report to the Council’s Executive on this topic was also submitted (copies of which had been circulated) for consideration and comment by the Board prior to its consideration by the Executive on 17 March 2015.

The following comments were made/ issues raised:-

·         There was a key role for the Health & Social Care Hubs in facilitating the integration of services, but simply integrating teams would be insufficient without providing services differently. Delivering genuinely proactive care would require significant cultural change.

·         It was anticipated that from July 2015 a detailed design process would begin in relation to the service areas identified.

·         Partners in Stockport had been successful in gaining NHS England ‘Vanguard’ status for its model for integration as part of the ‘New Models of Care Programme’ to arise from the NHS Five Year Forward View. This would mean additional resources would be available to support this development. Further details would be circulated when they were available.

·         It was queried how integration of services between existing local providers would allow for patient choice in the provision of care. It was commented that the ‘Vanguard’ project would provide clearer information about how to balance choice and integration.

·         In relation to the ‘quick wins’ referenced in the presentation, these included improving out-patient appointments; the new preventative commissioning strategy; expanding end-of-life pathways. These quick wins should make immediate improvements to patient experience although the organisations involved may take longer to accrue benefits. The real challenge to partners was to manage and control the growth of demand in the shorter term that would allow for savings to be ‘recycled’ into prevention etc., for the longer term.

·         The importance of supporting patients as they progressed through their treatment and the ‘system’ was emphasised. Expecting patients to understand and navigate complex health and social care systems was not appropriate.

·         In relation to the Vanguard proposals, queries were raised about when the detail of the project would be available and the timeline for when decisions would be taken and the project implemented. The importance of robust governance was highlighted.

·         The capacity and expertise within the existing health and social care workforce to deliver change on the scale proposed was queried. It was stated that there was sufficient capability within the existing workforce but that the challenge was their capacity to deliver change while maintaining services. Members emphasised the need to ensure that capacity was found within the partner organisations rather than reliance on  ...  view the full minutes text for item 4.(i)

To consider the draft Clinical Commissioning Group (CCG) Operational Plan for 2015-16.

The Board is invited to comment on the draft plan before its formal adoption by the CCG Board.

Gaynor Mullins (Stockport Clinical Commissioning Group) submitted the draft Clinical Commissioning Group (CCG) Operation Plan for 2015-16 (copies of which had been circulated) and invited the Board to comment.

The Plan had been considered by CCG Governing Body earlier in the day and members had expressed concerns about the ability of the CCG to deliver on all the elements contained within it, and about the unrealistic requirements being placed on CCGs. Further work was therefore needed to prioritise actions within the Plan.

It was commented that NHS England required CCGs to ensure a 1% surplus in their finances. The Stockport CCG Board had expressed the view that this resource could be better utilised to support the transformation programme the CCG were engaged with.

The following comments were made/ issues raised:-

·         There was risk in requiring additional activity from GPs without ensuring there was capacity within the system to deliver it.

·         The additional commitments of the CCG to preventative activity was welcomed, echoing the message from the Five Year Forward View. There was the need for further work with partners in the health economy to ensure that these elements were appropriately and consistently prioritised.

·         It was important to ensure that the aspirations of any plan were reflective of what there was a realistic prospect of achieving.

·         There was a common complaint from residents about GP appointments and the difficulties of securing these in a timely manner. Although residents in Stockport fared relatively well in comparison to other areas, there remained variation between practices. The ‘Vanguard’ project would in part seek to address this issue.

RESOLVED – (1) That the Stockport Clinical Commissioning Group Operational Plan for 2015/16 be noted and endorsed, subject to the concerns raised about its scale and deliverability.

(2) That Board Members be recommended to provide any further comments or suggestions in relation to the prioritisation of elements within the plan directly to the Chief Operation Officer.

To consider a report of the Services Director (Adult Social Care)

Following the recent meeting with the Chair of Local Safeguarding Adults Board, the Board will be provided with an update on the preparedness of the Council for assuming statutory safeguarding responsibilities with the implementation of the Care Act 2014.

Terry Dafter (Service Director (Adult Social Care) Stockport Council) submitted a report (copies of which had been circulated) providing the Board with an update on preparations for the implementation of the Care Act 2014 and the new statutory requirements relating to Adult Safeguarding. The Board had previously considered this issue during an informal meeting with David Mellor, Chair of the Adult Safeguarding Board, who had raised concerns in relation to the resourcing and funding for the new Board. It was confirmed that while partners had now agreed in principal to contribute to the funding of the Board from April 2015, no final agreement was yet in place.

RESOLVED – That the report be noted.

To consider a report of the Service Director (Adult Social Care)

The report sets out the Council’s preparations for assuming statutory responsibilities to support carers, as required by the Care Act 2014.

Terry Dafter (Service Director (Adult Social Care) Stockport Council) submitted a report (copies of which had been circulated) providing the Board with an update on preparations for the implementation of the Care Act 2014 and the new statutory requirements relating to carers. It was commented that although the Act placed new responsibilities on the Council in relation to assessments and support, it was not yet clear what the likely demand would be.

RESOLVED – (1) That the report be noted.

(2) That the Service Director (Adult Social Care) be requested to submit a further in approximately six months’ time to update the Board on the impact of the Care Act 2014 requirements relating to carers.

To consider a report of the Director of Public Health.

The report provides an update on progress with delivering the Health Inequality Programme which is a major contributor to the Health Inequality ‘We Wills’ in the Health and Wellbeing Strategy. The last report was received by Health and Wellbeing Board on 4th June 2014.

The Board is asked to note and comment on progress

Officer contact: Sarah Clarke, 0161 474 2456, sarah.e.clarke@stockport.gov.uk

A representative of the Deputy Director of Public Health submitted a report (copies of which had been circulated) providing the Board with an update on the delivery of the Health Inequality Programme that was a major contributor to the Health Inequality ‘We Will’ in the Joint Health & Wellbeing Strategy. The report highlighted significant achievements to date.

The engagement with housing providers in addition to Stockport Homes, particularly Moss Bank Homes, was welcomed.

Members also discussed the success of the Wellpoint Kiosks, although concerns were expressed about the data from these not being available for use by local partners. It was commented that these problems were linked to wider difficulties with data not being available from Public Health England due to data protection concerns.

RESOLVED – (1) That the report be noted.

(2) That the Director of Public Health be requested to provide an update to the next meeting on data access problems.

To consider a report of the Director of Public Health.

The report provides the Board with information on the Local Government Declaration and NHS Statement of Support for Tobacco Control and recommends their adoption by Stockport Council, Stockport NHS Foundation Trust and NHS Stockport Clinical Commissioning Group.

The Board is recommended to:

·         endorse the adoption of the Local Government Declaration on Tobacco Control.

·         invite NHS Stockport Clinical Commissioning Group and Stockport NHS Foundation trust adopt the NHS Statement of Support  on Tobacco Control.

·         note the formation of a Stockport Tobacco Alliance to implement the commitments made as result of signing the Local Government Declaration on Tobacco Control.

Officer contact: Mary Brooks, 161 474 2455, mary.brooks@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) updating the Board on the recent adoption by the Council of the Local Government Declaration on Tobacco Control and the recent launch of the NHS Statement of Support for Tobacco Control, attended by the Chair. The review of local tobacco control arrangements undertaken by CleAR in 2014 had recommended the signing of the Local Government Declaration by the Council. This, along with the re-establishment of the local Tobacco Alliance, had now been implemented.

RESOLVED – That the Board

(i)        welcomes the adoption by Stockport Council of the Local Government Declaration on Tobacco Control;

(ii)       encourages the Stockport Clinical Commissioning Group and Stockport NHS Foundation Trust to adopt the NHS Statement of Support on Tobacco Control; and

(iii)      notes the formation of a Stockport Tobacco Alliance to support implement the commitments made as a result of the signing of the Declaration and Statement.

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 meetings of the Board.

RESOLVED – (1) That the report be noted.

(2) That the Director of Public Health be requested to submit a report to the next meeting on the Physical Activity Strategy and to submit a report to a future meeting on healthy food.

The Board is invited to agree dates for future Board meetings:-

(All Wednesdays, commencing at 2pm)

10 June 2015 (previously agreed)

15 July 2015

2 September 2015

4 November 2015

13 January 2016

9 March 2016

20 April 2016

8 June 2016

RESOLVED – (1) That the following dates for the Board for 2015/16 be agreed, subject to there being business to consider:-

(All Wednesdays, commencing at 2pm)

10 June 2015 (previously agreed)

15 July 2015

2 September 2015

4 November 2015

13 January 2016

9 March 2016

20 April 2016

8 June 2016

(2) That the Democratic Services Manager be requested to cancel the meeting of the Board due to be held on 22 April 2015.