Agenda and minutes

The Chairman welcomed everyone to the meeting.

The Democratic Services Officer drew attention to the evacuation procedure as listed on the call to the meeting.

Jo Farrar, Pat Foster and John Holden had sent their apologies for this meeting.

David Trethewey was a substitute for Jo Farrar and Ronnie Wright was a substitute for Pat Foster.

At this point in the meeting declarations of interest are received from Members in any of the agenda items under consideration at the meeting.

(a) The agenda item number in which they have an interest to declare.

(b) The nature of their interest.

(c) Whether their interest is a disclosable pecuniary interest or an other interest,  (as defined in Part 2, A and B of the Code of Conduct and Rules for Registration of Interests)

Any Member who needs to clarify any matters relating to the declaration of interests is recommended to seek advice from the Council’s Monitoring Officer or a member of his staff before the meeting to expedite dealing with the item during the meeting.

Councillor Simon Allen declared an other interest in ‘Mental Health Update’ agenda item as he was employed by the Avon and Wiltshire Mental Health Partnership (AWP) NHS Trust.

To confirm the minutes of the above meeting as a correct record.

The minutes of the previous meeting were approved as a correct record and signed by the Chairman.

In early July 2014, the Department of Health (DH) announced the Government’s decision to place different requirements on the use of £1bn of the £3.8bn Better Care Fund (BCF). This was followed in the last week of July with the publication of new guidance on the use of the BCF and revised templates for the submission of plans along with the timetable for submission and assurance of plans, with a deadline for submission of plans signed-off by the Health and Wellbeing Board of 19th September 2014.

Changes to the use of the BCF do not, for Bath and North East Somerset, require amendments to the Better Care Plan 2014/15-2018/19 agreed by HWB on 26th March 2014 or to the use of the BCF.

The revised guidance and templates do require clarification of the vision for integrated care and support, case for change and plan of action along with the locally agreed target for reduction in total emergency admissions (to hospital).

This report sets out: i) summary of key changes to the guidance on use of the BCF; ii) the associated timetable; iii) better care plan summary revisions (Appendix 1); and iv) summary of schemes to be funded from the BCF with revisions highlighted (Appendix 2).

The report seeks delegated authority to the Chair of the HWB and CCG’s Interim Accountable Officer to sign-off submission of plans to meet the deadline of 19th September.

The Chairman invited Jane Shayler (Deputy Director for Adult Care, Health and Housing Strategy and Commissioning) to introduce the item.

The Chairman thanked officers for the work they put into this document. 

The Chairman also said that the Better Care Plan 2014/15-2018/19 built upon the previous joint working between the Council and the Clinical Commissioning Group

The Chairman also welcomed Janet Rowse (Sirona Chief Executive), James Scott (The RUH Bath Chief Executive) and Philip Rhodes (AWP Community Services Manager from BaNES Locality) to this meeting and asked for their views.

Janet Rowse commented that the Plan had been a phenomenal piece of work though it would be easy to get lost in some of the detail and technical terms.  The Plan had been excellent in terms of the delivery and in explaining on how everyone should work together.  Janet Rowse concluded that, in her view, focus should be on delivery of services to an individual.

James Scott commented that, given that the RUH has been providing acute services to wider population, B&NES would be in much better starting position considering the history of integration between health and social care partners in this area.  The Board of the RUH had supported this document in principle, though the biggest risk would be in the rise in demand and the hospital had relatively fixed capacity.  James Scott took the Board through some of the issues that the RUH had been facing in terms of the increases in A&E attendances and emergency admissions above its contracted values for 2014/15, all of which could create a potential risk to the CCG and the RUH and the BCF Plan.

Ian Orpen commented that the CCG recognised the points made by James Scott in terms of the pressure and risks that the RUH could have.  However, whilst there were notable increases above the CCG’s plan when activity  levels were compared against last year’s out-turn the growth was much lower.

Tracey Cox commented that the CCG had been in discussion with the RUH on these issues, especially on pressures and risks.  Tracey Cox agreed with James Scott that this year’s contractual arrangements were proving quite challenging.  There would be a number of additional initiatives set as a part of the Operational Capacity and Resilience Plan (ORCP) for this winter that should improve the position.  The CCG would need to provide further assurance to the RUH that there were other initiatives to support admission avoidance and to reduce the demand.  `

The Chairman asked if the framework of the BCF Plan had gone far enough in terms of what the requirements were.

Janet Rowse responded that she has not been aware of any framework for risk sharing.  The performance around the BCF had been associated with the small number of metrics.  All providers haven’t had the opportunity to discuss what the metrics were and what implications these might have for different providers.

James Scott said that it would be in everyone’s interest to maximise the resources from  ...  view the full minutes text for item 42.

This report provides an update on the mental health of people in Bath and North East Somerset, an update on commissioning and strategic progress and a request for further advice and support from the Health and Wellbeing Board.

The Board is asked to note:

•  The progress to date across all commissioning, strategy and provision areas.

The Board is asked for further advice and support in relation to:

•  Parity of Esteem

•  The Mental Health Crisis Concordat

•  Accommodation options for people with serious mental health problems (on CPA)

•  Ways to improve the employment options for people with serious mental health problems in B&NES

•  Reducing stigma about mental health and promoting wellbeing

The Chairman invited Andrea Morland (Clinical Commissioning Group) and Paul Scott (Public Health team) to introduce the item.

Members of the Board welcomed the report, in particular information within bullet point 1 of the report (‘what do we know about mental health?’).

Councillor Romero asked about bed provision for young people with mental health issues.

Ashley Ayre commented that traditionally, in South West, it was difficult for people to access the right facilities for young people due to specific geography of the region.  Ashley Ayre added that there is a need for a lot of work to be done on this matter.

The Board supported the concept of the Parity of Esteem Programme, which was about valuing mental health equally with physical health.

The Parity of Esteem Programme has been currently developed through discussions with stakeholders and the NHS England had identified three areas as initial priorities for urgent focus during 2013/14: 

• Improving Access to Psychological Therapies (IAPT)
• Improving diagnosis and support for people with Dementia
• Improving awareness and focus on the duties within the Mental Capacity Act

Members of the Board asked what the Board could do in terms of raising awareness and reducing stigma about mental health.

Andrea Morland and Paul Scott mentioned ‘Time To Change’ campaign, England's biggest programme to challenge mental health stigma and discrimination, and suggested that the Board could sign up to that campaign.

The Chairman welcomed that suggestion and invited the Board to sign up to the ‘Time To Change’ campaign.

The Board unanimously agreed with the Chairman.

Councillor Crossley welcomed the initiative to improve the employment options for people with serious mental health problems in B&NES.  Councillor Crossley also endorsed an increase in the self-management of long-term health and mental health conditions through piloting a Wellbeing College.

The Chairman asked if officers worked together with the Economic Development team on Economic Strategy.

Paul Scott responded that there had been close working relationship with the Economic Development team.

Andrea Morland commented that employment of people with mental health problems links to stigma and that the next step would be addressing these issues with the private sector.

The Chairman commented that the Board could trigger discussion with the biggest local employers, and then engage smaller companies.

Ronnie Wright commented that reducing stigma should be on everyone’s agenda.  Ronnie Wright suggested that ‘Stigma about mental health’ should be discussed at one of the future Health & Wellbeing Network meetings and results of that discussion could be presented to the Board.

The Chairman welcomed suggestion from Ronnie Wright.

The Chairman asked about inpatient facilities.

Andrea Morland replied that people would like to feel safe in these facilities, though often they don’t.  Andrea Morland also said that services would need to think about needs of people who are frail, whether they are elderly or young.  Andrea Morland commented that Hillview Lodge was not seen as good environment and the AWP would be exploring an option of decanting, demolishing and rebuilding Hillview to accommodate extended in-patient (wider than  ...  view the full minutes text for item 43.

The Chairman read out the relevant tweets and comments from the public that were posted during the meeting.