Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 13 November 2018.

The Minutes (copies of which had been circulated) of the meeting held on 13 November 2018 were approved as a correct record and signed by the Chair.

Following the retirement of the previous Vice-Chair, to appoint a Vice-Chair of the Board for the remainder of the 2018/19 Municipal Year.

RESOLVED – That Dr Cath Briggs be appointed Vice-Chair of the Board for the remainder until the next Annual Council Meeting.

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

No announcements were made.

To consider the implications for the Board and local partners on the recent publication of the NHS 10 Year Plan, published on 7 January 2019.

The full document can be viewed at https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/nhs-long-term-plan.pdf

A short summary is enclosed for information.

A representative of the Deputy Chief Executive submitted an NHS produced summary of their 10 Long Term Year Plan (copies of which had been circulated) for the Board’s information and consideration. The Chair invited members to comment or raise any issues of interest to the Board.

Members emphasised that the Plan was broadly in line with current policy, and mirrored the work underway local to develop Neighbourhood Models of Care. For Stockport, there was also a need to understand how Greater Manchester devolution and this Plan would complement each other.

It was further commented that the Joint Health & Wellbeing Strategy would need to be consistent with the Plan.

The Chair invited members to report back as appropriate on pieces of work associated with the Plan that would be relevant for the Board.

RESOLVED – That the report be noted.

To receive an update on the response to the CQC Local Area Review.

The Chair invited Members to provide an update on their organisation’s actions in response to the Care Quality Commission’s Local Area Review in April 2018.

The Director for Adult Social Care stated that progress was being made across the 15 areas included in the response, with five having been completed.

Members emphasised the need for ‘system-view’ of progress, drawing on key representatives from each partner organisation, in order to be prepared for any follow-up visit from the CQC.

RESOLVED – That the Chair be requested to co-ordinate a system-wide update on progress with responding to the findings of the CQC Local Area Review for submission to the next appropriate Board meeting.

To consider a report of the Deputy Chief Executive, Stockport Council

The Board will be asked to consider an overview of recent development work with the Local Government Association and activity to refresh the Board’s priorities in light of the evolving health and care landscape.

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

The Chair submitted a report (copies of which had been circulated) summarising recent Board development sessions and setting out proposed priorities for the Board.

The Chair thanked partners for their engagement with the development of the priorities and highlighted the input from other members who may not be present at the meeting but who had been involved in these efforts.

The following comments were made/ issues raised:-

·         Understanding the Board’s activity in the context of that of other boards and benchmarking against that might be useful.

·         The publication of the 10 year plan had provided reassurance that the Board’s recent development activity was on in accord with the broader direction of travel within the national health and social care economy. The priorities adopted by this Board would also need to be seen within this context and compliment the development of the Greater Manchester 5 year plan.

·         It would be helpful for the Board to be explicit about its priorities and how they were presented and how these were in turn prioritised since there was a sequential nature to these ambitions.

·         Given the challenges of addressing health inequalities and the wider determinants of health it was important to recongise that this was a long term aspiration and would require sustained efforts across a ‘system’that was wider than the health and care economy, again chiming with the new NHS Plan and references to an integrated system. The Board’s Joint Health & Wellbeing Strategy would be a vital tool in seeking to address this key area.

·         The Board had previously sought to engage with the wider economy and partners and that would be a useful exercise to repeat as the Board sought to refresh its Strategy and approach.

·         While the development work of the Board had sought to address the ‘why’ and the ‘what’ of its work, there remained uncertainty about the ‘how’ and what the ‘engine room’ would be to achieve these priorities. Greater clarity was needed on the structures underpinning this Board and the wider economy not least for the Board to be able to better hold those other bodies to account. In this context it was commented that there had been work to reform the architecture supporting Stockport Family and it was planned for this to report back into this Board.

·         Given the continued delay in the social care ‘green paper’, did the Board have sufficient assurance over the functioning of adult social care and support? Was that a function of this Board, or more appropriately that of the Health & Care Integrated Commissioning Board?

·         It was important for this Board to be clear about where the ‘engine rooms’ were in relation to its priorities so that it could hold to account partners for the delivery of those priorities. Particular concern was expressed about where the ‘engine room’ was for the delivery of the Neighbourhood Model.

·         There were a number of proposals being developed that sought to address urgent and emergency pressures and these could usefully be submitted to the Board for consideration. The Board also had a role in ensuring that partners were approaching the challenges to the economy in the most appropriate context, moving away from reactive approaches. The example was that of the ‘Winter Plan’ and whether it would be more effective is there was an all-year approach to resilience of the ‘system’ that took account and reflected the range of pressures that could be anticipated throughout the year.

RESOLVED – (1) That the report on priorities be endorsed and the priorities within be adopted.

(2) That the Chair, on behalf of the Board, be requested to write to the Chairs of relevant partnership boards to:-

·         inform them of the changes to this Board and the adoption of its priorities;

·         seek assurance that those boards were delivering against the wider economy needs in areas relevant to this Board and its priorities;

·         seek details of the priorities of those  ...  view the full minutes text for item 7.

To consider performance to date on the dleivery of the 2018/19 Winter Plan and identify areas for further consideration.

The Chair invited members to reflect on the effectiveness to date of local preparations for Winter pressures.

Members commented that it was too early in the implementation of the plan to give a definitive assessment of its effectiveness, though it was acknowledged that given its importance to the overall effectiveness of the health and social care system it was important that the Board discuss the matter.

The following comments were made/ issues highlighted:-

·         Stockport was not alone in finding performance against standards challenging, but there were nevertheless many areas of activity that were working well and it was important not to lose sight of this, particularly in the face of external scrutiny of performance.

·         There were a number of broad themes that remained of concern in relation to Urgent Care, notably governance and leadership; resources and investment, and continued challenges around integration and aligning of activity.

·         There was a role for the Board in asking the question of what could be done differently to make the system more effective.

·         The flu vaccination programme was an example of all parts of the health and care system working together to perform exceptionally well. This demonstrated that the system could work effectively together and what could be achieved through a system approach to a challenge. Was there learning that could be adapted to other parts of the system?

·         Urgent care was a complex ‘eco-system’ that was sensitive to small changes. It was important to recognise that while partners could be responsive and agile, there were often procedure and process challenges that could not be overcome that would mean the system could never be perfect. The optimal outcome may be ensuring that the system and partners could respond effectively to the peaks and troughs in demand.

RESOLVED – That the report be noted.

To consider an update on preparations within the local health and care economy for Britain exiting the European Union.

The Chair invited members to provide updates to the Board on preparations for the UK exiting the European Union without any transitional arrangements in place.

It was reported that the Clinical Commissioning Group Governing Board had earlier in the day received assurance that preparations were in hand, and that an update on Council preparations had been submitted to the Corporate, Resource Management & Governance Scrutiny Committee on 22 January 2019.

It was also report that Stockport NHS Foundation Trust (FT) were preparing measures, including coordinating with other organisations across Greater Manchester, and that a further report would be considered by the FT Board following this meeting.

RESOLVED – That the report be noted.

To consider a report of the Director of Public Health.

The report provides the Board with an overview of current health and wellbeing trends and sets out plans for the delivery of the 2019/20 work programmes for both the JSNA (Joint Strategic Needs Assessment) and the JHWS (Joint Health and Wellbeing Strategy).

The Board is asked to:-

·         consider the proposals for the 2020 JSNA and confirm that a working group be established to bring together a revised JSNA by early 2020 and to commit to providing members for this group as appropriate;

·         consider whether there are any additional new areas of focus (beyond population segmentation, neighbourhoods and mortality changes) that should be included in the development of the 2020 JSNA;

·         discuss the proposals for the 2019 review of the Health and Wellbeing strategy, and decide whether this should continue the previous series or whether a report focusing on action for social isolation should be developed.

Officer contact: Donna Sager, 0161 474 3928, donna.sager@stockport.gov.uk

The Director of Public Health submitted a report (copies of which had been circulated) providing the Board with an overview of current health and wellbeing trends and setting out plans for the delivery of the 2019/20 work programmes for both the JSNA (Joint Strategic Needs Assessment) and the JHWS (Joint Health and Wellbeing Strategy).

The Director of Public Health highlighted a number of trends, in particular the declining rate of improvement or reduction in life expectancy for women in deprived areas.

The following comments were made/ issues raised:-

·         It would be useful to include information in relation to health assets and an assessment of whether partners were using them to the best effect.

·         The Care Quality Commission published a document on the state of the health of the nation and the format may usefully be adapted for Stockport.

·         More data and a format that providing information reflecting the neighbourhood approach, particularly in providing assurance and accountability for delivery of outcomes in those neighbourhoods. This would reinforce the place based/ neighbourhood agenda and link to the Stockport Family approach. It would also provide useful information to support the development of the Local Plan.

·         Efforts should be made to ensure common language and consistency with that used in Greater Manchester documents.

·         Further consideration needed to be given to the process for reviewing and refreshing the Strategy.

RESOLVED – (1) That the 2019/20 Strategic View be noted.

(2) That the Director for Public Health be requested to establish a working group to develop a revised JSNA by early 2020.

To note the Minutes of the Better Care Fund Sub-Committee meetings held on 22 January 2019.

RESOLVED – That the Minutes of the meeting of the Better Care Fund Sub-Committee held on 22 January 2019 be noted.