Agenda and minutes

There were no declarations of interest.

Minutes of the meeting held on 21^st March 2019 are attached.

It was agreed:

The minutes of the meeting held on the 21^st March 2019 be approved as a correct record.

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

Tony Decrop, Assistant Director Children’s Social Care will report at the meeting.  Report attached.

Tony Decrop, Assistant Director, Children’s Safeguarding attended the meeting to provide members with an overview of the work undertaken to establish the new multi-safeguarding arrangements within the Borough.  The Assistant Director reported that the three statutory safeguarding partners in Bury, namely the Local Authority, the Clinical Commissioning Group (CCG) and Greater Manchester Police have agreed to join the local safeguarding children’s and adults boards together to form a Bury Integrated Safeguarding partnership.  The new integrated board will commence work in September 2019.  The Local Safeguarding Children Board will cease to exist, the Adult Board statutory functions will be carried out by the new Partnership.  The new arrangements adhere to the both the Care Act 2014 and the Children and Social Work Act 2017.  The current independent Chair will remain in post.

Those present were invited to ask questions and the following issues were raised:

Responding to a Member’s question, the Assistant Director reported that Schools and Schools leaders are vital to the success of the Integrated Board and will be represented on the sub-committee, the Children’s Business Group.  The largest number of safeguarding referrals are from schools, they will be pivotal in the development of the Bury version of the Stockport family model, a new system of early help and intervention.

Responding to a question from the Leader, the Assistant Director reported that safeguarding arrangements have developed greatly in recent years.  In particular the establishment and success of the Multi-Agency Safeguarding Hubs based in police stations, staffed by social workers and the police, working together to target child sexual exploitation and organised crime.  This will be further enhanced with the development of the public service reform “engine room”.  It is proposed that the engine room will help to gather intelligence, an example of this will include identifying areas with higher than normal levels of domestic abuse; this information can then be used to plan and deploy services more effectively.

It was agreed:

1.  The Health and Wellbeing Board notes the establishment of the Integrated Safeguarding Board.

2.  The Health and Wellbeing Board will receive an annual Children’s and Adult’s Safeguarding report and will be kept informed of issues as and when they arise.

Maxine Lomax Deputy Director of Nursing NHS Bury CCG, will report at the meeting.  Report attached.

Maxine Lomax, Deputy Director of Nursing Bury CCG attended the meeting to inform members of the changes to the reporting arrangements in respect of deaths of children under the Children Act 2004 in Bury, Rochdale and Oldham.  The purpose of the BRO CDOP is to undertake to review all child deaths up to the age of 18, collect, collate and analyse information and to make recommendations to the relevant officers. 

The Deputy Director of Nursing reported that going forward it is proposed that the CDOP is accountable to the HWB.

Members discussed the terminology in the report, the different ethnic cohorts in the designated areas, available support, as well as information sharing.

It was agreed:

1.  The Health and Wellbeing Board agrees that the Bury Rochdale and Oldham, Child Death Review Panel will be accountable to the Health and Wellbeing Board.

2.  An annual report will be provided to the Health and Wellbeing Board.

3.  Exception reports will be presented as and when required.

4.  The Board agrees to the publication of these revised arrangements on the Health and Wellbeing Board Website.        

Dr Jeff Schryer will report at the meeting.

Dr Jeff Schryer, Bury CCG Chair and Chair of the Transformation Board, attended the meeting to provide members with an update in respect of work being undertaken at the Transformation Board.  The verbal update provided information in respect of the following areas:

·         Governance

·         Financial challenges

·         Improvements and the development of the Primary Care Networks

·         NHS Long term plan/locality plan

The CCG Chair reported that in respect of the governance arrangements, it is envisaged that a new Board will replace the Transformation Board with revised terms of reference and membership; the new group will act as a system wide steering group.

The CCG Chair highlighted the severe financial challenges facing both the CCG and the Local Authority.  The £8 million Council savings are on track, with an additional 6 million pounds of CCG savings delivered with a further 6 million in the pipeline.  There are a series of proposed savings under development.  Going forward the CCG must consider how they continue to meet their statutory obligations as well as funding transformation projects when transformation monies are no longer available.  Work is underway to assess the impact and outcomes following of these projects to assist and identify future priorities.

The LCO Chief Officer reported that recruitment in some areas is problematic, the LCO is only able to recruit to fixed term contracts, these roles are less attractive to existing NHS staff.

The CCG Chair, provided an overview of the work underway to develop the primary care networks across the Borough.  The primary purpose of these groups is assist General Practice in becoming more resilient and sustainable.

Dr Schryer reported that the Bury Locality plan will be refreshed and will be aligned with the development of the Bury Strategy.  It is envisaged the next iteration of the locality plan will have population health and inclusive growth at its centre.    

Dr Jeff Schryer will report at the meeting.  Presentation attached.

Dr Jeff Schryer, Chair Bury CCG attended the meeting to provide members with an update in respect of the development of the One Commissioning Organisation.   The Chair reported that the establishment of the OCO is necessary to close the financial gap of £25 million, improve outcomes and re-balance from a system that all too often results in late intervention in hospitals and residential care to early intervention in communities. 

The main objective of the proposed changes is to empower people, to remain well for longer, make informed choices and create a different model of services for Bury people. 

Ultimately and over time the Bury “One Commissioning Organisation” will encompass all strategic commissioning from the Council and CCG and other public services where possible.  The Chief Executive reported that by 1st October 2019 the Strategic Commissioning Board, health and social care will commence work.  Governance and voting arrangements have now been agreed as well as single joint leadership and staffing, with a single approach and single budget.

Members of the Board discussed their concerns in respect of lack of democratic accountability.  Dr Schryer acknowledged these concerns and provided assurances that decisions would be reached via consensus.  The CCG lay members have also been elected by the health community, the new arrangements provide a balance between the Council decision making process and ensuring that the new establishment is inclusive of all parties.

It was agreed:

Members note the development of the proposals to establish a Strategic Commissioning Board.

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

Lesley Jones, Director of Public Health provided members with an overview of the suite of common standards for population health in Greater Manchester.  The standards have been developed for 7 key areas of population health; mental health and wellbeing; oral health; sexual and reproductive health; drug and alcohol services; physical activity; health protection and tobacco control.

Members raised concerns that there is very little reference within the document to addressing Obesity.  The Director of Public Health reported that the issue of Obesity will be addressed via the physical activity GM moving strategy as well as adopting a system wide approach to food and health.

The Director of Public Health reported that although there is no compulsion to adopt and implement it is recommended that the standards be used across the localities. 

Members of the Board discussed the application of these standards in Bury.  Members wanted this information to inform decision making and development of the Bury Strategy.  The Director of Public Health reported that the purpose of these standards is to reduce un-warranted variation and improve equity of outcomes across GM. 

Members of the Board expressed concerns that in agreeing to adopt the common standards that there may be associated costs which as of yet are unquatifyable and this costs would need to be met by partner organisations.  The Director of Public Health reported that it would be useful in the first instance to undertake a benchmarking exercise to ascertain Bury’s position in relation to the GM standards.

It was agreed:

1             Members note the Common Standards for Population Health in Greater Manchester and support its primary aim to improve health outcomes for local people.

2             The Director of Public Health will undertake to develop a proposal to benchmark against the standards with recommendations.

3             The Health and Wellbeing Board refer the application of the standards for further consideration to the newly established Steering Group.

Lesley Jones, Director of Public Health will provide members with a verbal update.

The Director of Public Health provided members with a verbal update in respect of the development of a refreshed health and wellbeing board strategy.  The Director of Public Health reported that it is envisaged that the refreshed strategy will be developed alongside/within the context of the Bury Strategy and the updated locality plan. 

In line with that it may be useful to review the Board’s terms of reference, membership going forward.

It was agreed:

A further update in respect of the development of the HWB Strategy will be considered at the next Board meeting.

It was agreed:

Democratic Services will circulate to all members of the Health and Wellbeing Board the GM Population Health Programme, Progress and Next Steps Report.