Agenda and minutes

The Chair welcomed everyone to the meeting.

Apologies for absence were received from:

Mark Coates – Liverty Housing

Cllr Eleanor Jackson – Observer (substitute Cllr Colin Moss)

Steve Kendall – Avon and Somerset Police

Kirsty Matthews – Virgin Care

Bernie Morley – University of Bath

Laurel Penrose – Bath College

Hayley Richards – Avon and Wiltshire Partnership Trust (substitute Nicola Hazle)

Elaine Wainwright – Bath Spa University (substitute Sara Gallagher)

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.

Cllr Paul May declared a non-pecuniary interest as a Non-Executive Director on the Board of Sirona.

(a)  Mr Viran Patel submitted some questions regarding waiting list information. A copy of the questions and responses were circulated at the meeting and this document is attached as Appendix 1 to these minutes.

(b)  Cllr Will Sandry introduced two young people – Phage Butt and Aviana Read – who made a statement to the Board regarding transgender health issues and the barriers they had found when accessing health care and support.  They had received excellent support from the LGBT Group in the “Off the Record” organisation. 

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

To consider an update regarding the Better Care Fund.

10.40am – 20 minutes – Caroline Holmes

The Board considered a report which outlined how B&NES was meeting the refreshed guidance and, in particular, how it will meet the requirements against reducing delayed transfers of care (DTOCs) from hospital which had been identified in the guidance as one of the key priorities for year two.

It was noted that the Board was constrained to a certain extent by the national policy guidance.  Caroline Holmes, Senior Commissioning Manager, presented the report and outlined the revised plan.  Local areas were asked to agree and report metrics in the following four areas:

·  Delayed transfers of care from hospital.

·  Non-elective admissions in acute hospitals (using the same metric which is agreed in the CCG’s operational plan).

·  Admissions of older people (65+) to residential and care homes.

·  The effectiveness of reablement.

Non-elective admissions were 12.5% above plan but this reflected business rules not being updated to reflect the changes to service delivery where ambulatory care episodes were being recorded as admissions.

The following five new schemes have been agreed to 2018/19:

·  Mental Health Pathway Review

·  Liquid Logic

·  Delirium Pathway

·  Enhanced Discharge – Care Home Selection

·  Trusted Assessor – it was noted that this post had now been filled.

An update report was circulated at the meeting which set out progress on DTOCs since 2017.  The Board noted the improvement since January 2018.  The September target for the DTOC trajectory would not be met this year but it was anticipated that the target would be met by March.  Confirmation from NHS England was awaited that the revised trajectory would be accepted.

Tracey Cox explained that the CCG was working hard to drive down DTOCs and waiting times.  The CCG had supported Virgin Care with the Home First scheme but there was still work to do to develop a Demand and Capacity Plan.

Jane Shayler explained that the Joint Commissioning Committee was a Sub-Committee of the CCG Board including representatives of the Council and the CCG Board members.  The better care fund scheme plans had been considered by the Joint Commissioning Committee and the Finance and Performance Committee prior to being brought before this Board for sign off.

Bruce Laurence stressed the need to focus on prevention as well as the speed of transfers.

Alex Francis noted that good work was taking place and stated that it was important to communicate this to local residents to raise awareness.  Caroline Holmes agreed to discuss this with the Communications Team.

A copy of the update report is attached as Appendix 2 to these minutes.

RESOLVED:

(1)  To note the Better Care Fund plan 2017-19 update provided in the report and attached appendices.

(2)  To approve the funding commitments to schemes outlined in the report at Appendix 3.

(3)  To approve the revised Delayed Transfer of Care (DTOC) trajectories but to note the risks to assurance which will be addressed with NHS England.

To consider the Annual Reports and Strategic Plans for forthcoming years.

11am – 20 minutes – Mary Kearney-Knowles

The Board considered a report which requested members to note the development of the Children and Young People Plan 2018-2021 and to consider how they could support the delivery of the plan.

Mary Kearney-Knowles, Senior Commissioning Manager, presented the plan and covered the following matters:

·  The plan set out the vision, outcomes and key priorities that will best support children and young people in B&NES to achieve the best possible outcomes.

·  The vision was that all children and young people will enjoy childhood and be well prepared for adult life.

·  The 4 outcomes set out in the plan were:

o  All children and young people are safe.

o  All children and young people are healthy (physically and emotionally).

o  All children and young people have fair life chances.

o  All children and young people are active citizens within their own community (New outcome).

·  The 4 cross-cutting themes were:

o  Strengthen Early Help

o  ‘Think Family’ approach

o  Narrowing the achievement gap

o  A skilled and competent workforce

·  The CAMHS Transformation Plan was developed and delivered by one of the sub-groups and the emotional health and wellbeing of young people was a key priority.

·  A number of areas had attracted additional investment including the development of a one year perinatal mental health project offering a peer support service.

Cllr Paul May noted the outcome of the recent OFSTED inspection of children’s services in which B&NES had performed better than any other local authority in the South West.  He congratulated officers and the voluntary sector on their quality of work.  He also stressed the importance of increasing the educational standards of disadvantaged children and young people.

Bruce Laurence recognised the large amount of work within the Plan and highlighted the need to focus on outcomes for areas such as mental health needs and childhood obesity. 

Tracey Cox pointed out the importance of support and sign up from all partner agencies in B&NES to enable the success and delivery of the outcomes identified in the Plan.

Nicola Hazle noted that the speed at which young people are able to access mental health services was very important.  A quick response and range of interventions was key.  The CAMHS transformation had improved services and online, school and community based counselling services were now available.

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

RESOLVED:

(1)  To note the development of the Children and Young People’s Plan 2018-2021.

(2)  To note the Year 4 review of the Children and Young People’s Plan 2014-2017.

(3)  To agree to receive an Annual Report from the Children and Young People Sub-Group in September each year and to receive other reports from the Sub-Group as and when requested.

(4)  To note the B&NES Local Safeguarding Children Board (LSCB) Challenges 2017-2018 to the Children and Young People’s Sub-Group from the work of the LSCB and its Annual Report 2016-17 and Business Plan 2017-18.

(5)  To endorse the draft CAMHS Transformation Plan  ...  view the full minutes text for item 23.

To consider and note the Annual Reports and Strategic Plans.

11.20am – 20 minutes – Robert Lake/Lesley Hutchinson

The Board received a presentation regarding the Annual Reports of the Safeguarding Adults and Safeguarding Children Boards.  The report was presented by Robert Lake, Chair of the Safeguarding Adults Board.  The presentation covered the following issues:

·  Mr Lake thanked the former Chair of the Adults Safeguarding Board, Mr Reg Pengelly, for all his work along with the officers from the Safeguarding Team.  The transition to a new Chair had been very smooth.

·  The OFSTED for the Children’s Board had given a rating of “very good”.  However, it remained important not to become complacent but to feel empowered by this excellent outcome.

·  The majority of the safeguarding work was carried out by the Sub-Groups overseen by the Boards.

·  There had been an increase in the number of children safeguarding referrals.

·  The Adult Safeguarding Board would continue to use the “Think Family” approach with an emphasis on “making safeguarding personal.”

·  More work had to be carried out regarding mental capacity and to gain a full understanding of the Mental Capacity Act.

·  The Children’s Board continued to work with families and to focus on prevention, early intervention and listening to the voice of the child.

·  It was important for all agencies to work together to find an effective way of working locally.

Cllr Paul May acknowledged the safeguarding pressures on the police and the probation service.  He also stressed the importance of a smooth transition from child to adult services to ensure no gap in provision.

Mike Bowden noted that safeguarding issues change over time and drew attention to the current risks around county lines and cuckooing.  Robert Lake confirmed that the Board had considered these issues and informed the Board that the Police were the lead organisation on this.  Future training sessions and newsletters would cover county lines and cuckooing to raise awareness.

Ashley Ayre stated that although legislative changes would be soon be coming into effect regarding safeguarding it was important to focus on the core business which was the protection of children and vulnerable adults.

RESOLVED:  To note the LSCB and LSAB Annual Reports and respective Executive Summaries and their new Strategic Plans for 2018-21.

To consider the forward work plan for the Health and Wellbeing Board and to discuss items to be considered at future meetings.

11.40am – 20 minutes

The Board considered its forward work plan and discussed which items should be discussed at future meetings.

Mental health was identified as a key area for future discussion.

RESOLVED:

(1)  To approve the current forward plan.

(2)  To agree to consider mental health, including autism and wider SEND issues, at the January meeting.

To note that the next meeting will take place on Tuesday 27 November 2018.

The next meeting will take place on Tuesday 27 November 2018.

The Chair will close the meeting.

12 noon – 5 minutes – Dr Ian Orpen

The Chair thanked everyone for attending the meeting.