53.1    Apologies for absence were received from Karen Bradshaw, Ann Hartley, Helen Herritty, Jackie Jefferies and Graham Urwin.

53.2    Rachel Wintle substituted for Jackie Jefferies (VCSA).

To approve as a correct record the minutes of the extraordinary meeting held on 29 August 2014 and the minutes of the meeting held on 11 September 2014.

RESOLVED:

54.1    That the minutes of the meeting held on 29 August 2014 be approved as a correct record and signed by the Chairman.

54.2    That the minutes of the meeting held on 11 September 2014 be approved as a correct record and signed by the Chairman, subject to it being amended that Dr Julie Davies substituted for Paul Tulley and not Dr Caron Morton as indicated.

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.

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.

At the request of the Chairman this item has been WITHDRAWN and will not be considered.

57.1    The Director of Public Health confirmed that the report entitled ‘Improving Access to Psychological Therapies – The Shropshire Model’ which had been previously circulated, by Professor Patrick Pietroni had been withdrawn from the agenda and would not be considered at the meeting. 

57.2    It was explained that due to the recent publication of a document entitled ‘Achieving Better Access to Mental Health Services by 2020’ by the Department of Health (DoH), which was circulated at the meeting for information only, plus a short briefing paper by Officers, (again for information only) which was also circulated giving background, key points and some information about funding – copies attached to the signed minutes – the original report by Professor Patrick Pietroni had been withdrawn.

57.3    It was agreed that the implications of what had recently been disseminated by central Government would have to be considered by everyone before the Board looked at this.  It was also noted that this item would be deferred to a future meeting for discussion once it had been to the Clinical Advisory Panel.

57.4    Very briefly, the DoH document put mental health on the same footing as other physical mental health services as far as access and treatment were concerned.  It also introduced targets, similar to physical health targets and put an emphasis on improving liaison psychiatry services, better resolution team services and more developed CAHMS services.  It was underpinned by the National Health Service Concordat.  It was understood that new monies were to be announced shortly; a lot of which would be ‘freed up’ from elsewhere.  It was generally agreed that it was vital that the implications of the targets and funding were understood.

57.5    Paul Cooper, Commissioning and Service Redesign Lead - Mental Health and Learning Disabilities, CCG, spoke about the challenges facing rural Shropshire and also about street triage for people in crisis.

57.6    It was agreed that a conversation needed to be had publicly around all of this to highlight changes and educate everyone involved.

A report will follow.

Contact Dr Caron Morton, Accountable Officer Shropshire CCG Tel 01743 277580.

58.1    Paul Cooper, Commissioning and Service Redesign Lead - Mental Health and Learning Disabilities, CCG,  introduced and amplified a report (copy attached to the signed minutes) on the publication of a national concordat regarding improving care for people experiencing mental health crisis and the expectation that a local concordat with an associated action plan would be produced and implemented with oversight for the Health and Wellbeing Board.

58.2    A summary of the background to and key points within the concordat was included and there was a summary of the current position for Shropshire Services against the standards and recommendations for the next steps.

58.3    A discussion ensued about concerns around crisis care and the use of Place of Safety Suites.  It was pleasing to note that because of the hard work undertaken recently that concern had dropped, but officers assured they would not become complacent and would continue to meet regularly with the Police to monitor this.

58.4    An observation was made that there did not appear to be any input from the Probation Service thus far and that perhaps they should be included in the local agreement when drawn up.  This was agreed.

          RESOLVED

a)    That the contents of the report be noted.

b)    That the development of a multi-agency mental health crisis care concordat for the population of Shropshire be supported.

c)     That the establishment of a task and finish group to facilitate the development of a local concordat and associated action plan for presentation to/approval from the Health & Wellbeing Board be approved.

d)    That a progress report on the concordat be made to the Health and Wellbeing Board on 21^st November 2014, prior to its final submission to the Department of Health.

A report will follow.

Contact Prof Rod Thomson, Director of Public Health, Tel 01743 253934.

59.1    A report (copy attached to the signed minutes) highlighting the issues raised at the Health and Wellbeing Delivery Group either for information, endorsement or decision that had not been addressed as their own item at the Board was introduced and amplified by the Health and Wellbeing Co-ordinator.

59.2    In discussing the Health and Wellbeing Strategy Refresh, it was agreed that this should take into consideration the engagement of the Call to Action and Future Fit programme and key programme priorities.  It was agreed that a report be made back to the Delivery Group on 7 November, to include a timeline and details of who was doing what and when.  Subject to the foregoing it was

          RESOLVED:

a.     That arrangements for the Shropshire Peer Challenge in January 2015 be welcomed and noted.

b.     That the process of refreshing the Health and Wellbeing Strategy as set out in paragraph 1.3.4 of the report and detailed in points 1 to 7 be approved and that work be progressed on the Communication and Engagement Strategy, with Healthwatch as a clear driver.

c.     That in taking Working with the Community Safety Partnership (CSP) further, it was agreed that the CSP should be invited to a future meeting of the Health & Wellbeing Board (H&WB) to discuss key areas of joint interest such as Mental Health and Substance Misuse at the 20 February 2015 H&WB meeting, including the following 3  agenda items;

                                                    i.     Evidence (JSNA and the Community Safety Strategy)

                                                   ii.     Alcohol, drugs and tobacco – impact on health, services and commissioning

                                                 iii.     Mental Health – impact on anti-social behaviour & parenting: available services; and section 136.

d.     That progress with work around Organ Donation be approved.

A verbal update will be made.

Contact Dr Caron Morton, Accountable Officer, Shropshire CCG Tel 01743 277580.

60.1    Dr Caron Morton, Accountable Officer, Shropshire CCG, gave a verbal update to the Board on the progress of Future Fit.

60.2    The Evaluation Panel appointed by the CCG Board had held a number of meetings since June 2014. At the conclusion of its last meeting, the Panel made recommendations to the Board. The Board had considered these recommendations and agreed both a Long List of Options and a set of Evaluation Criteria to be used in determining a Short List. 

It was briefly noted that;

·       Greenfields sites – were currently being evaluated

·       Urgent Care Centres (UCC’s) – numbers were not specified yet

·       Womens and Children’s Centre – the current location was not a fixed site

It was noted that Powys was also now engaged and held strong views that they should have their own UCC or a border UCC which was accessible for residents.

60.3    Next steps would be engaging the community and clinicians.  Two general public events were planned for the end of October 2014 in Telford and Shrewsbury and these would be backed up by at least 6 engagement events and numerous other meetings, such as using the local authority Local Joint Committees (LJC’s).  The Chair highlighted that Health Officers should communicate with the Council’s Communications Team, who could assist with this aspect, which was welcomed.

60.4    A question was raised regarding funding the decisions of the Future Fit programme. It was confirmed that no final decision had been made on Future Fit and it was not possible to confirm funding arrangements.  However it was likely that funding may come from a combination of sources.  Above all, it was stressed that it was important that any funding was affordable and sustainable in the long-term.

A report will follow.

Contact Stephen Chandler, Director of Adult Services Tel 01743 253704.

61.1    The Board considered a report – copy attached to the signed minutes – providing an introduction and context for the Shropshire and Telford & Wrekin Safeguarding Adults Board Annual Report 2013/14.

61.2    Concern was expressed at the delays around assessments and the potential backlogs that may occur relating to Deprivation of Liberty Safeguards.  It was therefore agreed that an update be made back to the Health and Wellbeing Board in 6 months’ time on this.

          RESOLVED: That the content of the report be noted alongside the Safeguarding Adults Board Annual Report 2013-14.  Particular attention was paid to the information highlighted in the report concerning the Supreme Court’s decision in March 2014 concerning Deprivation of Liberty Safeguards (DoLS).

A report will follow.

Contact Stephen Chandler Director of Adult Services Tel 01743 253704.

62.1    The Director of Adult Services gave an update on the submission of the final Better Care Fund Submission – a copy of which is attached to the signed minutes.  Informal feedback thus far confirmed that the plan was open and transparent and contained good metrics.  The next stage would be the assurance process, which would involve the Director of Adult Services.  The level of analysis was phenomenal and it was highlighted that this would need to be borne in mind in future.  There were 4 ratings that could be achieved; 1; Approved, 2: Approved with support, 3: Approved with conditions or 4: Not approved.  Shropshire’s formal rating was still awaited.

62.2    The Chair thanked everyone for their hard work on this and requested that when clarity was received that a copy of the final submission be distributed to all partners.

          RESOLVED:

a)    That the Health and Wellbeing Board noted and acknowledged the input from all partner organisations including statutory and non-statutory provider organisations, the Voluntary and Community Sector, and the independent sector in the development of this plan and acknowledged that all partners had demonstrated an on-going commitment to work together to deliver better outcomes for the people of Shropshire;

b)    That the Health and Wellbeing Board noted and acknowledged the Better Care Fund submission (as attached to the report) and the ongoing effort to gain assurance.

c)     That once approved, a copy of the Final Better Care Fund submission be distributed to all partners.

A presentation will be made.

Contact Stephen Chandler, Director of Adult Services Tel 01743 253704.

63.1    The Director of Adult Services gave a PowerPoint presentation on the Care Act and Care and Support Reforms 2015 and 2016 – copy attached to the signed minutes.  In introducing and amplifying the presentation he explained there would be a phased implementation in two main stages; April 2015 and April 2016.

63.2    It was noted that the Care Act contained provisions covering Adult social care reform, Care standards, Health education and research and Market oversight and managing provider failure.  The emphasis moving forward will be person centred, asset based care.

63.3    Initial consultations had concluded and the final guidance and regulations were to be published the week commencing 13 October 2014.  Preparations for implementation had begun at national, regional and local, Shropshire level.  Funding streams had been identified and the impact of the care reforms identified, not only for the Council, but for the voluntary sector too.  This was going to produce a big shift in arrangements for the future.

          RESOLVED: That the presentation be noted.

A report is attached.

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

64.1    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, which was duly noted.