To receive apologies for absence and notification of any substitutions.

Apologies were received from David Coull – Shropshire Partners in Care,  David Evans – Accountable Officer Shropshire and Telford and Wrekin CCGs, Mike Ridley – Shropshire Community Health Trust, Jane Randall-Smith – Chief Officer Healthwatch Shropshire, and David Minnery – Portfolio Holder for Children and Young People, Shropshire Council.

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 previous meeting held on 21 April 2016, which will follow.

Contact: Karen Nixon Tel: 01743 257720

Minute 78 page 3 Resolution B was amended to say ‘b)That alcohol would be a future strategic priority for the Health and Wellbeing Board’.  The minutes of the meeting held on 21 April 2016 were then approved as a correct record

The Chair referred to the Price Waterhouse Cooper Report referenced in minute 75 and stated that the report was yet to be made available.  It was agreed that the CCG be asked to provide the report as soon as possible.

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

Mr David Sandbach had submitted two public questions, one of which related to the need for CCG support of the Strategic Outline case and when the Business Case would be available to the public.  The other related to the General Practice Forward Plan and the £2.4 billion to be invested in General Practice by 2020/21.  Copies of the questions and the responses are attached to the signed minutes. 

Following discussion of the response to the first question, Dr Davies was asked to confirm that the timetable remained as published as the response regarding availability of the Outline and Full Business Case did not appear to correlate with it.   

A report is attached.

Contact Sam Tilley, Head of Partnerships and Planning Tel: 01743 277545.

Sam Tilley, Head of Partnerships and Planning provided an Update on the Better Care Fund (a copy of the report is attached to the signed minutes). 

The report focused on assurance feedback from NHS England and the Quarter 4 Performance Report.  She acknowledged that meeting a BCF Plan re-submission date of 27 June 2016 would be a challenge but confirmed it would be manageable.  The key focus going forwards would on non-elective admissions.

RESOLVED:

That the Health and Wellbeing Board note the assurance feedback from NHSE on the BCF plan for 2016/17 and the plan for addressing the outstanding items.

That the content of the BCF Q4 monitoring template be noted.

That the request for delegated authority to the H&WB Delivery Group to oversee the revisions to the BCF Plan and associated Partnership Agreement and to approve the final version for submission to NHS England be agreed. 

That the delay of publication of the final BCF plan until after re-submission and final NHS England approval has been received be supported.

STP

A report will be made.

Contact: Dave Evans, Accountable Officer Shropshire CCG and Telford & Wrekin CCG

Leadership Centre Offer Update – for Information

A report is attached.

Contact: Andy Begley, Interim Director of Adult Services 01743 253704

Sustainable Transformation Plan         

Fran Beck introduced herself as the new Director of Strategy for the Joint Executive Team across Shropshire and Telford and Wrekin CCGs. She outlined the challenges of weaving together the BCF and STP, as well as Future Fit and Community Fit.  The next submission date for the STP was 30 June 2016, this would not be the final version but would bring clarity around some of the big issue items.  All partners were committed to resilient communities, however the ‘how’ was not yet clear.  There would be a focus would be on reduction of duplication and merging of backroom functions.

The Chair emphasised the need for the Health and Wellbeing Board, local authority, private providers and the voluntary sector to be represented in discussions as soon as possible. The Director of Strategy explained that the NHS England deadline of 30 June had not allowed extensive engagement, but there was an intention to engage and effectively.   

Vikki Taylor, Locality Director - North Midlands, NHS England, said the challenge of the timescale was recognised.  Likely final submission would be August time although this was yet to be confirmed.  She offered to put the Director of Strategy in touch with other areas of the country which had more advanced plans.

The Chairman reported on the frustration of both Shropshire and Telford and Wrekin local authorities at the constraints of NHS England and at the introduction of yet another structure, when what was needed was improvement on the ground.  Concern was also expressed at the STP Board’s lack of democratic mandate, and the lack of STP Board representation on the Health and Wellbeing Board.

The Director of Strategy said she would take the challenges and comments of the Board back to the Joint Executive Team. 

RESOLVED: 

That STP be a standing item on the Health and Wellbeing Board agenda, with all Members being given the opportunity to state their input to date.

That an additional meeting be held, focusing on STP.

Leadership Update

The Director of Adult Services reported that 30 days support had been secured from the Leadership Centre at no cost, to support the level of change required across different organisational cultures.  He welcomed suggestions for key areas to focus on.  Dr Davies suggested that this was an opportunity to focus on integrated delivery.

A presentation will be given.

Contact Vikki Taylor, Locality Director, North Midlands, NHS England 01138 255520

Simon Collins, NHS England, gave a presentation providing an overview on specialised commissioning and priorities (a copy is attached to the signed minutes).  He referred to NICE guidance and staff recruitment issues leading to the need for reconfigurations and hub and spoke models. 

The Director of Children’s services highlighted the lack of tier 4 beds for young people in the West Midlands and urged that this be addressed as soon as possible.  She said that this issue was key not only for children and young people, but also for adults needing to access the section 136 suite at the Redwoods Centre, as this suite had been utilised for children, making it unavailable for adults.  Mr Collins explained that there was currently a large mental health re-procurement exercise progressing in the West Midlands.  This would allow more patients to be located closer to home, clarify responsibilities for knowing who and where patients were located and who was responsible for supporting the child’s family.  The Chair requested a copy of the timetable for this exercise. 

Members of the Board commented on how helpful it had been to have representatives of NHS England at the meeting.  

It was requested that NHSE return to a future meeting to discuss GP performance and recruitment alongside their local CCG colleagues. 

Delays

A presentation will be given.

Contact: Dr Julie Davies, Director of Strategy & Service Redesign, Shropshire

CCG 01743 277500

CQC Inspection

A verbal update will be given.

Contact: Jane Randall-Smith

Dr Davies reported that the Health and Adult Social Care Scrutiny Committee had looked at Ambulance Performance in March and would be returning to the issue at its meeting on 25 July.  She reported on the local system action plan developed and the ECIP analysis considered at a Chief Operating Officers meeting.  Members noted that West Midlands Ambulance Service was the hot topic for Healthwatch in June.   It was agreed that an update be provided at a future meeting.

A report is attached.

Contact: Adam Boughey, Staffordshire University

The Board received a report and also a presentation on the Carers Pilot from Adam Boughey, Research Associate and Trainee Health Psychologist.  (copies attached to the signed minutes).  The presentation highlighted issues relating to carers gathered through carers’ stories and stakeholder focus groups.  The presentation and report highlighted key recommendations for improving carers’ experiences. 

The Board thanked Mr Boughey for the presentation and agreed that the report and presentation had provided useful background in considering Shropshire’s Carers Strategy. 

A report is attached.

Contact: Penny Bason, Health & Wellbeing Coordinator 01743 253978.

The Health and Wellbeing Co-ordinator explained that the version before members represented the beginning of the first strategy which would cover carers of all ages.  Six priority areas had been identified and carers would be consulted on these.  Action plans would be developed based on priorities once agreed.

In discussion, it was confirmed that the Rapid Response Carers Service still existed, but that there had been a change of provider.  The Board confirmed that it was happy with the six priorities but more emphasis was requested within the strategy on how to identify carers across the partnership and on communication. 

RESOLVED:  that the Board agree the priority outcomes. 

A report is attached.

Contact: Lorraine Laverton, Business Manager - Children's Trust 01743 254205

The Board received the first of what would be a regular update from the Children’s Trust.  The Board’s attention was drawn to two key areas – tier 4 mental health bed availability (discussed earlier as part of the NHSE update) and also to SEN and Disability reforms and the lack of a CCG designated medical officer.  The Board asked for Assurance that recruitment would take place into this post as soon as possible.

A verbal update will be given.

Contact Irfan Ghani, Consultant in Public Health 01743 253969

Irfan Ghani, Consultant in Public Health provided an update on immunisation of NHS and Social Care Workers.  Shropshire Community Health Trust was the only organisation to have increased uptake of flu immunisation, all other local Trusts had decreased.  It was hoped that a new CQUIN for 75% uptake would drive a collaborative approach and the Board felt it was important to learn from the Community Health Trust’s success.

It was agreed that a partnership task and finish would be developed to look at ways to increase the uptake of the flu immunisation each winter within our own organisations.  Irfan Ghani would take this forward.