Agenda and minutes

Health and Wellbeing Board
Thursday, 21st March, 2019 6.00 pm

Venue: Meeting Rooms A&B, Bury Town Hall

Contact: Julie Gallagher  Democratic Services

No. Item


Declarations of Interest

Members of the Health and Wellbeing Board are asked to consider whether they have an interest in any of the matters on the Agenda, and if so, to formally declare that interest.


Councillor A Simpson declared a personal interest in respect of all items to be considered due to her appointment as Lord Peter Smith’s assistant at the Greater Manchester Health and Social Care Partnership Board.  Councillor Simpson is also employed by the NHS.



Public Question Time

Questions are invited from members of the public present at the meeting on any matters for which the Board is responsible.


Approximately 30 minutes will be set aside for Public Question Time, if required.


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



Minutes of previous meeting pdf icon PDF 81 KB

Minutes of the meeting held on 12th February 2019 are attached.


It was agreed:


The minutes of the meeting held on the 12th February 2019 be approved as a correct record.



Matters Arising pdf icon PDF 105 KB

·         Readmission Rates – Steve Taylor Chief Officer/Managing Director to update


·           Readmission rates


Chief Officer/Managing Director Bury & Rochdale Care Organisation reported that the readmission rates at the Fairfield General Hospital are in line with national averages.  Readmission rates at the Oldham site are higher, this in part, is due to the complexities of the patient seen there.


·           Loneliness Update


The Chair of the HWB provided an update on the loneliness event and thanked Members of the Board and/or officers for their support in facilitating the event.  Further work will be undertaken to identify those people in need of support, the support available and any gaps in provision.




Draft GM Substance Misuse Strategy - An Overview of Local Need pdf icon PDF 57 KB

Jon Hobday, Public Health Consultant will report at the meeting. 

Additional documents:


Jon Hobday, Public Health Consultant attended the meeting to update the Board with regards to the Greater Manchester drug and alcohol strategy as well as the approach taken in the Borough to address the issues raised.


This will be the first ever Greater Manchester drug and alcohol strategy setting out a collective ambition to significantly reduce the risks and harms caused by drugs and alcohol and help make Greater Manchester one of the best places in the world to grow up, get on and grow old. 


The Public Health Consultant reported that it is estimated that expenditure on alcohol related crime, health, worklessness and social care costs amount to £1.3bn per annum - approaching £500 per resident.


Alcohol places a significant burden on public services, causes health problems such as cancer, liver cirrhosis and heart disease, affects the well-being of families, and is a major contributor to domestic abuse, violent crime and public disorder.


The Public Health Consultant reported that there has been a long term downward trend in drug and alcohol use amongst adults and young people.  Locally our treatment services are more recovery focused than they used to be and that more people are successfully completing treatment, but there is much more to be done.


Questions were invited from those present and the following issues were raised:


Responding to a question from the Chair, the Public Health Consultant reported that prevention and early intervention is imperative to tackling substance misuse.  Services, including the Bury Lifestyle Service, have been encouraged to look and identify early signs of alcohol and substance misuse.  Data is available to identify the neighbourhood hot spots where substance misuse in particular is a problem.  It is envisaged that the roll out of neighbourhood working will lead to the development of an appropriate and proportionate approach in tackling these issues.


In response to a Member’s question, the six priorities identified within the GM strategy will be adapted to the specific requirements/need in the Borough, good practice will be shared across the region.


It was agreed:


The Board notes the information in the presentation and would like to put on record its support for the regional and local work being undertaken to address drug and alcohol related issues.



Sign off - Local Transformation Plan for Children and Young People Mental Health and Wellbeing pdf icon PDF 90 KB

Michael Hargreaves, Bury Clinical Commissioning Group will report at the meeting.  Reports attached.

Additional documents:


Michael Hargreaves Senior Commissioning Manager, Bury CCG attended the meeting to provide members with an update in relation

The Children and Young People’s Local Transformation Plan for Mental Health and Wellbeing is a “live” document which is required to be refreshed on an annual basis.


Given the substantial rewrite of the LTP in March 2017, which was approved by Health and Wellbeing Board in 2017 and 2018, it is recommended from the Bury LTP Implementation Group that the refresh for this year will be a lighter touch with updates for the most part limited to:


  • The Action Plan
  • Activity, Resource and Finance
  • Monitoring and Measurement


This approach has been mirrored by the majority of other CCGs in Greater Manchester. 


The Senior Commissioning manager highlighted to Board members the following associated risks:


  1. Delivery of identified schemes to ensure full and effective use of transformation financial allocations for 2019/20 and beyond. The CCG and LTP Implementation Group will need to work with wider partners to ensure timely delivery of agreed schemes and effective and timely use of the available resource.


  1. There is a risk that some of the roles identified for investment may not be straightforward to recruit into. This risk is considered to be moderately low by our core providers but may require alternative planning if recruitment issues materialise.


  1. There is a risk that due to resourcing challenges throughout the system some GM workstreams will not progress at the pace originally intended. This is being mitigated to an extent by the employment of a GM CYPMH Commissioning Lead on a full time contract. 


Questions were invited from those present and the following issues were raised:


Members raised concerns in respect of support provided to and in schools in the Borough. Responding, the Senior Commissioning Manager reported that the local development plan will improve capacity and knowledge in the system as well as providing a commitment to provide advice and support via the Healthy Young Minds service to those working in schools.


The Commissioning Manager reported that a commissioning strategy will be developed for all stakeholders, the strategy will include how services link together.  The Commissioning Manager acknowledged that service provision is not always seamless and there is confusion, as to which services are provided and by whom.


Members discussed the national target for treating children with a diagnosable mental health condition and the CCGs indicative trajectory of at least 32% of patients receiving treatment from an NHS community funding mental health service.  Responding the Commissioning Manager reported that this figure is only indicative and not a measure of the full range of support provided by other partners, including Healthy Young Minds and Early Break. 


It was agreed:


The Board agrees to:

·         Acknowledge that the refreshed document is a working draft and remains an iterative process leading up to final publication by the end of March.

·         Gives permission for the chair to sign-off the final refreshed plan with executive support from finance and commissioning to agree plan for final publication.

·         Note the  ...  view the full minutes text for item HWB.412


Joint Strategic Needs Assessment Annual Update pdf icon PDF 59 KB

Jon Hobday, Public Health Consultant will report at the meeting.  Report attached.


Jon Hobday, Public Health Consultant attended the meeting to provide an overview of the developments and a summary of the proposed next steps to the development of the Bury JSNA.


There is a work plan that is regularly reviewed which acts as the guide for what work needs to be prioritised, completed and added to the JSNA. This has been a new development and enables staff to prioritise which documents are updated.


As well as the new documents being added to the JSNA there has also been a number of behind the scenes developments including


-      Training of new staff.

-      Development of structural and presentation ideas of how the Bury JSNA can be more user friendly


The Public Health Consultant highlighted a number of proposed developments for 2019/20, including:

  • A full refresh/update of the existing documents contained within the work plan, changes to the website are proposed.
  • Development of more detailed neighbourhood profiles to support key decisions at a neighbourhood level.
  • A move for the JSNA to fit more to the life course. There will be 3 main level summaries which will be categorised into Starting Well, Living Well and Aging Well, ensuring alignment with Bury’s Single Outcomes Framework.
  • Integration of Piktochart infographics and Tableau dashboards embedded within the JSNA.


Questions were invited from those present and the following issues were raised:


Members discussed the expanding the role of the JSNA and current funding arrangements. 


The Director of Public Health reported that it is a statutory duty of the Board to produce a JSNA with good quality data and intelligence, this is currently undertaken with limited resources.  The Board should look to engage partners in giving greater consideration to how the JSNA is resourced, given the information is invaluable to the development of neighbourhood teams and commissioning as a whole.


It was agreed:


The Health and Wellbeing Board endorse the ongoing developments of the JSNA.



Better Care Fund (BCF) and Improved Better Care Fund (IBCF) Update Report pdf icon PDF 61 KB

Tracy Evans, Project Lead, Bury Council will report at the meeting.  Report and presentation attached.

Additional documents:


Tracy Evans Project lead, Bury Council, attended the meeting to provide members with updated performance information for the better care fund and improved better care fund.  The presentation provided information in respect of the BCF metrics which include:

      Non-elective admissions - The admissions target of 5,662 for this period was not achieved with 5,874 actual admissions.

      Permanent admissions - The admissions target was reviewed and a 20% reduction in permanent admissions into residential care was agreed. The target of 628 has been achieved with 570 admissions in this period. This is due to the positive impact of the care at home zones and the increased discharge to assess provision

      Effectiveness of reablement - The target of 85.4% of customers still at home 91 days after discharge is designed to promote excellence in the service and reduce re-admissions. Although it has dipped slightly this period it is still on target.

      Delayed transfers of care (DToC) - delayed transfers of care (delayed days) from hospital Performance on DTOC continues to reduce, although the target for this period has not been achieved. There were 516 delayed days in December, which equates to 17 delays per day.


There is no requirement to report iBCF to Better Care Fund this quarter, although information is still being collated through individual projects locally and regionally.

      DToC for reason 'awaiting package of care’

      DToC for reason 'awaiting residential home’

      Time taken to grant DOLS application


Questions were invited from those present and the following issues were raised:


In response to a Member’s question, the Interim Executive Director, Communities and Wellbeing reported that there has been a great deal of work undertaken to reduce the DTOCs within mental health services, this has been a focused piece of work and is now embedded in practice within CMHT and the Irwell Unit and as a result, the DTOC remain low.


It was agreed:


The performance information for the better care fund and improved better care fund be noted.



Tobacco Control Delivery Plan pdf icon PDF 62 KB

Lesley Jones, Director of Public Health and Helen Dawson will report at the meeting.  Report attached.

Additional documents:


Jon Hobday Public Health Consultant presented to members an overview of the Tobacco control delivery plan. 


Tobacco is the biggest cause of preventable death in the UK today, and a key cause of inequalities in Bury. The ambition is to inspire a smoke-free generation and improve the health and wellbeing of all Bury residents. Reducing smoking prevalence in Bury is a key action in the Locality Plan, and a stated ambition in the Primary Care Health and Wellbeing strategy.


The Tobacco Control Delivery Plan outlines how – with a strategic, partnership-based approach – how key stakeholders can effectively impact tobacco use across the Borough: reducing ill-health and early deaths in the population and improving lives of Bury residents.


Questions were invited from those present and the following issues were raised:


The Director of Public Health reported that it is essential that support to stop smoking is embedded across partner organisations, from the acute sector to primary care and including the integrated neighbourhood teams.  In order to reduce smoking prevalence it is essential that there is systematic support to help people stop and targeted work is undertaken to tackle the illicit tobacco trade.


Members discussed e-cigarettes.  The Public Health Consultant reported that the recently undertaken child survey has provided interesting data in respect of teen smoking; 9% of children have tried cigarettes, 14% have tried e-cigarettes, 2% would consider themselves to be regular smokers and 4% would smoke e-cigarettes regularly.


Responding to a Member’s question, the Public Health Consultant reported that the target to reduce smoking in pregnancy from 11.6% to 6% is an ambitious target.  Every pregnant woman will be offered support across multiple formats. The Director of Public reported that historically engagement with maternity services has been problematic, the issues is now been driven at a wider GM level and as such there seems to be wider ownership of the issue.


It was agreed:


The Board approves the Tobacco Control Delivery Plan.



Pennine Care Future Operating Model pdf icon PDF 68 KB

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


Julie Gonda, Interim Executive Director Communities and Wellbeing presented an update report in respect of the decision by PCFT Board to concentrate its business solely on the delivery of mental health and wellbeing services.  The proposal is that the Northern Care Alliance under the legal entity of Salford Royal NHS Foundation Trust will be the designated interim provider for a period of two years.


The CCG commissions a range of community services.  The total contract value for these services in 2018/19 was circa £18 million.  Bury Council also commissions a range of public health services with a current contractual value of £5.6 million.


Questions were invited from those present and the following issues were raised:


Members discussed the risks associated with the transfer, the decision not to go out to tender, the wider transformation agenda and the move away from an internal market place within the NHS.


Dan Lythgoe, representing Pennine Care assured the Board that engagement with staff commenced before the decision was taken by the Trust to concentrate on solely mental health services.  The engagement has been undertaken jointly with representatives from the Northern Care Alliance. 


It was agreed:


That the Interim Executive Communities and Wellbeing be thanked for her attendance.



Transformation Programme Board Update pdf icon PDF 51 KB

Dr Jeff Schryer, Chair Bury CCG will report at the meeting.  Report attached.


Mike Woodhead in the Dr Jeff Schryer presented a report providing an overview of the work undertaken by the Transformation Programme Board.


It was agreed:


Health and Wellbeing Board is recommended to note the work of the Health and Care Transformation programme Board