Apologies for absence were received from:

Penny Bason                    Health & Wellbeing Co-ordinator

Neil Carr                           SSSFT

David Coull                       Shropshire Partners in Care

Jan Ditheridge                   Chief Executive, Shropshire Community Health Trust

Dr Julian Povey                 Clinical Chair, Shropshire CCG

Mike Ridley                       Chair, Shropshire Community Health Trust

Rod Thomson                   Director of Public Health

MandyThorn                     Business Board Chair

Rachel Wintle                    VCSA

Substitutions notified were as follows;

Jean Robinson for Rachel Wintle (VCSA)

Cathy Riley, Head of Mental Health Services, for Neil Carr (SSSFT)

Sarah Lloyd for Jan Ditheridge (Shropshire Community Health Trust)

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.

There were no disclosures of Disclosable Pecuniary Interest.

To approve as a correct record the minutes of the previous meeting held on 9 June 2016, which will follow.

Contact Amanda Holyoak Tel 01743 257714.

RESOLVED That the minutes of the meeting held on 9 June 2016 be approved as a correct record and signed by the Chairman.

Arising thereon;

At minute 90. Shropshire Ambulance, it was confirmed that this topic would be picked up throughout the agenda and as part of the STP item.

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

Three formal public questions were received by the Health and Wellbeing Board (copies of the questions and the formal responses are attached to the signed minutes). 

Mr David Sandbach submitted two public questions.  The first related to the Board subscribing and giving their support to the revised Strategic Transformation Plan (STP).  By way of a supplementary question Mr Sandbach asked if the Accountable Officer for the CCG, Mr Dave Evans, could confirm if the next version of the STP would be put into the public domain.  Mr Evans said at this stage he could not confirm either way; it depended on the guidance given at the time, however he did confirm that it would eventually go public, but exactly when was not known at this stage.

The second related to the Local Digital Road Map.  By way of a supplementary question Mr Sandbach stressed that the first issue listed at A). was the most important in his view.  A lot of learning was required and he suggested that serious consideration should be given to the opening of a digital health and training centre.  It was agreed that there was also an opportunity for the promotion of joint training across health and the local authority and Cllr Lee Chapman agreed to take this forward.

The third question was from Mr John Bickerton, relating to Grant Thornton’s Audit of 68 CCG’s in 2015/16, the challenges of auditing the Better Care Fund and Pooled Budgets.

By way of a supplementary question Mr Bickerton asked why Shropshire CCG was in the bottom 3 and what was being done to rectify this.  Officers thanked Mr Bickerton for bringing this report to their attention and undertook to look into this in more detail.

Election of Chair

It was proposed by Lee Chapman, seconded by Jane Randall-Smith and duly

RESOLVED: That Karen Calder be appointed as the Chair of the Health and Wellbeing Board for the ensuing year.

Election of Co-Chair

It was proposed by Karen Calder, seconded by Lee Chapman and duly

RESOLVED: That Dr Julian Povey be appointed as Co-Chair of the Health and Wellbeing Board for the ensuing year.

Report to follow by Sam Tilley, Shropshire CCG.

Sam Tilley, Head of Partnerships and Planning, Shropshire CCG, provided an update on the Better Care Fund (a copy of the report is attached to the signed minutes).  In doing so it was noted that ‘Children’s Services’ would be removed and that the final sign off had been deferred due to a new management structure within the CCG and a request to review this first before signing off.  The Chair endorsed this action and welcomed the opportunity to look at the partnership agreement at the same time.

The position regarding performance and activity has not changed; challenges were still being seen in non-elective targets and DTOC.  Put into context nationally, Shropshire was OK when considering it with the regional and national picture.  It was noted that the CCG’s position was difficult.  There was a £14.5 million deficit.  The challenge would be how to deliver a recovery plan within a reasonable timeframe, without making short-term measures that may damage existing partnerships.  Local authority members expressed the view that decision-making should be joint as far as possible, whilst officers commented that they were concerned about people being safe and getting the care they needed, whilst the Chair confirmed that they were committed to helping the CCG if possible.

It was also agreed to check that where there were plans for procurement that this was aligned with the Better Care Fund.

RESOLVED:

a.     That the progress on the submission of the Better Care Fund narrative Plan for 2016/17 be noted.

b.     That the progress and aims of work to undertake a detailed financial review of the pooled budget that makes up the BCF be noted.

c.     That the content of the Better Care Fund Performance report be noted.

d.     That the updated BCF Partnership agreement be deferred.

Report to follow.

Contact: Jane Randall-Smith

A comprehensive report highlighting activity by Healthwatch Shropshire for the period January to June 2016 was introduced and amplified by Jane Randall-Smith, Chief Executive of Healthwatch Shropshire (copy attached to the signed minutes).

New membership of the Board was welcomed and sincere thanks were expressed to Carole Hall by the Chair for her excellent work over the years.

It was agreed by all Board members, including partners, that the work undertaken by Healthwatch was incredibly valued and essential.

RESOLVED:  That the report be welcomed and noted.

Report to follow.

Contact: Rod Thomson, Director of Public Health.

A report (copy attached to the signed minutes) was introduced and amplified by Dr Irfan Ghani.  This highlighted the work of the Delivery Group.  It included updates on Healthy Weight and Diabetes Prevention, the All Age Carers Strategy consultation and the work of the Leadership Centre.

RESOLVED:  That the progress report be noted and that a further report be made to the Health and Wellbeing Board in November 2016.

Report attached.

Contact: Penny Bason, Health & Wellbeing Co-ordinator.

The Board considered a report (copy attached to the signed minutes) on the completion of an internal audit by a Shropshire Council audit team into the work of the Health and Wellbeing Board, which took place in May 2016.

It was confirmed that any significant concerns were being actioned, which was welcomed.

RESOLVED:

a)    That the Audit findings and Action Plan be noted.

b)    That no additional areas for development be advised by the Board.

-        Sustainability and Transformation Plan

Report to follow.  Contact: Dave Evans T&W and Shropshire CCG

-        Digital Road Map

Report attached.  Steve James (Shropshire CCG) and Jon Duigenan (Shropshire Council).

          It was agreed to take the report on the STP first, followed by the LDR item.

22.1    Sustainability and Transformation Plan (STP)

Andy Layzell introduced and amplified a report and PowerPoint presentation (copies attached to the signed minutes) which set out the aims of the Shropshire and Telford & Wrekin STP, the key features, the financial challenge, how it might be resolved and feedback from the June review of the STP.

It was noted that the STP was unlikely to go public until it was formally signed off in October.  It was stressed that it was not an option to do nothing; if this happened there would be an approximate deficit of £140m by 2020.

A Communications Co-Ordinating Group was currently being established in the short term to help address people’s concerns about the STP.

Unease was expressed about the STP being decision-making without the input of local authority members; there were serious governance issues here that needed urgent attention.  There was a will to support this, but fundamental changes were required from the Council’s perspective

A discussion ensued about prevention which was a huge item, but did not appear within the plan.  It was acknowledged that more on this would be put into the next draft of the STP around prevention, such as falls and diabetes for example.

It was suggested there was a need to move away from the existing NHS focus and break out of that mould.  With regard to the engagement element there was a need to shift the relationship between public and health care services.

The Accountable Officer said that a neighbourhood locality approach was needed to target populations.  Shropshire Council Chief Executive highlighted that they were already targeting groups such as ‘edge of care’ people.  Through the STP we needed to find the money to make things happen.  There was a lot of good work going on that needed to be embraced within the STP and acknowledged.

RESOLVED: That the report and presentation be noted

22.2    Local Digital Roadmap (LDR)

Dr Steve James introduced and amplified a report and a PowerPoint presentation (copies attached to the signed minutes) which set out the objectives of LDR, the policy context, all about electronic health records and explained what this meant, looked at the issue of alignment; explaining this was the strategic alignment of digital strategy with the STP and Future Fit vision, outlined the Developmental stages and provided a Digital Maturity Index.

RESOLVED: That the report and presentation be noted

22.3    ICT Digital Transformation

Jon Duigenan introduced and amplified a PowerPoint presentation (copy attached to the signed minutes) which set out plans for the ICT Digital Transformation.  There were three key platforms and supporting technology was explained.  Details were given of the key elements which were;

·       Social Care

·       Unified Platform including CRM

·       ERP (Light)

·       Technology

The Social Care Project had recently received Council approval for funding and it was hoped to implement this in the first quarter of 2018.  Integration with Health and Other providers would be  ...  view the full minutes text for item 22.