Agenda and minutes

Apologies were received from Caroline O’Brien and Councillor Janet Clowes.

To provide an opportunity for Members and Officers to declare any disclosable pecuniary and non-pecuniary interests in any item on the agenda.

No declarations were made.

To approve the minutes of the meeting held on 29 November 2016

RESOLVED:

That the minutes of the meeting held on 29 November 2016 be approved as a correct record, subject to the inclusion of P Bowen as being present.

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 receive a report and presentation on the Health of Cared for Children and Young People

Sheila Williams, designated Nurse Care for Children, presented the Health of Cared for Children and Young People Annual Report for period September 2015-2016.

The purpose of the report was to provide assurance to the Board and to highlight any potential areas for service improvement in 2016/17.  It recognised both the statutory responsibilities and the role of agencies working together as corporate parents.

The report provided details on the numbers of children in care in Cheshire East, health indicators, staffing and funding.  The report listed 11 priorities and actions and the Board was advised that a detailed action plan had been produced taking these into account and following the Care Quality Commission Inspection report published at the end of last year.

It was noted that multi agency partnerships were being strengthened through working with the Corporate Parenting Operational Group, which reported to the Corporate Parenting Committee, so enabling greater scrutiny of how local authority and health services worked together in relation to the health of cared for children.

The Board commented on the impact of the resource shortages on statutory health assessments; the importance of emotional and mental health of care for children;  the shortage of foster carers and adopters, and asked for an update on performance at a future meeting.

RESOLVED: That

1        the Annual Report on the Health of Cared for Children and Young People be noted; and

2        a follow up report be brought to the Board in May with an update based on end of year data.

To receive a presentation on the Mental Health Needs of Adopted Children and Young People

Michael Lloyd was unable to attend the meeting to present the findings of the mental health needs assessment of adopted children and young people.

It was therefore agreed that this item should go to the Corporate Parenting Board.

To consider a report which details the allocation of the total historical Section 256 reserve funds (underspends) held by the Council

Consideration was given to a report on the allocation of the total historical Section 256 reserve fund (underspends) held by Cheshire East Council.  The creation of the reserve fund was approved by the Health and Wellbeing Board on 24 March 2015.

The Value of the S256 was £3.391m, which was made up of underspends in financial years 2013-14 and 2014-15.  These underspends had been set aside in an Earmarked Reserve by the Council to ensure that they were allocated in line with the conditions of the NHS England transfer.

Since the Board’s decision in March 2015, a number of proposals for spending the reserve fund had been set out by the Council but were not agreed by the Clinical Commissioning Groups, as it was felt the initiatives did not meet the whole care system pressures and did not represent evidenced value for money.

In May 2016 the Clinical Commissioning Groups had requested the reserve fund be returned and in November 2016 agreement was reached on the allocation of the reserve funds – details of which were set out in paragraph 1.6 of the report.

RESOLVED:

That the agreed allocation of the historic Section 256 reserve funds, in line with the details contained in the table in paragraph 1.6 of the report, be noted.

To consider the recommendations in respect of the Better Care Fund 2016/17 Quarter 2 Report

Cheshire East Council had submitted the Quarter 2 Better Care Fund return on 17 November 2016.  The return had been signed off by Councillor Rachel Bailey, as Chairman of Cheshire East Health and Wellbeing Board.

Consideration was given to a report which provided 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 report looked at national conditions; income and expenditure; metrics; additional measures and next steps. 

The Board noted the progress being made across the system to meet the national conditions. In relation to the performance metrics, the non-elective admissions the gap between the target  and actual was narrowing, whilst delayed transfer of care continued to be a challenging area. The reasons for this were being examined via the respective A&E Delivery Boards.

The Better Care Fund Governance Group was currently evaluating all Better Care Funded schemes with a focus on all the schemes’ effectiveness, overall benefits and costs.  The findings would inform the Better Care Funding Plan for 2017/19 in Cheshire East.

RESOLVED:  That

1        the contents for the Quarter 2 Better Care Fund report be noted;

2        the areas of improvement be noted;

3        the areas where performance had not improved and commitments from all partners to collectively address this in the coming months be noted;

4        the recommended next steps to improve performance where needed be supported; and

5        the two year planning of the Better Care Fund for Cheshire East for 2017-19 be supported.

To receive a presentation on the South Cheshire Clinical Commissioning Group Operational Plan 2017-19

Simon Whitehouse, Chief Executive of South Cheshire Clinical Commissioning Group, gave a presentation on the Operational Plan 2017-19.  A copy of the Plan was included in the agenda pack.

The South Cheshire Clinical Commissioning Group was facing significant financial challenge, with the current level of funding available not allowing them to meet increasing patient demand if they continued to deliver services in the way they did now. 

The Clinical Commissioning Group was looking at possible solutions to manage the financial position and this included the decommissioning and redesign of services;  transferring care closer to  home;  transferring  of outpatients to care communities for follow up; community services redesign; and reducing the number of community beds.

RESOLVED:

That the South Cheshire Clinical Commissioning Group Operational Plan 2017-19 be received.

To receive a presentation on the Eastern Cheshire Clinical Commissioning Group Operational Plan 2017-2019

Jerry Hawker, Chief Executive of Eastern Cheshire Clinical Commissioning Group, gave a presentation on the Operational Plan 2017-19.

It was stated that, at present moment in time, Eastern Cheshire Clinical Commissioning Group would not be producing an Operational Plan for 2017-19.  The Clinical Commissioning Group was trying to balance their funding allocation against the growing demand and expectations for services. A financial plan had been put in place to deal with the projected deficit of £17.8m. 

The key areas of focus for 2017-18 included a system transformation through the Care Together Programme and the development of Accountable Care; the effective use of resources to deliver value for money services, and continuous improvement to the way services were delivered.

RESOLVED:

That the presentation on the Eastern Cheshire Clinical Commissioning Group Operational Plan 2017-19 be received.

To review the Terms of Reference

The Health and Wellbeing Board’s Terms of Reference included the requirement for them to be reviewed on an annual basis. This provided an opportunity to ensure that they remained fit for purpose and were appropriate for the smooth functioning of the Board.

The current version of the Board’s Terms of Reference had been approved by Council in October 2015.  Following consultation with the Eastern and South Cheshire Clinical Commissioning Groups, there was a proposed alteration within Section 2 – Purpose, which had two wording options for consideration:

“To be a forum that enables member organisations of the Board to hold each other to account for implementation of strategic and operational plans”

or

“To be a forum that enables member organisations of the Board to hold each other to account for their responsibilities for improving the health of the population.”

It was also proposed that an additional paragraph be added with Section 7 -  Agenda and Notice of Meetings as follows:

“7.2    Any voting member of the Board may approach the Chairman of the Board to deal with an item of business which the voting member believes is urgent and under the circumstances requires a decision of the Board.  The Chairman’s ruling of whether the requested item is considered/tabled or not at the meeting will be recorded in the minutes of the meeting.”

RESOLVED:  That

1        the Terms of Reference be amended to include:

a)       in Section 2 – Purpose, the second wording option:

“To be a forum that enables member organisations of the Board to hold each other to account for their responsibilities for improving the health of the population.”;

b)       in Section 7 – Agenda and Notice of meeting, the additional paragraph:

“7.2    Any voting member of the Board may approach the Chairman of the Board to deal with an item of business which the voting member believes is urgent and under the circumstances requires a decision of the Board.  The Chairman’s ruling of whether the requested item is considered/tabled or not at the meeting will be recorded in the minutes of the meeting.”

2        the Terms of Reference be reveiwed every two years.