Agenda and draft minutes

The Chair welcomed all to the meeting.

Apologies were received from Dr Vicki Howarth, Dr Kieran Patel, Joanna Fawcus, Catherine Jackson, Cllr Mike Smith, Kath Wynne Jones and Jeanette Richards.

The meeting was declared quorate and commenced.

NHS GM has responsibilities in relation to declarations of interest as part of their governance arrangements (details of which can be found outlined in the NHS Greater Manchester Integrated Care Conflict of Interest Policy version 1.2).

NHS GM (Bury Locality) therefore, has a requirement to keep, maintain and make available a register of declarations of interest for all employees and for a number of boards and committees.

The Local Authority has statutory responsibilities detailed as part of Sections 29 to 31 of the Localism Act 2011 and the Relevant Authorities (Disclosable Pecuniary Interests) Regulations 2012.  For other partners and providers, we understand that conflicts of interest are recorded locally and processed within their respective (employing) NHS and other organisations as part of their own governance and statutory arrangements too.

Taking into consideration the above, a register of Interests has been included detailing Declaration of Interests for the Locality Board.

In terms of agreed protocol, the Locality Board members should ensure that they declare any relevant interests as part of the Declaration of Interest Standing item on the meeting agenda or as soon as a potential conflict becomes apparent as part of meeting discussions. 

The specific management action required as a result of a conflict of interest being declared will be determined by the Chair of the Locality Board with an accurate record of the action being taken captured as part of the meeting minutes.

There is a need for the Locality Board members to ensure that any changes to their existing conflicts of interest are notified to NHS GM (Bury Locality) Corporate Office within 28 days of a change occurring to ensure that the Declarations of Interest register can be updated.

Declarations of interest from last meeting held on 3rd April 2023

No declarations to note.

Declarations of interest from today’s meeting 5th June 2023

None to declare other than what was detailed on the Declarations of Interest register submitted within the meeting pack.

The Locality Board

Received the declaration of interest register.

The minutes from the Locality Board meeting held on 3rd July 2023 were considered as a true and accurate reflection of the meeting.

The Locality Board

Accepted the minutes from the previous meeting as a true and accurate reflection of the meeting.

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

The Locality Board

Noted that there had been no public questions received and one member of the public was present at the meeting.

Ms Ridsdale introduced her item, commending the GP community for the improvement in results from last year in the GP practice patient survey results despite a considerable increase in activity. She went on to highlight that the consultation process for NHS GM Bury staff had now broadly concluded, which would bring some certainty and stability, and thanked staff involved.

Ms Ridsdale reflected on the NHS contribution to children’s services and particularly SEND improvement plan.  It was noted that considerable progress had been made in many aspects of NHS services including waiting times in CAMHS, Speech and Language therapy, and in the provision of Epilepsy Nursing. However continuing challenges remain, particularly in the early years field, and further discussions would be had during the meeting in this context.

In relation to the Terms of Reference for the Bury Locality (System) Board, Ms Ridsdale advised of a proposed change to the Membership of the Board, to include three statutory officers from the Local Authority, and Sophie Hargreaves summarised the work to disaggregate Pennine Acute Trust, which was in its final stages and would come into effect from March 2024. It was noted that the view was that these did not constitute substantial change.

The Locality Board

Received the update and approved the changes in the Board’s membership.

Mr Blandamer advised that the Board maintained a line of sight across the breadth of the work of the Bury System, but also agreed five key priorities in July to provide focus for the Board against which progress will be measured and around which the partnership will gather at a senior and strategic level. The paper provided an update on the work being undertaken on each priority and set out the future reporting back to the Locality Board.

The Locality Board

Received the update.

Mr Blandamer presented the item outlining progress made with the key programmes of work within the IDC. He advised that systemic risks had been collated with a total of 42 risks identified for ongoing monitoring. The Board noted that the days kept away from home trajectory had been met for May, June and July 23 at Fairfield, which had become the second best performing adult site in GM for the four hour target, with year to date performance of 66.83%. This was a significant achievement and thanks and compliments were paid to NCA and partners.

The Board noted that local workarounds were in place to ensure the IDC Board monitors key performance challenges and improvement plans as systems were not yet in place to produce locality dashboards via GM, and it was agreed that a target date for the performance dashboard would be provided at the next Locality Board meeting.

The Locality Board

Received the update.

Isobel Booler and Michael Kemp gave a detailed presentation updating on steps taken to improve SEND arrangements in the borough.   The updated also included specific detail on the launch of the Graduated Approach Co-Production Project. The Board noted progress made but also some of the challenges being experienced in providing appropriate support to children and families.  The board also noted the significant impact of the increase in education, health and care (EHC) plans where Bury tracked very highly nationally and against comparable boroughs.

Members celebrated the strengths based and person centred approach, and celebrated the strong partnership work demonstrated between Council and Health Partners so far and agreed that this was the best way forward. A social model could help ensure SEND support was provided in the right place at the right time. This would also entail a culture shift, away from medicalising the response, and facilitate trust from parents and young people.

Will Blandamer asked all NHS partners – providers and the ICB – to ensure the recognition of the steps required to discharge obligations to the Bury SEND improvement board were fully recognised in the governance of their own organisations, and to ensure full participation in the SEND improvement planning arrangements.

Warren Heppolette commended the quality of the presentation and committed to ensuring the NHS GM ICB was sighted and addressing those issues of common concern pertaining to SEND across all 10 localities. The Board agreed that an update on this should be provided at the next Locality Board meeting, to clarify governance arrangements and maintain momentum.

The Locality Board

Agreed to review the extent to which each organisation was sighted and contributing as far as possible to the Bury SEND partnership arrangements.

Agreed that this item should come back to the next Board meeting.

David Thorpe presented the paper exploring the options and funds required to deliver the 0-19yrs service (comprising the Health Visiting and School Nursing Services). The Board discussed the report and noted the increased demand without the capacity to meet it. A collaborative approach was required to explore financial options and take it to the next stage. It was noted that the investment set out in the paper met current levels but did not address future proofing.

The Board supported the case for change in principle, noting the need for further work to explore the total funding required, the potential split of funding between partners and its phasing and governance, and to ensure any additional funding is aligned to exploring all transformational programmes required and to ensure it is positioned properly in the wider direction of travel for the service (in relation to family hubs and the model of neighbourhood working)

The Locality Board

Supported the case for change in principle  and noted the need for further work regarding the funding required, the source of potential funding, and the governance of the decision.

Ruth Passman presented the Bury and GM annual reports from Healthwatch. The Board noted the successful year for Healthwatch as well as the ongoing pressures of Covid recovery and cost of living crisis, as well as the additional pressures on disadvantaged communities. Healthwatch was pivotal in ensuring people could access services and get equitable treatment, through signposting and advocacy services.

The Board discussed the report, in particular Healthwatch’s strengths in co-production and collaboration, and ensuring the patient voice was being heard. The Board thanked Ms Passman for her presentation and for the work Healthwatch conducts.

The Locality Board

Noted the Healthwatch Annual Reports.

Sam Evans gave a verbal update, advising that the challenge remained across the NHS system, with elements off track and new pressures from strikes. She advised that a turnaround director had been appointed at GM level and holds had been put on spends. This moratorium was also in place at the Council, which was currently overspent without sufficient reserves to cover.

It was noted that a systemwide approach was needed, as cuts in one area would affect another and the entire system was experiencing the same increase in demand with reduced capacity to meet it.

The Locality Board

Noted the verbal update.

Carolyn Trembath advised the Board on the work from the Bury Integrated Care Partnership System Assurance Committee meeting in July 2023 including:

•              GM assurance processes for maternity services in response to the Ockenden reviews.

•              GP feedback of issues and concerns in relation to how services are provided to patients.

•              Healthwatch annual reports.

•              Impact on ADHD/ASD patients from the removal of LANCuk.

•              Oversight of risks.

•              Awards and achievements.

The Locality Board

Noted the update.

Will Blandamer advised that there was nothing further to add to the report attached to the agenda, and that a more substantial update would be provided at the next meeting.

The Locality Board

Noted the update.

Jon Hobday gave a verbal update on the last meetings of the Bury and GM Health and Wellbeing Boards, and advised that the Bury HWBB would be meeting later in September.

The Locality Board

Noted the update.

Mr Blandamer advised that the paper constituted a step forward but that work continued to refine the data and ensure it was presented consistently across GM. Further detail would be provided at Boards sitting under this one, and it was noted that analysis continued regarding the high attendance at A&E.

Board Members noted the positive progress made despite challenging circumstances, and it was agreed that as these reports progressed it would be easier to assess trends.

The meeting recognised in particular good progress on GP appointment numbers, on the performance of the urgent care system, and on IAPT waiting times.

The Locality Board

Noted the report.

The report was noted.

The Locality Board

Noted the report.

The Senate had not met in August so no update was required.

The Chair thanked everyone for their attendance, and tributes were paid to Donan Kelly as this was his last meeting. The Chair formally closed the meeting in public at 18.01.

The Locality Board

Noted that there was no other business to report and the meeting in public was closed at 18.01