To receive any apologies for absence

Apologies for absence were submitted from Andy Couldrick, Darrell Gale, Dr Lise Llewellyn, Nikki Luffingham, Clare Rebbeck and Kevin Ward.

The Chairman commented that the Board’s terms of reference stated that in order for a meeting of the Board to be quorate either the Chairman or Vice Chairman needed to be present.  It was proposed that this be removed from the terms of reference.  The Principal Democratic Services Officer was asked to provide wording which would clarify how a Chairman would be elected for a meeting should neither the Chairman nor Vice Chairman be present, and circulate it to the Board for agreement.

To confirm the Minutes of the Meeting held on 9 February 2017.

The Minutes of the meeting of the Board held on 9 February 2017 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 consider the Health and Wellbeing Strategy. (30 mins)

The Board received the Health and Wellbeing Strategy.

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

·           A new Health and Wellbeing Strategy for the period 2017-2020 had been designed around four newly articulated priorities:

o   Enabling and empowering resilient communities;

o   Promoting and supporting good mental health;

o   Reducing health inequalities in our Borough;

o   Delivering person-centred integrated services.

·           Judith Ramsden emphasised that the Strategy presented was high level and that a more detailed action plan to support it would be developed.  The Consultant in Public Health would be setting up meetings in order to discuss and produce this action plan.  This would be presented to the Board at its meeting in June. 

·           Dr Zylstra commented that Health and Wellbeing Board agendas currently included a summary of the Health and Wellbeing Strategy 2014-17.  He questioned whether this would also be updated.  Judith Ramsden indicated that this would be undertaken as part of the refresh.  The Health and Wellbeing dashboard would also be reviewed in order to ensure a coherent approach was being taken.

·           Councillor Bray commented that the Strategy included a number of acronyms and proposed that a glossary explaining the terms be included as an appendix to the Strategy.

·           Katie Summers questioned whether engagement would take place with residents.  Judith Ramsden commented that this would sit behind the Strategy and that there would be opportunities for conversations as to whether the Strategy priorities resonated.

·           Nick Campbell-White indicated that Healthwatch Wokingham Borough had a number of champions who could be used as sounding boards.

RESOLVED:  That the Health and Wellbeing Strategy priorities be approved and recommended to Council.

To receive the Berkshire Suicide Prevention Strategy and Wokingham Suicide Prevention Action Plan. (15 mins)

Carol-Anne Bidwell, Public Health Project Officer, presented the Berkshire Suicide Prevention Strategy and Wokingham Suicide Prevention Action Plan.

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

·           The Berkshire councils had not published a suicide prevention action plan at the time of the 2015 all Party Parliamentary Group inquiry into local suicide prevention plans in England.  Action plans had been a recommendation of the suicide prevention strategy published in 2012.  Since 2015, a high-level multi-agency Berkshire steering group had met to plan a local audit of suicides and to work on a strategy and action plans for the councils.

·           The Strategy was being presented to all of the Berkshire Health and Wellbeing Board for endorsement. 

·           The Strategy set out a target of reducing suicide by at least 25% from 2014 levels, by 2020.  Royal Berkshire NHS Foundation Trust and Berkshire NHS Foundation Trust had a zero suicide ambition.  West Berkshire Council had also indicated that they wished to have a zero suicide target. 

·           The Board supported the target of a 25% reduction rate in suicides and the aspiration to go beyond this.

·           There had been an increase in the number of suicides across Berkshire as a whole. 

·           For the year to date there had been 3 recorded suicides, although this number may increase.  There had been no child suicides for Berkshire.

·           The Strategy detailed ways in which access to suicide could be reduced and removed.

·           Councillor Bray questioned the inclusion of the wording ‘We recognise that a Berkshire without suicide is the true aim we work towards’ within the Strategy.

·           Carol-Anne Bidwell took the Board through the Wokingham Action Plan.  Councillor Haitham Taylor suggested that reference be made to the possible impact of social media and cyber bullying and also post-natal depression.  Superintendent Rob France suggested that reference be made to those accused of child sex offences.  Carol-Anne Bidwell stated that the Wokingham Action Plan was high level but that these could be referenced.

·           The Board questioned who the champion for Wokingham would be and was informed that it would be Darrell Gale, Consultant in Public Health.

·           It was hoped that the Strategy would be launched at a multi-agency suicide prevention summit in October 2017 or by Suicide Awareness Day in September 2017.

·           The Berkshire wide suicide audit would be refreshed and reported on.

RESOLVED:  That

1)        the strategy be noted and endorsed.

2)        the action plan for Wokingham Borough contained within the strategy be agreed.

To receive the Better Care Fund Briefing from the Better Care Fund – Quarter 3. (10 mins)

The Board received a Better Care Fund Briefing from the Better Care Fund – Quarter 3.

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

·           Non electives (NELs) in the third quarter had performed 0.4% better than planned.  It was noted that the Nurse led Rapid Response Service had commenced in September 2016 and that this had supported the strong performance in NEL avoidance.

·           Permanent placements in residential care had fallen by 25 placements compared with the figures for April 2016.

·           Cumulative Delayed Transfers of Care (DTOC) had saved more nights than the 130 nights planned. 

·           Due to there not being access to sufficient nursing staff and facilities, the Step Up scheme had not contributed as had been expected to the NEL avoidance.  Plans were being considered for six Step Up beds at Wokingham Hospital, which would ensure that the right support could be offered for a Step Up service.  The Chairman questioned whether people were asked if they felt that reablement was a better outcome than being admitted to the Royal Berkshire Hospital.

·           The Board was advised that reablement had underspent as a result of recruitment issues in Optalis START.  As a result the Council’s homecare spend was forecast to overspend.  Some of this underspend had been returned to the Council to offset the homecare spend.

·           Councillor Bray asked whether recruitment problems were ongoing and what was being done to resolve this issue.  Judith Ramsden commented that a new manager was in place and that she was confident that improvements would be seen.

·           The Night Responder scheme was not delivering as anticipated as the number of customers accessing the service had been low.  In addition some access was not considered appropriate.

·           The Step Down scheme was under review as it had not delivered above an average of 58% of the capacity.  Katie Summers commented that there were a number of patients who had used the facility longer than anticipated which had had an impact on the functionality of the facility.  There was currently no charge for reablement.

·           The Community Health and Social Care programme (CHASC) was moving forward and the PID would be brought to the Health and Wellbeing Board for approval.  The Community Navigator programme was in the final stages of development.

·           In response to a question from Nick Campbell-White as to when the Community Navigators would be rolled out to all GP practices, Katie Summers commented that they had been piloted in several practices to varying success.  They had been particularly successful at Wargrave Surgery and also worked well with the Community Nurses in Berkshire Healthcare NHS Foundation Trust.  However, they would not be rolled out to all practices until learning points from the pilot had been incorporated.

·           Nick Campbell-White commented that Healthwatch had received comments regarding some Community Navigators, such as they were not available when patients wished to access them.  Katie Summers indicated that these comments should be fed back to Involve.  Involve had had some issues regarding the recruitment of volunteers but  ...  view the full minutes text for item 68.

To consider a report regarding the Better Care Fund Annual Return to the Department of Health 2016/17. (10 mins)

The Board considered the Better Care Fund Annual Return to the Department of Health 2016/17.

An annual return was required for the Better Care Fund Programme in order to provide a high level overview of performance against the budget of the Better Care Fund for 2015/16 in accordance with the Section 75 agreement.  However, the Department of Health timetable for the returns did not fit with Wokingham Health and Wellbeing Board meeting dates.  It was therefore proposed that the Chairman of the Health and Wellbeing Board sign off the annual return on behalf of the Board.

RESOLVED:  That the sign off of the Better Care Fund Annual Return to the Department of Health 2016/17, be delegated to the Chairman of the Health and Wellbeing Board following consultation with the Director of People Services, in order to meet the date of the annual plan return within the timescales set by the NHS.

To receive an update on the Sustainability and Transformation Plan. (10 mins)

Dr Winfield updated the Board on the Sustainability and Transformation Plan.

The Board was informed that the Berkshire West system had been identified as one of nine systems in the country to be Accountable Care Systems (ACS).  The ACS was comprised of the four Berkshire West CCGs, Berkshire Healthcare NHS Foundation Trust and Royal Berkshire NHS Foundation Trust.  There was an ambition also to eventually involve social care across Berkshire West.  Wokingham Borough Council had been invited to participate in the ACS and the Chief Executive was part of the ACS Leadership Group.  The purpose of the ACS was to bring together the relevant partners to apply a single capitated budget to meet the health and care needs of the local population.

RESOLVED:  That the update on the Sustainability and Transformation Plan be noted.

To receive updates on the work of the following Board members:

·         Place and Community Partnership;

·         Business, Skills and Enterprise Partnership;

·         Community Safety Partnership;

·         Voluntary Sector;

·         Healthwatch Wokingham Borough.

(20 mins)

The Board was updated on the work of the following partnership Board members:

Business, Skills and Enterprise Partnership:

·           With regards to the targets from the Elevate City Deal, there would be differences to the way the service would be delivered in future.

·           Work was being undertaken with regards to promoting apprenticeship starts particularly in Science, Technology, Engineering and Maths.

·           Funding had been received from the European Social Fund for targeted activities for those aged 15 and over.

·           In response to a question from Dr Zylstra regarding the apprenticeship levy, Beverley Graves commented that Thames Valley Berkshire Local Enterprise Partnership (LEP) had surveyed local companies on the apprenticeship levy.  There had been significant interest in taking on apprentices; however, there was still much to be done around perceived ‘red tape.’

·           Beverley Graves commented that there was still a lack of understanding regarding apprenticeships and what they could offer.

·           Councillor Bray noted that the levels of unemployment in the over 50’s appeared to be increasing, and questioned why that was.  Beverley Graves indicated that she was unaware of a particular reason for this.

·           Board members asked about Elevate funding.  Judith Ramsden indicated that the Council had applied for additional funding from the EU. 

·           Katie Summers asked if apprenticeship opportunities in health and social care were being promoted.

·           Board members were informed of the Worlds of Opportunity initiative.

Community Safety Partnership:

·           The Community Safety Strategy had been refreshed.  It was requested that this be brought to the next Board meeting.

Healthwatch Wokingham Borough:

·           Healthwatch Wokingham Borough’s report on extra care had been completed and comments were awaited from the commissioners and suppliers.  Healthwatch had visited four extra care facilities and interviewed a number of people.  There was still a lot of confusion around what extra care was.

·           The Healthwatch Wokingham Borough quarterly report had been streamlined.

·           Healthwatch Wokingham Borough had launched a new website – Youthwatch, about young people’s concerns.  Board members were encouraged to look at the website. 

·           Four more reports had been produced by small groups that Healthwatch had provided funding to, to help get their messages out.

·           There had been a number of enquiries relating to Wokingham Medical Centre during the quarter and Healthwatch Wokingham Borough would be meeting with the Practice Manager.  Dr Zylstra asked whether these enquiries related to clinical competence and was informed that they did not and that they related largely to people not being able to get an appointment.  Katie Summers asked that Healthwatch Wokingham Borough share the outcomes of the conversations with the CCG.

·           Nick Campbell-White informed the Board that Healthwatch Wokingham Borough was currently producing its annual report and a list of projects that would be undertaken in the new financial year.

·           Two Enter and Views were due to take place, including a joint visit with Reading Healthwatch.

RESOLVED:  That the updates from Board members be noted.

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

The Board received the Health and Wellbeing dashboard.

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

·           The Board discussed the indicator relating to the number of affordable dwellings completed.  Councillor McGhee-Sumner commented that one development had been delayed due to poor weather.

·           Board members questioned if the Narrowing the Gap indicator needed to be monitored by the Board.  Judith Ramsden indicated that the dashboard and its key performance indicators would be reviewed in light of the new Health and Wellbeing Strategy and supporting action plan.  It was agreed that there was a need for a more outcomes based approach.

·           The Board discussed recruitment and retention at the Royal Berkshire Hospital and Berkshire Healthcare NHS Foundation Trust and General Practice Workforce vacancy rate for General Practitioners.  Dr Zylstra commented that there had been no take up locally of the NHS England scheme to recruit foreign doctors.

·           Dr Winfield suggested that the Board needed to focus in particular on the outcomes and whether these were being met. 

·           Councillor Bray emphasised that the Health Overview and Scrutiny Committee should hold organisations to account. 

·           Nick Campbell-White commented that it would be helpful to receive further information on CAMHS waiting times.  Judith Ramsden emphasised that there had been real improvements made.

·           Dr Zylstra suggested that the Tier 2 CAMHS wait time indicator be divided into those who were waiting for ADHD and ASD pathways and those who were not.  Those on the ADHD and ASD pathways tended to wait longer. 

·           With regards to accountability Dr Zylstra emphasised that the Board, in addition to monitoring what had already occurred, needed to look forwards.

·           Judith Ramsden commented that updated priorities would be produced for the next Board meeting.

·           It was noted that it was Sonia Khoury’s last Health and Wellbeing Board meeting.  Board members thanked her for her involvement with the Board.

RESOLVED:  That the Health and Wellbeing dashboard be noted.

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

The Board discussed the forward programme for the forthcoming municipal year.

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

·           Judith Ramsden asked that the following be added to the agenda for the June meeting:

o   Local Account 2016/17;

o   Healthwatch Annual Report;

o   Update on the Community Navigator Scheme;

o   Community Safety Partnership Strategy.

RESOLVED:  That the forward programme be noted.