Agenda and minutes

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

RESOLVED – That Councillor John Pantall 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 Crombleholme 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 meetings held on 11 March and 28 May 2015.

The Minutes (copies of which had been circulated) of the meetings held on 11 March and 28 May 2015 were approved as a correct record and signed by the Chair.

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

The Chair reported on the following:-

(i)    NHS England had stated that due to changes to responsibilities within the local team it would no longer be possible for a representative to attend Health & Wellbeing Boards as a matter of course. Instead, representatives would attend in response to specific requests for attendance.

(ii)  An announcement had been made about the expansion of 7 day working in primary care to cover all parts of Greater Manchester by the end of 2015, with further enhancements being rolled-out in subsequent years. He commented that the announcement made little reference to social care.

(iii) The Chancellor of the Exchequer had recently announced in-year departmental funding reductions, including a cut of £200m to the public health budget in the current year. It was proposed for a consultation to be undertaken on these reductions, although it was unclear what form this would take. The Deputy Director of Public Health confirmed that the reductions nationally could result in a reduction in the Stockport grant of up to £1m. Further consideration would need to be given to how the Council would respond to this challenge when further detail was available.

To consider a report of the Director of Public Health.

The report presents the health and wellbeing performance indicators previously agreed by the 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.

This report also summaries key updates from theme leads about progress towards achieving the Health and Wellbeing Strategy we wills in section 4. These are structured so as to give the board highlights on activity and progress made during the quarter, information on risks and to alert the Board to any issues or causes for concern and actions that need to be considered.

The Board is invited to:

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

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

Officer contact: Eleanor Bannister, 0161 474 2447, eleanor.banister@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) providing the Board with data on performance during the third quarter of 2014/15 against a range of health and wellbeing indicators, and providing a commentary on trends and other issues related to the indicators. The Board were invited to consider the report and identity any areas for further discussion.

The following comments were made/ issues raised:-

·         In relation to the unusual pattern of healthy life expectancy and between males and females in Stockport, it was commented that this pattern did not accord with the national trend and further work was being done to validate the local data, although there was confidence that this data was accurate. It was suggested that further consideration may be needed as to the data that is collected to ensure it was consistent with nationally collected data.

·         It was suggested that ‘champions’ be sought from within the priority cohort of expectant mothers who smoke during pregnancy, in order to provide peer support in a similar way to peer support for breastfeeding. It was commented that of the 12 women involved with the maternal stop smoking scheme, 8 were smoke free.

·         There were positive examples of young people acting as peer supporters for other young people trying to give up smoking, and that projects of this kind had been supported through the Health Inequalities pilot programme and the Offerton Neighbourhood Management arrangements.

·         In relation to e-Cigarettes, it was commented that while there was not sufficient medical evidence to indicate how harmful they could be, and that they were not as harmful as tobacco, they contained nicotine that was a harmful substance. The public health concern with e-Cigarettes was that there was evidence of take-up by people who were not currently smokers and the danger that their use normalised smoking. The use of e-Cigarettes as a smoking cessation tool was however a positive point.

·         It was reported that the Tobacco Alliance had recently met and had a useful discussion about the practicalities of restricting smoking around play areas and other public spaces.

·         In relation to delayed transfers, it was commented that although delays occurred these were not a contributing factor in the recent hospital winter pressures. It was recognised that performance in this area could always be better but that the situation had improved sufficiently for the Foundation Trust’s performance concerns to be de-escalated by Monitor, the NHS Regulator.

·         In relation to childhood obesity it was commented that the number of children overweight at Year 6 was improving, although challenges remained for children at reception age. The Council and partners were engaged in a range of programmes to seek to address the problem, and levels of participation in sport in schools were high. Comments were made that rates of physical activity were positive but the public health challenge remained around changing patterns of food consumption, particularly putting over complex messages about healthy food and diet.

RESOLVED – (1) That the report be noted.

(2) That the Director for Public Health be requested to provide an update on excess winter deaths once data was available.

(3) That the Director for Public Health be requested to submit a report to a future meeting on healthy life expectancy.

(4) That the Democratic Services Manager be requested to circulate for information a copy of the Stockport Clinical Commissioning Group’s Annual Report.

The Board will receive an update on the progress with the Stockport Together project, the recent visit undertaken by NHS England supporting the New Models of Care ‘Vanguard’ project, and developments at a Greater Manchester level with the integration of health & social care and the devolution of powers and resources.

Enclosed with the agenda is a briefing paper prepared by the Greater Manchester Combined Authority and NHS in Greater Manchester in relation to devolution.

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

The Corporate Director for People (Stockport Council) submitted a report (copies of which were circulated) providing the Board with an update on progress with the development of the Stockport Together, the programme of reform of the health and social care system in Stockport that brought together the Council, Clinical Commissioning Group (CCG), Stockport NHS Foundation Trust and Pennine Care NHS Foundation Trust.

A copy of a briefing pack produced by Greater Manchester NHS on progress with preparation for greater devolution was also submitted (copies of which had been circulated).

The Corporate Director highlighted the following key areas:-

·         The governance arrangements for Stockport Together had to accommodate the requirements of each partner organisation. There was a strategic Leaders Group, supported by the Integrated Care Board (ICB) that was responsible for overseeing the four workstreams.

·         A Senior Responsible Owner had been appointed to co-ordinate the activity of the ICB and to identify obstacles to system integration and make recommendations to partners.

·         A ‘deep dive’ review had been undertaken of the four Stockport Together workstreams, and recommendations to enhance this activity had been made to the Leaders Group. One key recommendation was to begin to roll-out the integrated service model within the Cheadle & Bramhall Locality. Building on the lessons of the Marple & Werneth Hub and drawing on the ‘Vanguard’ programme it was proposed to accelerate the implementation of the new hub for the end of October with a view to full implementation across Stockport by the end of the 2015/16 financial year.

·         Challenges remained in having two different models of care being commissioned and delivered simultaneously, including resourcing and clinical governance.

·         Discussions were ongoing between the Council and CCG in relation to the future arrangements for the pooling of resources to further support integrated working.

·         Stockport Together partners were also developing their Locality Plan that would feed into the Greater Manchester-wide plan for health and social care integration and reform, linked to the devolution agenda.

·         The recent announcements by the Chancellor of the Exchequer about in-year budget reductions could potentially pose significant challenges to the Stockport Together Programme as prevention formed a key element of the programme.

The Service Director (Adult Social Care), (Stockport Council) reported on the outcome of a recent visit by the NHS England ‘Vanguard’ Team. The ‘Vanguard’ Programme was supporting innovative approaches to developing new models of care. The Team had been impressed by the ambition shown by partners in Stockport but had cautioned on the need to ensure deliverability of local plans. It was hoped that the Vanguard input would provide greater impetus to the development of the integrated hubs. Particular interest had been shown in the local approach to People Powered Health.

The Chief Operating Officer (Stockport CCG) reported that work was ongoing with the development of detailed designs and plans for service models. ICT and Organisational Development were key enabler projects cutting across all the Stockport Together workstreams. Ensuring an appropriate IT solution was essential to the success of integrated care, but ensuring an appropriately skilled workforce was needed to ensure that staff worked differently and more effectively.

Announcements had been made on 7 day working and the development of primary care services as part of plans being developed at Greater Manchester level, although these plans were more advanced within the NHS context than within social care.

The Director of Public Health reported that the Greater Manchester Devolution agreement included an ambitious public health programme that would complement other Greater Manchester projects such as the work in developing a Dementia Friendly City and a Healthy Ageing City, and Work and Health programmes. These projects were essential to reducing demand on health and social care services in the longer-term. There were also a number ‘quick win’ projects planned relating to tackling diabetes, hypertension, health checks and physical activity.

The following additional comments were made/ issues raised:-

·         There was a balance between developing models  ...  view the full minutes text for item 7.

In light of the recently published guidance from NHS England regarding monitoring and reporting of the Better Care Fund, it is proposed to alter the dates for the Board as previously agreed. The proposed revised schedule is below:-

(All commencing at 2pm – new dates in italics)

·         Wednesday, 15 July 2015

·         Tuesday, 25 August 2015

·         Tuesday, 17 November 2015

·         Wednesday, 13 January 2016

·         Wednesday,, 17 February 2016

·         Wednesday, 18 May 2016

·         Wednesday, 8 June 2016

It is proposed to cancel the following dates:-

·         2 September 2015

·         4 November 2015

·         9 March 2016

·         20 April 2016

The Democratic Services Manager invited the Board to consider a revised programme of meeting dates for the Board. The revisions had been necessary in order to allow for NHS England reporting requirements for Better Care Fund monitoring.

RESOLVED – (1) That the following revised programme of Board meeting dates be approved:-

(All commencing at 2pm)

·         Wednesday, 15 July 2015

·         Tuesday, 25 August 2015

·         Tuesday, 17 November 2015

·         Wednesday, 13 January 2016

·         Wednesday,, 17 February 2016

·         Wednesday, 18 May 2016

·         Wednesday, 8 June 2016

(2) That the following previously agreed dates be cancelled:-

·         2 September 2015

·         4 November 2015

·         9 March 2016

·         20 April 2016

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.