|There were no declarations of interest.|
|The minutes of the meeting held on 26 September 2017 were confirmed as a correct record.|
|Members were provided with an update on the Domestic Abuse Strategy 2017 - 22.|
During discussion it was pointed out that, within some communities in the Tees Valley, there appeared to be a tolerance/acceptance of a level of Domestic Abuse. Partners would need to work differently to influence this and should take every opportunity to strongly push the message that any level of Domestic Abuse was totally unacceptable.
Discussion continued and reference was made to the procurement exercise that the Council was going through to identify a specialist domestic abuse services provider. The Council had committed further significant resources to this service. It was noted that there had not, to date, been a similar level of financial commitment by other partners and there was concern that this could impact on delivery of the priorities of the Strategy.
Reference was also made to the ongoing low level of referrals from Health settings. It was suggested that this needed to be addressed, as this was a key way of identifying incidents at an early stage. The current level of referrals did not reflect what was happening in the community. Fiona Adamson from Hartlepool and Stockton Health indicated that she would meet with Public Health (Mandy Mackinnon) to look at this in further detail and identify work that might improve the current situation in terms of GP referrals. Other relevant representatives indicated that they would raise this issue within their organisations.
|Members considered a report that provided details of the strategic priorities for the refresh of the Children and Young People's Mental Health and Wellbeing Transformation Plan.|
It was noted that reviews, and mapping of services, would be undertaken to understand the whole system and identify gaps, amend pathways and commission differently.
Work would continue to develop and maintain waiting time initiatives with TEWV to ensure that children & young people, who required a specialist service could access it in a timely manner. All areas of the TEWV service would continue to be monitored through the CCG contract management processes.
A key partner would continue to be schools and joint commissioning opportunities would be explored.
It was explained that there was a designated financial resource for Future in Mind Transformation. It had been determined that all projects already committed to would be rolled over into 17/18. However, there was a process in place to allocate additional funds from the financial pot, whereby Stockton Borough Council and other parties had submitted proposals for projects which they believed would help meet the Future in Mind objectives.
These proposals would be evaluated by a multi agency steering group which would determine where the resources were allocated. All resources allocated would be closely monitored to ensure they achieved the outcomes proposed.
It was explained that the refreshed plan had to be signed off by both the CCG and the local authority and displayed on relevant websites by the 31st October 2017.
The Board was informed that priorities could be changed, however, the principles behind them and the ethos of system transformation would not. The Health & Wellbeing Board was requested to delegate the sign off of the plan to the Director of Childrens Services, in consultation with the Chair of the Health and Wellbeing Board, to meet required deadlines.
The Board would be updated as to relevant financial decisions when they were finalised.
- Members were provided with details of the governance and financial arrangements relating to the plan and noted that funds had not been ringfenced.
- It was explained that there would be links to other projects, such as 0-19 and early help services.
- the Children nd Young People's transformation plan would slot into the developing Mental Health Strategic Action Plan that covered the life course.
- It was agreed that, in future years, the timing of the plans presentation to the Board should allow more time for consideration and should fit better with all organizations' budgetary cycles.
- the Children and Young People's Partnership was looking at the approach to risk and resilience in schools.
- it was noted that the Tees Valley had the highest referral rate to CAMHS in the country and this continued to rise. It was very important that the actions in the plan began to have an effect on this referral rate.
- It was suggested that, in the short term, early help and interventions may be increasing demand for services and moving referral rates towards actual prevalence.
- all members strongly supported the proposed work in schools.
|Members considered a report that presented progress, to date, regarding the development of the Autistic Spectrum Disorder Diagnostic Pathway. The report also provided details of demand and waiting times for assessment .|
Members noted that demand was high in Stockton and reasons for this were not fully understood. It was suggested that, in Stockton, children were not directed to alternative services, where their needs might be met, to the same degree as other areas. This meant that children would be directed straight to assessment and diagnosis. However, it was suggested that demand in Stockton was closer to expected prevalence in the community. It was explained that, because of the high demand and a fixed amount or capacity for dealing with that demand waiting times remained unacceptably high. Currently, the longest wait a child under 5, in Stockton, had waited for an assessment was 17 months.
The Board was provided with details of an event, held earlier in the year, to look at the way children, with suspected Autism, were being cared for locally. Following the event an expert reference group had been established to build on the outcomes of the event and develop a vision for a new pathway.
Details of the vision were provided to the Board, together with some short and medium term actions. The actions would attempt to deal with current waiting times but also consider capacity and demand to help manage waiting times going forward.
The emphasis of the new pathway was early identification of needs, and supporting those needs, whilst offering choice whether to pursue a formal diagnosis.
- Members noted the complex nature of finance around this matter and a number of services were involved. The CCG was looking to ensure that the investment in this area was working to its maximum capacity.
- Hartlepool pathway was slightly different to Stockton's and the CCG was looking at why there were differences. Feedback on this would come via an oversight Group, which the Director of Children's Services sat on.
- there was communications issue around the waiting list and work was being undertaken in this regard and could be shared with the Board.
- families would not be discouraged from pursuing a diagnosis but it was recognized that some families did not wish to, if needs were being identified and met. A mechanism would be in place that would prevent anyone without a diagnosis being disadvantaged when they moved from children's to adults services.
- the Board agreed that the pace of change towards the new pathway needed to be accelerated. It was also recognized that, in parallel with introducing the new pathway, there was a significant amount of work to be undertaken, in the short term, to try and reduce current waiting times.
|Members received an update relating to the STP prevention workstream. |
There was a regional tobacco task force that was driving the implementation of NICE guidance more consistently, with the aim of all trusts being smoke free by April 2019. A paper was due to go to the STP Board around resources to support this work.
It was explained that the whole emphasis of smoking prevention had shifted from being treated as a life style choice to being treated as an addiction, which needed treatment and support.
The workstream was also looking at alcohol; what the burden was on the NHS; what agencies needed to do to address it and could a regional approach help
Work associated with prevention in the local maternity services was being undertaken to embed principles of prevention relating to smoking , mental health, vaccination, alcohol, breastfeeding, health weight, making every contact count.
Further reports would be provided to the Board when appropriate.
|Members were provided with an update relating to the Sustainability and Transformation Plan (STP).|
It was noted that the footprint of STPs had recently increased and were now based on regions. Alan Foster had been appointed lead for the Cumbria and North East STP.
It was noted that workforce was one of the critical workstreams and a single strategic group was being created.
The Better Health Programme element of the STP would now need to take account of the new regional footprint.
|Members considered the minutes of the following meetings:|
Adults Health and Wellbeing Partnership - 4 July 2017
Children and Young People's Partnership - 20 September 2017
Children and Young People's Health and Wellbeing Commissioning Group - 5 July 2017
Adults Health and Wellbeing Commissioning Group - 18 July 2017.
Domestic Abuse Steering Group - 13 June 2017
|Members were reminded of the planned Development Session on 1st December 2017.|
Members were provided with an overview of the care coordinators initiative which had seen the delivery of over 4000 person centered care plans, across Hartlepool and Stockton, with around 2600 specific to Stockton. Further details would be provided at a future meeting.
An update on remedial works at TEWV's Roseberry Park Mental Health Hospital was provided. In terms of impact on Stockton residents it was noted that older people's services would be moving entirely to Sandwell Park, for a period, whilst works at Roseberry were carried out.
|Members noted the Action Tracker.|
|Members noted the Forward Plan.|