Agenda and draft minutes

To receive any apologies for absence from Board Members.

Apologies were received from Councillor L Dedman, and G Farrant, D Fleming, K Ryan, K Loftus and J Vaughan.

To receive information on any changes in the membership of the Board.

D Parker Deputy Chief Operating Officer Royal Bournemouth and Christchurch Hospitals acted as substitute for D Fleming.

a)    To confirm and sign as a correct record the minutes of the Meeting held on 24 July 2019.

b)    To note and comment as required on the action sheet which tracks decisions, actions and outcomes arising from previous meetings of the Board.

The minutes of the meeting held on 24 July 2019 were agreed as an accurate record.

The Action Sheet was agreed and noted by Board Members.

Members of the Board are required to comply with the requirements of the Localism Act 2011 regarding disclosable pecuniary interests. Declarations received will be reported at the meeting.

There were no declarations of Pecuniary Interest or any other interests made at this meeting.

To receive any public questions, statements or petitions submitted in accordance with the Constitution. Further information on the requirements for submitting these is available to view at the following link:-

https://democracy.bcpcouncil.gov.uk/documents/s2305/Public%20Items%20-%20Meeting%20Procedure%20Rules.pdf 

The deadline for the submission of:

Public questions is Wednesday 18 September 2019

A statement is 12.00 noon, Tuesday 24 September 2019

A petition is 12.00 noon, Tuesday 24 September 2019.

There were no public questions, statements or petitions submitted for this meeting.

To agree the narrative, themes and ambitions of the draft plan for the Integrated Care System.

The BCP Council Director for Public Health presented a report, a copy of which has been circulated and appears as Appendix ‘A’ of these minutes in the Minute Book.

The Board were provided with the first draft of the refreshed Integrated Care System Plan, Our Dorset – Looking Forward 2019-2024. The narrative, high-level themes and ambitions of the Plan were explained to the Board.

The Plan included a focus on delivering sustainable health and care services, the shifting of care closer to home and the delivery of a radical scaling up of prevention to help people stay well.

The plan had been through consultation with public sector partners, the voluntary and community sector and members of the public. It was highlighted that the plan was created through genuine partnership and engagement.

It was a five-year plan. Following the development of the plans ambitions the detailed work would begin to emerge through the task and finish groups outlined in the report. It was highlighted that the Board may want to consider oversight of the plan’s progress.

The Health and Wellbeing Board were asked to sign-off the plan as the statutory board that promotes integration and prevention for the BCP area and to delegate authority to the Chair and Vice-Chair the approval of any subsequent changes to the draft plan before submission to NHS England on 27 September 2019.

Members of the Board raised and discussed a number of questions, including the following;

• It was recommended that the plan include details of how partners were engaged in its development;
• When further iterations would be provided to the Chair and Vice-Chair;
• Whether there could be further clarification regarding the climate change percentages on page 6. It was agreed this could be amended;
• That the Dorset and Wiltshire Fire and Rescue Service had resources for prevention and would like to promote their ability, in the plan, to provide opportunities for people to be signposted;
• That the plan needed to clarify the Integrated Care System (ICS) status. The wording on page 2 on the ICS could be removed.
• Page 40 could include capacity and accessibility to CAHMS and emotional support services for children and young people with those needs;

RESOLVED that:-

(a)  The Health and Wellbeing Board note and approve the narrative of the draft plan, Our Dorset, Looking Forwards;

(b)  The Board delegate authority to the Chair and Vice-Chair to approve any subsequent changes to the draft plan before submission to NHS England on 27 September 2019;

Vote: Unanimous

To comment on and approve the Better Care Fund Plan prior to it going through NHS I and NHS England for a national assurance process.

The Principal Officer, Quality Assurance and Planning, for BCP Council presented a report, a copy of which has been circulated and appears as Appendix ‘B’ of these minutes in the Minute Book.

The report provided an overview of the contents of the Better Care Fund (BCF) Plan 2019-20. The Fund was a key delivery vehicle for providing person centred integrated care within health, social care, housing and other public services.

The Board were asked to sign off the Plan prior to it being submitted for national assurance on 27 September. It was highlighted that the Plan was on track to receive assurance.

The programme had run since 2013 and most of the pooled resources for the plan came from existing funds. Additional contributions were made by the Local Authority and the CCG. There were also extra short-term grants including the winter pressure grant.

The plan included details such as income and expenditure, progress on plans, and performance metrics. The plans initiatives and operational activities were also highlighted. The Board were informed that the 5 key schemes from the 17-19 plan would be carried over and additional work would be undertaken.

The Corporate Director for Adult Social Care highlighted the success of the plan and its benefit to local people, particularly in reducing delayed transfers of care.

Members of the Board raised and discussed a number of questions, including the following;

·         Where the focus needs to be to develop the schemes;

·         The importance of working collaboratively;

·         A recognition there are still challenges and a need for continued focus on these;

·         Healthwatch had undertaken work on access to primary care in care homes and would be keen to work collaboratively to improve access for those who live in care homes;

·         The numbers and timescales for delayed transfer of care targets and the targets’ impact; 

·         That an update on whether the Plan had passed the national assurance test be provided at the next meeting, and the next full update be provided in March; 

RESOLVED that:-

(1)  The Board approved the Better Care Fund Plan for 19/20, including the investment and delivery plans outlined in the report.

Vote: Unanimous

To provide an update on the recommendations presented to the Board at their meeting on 24 July 2019.

The Interim Service Director Inclusion and Family Services presented a report, a copy of which has been circulated and appears as Appendix ‘C’ of these minutes in the Minute Book.

The report provided the Board with an update against the recommendations presented at its meeting in July 2019. The Board were informed that there had been significant progress in the creation of a self-assessment covering health, education and care.

It was also explained that a workshop would be held on 18 October to aid the development of a BCP Joint Commissioning Strategy for special educational needs.

The Joint Commissioning Strategy, self-assessment and implementation plan would be bought to the next meeting of the Health and Wellbeing Board.

Members of the Board raised and discussed a number of questions, that included the following;

·         Ways BCP Council was engaging with parents of children with special educational needs. A survey had been carried out and the SEND Transformation Board would be looking at the summary of results. There was also a coproduction focus group with Parents Together Forum and BCP Council were looking at the network of opportunities parents had to engage with other systems.

·         The survey was designed to underpin the Plan and the Self-Assessment and would be available to the Health and Wellbeing Board. The Chairman requested that the outcomes of the survey, including any input from those age 18-25, were included in the next quarterly update;

·         BCP Council would be looking to develop a BCP approach to SEND which would be bought to the Board at the next meeting;

·         That BCP Council were working on a model to prepare young people for adulthood. The model would seek to strengthen the range of early planning available to families, parents, carers and young people. Its aim was to help young people achieve their aspirations for the future;

·         New independent living flats had been developed to help young people reach their aspirations and live a more fulfilled adult life;

·         That the increase in EHCP’s was part of a national and local picture and it was important to understand why some parents might feel the need to escalate their child’s needs to an EHCP;

·         The importance of engagement with headteachers and parents and the provision of support that would enable them to help children with emotional and mental health needs remain in a mainstream setting and receive the additional help and support they need.

RESOLVED that:-

(1)  The panel noted the progress against the recommendations presented to the Board in July 2019

(2)  The Board would continue to support the BCP Joint Commissioning Strategy

(3)  The Board considered and agreed a Peer Review for SEND to be held in January 2020

(3a) To work with the LGA at the next development session to agree the scope of the Peer Review. The length of the development session would need to be extended to accommodate this.

To consider two pharmacy applications to NHS England as a statutory consultee.

 The BCP Council Director for Public Health presented a report, a copy of which has been circulated and appears as Appendix ‘D’ of these minutes in the Minute Book.

The Health and Wellbeing Board had a statutory responsibility to publish a Pharmaceutical Needs Assessment (PNA) every three years and a role as a statutory consultee when pharmacies made an application to NHS England through its Primary Care Support Team.

Primary Care Support England had notified the Board of two applications. One relocation of a pharmacy with a response due by 20 September and one consolidation of pharmacies with a response due by 27 September.

The report included analysis on whether, within the Pharmaceutical Needs Assessment, any impact on the local populations ability to access pharmaceutical services could be identified.

It was considered that there would be a negligible impact on access in the first application and no material difference in access caused by the second application.

Members raised and discussed a number of questions including the following;

·         Whether enhanced services were considered when assessing applications, including opening hours, services and staff skill’s and training, particularly knowledge of the exploitation agenda. It was highlighted that the way the pharmacy was run was also important to ensure residents needs were being met;

·         Details of the recommended delegation to the Public Health Team of applications of no significant change, including that applications where there would be a significant loss would go to the Board and a process would need to be agreed for this;

·         That working with the Medicines Management Team at the CCG could be beneficial;

·         The Director of Public Health would find out whether changes to dispensing Doctors was included in the applications for consultation;

·          How people who use the pharmacy are informed of potential changes and can comment. The Director of Public Health agreed to find out and provide a response.

RESOLVED that:-

(1)  The Board noted the applications and that no response had been made for application 1;

(2)  The Board approved the response to the Primary Care Support Team in respect of application 2, as set out in appendix 1 of the report;

(3)  The Board delegated authority to the public health team to respond to applications for relocation where there is no significant change.

Vote: Unanimous

For the board to receive an update on the development of the Forward Plan.

A draft Forward Plan was circulated at the meeting.

Members of the Board raised and discussed a number of questions, including the following;

·         Details of the developmental session on 28^th November and the addition of an item to discuss the scope of the SEND Peer Review;

·         The addition of an item on suicide prevention, to aid the development of a suicide prevention plan for BCP. That the report include links to online training and other useful communications on suicide prevention;

·         The details of a talk on suicide prevention being held at the Arts by the Sea Festival;

·         The benefits of the WaitLess application, Healthwatch were talking to people about their experience in A&E and could promote it;

For Board members to note the meeting dates of the Board, as listed below:

30 January 2020 – 10am - 12 noon

26 March 2020 – 10am - 12 noon

17 June 2020 – 10am - 12 noon

Development Sessions:

28 November 2019 – 10am - 12 noon

27 February 2020 – 10am - 12 noon

30 January 2020, 10am – 12 noon.

26 March 2020, 10am – 12 noon.

17 June 2020, 10am- 12 noon.

Developmental Sessions

28 November 2019, 9.30am – 12 noon.

27 February 2020, 10am -12 noon.