Agenda and draft minutes

Councillor Andrea Simpson, Chair and Cabinet Member for Health and Wellbeing declared a personal interest in all items under discussion as an employee of Salford Clinical Commissioning Group.

Minutes of the meeting held on the 9^th March are attached.

Delegated decision:

That the minutes of the meeting held on the 9^th March 2017 be approved as a correct record.

Forward Planner attached.

The Chief Operating Officer Bury CCG reported that the Urgent Care Redesign consultation has been paused in anticipation of receiving national guidance on urgent care systems from NHS England.  During a period of purdah, NHSE does not issue any guidance, the guidance is now anticipated in late June or July.  The CCG will have to make a judgement if there is to be further delays in issuing the guidance as to whether they commence the public consultation.  

An update will be provided to the Board as soon as any guidance is received. 

Councillor Walker informed the meeting that he and Councillor Holt had met with representatives from the CCG to sign off the Locality plan and the Local Transformation Plan (CAMHS) prior to submission.

There were no members of the public present to ask questions under this item.

Dave Boulger, Programme Director (Devolution) will report at the meeting.  Report and presentation are attached.

Dave Boulger, Programme Director attended the meeting to update members on the recently submitted Locality Plan.  The Programme Director reported Bury, like every area of Greater Manchester, faces significant challenges in relation to Health and Social Care.  The refreshed Bury Locality Plan articulates these challenges and identifies an approach to tackling them.  The Plan has been collaboratively developed with key stakeholders from across the system.  The Plan is the basis for an Investment Proposition to the Greater Manchester Health and Social Care Transformation Fund.

The refreshed Bury Locality Plan sets our wide-ranging transformational proposals in relation to health and social care which are intended to:

·                     Improve Outcomes for local people

·                     Reduce Inequality in Bury

·                     Increase the extent to which local people are active participants in their own health and the health and social care system

·                     Create future financial and clinical sustainability across the health and social care system.

The refreshed Bury Locality Plan sets out wide-ranging and transformational proposals that are intended to close a projected financial gap of £75.6million by 2020/21.

The refreshed Bury Locality Plan is the basis for an Investment Proposition to the Greater Manchester Health and Social Care Transformation Fund of c.£27million.

The scale and scope of the Locality Plan make it likely that future consultation will be required with the public and/or workforce in relation to specific proposals.

Dave Bevitt raised concerns about the lack of engagement with the third sector in respect of the development of the locality plan.  In response, the Programme Director reported that part of the focus of the plan is to shift investment into voluntary sector and they will continue to be key players going forward.

       Delegated decision:

Members of the Board will receive regular updates in respect of the Locality Plan and the recently submitted bid to the Transformation Fund.

Dave Boulger, Programme Director (Devolution) will report at the meeting.  Report attached.

The Programme Director (Devolution) presented the recently submitted Better Care Fund Monitoring Report.  The data collection template requires the Health & Wellbeing Board to track through the high level metrics and deliverables from the Health & Wellbeing Board Better Care Fund plan.

The Programme Director reported that all of the national conditions are currently being met and there are no areas for concern.

There is no improvement in performance for Non elective admissions, Delayed Transfers of Care and permanent admissions to residential care. Admissions due to falls, patient satisfaction and reablement are on track to meet the target.

Reduction in non-elective admissions: There has been a steady increase in non-elective admissions for Bury patients throughout 16/17 however this has reduced in Q4.

Delayed transfers of care: Despite promising progress at the beginning of the year, target has not achieved at year end. There were 5980 delayed days in 16/17 compared with 5680 in 15/16 an increase of 5%.

Admissions due to falls: We have been on target for this measure through the year and have achieved target at year end with a decrease in falls over the past 2 quarters.

Were you involved in discussions on your care and treatment: This survey measure tends to be static and determine after releases of 3 different surveys throughout the year. The GP survey is now being published annually in July which when released will enable us to calculate the overall average for this measure.

Permanent admissions to Residential care: There has been an increase in residential admissions this year which after investigation seems to be due to the inclusion of full cost clients in the measure definition (clients who pay for their own care but who will continue to be reviewed annually by local authority) and a significant increase of those this year. On average there we 28 admissions per month but in February there were 44 and March 40. Without these full cost clients we would remain on target.

Reablement: We have achieved target for this measure at year end.

         It was agreed:

         That sign off of the Better Care Fund Monitoring Report will continue to be delegated to the Chair of the Health and Wellbeing Board, copies of the report, once submitted, will be forwarded for consideration by the Health and Wellbeing Board.

Tracy Flynn, Unit Manager (Economic Strategy and European Policy) will report at the meeting. Report attached.

The Unit Manager (Economic Strategy and European Policy)attended the meeting to provide members with an update in respect of continuing work of the working well scheme.  The principles of the Working Well Expansion are based on learning from the Working Well Pilot Programme which was designed and co-funded by all the GM Local Authorities. 

The Working Well Expansion programme has changed how skills, health and employment services function together, by offering a seamless, co-ordinated and sequenced package of support for eligible workless residents.   Across Greater Manchester the programme has and will be delivered in three distinct phases:

·             Phase 1a – Working Well Pilot – supporting 5,000 individuals who were attached to the programme between 1st October 2015 and 31^st March 2016.

·             Phase 1b – Working Well Expansion – supporting 13,500 individuals attached to the programme and receiving support through the Personalised Keyworker Service and referrals to the Mental Health IAPT Talking Therapies service between March 2016 and December 2017.  It also includes 1000 referrals to the GP Pilot in 4 Greater Manchester districts.

·             Phase 2a – Working Well - Work & Health Programme – supporting c.18,000 individuals attached to the programme between early 2018 and March 2023.

          DWP’s current welfare to work programmes, that support the long term unemployed and those with a health condition/disability, will come to an end during 2017.

The Greater Manchester Working Well - Work and Health Programme is a core element of the Greater Manchester Combined Authority’s (GMCA) devolution agreement with Central Government.

As with the national Work & Health Programme, GM’s programme will support:-

·         People who have a disability on a voluntary basis;

·         Early access disadvantaged groups on a voluntary basis; and

·         Long-term Unemployed on a mandatory basis

         JobCentre Plus will be the primary referral agent to the programme.  However, local signposting pathways to JobCentre Plus will be encouraged building upon the success of the GP referral route currently being piloted. 

         In response to a Member’s question the Unit Manager reported that the first client appointment will be mandatory, it will then be the responsibility of the key worker to sell the benefits of the scheme to the client.

         The Unit Manager reported that there will be one provider across all of the ten AGMA districts.

         It was agreed

         Further updates in respect of the working well programme will be considered at a future meeting of the Health and Wellbeing Board.

Chris Woodhouse, Improvement Advisor, Bury MBC will report at the meeting.  Report attached.

Chris Woodhouse, Improvement Advisor attended the meeting to provide members of the Board with a briefing paper in respect of the recently developed single outcomes framework.

In the last twelve months work has taken place across Team Bury to deliver on the ambition of Team Bury Wider Leadership Group to develop a shared outcomes framework across all partners, in order to embed an Outcome Based Accountability (OBA) approach across all partners.

The Single Outcomes Framework (SOF) has been developed as the shared outcome based approach for Bury. Within this five high level outcomes have been identified, that all partners have signed up to. These are:

·         All people of Bury live healthier, resilient lives and have ownership of their wellbeing.

·         Bury people live in a clean and sustainable environment.

·         People of Bury at all ages have high level and appropriate skills.

·         All Bury people achieve a decent standard of living (and are provided with opportunities through growth).

·         Bury is a safe place to live with all people protected, and feel protected from harm.

         An OBA approach involves looking at indicators under each outcome and gaining a true understanding of the past and current performance,  the reasons behind any trends, the partners that are (or should be) involved in improving the indicator and only then do actions get identified to deliver improvement.

         The Director of Public Health reported that there will be population level outcomes and the data will help partners to map where initiatives are making a difference.

         The Interim Executive Director of Communities and Wellbeing reported the information will be able to identify priority areas for the Board.

         It was agreed:

          That the Health and Wellbeing Board note the developments that have taken place on the Single Outcomes Framework.

Julie Gonda, Interim Executive Director, Communities and Wellbeing will report at the meeting.  Report attached.

The Executive Director of Communities and Wellbeing provided members of the Board with a Governance update.   The report sets out the rationale and arrangements, approved by the Integrated Health and Social Care Partnership Board, for the future governance requirements to underpin Health and Social Care transformation, and the development of appropriate governance arrangements for One Commissioning Organisation (OCO) and a Locality Care Organisation (LCO).

In response to a Member’s question, the Executive Director of Communities and Wellbeing reported that there will be Elected Member representation of the Transformation Board.  Representatives from the Voluntary Sector will be involved in the different enabling work streams.

It was agreed:

That the Health and Wellbeing Board note the content of the report.

Chris Woodhouse, Improvement Advisor, will report at the meeting.  Report attached.

Chris Woodhouse, Improvement Advisor attended the meeting to provide a PNA consultation update.  Bury Council and CCG, along with the other localities within Greater Manchester, have commissioned Greater Manchester Shared Services (GMSS) to undertake the development of the revised PNA.

          The first stage of activity includes surveys for both the public and pharmacies in Bury to complete. The questions are consistent across the North East Sector.

Questions consider access to pharmacies, frequency of use, reasons for use and on satisfaction. This survey will be circulated through SurveyMonkey and it is for the Council/Health and Wellbeing Board to promote this. As part of this Healthwatch are working to ensure any hard to reach groups are engaged in this process. Of note when this exercise was previously conducted 70% of the respondents were female whilst 88% were ‘White British’.

         The pharmacy survey seeks information on existing services that are provided, whether they have Healthy Living Pharmacy status, access, resources (including workforce) and patient feedback.

         Members of the Board raised concerns in respect of the format of the PNA consultation and sought assurances that the consultation would capture responses in respect of the evolving role of pharmacies going forward.

         The Chair also raised concerns in respect of members of the public accessing the survey and asked that paper copies are made available in more places.

         Delegated decision:

          The Improvement Advisor reported that comments and concerns raised will be fed back to Greater Manchester Shared Services and an update will be presented at a future meeting.

Stuart North, Chief Operating Officer will report at the meeting.

Stuart North, Chief Operating Officer provided members with a brief update in respect of Devolution Manchester.  The Chief Operating Officer wanted to place on record his thanks to all the organisations that had been involved in the recent incident at Manchester Arena.

Chloe McCann, Assistant Improvement Advisor will report at the meeting.  Update Attached.

          The Assistant Improvement Advisor reported that a calendar of events has been created outlining the up-coming board meetings along with relevant deadlines and development session. Calendar invites have been sent out to all board members,

          The Principal Democratic Services Advisor asked that members of the Board need to ensure that they have completed and returned their register of interest forms.

There was no urgent business reported.

·         Children’s Trust Board Minutes

·         Climate Change and Carbon Reduction Board Minutes

·         Bury Adults Safeguarding Board Minutes

·         Housing Strategy Programme Board Minutes

Children’s Trust Board Minutes

Bury Safeguarding Adult’s Board Minutes

Climate Change and Carbon Reduction Board Minutes

Housing Strategy Programme Board Minutes