Apologies for absence were received from;

David Minnery – Portfolio Holder for Children & Young People

Prof Rod Thomson – Director of Public Health

Karen Bradshaw – Director of Children Services

Dr Simon Freeman – Accountable Officer Shropshire CCG

Dr Julian Povey – Clinical Chair CCG and Co-Chair of the H&WB

Rachel Wintle – VCSA

Neil Carr – Chief Executive SSSFT

Simon Wright - Chief Executive SaTH

Dr Tony Marriott – Chair GP Federation

Mandy Thorn - Business Board Chair

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 a Disclosable Pecuniary Interest.

To approve as a correct record the minutes of the previous meeting held on 6 October 2016, which are attached.

Contact: Karen Nixon 01743 257720.

RESOLVED: That the minutes of the meeting held on 6^th October 2016, be approved as a correct record and signed by the Chairman.

Arising thereon:

At Minute 26, Public Question Time, officers confirmed that answers to Janet Cobb’s supplementary questions were in hand and that they would be reported to the next meeting of the Health and Wellbeing Board.

At Minute 29, GP CCG and NHS England Update, Julie Davies confirmed that yes the CCG were taking infrastructure planning and working with communities forward.

It was noted that the new interim Head of Primary Care would be starting at the CCG in January 2017; the name would be confirmed to the Chair after the Board meeting.

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

No public questions were asked in accordance with procedure Rule 14.

A report is attached and will be presented by Ivan Powell, Independent Chair, Safeguarding Adults Board.

Contact Ivan Powell.

Ivan Powell, Independent Chair of the Safeguarding Adults Board, presented the Annual Report of the ‘Keeping Adults Safe in Shropshire Board for April 2015 to March 2016’.  In doing so he highlighted that he was keen to raise the profile of this important area of work.

It was a requirement of the Care Act 2014 that the Local Authority sets up a Safeguarding Adults Board.  This is not new for Shropshire, who prior to the Care Act had a Board jointly with Telford & Wrekin. 

The Care Act requires the Board to produce an Annual report on: -

a)    What it has done to achieve its objective

b)    What it has done to implement its strategy and what each member has done to implement the strategy

c)     Findings of any Safeguarding Adult Reviews including what it has done or chosen not to do to implement the findings of those review

Following a request by David Coull, it was agreed that Joint Case Audit feedback and performance data would be made available to Mr Coull and the Chair after the meeting.

Mr Powell commented that domestic abuse work was being undertaken, including the provision of training days.  Whilst looking at broader issues, the service was currently working with both the Fire and Rescue Service and the Trading Standards Service to find out if there was any duplication of service and if so how things could be done better.  Following this the Chair asked all organisations present at the meeting to look at what they were doing with regard to domestic violence (briefly) and their approximate spend and then to please let her have that information in due course.

          RESOLVED:

a)    That the report be noted.

b)    That the progress made to date in implementing the requirements of the Care Act also be noted.

c)     That Joint Case Audit Feedback and performance data be made available to Mr Coull and the Chair after the meeting.

d)    That organisations submit their information on domestic violence direct to the Chair as agreed, following the meeting.

a.     System Update – Karen Calder (15 minutes).

b.     STP Neighbourhoods Update – Mel Duffy (10 minutes).

c.     Workforce Planning - (15 minutes).

a)    System Update

The Chair stated that all comments about the recent Future Fit announcement were welcome, whilst stressing that the solution had to be a whole systems solution for everyone.  Sadly some organisations had acted only with their own interests at heart which was disappointing.  She said that change was inevitable and pleaded to the STP Board to recognise the stress that was happening across the entire system. She accepted that change was inevitable, but the thought of an external team being parachuted in to sort things out was not acceptable.  There was a global phenomenon coming across that the public wanted to be listened to.  Bearing this all in mind, the Chair proposed that a formal letter be written on behalf of the H&W Board to the STP Board raising the following two big questions;

·       What is the STP Board doing to address the many concerns raised?

·       How will the STP Board challenge what they do?

This proposal was welcomed by Shropshire Healthwatch, who had also written a similar communication to the STP Board, and the H&W Board generally.

Main comments made;

o   Local Authorities had been charged with developing neighbourhood commissioning, but unfortunately there were no resources to do this currently.  The Chair asked around the meeting for honest and frank suggestions to deal with this.

o   It was noted that the CCG Team had improvements to make going forward.

o   The Chair stressed it was important for everyone to work together.

o   The STP in principle was good, but the timelines were too tight and largely undeliverable.

o   There was a lack of clarity around the STP and finances.

o   The NHS was criticised for having a lack of respect for Health and Wellbeing Boards and for not being actively involved enough.

o   Another view was that there was a clash of cultures – the NHS worked top-down, with Councils working bottom-up.  It was very early days at the moment and it was important to build on the good things that had happened recently.  Another big issue was a lack of time to undertake the work required properly.

o   Hopefully if the right questions were asked, then everyone could move on and work together in future.

b)    STP Neighbourhoods Update

A PowerPoint presentation was given by the Chief Executive, Shropshire Council, copy attached to the signed minutes, updating the Board on the progress to date.  Headlines covered were that;

Ø  NHS England had not assured the plan – out of hospital/place based model and financial plan does not form a credible basis for operational planning.

Ø  Plan is too acute focussed and lack of detail on the neighbourhood model

Ø  Financial Plan is not credible

The STP Neighbourhoods Group had developed a positive joint working group and were at a good starting point.  They had embarked on weaving prevention, resilient communities and care models into place based plans.

Their key priority for moving work forward was Leadership, Governance and Culture Change.

It was  ...  view the full minutes text for item 39.

a.     Partnership Prevention Programme, Healthy Lives – a report is attached.  Contact: Kevin Lewis.

b.     Better Care Fund – a report is attached.

Contact: Andy Begley, Director of Adult Services, Tel 01743 25811 or Sam Tilley, Head of Planning and Partnerships, Shropshire CCG, Tel 01743 277500.

c.     Mental Health Partnership Board Update

A Presentation will be made by Lorraine Laverton, Business Manager, Children’s Trust and Cathy Riley, SSS FT.

    Contact: Lorraine Laverton Tel 01743 253991.

a)    Partnership Prevention Programme – Healthy Lives

The Board received an update paper on the Prevention Programme, with an updated PiD, and a short high level description of the Oswestry Pilot.  It also updated on the Diabetes Prevention and Safe and Well visits as part of the pilot.

The Board agreed that investment in prevention through the STP needed to be clearer.

RESOLVED

                           i.          That the STP Board clarify spend on prevention.

                          ii.          That the approach of the Oswestry Pilot be endorsed.

                        iii.          That the progress of the Diabetes Prevention and the Safe and Well Programmes be noted.

b)    Better Care Fund Update

The Health and Wellbeing Board considered the content of the Better Care Fund Update report, presented by Sam Tilley, Head of Planning and Partnerships, Shropshire CCG, who particularly made reference to the Better Care Fund, Q2 Performance Submission.

It was noted that the performance position this time was mixed, with some ‘challenging’ metrics.  However, the Board was pleased to note that the STP and the BCF workstreams were aligning.

An announcement was expected that week in respect of future requirements for the BCF for the next planning cycle  It was anticipated that the timeframe would be tight and that it would be challenging to complete the work required on the assurance processes.

RESOLVED

                           i.          That the Better Care Fund Performance Report be noted.

                          ii.          That the likely requirements for Better Care Fund 2017/18 to 2018/19 be noted.

c)     Mental Health Partnership Board Update

Andy Begley, Director of Adult Services gave a verbal update to the Board on progress to date.  It was noted that work was being undertaken on a ‘Single Access Point, which was welcomed by the Board.

A presentation was made by Cathy Riley re SSSFT’s new service model.

The CCG supported the direction of travel, although they were not fully engaged at this point; it was therefore requested that a presentation on this be made to the next CCG Board meeting in January 2017, which was agreed.

a.       Healthwatch Dementia Report – A report is attached.  Contact: Jane Randall-Smith, Shropshire Healthwatch Chief Officer (10 minutes).

b.       Draft Dementia Strategy – Peter Downer, Dementia Commissioner (15 minutes) – a report will follow.

a)    Shropshire Healthwatch Dementia Report

Jane Randall-Smith introduced and amplified a report on Dementia Services - engaging for the future; A collaborative project to refresh the Shropshire Dementia Action Strategy Action Plan, copy attached to the signed minutes.

RESOLVED: That the report and recommendations be approved.

b)    Draft Dementia Strategy

Peter Downer, Dementia Commissioner, introduced and amplified a report, copy attached to the signed minutes, on the Dementia Strategy for 2017/2020; a product of collaboration, which was welcomed by the Board as an excellent piece of work.

RESOLVED: That the Strategy be endorsed by the Health and Wellbeing Board

A report is attached.  Appendices will follow.

Contact:  Karen Bradshaw, Director of Children’s Services, Tel 01743 254201.

Lorraine Laverton presented a report, copy attached to the signed minutes which provided regular assurance to the Health and Wellbeing Board on the work of the Trust and highlighted areas for closer consideration by the Board.

RESOLVED: That the report be welcomed and that the information and actions of the Children’s Trust within the report be duly noted.