Agenda and minutes

To receive any apologies for absence.

Apologies for absence were submitted from Nikki Luffingham, Nick Campbell-White, Helen Power, Jim Stockley, Katie Summers and Kevin Ward.

To confirm the Minutes of the Meeting held on 8 October 2015.

The Minutes of the meeting of the Committee held on 8 October 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 receive an update on CAMHs Transformation Plans-Implementing "Future in Mind" across Berkshire West CCGs and Wokingham Borough Council and Wokingham CCG Emotional Health and Wellbeing Strategy Action Plan.

The Board considered the CAMHs Transformation Plans-Implementing "Future in Mind" across Berkshire West CCGs and Wokingham Borough Council and Wokingham CCG Emotional Health and Wellbeing Strategy Action Plan.

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

·         The Board was reminded that there was a requirement for system wide transformation over 5 years with plans signed off by Health and Wellbeing Boards before additional recurrent funding was released to the CCGs.  The Transformation Plan had been submitted to the regional team and had received assurance.

·         Funding for the Eating Disorders work had already been released to the CCGs. 

·         30 WTE were being recruited to the current specialist CAMH service across Berkshire.  These would be a mixture of highly skilled and junior staff to meet the identified skill mix needs.  21.4 WTE new staff had been recruited so far, not all of whom were in post yet. 

·         New staff were beginning to take caseloads and a reduction was starting to be seen in wait times for the Common Point of Entry and the ADHD pathway.  Councillor McGhee-Sumner questioned when the public would start to see a difference.  Louise Noble advised that the time taken to see a first contact was already reducing and that those who had waited the longest were being allocated to new staff.  It was likely that a difference would be seen in the new financial year.

·         Sally Murray commented that substantial work had been carried out regarding risk mitigation and young people on the wait lists.  Support packages were arranged around some of those young people most at risk to reduce the likelihood of A&E attendance and the length of stay in A&E should they end up there and also to reduce those going into Tier 4 (in patient).

·         In Berkshire West there had been a 25% reduction in young people attending A&E due to self-harm.  The number of young people in Tier 4 had also reduced overall from 30 to 21.

·         Next year the University of Reading would be undertaking research to build evidence bases for the management of conduct disorder in children.  Wokingham schools and families would be asked to participate.

·         In response to a question from Dr Llewellyn regarding the longest waiter for the Common Point of Entry, Louise Noble explained that some young people in the Common Point of Entry were waiting beyond 42 days but that they were in contact with the service.

·         The Board discussed Tier 2 resources.  Funds had been released and volunteer organisations would be able to make bids for funding.  Clare Rebbeck commented that the outcome framework had been published a week prior to the deadline for bids to be submitted which had been challenging for the voluntary sector.

·         Clare Rebbeck went on to state that a meeting had been held recently with 18 organisations to discuss support available for parents and guardians.

RESOLVED:  That the CAMHs Transformation Plans-Implementing "Future in Mind" across Berkshire West CCGs and Wokingham Borough Council and Wokingham CCG  ...  view the full minutes text for item 61.

To receive the West of Berkshire Safeguarding Adults Board Annual Report.

The Service Manager, Adult Safeguarding and the Director of Health and Wellbeing took the Board through the West of Berkshire Safeguarding Adults Board Annual Report.

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

·         With the introduction of the Care Act 2014, the Safeguarding Adults Board was now based on a legal framework.

·         The Service Manager, Adult Safeguarding highlighted Wokingham’s contribution to the Safeguarding Adults Board goals.  This included:

Ø  Care Act training had been delivered to adult social care front line staff, providers and forums, including information about the Board and its statutory responsibilities. 

Ø  The prevention worker in conjunction with the Chartered Trading Standards Institute had developed a toolkit for Trading Standards to aid understanding of Adult Safeguarding and provide examples of good practice.

Ø  A mandatory safeguarding e-learning module for staff had been developed.

Ø  The Wokingham Forum had continued, its profile had been raised and it now had 60 members.

Ø  Quality Assurance framework and audit programmes had been implemented to meet the requirements of the Care Act and Making Safeguarding Personal.  Performance information was reported quarterly to management teams.

Ø  Awareness of the Safeguarding Adults Board was being raised.

Ø  The promotion of the Safer Places Scheme.  There had been a drop in the number of participating premises with the closure of several businesses.  Further venues would be identified next year.

Ø  Good outcomes had been achieved by the ‘Choice Champions’ project.

Ø  Members of Wokingham’s CLASP (Caring Listening and Supporting Partnership) had supported the production of ‘easy read’ formats for awareness raising publicity material.

Ø  The findings of two Safeguarding Adults Reviews had been delivered by Wokingham.

·         During 2014-15 there were 868 safeguarding alerts of which 499 were referred.  61% of referrals started in the year were for females and 39% were for males.  In 2014-15, 71% of referrals were from people aged 65 years or over, an increase from the previous year where 62% of referrals were from the 65+ age group.

·         Neglect and physical abuse were the most common types of alleged abuse.  Reports of financial abuse were lower than the national average. 

·         It was noted that care homes were the second highest location of alleged abuse. 

·         Councillor Bray questioned why Wokingham had a greater number of requests for Deprivation of Liberty Safeguards (DoLS) and a higher proportion of requests authorised, than either Reading or West Berkshire.  The Director of Health and Wellbeing commented that Wokingham had a greater number of care homes than its neighbouring authorities.  A lot of work regarding safeguarding had been carried out with the care homes, the CQC and partnership organisations and reporting rates were good.  In addition assessment timescales were being met.

·         With regards to alleged cases of sexual abuse, Rob France questioned how many of the cases had become criminal cases and was informed that it was hopefully all cases.

·         Board members discussed how awareness of the Safeguarding Adults Board could be further raised.  The Director of Health and Wellbeing suggested  ...  view the full minutes text for item 62.

To receive updates on performance against the following:

·         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 the Performance Metrics.

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

·         The Board discussed non-elective admissions.  It was suggested that further context, such as whether performance was good or otherwise, would be helpful.  Hilary Turner asked whether an analysis of the ages of those attending A&E was available.  Dr Zylstra commented that the under 3’s and over 70’s were the biggest attending age groups.

·         Dr Winfield advised that it was unlikely that the Q3 A&E target would be achieved and that there needed to be a step up in moving those on the medically fit lists. 

RESOLVED:  That the Performance Metrics update be noted.

To receive a report on the Adult Social Care Outcomes Framework.

The Director of Health and Wellbeing presented the Adult Social Care Outcomes Framework.

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

·         The Adult Social Care Outcomes Framework was published annually and overall Wokingham had performed well.

·         Wokingham was performing above the national average for 8 indicators and slightly below or on the national average for 9 indicators.

·         Wokingham was performing slightly below average with regards to the perception carers have of the services that they received.

·         Board members requested benchmarking information from Wokingham’s statistical neighbours in future.

RESOLVED:  That the Adult Social Care Outcomes Framework be noted.

To be updated on the progress of the Connect Care Programme.

Mark Sellman, Programme Manager NHS Central Southern Commissioning Support Unit, updated the Board on the Connected Care Programme.

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

·         Mark Sellman explained that Connected Care was person held health and social care records for Berkshire residents.  This would be across commissioners and health and social care providers so that the individual held and managed their care and gave consent to providers of care to view their record based on an agreed data set. 

·         The Connected Care Programme would enable the flow of data between two or more organisations for the benefit of co-ordinating service provision across care pathways, thereby improving patient care.

·         Mark Sellman outlined some of the benefits of the programme including giving staff more time with the patient, better decision making, reduced administration and job satisfaction.  Citizens would have better engagement with the care process and a better care experience.  Time efficiency savings would also be made.

·         Board members were assured that only those involved in the individual’s care process would be able to access the records and they would have access only to areas of the record appropriate to their role.

·         A phased approach was being taken to the roll out.  Since Summer 2014 the primary care provider had been sharing agreed data with Westcall.  Recently Phase 2, a proof of concept portal, had been implemented.  Phase 3 would be the implementation of the full portal solution for the Berkshire Partnership community, including the local authorities and the Ambulance Trust.  Procurement was underway and it was anticipated that a preferred provider would be selected by January and the contract signed by March.

·         Councillor Haitham Taylor asked whether it would be a statutory requirement for partners to make their data available and was informed that it was not but it was important for the success of the programme. 

·         Dr Winfield emphasised that it was important that the Board were kept updated on the project milestones as it was a key enabler to integration.

·         Clare Rebbeck questioned whether Community Hospitals and Pharmacies would be included in the Connected Care programme and was informed that Pharmacies were not included. 

·         Dr Llewellyn asked whether enough had been done to publicise the programme.  Clare Rebbeck commented that information could be included as part of the Community Awareness event being held in June.  Dr Winfield indicated that many people at Call to Action events had assumed that records were already shared.

·         It was emphasised that staff would also need to be kept informed of project milestones.

RESOLVED:  That the presentation on the Connected Care Programme be noted.

To note the Better Care Fund Quarterly Return.

The Board considered the Better Care Fund Quarterly Return to Department of Health Quarter 2 2015.

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

·         Steady progress was being made against the Better Care Fund programmes.

·         Councillor Bray asked about central guidance for 2016/17.  It was anticipated that guidance would be released on 18 December.  Hilary Turner commented that following the Q1 returns NHS England had asked localities for information on what support they required.  She informed the Board that a self-assessment framework was available.

RESOLVED:  That the content of Wokingham’s Better Care Fund quarterly return to the Department of Health (DoH) for Quarter 2 of 2015 be noted.

To receive a Section 75 Finance update.

This item was deferred to the Board’s meeting on 11 February 2015.

To receive updates on the work of the following Health and Wellbeing Board members:

·         Business, Skills and Enterprise Partnership

·         Community Safety Partnership

·         Place and Community Partnership

Updates were provided by several Board Members.

Business, Skills and Enterprise Partnership:

Beverley Graves updated the Board on progress against the following objectives within the Health and Wellbeing Strategy; 1d) Improving the life chances and wellbeing of disadvantaged young people (Not in Employment Education or Training (NEET), aged 16-25 years) in the borough and 1e) ‘Enabling the older working population to work in fulfilling, productive employment for longer - Including volunteering.’  Elevate Wokingham had indicated that between April-October 2015 67 had accessed advice and 9 apprenticeships had started.  The target for NEETs was 3.2%.  In October the level of NEETs had been 2.3%.  The Board was informed that 11 people had attended a workshop on career information aimed at over 50s.  Elevate had seen 49 new clients who were over 50. 

Beverley Graves went on to comment that a Thames Valley Local Enterprise Partnership report on skills and skills shortage had highlighted a skills shortage in the care industry.  The Director of Health and Wellbeing commented that a pilot project regarding key worker housing was under consideration.

Community Safety Partnership:

Partnership working was strong locally.  In response to a question Councillor Bray, Rob France indicated that there would be an anti-drink driving campaign over the Christmas period.

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

To discuss a recommendation from the Health and Wellbeing Board Subcommittee.

The Board received a report regarding a proposed S106 payment for Wokingham Medical Centre.

The support for increased infrastructure provision in primary healthcare through the release of capital funding from Section 106 and Community Infrastructure Levy contributions was one mechanism that the Council could use to ensure existing and new residents had access to the high quality primary healthcare provision that met their needs. 

RESOLVED:  That the Board agrees to recommend that the Executive approves the capital payment of £150,000 to Wokingham Medical Centre as specified in this report.

To consider the Board’s work programme for the remainder of the municipal year.

The Board considered the Forward Programme for the remainder of the municipal year.

·         Judith Ramsden suggested that the Children’s Safeguarding Ofsted report and the Local Safeguarding Children’s Board Ofsted report be requested for the Board’s February meeting.

·         Councillor Bray requested an update on Public Health funding at the Board’s February meeting.

·         Dr Winfield indicated that the Wokingham CCG Co-Commissioning Delegation and Primary Care Strategy would be taken to the February meeting.

·         It was requested that the new Better Care Fund Plan and CCG Operating Plan be presented at the Board’s meeting in April.

·         Clare Rebbeck asked that the Voluntary Sector be included under on the list of Board Members providing updates in future.

RESOLVED:  That the Forward Programme be noted.