Agenda and minutes

Councillor Walker declared a personal interest in respect of HWB.273 as a former lay member of Cygnet Health Care.

Minutes of the meeting held on the 28^th September 2017 are attached.

It was agreed:

The minutes of the meeting held on the 28^th September 2017 be approved as a correct record.

Transferring Public Health Functions to Greater Manchester Combined Authority.

Forward plan is attached.

Councillor Walker referred to an ongoing Parliamentary Select Committee review into the potential harm and risks associated with electronic cigarettes.

The Director of Public Health reported that the most recent evidence suggests that vaping is safer than smoking however it is still unknown the long term effects of constant use of e-cigarettes.

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

Representative from Bury Clinical Commissioning Group and Pennine Acute will report at the meeting.

In the absence of Steve Taylor, representative from Pennie Acute NHS Trust, Stuart North, Chief Operating Officer, Bury CCG provided members of the Board with a verbal update. 

Fairfield General Hospital has been the best performing hospital in Greater Manchester for the last three months.  Challenges still remain as a quarter of Bury Residents use North Manchester General Hospital and problems still exist at this site with regards to delayed discharge.

In response to a Member’s question the Chief Operating Officer reported that CCGs proposals for Urgent and Emergency Care were discussed at the most recent CCG Board meeting.  A comprehensive update will be considered at the next meeting of the Health and Wellbeing Board.

It was agreed:

Bury Clinical Commissioning Group’s proposals for Urgent and emergency Care will be considered at the next meeting of the Health and Wellbeing Board

Tracy Minshull, Interim Assistant Director Commissioning, Procurement and Finance attended the meeting to provide members with an update in respect of the Better Care Fund and the new Improved Better Care Fund.  The presentation contained the following information:

The Better Care Fund is a programme spanning both the NHS and local government, the programme seeks to join-up health and care services and aims to help people can manage their own health and wellbeing.

The following better car fund metrics have been identified:

·         Non-Elective admissions

·         Long term support needs for 65+ met by admission to residential or nursing home (per 100,000)

·         Proportion of people 65+ still at home 91days from hospital into rehabilitation services

·         Delayed transfers of care from hospital (per 100,000)

The Assistant Director reported that the Local Authority and its partners are not yet on track to meet the targets in the following areas:

1.   Non-elective admissions first consultant episodes

2.   Long term support needs of older people (aged 65 and over) met be admission to residential and nursing care homes per 100,000 population

3.   Delayed transfers of care (delayed days) from hospital per 100,000 population (aged 18+)

The Assistant Director reported that the Council are on track to meet the target in respect of the proportion of older people (65 and over) who were still at home 91 days after discharge from hospital into re-ablement and rehabilitation services.

The Assistant Director reported that the IBCF was given on topof the national BCF funding to help with covering the costs associated with the National Living Wage, Maintain Adult Social Care, Investing in new services to support managing transfers of care

The IBCF funded projects will include; Care at home, residential care, supported living services and re-ablement.

Responding to a member’s question with regards to Social workers working as trusted assessors across Local authority boundaries; the Executive Director reported that cross boundary work has now commenced.  Training has been embedded, however difficulties remain in respect of the different funding arrangements, IT systems and an agreed common passport.  A Bury social worker can assess a Rochdale or a Manchester resident, this system is not yet fully operational across all of Greater Manchester.

Dave Bevitt raised concerns that there has been limited involvement of the third sector/voluntary sector in the development of the locality plan and better care fund.

Responding to a question from the Director of Public Health, the Chief Operating Officer reported that the development of a strategic commissioning functions, including pooled budgets will eventually replace the Better Care Fund.

Members discussed continuing problems with delayed discharge, the Assistant Director reported that an action plan is being developed to address problems in this area.  A suite of discharge to assess beds has been commissioned, beds can also be “spot purchased” as and when required.

The Interim Executive Director reported that following devolution a number of GM standards and Key Performance Indicators have been developed in respect of delayed discharge. 

It was agreed:  ...  view the full minutes text for item HWB.272

Karen Whitehead, Strategic Lead, will report at the meeting.  Report is attached.

Maxine Lomax, Head of Safeguarding/Deputy Director of Nursing and Designated Nurse for Child Protection and Looked after Children, Bury CCG attended the meeting to provide an update with regards to the Bury Safeguarding Board Annual report.  An accompanying report had been circulated to Members prior to the meeting and contained information in respect of:

·         The role of the Local Safeguarding Children’s Board

·         Promoting effective partnership working

·         Holding partners to account

·         Reviewing child deaths

·         Effectiveness of the Safeguarding Board    

Responding to a question from the Chief Operating Officer, in respect of concerns raised nationally about the quality of services provided by Cygnet Healthcare; The Head of Safeguarding/Deputy Director of Nursing and Designated Nurse for Child Protection and Looked after Children reported that the services provided in Bury have been rated as good.  The Safeguarding Board works proactively with the organisation to provide help and support.

It was agreed:

That Maxine Lomax, Head of Safeguarding/Deputy Director of Nursing and Designated Nurse for Child Protection and Looked after Children be thanked for her attendance.

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

Julie Gonda, Interim Executive Director Communities and Wellbeing attended the meeting to provide an update with regards to the Bury Adult’s Safeguarding Board Annual report.  An accompanying report had been circulated to Members prior to the meeting and contained information in respect of:

·         Defining abuse

·         Board Activity report

·         Adult Safeguarding Concerns and Enquiries

·         Deprivation of Liberty Orders

It was agreed:

The Interim Executive Director Communities and Wellbeing be thanked for her attendance.

Karen Whitehead, Strategic Lead and Jon Hobday, Public Health Consultant will report at the meeting.  A report is attached.

Karen Whitehead, Strategic Lead, Children/Families submitted a briefing note in relation to mental health provision and costings across the Borough.  In attendance with Karen to provide a verbal update were, Jon Hobday, Public Health Consultant, Kim Marshall, Representative from Healthy Young Minds and Michael Hargreaves, Bury CCG.  The presentation contained the following information:

·         What is and who does mental health affect

·         Types/levels of service to address mental health

·         National context/drivers

·         Bury’s spend on Mental Health

·         Challenges and recommendations

In respect of mental health spend within the Borough, the Public Health Consultant reported that the direct spend on mental health provision is as follows:

                   Local Authority      CCG                      Spend per head

Adult           £3,604,500           £30,486,000                  £237

Children      £3,815,793           £2,108,000           £181

Total            £7,420,293           £32,594,000                  £227

The Public Health Consultant reported that there is an additional local indirect spend on mental health services from the Local Authority of £26,393,629, the CCG indirect spend is difficult to quantify.

The HWB Chair raised concerns with regards to the support available to schools to help with the growing numbers of students requiring mental health support.  Responding to these concerns, the Strategic Lead reported that this was identified as an issue during the recent SEND inspection by the CQC and Ofsted.  The Healthy Young Minds service will provide help, assistance and training within schools.  A recently published Green Paper co-written by the Department for Health and the Department for Education will include additional funding for schools to support staff and pupils within schools.

The Director of Public Health reported that there is an increasing body of evidence which suggests that adverse childhood experiences significantly increase the chance of developing a mental health condition.  Prevention and identification should be a key part of any long term approach to developing mental health service provision.

 It was agreed:

1.   A workshop will be facilitated with appropriate stakeholders and staff to explore the most appropriate way to ensure a collaborative, integrated and governed system wide approach to addressing mental health across the life course, which should ensure a system wide approach and to achieve efficiencies and reduce duplication. 

Bring the findings back to the health and wellbeing board for agreement and endorsement.

Lesley Jones, Director of Public Health will report at the meeting.  Report is attached.

The Director of Public Health submitted a report in relation to the Greater Manchester Working Well Early Help Programme.  The objective of the Working Well scheme is to facilitate health GM work places, supporting employers and employees to reduce sickness absence and increase productivity; as well as effectively supporting workers to retain or return to employment when suffering from poor health or disability.

It was agreed:

That Bury’s Health and Wellbeing Board approves the participation in the Greater Manchester Working Well Early Help Programme: towards a population approach to work and health.

There was no urgent business reported.

Minutes from the sub groups are attached:

Bury Adults Safeguarding Board

Climate Change Board

HSPB

Children’s Trust

The following minutes were included for information:

·                Children’s Trust

·                Housing Strategy Board

·                Adult Safeguarding Board

·                Climate Change Board