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Declarations of Interest
To provide an opportunity for Members and Officers to declare any disclosable pecuniary and non-pecuniary interests in any item on the agenda.
Councillor S Corcoran declared a non-pecuniary interest by virtue of his wife being a GP and a Director of South Cheshire and Vale Royal GP Alliance Ltd.
Cllr J Clowes declared that she had been asked to represent Adult and Social Care on the STP.
To approve the minutes of the meeting held on 27 September 2016.
That the minutes be approved as a correct record.
Public Speaking Time/Open Session
In accordance with Procedure Rules Nos.11 and 35 a period of 10 minutes is allocated for members of the public to address the meeting on any matter relevant to the work of the body in question. Individual members of the public may speak for up to 5 minutes but the Chairman or person presiding will decide how the period of time allocated for public speaking will be apportioned where there are a number of speakers. Members of the public are not required to give notice to use this facility. However, as a matter of courtesy, a period of 24 hours’ notice is encouraged.
Members of the public wishing to ask a question at the meeting should provide at least three clear working days’ notice in writing and should include the question with that notice. This will enable an informed answer to be given.
There were no members of the public present, wishing to use the public speaking facility.
To consider the Cheshire and Merseyside Sustainability and Transformation Plan.
Jon Develing, Senior Responsible Officer, Cheshire and Wirral Local Delivery System, attended the meeting and presented the Cheshire and Merseyside Sustainability and Transformation Plan (STP).
Partners across Cheshire and Merseyside had been working together over the past four months to develop further the blueprint set out in June to accelerate the implementation of the Five Year Forward View for communities. They had come together to address the challenges: that people are living longer, but not always healthier, lives; that care was not always joined up for patients in their local community, especially for the frail elderly and those with complex needs; that there was, as a result, an over-reliance on acute hospital services that often did not provide the best setting for patients; that there was a need to support children, young people and adults more effectively with their mental health challenges. At the same time, there were enormous pressures on health and social care budgets. It was clear that these issues required much more radical thinking about how best to address the problems faced, in order to support the needs of communities into the future. The Plan summarised the plans developed to-date to address these challenges across all the different communities in Cheshire and Merseyside, which fell into four common themes:-
· Support for people to live better quality lives by actively promoting the things we know have a really positive effect on health and wellbeing;
· Working together with partners in local government and the voluntary sector to develop more joined up models of care, outside of traditional acute hospitals, to give people the support they really need in the most appropriate setting;
· Designing an acute care system for our communities that meets current modern standards and reduces variation in quality;
· Making ourselves more efficient by joining up non front-line functions and using the latest technology to support people in their own homes.
Much of this work was already underway at local level, but there was still much to do. The role of the STP for Cheshire and Merseyside was to co-ordinate efforts, ensuring that the best ideas and expertise were promoted to provide for the needs of the whole region in the future. It would be necessary to consider more efficient ways of working and also to look at a governance and decision making framework for the STP.
It was noted that the STP contained a series of scenarios and this was not necessarily what would happen and that the various options would need to be tested. It was proposed to hold a series of consultation events and workshops in the future in order to engage with people as definitive plans were developed.
Following the presentation, members of the Board raised a number of comments and questions:-
· The Chairman thanked Mr Develing for his presentation and welcomed his comments. She referred to Section 2, at page 7 of the Plan, “Our Cheshire and Merseyside Strategy”, which highlighted that often good strategies were developed, with clear benefits, but were ... view the full minutes text for item 39.
To consider the recommendations in respect of the Better Care Fund 2016/17 Q1 Report.
On 2 September 2016, Cheshire East had submitted the 2016/17 quarter 1 Better Care Fund (BCF) return. The return had been signed-off by Cllr Rachel Bailey, as Chair of the Health and Wellbeing Board.
Consideration was given to a report, the purpose of which was to provide the Board with a summary of the key points arising from the return and to recommend next steps to improve performance within the Cheshire East health and social care system. The paper looked at national conditions, income and expenditure, metrics, additional measures and the next steps.
It was noted that good progress was being made across the system, to fully meet the national conditions. Performance metrics were variable, with some positives, but other areas were proving to be more challenging, such as Non-elective Admissions(NELs) and Delayed Transfer of Care(DToC). However, this was not unique to Cheshire East, as recently published BCF national data showed deteriorating NELs and DToCs at a national level. Health and social care colleagues were working hard together to address these challenges.
BCF would continue for at least two more years in Cheshire East, with a two year planning cycle for 2017-2019, commencing in November 2016.
In considering the report, the Board noted that there had been some interesting results when looking at the national figures and some positive results for those who have invested in the BCF and it was suggested that it would be useful to look at this in more detail.
S Whitehouse made reference to the significant challenges evidenced in the performance metrics, particularly around the deficit in hospital levels and what could be afforded. South Cheshire CCG would wish the Board to commit to review and understand this issue at an early stage and to commit to paying the minimum contribution to the BCF in the following year.
1. That the contents of the quarter Better Care Fund report be noted.
2. That the areas of improvement be noted.
3. That the areas where performance has not improved and commitment from all partners to collectively address this in the coming months be noted.
4. That the recommended next steps to improve performance where needed be supported.
5. That the two-year planning of the Better Care Fund for Cheshire East for 2017-19 be supported.
To receive a report updating the Board on progress against the Children and Young People’s Improvement Plan
Consideration was given to a report updating the Board on the progress against the Children and Young People’s Improvement Plan.
The Health and Wellbeing Board was the accountable body for the Improvement Plan and had a responsibility to ensure that sufficient progress was being made to address the 25 recommendations for improvement identified by Ofsted in its 2015 inspection report of Children’s Services.
The Improvement Action Plan had been endorsed by the Health and Wellbeing Board in November 2015 and subsequently approved by the Department for Education. The Board had subsequently received a number of updates around progress against the plan. Appendix 1 of the report provided an annual review of progress since the inspection in July 2015. This review would inform the development of the new Improvement Plan for 2017. Appendix 2 of the report set out progress against the key quantitative measures to assess impact of the plan.
1. That the progress achieved against the Improvement Plan, as set out at Appendix 1 and 2 of the report, respectively, be noted
2. That it be noted that the new Improvement Plan for 2017 would be presented to the Health and Wellbeing Board for endorsement in May 2017.
To consider a report concerning the promoting of population influenza vaccination and arrangements for the vaccination of front-line Council staff.
Consideration was given to a report providing a summary of the Council’s work to raise awareness of the Department of Health (DOH), Public Health England (PHE) and NHS England (NHSE) winter Flu Vaccination Programme 2016/17.
This work fitted with the Council’s Corporate Plan 2016 – 2020 objective: Health – Safeguarding the vulnerable and providing appropriate care that helps people live well and for longer.
The eligible vulnerable groups for this programme were identified in section 4.2 of the report and some of the local initiatives to raise awareness of this national programme across the life course were set out in Appendix 1 to the report.
The report also described how the flu vaccine was being offered to front-line staff in 2016/17 and suggested a review of this and the wider promotional work to inform the following year’s approach.
In 2016/17, the following individuals were advised to have flu vaccination:
· All children aged two to seven on 31 August 2016
· Those aged six months to under 65 years in clinical risk groups
· Pregnant women
· Those aged 65 years and over
· Those in long-stay residential care homes
· Frontline health and social care workers should be provided flu vaccination by their employer. This includes general practice staff.
Most flu vaccinations were delivered by the NHS in general practices, community pharmacies and other settings. Although vaccine uptake in Cheshire East among people aged 65 and over was 76.0% in the previous year (5% higher than England), fewer than half of pregnant women and young children were vaccinated. Pregnant women had a seven times higher risk of dying from flu than non-pregnant women.
During consideration of the report it was suggested that the Board may wish to consider alternative approaches to uptake of the vaccine. It was also felt that it would be useful to know the figures in terms of the amount of pregnant women who were offered the vaccine, uptake and deaths. It was felt that consideration should be given to ensuring a co-ordinated approach across partners, in order to achieve the right outcomes in terms of uptake.
It was agreed that a report should be submitted to a future meeting of the Board, providing a final assessment of the data, including the points raised by the Board.
1. That the Directorate’s work and that of the Health and Safety Team be acknowledged.
2. That all staff who work in children’s and adult’s services be encouraged and empowered to endorse and promote flu vaccination.
3. That a review of learning from the current year’s work to develop proposals for the 2017/18 Flu Vaccination Programme and Council vaccination scheme for reporting to Peoples DMT be supported.
4. That a report be submitted to a future meeting of the Board, providing a final assessment of the data, including the points raised by the Board.