Agenda and minutes

There were no declarations of interest.

Delegated decision:

That the Minutes of the meeting of the Health and Wellbeing Board held on Thursday 19^th June 2014, be approved as a correct record and signed by the Chair.

The forward plan is attached.

Members of the Board reviewed the Health and Wellbeing Board forward plan.

Delegated decision:

The Health and Wellbeing Board forward plan be noted

There were no questions from members of the public present at the meeting.

A report from the Director of Public Health is attached.

The HWB considered a verbal presentation from the Director of Public Health, in relation to establishment of an Early Years Partnership Board.  An accompanying report had been circulated to Board members; the report contained the following information;

Priority one of Bury’s Health and Wellbeing Strategy outlines Bury’s aim of ensuring a positive start to life for all children, young people and families.  Identifying those in need of help and support, intervening early and addressing the whole family’s needs are crucial to a child’s development.

There are several areas in Bury where further improvements are required to enable children to have the best start in life such as, improving early access to maternity services, reducing smoking in pregnancy, increasing breastfeeding rates, improving oral health, reducing childhood obesity , reducing childhood accidents and increasing the number of children that are assessed in reception as school ready.

The Director of Public health reported that it is proposed that a “Starting Well” partnership Board be established to further develop and drive forward the vision.  The Board will also incorporate the work of the family nurse partnership board.

                Delegated decision:

The Health and Wellbeing Board agrees to the establishment of a Starting Well Partnership Board with remit for providing leadership, direction and oversight of the early year’s health improvement agenda

The Executive Director, Children and Families will report at the meeting.  A report will be sent to follow.

The Health and Wellbeing Board considered a verbal presentation from the Executive Director, Children, Young People and Culture in relation to the Bury Children’s Safeguarding Boards annual report. 

The BSCB is required to ensure the effectiveness of the work that is done to safeguard and promote the welfare of children and young people in Bury.  2013/14 has been a year characterised by rising numbers of children who are subject to a child protection plan and a marked increase in the conversion rate of contacts to Children’s Social Care that progress to referrals.

The result has been a rising rate of referrals to children’s social care as a response to concerns about children’s welfare.

Members of the Board sought assurances from the Executive Director, Children, Young People and Culture that child sexual exploitation (CSE) was not an issue within Bury.  The Executive Director reported that there is a strategy in place to deal with CSE and a dedicated team of professionals has been established across Greater Manchester to work together and share intelligence.

                Delegated decision:

The Annual report on the effectiveness of Safeguarding children in Bury be noted.

The Director of Public Health will report at the meeting.

Members of the Board discussed priority one of the health and wellbeing strategy.  There was consensus amongst the Board members that the priority, actions and measures of success needed to be refreshed.

The Executive Director, Children, Young People and Culture recommended that the following should be included:

·                     the number of child protection plans be replace with the number of repeat child protection plans

·                     redefine the education measure to "narrowing the attainment gaps for vulnerable groups and ensuring that they make at least as good progress as their peers"

·                     In terms of actions an action be included to monitor the quality and standards of education in all maintained schools and challenge/ intervene as necessary.

Members discussed the inclusion of actions/measures to tackle infant mortality and the high percentage of children with tooth decay in the Borough.

Delegated decision:

Taking into account the suggestions made above, the HWB Policy lead, The Director of Public Health and Democratic services would meet prior to the next Board meeting and a refreshed priority one report will be prepared for consideration at the next meeting of the Health and Wellbeing Board.

The Deputy Chief Operating, Bury Clinical Commissioning Group will report at the meeting.  Report is attached.

Members of the Board considered a verbal presentation from the Deputy Chief Officer/Head of Commissioning, Sharon Martin; with regards to the Clinical Commissioning Groups five year strategy.

The CCG is required to submit a Strategic Plan to NHS England to outline how they will commission services for their registered population. This plan was submitted in draft on the 20^th June 2014, but has been refreshed and resubmitted following the review of the Better Care Fund.

The plan outlines how the CCG will deliver improvements in seven national outcome ambitions.

Bury CCG’s Strategy includes ambitions aligned to the six transformation characteristics highlighted in the national Everyone Counts guidance identified by NHS England to ensure provision of high quality, sustainable health and care in five years’ time.

Bury CCG has collaborated with the Local Authority to ensure that opportunities for partnership working are advanced in the coming years and the strategy outlines plans to further align work programmes and commissioning arrangements in the future.

Delegated decision:

The report be noted.

The Deputy Chief Operating, Bury Clinical Commissioning Group will report at the meeting. Report is attached.

Members of the Board considered a verbal presentation from the Deputy Chief Officer/Head of Commissioning, Sharon Martin; with regards to the Clinical Commissioning Group co-commissioning proposal.

NHS England invited CCG to submit bids to Co Commission services with NHS England Local Area Teams in June 2014. The bid was made by NHS Bury CCG to undertake co-commissioning of primary care services.  Although the bid was made by Bury CCG, it was been developed as part of a Greater Manchester (GM) framework for the development of primary care commissioning across GM.

NHS England assessed the bids based on two national criteria;

The entry level of co-commissioning required. The Area Team judged category C to be equivalent to Greater Manchester’s Levels 3 & 4.

Speed of implementation (The speed of implementation was judged as Ready Now, Ready Soon and Ready Later).

Bury CCG were judged to be ready now and at Category C which meant that the CCG can start to collectively work with NHS England Local Area Team to facilitate the proposals.

The Executive Director for Communities and Wellbeing reported that the proposal present an opportunity for all partners to develop a framework to enable co-commissioning of services across all organisations.  To co-commission effectively all stakeholders must understand the needs of the local population and work towards the integration of health and social care services.

Members highlighted the need for greater joined up commissioning particular in relation to preventative work and also public health services currently commissioned by NHS England.

Delegated decision:

The report be noted

The Chief Operating Officer, Bury CCG and the Assistant Director, Commissioning and Procurement, Bury MBC will report at the meeting.  A report will be sent to follow.

Members of the Board considered a verbal presentation from the Deputy Chief Officer/Head of Commissioning, Sharon Martin and the Assistant Director commissioning and Procurement, Julie Gonda in relation to the Better Care Fund.

The Better Care fund is a joint pooled budget for health & social care implemented from April 2015 which will have to be agreed between Local Authorities and CCG’s and then signed off by Health & Wellbeing Boards.

The Better Care Fund will develop a sustainable health and social care system

The CCG Deputy Chief Executive reported that it will be necessary to organise services around people to enable them to receive care & support in their own homes.

The total Better Care Fund resource is £12.94 million and will be categorized as follows; Social care spend, £5.8 million; Performance care element £3.4million, new investment £2.5 million; Local Authority capital allocations 1.24 million.

The CCG Deputy Chief Executive reported that there are national supporting metrics underpinning delivery these are not linked to payment & performance but still need to set ambition & measure:

—      Permanent admissions of older people to care homes

—      Proportion of older people- still at home 91 days after discharge to reablement & rehabilitation services

—      Delayed transfers of care

—      Local metric – emergency hospital admissions for injuries due to falls

—      Patient /service user experience – local or national metric

Members of the Board discussed the levels of risk attached to the performance care element of the funding. 

Delegated decision:

1. The Health and Wellbeing Board approve the content of the Better Care Fund plan as required.

2.The Health and Wellbeing Board delegate sign off of the Better Care Fund to the Chair of the Board; Councillor Rishi Shori.

3. The Health and Wellbeing Board approve the financial breakdown regarding transfer of funds and Better Care Fund for 2014/15 and 2015/1.6

4. The Health and Wellbeing Board approve the vision and direction of travel for the Better Care Fund in Bury.

The Deputy Chief Operating Officer, Bury CCG will report at the meeting.  A report is attached.

The Deputy Chief Executive provided members of the board with an overview of the quality and efficiency scorecard for frail and elderly.

The report outlines the CCG and Local Authority performance against benchmarked standards across the North West, including:

a.            Non elective admissions aged 65+

b.            Non-elective bed days aged 65+

c.            Non-elective re-admission rate within 30 days aged 65 and over

d.           Non-elective re-admission rate within 90 days aged 65 and over

The Deputy Chief Executive reported that the CCG and LA are the highest performing against these standards. This is an excellent achievement, despite the CCGs underfunding and funding constraints place on the LA.

Delegated Decision:

The H&WB Board note the achievements outlined in the ADASS report.

The Head of Commissioning, Greater Manchester Area Team, NHS England will report at the meeting.  A report will be sent to follow.

The Health and Wellbeing Board considered four quarterly commissioning reports produced by Nhs England, the reports refer to the provision of Dental, Eye, Pharmacy and medical services currently commissioned by NHS England.

The Director of Commissioning, Nhs England reported that the purpose of the reports is to provide Board members with assurances around quality and quantity of services provided within the Borough.

Members of the Board welcomed the reports but queried some of the information presented in particular, the data relating to the number of GP practices providing directed enhanced services for patients with dementia.

It was agreed:

1.           The Director of Commissioning, NHS England would clarify the figures in relation to dementia contained within the medical briefing paper.

2.           The Board agrees to receive regular direct commissioning quarterly update reports from NHS England.

There was no urgent business.