Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 15 January 2014.

The Minutes (copies of which had been circulated) of the meeting held on 15 January 2014 were approved as a correct record and signed by the Chair.

No declarations of interest were made.

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

The Chair reported on his recent attendance at the NHS Innovation Expo.

To consider an update on progress with the ‘We Will’s’ in the Health & Wellbeing Strategy Chapter 5 on Prevention and Maximising Independence.

The Board is recommended to note and comment on progress.

Officer contact: Jane Jefferson/ Sarah Newsam, 0161 474 2459 / 07891949204, jane.jefferson@stockport.gov.uk / sarah.newsam@stockport.gov.uk

Sarah Newsam (Head of Health & Wellbeing) and the Jane Jefferson (Public Health specialist, Health Promotion), Stockport Council attended the meeting and made a presentation on progress against the ‘We Wills’ in Chapter 5 of the Health & Wellbeing Strategy relating to prevention and maximising independence. A written update was also submitted (copies of which had been circulated).

The following areas were highlighted:-

·        The need for a clear and shared understanding of what was meant by prevention and to place this at the heart of public service reform and improvement.

·        Progress was being made with NHS health checks, screening and immunisation programmes but more was planned to target those who had not taken up the service before. Targeting hypertension was a priority for partners and could have a significant impact on outcomes.

·        Improving ‘health literacy’ was a key preventative priority, and would form a part of the health inequalities pilot. The Healthy Stockport website was a useful tool to assist with this work.

·        Embedding people powered health and building in community capacity in reform work was also a priority for partners, including as part of the integrated health and social care model.

·        The Board had a vital role in championing prevention.

The following comments were made/ issues raised:-

·        It was important to recognise the value of simple activity and the disproportionate impact if these were not done properly.

·        The variation in take up of NHS Health Checks often reflected the organisation of GP practices, and where certain data was already held on a particular individual this would negate the need for a further check. The Stockport Health Record was assisting in this process. Consideration was being given to other settings for health checks as a way to improve take-up.

·        The need and value of prevention needed to be seen within the context of a system that was geared toward acute and hospitalised care which was unsustainable and which had to change.

·        From April 2014 the CCG would be working with a selection of GP practices to pilot more flexible approaches to delivering services, which may improve screening rates.

·        The ‘Making Every Contact Count’ initiative of training front line staff to engage the public in conversations about lifestyles was hoped would have a significant impact on preventative work.

RESOLVED – That Sarah Newsam and Jane Jefferson be thanked for their attendance and presentation.

To consider a verbal update on the second submission with particular focus on the work of Health and Social Care professionals and the outcomes to be secured.

The Service Director (Adult Social Care), Stockport Council and the Chief Operating Officer, Stockport Clinical Commissioning Group, provided an update to the Board on Stockport’s Better Care Fund submission to the Department of Health and NHS England.

It was reported that feedback had been recently been received from the NHS England on the first submission of the integration plan, and all the points in the submission had been rated either green or amber. The feedback was consistent with expectations, and further work was already planned to address those elements rated amber as part of the preparation of the final submission.

The submission was highly ambitious, partly because it needed to be because of the overly hospitalised system in Stockport, but this also meant it was high risk. Nevertheless, NHS England believed the plan was deliverable and the commitment of partners was evident from the submission.

It was stated that the work on integration remained work in progress and the existing Marple and Werneth Locality Hub would provide valuable evidence and experience in the evolving system.

Members commented that the plans in Stockport were ambitious without being reckless, and realistic without being risk adverse, although it was recognised that there remained significant work still to do. The challenge remained to ensure that the savings accrued from integration were released for reinvestment.

RESOLVED – (1) That the update be noted and all those involved in the Better Care Fund preparation be thanked for their hard work to date.

(2) That the Service Director (Adult Social Care), Stockport Council and the Chief Operating Officer, Stockport Clinical Commissioning Group be requested to circulate a summary of the key issues from the first Better Care Fund submission.

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

To outline the context for the renewal of the s75 agreement between Stockport Council (SMBC) and Stockport Clinical Commissioning Group (SCCG) for 2014/15 in advance of finalising the agreement at the Health and Wellbeing Integrated Commissioning Board (HWBICB) in March.

The Health and Wellbeing Board is recommended to note the report.

Officer contact: Simon Finch, 0161 474 4019, simon.finch@stockport.gov.uk

A representative of the Corporate Director for Corporate and Support Services submitted a report (copies of which had been circulated) informing the Board of the intention of the Council and Clinical Commissioning Group to renew the Section 75 Agreement for 2014/15 and to review the agreement for future years in light of the changing demands and circumstances.

RESOLVED – That the report be noted.

To consider an update on local and Greater Manchester transformation and improvement initiatives.

The Chair invited members to provide an update on transformation and improvement activities underway that would have an impact on Stockport.

Healthier Together

It was reported that consultation on the Healthier Together programme was expected to begin in July 2014. The delay was due to the complexity of the programme. Work was ongoing to ensure the proposals accorded with other areas of activity, such as the sector-based work. The Programme had received national interest because of its scope and ambition.

Members expressed concern that the length of time taken to develop proposals was impacting on service delivery as it created uncertainty for professionals and difficulties in recruiting to key posts.

Review of Specialist Services

It was reported that NHS England was undertaking a review of specialist services with a view to the possibility of creating a number of regional centres. At this stage it was not clear what the impact would be on Greater Manchester, and no clear proposals were being made about sites or locations. Given the work already underway in relation to Healthier Together, it was likely that this would feed into the national process.

Work Programme Leavers Protocol

The Chair invited the Board to consider a draft protocol (copies of which had been circulated) developed by the Combined Authority in conjunction with NHS England that set out the commitment of partners to support Employment Support Allowance claimants into sustained employment.

RESOLVED – (1) That the updates be noted.

(2) That the Work Leavers Programme Protocol be endorsed.

The Chair informed the Board that due to another commitment he would not be able to remain for the conclusion of the meeting and that in the absence of the Vice-Chair it would be necessary to elect a chair.

RESOLVED – That Councillor Tom McGee be elected Chair for the remainder of the meeting.

To consider a report of the Chief Operating Officer, Stockport Clinical Commissioning Group.

This is the draft of the Clinical Commissioning Group’s five year strategy. It is currently in the form of a Key Lines of Enquiry (KLOE) as required by NHS England. Once this is broadly agreed and following an on-going conversation with the partners and the public it will be revised and published in a more typical plan format.

The Health & Wellbeing Board is invited to comment on the draft Strategy.

Contact: Tim Ryley, Stockport CCG, 0161 426 9900

The Chief Operating Officer, Stockport Clinical Commissioning Group (CCG), submitted the CCG’s draft 5 Year Strategy (copies of which had been circulated) and invited the Board to provide a view on the proposed direction of travel and the eight key objectives for service change and improvement.

It was reported that the CCG Governing Body had considered and endorsed the draft Strategy earlier in the day, subject to further detailed work being undertaken.

The following comments were made/ issues raised:-

·        Members welcomed the commitment for greater investment in mental health services, particularly Improving Access to Psychological Therapies, as well as the aspiration to put mental health on a par with physical health. Comment was made about the potential complications of working with a provider that worked across a number of boroughs. There was discussion about the pressure on all NHS Trusts to reduce costs and tariff deflation.

·        There remained a challenge to inform and encourage the public to take greater ownership and responsibility for their health, and it was encouraging to see this aspiration reflected in the Strategy.

·        It was suggested that greater reference could be made to resourcing the implementation of the Winterbourne View Concordat and related requirements. In response it was stated that this would be considered but that resourcing levels had been deemed to be adequate to meet the requirements.

RESOLVED – (1) That the aspirations and objectives set out in the draft Stockport Clinical Commissioning Group 5 Year Strategy be welcomed.

(2) That the Stockport Clinical Commissioning Group be requested to give consideration to the comments of the Board in relation to its draft 5 Year Strategy.

To consider a report of the Chief Operating Officer, Stockport Clinical Commissioning Group.

This plan describes the links between the 5 year strategic objectives, the proposed programmes and interventions and the changes in activity and outcomes resulting. The plan describes a significant step towards in improving the outcomes for patients (less hospitalisation, less lives lost) and a major rebalancing of the economy.

Copies of the Adult Social Care Priorities and Public Health Business Plan for 2014/15 are attached for information.

The Health & Wellbeing Board is invited to comment on the Plan.

Contact: Tim Ryley, Stockport CCG, 0161 426 9900

The Chief Operating Officer, Stockport Clinical Commissioning Group (CCG), submitted the CCG’s draft Operational Plan (copies of which had been circulated) for consideration by the Board. The Plan provided further detail on the proposed actions and activity that would support the implementation of the CCG’s 5 Year Strategy.

It was reported that the CCG Governing Body had considered and endorsed the draft Plan earlier in the day.

To assist the Board in its deliberations, copies of the proposed refreshed Council Plan Priorities and the Public Health Business Plan were also submitted (copies of which had been circulated) to allow the Board to satisfy itself that there was consistency between the Council and CCG’s plans.

The importance of Public Health activity, with its focus on prevention, to the delivery of key objectives for both the Council and CCG was emphasised, in particular in managing demand for health and social care services.

RESOLVED – That the Stockport Clinical Commissioning Group draft Operational Plan, Public Health Business Plan and refreshed Council Plan priorities be noted.

To consider a report of the Council Solicitor.

The report invites the Board to consider changes required to the ‘Terms of Reference’ as set out in Article 9 of the Council Constitution. The changes are needed to take account of changes to the Code of Conduct for Councillors and Co-opted Members.

This item was deferred at the last meeting to allow the partners to give further consideration to the matter.

The Board is requested to give consideration to the content of the report and consider the arrangements for substitute members of the 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) inviting the Board to consider governance issues arising from the operation of the Board since its establishment in April 2013, in particular the arrangements for substitute members and proposed additions to the Board’s general role in light of guidance issued by Department of Health. This item had been deferred from the last meeting to allow members of the Board to consider further the implications of the proposed amendments.

RESOLVED – That the Board supports the proposed amendments to Article 9 of the Council Constitution as detailed in the report, including the proposal to appoint one named substitute for each organisation represented on the Board, subject to the revision of the addition in point 9.03 of Appendix 1 to read:-

All members of the Board who are not elected members of the authority will be treated, for the purposes of the Board, as if Co-opted Members of the Authority for the duration of their membership of the Board.

To consider a report of the Director of Public Health.

This report presents the health and wellbeing performance indicators previously agreed by the Health and Wellbeing Board. Data is taken from the Council’s quarterly PPRRs (Portfolio Performance Resource Reports) for the Health and Wellbeing, Adult Social Care and Children and Young People portfolios wherever possible, so that these processes are aligned.

The Health & Wellbeing Board is recommended to:-

·         to receive and note this report and the key indicators summarised within it;

·         to comment on the proposal that for 2014/15 the report structure will expand to incorporate key updates from theme leads about progress towards achieving the Health and Wellbeing Strategy ‘we wills’; and,

·         to identify any further information that the Board would like to receive as part of the outcomes framework.

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) summarising performance in the third quarter of 2013/14 against a range of measures in the Board’s Outcomes Framework.

It was reported that in relation to healthy life expectancy and life expectancy data further validation would be undertaken to ensure accuracy.

RESOLVED – (1) That the report be noted.

(2) That a further update be provided in the next Outcome Framework update in relation to healthy life expectancy and life expectancy.

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 – That the report be noted.

The Chair informed the Board that this would be the last Board meeting attended by Councillor Bryan Leck in his capacity as a councillor as he was standing down at the next election after 40 years of service to the Borough and involvement in the health economy in Stockport. On behalf of the Board the Chair thanked Councillor Leck for his contribution and wished him well for the future.