Agenda and minutes

To receive any apologies for absence from Board Members.

Apologies for absence were received from Councillor Nicola Greene, Chairman, Graham Farrant, Chief Executive BCP Council, Elaine Redding, Corporate Director BCP Council, Sally Sandcraft, CCG and Scott Chilton, Chief Constable.   

To receive any changes in the membership of the Board.

The Board was advised of the following substitutes for this meeting:

• Brian Relph Children’s Services for Elaine Redding, Corporate Director BCP Council.
• Mark Harris CCG for Sally Sandcraft, CCG

Board Members are requested to declare any interests on items included in this agenda. Please refer to the workflow on the preceding page for guidance.

Declarations received will be reported at the meeting.

There were no declarations of interest made for this meeting.

To receive anypublic questions, statementsor petitions submitted in accordance with the Constitution,which is available to viewat the following link:

https://democracy.bcpcouncil.gov.uk/ieListMeetings.aspx?CommitteeID=151&Info=1&bcr=1

The deadline for the submissionof a public question is4 clear working days beforethe meeting.

The deadline for the submissionof a public statement is middaythe working daybefore themeeting.

The deadlinefor the submission of a petition is10 working days before the meeting.

There were no public issues for this meeting.

To confirm and sign as a correct record the minutes of the Meeting held on 17 June 2021.

The Board is also asked to consider the action sheet.

The minutes of the meeting held on 17 June 2021 were confirmed as a correct record.

Voting: Agreed

The Board considered and agreed the action sheet

The Board will be updated following the recent presentation from the Health Foundation.

The Board received an update on the recent presentation held in September on Anchor Institutions for the Dorset and BCP Health and Wellbeing Boards hosted by the Health Foundation. Paul Iggulden reported on the focus of the session which referred to models of good practice, themes and the impact on the Dorset network.  The Board was advised of the need for partners to sign a Charter of initial sign up and proposed discussions at the forthcoming network meeting in early November. Mr Iggulden reported that the initiative was being developed and a report would be submitted to the Board in due course.

Debbie Fleming reported that she was really excited by this development. She asked if the accountable Officers could prepare a briefing note on the proposals for the Chief Executives of the relevant organisations.

RESOLVED – that the update be received and noted.

This report provides an update on the work of the BCP Access to Food Partnership.  There is much to celebrate in what the partnership has so far achieved, and local community partners are demonstrably helping families to build more food resilience.  However, the challenge is growing – although the BCP area has some outstanding food support, Sheffield University research suggests people seriously struggle to afford food in BCP, which attracted negative local press coverage.   In addition, rising food and fuel prices combined with changes in universal credit going into the winter will mean more residents are likely to struggle with access to food.  Therefore, the Board are asked to redouble their efforts to collaborate on communicating key messages around finding help within and across all statutory partners, and to invest in the continuation of the partnership beyond March 2022.

The Board considered a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'A' to these Minutes in the Minute Book which provided an update on the work of the Access to Food Partnership. This was also accompanied by a presentation.

The Board was informed that there was much to celebrate in what the partnership had so far achieved, and how local community partners were helping families to build more food resilience.  However, the challenge was growing – although the BCP area had some outstanding food support, Sheffield University research suggested people seriously struggle to afford food in BCP, which has attracted negative local press coverage.   In addition, rising food and fuel prices combined with changes in universal credit going into the winter would mean more residents were likely to struggle with access to food.  Therefore, the Board was asked to redouble its efforts to collaborate on communicating key messages around finding help within and across all statutory partners, and to invest in the continuation of the partnership beyond March 2022.

The Chief Operations Officer, BCP Council highlighted the need for the members of the Board to challenge their role as leaders in this field and for organisations represented to consider what commitment can be provided going forward to achieve resilience.  The Board was advised of the longer-term aims and the financial implications including matched funding to move the partnership on to a more sustainable footing.

Alistair Doxat-Purser, the Chair of the Access to Food Partnership explained that this was a significant balancing act in having access to food and for people to be able to cook. In particular he highlighted the need for key messages to be communicated and for this work to be recognised as core business.

Tim Goodson, who was taking the Chair, explained that the organisations represented had good communication networks.

Kate Ryan, Chief Operations Officer, reported that she would act as a conduit in respect of the submission of dedicated representatives to be part of the Access to Food Partnership and lead on the food insecurity agenda within their organisations.  It was suggested that these representatives should be submitted within a month.

Sam Crowe, Director of Public Health emphasised the need to ensure that actions were followed through.  He also referred to the Integrated Care System and that the food insecurity agenda should put forward as a priority.

RESOLVED that

(a)  Board members consider how they can help to support the longer-term sustainability of the Access to Food partnership beyond March 2022.

(b)  Board members identify how their partner organisations are able to help communicate key messages and share information to help residents more easily identify and ask for relevant support if they are struggling with food insecurity.

(c)  Board members identify a dedicated representative from their organisation to be part of the Access to Food partnership and lead on the food insecurity agenda within their organisations.

(d)  Board members allocate a future  ...  view the full minutes text for item 22.

The Board is asked to consider the report on the above.

Phil Hornsby, Director – Commissioning for People presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'B' to these Minutes in the Minute Book which provided an update on the Better Care Fund and Home First Programme.

The Board was advised that the report considered budget issues, for extending existing BCF Section 75 agreements to include the impact of COVID 19 pooled expenditure. Members were informed that the Dorset Integrated Care System had been providing an enhanced supply of out of hospital care and support services, commissioned via BCP and Dorset Council on behalf of the system.

The Director reported that this service was to be extended to the end of March 2022 and the enhanced supply of out of hospital care and support services can be approved by delegated authority as outlined in the recommendations. (The Board was referred to agenda item 9 – Hospital Discharge Programme Funding).

The Board was updated on progress and performance of the Better Care Fund (BCF) Plan and Home First Programme for 2020/21 including information against each scheme. A national programme of work has taken place led by NHS England considering changes to the BCF from 2021 onwards. This report takes account of the new requirements, and the content of the report was in line with the BCF changed requirements recently provided (August 2021) and officers would continue to monitor changes and adhere to these as we progress.

Officers commented on the impact and demands of Covid as detailed in the report. The Board was updated on the operational aspects including additional capacity to support carers with a refresh of the Pan Dorset Carers Provision, in respect of maintaining strong and sustainable care markets key elements of work included the remodelling of Coastal Lodge for an enhanced intermediate care bedded unit for the ICS and a summary of the financial implications.

The Board was updated on the progress of Home First Programme, which was established in response to the national mandate to implement a full ‘discharge to assess’ model in each local system and supported by national hospital discharge funding.  Officers outlined the programme focus which was on embedding the changes made to date and to establish a sustainable long-term model for intermediate care that would meet the evolving needs of the Dorset Population.  Officers reported on the appointment of IMPOWER as the strategic partner who have commenced the diagnostic phase.  The Board was advised of the Plan for the next quarter, which was to progress priority interventions, to address immediate challenges of increased demand, reduce flow and resilience in existing services.

The Board was informed that this was a significant programme of change and workforce pressures exacerbate the situation. The Director of Public Health reported that demand was unprecedented and therefore the focus should be on discharge from hospital, the community role and the integration of locality teams. The Board was informed that a more integrated approach was  ...  view the full minutes text for item 23.

At the June Health and Wellbeing Board the council and CCG committed to bring a full report on Hospital Discharge Programme (HDP) funding to the October Board.

However, the reconciliation of the funding for April to September 2021 is not yet available therefore cannot be shared at this meeting.

On 6^th September 2021 the Government confirmed, via a press release, the extension of the HDP funding for a further six months. The allocation for Dorset Integrated Care System is £8.889m.

The Pan Dorset Home First Board continues to review options and service models to meet the significant challenge it faces in supporting people with a swift and safe discharge from hospital. There remains significant financial concern and workforce pressures despite the additional funding being made available. The Home First Board have engaged Impower as a strategic partner to assist in developing a plan to support the changes needed to improve our position.

Phil Hornsby, Director – Commissioning for People, BCP Council presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'C' to these Minutes in the Minute Book.

The Board was reminded that at the June Health and Wellbeing Board the Council and CCG had committed to bring a full report on Hospital Discharge Programme (HDP) funding to the October Board. However, the reconciliation of the funding for April to September 2021 was not yet available therefore could not be shared at this meeting.

On 6 September 2021 the Government confirmed, via a press release, the extension of the HDP funding for a further six months. The allocation for Dorset Integrated Care System was £8.889m.

The Pan Dorset Home First Board continues to review options and service models to meet the significant challenge it faces in supporting people with a swift and safe discharge from hospital. There remains significant financial concern and workforce pressures despite the additional funding being made available. The Home First Board has engaged IMPOWER as a strategic partner to assist in developing a plan to support the changes needed to improve our position.

Officers emphasised the risks and the need for a sustainable model taking account of the complexities of patients needs.  Debbie Fleming commented on an appropriate workforce and the need to retain high quality staff.  She touched on issues including the provision of affordable key worker housing which should be part of the strategic agenda. 

RESOLVED – that there is an extension to the period of delegated authority for the Chair and Vice-Chair of the Board (following discussions with the Cabinet Portfolio Holder and subject to Council and CCG governance processes) to make relevant decisions on behalf of the Board related to Dorset Integrated Care System funding for the Hospital Discharge Programme for the period up to the end of March 2022.

Voting: Agreed

The Board is asked to consider the update on the Dementia Services Review.

Mark Harris, Head of Service (Mental Health & Learning Disabilities) – CCG presented a report, a copy of which had been circulated to each Member and a copy of which appears as 'D' to these Minutes in the Minute Book which provided an update on the implementation of the Dementia Services Review including reference to current diagnosis rates, the impact of covid and resulting specific actions.

The Board was advised that the implementation of the Dementia Services Review had been delayed due to Covid.  Mr Harris reported that there was an open access referral system and a new workforce model.  He outlined the key elements reporting that there had been a bounce back in referrals and the aim was to reduce waiting times.  The Board was informed that there were one off funds to address the backlog with temporary staff in diagnostics.  The Board was advised of the provision of Dementia Co-ordinators and that diagnostic rates nationally were 66.7% but had reduced to 50% which was reflected locally.

Members in commenting on the review welcomed the new pathway in Dorset with increased diagnostics. The emotional workshop for carers was highlighted and in particular virtual access. Mark Harris commented on the dementia co-ordinators and how they provide support to the patient and family throughout the pathway with access to services. 

RESOLVED that the report be received and noted.

(Councillor Dove left the meeting at 11.15 am)

The Board is asked to consider the Annual Report from the Safeguarding Adults Board.

The Chairman of the Bournemouth, Poole & Christchurch Safeguarding Adults’ Board, Sian Walker presented the Annual report 2020-21 for the Safeguarding Adults Board, a copy of which had been circulated to each Member and a copy of which appears as 'E' to these Minutes in the Minute Book.

The Board received a presentation from Sian Walker-McAllister which was the annual report of the outgoing chairman. In presenting the report Sian outlined the role of the statutory partners, the work undertaken with the Dorset Board, the development of the joint strategic planning and working together with the whole family.

The Director of Public Health reported on data increases during the pandemic and touched on section 42 enquiries. Sian Walker explained that volunteers were raising concerns that might not fit the criteria and that the volunteers return the data.  The Board was informed of the impact of the pandemic and the benchmarking which would be included in the Annual report to outline the trend.

Councillor Mike White reported that he was encouraged by the close working of the Adults Board with the Children’s Board. Brian Relph referenced the transition of safeguarding on the Boards agenda and that as a result of the pandemic there had been a rise in mental health issues which significantly affect young adults. Sian emphasised the co-working with the Children’s Safeguarding Board.

RESOLVED - that the Board receive the Annual report 2020-21 from the Safeguarding Adults Board and places on record its thanks to Barry Crook the former Chairman of the Board.

Voting - Agreed

The Board is asked to consider the report on the above.

Jane Horne, Public Health presented a report, a copy of which had been circulated to each Member and a copy of which appears as 'F' to these Minutes in the Minute Book on the delivery of the Pharmaceutical Needs Assessment (PNA).

The Board was reminded that it has a statutory responsibility for publication of a Pharmaceutical Needs Assessment (PNA) by October 2022. The report sets out plans for how this will be delivered.

Richard Jenkinson explained that there was a changing landscape with access to Pharmacists online for repeat prescribing which needed to be balanced against the need for community pharmacists.  Jane Horne referred to the increase in online pharmacies and footfall to community pharmacies eg due to administering vaccinations. She acknowledged that the role of the community pharmacy had changed but it was still necessary to have access to such services.  The Board was advised that online pharmacies would be raised at a regional level 

RESOLVED that following be approved:

• development of a single PNA that covers both the BCP and Dorset Health and Wellbeing Boards
• use of Primary Care Networks as the basic framework for the PNA
• delegation of authority to the Director of Public Health to agree final content for publication by October 2022, following statutory consultation.

Voting - Agreed

The Board will be updated on the above and any recent developments.

The Board was updated on the plan and recent developments.

The Director of Public Health outlined the level of infections with the rate for over 60s starting to increase. The Board was advised of the work with schools and that the level of hospital admissions had been held back by the success of the vaccination programme.  The Director of Public Health reported that the booster programme was underway with flu vaccinations also available.

The Board was advised of the outlook for the Autumn/Winter including the reproduction rate of the virus and the impact of the Government’s Plan which would include a move to additional restrictions such as face masks and covid passports.  The Director of Public Health reported that an updated contain strategy would be published.

Karen Loftus reported that work was ongoing in all sectors to increase awareness about the vaccination and booster programme to enable people to make informed decisions.  She explained that the this included running training sessions.

RESOLVED that the report be received and noted. 

Voting – Agreed

The Board is asked to consider the report on the above.

The Director of Public Health presented a report, a copy of which had been circulated to each Member and a copy of which appears as 'G' to these Minutes in the Minute Book on the feedback from the development session on Understanding the role of Health and Wellbeing Boards in our developing ICS.

The Board was advised that the session had provided an opportunity to think about the future of partnerships, the development of the Integrated Care System and how Councils and NHS Partners come together.  The Director of Public Health reported that there was an opportunity for Health and Wellbeing Boards to work within an effective system and influence the development of strategy. He explained that the two Board chairs recognised the need to work together articulating the needs of the different areas across the County and making a difference at a local level.  The Board was informed that existing statutory committees continue to be engaged and it was necessary to develop draft proposals on how Health and Wellbeing Boards would fit into the ICS developments.

RESOLVED that the output from the development session be noted. 

The Board is asked to consider and agree the latest version of the Forward Plan and consider proposed development sessions.

The Board considered the development of the Forward Plan. The following issues were highlighted for inclusion on the Forward Plan:

• The changes taking place within the hospitals, the role of hospital and responding to the needs of the community
• Summary of the Joint Strategic Needs Assessment
• Vibrant Communities Partnership Board – report from the co-chair to the Health and Wellbeing Board.

RESOLVED that the above items be included on the Forward Plan.

Voting – Agreed