Stockton-on-Tees Borough Council

Big plans, bright future

Health & Wellbeing Board Minutes

Date:
Wednesday, 29th March, 2017
Time:
2.00pm
Place:
Jim Cooke Conference Suite, Stockton Central Library, Stockton on Tees, TS18 1TU
 
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Present:
Cllr Jim Beall (Chairman),

Cllr Sonia Bailey, Tony Beckwith, Sarah Bowman-Abouna, Sheila Lister, Ali Wilson, Cllr Lynn Hall, Cllr Di Hewitt, Martin Gray, Dominic Gardner (Substitute for David Brown), Alan Foster and Ann Workman,
Officers:
Tanja Braun, Michael Henderson (SBC)
In Attendance:
Pat Lee (NHS England)
Apologies for absence:
Cllr David Harrington, Barry Coppinger, Paul Williams, David Brown, Steve Rose, Saleem Hassan
Item Description Decision
Public
HWB
98/16
DECLARATIONS OF INTEREST
 
HWB
99/16
MINUTES OF THE MEETING HELD ON 22 FEBRUARY 2017
 
HWB
100/16
HEALTH AND WELLBEING UPDATE
RESOLVED that the minutes and issues highlighted be noted.
HWB
101/16
FLU AND PNEUMOCOCCAL IMMUNISATION ACROSS STOCKTON ON TEES
RESOLVED that the report and discussion be noted/actioned as appropriate.
HWB
102/16
EARLY HELP UPDATE
RESOLVED that proposals described in the paper be endorsed.
HWB
103/16
SPECIAL EDUCATIONAL NEEDS AND/OR DISABILITIES (SEND) LOCAL AREA INSPECTION AND DEVELOPMENT WORK
RESOLVED that

1.the report and discussion be noted and the development work identified, be supported..

2. the Board receive a report relating to any key messages coming from any
future Local Area Inspection.

3.the Board receive a further report on integrated working/joint commission at an appropriate point
HWB
104/16
DIRECTOR OF PUBLIC HEALTH ANNUAL REPORT
RESOLVED that the report be noted and Members provide any feedback to the Council's Assistant Director (Public Health)
HWB
105/16
PERFORMANCE UPDATE
RESOLVED that the report and discussion be noted/actioned as appropriate.
HWB
106/16
ADULTS MENTAL HEALTH AND WELLBEING NEEDS ASSESSMENT
RESOLVED that this matter be deferred to a future meeting of the Board.
HWB
107/16
STP
RESOLVED that the update and discussion be noted.
HWB
108/16
MEMBERS' UPDATES
RESOLVED that the updates be noted.
HWB
109/16
ACTION TRACKER
RESOLVED that the Action Tracker be noted.
HWB
110/16
FORWARD PLAN
RESOLVED that the Forward Plan be noted.

Preamble

ItemPreamble
HWB
98/16
Councillor Jim Beall declared a personal interest in item 7, Special Educational Needs and/or Disabilities (SEND), as he was the Chair of Governors of a school that may have Additionally Resources Provision located at it.
HWB
99/16
The minutes of the meeting held on 22 February 2017 were confirmed as a correct record.
HWB
100/16
Members considered a report that presented the minutes of a number of meetings associated with the Health and Wellbeing structure:

-Adults Health and Wellbeing Partnership - 7 February 2017
-Children and Young People Partnership - 15 February 2017
-Children and Young People's Health and Wellbeing Joint Commissioning Group - 1 February 2017

An update on the 100 day challenge was provided [the challenge had recently passed its half-way point]. It was noted that a report on outcomes of the challenge would be provided to a future meeting of the Board.

Members noted that the Children and Young People's Partnership had recently discussed refreshing the Children and Young People's Plan and changing the focus of the Partnership to be more about problem solving, using the skills of partners in a slightly different way. Reference was also made to some discussion around information sharing and the Partnership's intention to look at this in detail, with a view to finding solutions to the problem.

It was explained that the Domestic Abuse Strategy was out to consultation with a number of Partnerships and would come to the Board for endorsement in April.
HWB
101/16
Members considered a report, prepared by NHS England that provided the Board with data relating to the uptake of flu and pneumococcal vaccination across Stockton on Tees, including workforces operating in the Borough.

Issues arising from discussion of the report could be summarised as follows:

- consideration should be given to improving the immunisation rates of the wider social care workforce e.g. domiciliary care and care home staff. It was noted that NHS England and Public Health Teams would work together on this matter.

- a strategic action plan was in the process of being developed via the Flu and Adult Immunisation Board, which included public health representation. The action plan was likely to be available in May/June and would identify actions for health and social care partners, and could include some specific actions relating to Stockton priorities.

- Commissioners could look at using contract clauses/specifications to encourage uptake of vaccinations within provider workforces.

- Members considered information relating to uptake of vaccinations, by staff, working in Foundation Trusts, within the Borough. It was noted that though improvements had been made, uptake at the Trusts was below a national target of 75%. Members heard of the considerable efforts made to increase uptake, but noted that despite the benefits to themselves and patients, some staff still resisted being vaccinated. Staff could not be compelled, through their employment contract, to have a flu vaccination. It was suggested that, locally, there should be actions to dispel the myths associated with vaccination and partners should seek to change the culture of workforces around this issue.

- Members discussed the sensitivities associated with offering incentives to take up vaccinations.

- It was noted that producing an accurate breakdown of people who received vaccination from the GP versus the Community Pharmacy was not possible.

- Members noted that it was also not possible to monitor the number of carers who received a vaccination. It was noted that the Council's Carers' Support service would be going to tender soon and there may be some way to include something in specification that required the provider to maximise and monitor Carer uptake.

- The Board noted that, next year, four year olds would be vaccinated at school and two and three year olds would need to go to GPs. It was difficult to introduce any flexibility into this approach as contractual arrangements were set nationally.
HWB
102/16
The Board considered a report that set out proposals for the next phase of refinement of the early help approach. These proposals had been drawn together following the design sessions held in late 2016 with partners, focusing on the vision process and prevention. The proposals set out the basis of closer integration with the 0-19 model; enhancing the visibility of early help and an increased focus on a number of priority areas.
The new proposals were based on addressing the following:

- Vision, ethos and visibility
- An increased focus on secondary prevention
- Pathways and systems
- Our offer
- Skills
- Collaboration and integration

The report provided members with details of the work that was being undertaken in the areas above.

Discussion:-

- It was noted that the new specification for 0 -19 services was being developed and the role of the Family Nurse Partnership would be considered as part of this.

- Work on the early help approach had included feedback from families; however, given the complex and diverse nature of the system involved, it was difficult to have a complete overview of it. Given this it was important that the correct ethos was in place and this is what was driving the early help approach.
HWB
103/16
The Board received a report relating to the Children and Families Act 2014 which introduced significant changes to the systems and approaches for children and young people aged 0-25 with special educational needs and/or disabilities (SEND). In 2016 an inspection framework was introduced to assess the effectiveness of local areas in fulfilling their statutory duties and in identifying and meeting the needs of children and young people with SEND. The report provided information about the inspection and associated implications and ongoing development work in Stockton-on-Tees in respect of SEND.

Members were reminded that SEND was an area where the Board had agreed to look at integration.

Discussion:

- Members were supportive of working in a joint way, including joint commissioning, any opportunity of working better together in the interests of the public was considered to be positive.
-
- Reference was made to the Designated Medical Officer (DMO) role, which was crucial to the successful operation of the process for Education, Health and Care assessments and plans. Currently, there was no permanent DMO. It was noted that there were difficulties identifying people to take on such roles but the CCG was working hard to resolve this matter soon.

- Members discussed Additionally Resourced Provision and noted that schools had been invited to put forward proposals. The Council was going through a process to make sure there was provision that reduced the need for travel and didn't require children to move at key stages. It was recognised that there may need to be a little compromise to achieve this.

- The Board noted that following the Hartlepool Local Area Inspection the CCG had challenged the finding, as it was felt that it did not adequately reflect some of the good practice. It was also felt that the process had not been positive in terms of identifying learning.

- The Board asked for some key messages to come back to a future meeting following Stockton's Local Area Inspection.

It was noted that, at an appropriate point, the Board would receive a further report on integrated working/joint commissioning.
HWB
104/16
Members were provided with the final draft of the Director of Public Health Annual Report for 2015/16.

Members noted that the key focus of the report was inequalities and the work that was ongoing with partners to address inequalities through proportionate universalism.

The Board was asked to provide comments on the report to the Council's Assistant Director (Public Health).
HWB
105/16
The Board considered a report that provided a performance update on key indicators from the performance monitoring framework for the Joint Health and Wellbeing Strategy delivery plan, as at March 2017.

Discussion

- It was noted that the North Tees and Hartlepool Foundation Trust had signed up as a pilot site to try and get more smoking quitters. It was reiterated that smoking was still the biggest killer and therefore addressing it could have the biggest impact on individuals and families.

-‘Smoke free areas', around schools, parks etc. needed to be refreshed.

-Instead of just treating related illnesses, smoking needed to be looked on as an addiction, which needed a treatment too.

-Members noted the drop in the use of stop smoking services and it was suggested that there should be a discussion about what other work this team could do to help reduce prevalence. It was also suggested that all staff, coming into contact with the public could provide brief interventions around smoking.

-Reference to using cigarettes as a treatment method rather than a problem, was raised again.
HWB
107/16
Members received a brief update around the Sustainability and Transformation Plan.

Members noted some of the work that would be going on during the purdah period for the Tees Valley Combined Authority Mayoral elections. This included
trying to update manpower planning and the impact of the new junior doctors' contract.

The Board was reminded that some block social care finance had been mentioned in a recent budget. Further information was needed on this, in terms of what specifically the money was intended for.

Reference was made to a recent article in the local press, reporting claims that urgent care arrangements were the precursor to closure of A and E, at North Tees Hospital. Alan Foster, Chief Executive of the Trust, confirmed that there were no plans for this.
HWB
108/16
Members provided the following updates:

- The Chair circulated a letter that had come from a meeting of Tees Valley Health and Wellbeing Board's Chairs' Network that had been attended by the local STP Lead, and set out some shared concerns of the seven local authorities making up the STP area.

- The Chair explained that the Network had discussed the possibility of arranging a Tees Summit to look at issues across the Tees footprint. Members present expressed their support for such an event and were encouraged to provide details of any subjects they may wish to see considered, to the Chair of the Board, or the Assistant Director (Public Health)

- Members were informed of a spate of drug overdoses. There had been 66 overdoses with 6 deaths since the 27th January 2017, all related to a bad batch of heroin circulating in the community. The heroin has been cut with other substances and had some serious additional side effects. The substance drugs misuse service was working with the Police, Community Safety and CGL and a range of interventions had been put in place to provide additional support to those affected and at risk.
HWB
109/16
Members considered the Board's Action Tracker.
HWB
110/16
Members considered the Board's Forward Plan.

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