Stockton-on-Tees Borough Council

Big plans, bright future

Adults' Health and Wellbeing Commissioning Group Minutes

Wednesday, 29th November, 2017
2.00 p.m
Conference Room 2, Municipal Buildings, Church Road, Stockton on Tees
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Ann Workman (Chairman) (SBC), Cllr Jim Beall (SBC), Emma Champley (SBC), Sarah Bowman Abouna (SBC), Paula Swindale, (CCG)
Michael Henderson, Mandy Mackinnon, Karen Shaw, Ruby Poppleton, Louise Deer, Jane Smith (SBC), Karen Hawkins (CCG
Apologies for absence:
Kate Birkenhead (NHSE), Liz Hanley (SBC)
Item Description Decision

1. a further 12 months' extension be agreed.

2. the stop smoking service development pilot, within the VCS setting, be agreed.

3. a quick expressions of interest process be undertaken.
RESOLVED that the update report be noted.

1. the mapping exercise, referred to in the report, be expanded to incorporate projects from the Better Care Fund and from the CCG.

2. appropriate services be maintained during the development of the Early Help model.

3. data, relating to risk factors, leading to the need for social care, be collected and collated as outlined in the report
RESOLVED that information and discussion be noted and the spreadsheet referred to above circulated.
RESOLVED that the Forward Plan be amended and discussion noted/actioned
  • Report (80K/bytes)
  • |
    Report (385K/bytes)
RESOLVED that the report and discussion be noted/actioned as appropriate.


There were no declarations of interest.
The minutes of the meeting held on 23 October 2017 were confirmed as a correct record.
Members considered a report that provided an update on the current contractual position of the Specialist Stop Smoking Service and requested that the option to extend, for a further twelve months, be approved

The report also informed the Commissioning Group of the stop smoking service development, through identified potential VCS organisations, to pilot the delivery of services.

It was explained that the current joint contract, involving Stockton on Tees Borough Council, Hartlepool Borough Council was with North Tees and Hartlepool Foundation Trust and was due to expire 31/03/2018, however, there were options to extend the contract.

The current cost of the service, for a 12 month period was 564, 380, with Stockton's contribution being 359,485.

Members were reminded that the number of people accessing local stop smoking service was reducing each year, which was in line with the national picture. The Council's Public Health team was aiming to pilot the stop smoking services, through local VCS organisations. Three potential organisations had been identified to be trained and provide stop smoking advice, support and Nicotine Replacement Therapy (NRT) treatment to local residents through the NRT voucher scheme. The organisations were:

• Five Lamps
• Billingham Environmental Link Project (BELP)
• Middlesbrough & Stockton MIND

It was explained that, during the next 12 months, evidence would be gathered around the pilot, to understand what worked and what did not, in order to support the service development of the future stop smoking services.


- The pilot was in line with a community based approach to provision, understanding community needs better and responding to them in a tailored way.

- Also supported a focus on people with mental health issues, pregnant women and people living in areas of the greatest deprivation.

- It was noted that the pilot could be extended if results were positive. The organisations identified, to be involved in the pilot, were considered to have sufficient capacity.

- It was important to make sure that the organisations were not being double funded.

- Payment would be made according to activity and results, with a small payment for training.

- Timescales - if the pilot was going to inform next steps, in terms of any new model of provision after March 2019, then it would need to be completed and conclusions made by September next year to enable procurement and mobilisation.

- It was suggested that a very quick expressions of interest process be undertaken to gauge if any other VCS organisation were interested in the pilot work.
Members were provided with a report that gave an update on the commissioning arrangements for sexual health services in Stockton and the progress to implement a revised model of delivery with a clear focus on prevention, testing and treatment and promotion of health care.

It was explained that data was being gathered on people who crossed boundaries to access services.

Members noted that recharge arrangements were in place for people living outside the Tees Valley, using Tees Valley services and vice versa. The current recharge arrangements were currently being reviewed.
Consideration was given to a report that provided an update on progress and intentions to provide early help to adults and older people in order to contribute to the delivery of the vision set out in the Adults Social Care Strategy.

It was explained that in order to deliver the vision a three tiered approach had been identified:

I. Primary Prevention- Provision was universal: for people without social care needs and/or a health problem; promoting health and wellbeing; addressing social, economic and environmental risk factors.

ii. Early Help- Provision targets people at risk of developing social care needs and/or a health problem. Identify, minimise or alleviate risks.

iii. Adults Social Care- Provision for people with assessed social care needs and/or a health problem. Prevent complications, improve quality of life and stop needs becoming greater.

It was the Council's ambition to develop a more co-ordinated, robust, early intervention model that could identify and provide low level support to people who needed it.

Members noted that current provision was being mapped and this had revealed a number of services and service models.

The mapping and discussion with stakeholders suggested that there was little provision that :

- Focused on preventing loneliness and social isolation

- Provided befriending/handholding/community bridging support to individuals who were not eligible for social care support.

Members agreed that identifying precursors, or risk factors, which led to the need for social care intervention was important and this could be achieved by identifying:

• the reasons individuals, who do not meet the threshold(s) for social care support, are referred.

•the commonest presenting issues, when accessing social care support and identify the associated precursors (risk factors)

The JSNA identified the wider determinants and risk factors associated with social care need. Collating data on the presenting issue(s) at point of service would strengthen our understanding and indicate the opportunities to prevent, reduce and mitigate risk factors which lead to social care need.

Combining what was known about Early Help, from the mapping, and what could be learned from the data would assist in the development of an early intervention model. In order to maintain infrastructure and capacity during this development period the Public Health Team was seeking to extend existing contracts with SSNP and First STEPS until 30th September 2018.

- The principles of wellbeing and the Care Act needed to be captured in this work and further discussions would take place in this regard.

- It was accepted that it would be sensible to continue certain existing services, to maintain capacity and infrastructure during development of the Early Help model. However, it was agreed that these services needed to be explicitly identified and shared with the CCG.

- Members highlighted the importance of commissioners working together. Consideration of who the most appropriate CCG officer(s) were to work on the mapping exercise would be given and provided to the Council.

- The prevention work-stream under the new BCF Governance Structure would lead work on the expanded mapping process.
Members were reminded that a Better Care Fund Development Day had recently been held, to look at BCF going forward, including its governance structure.

Members noted a document detailing the proposed governance and delivery structure and were provided with brief details of the individual work-streams involved.

It was explained that any business cases, developed by the work-streams, would be passed to the BCF Delivery Group, they would then be submitted to the Commissioning Group for discussion before the Integration Board, for ratification and approval

A performance framework was being developed and each group had a consistent Terms of Reference. A spreadsheet had been developed that showed all areas of funding and when contracts were ending. This would be used as a tracker and could be shared with the Commissioning Group.

It was noted that, given the number of groups (9), the capacity of officers was likely to be an issue and this was a potential barrier, so would need to be monitored and considered going forward.

It was explained that the governance arrangements would need to be approved by the Integration Board.

Members agreed that linkages with the Health and Wellbeing Board needed to be made clearer in the governance structure diagram presented.
Members considered the Forward Plan and agreed a number of amendments.

It was agreed that officers from the Council and the CCG's Director of Nursing would meet to consider links between Alcohol Strategy/Services and Alcohol CQUIN.
Members considered a report that provided an update relating to the Adult Carers' Support Service.

The current service would end on 31 December 2017 and be replaced with a Stockton on Tees Borough Council, provided service. A draft specification for the service was provided. It was noted that the sitting service would, in the short term, be provided in house, from 1st January 2018, with other options considered at a later date.

It was explained that a timeline had been developed to summarise the actions required and progress made to implement the delivery model by 1st January 2018 and to ensure continuity of services. This would be extended and further developed to identify actions required up to the end of March 2018 to establish and embed the service within Adult Operational Services.

Members agreed that it was important to get the outreach locations up and running very quickly.

Data on the sitting service could be anonymised and provided to the CCG.

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