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

Apologies for absence were received from;

Nick Bardsley                    PFH Children’s Services, Shropshire Council

Karen Bradshaw                Director of Children’s Services, Shropshire Council

Lee Chapman                   PFH Health & Adult Social Care, Shropshire Council

David Coull                       Chair SPIC

Dr Simon Freeman            Accountable Officer Shropshire CCG

LezleyPicton                    PFH Culture & Leisure, Shropshire Council

Jane Randall-Smith          Shropshire Healthwatch

Bev Tabernacle                 Director of Nursing / Deputy Chief Executive, Robert Jones  & Agnes Hunt Orthopaedic Hospital NHS Trust.

Mandy Thorn                    Business Board Chair

Rachel Wintle                    Voluntary and Community Sector Assembly

Clive Wright                      Chief Executive, Shropshire Council

Simon Wright                    Chief Executive, Shrewsbury & Telford Hospital (SATH) NHS Trust

Substitutions notified were as follows;

Daphne Lewis substituted for Jane Randall-Smith, Shropshire Healthwatch.

Neil Nisbet substituted for Dr Simon Wright, Chief Executive, SaTH.

Michael Whitworth, Interim Director Contracting and Planning, Shropshire CCG, substituted for Dr Simon Freeman.

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 as a correct record, the minutes of the Health and Wellbeing Board meeting held on 25 May 2017, which are attached.

Contact Amanda Holyoak Tel 01743 257714.

RESOLVED: That the minutes of the meeting held on 25 May 2017 be approved subject to amending the name Nicky James to read Nicky Jacques, under ‘also present’ representing SPIC.

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

Two public questions were submitted from a Mr David Sandbach and a Mr John Bickerton (copies of each of the questions and the formal responses are attached to the signed minutes). 

The first question from Mr David Sandbach asked if ‘As part of the Healthy Lives initiative will the CCG and Shropshire Council involve commercial and industrial organisations in the task of preventing ill health.’

The Board replied that it would work to involve as many partners as possible for the prevention work.  The Board was keen for businesses to be involved to support their workforce in Shropshire and to support the delivery of health and wellbeing initiatives.  In response, Mr Sandbach commented he believed this course of action was flawed and he undertook to provide the Director of Health with his ideas, which were welcomed.

The second question from Mr John Bickerton, Oswestry asked “Why am I being misled by the Council regarding the Better Care Fund, when the Public Health Supplement to the NHS Constitution states that the local Council should take into account all 7 articles of the NHS Constitution, one of which is to be open and transparent with the public. I do not believe they are doing this with the Better Care Fund.”  The Director of Public Health proposed to take this question at item 5a of the agenda – Better Care Fund Update.

a)    Better Care Fund – report (to follow) – Tanya Miles, Head of Operations, Adult Services.

b)    STP update - 90 day plan – report (to follow) Stuart Aspin, STP PMO.

c)     STP Optimity update  - a report will be made -  Simon Freeman, Accountable Officer, Shropshire CCG and Rod Thomson, Director Public Health.

a)    Better Care Fund

Tanya Miles, Head of Operations, Adult Services, introduced a report on the Better Care Fund.  The Board considered the content of the draft BCF Plan 2017/19 and commented on its content in light of the publication of the BCF guidance on 3^rd July 2017.  This latest formal guidance had only been released that Tuesday afternoon.  The detail still had to be gone through, whilst the first deadline for the draft submission of 11 September was quickly approaching.

Tom Brettell, Better Care Fund Manager gave a presentation on Integration and the Better Care Fund Plan and in doing so he stated that significant progress was being made on systems leadership and that work towards integrated working at all levels was being made.

In response to the public question from Mr Bickerton (see Minute11), Dr Povey said he believed the BCF Plan was clear, concise and easy to read.  Overall, it summed up very well what the BCF was and where it was headed.  Each of the scheme descriptors within the BCF document highlight the key deliverables, milestones and outcomes and the associated funding. Also in response to Mr Bickerton Andy Begley, Director of Adult Services, clarified that the dispute between the Local Authority and Shropshire CCG regarding a number of funding issues (which may have been the basis for Mr Bickerton’s question) had been resolved.

The Board agreed that the document highlighted the system wide work to tackle key health and care challenges.  A specific discussion ensued about Delayed Transfers of Care (DToC) and the wider implications this covered.  It was agreed that it was key for the STP and the BCF to use the same language.

It was noted that a new NHS Social Care Dashboard had just been published and the Director of Performance and Delivery from the CCG suggested it might be good to look at this in more detail at a future Board meeting.

In respect of governance and sign-off the Board generally agreed that the next Board meeting did not need to be brought forward to 7^th September, but instead this could be delegated to the Joint Commissioning Group and the Chair of the Health and Wellbeing Board.

RESOLVED

                           i.          That the proposed approach for pooled budget for 2017/18 be approved.

                          ii.          That the submission timeframes be approved and that delegation to the Joint Commissioning Board and the Chair of Health and Wellbeing Board be approved.

                        iii.          That workshop sessions with partners be approved, depending on the model used.

b)    STP Update

Stuart Aspin, Project Manager STP, gave a PowerPoint presentation (copy attached to the signed minutes) updating the Board on the following main STP issues and generally commenting that after tweaks here and there, he was confident everything was now clearer;

·       STP Transformation and Vision

·       STP Governance Structure – excellent work being shared re Neighbourhood Boards

·       Delivery Group

·       STP Time line

·       One Plan (90 Day Plans) – highlighted and Shropshire’s 90 Day Plan was circulated at  ...  view the full minutes text for item 13.

a)    Healthy Lives – Social Prescribing next steps, Rod Thomson, Director of Public Health.

b)    Leadership & Stepping up to the place - Place Based Planning offer from the LGA, Andy Begley, Director Adult Services.

a)    Healthy Lives – Social Prescribing Next Steps

Rod Thomson, Director of Public Health, introduced and amplified a report (copy attached to the signed minutes) on ‘Healthy Lives’; which focussed on taking a whole system approach to reducing demand on services and relied on working together in partnership to deliver activity.  It supported integration across health and care as set out in the Health and Wellbeing Strategy and was an integral component of the STP Neighbourhoods Workstream.

The Social Prescribing pilot in Oswestry was the flagship element of Healthy Lives; however all aspects of the programmes were moving forward.  It was noted that everyday work was developing and that the Social Prescribing pilot would be evaluated during quarter 4 of 2017/18. 

More specifics about baselines and trajectories were hoped for – for example how many falls were projected to be prevented and what cost savings that would make for the system. 

In conclusion the Board was pleased to see that everything was moving forward in a positive way.

The CCG was concerned about how this work would link in to the national drivers and metrics.  After discussion, they the CCG was assured that the range of metrics could be made available to them as the work progressed.

RESOLVED;

                                     i.          That the development of Healthy Lives be supported.

                                    ii.          That financial investment into prevention activity be endorsed.

b)    Leadership and Stepping up to the Place – Place Based Planning offer from the LGA

Andy Begley, Director of Adult Services reported verbally on progress to date with place based planning.  Several successful workshops had been held recently, which was a positive use of resources.  ‘Stepping up to the Plate’ was an opportunity to gain support from the LGA and he advised the former Chair had been keen to do this, especially as it linked in to system planning.

A debate ensued and the Board supported continuation of working with the Leadership Centre and the LGA on system leadership.  It was agreed that the support for leadership development could be focussed on a system approach to workforce development.  It was therefore:

RESOLVED: That the Director of Adults Services, the Health & Wellbeing Co-Ordinator, the Chief Executive of Shropshire Community Health Trust and Phil Evans, be charged jointly with making the connections and have the conversation about joining in with this initiative.

Report attached.

Contact Stewart Smith Development Support Worker or Andy Begley Director of Adult Services Tel 01743 258911.

Andy Begley, Director of Adult Services introduced and amplified a report (copy attached to the signed minutes) on ‘Making it Real’ the Local Account.  The Director discussed the proposal to amalgamate Making it Real (MiR) and People to People (P2P) boards and the implications of this for partnership boards.  The Health and Wellbeing Board supported this idea and the excellent work undertaken to date.

Stewart Smith, a Development Support Worker spoke personally about MiR and the Local Account in Shropshire, which was all about the aim of making personalisation a reality in adult social care.  Working with local people and understanding service users’ perspectives and needs sat in the centre of service design delivery.

Broadly this work linked in to both the CCG who were engaging with this and Healthwatch, who were seen as one way to draw this all together.  Both were seen as core members. 

A discussion ensued about how this information could be got out to the public more broadly.

It was agreed that workshops would be a critical element that needed to be built in.  Daphne Lewis commented that Healthwatch would have a wealth of experiences to draw upon and she undertook to highlight this up to Jane Randall-Smith following the meeting. 

Work on an electronic version of the document was welcomed and the opportunity to consider the importance of the voice of people who used services in developing and shaping future services was welcomed very positively by the Board.

RESOLVED: That the excellent progress to date on Making it Real be welcomed and noted.