Agenda and minutes

Alison Issott  Chief Operating Officer - TCCG

Faye Hames  Commissioning Manager – TCCG

Margaret Mogentale  Commissioning Manager – TCCG

Adrian Grant  Head of Integrated Commissioning – TCCG

Mark Lemon  Strategic Business Advisor - KCC

Gerald Bassett  Head of Commissioning Development – NHS

Martyn Cassell  Community Safety and Leisure Manager - TDC

A brief discussion took place regarding the subject of officers giving declarations of interest at meetings. Councillor Gibbens said that some debate had been had on this matter at County wide sub-committee meetings and it was agreed that this facility should be included for future meetings once clarification on the wording for these declarations is agreed.  

Apologies were received from Dominic Carter, Lay Member PPE, Thanet CCG.  

To approve the minutes of the previous meeting held on 28 November 2013, copy attached.

The minutes of the Thanet Health and Wellbeing Board meeting held on 28 November 2013, were approved and signed by the Chairman.

Hazel Carpenter, Accountable Officer, Thanet Commissioning Group introduced the report which was to agree the terms of reference of a Children’s sub group, now known as the ‘Children’s Sub-Committee’. It was agreed that the Chair of the Local Children’s Trust Board should become the Chair of the Children’s Sub-Committee and that the governance arrangements should ensure that the Chair was accountable to the Thanet Health and Wellbeing Board. It was also proposed that the Chair of the Children’s Sub-Committee should be appointed as a member of the Thanet Health and Wellbeing Board to ensure the group can be held to account.

The draft terms of reference were attached for consideration but Hazel felt that although she recommended that it was the way forward the terms of reference for the new Children’s Sub-Committee should be more ambitious and clear and recommended the Children’s Sub-Committee be asked to recommend revision to the terms of reference to ensure they had scope to develop and oversee delivery of a children’s plan. Councillor Johnston advised the Board that she had been a member of the Local Children’s Trust Board and asked whether she would now be appointed to the Children’s Sub-Committee. Sue McGonigal advised that this would be the case.

Dr Martin asked that a report be brought to the next meeting (20 March 2014) with the final terms of reference for the Children’s Sub-Committee.

Agreed.

Adrian Grant to present the paper.

Andrew Scott-Clark to give a presentation.

Andrew Scott-Clark introduced his presentation which was designed to engender debate about what the overall aspirations are for the Health and Wellbeing of the Thanet population in order to agree how the Health and Wellbeing Board empowers others to deliver the agenda.

The priorities for Kent are that:

• Every child has the best start in life
• Effective prevention through people taking greater responsibility for their health and wellbeing
• Improved quality of life for people with long term conditions (access to good quality care and support)
• People with Mental Health issues are supported to live well
• People with dementia are assessed and treated earlier

The ultimate challenge for life expectancy is to close the gap between the most deprived and the least deprived and flatten this line.

The aspirations for Thanet’s Children are to:

• Reduce the prevalence of smoking mothers
• Increase the prevalence of breast feeding
• Reduce alcohol specific stays in hospital of the under 18’s
• Reduce teenage conception rates
• Deliver the universal child health programme to the whole Thanet children population

Andrew Scott-Clark added that it was important that the ‘Children’s Sub Committee (Children’s Operational Group) focussed on these 5 areas. Councillor Hart agreed that these headings were right and asked whether ‘best practice’ had been looked for in other areas. He gave the example of teenage conceptions in Dover being reduced. Councillor Johnston said that a lot was down to education and also agreed with the headings. She added that more funding was needed to support mothers breastfeeding for longer. Drug abuse involving young school children was a real concern but the use of alcohol in young people was an even wider problem.

Sue McGonigal said that she was not sure how we are attacking the root cause of these lifestyle choices. She added that young people learn behaviours from family and that this was a concern. It was noted that the Police had advised that drugs were a significant problem in all age groups.

Councillor Gibbens suggested to the Board that Professor Chris Bentley FRCP, FFPH be invited to attend a meeting of the Thanet Health and Wellbeing Board. The Professor could advise on whole system reviews and support for strategic assessment best practice to address health and wellbeing improvement, health inequalities, and population healthcare. Andrew Scott-Clark advised that Professor Bentley had not to date been invited to a meeting and it was agreed that this was a good idea. He added that discussion should be about the whole picture, prevention, treatment and education. Mark Lobban, in addressing the Board said that if everything was a priority then nothing is! Dr. Martin added that it was about helping people raise their social aspirations and reducing overall demand.

The prevention aspirations are to:

• Reduce the prevalence of smokers
• Ensure at least 50% of people invited for a health check take up the invitation
• Reduce early deaths from cardiovascular disease
• Reduce the number of falls that lead to hip fractures

Andrew Scott-Clark said that this was about the whole  ...  view the full minutes text for item 29.

Andrew Scott-Clark to give a presentation

Andrew Scott-Clark introduced his presentation which had been prepared by Natasha Roberts, Head of Health Intelligence.

Data and information underpin the JSNA and there is a recommended data inventory which covers more that 350 indicators. A refresh of Joint Strategic Needs Assessments are carried out annually and help the development of the joint health and wellbeing strategy. In so doing it is important to know where it begins and understanding where we are now, also to identify gaps in knowledge. He added that all the data is bought together and collectively indicates what is relevant to the population of Kent. There are about 40 needs assessments ‘Umbrella of needs assessments’ that contribute to the overall summary document of the Joint Strategic Needs Assessment.

A draft report is to go to the next Kent Health and Wellbeing Board (29 January 2014) with the final report being signed off by March 2014. The JSNA will identify priorities in Kent, for CCG’s and for Districts. A number of the priorities are likely to be similar at all commissioning levels. There will however be localised priorities within communities which will need to be addressed to improve health outcomes and to reduce health inequalities.

Sue McGonigal asked whether the information in the HWB Strategy would be at Kent level with individual reference or down to us for the Thanet Strategic Plan. Andrew Scott-Clark said that it would be kept at higher level. Members were concerned that if this was so and the priorities were spread evenly that Thanet would lose as our needs were greater. Dr. Martin assured Members of the Board that any papers would be passed to them in advance of the next meeting.

The link below is for information only.

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215261/dh_131733.pdf

Noted.

Mark Lobban to give an update.

Mark Lobban, Director of Strategic Development, KCC gave a brief update on the Pioneer Programme and advised Members of the Board that he would give the Kent Sharepoint web address out with the minutes which would provide a more detailed update. He added that the 1^st draft of the BCF (Better Care Fund) would be taken to the KHWBB on 12 February 2014. Please see below:

Key update:

·  Integration Pioneer Steering Group was tasked in helping coordinate the development of the Better Care Fund.

·  Second Steering Group meeting engaged with providers on proposed content of the fund.

·  On-going meetings of the IPSG will be themed around key topics of the Pioneer programme. Next meeting on Information Systems/Information Governance.

·  An integration pioneer working group has been established – Adrian Grant is the representative for Thanet CCG.

·  The Kent Pioneer programme plan will be available at the end of January and will outline the overarching delivery plan based on the original submission.

·  A Kent SharePoint site is available to access information on the programme. For access email pioneers@kent.gov.uk. This will also feed the national Pioneer website ICASE – www.icase.org.uk

·  An update on Kent as an Integration Pioneer has been circulated, explaining what it means for Kent and what support is available. If not received please email pioneers@kent.gov.uk for a copy.

Key Actions for February

·  National programme will confirm performance measures they expect Pioneer sites to monitor.

·  Pioneers will undertake a baseline assessment to inform future progress within the programme.

·  First draft BCF to HWB on 12 February.

Update noted.

Adrian Grant to give a verbal update.

Adrian Grant, Head of Integrated Commissioning, TCCG gave a verbal update on the work that is being done in Thanet.

The £3.8bn Better Care Fund (formerly the Integration and Transformation Fund) was announced by the Government in the June 2013 spending round, to ensure a transformation in integrated health and social care. The Better Care Fund (BCF) is a single pooled budget to support health and social care services to work more closely together in local areas.

The next steps in implementing the Better Care Fund are to come up with a viable proposal to push for the provision of services outside of hospital. Health and Wellbeing Boards are encouraged to extend the scope of the plan and pooled budgets.  The plan for 2015/16 needs to start in 2014 and form part of a five year strategy for health care. The 1^st draft of the plan to 2018 will be considered at high level and refined through a 5 year strategic plan. The final version is to be considered by the Kent Health and Wellbeing Board in late March 2014.

Hazel Carpenter said that the update had been very helpful and confirmed that the Better Care Fund was not ‘new money’. She added that assurance was needed when drawing up contracts that funding was released in a way that made sense. Members asked whether any of the BDF monies would find its way to private care homes. Adrian Grant said that this was possible. He added that Health and Wellbeing Boards on behalf of the NHS (on a higher level) were to formulate proposals on what is acceptable use of the BCF.

Some Members were concerned about the monitoring of care homes and hoped that ‘spot checks’ were intended to be part of the plan. Hazel Carpenter advised that anywhere that community money was spent, systems and processes were in place. The CQC (Care Quality Commission) had minimum standards to be met.

In continuing the discussion regarding the Better Care Fund, Sue McGonigal asked whether this money was ‘ring-fenced’. Mark Lobban said that it was an artificial ring-fence and that plans should show how the new duties are being met. A condition of accessing the money in the Fund is that CCGs and councils must jointly agree plans for how the money will be spent, and these plans must meet certain requirements.

Hazel Carpenter, in addressing the Board advised that the focus was on drawing up contracts for statutory organisations and ensuring that they were ‘tight’ and done by the deadline. She added that it was a difficult and complex process with a difficult balance to be made.

The link below is for information only:-

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213223/Funding-transfer-from-the-NHS-to-social-care-in-2013-14.pdf  

Update noted.

Gerald Bassett to give a verbal update on the Mental Health Summit.

Gerald Bassett, Head of Integrated Commissioning in addressing the Board advised that a provisional date was being considered for the Mental Health Summit. This is 27 February 2014, the location is yet to be decided although Glo-Gen and the Turner Centre were being considered.

Noted.