Agenda and minutes

To receive any apologies for absence

Apologies for absence were submitted from Nick Campbell-White and Dr Johan Zylstra.

To confirm the Minutes of the Meeting held on 9 April 2015.

The Minutes of the meeting of the Board held on 9 April 2015 were confirmed as a correct record and signed by the Chairman.

To receive any declarations of interest

There were no declarations of interest made.

To answer any public questions

A period of 30 minutes will be allowed for members of the public to ask questions submitted under notice.

The Council welcomes questions from members of the public about the work of this Board.

Subject to meeting certain timescales, questions can relate to general issues concerned with the work of the Board or an item which is on the Agenda for this meeting.  For full details of the procedure for submitting questions please contact the Democratic Services Section on the numbers given below or go to www.wokingham.gov.uk/publicquestions

There were no public questions.

To answer any member questions

There were no Member questions.

To elect a Chairman for the 2015/16 municipal year. (2 mins)

RESOLVED:  That Councillor Julian McGhee Sumner be elected Chairman of the Health and Wellbeing Board for the 2015/16 municipal year.

To elect a Vice Chairman for the 2015/16 municipal year. (2 mins)

RESOLVED:  That Dr Zylstra be appointed Vice Chairman of the Health and Wellbeing Board for the 2015/16 municipal year.

To appoint members of the Health and Wellbeing Board Sub Committee for 2015/16. (5 mins)

The Board discussed membership of the Health and Wellbeing Board Sub Committee.  The terms of reference of the Health and Wellbeing Board Sub Committee stated that:

The membership of the Health and Wellbeing Board Sub-Committee will be as follows:

a)      Two Elected Members who sit on the Health and Wellbeing Board

b)      Two representatives from the Wokingham Clinical Commissioning Group

c)      One representative from NHS England

d)      One representative from local Healthwatch

e)      Wokingham Borough Council Consultant in Public Health

f)       One Wokingham Borough Council Director

g)      One senior Wokingham Borough Council Planning Officer working on the Strategic Development Location’s delivery

h)      One representative representing the Health and Wellbeing Board Partnership Groups

It was suggested that the Partnership Group representative be from the Place and Community Partnership. 

RESOLVED:  That the following be appointed to the Health and Wellbeing Sub Committee for 2015/16 and that the remainder of the appointments be confirmed at a later date.

a)      Two Elected Members who sit on the Health and Wellbeing Board – Councillors Julian McGhee-Sumner and Charlotte Haitham Taylor

b)      Two representatives from the Wokingham Clinical Commissioning Group – Katie Summers and Dr Johan Zylstra

c)      One representative from NHS England – to be confirmed

d)      One representative from local Healthwatch – Nick Campbell-White

e)      Wokingham Borough Council Consultant in Public Health – Darrell Gale

f)       One Wokingham Borough Council Director – To be confirmed

g)      One senior Wokingham Borough Council Planning Officer working on the Strategic Development Location’s delivery – To be confirmed

h)      One representative representing the Health and Wellbeing Board Partnership Groups – (Place and Community Partnership) Kevin Ward

To consider the Joint Wokingham CCG and Wokingham Borough Council Emotional Health and Wellbeing Strategy 2015 to 2017. (20 mins)

The Board considered the Joint Wokingham CCG and Wokingham Borough Council Emotional Health and Wellbeing Strategy 2015 to 2017 which was presented by Brian Grady and Sally Murray.

During the discussion of this item the following points were made:

·         A strategy and action plan to improve comprehensive CAMHS had been produced by the Council and Wokingham CCG.

·         Issues included:

o   Rising demand for CAMHS;

o   Rising demand in waiting times;

o   Focus on intervention for those children and young people most in critical need;

o   Workforce capacity.

·         Healthwatch Wokingham had completed an extensive survey of children and young people, identifying emotional health and wellbeing priority issues for Wokingham children and young people, the findings of which informed the strategy.  At least one in ten of those young people who had responded had indicated that they were carers.

·         The six Berkshire Local Authorities had a shared action plan to work more cooperatively across the emotional health and wellbeing pathway. 

·         Brian Grady outlined actions required.  These included:

o   The provision of a more comprehensive CAMHS;

o   A reduction in waiting times;

o   The delivery of improved administration and communication;

o   Better access to services out of hours and in times of crisis;

o   Improving the environment where children and young people are seen or are waiting for CAMHS.

·         Sally Murray informed the Board that with regards to Tier 3 services £6,166,360 had been allocated.  In addition Berkshire West CCGs had committed to increasing Tier 3 spend in Berkshire West by £1 million recurrently and £500K non recurrently from 2015/16.

·         Board members were also informed of Partnership Development Fund grants relating to emotional health and wellbeing.

·         Tiers 1 and 2 were commissioned by the Council and schools.  A mapping exercise had been undertaken.  Councillor Haitham Taylor commented that many schools were facing budget pressures and questioned whether the figures discussed would reduce further.  Brian Grady commented that he believed that the figures already represented a reduction. 

·         The Children and Young People’s Partnership was starting to identify budget priorities and challenges.

·         Sally Murray reminded Board members that the national report ‘Future in Mind: Promoting, protecting and improving our children and young people’s mental health and wellbeing’ suggested that the emphasis should be on lower tiers to reduce escalation to higher tiers.  Judith Ramsden commented that issues surrounding CAMHS were wider than a need for greater investment in Tier 1 services.

·         Dr Llewellyn emphasised the importance of promoting positive resilience.

·         The Board discussed parity of esteem.

·         The Board was assured that all urgent referrals were being seen by Tier 3 CAMHS within 24 hours.

·         Councillor Bray questioned whether delays in the time between when a young person was first seen and first received treatment would be addressed.  Sally Murray commented that there was a backlog and many of those waiting the longest were those on the ASD diagnostic pathway; which was a diagnostic pathway not a treatment pathway. 

·         Councillor McGhee-Sumner asked how Wokingham compared to its neighbours.  Sally Murray indicated that there was no national  ...  view the full minutes text for item 9.

To consider a report regarding the Children's Social Care Annual Review.

(20 mins)

Brian Grady informed Board members of the Children’s Social Care Annual Review.

During the discussion of this item the following points were made:

·         The review had involved a review team from both Children’s Services and Strategic Commissioning.

·         The methodology had included triangulating evidence collected throughout the year and the aim of the review had been to gauge progress against the previous year and to identify strengths in the service, and areas for development in the coming year.

·         Strengths identified included:

o   Implementation of the Practice Framework (Signs of Safety, Attachment, Family Star and Restorative) was going well;

o   50 people have been trained as Signs of Safety Practice Leaders;

o   Turnover of Social Workers had reduced from 33% to 14% against the national picture.  Judith Ramsden explained that financial rewards had been reconfigured, a practice framework had been adopted and caseloads had been reviewed and managed;

o   Bridges being awarded outstanding by Ofsted;

o   6 experienced social workers appointed from overseas;

o   Early Help Senior Social Worker in post (Family Resource Team).

·         Areas for further improvement identified included:

o   Further develop a Multi-agency Safeguarding Hub (MASH);

o   Improving delivery of life story work;

o   Continue to contribute to university seminars and implement the Social Work Academy;

o   Comprehensive CAMHS.

RESOLVED:  That the Children’s Social Care Annual Review be noted.

To consider the Local Account. (20 mins)

This item was deferred to enable to the collation of further information.

To receive updates on performance against the following: (20 mins)

·         Better Care Fund;

·         Public Health Outcomes Framework, NHS and Adult Social Care,

·         Health & Wellbeing Strategy 2014-17.

Please note that this will be by exception only.

The Board considered Performance Metrics.

During the discussion of this item the following points were made:

·         The ‘Total non-elective admissions in to hospital (general and acute), all-age’ indicator was rated red.  Katie Summers explained that Wokingham was one of the best performers with regards to non-elective admissions and the target hard to sustain.  There had been a growth in non-elective rates and in the acuity of cases.  It was noted that the Royal Berkshire Hospital was under pressure and that the rest of Berkshire West faced a similar problem to Wokingham.  Whilst it had been hoped that the target level would be revised in order to be more achievable, NHS England had indicated that it would be difficult to get a reduction in the target level particularly in light of Wokingham’s anticipated population growth.

·         Stuart Rowbotham reminded the Board that the figures provided were only a snapshot.  He indicated that the direction of performance for the ‘Delayed transfers of care (delayed days) from hospital per 100,000 population (aged 18+)’ was downwards.  Delayed transfers of care were becoming an acute issue and the levels of delay and activity were unprecedented.  Issues of resilience in community based services were starting to become apparent.  Dr Winfield reiterated the unprecedented levels of demand, particularly at this time of year.  Royal Berkshire Fit to Go lists remained low and the A&E 4 hour wait target was only just being held.  Judith Ramsden questioned how the Board could monitor the issue and was informed that there was already architecture in place in the Berkshire West Partnership Board and a system wide approach was needed.  Dr Winfield indicated that work was being undertaken with neighbouring authorities with regards to joint commissioning.

·         Darrell Gale updated the Board on several Public Health Outcome Framework indicators.  ‘Healthy life expectancy at birth (Male)’ had increased to 71.4 but ‘Healthy life expectancy at birth (Female)’ had decreased to 69.9.  Darrell Gale commented that he did not believe there were links with deaths in maternity.  Councillor Haitham Taylor emphasised the need to understand factors behind the decrease in healthy life expectancy at birth for females and questioned whether more females were carers and whether this would have an impact.

·         ‘Hips fractures in people aged 65 and over’ had turned from green to amber.

·         In response to a question, Darrell Gale confirmed that Wokingham was no longer an outlier for breast cancer.

RESOLVED:  That the update on Performance Metrics be noted.

To receive updates on the work of the following Health and Wellbeing Board members: (20 mins)

·         Business, Skills and Enterprise Partnership

·         Community Safety Partnership

·         Place and Community Partnership

·         Healthwatch Wokingham Borough

Jim Stockley encouraged Board members to read Healthwatch Wokingham Borough’s Annual Report 2014/15.

RESOLVED  That the update from Health and Wellbeing Board members be noted.

To consider the Board’s work programme for 2015/16.(5 mins)

The Board considered the Forward Programme for 2015/16.

Judith Ramsden indicated that the Board would receive a full briefing on the impact of school readiness at its October meeting.

RESOLVED  That the Forward Programme for 2015/16 be noted.