Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 1 March 2023.

The Minutes (copies of which had been circulated) of the meeting held on 1 March 2023 were approved as a correct record and signed by the Chair.

To appoint a Vice Chair for the period until the next Annual Council Meeting.

RESOLVED – That Dr Simon Woodworth be appointed Vice-Chair of the Board for the period 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 a report of the Greater Manchester Integrated Care Partnership.

The report outlines the draft Joint Forward Plan which is the delivery plan for the Integrated Care Partnership Strategy. There are 4 key questions we are required to consider (see Section 2). The document is based on the six missions in the Strategy; the actions to deliver them; the measures for tracking delivery; and where accountability is held. This is supported via the performance framework and ways of working. The Plan will be revised and update each year.

The Board is recommended to respond to the key questions and make any further comments on the document.

Officer contact: Geraldine Gerard on 07800 617 956 or by email: geraldine.gerrard@stockport.gov.uk

The Assistant Director for Strategy & Innovation, NHS Greater Manchester Integrated Care submitted a report of the Greater Manchester Integrated Care Partnership (copies of which had been circulated) outlining the draft Joint Forward Plan which was the delivery plan for the Integrated Care Partnership Strategy. There were 4 key questions the Board were required to consider.  The document was based on the six missions in the Strategy; the actions to deliver them; the measures for tracking delivery; and where accountability was held. This was supported via the performance framework and ways of working. It was reported that the Plan would be revised and updated each year.

The following comments were made/issues raised: -

·         It was noted that the Greater Manchester Integrated Care Partnership Strategy had been considered at the meeting of the Board on 1 March 2023 which had been well received and that the Joint Forward Plan document was reflective of the comments previously raised.

·         It was commented that the separation between system leadership and delivery leadership was clear and well made.

·         Thanked officers for the comprehensive summary of the document.

·         It was queried how the Joint Forward Plan related to the ICP strategy.

·         In response, it was stated that the Joint Forward Plan was the delivery plan for the ICP strategy and was part of the requirement by NHS England to create an implementation plan alongside the core strategy.

·         It was noted that a number of metrics were incomplete and queried whether it would be possible to complete those metrics in advance of the deadline set by NHS England.

·         In response, it was commented that there was a framework for those measures in place and work was ongoing to confirm the individual details.

·         It was commented that it was difficult to make a judgement as to whether the right bodies were identified to be held to account until the metrics had been completed.

·         In response, it was stated that some of the metrics would come from some of the system leadership and Boards that were in place through discussions to identify what the right measures and metrics were.

·         In relation to the review of the Better Care Fund, it was queried whether the two programmes of work were congruent in making improvements in the ambitions around health and inequalities.

·         In response, it was commented that the last two years of work around the ICP strategy including workshops with stakeholders across the system meant that the various plans and strategies were coalesce in terms of delivery, objectives, outcomes and value for the wider population.   

·         It was noted that different emphasis around the metrics would be required in each neighbourhood in recognition of the varying demographics in Stockport.

·         It was commented that as a locality Stockport was aligned in the direction of travel, however there was ongoing delivery work to ensure the best for the residents of Stockport.

·         Members commented on the importance of assigning timelines and deadlines within a delivery plan.

·         It was noted that the workforce was a key challenge within the system and that there was an opportunity for integrated working to address the challenges.

·         Welcomed the reference to unpaid carers within the workforce strategy.

·         It was queried whether there were clear plans for locality reporting within the Joint Forward Plan.

·         In response, it was commented that a comprehensive plan of reporting and accountability for the Joint Forward Plan would be in place in the near future and communicated to stakeholders and localities within Greater Manchester.

·         It was noted that some of the actions within the Joint Forward Plan were broad and ill defined and suggested that more detail be provided.

·         It was suggested that equity in outcomes be considered at a metric in addition to equity of access.

RESOLVED – That the report be noted.

To consider a report of the Director of Strategy.

The purpose of this report is to review the Terms of Reference for the Health & Wellbeing Board to ensure clarity on the duties of the Board.

The Board is recommended to review and comment on the draft Terms of Reference.

Officer contact: Geraldine Gerard on 07800 617 956 or by email: geraldine.gerrard@stockport.gov.uk

A representative of the Director of Strategy submitted a report (copies of which had been circulated), the purpose of the report was to review the Terms of Reference for the Health & Wellbeing Board to ensure clarity on the duties of the Board.

The following comments were made/issues raised: -

·         Welcomed the report and focus on the role and duties of the Health & Wellbeing Board within the report.

·         It was queried whether the Board had the authority to refuse the reports within its remit. In response, it was stated that the authority to agree and refuse report was within the powers and remit of the Board.

·         It was noted that the terms of reference would likely be reconsidered in the future as the system and duties of the Board evolved.

RESOLVED – That the report be noted and Terms of Reference be endorsed.

To consider a report of the Director of Public Health.

The report provides the Stockport Health & Wellbeing Board with an overview of JSNA (Joint Strategic Needs Assessment) activity in 2022/23 and the proposed work plan for the Stockport JSNA for 2023/24.

The Board is recommended to consider and comment on:

·         the proposals for the 2023/24 JSNA set out above and approve priorities for the work programme for the year

·         the proposal to include representatives from the provider partnership as part of the JSNA Programme Group

Officer contact: Eleanor Banister on 0161 474 2447 or email: eleanor.banister@stockport.gov.uk

A representative of the Director of Public Health submitted a report (copies of which had been circulated) providing the Stockport Health & Wellbeing Board with an overview of JSNA (Joint Strategic Needs Assessment) activity in 2022/23 and the proposed work plan for the Stockport JSNA for 2023/24.

The following comments were made/issues raised: -

·         Welcomed the report and the proposed work programme, and thanked officers for the level of detail provided.

·         In relation to face-to-face GP appointments, it was suggested that further information could be provided in relation to other means of access within primary and community care.

·         It was suggested that the Board be used to invite representatives from Pennine Care and the NHS Foundation Trust to form the JNSA Programme Group.

RESOLVED – That the report be noted and priorities for the work programme for the year be approved.

To consider a report of the Director of Public Health.

NHS England have informed Stockport Health and Wellbeing board of two pharmacy closures in May 2023 and June 2023 and as a result the Stockport Pharmaceutical Needs Assessment (PNA) Project Group have undertaken a review of an impact of these closures and have drafted a supplementary statement to the 2022 PNA signalling an additional pharmacy need.

The report summarises the findings of this review and the contents of the supplementary statement for approval by the Stockport Health and Wellbeing Board.

The Board is recommended to approve the draft Supplementary Statement to the Stockport 2022 PNA.

Officer contact: Eleanor Banister on 0161 474 2447 or email: eleanor.banister@stockport.gov.uk

A representative of the Director of Public Health submitted a report (copies of which had been circulated) summarising the findings of the review of the impact of two pharmacy closures in May 2023 and June 2023 by Stockport Pharmaceutical Needs Assessment (PNA) Project Group and outlines the contents of the supplementary statement to the 2022 Pharmaceutical Needs Assessment signalling an additional pharmacy need for approval by the Stockport Health and Wellbeing Board.

The following comments were made/issues raised: -

·         It was noted that the supplementary statement to the 2022 Pharmaceutical Needs Assessment had been considered at the ONE Stockport Health & Care Locality Board in May and at the meeting there was agreement from the Board that the closures would be a carrier to people accessing timely care and potentially place increased pressure on other services. It was commented that the Locality Board had agreed that the Chair of the Board would write to NHS England copying in Greater Manchester ICB colleagues to express their concern and the need to address the issues in a timely manner.

·          It was commented that the Board endorsed the concerns raised by the ONE Stockport Health & Care Locality Board.

·         It was noted that there were a number of other pharmacy closures within Greater Manchester.

·         It was suggested that NHS England be recommended to discuss with other pharmaceutical chains who may wish to expand their presence in Stockport in place of these closures.

·         In response, it was stated that NHS England would be working with the pharmaceutical market to highlight the need for a provider and address the market gaps, and the Council would continue to work with NHS England to address the challenges.

RESOLVED – That the draft Supplementary Statement to the Stockport 2022 Pharmaceutical Needs Assessment be approved.

To consider a report of the Deputy Place Lead.

The report follows on from the update provided to the Health & Wellbeing Board in March 2023 and outlines the progress of the One Health and Care Plan.  

The Board is recommended to:

·         Note progress so far on the One Health and Care Plan

·         Agree outline engagement plan and associated activities

·         Agree proposed timeline

Officer contact: Patrick McGee on 07736564540 or email: patrick.mcgee@nhs.net

The Deputy Place Lead submitted a report (copies of which had been circulated) providing a further update to the report provided to the Health & Wellbeing Board in March 2023 and outlining the progress of the One Health and Care Plan

The following comments were made/issues raised: -

·         It was noted that the One Health and Care Plan had been considered at Healthwatch’s Strategic Monitoring Group and welcomed the opportunity to comment on the progress of the One Health and Care Plan.

·         Welcomed that mental health, learning disability and autism remained a priority within the plan and commented on the importance of continuing the work in this area.

·         In relation to the hard to reach groups to obtain feedback and given the focus on safe and timely discharge, neighbourhoods and mental health, learning disability and autism, it noted that some of these individuals may not be able to partake in some of the engagement activities described and queried the measures in place.

·         In response, it was stated that the service was working with Healthwatch, Fair and Inclusive Stockport and Sector Three’s Equality Lead to engage with the hard to reach groups.

·         It was suggested that the service engage with the Learning Disability Partnership Board to support the work to engage with the hard to reach groups.  

·         Welcomed the focus on meaningful engagement, however recognised the challenge of this approach and felt more work was required to define the set of questions so that the people tasked with the engagement activities were aware of what success in that engagement would look like.

RESOLVED – (1) That the report be noted.

(2) That the outline engagement plan and associated activities be agreed.

(3) that the proposed timeline be agreed.  

To consider a report of the Deputy Place Lead, NHS Greater Manchester.

The report provides an update on integrated health and care in Stockport.

The Board is recommended to:

·         Note the developments on the Greater Manchester Integrated Care System and the One Stockport Health and Care Partnership since July 2022

·         Agree the proposed approach for Neighbourhood level of integrated health and care.

Officer contact: Patrick McGee on 07736564540 or email: patrick.mcgee@nhs.net

The Deputy Place Lead submitted a report (copies of which had been circulated) providing an update on integrated health and care in Stockport.

The following comments were made/issues raised: -

·         Members commented on the benefits of health and care staff being co-located, welcomed the progress that had been made and noted the challenges around space and cost.

·         It was suggested that a report be submitted to each of the Area Committees in relation to health care provision within the remit of each of the Area Committee areas.

·         Welcomed the inclusion of family hubs and identification of sites, and queried whether pharmacies could be placed within the family hubs to make services accessible to local people in a convenient way.

·         In response, it was commented that the suggestion of placing pharmacies within family hubs would be explored and noted that pharmacy provision was commissioned by NHS England.

·         Welcomed the definition of neighbourhoods within the report and requested that a future report be provided in relation to an update around the neighbourhoods work.

RESOLVED – (1) That the developments of the Greater Manchester Integrated Care System and the One Stockport Health and Care Partnership since July 2022 be noted.

(2) That the proposed approach for a neighbourhood level of integrated health and care be agreed.

To consider a report of the Director of Adult Social Care.

The report sets out the contribution Stockport Council has made to deliver the Fair and Inclusive strand of the Borough Plan during 2022-23.

The Board is recommended to note the report.

Officer Contact: Ben Lawton by email: ben.lawton@stockport.gov.uk

A representative of the Director of Public Health submitted a report (copies of which had been circulated) outlining the contribution Stockport Council had made to deliver the Fair and Inclusive strand of the Borough Plan during 2022-23

The following comments were made/issues raised: -

·         Welcomed the inclusion of case studies within the annual report and commented on the importance of referencing the patient journey.

·         Thanked the officers for a comprehensive report and ongoing work of the Fair and Inclusive Stockport team.

·         It was commented that the report detail and content demonstrated the issues surrounding health and health inequalities and the need to look more broadly at the issues to create change.

·         Welcomed the suggestions within the report and learning opportunities for the Council and its partner organisations.

·         It was noted that there was a partnership piece of work ongoing with Pennine Care around contacting community mental health team service users to ensure users were receiving the rebates for council tax which they were entitled to and providing wrap around benefit support.

·         Welcomed the inclusion to the reference of the Brinnington Jobs Fair within the report as a case study of progress at a locality level.

RESOLVED – That the report be noted.

To consider a report of the Head of Commissioning.

The Department of Health and Social Care (DHSC have published a Better Care Fund Policy Framework for the implementation of the Better Care Fund (BCF) in 2023-25. The Better Care Fund (BCF) is one of the government’s national vehicles for driving health and social care integration. It requires integrated care boards (ICBs) and local government to agree a joint plan, owned by the health and wellbeing board (HWB). These are joint plans for using pooled budgets to support integration, governed by an agreement under section 75 of the NHS Act (2006)

A plan for 2022/23 was agreed in September 2023 by the Health and Wellbeing Board and this latest plan builds on the previous developments since that time. The national conditions for the BCF in 2023 to 2025 are:

·         a jointly agreed plan between local health and social care commissioners, signed off by the HWB

·         implementing BCF policy objective 1: enabling people to stay well, safe and independent at home for longer

·         implementing BCF policy objective 2: providing the right care, at the right place, at the right time

·         maintaining the NHS’s contribution to adult social care (in line with the uplift to the NHS minimum contribution to the BCF), and investment in NHS commissioned out of hospital services

In addition to the existing national conditions the delivery of the BCF for 2023/25 will support 2 key priorities for the health and care system that align with the 2 existing BCF objectives:

·         improving overall quality of life for people, and reducing pressure on UEC, acute and social care services through investing in preventative services

·         tackling delayed discharge and bringing about sustained improvements in discharge outcomes and wider system flow

The Board is recommended to approve the BCF Plan 2023-25.

Officer contact: Vincent Fraga on 0161 474 4401 or email: vincent.fraga@stockport.gov.uk

A representative of the Head of Commissioning submitted a report (copies of which had been circulated) outlining the Better Care Fund (BCF) Planning Submission for 2023-25 ahead of the deadline for submission to NHS England on 28 June 2023.

The following comments were made/issues raised: -

·         Welcomed the flexibility that had been provided within the BCF to invest in services to support safe and timely discharge from hospital to home or an appropriate community setting.

·         Thanked officers for the report and welcomed the innovative solutions within the proposals and opportunity to deliver the services.

·         It was noted that the report referenced indicative figures where the service was awaiting confirmation and clarification linked to the BCF outturn position. It was stated that any further feedback from the BCF national team would result in an update from indicative analysis to outturn figures for actuals prior to submission to NHS England.

RESOLVED – That the Better Care Fund Plan for 2023-25 be approved. 

To consider a report of the Assistant Director - Legal and Democratic Governance.

The report provides the Forward Plan of agenda items for future meetings of the Health & Wellbeing Board. 

The Board is asked to consider the information in the report and put forward any agenda items for future meetings of the Health & Wellbeing Board.

Officer contact: Georgia Latham on 0161 474 3229 or email: georgia.latham@stockport.gov.uk

A representative of the Assistant Director - Legal & Democratic Governance (Monitoring Officer) submitted a report (copies of which had been circulated) providing the Forward Plan of agenda items for future meetings of the Health & Wellbeing Board.

RESOLVED – That the report be noted.