To elect two Co-Chairs of the Health and Wellbeing Board for the ensuing year.

Councillor Lee Chapman and Dr Julian Povey were elected as co-chairs of the Board.

To receive apologies for absence and notification of any substitutions.

Apologies for absence were received from: David Coull, Chairman – SPIC, Simon Freeman, Accountable Officer - Shropshire CCG, Karen Bradshaw, Director of Children’s Services - Shropshire Council, Dr Julie Davies, Director of Performance and Delivery – Shropshire CCG, Jan Ditheridge, Chief Executive - Shropshire Community Health Trust, Simon Wright, Chief Executive – SaTH, Jane Randall-Smith, Healthwatch

Michael Whitworth substituted for Simon Freeman., Nicky Jones substituted for David Coull, Terry Harte substituted for Jane Randall-Smith.

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 confirm the minutes of the Health and Wellbeing Board meeting held on 23 March 2017, which are attached.

The minutes of the meeting held on 23 March 2017 were confirmed 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.

Public questions were received from John Bickerton, Nicola MacPherson and Gill George.

Mr Bickerton asked whether there would be cuts in Health and Community Services in Shropshire, and about apparent differences of opinion on the Better Care Fund,

Nicola MacPherson had submitted a question on behalf of the VCSA Health and Care Forum about the financial challenges faced by the voluntary and community sector and how the Board could ensure threats to the sector were minimised in the face of potential cuts to funding for preventative services.    Following discussion, it was agreed that the Board should look at this issue in depth at its September meeting. 

Gill George’s question asked about the possibility of exploring alternative approaches in other parts of the country, eg, those involving capital investment into community hospitals and modern health centres in areas poorly served by community hospitals, less focused on the organisational needs of the acute sector.   

A copy of the questions and the responses made are attached to the signed minutes.  In asking a supplementary question on behalf of Mrs Geroge, Mr Deaves asked about a timescale for the actions recommended in the Optimity report, how they would be implemented and where the ultimate governance for implementation lay.  The Director of Public Health confirmed that he would be meeting with Mrs George to respond to her question and take her through the detail of the Optimity report. The Chief Executive, Shropshire Council, commented that some powers to make decisions lay with the Council and some with the CCG.  A tightly closed governance structure imposing decision would not work and conclusions about action needed were being arrived at together. 

AGREED

That the Board would look at this issue of funding of the VCS and preventative services in depth at its September 2017 meeting. 

The Board considered a report on Shropshire Neighbourhoods/Out of Hospital Work (copy attached to the signed minutes).

The Board noted that the Optimity report has been a catalyst for agreeing the key areas of work needed to support the planning and transformation needed as part of the STP Neighbourhoods/out of hospital work.  The Programme Board for this work had proposed five key workstreams:  Prevention/Healthy Lives; Population Health Management; Primary Care Five Year Forward View; Admissions Avoidance; and Community Services Review.

Attention was drawn to the draft governance structure which highlighted the key programmes and was designed to build on work already taking place.  Mental Health was intended to be woven into each of the workstreams.

Currently STP governance did not include reference to the Health and Wellbeing Board which was where accountability lay to the public of Shropshire.  The Board felt that this accountability should  be weaved into all governance structures and approaches. 

The CCG Clinical Chair said the Optimity report had helped reset the agenda.  The Chairman of the Board referred to the considerable amount of work needed.  He stated the Board would need to be strong enough to take a long view and that the CCG and Council would need to work together jointly around the priorities identified, rather than simply align activity.  The Board endorsed the approach set out in the report to take out of hospital work forward and the key workstreams. 

The Chair thanked the Director of Public Health for the report and stated that the Board would expect regular updates. 

Mental Health Partnership Board and Suicide Prevention Strategy

The Board received its regular update briefing (copy attached to signed minutes) designed to provide assurance from the Mental Health Partnership Board concerning the partnership approach to promoting and supporting the mental health and emotional wellbeing of the people of Shropshire. 

The Clinical Chair of the CCG emphasised that Mental Health was paramount and that everyone needed support and development at some point in relation to mental wellbeing.  The Chairman said that he had observed a Partnership Board meeting which had been well attended and included representation from a large range of organisations.  It was confirmed that mental health would be embedded through all planning at every stage. Members felt that the vision was clear and precise. 

AGREED

i)     to endorse and champion the vision of the Mental Health Partnership Board as “Shropshire is a place where mental health is everyone’s business, positive emotional wellbeing is promoted and services and communities work together to provide appropriate support when our people need it”

ii)    to endorse the key themes of the 12 month action plan. 

Suicide Prevention Strategy

Gordon Kochane, Public Health Registrar presented the Suicide Prevention Strategy (copy attached to signed minutes) for agreement and endorsement by the Board. 

He explained how the priorities within the Strategy had been identified, and how national guidance and feedback on the draft had also informed it.  He reported on updates suggested at a recent Mental Health Partnership meeting.

Board members felt that the strategy was excellent but asked questions about information sharing, which was already difficult across the statutory services and would be even harder for third sector organisations to access.  They heard that a Memorandum of Understanding was being developed which would include an information sharing agreement.    

Members’ attention was drawn to a workshop on 7 June 2017 on the Strategy which they would be welcome to attend if they wished to do so.

It was confirmed that the updated version of the draft would be circulated when available.

AGREED

To agree and endorse the Suicide Prevention Strategy for implementation within Shropshire.

Integration and Better Care Fund Plan 2017 - 2019

Tanya Miles, Head of Social Care Operations – Shropshire Council and Tom Brettell, Better Care Fund Manager introduced the report on the draft Integration and Better Care Fund plan for 17/18 to 18/19 and the 2016/17 Quarter 4 Performance Report.  A presentation was made (copy attached to the signed minutes) which covered:  reflections on 2016/17; the current position; the approach to the plan; national conditions and metrics; pooled budget and governance and sign off.

The Board noted that delayed guidance on the two year plan was still expected from Central Government and was not now expected until after the general election.  However, this had meant that a 2 Year Plan had been created that suited Shropshire, was shorter and clearer and drove greater system integration. 

It was likely that a special meeting of the Board would need to be arranged  ...  view the full minutes text for item 7.

A report is attached.

Contact David Fairclough, Community Action Officer, Tel 01743 252483

David Fairclough introduced a report on Shropshire Armed Forces Covenant in Healthcare (copy attached to signed minutes)

The key principal of the Covenant was to remove disadvantage to armed forces personnel, their families and veterans.  The paper set out the key principles to which the Health and Wellbeing Board are expected to adhere to, and where possible, undertake recommendations in line with national best practice and Government guidance. 

Karen Calder, Armed Forces Covenant Chair, explained that although the MoD delivered primary healthcare, Forces Personnel might not have access to a GP whilst on leave.  It was hoped by the Covenant Partnership that each partner on the Health and Wellbeing Board would sign up to the key principles and make a specific pledge on how it could support armed forces personnel. 

Attention was drawn to the national Armed Forces Covenant e-learning package for all health staff.  The Board also discussed the difficulties experienced by veterans and their spouses in accessing NHS dentistry. 

The Director of Public Health suggested that the Covenant identify which were the reputable Military charities as many had been formed in recent times. 

The Chairman thanked David and Karen for the report and said that an update would be welcome on any support that the Board could provide in future. 

Agreed

That the Director of Public Health write to the Local Dentistry Committee and NHS England to draw attention to the difficulties experience in accessing NHS dentistry;

That the Health and Wellbeing Board assist in promoting the national Armed Forces Covenant e-learning package for all health staff within Shropshire;

That the Health and Wellbeing Board endorse finding practical ways to identify a veteran within health services within Shropshire

That the Health and Wellbeing Board endorse that those within the military community, including spouses and veterans moving in to Shropshire have the opportunity to have their place on any NHS waiting lists moved with them

That the Health and Wellbeing Board endorse raising GPs awareness of the process when serving personnel are on leave and accessing primary healthcare