Agenda and minutes

Janice Wason  Strategic Community Manger – TDC

Mark Lemon      Strategic Business Advisor-Health & Well Being       Boards – KCC

Colin Thompson  Public Health Specialist – KCC

Jo Frazer  Programme Manager, Health and Social Care     Integration - NHS

Kim Solley    Associate Partner Mental Health KMCS

Faye Haves  Commissioning Manager – TCCG

Margaret Mogentale  Commissioning Manager – TCCG

Jess Andrews  Commissioning Manager – TCCG

Adrian Grant  Head of Integrated Commissioning - TCCG

Apologies were received from Councillor G Gibbens for whom Councillor G Lymer was substitute.

Apologies were also received from Dominic Carter and Gerald Bassett (for whom Faye Haves and Jess Andrews were in attendance).

To approve the minutes of the previous meeting held on 26 September 2013, copy attached.

Subject to an amendment to the minutes at item 10, Dominic Carter and not Carpenter, the minutes were approved and signed by the Chairman.

Children’s agenda

  -ratification of write up from September summit

  -Governance/ToR

  -Report to Kent HWBB

Andrew Scott-Clark, Director of Public Health Improvement for KCC introduced the report which gives a summary of the workshop results from the “Thanet Children’s Summit” meeting held on 26^th September 2013.

The workshop involved members of the Thanet Health and Wellbeing Board, Thanet Children’s Trust Board and several other relevant commissioning stakeholders who considered a range of questions relating to children and young people in Thanet.

In setting out to deliver a greater ambition in Thanet Andrew said that they must:

·  Align governance of all commissioners so that it ‘happens’ in one place with a single leadership – ‘Thanet Children’s Board’

·  Align resources and where it gives better results that we ‘pool’ budgets

·  Increase the aspiration of the outcomes we expect from the delivery of services – we want the best in health, social care and education

·  Set challenging highly aspirational goals and realistic annual plans

·  Agree mutual agency support for delivering each other’s targets

Andrew continued to emphasise the importance of integrated working with other providers to ensure the best outcome for children. He added that though County were not all in agreement on the best way forward, locally it was important that a sub committee (Children’s Trust Board) of the Health and Wellbeing Board be established to ensure delivery of the aspirations as mentioned above, for children and young people in Thanet. Andrew suggested that at the next Thanet Health and Wellbeing Board meeting (23^rd January 2013) an item for the agenda could be ‘What the Board’s aspirations are and what we want to nail down in order to deliver more focus and positive outcomes for children’. He added that nothing substantive had been achieved thus far although he was encouraged by the attendance at the Workshop of key players. It was important to establish Terms of Reference for the sub-committee to ensure that it could go onto deliver the desired aspirations.

Both Hazel Carpenter, Accountable Officer, Thanet Clinical Commissioning Group and Councillor Johnston, Thanet District Council supported what Andrew had said with Hazel adding that they had to go through the Governance arrangements to establish how the Sub-Committee will function to enable it to focus on what they were all trying to do.  Councillor Johnston was concerned that opportunities were being missed in dealing with big issues concerning maternity and the loss of children’s centres. Reference was made to the TDC ‘sport for energy’ team (page 9 of the paper) where it stated that this was something that needed to change. Councillor Johnston emphasised that this was a mistake as the ‘sport for energy’ team had recently won sports awards for their work with young people and interaction with youth clubs.

Dr Martin, Chairman of the Thanet Health and Wellbeing Board said that reassurance was needed that the Sub-Committee of the THWBB and Local Children’s Trust Board (LCTB) could overcome the current gaps in integration of multi-agency working and services. Hazel added that clarity was also needed in establishing who needed to be around  ...  view the full minutes text for item 18.

To receive a presentation from Mark Lobban;

Integration group work programme

  -local work programme

  -ITF approach

The Board agreed to take items, 4, 6 and 7 together.

(4)  Integrated Commissioning

(6)  Pioneer Bid

(7)   Integrated Transformation Fund

Members of the Thanet Health and Wellbeing Board received a presentation from Mark Lobban, Director of Strategic Commissioning, entitled ‘Kent as Integration Pioneers’. The presentation (attached) had been produced by Jo Frazer, Programme Manager Health and Social Care Integration.

Mark, in giving the presentation advised the Board of the significant savings that needed to be made and the Kent Plan for 2013-2018. The headline was that ‘An integrated health and social care system that has at its heart an ability to assist people to live as independent a life as is possible for them given their needs and circumstances. (Optimum integrated health and social care pathway, commissioning and provision)’. He added that they needed to know how efficient these services were today and how they can be made better and also how to make the necessary savings. It was essential that both were achieved.

The Integration Pioneer Programme had identified 14 areas to lead on health and social care integration. The outcome of the ‘Pioneer’ bid had been presented to the Kent Health and Wellbeing Board on 20 November 2013. This was underpinned by the Integration Transformation Fund (£3.8bn) announced by the Government and would dramatically accelerate the timescales for achieving the integration of health and social services.

In discussing the Health and Social Care Integration Mark summarised the following:-

o  To recognise that the scale of challenge is unprecedented and required a radically different approach

o  It was necessary to fully understand the current operating model including cost, activity and outcomes

o  Appreciate the current and future pressures of partner organisations and how much resource should be invested in social care

o  Produce individual 5 year strategies with detailed 2 year plans for both health and social care

o  Recognise that you can’t jump from A to B in one go

o  Understand the inter-dependencies between commissioning, care pathways and optimisation

o  Move forward at pace and scale in waves ensuring at the end of each   wave outcomes have been improved & money saved (measure impact)

o  Carefully prioritise and sequence activities-If everything is a priority then nothing is!

o  Ensure that the Integration Transformation plan is the output and coming together of the individual health and social care plans-it can’t be something separate

o  Fully engage health and social care providers

o  Ensure that the pooled budget scope reflects the agreed priorities, for   example, intermediate care/enablement

o  Put in place robust governance and programme management arrangements which are fully resourced by the partners

Jo Frazer said that the Integrated Transformation Fund was part of the Pioneer bid and not necessarily just about the funding, that there was a focus on older persons. Dr Martin said that the children’s group (sub-committee) was a priority to ensure integration of children’s services but it was also important to deal with the vulnerable elderly as a major topic for the next  ...  view the full minutes text for item 19.

Kim Solley, Associate Partner Mental Health KMCS outlined the paper which sets out the objectives of the national “No health without mental health strategy” and shows how 2 local strategies set out to achieve better outcomes and reduce inequalities for the people of Kent who are either know to have a mental illness or those with or at risk of common mental health problems. The 2 strategies are “outcome four for mental health – Kent Health and Well0being strategy” and the Kent “Live it Well strategy.

The Thanet Health and Wellbeing Board are asked to host a mental health summit where key leaders are presented with the findings of the Joint Strategic Needs Assessment and Assets by Public Health in order to consider and understand the needs of the people of Thanet. They can then collectively agree that target group, strategic priorities and actions required ensuring “every contact counts” for those most at risk of developing a mental health problem.

Members of the Board supported the need for a summit and added that preventing young people from becoming depressed and developing mental health problems was of paramount importance. It was emphasised that focus should be on prevention and the provision of mechanisms to give resilience which isn’t happening currently. Councillor Hart, Leader, Thanet District Council said that the living conditions in Thanet were a contributory factor in mental health problems and that planning needed to look at the size of rooms.

Dr Martin felt that it would not be appropriate to hold a mental health summit along with the THWBB.

Proposed by Hazel Carpenter and seconded by Dr Martin that:

“to set a date and location for a mental health summit following the next THWBB meeting which was scheduled for 23 January 2014”

AGREED.

Paper to follow.

Taken together with 4, 6 and 7.

Paper to follow.

Taken together with 4, 6, and 7.