Agenda and minutes

The Chair welcomed everyone to the meeting.

Apologies for absence were received from:

Ashley Ayre – B&NES Council

Mike Bowden – B&NES Council

Jayne Carroll – Virgin Care (substitute Kirsty Matthews)

Tracey Cox – CCG

Cllr Paul May – B&NES Council

Hayley Richards – AWP

Sarah Shatwell – Developing Health and Independence

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.

There were no declarations of interest.

Three questions were submitted by John Drake, Regional Organiser, UNISON South West.  A copy of the questions and responses are attached as Appendix 1 to these minutes.

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

The minutes of the meeting held on 25 October 2017 were approved as a correct record and signed by the Chair.

To receive an update from the Children and Young People’s Sub-Group.

10.40am – 25 mins – Jane Shayler and Mary Kearney-Knowles

The Board considered a report from the Children and Young People Sub-Group of the Health and Wellbeing Board.

Officers thanked all partners and the young people who had assisted in the production of the draft Children and Young People’s Plan 2018 – 2021.  The new plan set out the vision, outcomes and priorities that will best support children and young people in B&NES to achieve the best possible outcomes.

The vision is that “all children and young people will enjoy childhood and be well prepared for adult life.”

The 4 outcomes are:

·  All children and young people are safe

·  All children and young people are healthy (physical and emotional)

·  All children and young people have fair life chances

·  All children and young people are active citizens within their own community

The 4 cross cutting themes are:

·  Strengthen early help

·  “Think family” approach

·  Narrowing the attainment and inequalities gap

·  A skilled and competent workforce

Officers also informed members of the consultation process to be followed and the next steps. 

Board members then discussed the following issues:

·  The importance of considering the effect of social media on the health and emotional wellbeing of young people.  It was vital to consider online safety.

·  It will be important in future to work more closely with partners due to services being under increasing pressure.

·  There is a focus on early intervention and joined up services.  Peer support and mentoring will also be key.

·  It was noted that there could be opportunities to work more closely with the universities given the large student population in Bath.

·  Bath College has a significant amount of data, which can be shared as appropriate, relating to 16-19 year olds, with a particular focus on protected characteristics and areas of deprivation.

·  It was suggested that more emphasis should be put on housing as the risk of homelessness can greatly affect children and young people.

A copy of the presentation slides is attached as Appendix 2 to these minutes.

RESOLVED:

(1)  To endorse the draft Children and Young People’s Plan for 2018 – 2021 (attached as appendix 1 to the report) and to agree that each individual agency supports and promotes the outcomes and priorities within their service delivery to children, young people and their families.

(2)  To note the timescales on the completion of the Year 4 review of the Children and Young People’s Plan (covering 2017 – 2018) and the proposal that the completed Year 4 review is presented to the Health and Wellbeing Board in December 2018.

(3)  To receive six monthly information reports in June and December on the work undertaken by the Children and Young People Sub-Group and its delivery groups.

(4)  To note the B&NES Local Safeguarding Children’s Board (LSCB) challenges 2017 – 2018 to the Children and Young People Sub-Group from the work of the LSCB and its Annual Report 2015 – 2016 and Business Plan 2015 – 18. (These challenges will be reported on every 6 months within the LSCB Business  ...  view the full minutes text for item 43.

The Bath and North East Somerset Health and Wellbeing Board has a legal obligation to produce and publish a refreshed Pharmaceutical Needs Assessment (PNA) for the area by 1 April 2018.  The refreshed 2018-21 draft Pharmaceutical Needs Assessment is currently out for consultation for a period of 70 days from 11 December 2017 to 18 February 2018.  The Board is asked to consider the attached report.

11.05am – 25 mins – Paul Scott and Joe Prince

The Board considered a report regarding the refreshed 2018 – 2021 Pharmaceutical Needs Assessment (PNA) which was currently out for consultation.

The PNA is a statement from the Health and Wellbeing Board which describes the provision of pharmaceutical services across Bath and North East Somerset, as well as assessing whether there are any significant gaps in the provision of local pharmaceutical services.  The key findings will help to inform the future commissioning and delivery of local pharmacy services by NHS England, the CCG and the Council.

The key findings of the report are:

·  There are no significant gaps in the current provision of easily accessible local community pharmaceutical services that serve all three PNA areas in B&NES.

·  Within the existing pharmaceutical provision there are a number of pharmacies that do not have wheelchair accessible “closed” consultation rooms.

·  It is anticipated that current pharmaceutical provision from existing pharmacies will be able to cope with the demand from new populations during the period of this PNA.

·  There are no known planned relevant local NHS services that could significantly alter the need for pharmaceutical services in B&NES.

It was noted that further work may be required to ensure that there is alternative provision for wheelchair users within a suitable distance of their homes.

Officers confirmed that substance misuse services were covered within the assessment.

It was noted that the majority of people still collect their prescription medication from their local pharmacy.  However, this may change in the future with more electronic prescribing and delivery services which could affect the viability of local pharmacies.  Seven day working is also becoming more prevalent so the term “out of hours” is becoming less relevant.

Officers explained that if a pharmacy were to close then this would lead to a gap being identified by the PNA Steering Group which meets regularly.

Local communities have been consulted as part of this process and satisfaction with pharmacy services is high.

RESOLVED:

(1)  To note the key findings set out in the current draft Bath and North East Somerset Pharmaceutical Needs Assessment 2018 – 2021.

(2)  To delegate authority to the co-chairs of the Health and Wellbeing Board to approve the final version of the Pharmaceutical Needs Assessment 2018 -2021 following the end of the consultation period in February and any further amendments made in March 2018.

(3)  To agree the proposed arrangements for maintaining and keeping the Pharmaceutical Needs Assessment up to date.

The attached report summarises the feedback and findings from the Mental Health Pathway Review as well as making recommendations for further areas of work.

11.30am – 25 mins – Jane Shayler

The Board considered a report which summarised the feedback and findings from the Mental Health Pathway Review and made recommendations for further areas of work.

The Review Team has engaged with service users, carers, providers and the general public.  This has highlighted a number of areas where people felt that services could improve along with some areas where services were duplicated.

There are 6 workstreams as follows:

·  Mental Health Collaborative

·  Care Co-ordination

·  Crisis Response

·  Employment

·  Transition

·  Governance

It was noted that in there may be opportunities to expand the crisis response service provided by The Wellbeing House.  It is currently only available from Monday to Friday and has no staff on site after 5pm which means that there is no safe haven out of hours.

It was also important to consider physical and mental health services together as mental health can often have an effect on a person’s physical health.

Concern was expressed about the fact that the options appraisal regarding future contracting arrangements had been unable to conclude because further guidance from HMRC is awaited.

Some work is also taking place regarding flexible transitions between children and young people’s mental health and adult mental health with a view to commissioning specific services for this younger age group.

Healthwatch was pleased to see that the report highlighted collaborative working between services.  It was noted that some services currently shared with the voluntary sector had been affected by the review.  Officers confirmed that information will be circulated to various organisations and partners following this meeting.

The Director, Integrated Health and Care Commissioning, also gave an update regarding the Mental Health Prevention Concordat which covered the following issues:

·  Leadership

·  Year of Mental Health – this will take place from April 2018 – March 2019.  The possible outcomes were also outlined.

·  An initial planning session for the year has taken place and a small planning group will be established to develop a communications plan and schedule of events.

A copy of the presentation slides is attached as Appendix 3 to these minutes.

RESOLVED: 

(1)  To note the proposed allocation of resources.

(2)  To note the process in respect of future contracting arrangements.

11.55am – 30 mins – Jane Shayler and Caroline Holmes

The Board considered a report which gave an update on performance against the B&NES Better Care Plan.  This included an update on schemes, governance, finance and the position against delayed transfers of care (DTOCs) from hospital.

The report also set out details of the national performance metrics.  The metrics so far this year demonstrate a health and social care system under significant pressure.  It was noted that permanent admissions of older people to residential and nursing care homes were 2% below plan.  The number of people being placed at home with very intensive care packages has also decreased.

There are a number of schemes in place to reduce delayed transfers of care as follows:

·  Reablement and its review

·  7 day working in Home First

·  Discharge to Access beds

·  Support planning and brokerage (commissioning Care Home Select to provide interim support)

·  Community equipment

·  Fracture support pathway beds

·  Community hospital review

Work is ongoing with Virgin Care and a number of schemes are progressing well.  However, some measures have been delayed which means that they have not been as effective as expected.

The use of the additional 5 beds that had been provided would be evaluated to gauge whether this was set at the right level.

Board members were keen to see community equipment being recycled as much as possible.  Officers informed the Board that a stocktake has been carried out and that some equipment has been returned.  An equipment amnesty is also planned to take place in February.

The figures reflected the national situation and it was noted that evidence showed that the number of emergency admissions are growing and are currently at record levels.  This is proving to be a challenge for the RUH.

Concern was also expressed about the projected growth in the number of people aged over 85 which is predicted to grow by 13.6% in the next 10 years.  This is likely to present a significant challenge to the health and social care sectors.

RESOLVED:  To note the update on the Better Care Fund 2017-19 provided in the report and appendices.

To note that the next meeting will take place on Tuesday 17 April 2018 at 10.30am in the Brunswick Room, Guildhall.

It was noted that the next meeting would take place on Tuesday 17 April at 10.30am in the Brunswick Room, Guildhall, Bath.