To receive apologies for absence and any substitutions.

Apologies for absence were received from Dr Bill Gowans, Dr Colin Stanford and Mrs Ann Hartley.

Members are reminded that they must not participate in the discussion or voting on any matter in which they have a Disclosable Pecuniary Interest and should leave the room prior to the commencement of the debate.

Members were reminded that they must not participate in the discussion or voting on any matter in which they had a Disclosable Pecuniary Interest and should leave the room prior to the commencement of the debate.

To approve as a correct record the Minutes of the meeting held on 21 November 2014 which are attached.

Contact Karen Nixon on 01743 252724 or Michelle Dulson on 01743 252727.

RESOLVED: That the Minutes of the meeting held on 21 November 2014 be approved as a correct record and signed by the Chairman.

Matters arising: at Minute 77.1; it was clarified that the Second Phase of Future Fit and the Long-term Strategy for GP provision would be partly picked up within the agenda for the 20 January 2015 meeting, whilst the Role as Commissioners and possibly Co-Commissioning Primary Care would be considered at the 20 February H&WB meeting.

To receive any questions, statements or petitions from the public, notice of which has been given in accordance with Procedure Rule 14.

There were no public questions.

A verbal report will be made.

Contact Stephen Chandler, Director of Adult Services Tel 01743 253704 or Kerrie Allward Better Care Fund Manager Tel 01743 253095 or 01743 277500 ext 2092.

83.1    The Director of Adult Services gave a verbal update on the progress with this item.  He was pleased to confirm that the Task and Finish Group work to develop a partnership agreement was progressing at a pace.  A few small items remained to be completed by the end of the week, but no approval problems were envisaged.

83.2    Transformation Group work continued and all projects would be progressed by the end of February.  The Finance and Performance Group had met the previous week and were gathering together the key metrics relating to the Better Care Fund.  It was also pleasing to find that the Commissioning Support Unit and the Council’s Performance Group had worked together well throughout this.

83.3    Finally the Director was pleased to confirm that Shropshire had now received formal approval for their Better Care Fund Plan, which was welcomed by the Board. 

In response to a query about whether a copy of the final plan had been circulated to all members, the Director confirmed that yes this had been circulated electronically, and that he would ensure this was resent following the meeting.

RESOLVED: That formal approval of the Better Care Fund Plan for Shropshire be welcomed and noted by the Board.

A verbal report will be made.

Contact Dr Caron Morton, Accountable Officer Shropshire CCG, Tel 01743 253704.

84.1    The Accountable Officer for Shropshire CCG, Dr Caron Morton, gave a verbal update about the progress with Future Fit.  The Evaluation Panel will provide the Future Fit Programme Board with a short list of options for Shropshire’s Hospital Services for consideration.  The CCG Board will make a decision on the short list at the beginning of February.

84.2    Future Fit Phase 2 was also about to start.  A soft launch had recently been held, a great many volunteers had come forward and currently work was being undertaken with GP responses and the strategy of Primary Care for General Practices in Shropshire.  The timescale for this was 18 months, benefiting from using the same clinical design framework as Future Fit 1.

84.3    Planned prototyping will take place as the process moves along, using workshop meetings, and working from the bottom up.  There were two strands to the GP work, one of which would involve public and group participation.  It was noted that Shropshire Council was keen to have input here as soon as possible in order to commission services better in the future.

84.4    A discussion ensued regarding the involvement of partners and stakeholders in the development of Future Fit 2.  A request was made to fully involve partners in this process and Board members confirmed that they wished to be involved in the process too.

          RESOLVED: That the verbal update be noted.

A verbal report will be made.

Contact Dr Caron Morton, Accountable Officer Shropshire CCG, Tel 01743 253704.

85.1    A summary report of an informal Health and Wellbeing Board meeting (14 January 2015) that was held to discuss Urgent Care in Shropshire was circulated (copy attached to the signed minutes).  This gave a synopsis of the local health economy in Shropshire, an analysis of current system performance and detailed LHE urgent care recovery programmes being undertaken. 

85.2    A verbal update was also given by Dr C Morton, Accountable Officer, Shropshire Clinical Commissioning Group (CCG) on the position.  In doing so, she gave a synopsis on the Urgent Care System in Shropshire, and highlighted that locally, as well as reflected nationally, that our urgent care system was struggling, and confirmed that eleven 12 hour trolley breaches had been noted in Shropshire.  She assured the Board that the CCG was doing its utmost to remedy this.

85.3    A debate ensued.  Briefly, the following points were made;

o   The role of the Care Quality Commission (CQC), and the NHS Trust Development Agency (TDA) were discussed.  It was noted that a report regarding the recent inspection of SaTH had been published on 20^th January.  This report highlighted areas for improvement; one such area was the Trust’s response to shortfalls and improvement planning to address such shortfalls.  The Board discussed the importance of updating the regulators, with its concerns as highlighted in the summary report.

o   Twelve hour Trolley Breaches, as highlighted in the summary report and the CCG presentation, copy attached to the report, were discussed.  The Board was concerned that learning was not being identified through the reporting mechanisms and therefore it was not clear what actions were being taken by the Hospital Trust to ensure that future trolley breaches did not occur.

o   In understanding the metric of 12 hours, it was explained that the clock started from when a person was formally admitted to hospital through A&E, not when a person initially arrived at the A&E department, and as such they could actually be waiting a much longer time than 12 hours on a trolley before being provided care on a ward; it was noted that there was a strong evidence base for why individuals should not be waiting longer than 12 hours on a hospital trolley.  In cases where they did, concerns for safety and welfare needed to be raised.

o   The concern was raised that with the number of trolley breaches and little identification of learning from each breach, the Hospital Trust was ‘normalising the abnormal’.  The Board highlighted this as a potential marker of poor quality at SaTH.

o   The Board noted the difference between ‘Fit For Transfer’ and ‘Delayed Transfer of Care’.  The Board was keen to see the Health Economy as a whole taken into account as part of any improvement programme.

o   It was noted that the Integrated Community Service (ICS) programme had been successfully rolled out to the Shrewsbury and Atcham area the previous winter and further rolled out across Shropshire in autumn 2014.  ICS was able to  ...  view the full minutes text for item 85.

A presentation will be made.

Contact Penny Bason, Health and Wellbeing Co-ordinator, Tel 01743 253978.

86.1    The Health and Wellbeing Coordinator introduced and amplified a PowerPoint presentation, copy attached to the signed minutes, on Health and Wellbeing Development; JSNA and Strategy Refresh, Communication and Engagement Strategy.  It set out the Programme Development Timetable, the Shropshire Strategic Context, Strategy Refresh Engagement, the Shropshire context for the JSNA, the key themes for the development of health and wellbeing programmes, the H&WB Strategy Refresh Framework for discussion and what people had said to date.  It was noted that more work would be undertaken in the coming months to engage and consult with stakeholders

86.2    Healthwatch informed members of the developments of the Health and Wellbeing Board’s Communications and Engagement Task and Finish Group.  The Task and Finish Group had worked with health and care partners to develop key principles for communications and engagement; these principles were shared with the Board for consideration and were also included within the presentation which was attached to the signed minutes.  A draft Strategy Plan was going to the Delivery Group at the end of January and it was hoped to be signed off in May 2015.

86.3    The Chairman thanked all those involved for their excellent work on this to date, but especially praised Jane Randall-Smith, Penny Bason and Charlotte Cadwallader for their hard work in bringing this together.

          RESOLVED: That subject to the foregoing, the presentation be noted.

A report is attached.

Contact Linda Offord, Public Health Programme Lead – Tobacco Control, Tel 01743 453537.

Due to time constraints, this item was deferred for consideration to the next meeting of the Health and Wellbeing Board on 20 February 2015.

A report is attached.

Contact Louise Jones, Commissioning Lead – Dementia Services, Tel 01743 277500 extension 2096.

88.1    The Commissioning Lead for Dementia Services, Louise Hall, introduced and amplified a report, copy attached to the signed minutes, on Dementia Strategy Delivery Update and Year of Dementia 2014.

88.2    RESOLVED:

a.     That the Health and Wellbeing Board reviewed and commented on the progress of the implementation of Shropshire’s Dementia Strategy and Action Plan 2014 – 16, which was attached as Appendix A to the report.

b.     That the Health and Wellbeing Board reviewed and commented on the end of year report for “The Year of Dementia” (see section 3).

c.     That the Health and Wellbeing Board ensured that work to support the Year of Dementia continued and that progress was measured against the objectives.

d.     That the Health and Wellbeing Board approved Shropshire Dementia Action Alliance reporting to the BCF Service Transformation Group; creating stronger links to enable the Alliance to provide recommendations on developing dementia services across Shropshire.

A report is attached.

Contact Jane Randall-Smith, Chief Officer, Healthwatch Shropshire Tel 01743 342183.

89.1    The Chief Officer of Healthwatch, Jane Randall-Smith, introduced and amplified a report, copy attached to the signed minutes, which gave an update on Healthwatch Shropshire, which continued to undertake engagement events across Shropshire and was active in the NHS Future Fit Programme.  It was noted that the second call for research grant proposals closed in December 2014.

89.2    In updating the Board the Chief Officer reported that not a great number of comments had been received about A&E in Shropshire to date, but assured the Board that these would be proactively sought and the outcome would be shared with the Board in due course.

89.3    Jane Randall-Smith discussed Healthwatch’s forward planning process and highlighted the need to take care and allow for reactive work.  Healthwatch routinely shared its comments with the CCG and the Council to ensure data was triangulated as far as possible.  It was also noted that Healthwatch was working on raising its profile in Shropshire.

89.4    The Chair highlighted that there was no ‘collective pot’ of complaints and that perhaps this was an area for improvement.  A discussion then took place regarding complaints and the Board requested that Healthwatch lead on investigating a more co-ordinated approach in the future.  The Board also asked Healthwatch to arrange a meeting to discuss this further which was agreed.

89.5    The forthcoming opening of the Autism Hub at Louise House was welcomed by the Board.

          RESOLVED:

a)    That the report be welcomed and noted.

b)    That a meeting be arranged by Healthwatch to discuss co-ordinating complaints.

A report is attached.

Contact Lorraine Laverton, Business Manager for the SSCB & Children’s Trust, Tel 01743 254205.

91.1    The Independent Chair of the Shropshire Safeguarding Children Board, Sally Hall, introduced and amplified a report, copy attached to the signed minutes, on the Annual Report of the Shropshire Safeguarding Children Board 2013/14.  The report evaluated the work and impact of the Board, whilst identifying priority areas of work for the period 2014 to 2015.

91.2    Challenges ahead included financial constraints, unintended consequences and increased demands on the service.  Particular attention was drawn to page 46 of the report; Conclusion and assessment of effectiveness of multi-agency safeguarding arrangements.

91.3    The Independent Chair urged members to think about the following points;

·       Please remember children; often the H&WB agenda was very ‘adult focussed’.

·       Exercise leadership in a coordinated response to financial constraints.

·       To work with the Safeguarding Board to provide a safe base for guarding children.

·       Children generally suffered at the hands of adults – there was a need to work together to reduce risk.

·       To strengthen grievance arrangements with LSCB and Shropshire Council in future.

91.4    The Chairman of the Board welcomed the report which she found inciteful and honest.  In
discussing the CAHMS service, concern was expressed at the lack of psychotherapists
within the County, and the poor ratio of clinicians to patients for this service.  It was noted that there was a national problem in recruiting such staff, and that this was not just a local issue.  Furthermore, it was agreed that it was important for the CCG Board to tie into this work as well. 

RESOLVED: That the information contained within the Shropshire Safeguarding Children Board Annual Report 2013/14 be noted.

A report is attached.

Contact Gerald Dakin, Chair of the Health and Adult Social Care Scrutiny Committee.

92.1    The Chairman of the Health and Adult Social Care Scrutiny Committee appraised the Health and Wellbeing Board of some of the recent activity of his scrutiny Committee and also that of the Shropshire and Telford and Wrekin Joint Health Overview and Scrutiny Committee, had undertaken, copy attached to the signed minutes, which was duly noted.

Meeting dates for future Health and Wellbeing Board meetings in 2015/16 are suggested as follows;

27 March 2015

8 May

19 June

31 July

11 September

23 October

4 December

22 January 2016

26 February

15 April.

All meetings will be held on a Friday, starting at 9.30 am, at the Shirehall, Shrewsbury, unless notified otherwise.

The Health and Wellbeing Board are recommended to approve the above meeting dates.

It was agreed that the following meeting dates for the Health and Wellbeing Board in 2015/16 be approved;

20 February 2015

27 March

8 May

19 June

31 July

11September

23 October

4 December

22 January 2016

26 February

15 April.

All meetings would start at 9.30 am and be held at the Shirehall, Shrewsbury, unless notified otherwise.