Agenda and minutes

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

CouncillRESOLVED - That Councillor Tom McGee be elected Chair of the 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 Cromblehome be appointed Vice Chair of the Board for the period until the next Annual Council Meeting.

To approve as a correct record and sign the Minutes of the meeting held on 11 April 2018.

The Minutes (copies of which had been circulated) of the meeting held on 11 April 2018 were approved as a correct record and signed by the Chair.

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

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

No interests were declared.

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

The Chair referred to the discussions at the last meeting (Minute 6 of 11 April 2018 refers) relating to possible reconfiguration of the Board and the agreement to hold a workshop for members. He stated that regrettably it had not been possible to facilitate that discussion. The Chair also referred to a number of reviews of other Boards, including the Urgent Care Board, and suggested that options to dovetail these other pieces of worked should be explored. 

It was also highlighted that the recent CQC Review had highlighted Stockport Together governance as an area requiring attention. 

Members welcomed the Chair's suggestion. 

It was commented that the template of reform across Greater Manchester was for the integration of commissioning and of provision, and the Board was a key element of that agenda. It was important for all partners in the economy to form a view on future governance. 

In relation to the possible scope for a review of the Board it was suggested that it should include comparisons with Board structures in other economies and further reflection on the outcomes of the University of Durham review of Health and Wellbeing Boards.

It was also highlighted that Stockport had a long standing joint commissioning arrangement that had complicated consideration of governance arrangements.

RESOLVED - That the Chief Executive be requested to circulate a draft scope for a review of the Health and Wellbeing Board to members as soon as possible.

To consider a report of the Head of Population Health Transformation, GMHSCP.

The Framework and Dashboard have been developed following GMHSCP agreement to a set of proposals to facilitate the creation of a unified population health system, to support the delivery of the GM Population Health Plan at pace and scale - http://www.gmhsc.org.uk/assets/08-Public-Health-System-Reform-Full-Report-Exec-Summary-FINAL-v2.pdf.  This included a commitment to the reduction of unwanted and unwarranted variation in standards, improvement in population health outcomes, more consistent adoption of evidence based practice, and the enhanced use of benchmarking data.  The Framework also seeks to reconcile the ambitions of Taking Charge and the GM Strategy.

The GM Population Health Outcomes Framework has been developed through a process of engagement and co-design with key stakeholders from across the Health and Social Care system and the wider Public Service.  The framework has been reviewed and endorsed by GMHSCP Performance and Delivery Board on 14 March 2018. The framework and associated datasets have been built into an interactive, tableau based dashboard which will be tested during the 2017/18 Q4 Assurance Cycle in April and May 2018. The link to this dashboard is https://public.tableau.com/profile/dashboard6270#!/

Officer contact: Mark Brown, GMHSCP, mark.brown7@nhs.net

A copy of a briefing note on the development of a Greater Manchester wide public health outcome framework was submitted (copies of which had been circulated) for consideration and comment by the Board.

The Chair reported that due to the delayed start of the meeting the representatives of the Greater Manchester Population Health Team had been unable to attend the meeting. He suggested that consideration of the item be deferred to the next meeting.

The Deputy Director of Public Health outlined the role of the Stockport public health team in supporting the development of the framework. Assurance was given that the ambitious outcomes for Stockport were consistent with those of the local Health & Wellbeing Strategy.

 The following comments were made / issues raised:-

·         The work taking place across Greater Manchester was welcomed, as were targets tailored to Stockport as there was a danger that Stockport was overlooked given the different health profile of the borough.

·         There was a known correlation between life expectancy and educational qualifications. Given the challenges of life expectancy in Greater Manchester it was surprising there was no reference to improving educational attainment as an outcome. In response it was stated that Stockport outperformed most other Greater Manchester authorities in this respect but there was always scope for improvement. The Council's Healthy Ageing Strategy would seek to identify how services can contribute to healthy ageing for all ageing. 

·         Unplanned pregnancies could have an impact on health, and educational, outcomes for young children. What more could be done in Greater Manchester to reduce the rate, given the sensitivities of the issue? What was the availability of appropriate contraception in Greater Manchester? Concerns were expressed about the impact of the national trend for the reduction in sexual health services.

RESOLVED - (1) That consideration of the Greater Manchester Outcomes Framework be deferred to the next meeting.

(2) That the Deputy Director of Public Health be requested to submit a report to a future meeting on Sexual Health Services, including information about accessibility of contraception and terminations.

At the request of Board, this is a standing item on the agenda.

Members and officers present are invited to update the Board on developments with the Stockport Together Programme.

The Chair invited partners present to update the Board on Stockport Together.

The following updates were provided:-

·         Partners had strengthened the Stockport Together Provider Board to include the chief officers of the four provider organisations, and to ensure that there was now more thorough oversight of the programme to improve the pace of change.

·         Possible industrial action had been averted. Partners were engaging in positive dialogue with the workforce.

·         The launch in the following week of the new GP home visiting service was hoped to speed up interventions, including admissions if needed, with the aim of speeding up treatment and improving outcomes.

·         There was a planned launch of a new Prescribing Services to address the of spend on repeat prescriptions and problems that arise from oversubscribing or inappropriate usage. In response it was queried whether the service would include anti-biotic prescriptions. In response it was stated that such prescriptions were driven largely by infection rates that was in turn being driven by patterns of care in nursing and care homes which in turn was often due to a lack of understanding and training.

The following additional comments were made/ issues raised:-

·         There was a need for the Neighbourhood Teams to accelerate the GP led model of care to ensure there was appropriate clinical governance of their work and directing resources. There was a particular need for this acceleration to ensure the economy was ready for the upcoming winter period.

·         Given the challenge of improving healthy life expectancy, was there a danger the neighbourhood model would lead to variations in service that undermined this outcome? In response it was stated that the underpinning of the Stockport Together Programme was to ensure the standardisation of services and access, but to give localities additional flexibilities to address specific needs of its populations. It was further commented that because there was a correlation health inequality and mortality rates, by reducing inequality there was a projected reduction in health & social care spend by 12%. By focussing on outcomes, this should ensure that everyone received the services they needed regardless of where they lived.

RESOLVED - That the report be noted.

At the request of the Board, this is a standing item on the agenda.

Members and officers present are invited to update the Board on developments with the transformation of health and social care services in Stockport and Greater Manchester.

This item had been addressed during consideration of Minute 7 ‘Stockport Together’.

To consider a report of the Deputy Chief Executive.

The report sets out the responses of the Council, Stockport Homes and the approved response of Stockport CCG to the 24th Annual Public Health Report. The Council Cabinet is due to consider the response on 12 June 2018.

The Health & Wellbeing Board is asked to:

·         Consider the 24th Annual Public Health Report;  

·         Review the 49 recommendations of this Report which the Cabinet has accepted in its response, including two which are updates to recommendations made in the previous year’s report;

·         Highlight any significant issues or challenges with the proposed response to be fed back to the Cabinet; and

·         Highlight areas of good practice in existing work which can be offered in support of the Cabinet’s response.

Officer contact: Karen Kime, 0161 474 3574, Karen.kime@stockport.gov.uk

(Note: the Chair was of the opinion that this item, although not included on the agenda, should be considered as a matter of urgency in accordance with section 100B(4)(b) of the Local Government Act 1972 in order that the matter could be considered prior to its consideration by the Cabinet meeting on 12 June 2018.)

A copy of the draft Cabinet response to the 24^th Annual Public Health Report was submitted (copies of which had been circulated) that was due to be considered by the Council’s Cabinet on 12 June 2018. The report also included the approved response of Stockport CCG to the recommendations of the Director of Public Health.

The Director of Public Health welcomed the response and engagement of partners.

The links between the recommendations contained in the report and Stockport Together were stressed, in particular the causes of pollution from unnecessary or duplicated journeys of health professionals that could be reduced by joined-up health records. The availability of integrated, real time information would be cost saving but more importantly improve care given to clients.

RESOLVED – That the 24^th Annual Public Health report be noted and the responses of the Council and Clinical Commissioning Group to it be endorsed.

To suggest agenda items for future meetings of the Health & Wellbeing Board.

A representative of the Democratic Services Manager invited suggestions of items for future meetings of the Board.

RESOLVED – That the report be noted.