Agenda and minutes

The Chair welcomed everyone to the meeting.

He explained that two information reports had been circulated to Board members regarding the annual reports of the Sexual Health Board and the Local Safeguarding Adults Board.  These reports were circulated for information only and would not be discussed at this meeting.

Apologies for absence were received from:

Cllr Tim Ball – Observer – substitute Cllr Will Sandry

Jane Carroll – Virgin Care – substitute Val Scrase

Mark Coates – Knightstone Housing

Tracey Cox – Clinical Commissioning Group

Stuart Matthews – Avon Fire and Rescue Service

Bernie Morley – University of Bath

Laurel Penrose – Bath College

Cllr Vic Pritchard – B&NES Council

Hayley Richards – Avon and Wiltshire Partnership Trust

James Scott – Royal United Hospital Bath NHS Trust – substitute Fiona Bird

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

There were no public questions or comments.

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

The minutes of the previous meeting held on 6 September 2017 were approved as a correct record and signed by the Chair.

To consider the attached report which describes the role the two key organisations, B&NES Council and B&NES CCG, could play in the B&NES system in leading the extension and enhancement of integrated commissioning for the benefit of the population and to create a more sustainable approach to Health and Care going forward.

10.40am – 30 mins – Mike Bowden/Jane Shayler

The Board considered a report which described the role that B&NES Council and B&NES CCG could play in leading the extension and enhancement of integrated commissioning for the benefit of the population and to create a more sustainable approach to Health and Care going forward.

Each organisation has its own constitution and separate accountabilities but has a common interest in the health and wellbeing of local people.  There is now an opportunity to strengthen existing joint arrangements to achieve the level and pace of service integration needed to meet current and future challenges.  This will enable both organisations to provide the seamless health and care which residents need and to meet the sustainability challenge faced by both organisations.

There are already a number of joint commissioning arrangements in place.  The focus in the first instance would be on governance and decision making arrangements.  The key principle to support integrated commissioning is that the new model must be capable of adding value and improving outcomes.  Providers would appreciate a clearer single voice from commissioners and shared information could be used to good effect.

This proposal offered an exciting opportunity to move the partnership forward to support the delivery of the Health and Wellbeing Board strategy.

In response to a question from Sarah Shatwell, Jane Shayler confirmed that the following services currently operated pooled budgets:

·  Mental health

·  Learning disabilities

·  Better Care Fund including from 2017/18 community health and care services

·  Community equipment

·  Children’s complex needs

She also confirmed that further updates would be brought back to the Board as the project progresses.  It was noted that the proposed integration will take the form of a “partnership of equals.”

Dr Ian Orpen stated that this provided a good opportunity to bring together many elements as commissioning is currently fragmented.  The focus should be on considering the person and not the condition and how to do this effectively.

RESOLVED:

(1)  To agree broad support for the proposal to develop an Integrated Commissioning model between the Council and the Clinical Commissioning Group, that is fit for purpose, sustainable and responds effectively to emerging issues and pressures across health and social care.

(2)  To note the benefits of this integrated commissioning model as an enabler for delivering the Joint Health and Wellbeing Strategy and improved health and wellbeing outcomes for the people of B&NES.

(3)  To note the links to the early work of the Board in considering the development of an Accountable Care model across Bath & North East Somerset.

To receive an update on the Economic Strategy Review, which was presented in 2015, along with an introduction to the B&NES Virtual Employment Hub.

11.10am – 30 mins – Ben Woods

The Board considered a report which provided an update on the Economic Strategy Review, which was presented in 2015.  The report also set out an introduction to the B&NES Virtual Employment Hub.

Ben Woods, Group Manager – Economy and Culture, gave a presentation to the Board regarding the Employment Hub.  The presentation covered the following issues:

·  It is important to improve the employment prospects of residents as evidence shows that being in work improves both physical and mental health.

·  The latest information on benefit claimants in the B&NES area is:

o  1671 people claiming Universal Credit and seeking work intensively.

o  581 people in work, claiming Universal Credit and required to increase their income.

o  656 people with no work requirements following the work capability assessment

o  260 people on Jobseekers Allowance

o  2330 people on Employment Support Allowance

o  1720 on Employment Support Allowance and Disability Living Allowance

o  920 on Disability Living Allowance only

o  2500 on other combinations

·  Work and Health Programme – the organisation Pluss has been awarded the Southern Contract Package area.  This replaces the work Choice and Work Programme.

·  There will be voluntary referral for claimants with health barriers and mandatory referral for claimants who are long term unemployed (over 2 years).

·  The programme will provide an opportunity to improve service integration.  There are currently a large number of employment support programmes in the local area which officers will track and engage with.

·  Officers will be identifying employment opportunities in the local area and aiming to secure jobs for residents (for example the in new Bath casino)

·  The West of England Combined Authority will also have an important role in the provision of work and training opportunities.

·  It is vital to ensure that training takes place at the point where people can use these skills to get into work.

·  Of people out of work due to health barriers 51% are because of mental health issues.

·  There will be early engagement with Virgin Care and links to existing arrangements such as the Volunteer Centre.

·  Pathways and referral mechanisms between services will be developed.

The Board then discussed the report and presentation covering the following points:

·  Bruce Laurence noted the importance of considering outcomes, particularly for people with mental health issues and learning difficulties.  He noted that it was also important to provide relevant vocational training to provide the skills required locally.

·  Cllr Jackson asked officers to consider engaging with two other organisations – Bath Mind and Swallows - in the Somer Valley area who provided employment support.

·  Jane Shayler advised, in response to a question about performance indicators for supporting people with a mental health need or learning disability into employment, that performance is good but these performance indicators only capture employment information for those already in contact with services so there was more that could be done to identify and provide support into employment for those people not in contact with statutory services.

·  Fiona Bird stated that the RUH, as a large  ...  view the full minutes text for item 32.

To receive a presentation regarding the creation of a prevention concordat.

11.40am – 20 mins – Jane Shayler

Jane Shayler, Director – Integrated Health and Care Commissioning, gave a presentation to the Board regarding the implementation of the prevention concordat.  The following issues were outlined:

·  The concordat is a shared commitment by a wide range of national organisations.

·  It represents an approach to improving people’s mental health and reducing the risk of mental illness.

·  It was launched by Public Health England as an ambition of the Five Year Forward View for Mental Health to support the objective that all local areas have a prevention plan in place by 2017/18.

·  The concordat includes:

o  Promoting good mental health and wellbeing

o  Preventing mental health problems and suicide

o  Improving the lives of people experiencing and recovering from mental health problems

From early years and adolescence through adults and parenthood and into older age.

·  Public Health England proposed the following five key steps to create a local prevention plan for better mental health:

o  Needs and assets assessment

o  Partnership and alignment

o  Translating need into deliverable commitments

o  Defining success outcomes

o  Leadership and accountability

·  The Health and Wellbeing Board could take a lead role in:

o  Raising the profile of this work

o  Inviting the key partnerships and groups to account for progress

o  Supporting co-ordination across the system

o  Identifying one or two specific preventative initiatives to promote good mental health and wellbeing in B&NES.

Bruce Laurence noted that many physical health symptoms were generated by stress and so improving mental health would also lead to improvements in physical health.

Diana Hall Hall stressed the need to listen to local health and wellbeing and mental health networks to ascertain their needs and requirements.

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

RESOLVED:

(1)  To agree the approach outlined in the presentation with regard to implementing the Prevention Concordat.

(2)  To support the suggestion of a “Year of Mental Health” including events to raise awareness of mental health issues and tackle stigma including the “5 ways to wellbeing” model:

·  Connect – with the people around you family, friends, community

·  Be active

·  Take notice – be curious, catch sight of the beautiful, savour the moment, be aware of the world around you

·  Keep learning

·  Give – thank someone, smile, volunteer, join a community group

To consider the annual report of the Health Protection Board which documents the progress made on the priorities and recommendations set out in the 2015-16 report; highlights the key areas of work that have taken place in 2016-17 and identifies priorities for the next 12 months.

12 noon – 20 mins – Becky Reynolds

(Note: At this point Dr Ian Orpen left the meeting and Cllr Paul May took the chair.)

The Board considered a report setting out the annual report of the B&NES Health Protection Board 2016/17.  The report detailed the progress made by the Board on its priorities and recommendations, highlighted the areas of work that had taken place in the last year and identified priorities for the forthcoming year.

Becky Reynolds, Consultant in Public Health, and Anna Brett, Health Protection Manager, gave a presentation covering the following issues:

·  Definition of Health Protection

·  Specialist areas covered by the Health Protection Board

·  Progress on 2015/16 priorities – 4 of the priorities had been rated as “green” and 3 as “amber”.

·  The primary school project to raise antibiotic awareness had been particularly successful.  The campaign in B&NES to raise awareness of the importance of using antibiotics won in the Community Engagement category of this year’s national Antibiotic Guardian awards.

·  The importance of immunisation was stressed and in particular the uptake of the MMR vaccination.

·  Illegal tattooing was another issue that had arisen last year with a particular instance of under 18 year olds being tattooed by an unregistered tattooist.

Andrew Smith stated that the antimicrobial resistance strategy had been very helpful to GPs.

It was noted that overall in B&NES there had been a 65% uptake of bowel cancer screening.  Research showed that men were less likely to participate in screening than women.

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

RESOLVED:

(1)  To note the annual report of the Health Protection Board for 2016/17.

(2)  To support the following priorities for the Board for 2017/18:

·  Assurance: continue to monitor the performance of specialist area, identify risks, ensure mitigation is in place and escalate as necessary.

·  Support activities to slow the development and spread of antimicrobial resistance.

·  Continue to ensure that the public are informed about emerging threats to health.

·  Support the review, development and implementation of all Air Quality Action Plans.

·  Improve the uptake of flu vaccinations in at risk groups, pregnant women, health and social care workers, and carers; and pneumococcal vaccination amongst under 65s at risk and over 65s.

·  Continue to reduce health inequalities in screening and immunisation programmes.

To note that future meetings will take place on the following dates:

Tuesday 30 January 2018 – Kaposvar Room, Guildhall

Tuesday 17 April 2018 – Brunswick Room, Guildhall

Tuesday 26 June 2018 – Brunswick Room, Guildhall

Tuesday 25 September 2018 – Brunswick Room, Guildhall

Tuesday 27 November 2018 – Brunswick Room, Guildhall

Meetings will normally commence at 10.30am.

It was noted that the next meeting would take place on Wednesday 6 December 2017 and that meetings in 2018 would take place as follows:

Tuesday 30 January 2018 – Kaposvar Room, Guildhall

Tuesday 17 April 2018 – Brunswick Room, Guildhall

Tuesday 26 June 2018 – Brunswick Room, Guildhall

Tuesday 25 September 2018 – Brunswick Room, Guildhall

Tuesday 27 November 2018 – Brunswick Room, Guildhall