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

Di Beasley                        NHS Telford & Wrekin CCG

Nick Bradsley                    PFH Childrens Services and Education

Dr Julie Davies                  Director of Performance and Delivery, Shropshire CCG

Dr Simon Freeman            Accountable Officer, Shropshire CCG

Sarah Hollinshead-Bland    Service Manager, Adult Safeguarding, Shropshire Council

Neil Nisbet                        SaTH

Dr Julian Povey                 Clinical Chair, Shropshire CCG

Bev Tabernacle                 RJ&AH Hospital

Mandy Thorn                    Business Board Chair

The following substitutions were also notified:

Sam Tilley, Director of Corporate Affairs; substituted for Dr Simon Freeman, Accountable Officer, Shropshire CCG.

Lisa Wicks, Head of Out of Hospital Commissioning & Redesign Shropshire Clinical Commissioning Group, substituted for Dr Julie Davies, Director of Performance and Delivery, Shropshire CCG.

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 meeting held on 12 January 2018.

Contact: Karen Nixon Tel 01743 257720.

At Minute 48, it was agreed that the resolution should have also stressed that the ratification of the Partnership Agreement was subject to the approval by the CCG; at the time, more work was required on this.  Subject to this, it was duly

RESOLVED: That the minutes of the meeting held on 12^th January 2018, 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.

There was one public question from John Bickerton, local resident from Oswestry about the Better Care Fund in relation to the Grant Thornton progress report (March 2018) and its implications.  This question was circulated round the table at the meeting (copy attached to the signed minutes). 

In response, the Chair advised that he could not address this at the meeting; he needed time to check out the Grant Thornton report and therefore he undertook to respond directly to Mr Bickerton after the meeting, which was duly agreed.

Regular update report to the Health and Wellbeing Board is attached:

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

      ii.          Neighbourhoods work

    iii.          Future Fit

Contact: Director of the STP Programme, Phil Evans.

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

In introducing the STP Programme update, (copy attached to the signed minutes) Phil Evans, Director of the STP Programme, advised that the next report would not be so detailed in future; it would be in a different format and split into 3 sections as follows

Ø  Commission Section

Ø  Acute Section

Ø  Enablers Section

This new monthly update would inform all, including NHS stakeholders.

It was agreed that Claire Old, newly appointed Urgent Care Director be invited to a future Health and Wellbeing Board to give an update on A&E and urgent care in Shropshire.

It was noted that in respect of prevention, the Healthy Lives work continued and dovetailed well into the planning system.  This covered Diabetes and CBT and the Board was assured that a whole system was implicit within ongoing work.

In response to questions from the Chair the Board was assured that the Joint Strategic Needs Assessment was due a refresh soon and that there were no issues in respect of the Strategic Estates Group and engagement. Phil Evans assured that this document was a snapshot in time and that things had moved on.

The Director of Health informed that at a recent meeting of the Joint Health Overview and Scrutiny Committee the Chief Executive of the Hospital Trust had given an update on the sustainability and safety of clinical services provided by Shrewsbury and Telford Hospitals NHS Trust which had been very informative.  To this end he suggested that it might be beneficial for the Health and Wellbeing Board to also be sighted on this and have a similar presentation/briefing in future.

61.ii    Neighbourhood Work

          Noted.

61.iii   Future Fit

          An update on this was still awaited.

          RESOLVED: That the report be noted.

ACTION: Invite Claire Old, Urgent Care Director to the next Health and Wellbeing Board meeting on 24^th May 2018.

ACTION: Invite the Chief Executive of the Shrewsbury and Telford Hospitals NHS Trust be invited to brief the Health and Wellbeing Board on the sustainability and safety of clinical services in Shropshire.

Regular update reports will be made to the Board on:

       i.          Better Care Fund Update & Performance – report attached.

      ii.          Healthy Lives – report attached and a presentation will be made.

Contact: Tanya Miles, Penny Bason and Val Cross.

62.i     Better Care Fund Update & Performance

Tanya Miles, Head of Operations, Adult Services, gave a verbal update on progress to date with the Better Care Fund.  The Better Care Fund final submission had been duly approved in November 2017.  The Partnership Agreement was nearly complete and subject to ironing out a few issues and firming up agreements between Shropshire Council and the CCG, she was hopeful that a fuller report would be made to the next Health and Wellbeing Board.

In noting this, the chair sought reassurance that the delays would not have any impact on the voluntary organisations concerned.  The Head of Operations assured that over the next two weeks those schemes would be clarified and it would then the CCG would be able to write out to them and confirm their positions, which was welcomed by the Chair.

62.ii    Healthy Lives

The Health and Wellbeing Officer and Healthy Lives Co-ordinator, Val Cross, introduced a report and gave a PowerPoint presentation (copies attached to the signed minutes) updating the Board on the role of the Healthy Lives Programme and each of its areas;

·       Social prescribing

·       Carers

·       SFRS ‘Safe and Well’ visits

·       Diabetes (pre-diabetes)

·       Dementia

·       Mental Health, Housing, Musculoskeletal system (MSK)

·       Falls and Physical Activity and Cardio-Vascular Disease (CVD)

In response to a question on social prescribing, the Director of Public Health informed that the bid for funding had been unsuccessful.

A report is attached.

Contact: Di Beasley, Shropshire CCG.

The Director of Adult Services introduced and amplified a report (copy attached to the signed minutes) informing the Board on progress in meeting the targeted level of bed reductions by April 2019; moving long stay patients out of long stay beds and into the community.  In doing so, he explained that the Transforming Care Partnership (TCP) was a small team across both authorities and to that end they were both working towards two pooled budgets.  However there were two issues of concern that he highlighted to the Board;

·       Finances

Funding moves with each person and there were issues that the money was not coming across with the individuals concerned thus far.  A letter outlining concerns had been sent to the NHSE.

·       Trajectory

Activity at national level was scrutinised very closely.  Currently Shropshire was +1 over the trajectory, which put us on the ‘At Risk’ register, however he assured that as numbers increased from original the deviation, such variations would not be so significant. 

The people the team were working with were also often susceptible and therefore this is turn sometimes made the numbers fragile. He assured the Board that by the end of Quarter 4, numbers should be back on track.

There was an offer to provide an interim report on numbers to a future meeting of the Health and Wellbeing Board, which was welcomed by the Chair.

The Board generally welcomed this report and the work being undertaken, but were concerned about the long-term sustainability of funding for this in the future and asked if this could be looked into.  The Director of Adult Services said that robust discussions were currently being held about long-term funding.  The Board welcomed this and offered to support the Director in any way in future discussions if need be.

RESOLVED:

a)    That the report be welcomed and noted.

b)    That completion of the targeted bed reduction by March 2019 be required by the Health and Wellbeing Board.

c)     That closure of the programme, post March 2019 be confirmed.

d)    That an interim report on numbers be made to a future meeting of the Health and Wellbeing Board.

The Annual Review report will follow.

Contact: Jane Randall-Smith, Chief Officer, Shropshire Healthwatch, Tel 01743 342183.

A report (copy attached to the signed minutes) was received and welcomed by the Health and Wellbeing Board on the activities and impact of Healthwatch Shropshire. 

The end of March 2018 heralded the end of the first Healthwatch Shropshire contract and 1^st April 2018 the beginning of a new three year contract.  This was an opportunity to look back over the first five years of Healthwatch, with a focus on the last 6 months, and then to look forward to the next contract ahead.

Page 5 of the Appendix was highlighted where stakeholders were asked for any suggestions for the future Healthwatch topics (input and ideas).  Generally, the Board welcomed Enter & View, Hot Topics and the successful brand that had been created to date.  A topic suggestion was raised at the meeting; ‘Long term funding for social care’ which was duly noted by Jane Randall-Smith, Chief Officer, Shropshire Healthwatch.  In doing so she also invited individuals to contact her after the meeting if they had any more suggested priorities they might want to be looked at in the future.

It was noted that the engagement of Future Fit when it were to come on stream would create a lot of work for Heath watch and that dashboards might be introduced.  Finally it was noted that due to reduced funding the opening hours of Healthwatch Shropshire would be reduced down from 5 day to 4 days per week and therefore the offices would be shut on Fridays.

RESOLVED:  That subject to the foregoing the report be noted

Report on the work of the Children’s Trust is attached.

Contact: Director of Children’s Services, Karen Bradshaw Tel 01743 254201.

The Director of Children’s Services introduced and amplified a report (copy attached to the signed minutes) which gave an update briefing on the focus of Educational Achievement in Shropshire – ‘Diminishing the Difference’ – a partnership approach to promoting and supporting the health and wellbeing of children, young people and families in Shropshire.

Sadly it was noted that many schools in Shropshire might be missing out on the pupil premium because many families did not take up their entitlement to Free School Meals (FSM).  It was thought this might be due to lack of knowledge or often due to a perceived stigma associated with claiming FSM.  Therefore the Director of Children’s Services stressed the importance of getting the message out to those who were entitled to claim to please do so and thereby draw down as much money as possible for their schools.

RESOLVED: That the information within the report be noted and that all partners consider how they might raise awareness with families they come into contact with and encourage them to claim Free School Meals as far as possible.

Report attached about the work of the Mental Health Trust.

Contact: Director of Adult Services, Andy Begley, Tel 01743 258911.

A regular update briefing paper (copy attached to the signed minutes) was introduced and amplified by the Director of Adult Services; it gave assurance to the Board on the work of the Mental Health Partnership Board and highlighted areas for closer consideration.

There had not been a lot of activity recently and therefore it was suggested that this item become a ‘for information’ item on the Board’s agenda in future and that a report only be made to the Health and Wellbeing Board by exception, which was generally agreed.

The issue of parity of esteem, valuing mental health equally with physical health for younger people was highlighted.  The Board was assured that this topic was being looked at.  It was proposed that this might be an item for the Health and Wellbeing Board to look at in more depth and perhaps from a more strategic point of view. 

          RESOLVED:

a)    That the information contained in the report be noted.

b)    That the Board encourage people to undertake the free training being provided by the Zero Suicide Alliance.

c)     That the issue of parity of esteem be included into the development of the Strategy for Mental Health.

d)    That it be noted the Health and Wellbeing Board Refresh was taking place at 10.00 am on 29^th March 2018.  All Board members were urged to attend or to send a substitute if they were not available.