To receive apologies for absence and any substitutions notified to the Clerk before the meeting.

Nick Bradsley                    PFH Childrens Services and Education

Andy Begley                      Director of Adult Services

Jan Ditheridge                   Shropshire Community Health NHS Trust

Dr Simon Freeman            Accountable Officer, Shropshire CCG

Neil Nisbet                        SaTH

Dr Julian Povey                 Clinical Chair, Shropshire CCG

Many Thorn                      Business Board Chair

Gail Fortes-Mayer             NHS

Substitutions notified:

Ros Preen, Director of Finance; substitute for Jan Ditheridge, Shropshire Community Health NHS Trust.

Sam Tilley, Director of Corporate Affairs; substitute for Dr Julian Povey, Clinical Chair, Shropshire CCG.

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 Disclosable Pecuniary Interests.

To confirm as a correct record, the minutes of the Health and Wellbeing Board meeting held on 16^th November 2017, which will follow.

Contact Karen Nixon Tel 01743 257720.

RESOLVED: That the minutes of the meeting held on 16^th November 2017, be approved and signed by the Chairman as a correct record.

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, statements or petitions had been received in accordance with Procedure Rule 14.  However, the Chairman permitted Nicola McPherson to ask a verbal question to the Board as follows;

On reading the savings table in the budget consultation I note a £500,000 saving in preventative services and a further £22,000 in grants.  I was under the impression that the VCS Preventative Services grants and contracts (£2.1 million) had been extended for another year, is this £500,000  part of that or from somewhere else?

In response the Chair confirmed that, following adoption of the recent financial strategy by Council, the process of confirming the funding available for 2018/19 was now in hand and that written notification of this would be made to relevant grant/contract holders very shortly.

A report is attached.

Contact:  Lorraine Laverton Tel 01743 253991.

The Board received a report (copy attached to the signed minutes) on proposals to review and refresh the Health and Wellbeing Board’s Strategy, Terms of Reference and membership.  After a general discussion it was

          RESOLVED:

a)    That the co-option of Phil Evans (STP) onto the Shropshire Health and Wellbeing Board be deferred pending the outcome of the review and refresh, including the terms of reference review.

b)    That the Health & Wellbeing Board; Strategy 2016-2021, Terms of Reference and Membership be reviewed and refreshed.

c)     That a workshop involving Shropshire Health and Wellbeing Board Members and relevant key stakeholders be held in March 2018 in order to undertake the review and refresh.

·       The Sustainability and Transformation Plan for Shropshire, Telford & Wrekin.

·       Neighbourhoods Work

·       Future Fit

Contact:  Phil Evans, Director STP Programme

Two reports on the STP Programme Update (copies attached to the signed minutes) were  circulated at the meeting (one dated December 2017 and one dated January 2018).  Each provided an update with a high level RAG rated Programme Status Report against the STP Programme Structure, Governance and Delivery Plan.

A verbal update was given by Phil Evans, STP/Future Fit Director.

Concerns were expressed about where the provider sector linked in to the STP and an assurance was given that once the refresh had been undertaken, Phil Evans would be part of the Delivery Group and would have input there.  Likewise concerns about where services for children and young people linked in to the STP were also raised.  Again the Delivery Group, the Neighbourhood Group and the Prevention Group were all highlighted as avenues for future input and an offer to discuss this further after the meeting was extended to the Director of children Services, which was welcomed.

There was some criticism that the report was somewhat ‘Telford top-heavy’ and it was duly accepted that maybe the report needed to be ameneded somewhat.  It was however stressed that this report was merely a snapshot in time and would change.

The reference to the overusage of the word ‘hospital’ was also highlighted and it was agreed that this would be looked at again.

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

·       Better Care Fund Performance – Contact: Tanya Miles, Head of Operations, Tel 01743 253094

Tanya Miles, Head of Operations, introduced and amplified a report (copy attached to the signed minutes), on progress on the Better Care Fund review and development, including the Draft Section 75 Partnership and the BCF Quarter 3 return.

It was noted that an Action Plan was being developed and this would be reported to the March Health and Wellbeing Board meeting.

The Director of Performance and Delivery placed on record her sincere thanks to social care colleagues for their excellent work on this.  Great work had been achieved together and whilst she acknowledged there were still challenges ahead, she felt they were well placed to go forward.  The Chair echoed this and congratulated all staff involved.

RESOLVED:

a)    That the Partnership Agreement for ratification by the CCG and Shropshire Council Governance be approved.

b)    That the BCF Quarter 3 return, as circulated at the meeting, be discussed and noted

·       Healthy Lives – Contact: Rod Thomson, Director of Public Health, Tel 01743 252003

A report (copy attached to the signed minutes) providing an update on the Healthy Lives Programme was discussed by the Board.  This included the updated Social Prescribing Business Case, and the scope and proposals for the creation of an integrated team model that supported locality need.

Progress made against each of the main programme areas was provided.

It was requested that social prescribing for children and young people also be included in future work, as well as mental health.  It was agreed that this would be discussed and taken forward.

In response to a question about whether there was a plan to show the impact and improved outcomes for the population, the Director of Public health assured that work was currently being undertaken on this by Westminster University, the outcome of which would be reported to a future Delivery Group meeting.  This was welcomed.

          RESOLVED

a)    That the continued expansion of the Healthy Lives Programme, the model of social prescribing and the model of integrated working around Primary Care and Adult Social Care be supported.

b)    That the Business Case for Social Prescribing be endorsed by the Health and Wellbeing Board, including children and young people.

A report is attached. 

Contact:  Emma Sandbach, Public Health Officer, Tel 01743 253967.

The Health and Wellbeing Board received and noted a report (copy attached to the signed minutes) on the Pharmaceutical Needs Assessment (PNA) which was a statutory requirement of Local Authority Health and Wellbeing Boards.

The PNA runs from 18^th January to 18^th March 2018; Members noted that the link to the PNA report would be published in an addendum, following the meeting.  Any comments were to be made directly to Emma Sandbach, Public Health Team.

RESOLVED: That the statutory requirement for a public consultation to be undertaken on the draft Pharmaceutical Needs Assessment be duly noted.

A presentation will be made and a report will follow.

Contact:  Dr Julie Davies, Shropshire CCG, Tel 01743 252295.

A report (copy attached to the signed minutes) updated the Shropshire Health and Wellbeing Board regarding the implementation of the new 0-25 Emotional Health and Wellbeing Service through a report presented to the Shropshire CCG Governing Body meeting on 10^th January 2018.

The background to the commissioning of the new 0-25 Emotional Health and Wellbeing service was given by Frances Sutherland, Telford and Wrekin CCG.  Issues that had recently emerged were identified and the work undertaken to address these were described.

The report was welcomed by the Board.  It noted that there was still work to be done such as Pathways, Neuro development and Looked After Children were to be prioritised in the future, It was anticipated this would take a couple of years to get right, but the positive was that the service now knew exactly where it was and what it needed to do to get things right going forward.

The Chief Officer, Shropshire VCSA, welcomed the report which she found useful and confirmed that they were happy to become involved in forthcoming workshops.

The Director of Performance and Delivery, Shropshire CCG confirmed that they were currently working on the single point of access and referral with GP’s.

The Director of Children’s Services acknowledged that this was a steep and rapid improvement course, but she remained concerned; 2 years was a long time and exposed the system and children in need. Therefore it was requested that this be progressed as soon as possible.  She welcomed the continued oversight and felt that Children’s Scrutiny should be in here too. 

Additional capacity was mentioned in the report and the timescales and viability of this was queried.  Officers confirmed they were currently recruiting additional staff

Any comments regarding the consultation were to be fed back to either Carolyn or Lorraine Laverton who were co-ordinating responses.

RESOLVED: That the service issues identified and the actions taken to date by both SSSFT and Commissioners be noted, and that the progress of the implementation of the Remedial Action Plan be monitored.

A report is attached.

Contact:  Andy Begley, Director of Adult Services, Shropshire Council, Tel 01743 258911.

The Health and Wellbeing Board received a report (copy attached to the signed minutes) providing an update from the Mental Health Partnership Board.  This also included a copy of the Green Paper on Transforming Children and Young People’s Mental Health Provision.

The work of the Outdoor Partnership Health Initiatives work was highlighted, and again links to children and young people were highlighted by the Director of Children’s Services

RESOLVED:  That the report be noted.

VCSA Prevention Report for Shropshire 2017 attached.

Contact:  Nicola McPherson

Nicola McPherson introduced and amplified a report (copy attached to the signed minutes) about the work of the voluntary and community sector in Shropshire.  In doing so she also gave a powerpoint presentation (copy attached to the signed minutes) to illustrate this covering

Ø  Prevention research: increasing demand/reducing income

Ø  Shropshire’s VCS

Ø  Impact Assessment

Ø  Prevention Services and Support

Ø  Scale

Ø  Volunteering and match investment

Ø  Organisation risk

Ø  Service level risk

Ø  Impact

Ø  A potentially catastrophic situation

Ø  The way forward

·       Raise awareness of current pressures.

·       Review expectations of the VCS (volunteering isn’t free).

·       Recognise that volunteering not only allows services to be delivered but it should also be invested in as a form of prevention.

·       Invest in infrastructure support for VCS organisations.

·       Align public sector approaches - prioritise support where it is most needed in communities.

·       Plan long term and work now to mitigate against longer term risks.

A discussion ensued and the work of the VCSA was acknowledged, along with the messages conveyed in the presentation.  It was agreed that sustainability was crucial and to this end the VCSA needed to be involved at all levels.

A point of contact within Shropshire CCG was specifically requested and the Director of Performance and Delivery (CCG) undertook to identify this with Nicola McPherson after the meeting.

The Chair welcomed the report and thanked the VCSA for the excellent information presented, which was stark but essential to understand what was happening in this area.  He looked forward to positive engagement for the future.

RESOLVED:  That the reports and presentation be welcomed and noted.

A report will follow.

Contact Ivan Powell, Chair, Keeping Adults Safe in Shropshire Board and the Safeguarding Children Board.

The Health and Wellbeing Board considered a report (copy attached to the signed minutes) on the latest Keeping Adults Safe in Shropshire (KASIS) Annual Report and providing an update on progress since the November 2015/16 report, which was introduced and amplified by Sarah Hollinshead-Bland.

The introduction of personal stories within the report to make the document more interesting and illustrate the work done was welcomed.

RESOLVED: That the report be noted.

A report is attached.

Contact Cllr Karen Calder or Sean McCarthy, Sports Development Officer and Armed Forces Covenant Co-Ordinator for Shropshire Council, Tel 01743 255933.

A report setting out the key principles to which the Health and Wellbeing Board were expected to adhere to in respect of the Armed Forces Covenant was introduced and amplified by Councillor Karen Calder and Sean McCarthy.  This was a clear mandate of how health organisations should ensure that the Armed forces community was not disadvantaged and treated fairly, given their uniqueness.

The Shropshire Armed Forces Covenant Partnership was chaired by Shropshire Council and attended by all Shropshire military organisations, service charities and veteran groups and associations.  The partnership provided several recommendations they felt should be adhered to, which would support individuals and families in Shropshire.

          RESOLVED:

a)    That the Health and Wellbeing Board promote the use of Veterans Gateway to Commissioners, Primary Care, Acute Trusts and Private Sector Care Providers.

b)    That the Health and Wellbeing Board ensures that GPs and Practice Managers are aware of the signing up process for Reservists and the role they play in signing off the Recruiting Group Medical Declaration Form.

c)     That the Director of Public Health and the Chair of the Armed Forces Covenant Partnership write to the Local Medical Committee to see if a way forward can be agreed to improve the length of time it takes for a Recruiting Group Medical Declaration form to be completed.

A verbal update will be made.

Contact: Neil Evans, Commissioning Development Manager Tel 01743 253019.

A verbal report was made by Neil Evans, Commissioning Development Manager on the status of the Healthwatch contract in Shropshire.  He confirmed that the recent tender process had seen the receipt of two tenders and that the 3 year contract had been awarded to Healthwatch Shropshire Limited (which became independent in 2016).

The Chair joined others in conveying their congratulations to Jane Randall-Smith and her team and commented how invaluable their work was in making things more effective when commissioning services.

RESOLVED:  That the appointment of Healthwatch Shropshire Limited be welcomed.