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

The following apologies were reported to the meeting by the Chair:

Andy Begley

Lynn Cawley

David Stout

Ed Potter

Megan Nurse

The following substitutions were also notified:

Nick Bardsley will be substituting for Ed Potter

Tanya Miles will be substituting for Andy Begley

Cathy Riley will be substituting for Megan Nurse

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 meetings held on 23 May 2019 and 4 July 2019.

Contact: Michelle Dulson Tel 01743 257719.

RESOLVED:

That the Minutes of the meetings held on 23 May 2019 and 4^th July 2019, 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.  The deadline for this meeting is 9.30am on Tuesday 10 September 2019.

No public questions were received.

The Chairman agreed to amend the agenda order to move Agenda Item 5 - School Readiness Report to later in the meeting to enable Councillor Nick Bardsley and Karen Bradshaw to be present when the item was discussed.

Regular update reports to the Health and Wellbeing Board are attached:

Shropshire Care Closer to Home

Report attached.

Contact: Barrie Reis-Seymour, Shropshire CCG / Lisa Wicks

Primary Care Networks Update

Report to attached.
Contact: Nicky Wilde/Steve Ellis

The Sustainability and Transformation Plan for Shropshire, Telford & Wrekin

A presentation will be given.

Contact: Martin Harris, Telford and Wrekin CCG / Rachel Robinson, Director of Public Health, Shropshire Council

Better Care Fund, Performance

Report to follow.

Contact: Penny Bason, Shropshire Council / Shropshire STP/Tanya Miles

Healthy Lives Update – Social Prescribing – Final evaluation report and ambitions for the future

Report attached.

Contact: Jo Robins

i.        Shropshire Care Closer to Home

Lisa Wicks, the Head of Out of Hospital Commissioning and Redesign introduced the Shropshire Care Closer to Home update (copy attached to the signed Minutes).

She confirmed that the pilot for the phase 2 model of Risk Stratification and Case Management was now underway and letters had been sent out in a staged approach to seek consent from patients that wanted to be involved. At present only 11 patients had declined to be involved with the pilot.

The Head of Out of Hospital Commissioning and Redesign explained that a 3 month impact assessment, which was part of phase 3 was almost complete and the results would be shared with stakeholders in due course, however, clear themes already coming through from the assessment so far included the lack of a shared clinical record and 24/7 working.

The next steps of the programme were outlined by the Head of Out of Hospital Commissioning and Redesign and it was reported that over the past few months work had been undertaken with the Shropshire Council Public Health team to develop a current Joint Strategic Needs Assessment.

The Chairman thanked the Head of Out of Hospital Commissioning and Redesign for the update and stated that it was pleasing that only 11 patients so far had declined to be involved with the pilot.

ii.       Primary Care Networks Update

Steve Ellis, the Head of Primary Care introduced the Primary Care Networks (PCNs) update (copy attached to the signed Minutes).

The Head of Primary Care referred to the Maturity Matrix produced by NHS England to support PCNs through their development. He noted that the matrix outlined the core components which underpin the successful development of networks.

It was reported that from July 2019 PCNs had been commissioned to provide extended access appointments and from April 2020 they will be required to deliver an additional 5 Directed Enhanced Services.

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

Martin Harris, STP Director gave a verbal update on the STP Programme.  Copies of the STP Long Term Plan were circulated (copy attached to the signed Minutes). 

The STP Director explained that even once the plan had been submitted it would continue to evolve and change based on the feedback and views gathered across the system. He reported that the plan had to balance the needs of the population against national priorities.

The STP Director referred to the flow diagram which detailed the document development and sign off process and informed the meeting that initial system planning submission was due on 27^th September 2019.

The draft content and involvement of the Board in the development of the Long Term Plan was outlined by the STP Director and he highlighted the vision going forward stressing the importance of working together as one to transform health and care for Shropshire, Telford & Wrekin to provide a better service for everyone.

In response to comments the STP Director agreed that the voluntary sector should be involved  ...  view the full minutes text for item 28.

Report attached.

Contact: Anne-Marie Speke, Healthy Child Programme Co-ordinator / Neville Ward, Senior Early Years and Childcare Officer

Anne-Marie Speke, the Healthy Child Programme Co-ordinator and Neville Ward, the Senior Early Years and Childcare Officer introduced the report (copy attached to the signed Minutes) which outlined the work undertaken as part of the improving school readiness.

The Senior Early Years and Childcare Officer explained that the Department of Education had set an ambitious goal to halve the number of Children leaving reception without the appropriate level of communication and language skills they require by 2028. The initiatives already underway in Shropshire to meet this target were outlined by the Senior Early Years and Childcare Officer and he explained how the progress was measured.

The Senior Early Years and Childcare Officer referred to the Age and Stages Questionnaire (AQS), a parent led questionnaire that helped to assess the development of children in 5 domains and noted that where children were not meeting milestones in these domains, appropriate support was given to families and shared with the early year setting.

It was reported that training was to be rolled out by the Local Authority during 2019/20 to improve the overall level of communication between early years workforce and children, and the various sessions available in libraries were detailed. It was noted that the Local Authority was working with all services that come into contact with families to make the most of every contact.

RESOLVED:  That the contents of the report be noted.

Report attached.

Contact: Gordon Kochane

Gordon Kochane, the Public Health Consultant introduced his report (copy attached to the signed minutes) which provided an update on the Suicide Prevention Strategy.

The Public Health Consultant reported that Public Health were continuing to implement the strategy and referred to the Z card launch. The Z card was a quick reference guide which provided information for those at risk. He explained that feedback had been good and although there was a limited number of printed copies of the Z card an electronic copy was available.

RESOLVED: That the report be noted

A presentation will be given.
Contact: Fiona Elllis

Fiona Ellis, the Programme Manager introduced her report (copy attached to the signed minutes) which provided an update on the review of Midwife-led Care across Shropshire and Telford & Wrekin.

The Programme Manager recapped on why a change was needed and referred to the need for overnight closures of rural Midwife led units in order to ensure safe staffing levels across the service. It was noted that the proposed new model of care would offer more flexibility and better respond to the needs of women throughout their pregnancy, birth and beyond.

The outcomes of the options appraisal were outlined by the Programme Manager and it was explained that an access impact assessment had been commissioned with the findings considered by a professional group and CCG Board.

The Programme Manager informed the Board that a consultation plan was to be developed and the next steps were noted.

RESOLVED: That the update be noted.

Item to be deferred to the next meeting on 14 November 2019.

Contact: Lynn Cawley

RESOLVED: Deferred to the next meeting.

Report attached.

Contact: Emily Fay

Emily Fay, the Food Poverty Alliance Co-ordinator introduced her report (copy attached to the signed Minutes) which provided an update on the Shropshire Food Poverty Alliance.

The Food Poverty Alliance Co-ordinator outlined the work of the Shropshire Food Poverty Alliance which was formed in 2018 to tackle the issue of food poverty. She explained food poverty was affecting an increasing number of households in Shropshire with the use of food banks going up by 27% in North Shropshire and 23% in Shrewsbury. It was noted that public donations for some foodbanks were increasing in line with the demand, but others were not meeting this and also space was an issue. The Food Poverty Alliance Co-ordinator referred to the Yellowhammer document and how leaving the EU was likely to impact on low income groups.

The Food Poverty Alliance Co-ordinator drew attention to the projects in the county to improve access to low cost healthy food and noted that there would be a workshop in the New Year to share ideas. It was highlighted that the uptake of Healthy Start vouchers, which can be used by families in low incomes to buy fruit, vegetables and milk, was 52% and the Alliance was working with Healthy Lives to identify how to increase the uptake of these vouchers.

In response to the concerns in relation to leaving the EU, the Chief Executive explained that the Council was leading on this issue locally and if any other partners need to highlight potential issues to contact himself or the Director of Public Health.

Concern was raised in relation to the fact that some foodbanks were required to pay for venue hire to provide the service and it was suggested that provision for this should be built into the estates strategy.

In response to a comment that the projects referred to in the update report were mainly in urban areas and more rural projects were needed, the Food Poverty Alliance Co-ordinator explained that it was difficult to find existing organisations in rural areas to build on when developing projects.

RESOLVED:   It was agreed that the Health and Wellbeing Board continue to support the work of the Shropshire Food Poverty Alliance.

Report for information attached.
Contact: Alison Smith

Dr Julian Povey, Shropshire CCG Clinical Chair introduced the update report in relation to a Single Strategic Commissioner for Shropshire and Telford & Wrekin (copy attached to the signed Minutes). The report provided a further update and sought the support of the Board on the decision to dissolve the existing two CCG organisations with a view to creating one organisation.

The Shropshire CCG Clinical Chair explained that there were benefits of reducing to one organisation and noted how this would tie in with the target imposed on all CCGs by NHS England to reduce running costs by April 2020. He also referred to the NHS Long Term Plan and the requirement to streamline commissioning organisations as another reason to move to the one organisation.  He noted that work was proceeding to create a new CCG by April 2020 and this would redesign how the CCG works.

It was noted by Mark Brandreth (CEO - RJAH Hospital) that the proposal was logical and offered real benefit, adding that specialist services were currently too stretched over too many commissioners.

In conclusion the Chairman stated that the proposals were welcomed by the Board.

RESOLVED: That the update be noted.

Correspondence – action for noting.

None received.