Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 16 August 2016.

The Minutes (copies of which had been circulated) of the meeting held on 16 August 2016 were approved as a correct record and signed by the Chair.

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

No announcements were made.

Dr Robin Jackson, Chair of the NHS Armed Forces Network North West, will attend the meeting to provide the Board with an update on the work of the Network, highlighting particular challenges for veterans in accessing health care.

Enclosed is a summary document for the Board’s information.

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

Dr Robin Jackson, Chair of the North West NHS Armed Forces Network, attended the meeting to inform the Board about the work of the Network, and highlight the particular health needs and challenges faced by veterans. A briefing note was also submitted (copies of which had been circulated).

The following comments were made/ issues raised:-

·         Was there a correlation between those veteran least able to reintegrate and those who had experienced the most traumatic service? In response it was stated that there was no statistical evidence that those suffering Post Traumatic Stress Disorder (PTSD) had longer term problems as most sufferers would adjust eventually, and those with repeated tours tended to cope better. Young service leavers were often those who joined-up to escape problems at home, which then return once they left the service.

·         It was suggested that those veterans who were also had a limb amputation were also suffering longer term mental health issues that were being missed. In response it was suggested that for amputees, PTSD instances were much higher and they were more likely to suffer a long term mental health issue. When amputees left Ministry of Defence specialist facilities they should transfer to the care of their GP. There were examples of transitionary mental health treatment service to avoid individuals ‘falling through the net’.

·         It was importance to ensure that individuals acknowledged and sought support.

·         Services and treatments needed to be kept under review to ensure that they could meet the needs of individuals and patients as increasingly those services were dealing with patients who might not have survived previously.

The Deputy Director of Public Health gave an undertaking to enhance reference and information relating to veterans within the JSNA.

RESOLVED – (1) That Dr Robin Jackson be thanked for his attendance and presentation.

(2) That the matter be referred to the Council’s Armed Forces/ Veterans Champion for information.

Board members and officers to declare any interests which they have in any of the items on the agenda for the meeting.

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 consider a joint report of the Interim Chief Finance Officer (CCG) and Borough Treasurer (Council).

The BCF data collection for Q2 2016-17 focuses on budget arrangements, the national conditions for access to the funds, income and expenditure to and from the fund, and performance on BCF metrics. The Q2 data collection is due to be submitted to NHS England in November 2016.

The Board is recommended to approve the submission of the Q1 BCF monitoring tool to NHS England.

Officer contact: Michael Cullen (Council) / Marc Brady (CCG), 0161 474 4631, 0161 426 558.

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 2 Data Collection Return for the Better Care Fund that was required for submission to NHS England.

Improved performance in relation to non-elective admissions was highlighted, as were ongoing efforts to reduce Delayed Transfers of Care.

RESOLVED – (1) That the Q2 BCF monitoring tool be approved for submission to NHS England on or before 25 November 2016.

(2) That the Democratic Services Manager be requested to circulated the recent reports on Delayed Transfers of Care from Healthwatch Stockport and the report considered by the Health & Care Integrated Commissioning Board on 11 November 2016.

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

Following the publication of the Stockport Health and Wellbeing Board’s refresh of the Joint Strategic Needs Assessment, (www.stockportjsna.org.uk) the Board agreed that there was a need to review and refresh the Stockport Joint Health and Wellbeing Strategy, which is one of its statutory duties.

The attach report sets out the process followed in refreshing the Strategy, a copy of which is attached at Appendix 1.

The Board held a stakeholder event in October 2016, a note of which is attached at Appendix 2.

(1)  The Health and Wellbeing Board is invited to review, comment on and amend the JHSW 2017-2020.

(2)  Pending amendments, the Health and Wellbeing Board endorse the JHSW 2017-2020 and recommend it to go forward to:

•     Health Scrutiny Committee on 27th November

•     Council Executive on 20th December

(3)  The Stockport Joint Health and Wellbeing Strategy 2017-2020 be published in January 2017.

(4)  The Board commit to a regular cycle of review and refresh of the strategy, actions and outcomes over the next three years.

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 Stockport Joint Health & Wellbeing Strategy 2017-2020 that had been developed in conjunction with health and social care partners, in line with a framework previously agreed by the Board. The Strategy differed in format and approach from the previous Strategy and would be subject to an annual review to ensure it kept pace with the growing complexity in the local health and social care system.

The Chair welcomed the feedback and engagement of partners in the development of the Strategy.

RESOLVED – That:-

·         the Stockport Joint Health & Wellbeing Strategy 2017-202 be endorsed and submitted to the Health & Wellbeing Scrutiny Committee and Council Executive;

·         the Strategy be published in January 2017;

·         a regular cycle of review and refresh of the strategy, actions and outcomes be undertaken over the next three years.

This item has been placed on the agenda at the request of the Chair.

Health and Wellbeing Boards and Local Authorities are being invited to work with local partners to create Time to Change Hubs to deliver local campaigns that supports communities, workplaces and schools to take action to change the way we think and act about mental health problems. The initiative is being led by Mind and Rethink Mental Ilnness. Local Health & Wellbeing Boards are being invited to submit bids to become a hub. www.time-to-change.org.uk/get-involved/hubs

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

The Chair reported that health and wellbeing boards and local authorities, in conjunction with local partners, had been invited to participate in the development of Time to Change Hubs to deliver local campaigns to change perceptions and actions relating to mental health. The initiative was led by Mind and Rethink Mental Ilnness. Although the invitation suggested that this project should be led by a health and wellbeing board, it was proposed to invite Stockport Homes to act as the lead organisation for the bid.

RESOLVED - That the proposal to participate in the Time to Change Hub project be endorsed, and Stockport Homes Ltd acting as lead organisation be supported.

This item has been placed on the agenda at the request of the Chair.

A verbal update on progress with the Stockport Together Programme will be provided.

The Chair invited those present to provide an update on Stockport Together.

Andrew Webb, Corporate Director for People, Stockport Council and Senior Responsible Owner for Stockport Together provided the following update on progress in delivering the transformation programme:-

·         Neighbourhood leadership arrangements were complete in all 8 localities. Social workers had been aligned to GP populations, and nursing alignment was underway. Enhanced case management was now in place.

·         Three Neighbourhoods now had the enhanced primary care offer.

·         Intermediate Tier crisis response was now operating that would allow additional support to be deployed within 2 hours.

·         Mastercall were now providing triage of patients at Stepping Hill ED to stream patients to GP led care where appropriate, and coverage was to be expended in December. So far 300 patients had been deflected.

·         Work had recently been undertaken to identify the skills needs of the Multi-Speciality Community Provider, and steps were being planned to address challenges in recruiting Advanced Nurse Practioners and similar staff.

·         3 Mental Health Liaison workers were now in place.

Donna Sager, Deputy Director of Public Health provided the following update on the preventative workstream:

·         The Behaviour Change Services were now online.

·         Work was continuing with the voluntary sector to provide practical support for discharge.

·         A pilot had been launched to support and encourage volunteering in general practice.

·         The work undertaken on empowering local communities had been recognised nationally and partners had been invited to put forward a bid for Vanguard status in this area.

Ann Barnes, Chief Executive of Stockport NHS Foundation Trust emphasised that the theoretical aspirations of Stockport Together were now becoming reality, but that this created further challenges that required the approach to be reviewed and refreshed to ensure the programme objectives remained achievable.

Echoing the comments of others, the significance of the workforce development challenge was again emphasised, in particular the shortage of skills in some areas, but also the opportunity to ‘grow’ those skills locally.

Dr Ranjit Gill, Chief Clinical Officer, Stockport Clinical Commissioning Group stated that the reduction in Non-Election Admissions at the hospital was reflective of the work partners were already doing, and demonstrated that the investment in change was starting to yield results. He further emphasised the need to ensure that further investment was weighted to create a system capable of long term impact, not just resolve short term challenges, and that partners used their data and intelligence to predict and prevent problems in order to reduce Winter demand the following year.

Andrew Webb emphasised the significance and scale of the change underway and the progress that had been made so far. As work intensified, the Programme Communications Strategy would also change to reflect this.

RESOLVED – That the update 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.

Partners were invited to update the Board on developments with the transformation of health and social care services in Greater Manchester.

Andrew Webb, Corporate Director for People, Stockport Council highlighted the significant work taking place in the development of the process for the distribution of the Transformation Fund. He also reported that many of the appointments to significant posts within the Greater Manchester health and social care partnership structure had now been made.

Donna Sager, Deputy Director of Public Health, reported that the Greater Manchester Population Health Plan recently been launched. She emphasised that there was consistency between it and the local Joint Health & Wellbeing Strategy. Local partners had also expressed interest in participating in a number of the pilots arising from the GM Plan.

Dr Ranjit Gill, Chief Clinical Officer, Stockport Clinical Commissioning Group, reported that as part of the ongoing work to standardise hospital standards across GM (known as ‘Theme 3’), the specialisms had now been selected that would be subject to review with a view to removing variation in access and in prescribing inefficiencies. He emphasised the significance and scale of this piece of work.

RESOLVED – That the update be noted.

To consider a letter sent to the chairs of Health & Wellbeing Boards highlighting the importance of primary care in the delivery of local health and wellbeing strategies.

The Board is invited to note the correspondence.

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

The Chair reported on the receipt of a letter from the Department of Health to local health and wellbeing boards stressing the importance of primary care in delivering improvements in health and in delivering local integration strategies.

The Chair emphasised the significant work already underway locally.

RESOLVED – That the Chief Operating Officer of the Stockport Clinical Commissioning Group be requested to prepare a response on behalf of the Board to David Mowat MP, Parliamentary Under Secretary of State for Community Health and Care.

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 – That the report be noted.

Donna Sager, Deputy Director of Public Health, presented a short video to the Board that highlighted the beneficial effects of walking on health, using interviews with patients.

The video could be viewed at https://play.buto.tv/JPPZk

RESOLVED – (1) That the presentation be noted.

(2) That the Board would welcome further Patient Stories at future meetings.

Donna Sager, Deputy Director of Public Health and Chair of the Cold Weather Group gave assurance to the Board that partners had begun to implement the Cold Weather Plan and that publicity was now underway to highlight key public health and self-care messages to the public.

RESOLVED – That the update be noted.