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

The Sustainability and Transformation Plan for Shropshire, Telford & Wrekin

A presentation will be given.

Contact: Martin Harris / David Stout, Telford and Wrekin CCG

Better Care Fund, Update and Performance

Report to follow.

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

Healthy Lives Update

Report attached.

Contact: Val Cross, Shropshire Council

i.        Shropshire Care Closer to Home

The report of the Shropshire Clinical Commissioning Group which provided an update on the Care Closer to Home programme was received for information only (copy attached to the signed Minutes).

RESOLVED: That the report be noted.

ii.       Healthy Lives Update

Val Cross, the Health and Wellbeing Officer introduced and amplified her report (copy attached to the signed Minutes) which provided the Board with an update on the Healthy Lives programme.

The Health and Wellbeing Officer updated the Board on the following areas:

·         Cardio-Vascular Disease (CVD) risk prevention

·         Physical Activity – Elevate

·         Social Prescribing

·         Carers

In response to a query, the Health and Wellbeing Officer reported that the impact on both the lives and wellbeing of children was indeed being considered and that All-Age Strategies were starting to be produced eg All-Age Mental Health Strategy and All-Age Carers Strategy.  She informed the Board of a Social Prescribing event taking place on 5 December with a focus on young people.

In response to a query in relation to the future roll out of AF (Atrial Fibrillation) devices, the Director of Public Health explained that costings and the outcomes of roll out were currently being worked up and that this would be reported to a future meeting of the Board.

The Accountable Officer reported that each PCN (Primary Care Network) would have a mandatory social prescribing function.  The Director of Public Health informed the Board of a workshop taking please on 12 December where partners had been invited to look at rolling out the social prescribing model across the County including how to link in volunteers.  A clearer picture would therefore be presented to the next meeting of the Board setting out the current position and what happens in Shropshire.  Invitations would be cascaded widely the following week.

RESOLVED: That the report be noted.

iii.      Better Care Fund, Performance

Penny Bason, the STP Programme Manager introduced her report (copy attached to the signed Minutes) which set out the Better Care Fund (BCF) Plan for 2019/20, along with the variation to the Section 75 Partnership Agreement for endorsement by the Board. 

The STP Programme Manager reported that the BCF Plan had kept the same focus as previously which matched the national Eight High Impact Model to keep people out of hospital for as long as possible.  The BCF Plan still had to go through the assurance process but in terms of expenditure and narrative, the BCF Plan matched that in the STP Plan.

The STP Programme Manager explained that variations to the Section 75 Partnership Agreement were around changes within the scheme in relation to pooled budget amounts, risk sharing and how to work together.

The Chairman congratulated the STP Programme Manager for pulling the Plan together which had been a huge amount of work.

The Chairman then highlighted the risks around the continued reliance on grant funding and the ability to plan in the longer term for Adult and Children’s Social Care and he urged Members to lobby their MPs and Central Government for a longer-term solution.

RESOLVED:

A.  That the BCF plan attached at Appendix A be endorsed.

B. That the variation of the Section 75 Partnership Agreement attached at
     Appendix B be endorsed, prior to final approval by Shropshire Council and
     Shropshire CCG.

C. That the risks associated with continued reliance on grant funding to pay for
     system initiatives to support transfers of care and admission avoidance be
     noted.

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

David Stout, the Interim Transformational Director gave a presentation on the STP Long Term Plan, which gave a high-level overview and timeline of the system Long Term Plan (LTP) submission (copy of slides attached to the signed Minutes).  He reported that the LTP was due for submission the following day, Friday 15 November 2019.  He commented on the phenomenal amount of engagement that had gone into producing the LTP and was confident that it contained no great surprises.

The Interim Transformational Director then gave a brief update on the individual Chapters contained within the LTP, as follows:

·         Chapter 1 – sets out how the Plan was pulled together; the vision of working together more collaboratively and blurring the boundaries between commissioners and providers; plans for an Integrated Care System; the approach to system development, including the establishment of a shadow ICS Board which would start meeting in early 2020 to help drive forward implementation of the Plan; person-centred approach to system development.

·         Chapter 2 – Provided an overarching view of the health and wellbeing of the population for which the two JSNA documents feed into.

·         Chapter 3 – Population Health Management (PHM), ensures services are based on data and evidence to ensure that the delivery of health and care services achieve the best outcomes.

·         Chapters 4, 5 and 6 are the service transformation elements of the Plan.

·         Chapter 4 – to ensure enough effort was put into prevention to keep people healthy for as long as possible and ensure that people only go to hospital when they really need to.  This was a key part of the Plan and focused on how to stop the increase in non-elective admissions.

·         Chapter 5 – addressed Mental Health prevention and its impact on A&E attendance.

·         Chapter 6 – focused on people who most need acute care.

·         Chapter 7 – sets out the plan to transform the workforce.

·         Chapter 8 – looked at clinical and non-clinical support services and working together to drive efficiencies.

·         Chapter 9 – sets out the vision for digital support and utilising technology more effectively.

·         Chapter 10 – sets out the estates strategy and opportunities to improve/use more effectively.

·         Chapter 12 – sets out the next steps in delivery of the Plan.

The Interim Transformational Director informed the Board that although the LTP did not financially balance, it set out a reasonable, plausible plan.  The LTP was due to be signed off mid-December so they had from now until April 2020 to develop an implementation plan.  He confirmed that the delivery plan would come back to this Board at a future meeting. 

Concerns were raised about whether the Plan was ambitious enough to deliver prevention, particularly for young children and families and the impact on children’s health and wellbeing.  In response, the Accountable Officer felt that the LTP needed to be as ambitious as possible and that this would be tested as it was implemented.  It was confirmed that children were a key priority and were addressed in all sections of the LTP rather than having a separate section for them.

The Chairman noted that a lot of ambition had been invested in the expectation of delivery and that this ambition needed to be translated into what the technical requirements would be.  He urged caution not to underestimate the difficulty and time required to achieve a culture change and new ways of working.

RESOLVED:  That the update be noted.