Agenda and minutes

To receive any apologies for absence

Apologies for absence were submitted from Nick Campbell-White, Beverley Graves, Nikki Luffingham, Judith Ramsden and Clare Rebbeck.

To confirm the Minutes of the Meeting held on 8 December 2016.

The Minutes of the meeting of the Board held on 8 December 2016 were confirmed as a correct record and signed by the Chairman.

To receive any declarations of interest

There were no declarations of interest.

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 discuss the draft Health and Wellbeing Strategy. (30 mins)

Darrell Gale, Consultant in Public Health gave a presentation on the draft Health and Wellbeing Strategy.

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

·         The Board had held a number of workshops to discuss the development of a refreshed Health and Wellbeing Strategy.

·         Key health indicators for the Borough included; life expectancy and healthy life expectancy, health inequalities gap, child and adult obesity and suicide rates.

·         It was proposed that the new strategy include an overview, information about who sat on the Board and information on achievements from previous Health and Wellbeing strategies.

·         Four overarching priorities had been identified:

Ø  Ensure that Wokingham Borough’s children have a healthy and secure start to life and their early years;

Ø  Prevent our population developing poor health and long term conditions by enhancing healthy lifestyles and maximising independence in later years;

Ø  Promote good emotional wellbeing across all ages and population groups;

Ø  Improve access to health and social care services in the community.

·         Each priority would have a number of sub priorities.

·         For each outcome there would be a delivery plan, some of which might come from existing plans and strategies.

·         Performance measures from the baseline would be reported through the Health and Wellbeing performance dashboard.  Where appropriate annual targets would be set.

·         Andy Couldrick commented that the strategy was developing well but that he felt that children and young people’s mental health should be more clearly referenced.  He also suggested that increasing self-resilience was further highlighted.  It was important to focus on those most in need within the community.

·         Jim Stockley commented that there needed to be an element of education around increasing self-resilience.

·         With regards to the fourth priority the Board felt that it should refer to the ‘most appropriate help’ instead of ‘health and social care services’.

·         With regards to the second priority, Councillor Haitham Taylor suggested that a sub priority should be reducing physical inactivity rather than increasing physical activity, to better target those most in need.

·         In response to a question from Superintendent France regarding elderly frailty, Dr Zylstra commented that changes to the General Medical contract would introduce a frailty index.

·         It was agreed that Health and Wellbeing priorities should be aligned to individual Board members’ roles to enable greater ownership of the strategy.

·         Councillor McGhee-Sumner questioned when a Health and Wellbeing Board Manager would be in post and was assured that this would be resolved by April.

RESOLVED:  That the Health and Wellbeing Strategy presentation be noted.

To receive the Clinical Commissioning Group Operational Plan 2017-19. (15 mins)

Katie Summers presented the Clinical Commissioning Group Operational Plan 2017-19.  The Plans had been submitted to NHS England on 23 December 2016 and had been approved by the four CCG Governing Bodies. Initial feedback from NHS England had been positive.

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

·         The Plan was now a 2 year plan.  It had to deliver within the allocated financial resources.  The Board was informed that there was a financial gap of £23m for the year across the Berkshire West CCGs to be met.

·         Dr Zylstra commented that much of the government funding received via the GP Forward View was badged for practices with over 30,000 patients.  Practices also had to be a legal entity in order to make a bid for this funding.  Discussions were taking place regarding practices coming together.  In response to a question regarding the level of interest amongst the practices within the Borough, Dr Zylstra commented that all 13 practices had expressed an interest. 

·         The Board discussed urgent care and A&E targets.  It was noted that outpatients was one of the challenge areas for the Royal Berkshire NHS Trust.

·         Performance against cancer wait targets had improved significantly.  Dr Zylstra stated that the Royal Berkshire NHS Trust had put a recovery package in place and that from November 2016 the 2 week wait cancer target had been met.

·         Councillor Haitham Taylor commented that the Local Safeguarding Children’s Board was informed of the maternity staffing levels.  Dr Zylstra indicated that a recent recruitment drive had resulted in the recruitment of 18 new members of staff.

·         Board members were informed that the Wokingham CCG Quality Premium Target was increasing the number of patients diagnosed with diabetes (diagnosed for less than a year) who attended a structured education course from 5.86% to 15%.  It was estimated that the real attendance was much higher due to the record of attendance not being recorded on GP clinical systems correctly.  A list of read codes had been distributed to practices to ensure the correct codes were used and the provider of the service had updated their record of attendance letters to GPs which would highlight the correct code to use in relation to attendance, DNA or declined service.

·         The Board agreed that it would be helpful to ascertain the actual number of patients who had attended the structured education course.  Councillor Haitham Taylor questioned whether the target was challenging enough.

·         Katie Summers commented that diabetes was a major focus for all the Berkshire West CCGs.

·         Dr Llewellyn commented that greater reference could be made in the plan to the Diabetes Prevention Programme.

·         Councillor Bray questioned whether the CCGs had sufficient staff in place to deliver the Plan.  Katie Summers commented that the system was challenged but that this was a national issue.

RESOLVED:  That

1)         the Berkshire West CCGs Operational Plan 2017/19 be noted;

2)        the Quality Premium Targets for Wokingham CCG for 2017/18 and 2018/19 be noted.

To appoint a Health and Wellbeing Board representative to the Primary Care Commissioning Committee (5 mins)

The Board received a report regarding the appointment of a Health and Wellbeing Board representative to the CCG’s Primary Care Commissioning Committee.

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

·         The Board was reminded that the Primary Care Commissioning Committee was a joint quarterly meeting between the four CCGs in Berkshire West to which NHS England had delegated responsibility for the commissioning of GP services.  The Committee was also responsible for the delivery of the local strategy for primary care.

·         The Board’s previous representative had been Stuart Rowbotham, former Director of Health and Wellbeing.

RESOLVED:  That the Chairman discuss the appointment further with the Director of People Services.

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

·         Voluntary Sector

·         Healthwatch

(20 mins)

The Board was updated on the work of several Board members.

Community Safety Partnership:

·         The Domestic Abuse Strategy was being refreshed.

·         Whilst the Community Safety Partnership had received a reduction in funding it was not as great as had been anticipated.

·         Work was being undertaken on the Community Safety Strategy.

·         Councillor Bray commented that Reading Borough Council was currently consulting on potentially reducing the refuge budget.  She questioned whether this would have an impact on Wokingham Borough and was informed that it might.

Business, Skills and Enterprise Partnership:

·         A written update from the Partnership was noted.

Healthwatch Wokingham Borough:

·         Jim Stockley reminded the Board of the community research project launched by Healthwatch Wokingham Borough in December.

·         Board members were informed that Healthwatch Wokingham Borough was working with More Arts.

RESOLVED:  That the updates from Board members be noted.

To receive the Health and Wellbeing dashboard. (15 mins)

The Board considered the Health and Wellbeing dashboard.

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

·         Updated figures were provided regarding the General Practice Workforce vacancy rate for General Practitioners (GPs) and Number of patients per GP.  It was noted that there were currently 3.2 whole time equivalent GP vacancies across Wokingham CCG’s 13 general practices.  There were 2097 patients per GP. 

·         The Board was reminded that some aspects of “traditional GP work” were now being completed by urgent care nurses, pharmacists and paramedics.  It was suggested that the Board receive information regarding clinician vacancies and also midwifery vacancies.

·         It was felt that the information regarding the Trust Board reports could be clarified and that commentaries for the different areas could be more detailed in future.

·         With regards to the number of young people who were not in education, employment or training, Councillor Haitham Taylor explained that the quarter in question often performed less well as it covered when young people left school in summer.

RESOLVED:  That the Health and Wellbeing dashboard be noted.

To consider the Board’s work programme for the remainder of the municipal year. (5 mins)

The Board discussed the forward programme for the remainder of the municipal year.

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

·         The Health and Wellbeing Strategy would be taken to the April meeting.

·         The Board requested an update on the Sustainability Transformation Plan at the April meeting.

·         A report regarding the Council’s commissioning intentions was requested for the next meeting.

RESOLVED:  That the forward programme be noted.