Stockton-on-Tees Borough Council

Big plans, bright future

Health & Wellbeing Board Minutes

Date:
Wednesday, 26th April, 2017
Time:
2.00pm
Place:
First Floor Committee Room, Town Hall , High Street, Stockton on Tees, TS18 1AU
 
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Present:
Cllr Jim Beall(Chairman), Cllr Mrs Ann McCoy, Cllr Sonia Bailey, Cllr Di Hewitt, Tony Beckwith, Dominic Gardner (substitute for David Brown), Cllr Maurice Perry (substitute for Cllr Lynn Hall) Steve Rose, Ali Wilson, Paul Williams, Ann Workman
Officers:
Michael Henderson, Mandy Mackinnon, Sue Reay, Johanne Parker
Apologies for absence:
Cllr Lynn Hall, Cllr David Harrington, Barry Coppinger, Sheila Lister, Sarah Bowman-Abouna, Saleem Hassan, Martin Gray
Item Description Decision
Public
HWB
1/17
DECLARATIONS OF INTEREST
 
HWB
2/17
MINUTES OF THE MEETING HELD ON 29 MARCH 2017
 
HWB
3/17
HEALTH AND WELLBEING UPDATE
RESOLVED that:

1. the minutes and discussion be noted.

2. feedback relating to the two issues raised by the Domestic
Abuse Steering Group, as detailed above, be provided to the
group.

3. the Steering Group receive updates from the CCG around work
it was undertaking to raise awareness of Domestic Abuse.
HWB
4/17
STOCKTON BETTER CARE FUND - QUARTERLY PERFORMANCE
RESOLVED that:

1. the Quarter 3 Better Care Fund performance submission be
endorsed.

2. the discussion detailed above be noted and considered in the
context of how performance might be improved in certain
areas.
HWB
5/17
DOMESTIC ABUSE STRATEGY 2017 -2022
RESOLVED that:

1. the Domestic Abuse Strategy 2017- 2022 and the Domestic
Abuse Action Plan 2017 - 2018, be endorsed.

2. the Board's comments on the launch of the Domestic Abuse Strategy be forwarded to the Domestic Abuse Steering Group.
HWB
6/17
ADULT SOCIAL CARE STRATEGY
RESOLVED that:

1. the overall approach of the draft Strategy be supported.

2. the comments provided be considered.

3. consideration of how the Adults' Strategy might link with other
strategies be undertaken outside the Board's meetings.
HWB
7/17
MEMBERS' UPDATES
 
HWB
8/17
ACTION TRACKER
RESOLVED that the Action Tracker be noted.
HWB
9/17
FORWARD PLAN
RESOLVED that the Forward Plan be noted.
2pm/4pm

Preamble

ItemPreamble
HWB
1/17
There were no declarations of interest.
HWB
2/17
The minutes of the meeting held on 29th March 2017 were confirmed as a correct record.
HWB
3/17
The Board received an update, which detailed the minutes of meetings associated with the Health and Wellbeing structure:

- Children and Young People Partnership - 22 March 2017.

- Domestic Abuse Steering Group - 8 February 2017

The Chairman explained that, at the Domestic Abuse Steering Group, held in February, an issue was raised relating to charges, levied by some GPs, for providing letters of evidence to victims of Domestic Abuse. Such letters were used to help secure legal aid. It was indicated that the issue had already been recently raised with GPs, with a request that the charge should not be levied. In addition, the GP Federation representative indicated that he would have conversations with relevant practices, but the final decision on this issue lay solely with those practices. The discussion above would be fed back to the Steering Group, which would monitor the situation.

The Chairman then referred to discussion at the April meeting of the Steering Group, relating to low levels of GP referrals to specialist services (Harbour). It was explained that this was likely to be because GPs tended to signpost people, rather than undertake a formal referral. The low level of referral across health agencies was highlighted and it was noted that TEWV was undertaking work to improve this, including awareness raising and training. It was explained that the referral form was eight pages long and it was accepted that this may be a barrier to the formal referral of victims, and why signposting was often preferred by health professionals. It was queried if Harbour could simplify the referral process?

Wider discussion, relating to Domestic Abuse, could be summarised as follows:

- Partners needed to ensure that appropriate members of their staff undertook routine enquiries around Domestic Abuse.

- The CCG was committed to raising awareness of Domestic Abuse within its own organisation and within the services it commissioned.

- It was confirmed that work to raise awareness within primary care was already underway and it was suggested that updates on this should be provided to the Steering Group through the CCG's representative.
HWB
4/17
Members considered a report that provided the Board with the Better Care Fund (BCF) Quarter 3 2016/17 submission, to NHS England.

It was explained that, since the last submission there had been no improvement in non-elective activity, delayed transfers of care and reablement. The Board's discussion centred on this lack of improvement, given its role in facilitating integrated working and resolving problems:

- It was noted that the BCF budget was a small
part of the jigsaw, and there was lots of other
work in these areas that would impact on
activity. It was important to scrutinize
performance but there were limits to what the
BCF would achieve on its own.

- The focus of BCF 2017/18 was much more on
integration and pathways out of Hospital, and
this focus may have a positive influence on
activity.

- It was accepted that some of the increase in
non elective admissions could be
readmissions, though there was no specific
data gathered around this.

- Members noted that, currently, national
financial plans were to increase BCF funding
and the Board was reminded that there was an
option to increase the pot with local resources.

- It was explained that the target of reduction,
for non-elective admissions, was 5%, with a low
starting base.

- The Board considered that the interventions
being undertaken were appropriate, however,
there was discussion around whether those early
interventions were always delivered to the right
group of people. Predominately, interventions
were provided for those who contacted social
care, though work was ongoing to extend this
more into health. This included the triaging of
individuals from a health and social care
perspective. It was noted that GPs had data that
could predict with 80% certainty, which
individuals would need admission to hospital. in the near future and this could
be used to target proactive interventions, at an earlier stage.

- The Board was reminded that services in the acute trusts had to be
maintained to meet demand and resources could not be released for
prevention until that demand was reduced.

- It was explained that issues around BCF performance continued to be considered at a local Stockton group and at the North of Tees Partnership. It was agreed that evidence needed to be continually evaluated and approaches challenged on a regular basis.

- A strategic meeting, focused on Stockton and looking at integration work, was
planned. The meeting would use data from the 100 day challenge.

- - The Board supported patient choice but noted that delays in leaving hospital
- could see a deterioration in the health of patients affected.
HWB
5/17
Members received a revised Domestic Abuse Strategy (2017-22) for the borough, which had been developed by the Domestic Abuse Steering Group. It was explained that the new strategy built on the work of preceding years and strengthened the focus on working together, as local partners, agencies and communities to prevent individuals from becoming victims and perpetrators of domestic abuse.

The suggested strategic approach would support professionals to identify and deal with the earliest signs of abuse, stop abuse before it happened, prevent abusive behaviour from becoming entrenched and prevent perpetrators from moving from one victim to the next. Critically, it would provide victims and their families with support, before a crisis point was reached.

It was noted that extensive consultation had taken place, including, with:

Adults Health & Wellbeing Partnership
Children & Young People Partnership
Safer Stockton Partnership
Local Safeguarding Children Board
Teeswide Adults' Safeguarding Board (via Business Support Unit).

The Board was provided with a copy of the Strategy (2017 - 2022) and the Action Plan (2017/18) and endorsed both documents.

Members were informed that the Strategy had been scheduled to go to Cabinet on 18 May 2017 and, in line with the Council's Constitution, to full Council for formal agreement on 21 June 2017.

The Board noted that, following consideration, by Cabinet in May, and agreement by Council in June, the Domestic Abuse Strategy would be formally launched.

Members noted that the action plan for 2017/18 focused on specific priorities. Other important issues would be included in future years' action plans and all partners would have an opportunity to influence this.

Members discussed the launch of the Strategy and made the following suggestions, for consideration by the Domestic Abuse Steering Group:

- ‘hard launch'
- A specific high profile event, with the press in
attendance.
- A prominent person to attend the event and
endorse the Strategy e.g. a local sports star.
- Must be branded as a multi-agency strategy.
- Attempts should be made to have survivors of
domestic abuse at the event.
- It would be important to have Board members
and other partners at the event.
HWB
6/17
Members considered a draft Adult Social Care Strategy for the Borough.

The Board was asked for its views on the draft document, the proposed vision, objectives and overall approach and direction of travel.

Discussion could be summarized as follows:

- Members supported the format and felt it was easy and clear to read.

- It was queried if the strategy could be even
more radical and transformational around how
adults' services would be delivered going
forward.

- Understandably, frail and elderly featured
strongly in the strategy and, perhaps,
references to other adults, who needed
different kinds of support, needed to be
strengthened.

- It was suggested that the Mental Capacity Act
(2005) should have more profile in the
document, as it was a fundamental piece of
legislation relating to the work undertaken in
Adult Social Care.

- A short summary version of the strategy
would be produced.

- Consideration should be given to how this
strategy might connect with certain CCG
strategies, in terms of delivery. A discussion
around this would be held outside the Board
meeting.

Members were asked to provide any comments on the strategy within the next two weeks.
HWB
7/17
Members were informed that the health initiatives/social prescribing programme, funded by the CCG, would take place again this year. Members were asked to identify, to Catalyst, any organisations that had initiatives involving health outcomes. The funding associated with the programme was around 500k.

CCG had commissioned, from the GP Federation, two GP practices to be open every evening until 8pm, 3 hours on a Saturday and 2 hours on a Sunday. Appointments would be bookable through patient's own GP and was for planned care only.

The Urgent Care Centre had gone live on 1st April, located next to A and E, at North Tees.

Public Health Team had put together a calendar of the year identifying various activities like Stoptober, Alcohol Awareness week and it was suggest that a joint calendar may be produced in the future, so that a planned response to events could be arranged.
HWB
8/17
Members considered the Board's Action Tracker.
HWB
9/17
Members considered the Board's Forward Plan.

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