Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 13 January 2016.

The Minutes (copies of which had been circulated) of the meeting held on 13 January 2016 were approved as a correct record and signed by the Chair.

Councillors 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 Interests

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

The Chair reported on the recent Local Government finance settlement announced by the Council and the unexpected reduction in Public Health funding allocations. The Chair emphasised the challenge this reduction represented.

To consider a report of the Chair of the Stockport Safeguarding Children Board.

The Board is invited to consider and comment on the Annual Report from the Stockport Safeguarding Children Board.

Officer contact: Una Hagan, 0161 474 5657, una.hagan@stockport.gov.uk

David Mellor, Independent Chair of the Stockport Safeguarding Children’s Safeguarding Board, attended the meeting and submitted the Board’s Annual Report (copies of which had been circulated) for the Board’s comment and discussion. The report set performance of the children’s safeguarding system in the previous 12 months, highlighting achievements and challenges.

The following comments were made/ issues raised:-

·         There was discussion about the impact of the Looked After Children (LAC) placed in Stockport from other Local Authorities, and the decision not to charge for their placement. It was acknowledged that as a ‘net importer’ of LAC, this presented particular challenges for services in Stockport. It had been decided that given the relatively small numbers involved, for many services the charging would not be effective, though recharging for certain health services may be considered.

·         In relation to the increased demand on safeguarding services, clarification was sought on whether this represented additional children at risk or repeat referrals. It was clarified that the referral rate that had been increasing was now levelling off, but the re-referral of children was monitored as it was a useful indicator of the effectiveness of services when children were ‘stepped down’ from more intensive interventions. Although performance in Stockport for re-referrals was relatively good, there was scope for improvement. It was hoped that the Stockport Family approach would ensure that Children in Need could receive more timely support to prevent escalation to more stringent intervention.

·         In relation to a review of work relating to children missing from home, it was reported that the Children at Risk Group was using data from partners to better identify those children who were within this definition and correlating this with those who were at risk of Child Sexual Exploitation. It was reported that good progress was being made in this challenging area.

·         In relation to queries raised at the last meeting about Children Missing from Education, it was reported that the currently there were four children not on roll at any school and know to the local authority; 35 children who were off roll and not known to the local authority, of whom 29 were believed to be abroad and six believed to be elsewhere in the UK. The other group of children within this category were those who did not go to school every day. There were issues with capacity at specialist placements such as Highfield School, with some children receiving support from home. The Council was working with the National Children’s Bureau to identify more effective ways to support these children.

·         The Board had commissioned four Serious Case Reviews that were due for completion shortly. This was an unprecedented number, but it was hoped they would provide learning that would enhance safety in the future.

It was reported that David Mellor would shortly be standing down from the position of Independent Chair of the Safeguarding Children and Safeguarding Adult boards, and that Gill Frame had been appointed as the new independent chair. On behalf of the Health & Wellbeing Board, the Chair thanked David Mellor for his hard work and dedication to safeguarding both children and adults in Stockport.

RESOLVED – (1) That Stockport Safeguarding Children Board

Annual Report 2014-5 be noted.

(2) That in relation to the Annual Report, the Board notes:-

·         that change within the children’s safeguarding system is generally well managed;

·         the priorities for 2015/16; and

·         the importance of transition from children’s to adult services.

To consider a report of the Corporate Director for People.

The report provides the Board with an update on the implementation of the Care Act 2014 since the last update provided in June 2014.

The Board is invited to comment on the report.

Officer contact: Jenny Rollinson, 0161 218 1064, jenny.rollinson@stockport.gov.uk

Representatives of the Service Director (Adult Services) submitted a report (copies of which had been circulate) updating the Board on progress with the implementation of the Care Act 2014 a year after the implementation of the first phase of provisions. The second part of the Act, due for implementation in April 2016 and relating to funding reform, had been postponed until 2020.

It was highlighted that prior to implementation, it has been anticipated that there may be 1050 additional carer assessments needed as a result of the new act. Since implementation in April and November 2015, there had been 117. This was reflected across the North West. Work was underway with Signpost Stockport for Carers to raise awareness of the assessment amongst carers.

The following comments were made/ issues raised:-

·         Queries were raised about the relationship between the new approach to Information, Advice and Guidance (IAG) and the Care Act requirements. In response it was stated that, regardless of eligibility, all residents would be able to seek IAG and this could include signposting to support within the community. It was also stressed that those in crisis would be supported through that period.

·         Questions were raised about out-of-hours support, particular for carers with dependents at home. It was commented that Adult Social Care had out-of-hours provision, and Stockport Together was looking to expand the services available, but that early morning crisis response would still only be for those with severe need/ in danger. The role of peer support and volunteering was acknowledged, and possible options to expand this into late night support. It was suggested the NHS may be the most appropriate to respond during these periods.

·         There was discussion of the role of peer support groups in supporting people to live independently, particularly in supporting carers. It was acknowledged that much of the work around preventative commissioning and maintaining independence were not necessarily targeted toward carers. It was important to ensure that groups such as Signpost and others were empowered and able to support carers and signpost where appropriate.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager be requested to make arrangements for a future agenda item on carers.

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

The report provides the Board with an update on the work of the Stockport Tobacco Alliance in implementing the CLeaR recommendations. The Board previously considered the outcomes of the CLeaR Review in November 2014 (a copy of the report and CLeaR report are attached).

The Board is invited to note and comment on the progress report.

Officer contact Mary Brooks, 0161 474 2455, mary.brooks@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) providing the Board with an update on the work of the Stockport Tobacco Alliance in implementing the CLeaR recommendations. The Board previously considered the outcomes of the CLeaR Review in November 2014.

The following comments were made/ issues raised:-

•        There was some scepticism about the value of re-establishing the Alliance, but broad membership and focussed work had demonstrated how effective it could be.

•        The public were aware of the lethal dangers of smoking, but were they aware of the other life changing side-effects such as dementia. It was commented that cessation trainers were aware of, and did, highlight these risks.

•        There remained a clear divide in take-up and cessation levels based on inequality. There was a certain fatalistic attitude within some communities meaning that public health messages had less traction. It was important to ensure that messages were innovative and could tackling these prevailing social norms.

•        The Alliance had a long debate about the e-cigarettes, given the finely balanced arguments on both sides, but the Alliance were recommending them as a smoking cessation aid, but also recommending that they be banned from the workplace.

RESOLVED – That the report be noted.

To consider a report of the Director of Public Health.

The Health and Wellbeing Board has a statutory duty to produce a regular Joint Strategic Needs Assessment (JSNA). This report introduces the 2015/16 JSNA summary document which is the main output of the 2015/16 JSNA Process. The JSNA has been produced in partnership, under the leadership of the Health and Wellbeing Board, with the particular involvement of Stockport Council, Stockport HealthWatch and Stockport CCG.

The summary document identifies the key priorities for health and wellbeing for the next three years as identified by the JSNA analysis and provides an overview of key trends in health and wellbeing.

The Board is asked to

·         to consider and comment on the priorities identified on page 8 of the summary report, and detailed more fully on pages 9-12.

·         to endorse the revised 2015/16 JSNA for publication and communication in March 2016.

·         to approve the next steps identified for the 2016/17 JSNA work programme.

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

The Director of Public Health submitted a report (copies of which had been circulated) providing the Board with the summary of the 2015/16 JSNA summary document which was the main output of the 2015/16 JSNA Process.

The 2015/16 JSNA had been produced in partnership, under the leadership of theBoard, with the particular involvement of Stockport Council, Stockport HealthWatch and Stockport CCG. The summary document identified the key priorities for health and wellbeing for the next three years as identified by the JSNA analysis and provides an overview of key trends in health and wellbeing.

The following comments were made/ issues raised:-

·         The response rate to the JSNA consultation process had been encouraging, with particularly high responses for the consultations on lifestyle, vulnerable and at risk groups, and for long term condition prevalence. Ensuring wider engagement with the JSNA and development of the Joint Health & Wellbeing Strategy would be a challenge.

·         It was important for the JSNA findings to underpin the Stockport Together work, particularly the preventative strand. It was a challenge to weave the JSNA into the implementation of the Stockport Together model.

·         The important findings relating to children and families would need to be addressed as it was currently outside of the Stockport Together programme.

RESOLVED – (1) That the revised 2015/16 Joint Strategic Needs Assessment (JSNA) be endorsed for publication and communication in March 2016 and those involved in the project be thanked for their hard work.

(2) That the next steps identified for the 2016/17 JSNA work programme be approved.

(3) That the priorities identified on page 8-12 of the summary report be supported.

To consider a joint report of the Corporate Director for Corporate and Support Services (Stockport Council) and the Chief Finance Officer (Stockport Clinical Commissioning Group).

The report will set out data relating to performance of the Better Care Fund for the third quarter of 2015/16. The report will also include the completed template returns required by NHS England.

Officer contact: Michael Cullen (Council) / Marc Brady (CCG), 0161 474 4631, 0161 426 5589

A joint report of the Chief Finance Officer (Stockport Clinical Commissioning Group) and the Corporate Director for Corporate and Support Services (Stockport Council) was submitted (copies of which had been circulated) providing the Quarter32 Data Collection Return for the Better Care Fund that was required for submission to NHS England.

It was reported that because the number of Non-Elective Admissions was 10,345 which was in excess of the planned figure no performance funding would be released by NHS England.

It was reported that no planning guidance had yet been published in relation to the 2016/17 BCF, but that the likely funding allocation would be £19.295M, an increase of £700,000. The changes announced by the Government in relation to the BCF were likely to mean no further increase in resources until 2018/19.

Clarification was sought on the proposal to invest £700,000 into GP development. In response it was stated that this was designed to enhance primary care to prevent hospital admission and support the Proactive Care strand of Stockport Together.

RESOLVED – That in relation to the Better Care Fund Quarter 3 Data Collection Return:-

·         the continued growth of non-elective admissions at a rate greater than planned in the BCF and no element of the performance fund will being released be noted; 

·         the submission of the Q3 BCF monitoring tool to NHS England on or before 26 February 2016 be approved;

·         the financial performance of the BCF as at Q3 be noted; and

·         the direction of planning proposals around the BCF financial plans for 2016/17 be noted.

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 Corporate Director for People, Stockport Council updated the Board on developments with Greater Manchester Health & Social Care Transformation. The update included the following:-

·         The Greater Manchester Plan was currently out for consultation with partners and the public.

·         Work was underway to aligned local implementation plans and devolved funding. Much of this work was well advanced in Stockport through the Stockport Together Programme.

·         The Investment / Transformation Fund of £450m had been confirmed, although the allocations process was not yet finalised. It was likely that a key criteria for funding would be deliverability of projects. The two Greater Manchester ‘Vanguard’ sites (one of which was Stockport) would need to bid to this fund for its second year funding.

·         Proposals were being developed for the integration of children’s health services and would be published in due course.

·         Consultation had begun on the Greater Manchester Strategy for promoting behavioural change called ‘Taking Charge’.

Clarification was sought on the impact of not receiving funding for the second year of the Vanguard project. In response it was stated that the most significant impact would be to slow the pace of change as the Vanguard resources were facilitating the dual-running of old and new models.

RESOLVED – That the report be noted.

To consider the Forward Plan of agenda items for future meetings of the Health & Wellbeing 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) setting out a forward plan of agenda items for future meetings of the Board.

RESOLVED – (1) That the report be noted.

(2) That the following items be programmed for future agendas:-

·         Joint Health & Wellbeing Strategy Proposals (June 2016)

·         Carers

·         Dementia Strategy refresh

·         Board Governance and the relationship with the new Integrated Commission Board