|There were no declarations of interest.|
|The minutes of the meeting held on 29 January 2015 were agreed as a correct record and were signed by the Chairman.|
|The minutes of the above meetings were noted. |
|The minutes of the Adults Health and Wellbeing Partnership held on 6 January 2015 and the Children and Young People's Partnership held on 26 January 2015 were noted.|
The Chairs of the Partnerships provided a brief overview of areas considered at the above meetings, including:
- tobacco and alcohol action plans - discussion had identified some work that Stockton Riverside College and Durham University would undertake to try and understand some of the motivations and attitudes of young people relating to smoking.
- arrangements for an event, at which, partners, serving on the Adults Health and Wellbeing Partnership, could provide an overview of how they were contributing to achieving priorities.
Children and Young People
- an analysis of activity and performance in terms of services for children and young people who were looked after by the Council, including discussions around pressures and actions to support improvement.
- feedback from looked after children, who had attended a meeting of the Partnership, which had been excellent, and had generated a number of actions, including one around transitions and arrangements relating to looked after children wishing to access what the college offered.
|Members considered a report that summarised responses received to formal consultation on the draft Pharmaceutical Needs Assessment (PNA) for Stockton Borough, and presented the final draft to the Board for consideration and approval.|
Members noted that a key issue coming from the consultation was that patients and health professionals were not always aware of the full range of services available in community pharmacies. Raising awareness would be picked up by Tees Valley Public Health Shared Services.
The Board noted that there were no gaps in service that couldn't be addressed through existing contractors and commissioned services. This included Port Clarence which had a geographically isolated population. However, it was considered that needs were met by existing provision. There was therefore no current need for any new providers of pharmacy services in the Borough.
It was noted that there was substantial endorsement by patients and stakeholders of the potential value of a Pharmacy First service but there was not currently a commissioned service. A pilot seasonal ailments service, which was an example of a 'Pharmacy First' type services was currently operating for 3 months to 31st March 2015 and was commissioned by the CCG. This scheme would be evaluated in due course. There was some discussion on whether such a service came within the statutory remit of the PNA. This point needed to be clarified, but it was agreed that it was useful to keep the reference to the service in the document.
Members noted that the document had been future proofed in terms of projected housing developments.
During discussion reference was made to large operators who delivered drugs to people's homes. It was suggested that this could have an effect on smaller pharmacies and some of the services anchored in them.
|Members received a report that provided an update on primary care co-commissioning.|
It was explained that NHS England had chosen a standardised approach across the country to implement co commissioning of primary care. This presented the CCG with three proposed models of co commissioning.
Model 1 - Greater Involvement
Model 2 - Joint Commissioning
Model 3 - Delegated Arrangements
Members noted the models and the associated opportunities and risks that each presented.
It was explained that that the CCG Council of Members had determined that it wished to progress with model 2 - Joint Commissioning during 15/16. The Council of Members did not want to opt for full delegated arrangements as it was not possible to have certainty around budgets at this time. It was anticipated that NHS England would look for full delegation after the first year.
It was explained that CCGs could create joint committees with each other and with NHS England. It was for the NHS England Area Teams and CCGs to agree full membership of their joint committees. It was noted that a local Healthwatch representative and a local authority representative from the Health and Wellbeing Board would have the right to join the joint committee as non-voting attendees. There was a suggestion that these positions should have voting rights on a par with the rest of the Committee. In regard to these specific positions the Board asked for:
- clarification of whether those appointed would be acting as
attendees, or observers, as they were described in both of these
ways, in different parts of the governance documents.
- clarification on whether there was any discretion around the
voting rights of those appointed. Did guidance recommend/suggest
their status on the committee or was it mandatory/directed.
- an indication of what the time commitments might be for those
Discussion continued and touched on:
- an observation that the new arrangements were similar to the former Family Health Services Authority.
- conflicts of interest and capacity issues
|Members received a report that presented an overview of planning guidance entitled 'The Forward View into Action: Planning for 2015/16', which built upon the vision set out in the 'NHS Five Year Forward View'. It was noted that the CCG had to undertake a refresh of the operational plan for 2015/16 and the report covered issues associated with that.|
Members considered the key focus points of the Forward View into Action planning guidance and particular discussion took place on prevention and reducing local health and health care inequalities. It was suggested that further discussion on this should take place at a future meeting of the Board.
It was explained that for the refresh of the operational plans templates had been issued to complete in relation to activity, finance and planning outcomes.
In addition to these templates, the CCG was also required to submit, as part of the NHS England North East and Cumbria sub-regional team (formerly known as the NHS England Durham, Darlington and Tees Area Team)assurance process:
a revised plan on a page
a self-assessment of operational plan risk
The sub-regional team's approach to plan assurance was both to seek to add value to commissioner's plans, as a critical friend, and to provide assurance to NHS England that plans were credible, deliverable and met the NHS Constitution, supported by agreed contracts with providers.
Members noted the timetable for submission of plans.
Due to the tight timescales and current unavailability of key elements of the national plan template (e.g. the quality premium ambition part of the UNIFY template had not yet been released) the CCG was not in a position to share draft submissions.
Once the quality premium measures were released nationally, CCGs would be required to work in partnership with local government partners, where necessary, to review and set quantifiable levels of ambition.
Given the national timescales the CCG had to follow, to submit plans, it was suggested that the Board provide the Adult's Health and Wellbeing Joint Commissioning Group and Children and Young People's Health and Wellbeing Joint Commissioning Group with delegated authority to work with the CCG to set quantifiable levels of ambition where relevant. It was suggested that the Adults' Health and Wellbeing Partnership and Children and Young People's Partnership may be able to provide input into this process too, if timescales permitted.
|Members received a report that provided suggestions to strengthen the overall Health and Wellbeing system across the themes of Governance, Risk and Assurance of Outcomes, Information and Intelligence.|
Members supported the suggestions.
|Members considered the Forward Plan and agreed that a report be presented to the March meeting around arrangements for the CQC's inspection of North Tees and Hartlepool NHS Foundation Trust, in July, with a report on outcomes being provided following the inspection.|
|The Chairman provided an update, in which he highlighted:|
1. a joint letter he had received from the Department of Health and
NHS England, which provided an update on a number of developments
relating to out of hospital care. The letter expressed a wish to
see a significant reduction in medically fit patients unable to
leave hospital and, in particular, in Delayed Transfer of Care.
The letter referred to :
- a temporary National Helping People Home Team to help drive
and co ordinate action around out of hospital care.
- additional funding for social care
- capacity mapping and identifying what capacity was
available within the residential, home care and voluntary
- applying best practice, including some examples.
2. an e mail detailing drop in clinics and interactive workshops
regarding the implementation of the Better Care Fund.
3. a joint letter from the Association of Directors of Adult Social Care Services, Department of Health, Local Government Association and NHS England relating to a review on progress against the programme of work established in response to Winterbourne View. The letter also referred to a document, Transforming Care: Next Steps, which set out the plans for the next stage of work in this area.