Agenda and minutes
Venue: Maidstone House, King Street, Meeting Room 6E
Contact: Yvonne Wilson 01732 375251
Welcome and Introductions, Apologies for Absence
The Chair welcomed everyone to the meeting.
Apologies had been received from the following Board members:
Gail Arnold Chief Operating Officer, NHS West Kent CCG
Julie Beilby Chief Executive, Tonbridge & Malling Borough Council
Cllr Annabelle Blackmore Maidstone Borough Council
Lesley Bowles Chief Officer for Housing, Health, Communities and Business, Sevenoaks District Council – Substitute, Hayley Brooks
Alison Broom Chief Executive Maidstone Borough Council – Substitute, Matt Roberts
Reg Middleton Finance Director, NHS WK CCG
Dr Andrew Roxburgh GP representative NHS WK CCG
Dr Sanjay Singh GP representative, NHS WK CCG
Penny Southern Director of Disabled Children, Adults, Learning Disability & Mental Health, KCC
Malti Varshney KCC Public Health/CCG Aligned PH Consultant
Declaration of Disclosable Pecuniary Interests
There were none.
The minutes of the previous meeting were agreed.
The Chair, Bob Bowes invited specific feedback on the following Action Points from previous meeting:
7/16: Welfare Reforms and Housing Planning Bill (2015 – 2016): Impact on Health
Hayley Brooks reported that initial discussions were yet to be held on the feasibility of setting up a Task & Finish Group. The HWB Partnerships Officer reported on a number of developments since the previous meeting which addressed recommendations of the last meeting including housing and homelessness workshop facilitated by Maidstone Borough Council involving participants from NHS WK CCG; Maidstone & Tunbridge Wells NHS Trust representation; national and local community voluntary sector; service users; Public Health; faith organisations; KCC and WK HWB.
Cross-borough Housing Strategy development event held (TMBC, SDC and TWBC) which included reflection on economic and health impacts and offered an opportunity to share the outcome of the recent Board deliberations and feed into the strategy development.
Liaison and engagement commenced with local Citizen’s Advice Bureaux about the contribution they make, establishing links also with the Self-Care, Self-Management Task & Finish Group work.
Meeting held between NHS WK CCG and Sevenoaks District Council officers to explore joint work supporting work to address Delayed Transfers of Care.
CCG has accepted representation on cross-Kent Board developing protocols for Disabled Facilities Grant.
8/16: Growth & Infrastructure Framework (GIF)
Hayley Brooks reported that Chris Metherill, KCC had duly made contact with borough/district councils as recommended following the last Board Meeting.
Election of WK HWB Chair and Vice Chair
Dr Bob Bowes was re-elected as Chair of the WK HWB. Cllr Roger Gough was re-elected as Vice Chair of the WK HWB.
Kent Health and Wellbeing Board - Feedback
Cllr Roger Gough highlighted the following key issues from the Kent HWB meeting:
· Discussion on Delivering the Five Year Forward View had been the main agenda item focussing on issues which were at that time a reflection of progress made. Cllr Gough explained that the work had moved on from articulating a ‘vision’ to developing a ‘plan’.
· Workforce Task & Finish Group co-chaired by Hazel Carpenter and Philippa Spicer presented its final report to the Board setting out issues and steps to tackle these. The Kent HWB agreed that this Action Board would serve under the governance of the Delivering the Five Year Forward View Group.
· The Board considered Kent’s Better Care Fund (BCF) for 2017-18 which reflected little change from the previous year. The Kent HWB noted that there would be new arrangements for the BCF from 2018 – 2019 with a significant increase in monies from the period 2019 – 20 as part of the programme drive health and social care integration.
· A major review of Obesity work led by local HWBs was conducted and highlighted positive work across Kent. Cllr Gough noted that work on Delivering the Five Year Forward View had begun to recommend a strong focus on prevention, including tackling obesity and highlighting a need to promote increased levels of physical activity.
· Elements of the Joint Strategic Needs Assessment were reviewed.
- KCC Position – Paper attached
- CCG Footprint Position
- Governance Structure
Mark Lemon outlined the KCC position as set out in the attached paper as at 19 May 2016. Mr Lemon explained that the Steering Group was meeting regularly and a series of drafts reflecting on progress had been produced.
Cllr Gough reported the following additional information to Board members:
· System Leaders’ workshop was held on 21 June 2016 (Bob Bowes and Cllr Roger Gough were in attendance)
· Draft Plan had been submitted to the NHS Executive on 30 June 2016 (this was the 5th version of the Plan)
· Kent & Medway System leaders (including Cllr Gough), were due to meet the NHS Chief Executive on 25 July 2016. The ‘centre’ had posed a number of key questions for the System Leaders, including how sustainability in the acute sector would be addressed; what investment would look like and how hospital rationalisation will be managed
· Emerging information suggests that the Plans submitted would be graded into three categories, those that adequately set out the plans for the designated footprint area; plans which demonstrated that the work being developed by the System Leaders was broadly on track and the final group where more work was required to construct a credible plan. Early indications suggested that ‘support/assistance’ may be given to footprint areas falling within this last category
· Localities would be given the period over the summer to do further work on Plans in time for re-submission in September 2016
· The current Plan version contained a coherent and cogent section on prevention
· Emerging Governance arrangements would need to involve 8 CCGs, 23 Providers and Commissioners and a total of 43 ‘relationships’ in the system, a measure of the complexities across the Kent and Medway ‘footprint’.
Bob Bowes reported on the “CCG position” and explained that there was now a new way of looking at issues, and no longer an approach which represented a ‘CCG view’. Important areas for consideration included prevention; focus for investment; addressing population growth; ways of managing the clustering of populations around GP Federations; the clustering of services in community settings and staffing/skill-mix. A Kent Commissioning Forum and CCG representative body was being established as a Clinical Reference Group in the Delivering the Five Year Forward View governance structures.
Task & Finish Group Reports
Governance (Oral Update)
WK HWB Annual Report – Report to follow
Self-Care, Self – Management (Oral Update)
Self-Care, Self- Management
Tony Jones reported that the group had now held a first meeting with participants drawn from a range of agencies and also including service user representatives. The following was agreed at the first meeting:
· Terms of Reference
· Chair and Vice – Chair arrangements
· Core principles/values and ways of working
· Priorities for action and lead officers
The HWB Partnerships Officer reported that the Group had not yet completed the task set by the HWB in response to the Kent HWB report on relationships, functioning and leadership, though all the issues highlighted by the Kent HWB had been reviewed in the drafting of the Annual Report before the WK HWB.
WK HWB Annual Report
Bob Bowes introduced the report and acknowledged that it offered the Board important opportunities to:
· place a sharper focus on the work it had carried out
· assess achievements
· refresh its ‘direction of travel’ within the context of the emerging new agenda
· consider the experience of the Task & Finish Groups
· evaluate the extent to which the HWB had been able to influence/drive forward the integration agenda
· review whether the HWB had influenced strategic commissioning
Bob Bowes invited Cllr Gough’s comments as the Chair of the parent Committee to this Board. Cllr Gough expressed the view that the local HWBs were asked to conduct two differing types of business, within an environment in Kent, very different to many other places. Cllr Gough acknowledged the presence of social care at Board meetings had been patchy; discussions around commissioning and the drive towards integration had been limited. However, the role of the district/borough councils was central to the HWB making progress towards a prevention focus and the need for effective relationships between the CCG and councils at a local level was paramount in addressing inequalities and wider determinants. This aspect of the local HWBs work was felt to be what required strengthening as alluded to in the report.
Cllr Gough outlined his position in relation to implementing the Five Year Forward View developed, which was that as new models of care developed including stronger association between commissioners and providers, the rationale for and nature of HWBs as initially established must necessarily change.
Bob Bowes reported that as chair, he felt there needed to be a stronger focus on looking at how to make the HWB more effective by focusing on the population outcomes; how to ensure populations are better served in relation to addressing wider determinants as a result of improved strategic and operational efforts between the CCGs, councils and others.
Cllr Weatherly felt that the HWB had worked very hard, but had not achieved much that affected residents in obvious ways. Pat Graham commented that there was a need to identify common concerns and to understand the needs of different agencies.
The HWB Partnerships Officer drew members’ attention to the recommendations set out within the boxes in the Annual Report and emphasised the importance of the Board being able to measure its success, track the work carried ... view the full minutes text for item 8.
Thom Wilson, Head of Strategic Commissioning, Children’s Social Care, Health & Wellbeing at KCC delivered a presentation to the Board based on the slide pack distributed in advance. Mr Wilson explained that the Section 10 of the Children’s Act xxxx set out a requirement that agencies collaborate and that each area must maintain a partnership body to undertake strategic and operational planning around the needs of children and young people. In addition, Ofsted required each area to produce a strategy for children and young people.
KCC has developed a ‘blueprint’, setting out arrangements across the county area that also enables a district focus. Mr Wilson reported that the Children and Young People Plan is being finalised against which 17 indicators of the health and wellbeing of local children and young people have been identified. Each Local Children’s Partnership Groups has a strong focus on tracking and measuring indicators of success supported by training in Outcome Based Accountability (OBA) the methodology for delivering interventions capable of addressing the factors at the root cause of the chosen concern/problem/issue. Mr Wilson explained that a performance Dashboard is being compiled using public health and other data which will assist each of the LCPGs and the parent body, the 0-25 Health and Wellbeing Board to assess progress against the Plan ambitions. Mr Wilson described the programme for rolling out training for OBA for commissioning officers and LCPG members. Mr Wilson also explained that it may be possible to offer training on OBA to partners so that there is a shared understanding about the process and meaning behind the OBA methodology.
The Chairs of the West Kent LCPGs had been invited to attend the HWB, Heather Brightwell, the independent chair of the Sevenoaks LCPG was in attendance and shared her reflections on the challenges facing partnership groups to provide a real focus on making a difference and in making sure that identifying real outcomes for local communities, especially those most in need was at the heart of the partnership’s work.
Bob Bowes commended the efforts to boost the effectiveness of the Local Children’s Partnership Groups and reminded members that careful though needed to be given to making sure the efforts of the LCPG were acknowledged and supported by the HWB which also has a duty to carefully consider how to establish strategic links with these and other strategic partnerships. It was agreed that this issue should also feed into the work to strengthen the HWB’s effectiveness. ACTION: BB/YW/MV/HWB members.
WK HWB Representation on NHS West Kent Clinical Commissioning & Group Primary Care Commissioning Committee (Oral Update)
Cllr Pat Bosley had volunteered to represent the interests of the WK HWB on this newly established Committee. Bob Bowes reported that the first meeting was being held this evening 5 July.
Any Other Business - Future Agenda Items
Date of Next Meeting
16 August – Sevenoaks District Council
Tuesday 18 October 2016, 4.00pm – 6.00pm, Tunbridge Wells Borough Council