Agenda and minutes

Wokingham Borough Wellbeing Board
Thursday, 8th February, 2018 5.00 pm

Venue: David Hicks 1 - Civic Offices, Shute End, Wokingham RG40 1BN. View directions

Contact: Madeleine Shopland  Democratic & Electoral Services Specialist

Items
No. Item

57.

Election of Chairman for remainder of the 2017-18 municipal year

To elect a Chairman for the remainder of the 2017-18 municipal year.

Minutes:

RESOLVED:  That Councillor Richard Dolinski be elected Chairman of the Health and Wellbeing Board for the remainder of the 2017/18 municipal year.

 

58.

Apologies

To receive any apologies for absence

Minutes:

An apology for absence was submitted from Nick Campbell-White.

59.

Minutes of Previous Meeting pdf icon PDF 186 KB

To confirm the Minutes of the Meeting held on 14 December 2017.

Minutes:

The Minutes of the meeting of the Board held on 14 December 2017 were confirmed as a correct record and signed by the Chairman.

60.

Declaration of Interest

To receive any declarations of interest

Minutes:

Dr Zylstra declared a Personal Interest in Item 68 Wokingham Pharmaceutical Needs Assessment 2018-2021 on the grounds that his practice had an attached pharmacy.

61.

Public Question Time

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

Minutes:

In accordance with the agreed procedure the Chairman invited members of the public to submit questions to the appropriate Board Members.

61.1

Anne-Marie Gawen asked the Chairman of Health and Wellbeing Board the following question:


Question:

At this moment in time, for an adult being discharged from CMHT or Crisis Home Treatment Team or Hospital (Prospect Park or A&E following a mental health crisis), what services are available to support them in Wokingham Borough or even whilst they are receiving care in the community from CMHT or CRHTT?

 

Minutes:

Question:

At this moment in time, for an adult being discharged from CMHT or Crisis Home Treatment Team or Hospital (Prospect Park or A&E following a mental health crisis), what services are available to support them in Wokingham Borough or even whilst they are receiving care in the community from CMHT or CRHTT?

 

Answer:

For clients being discharged from the CMHT there is access to a Duty Worker for 6 months.  There is a self-referral process that is currently in place, when in distress.

 

For clients accessing the CRHTT, they are able to contact the Crisis Response Treatment Team 24 hours a day, 7 days a week.

 

In the Hospital, every client is to be seen within 7 days of discharge but the Berkshire Healthcare Foundation Trust are trying to improve this to 3 days, but at the moment it is an intention to be seen within 7 days.

 

Services available do depend on individual assessment to assist in the client’s recovery, working in partnership with family, friends and carers where appropriate.  This may include social care needs and review of packages of care. 

 

Supplementary Question:

What are the services and who provides the services?

 

Supplementary Answer:

In terms of who provides the services, it is a mixture from the Berkshire Healthcare Foundation Trust.  There is also a combination of our services in terms of Adult Mental Health Services as well.  So in terms of the actual teams; the Crisis Response Home Treatment Team, as well as the CMHT.

 

Longer term we have the Integrated Adult Mental Health Services.  In terms of my portfolio, I have a team led by an Assistant Director, Christine Dale, who is responsible for that service.

61.2

Alison Sellers asked the Chairman of the Health and Wellbeing Board the following question:


Question

1: 3 children in every Primary School classroom is affected by Mental Health.  We know that children with Mental Health difficulties face unequal chances in their lives and that 50% of adults with Mental Health experienced their first symptoms before the age of 14 years old and 75% before 18 years old.

 

How is Wokingham supporting and empowering children’s’ Mental Health and Emotional Wellbeing and their families, in particular bridging the gap before a crisis situation e.g. meeting CAMHs threshold, so that it doesn’t reach that point? 

 

Noted that:

 

Health & Wellbeing Strategy Action Plan for 2017-2020 mentions children and Young people twice.

 

Promoting and supporting good mental health 1.8 – Scope the potential of schools nursing service to contribute to development of resilience in children and young people.

Enabling and empowering resilient communities 2.2 – Berkshire Health Trust Mental Health strategy implementation plans for child and adolescence mental health.

 

Berkshire Health Trust Mental Health strategy 2016 – 2020 Improve the transition to adult mental health services for young people in CAMH service.

 

No mention of children.

 

Minutes:

Question

1: 3 children in every Primary School classroom is affected by Mental Health.  We know that children with Mental Health difficulties face unequal chances in their lives and that 50% of adults with Mental Health experienced their first symptoms before the age of 14 years old and 75% before 18 years old. 

 

How is Wokingham supporting and empowering children’s’ Mental Health and Emotional Wellbeing and their families, in particular bridging the gap before a crisis situation e.g. meeting CAMHs threshold, so that it doesn’t reach that point? 

 

Noted that:

 

Health & Wellbeing Strategy Action Plan for 2017-2020 mentions children and Young people twice.

 

Promoting and supporting good mental health 1.8 – Scope the potential of schools nursing service to contribute to development of resilience in children and young people.

 Enabling and empowering resilient communities 2.2 – Berkshire Health Trust Mental Health strategy implementation plans for child and adolescence mental health.

 

Berkshire Health Trust Mental Health strategy 2016 – 2020 – Improve the transition to adult mental health services for young people in CAMH service. 

 

No mention of children.

 

Answer:

There are a number of strategic developments ongoing and that will be progressed over the next few years with regards to improving the life chances and choices for children and young people with mental health needs.

 

The Wokingham Borough Council School Nursing Service is currently being redesigned.  The new service will be effective at the beginning of the autumn term, fairly soon.  The Public Health Team are working in partnership with other key agencies and stakeholders to strengthen prevention pathways by linking into, and between, services such as CAMHS, sexual health services, substance misuse, domestic abuse services, Police, health, GPs, education and the youth offending service.

 

In addition to the School Nurse Service redesign the universal and tier 2 mental health services for children and young people are also going through a redesign.  We are proposing to align children’s emotional and mental health support and the wider early help offer with the aim of bringing better outcomes to children and young people earlier.  We are exploring the best way to do this and have been linking in with key stakeholders including schools and yourselves.

 

The ambitions for children and young people’s emotional and mental health of this Borough and Berkshire West is set out in the Local Transformation Plan – and there is a link on our website.  The Local Authority is also working on a localised mental health strategy that is in development and links with the Local Transformation Plan.

 

In addition to the redesign work there are a number of other initiatives that are taking place across the Borough to support children and young people’s emotional and mental health.  For example, we are currently piloting the School Link project which aims to build up knowledge and support in schools to identify and support emotional and mental health needs earlier before they require specialist clinical support.  This aligns with the new government ambitions that have been set out  ...  view the full minutes text for item 61.2

62.

Member Question Time

To answer any member questions

Minutes:

Councillor Pittock asked a question about what was being done locally regarding homelessness.

 

63.

Update on Progress towards Promoting Positive Mental Health and Wellbeing in Children and Young People pdf icon PDF 662 KB

To receive an update on progress towards Promoting Positive Mental Health and Wellbeing in Children and Young People. (15 mins)

Minutes:

Sally Murray, Head of Children’s Commissioning, Berkshire West CCGs, provided an update on progress being made towards promoting Positive Mental Health and Wellbeing in Children and Young People.

 

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

 

·         NHS England had approved the revised Future in Mind Local Transformation Plan.  A short summary was required to be produced which would be available online shortly.

·         Sally Murray advised the Board that locally there was movement away from a tiered model and movement towards the THRIVE model.

·         Sally Murray highlighted what had been achieved so far with regards to children’s emotional and mental health.

·         There had been a continued focus on reducing waiting times for specialist CAMHs since additional investment was put into the service in 2015.  Demand was still increasing.  According to NHS England, the average waiting time for specialist treatment was 73 days.  Sally Murray outlined the average Berkshire Healthcare Foundation Trust CAMHs waiting times as of September 2017.  The current average wait time for referrals to the Specialist Community Teams was 6 weeks.

·         Locally the average waiting time for those currently waiting for an autism assessment was 44 weeks.  The national average was 3 years. 

 

RESOVLED:  That the update on progress towards promoting positive Mental Health and Wellbeing in Children and Young People be noted.

 

64.

West of Berkshire Safeguarding Adults Board Annual Report 2016-17 pdf icon PDF 772 KB

To receive the West of Berkshire Safeguarding Adults Board Annual Report 2016-17. (10 mins)

Additional documents:

Minutes:

The Board received the West of Berkshire Safeguarding Adults Board Annual report 2016-17.

 

RESOLVED:  That the West of Berkshire Safeguarding Adults Board Annual Report 2016-17 be noted.

 

65.

Better Care Fund review of schemes 2017-18 pdf icon PDF 406 KB

To receive a report regarding the review of Better Care Fund schemes 2017-18. (10 mins)

Minutes:

Katie Summers updated the Board on the progress of the Better Care Fund review schemes 2017-18.

 

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

 

·         Board members were reminded that a revised Plan was required to be submitted annually.

·         Wokingham’s Better Care Fund programme had achieved many successes in the move towards delivering its original aims.  It was one of only seven systems to be shortlisted for Graduation status.  In addition Wokingham had been recognised as an example of good integrated care in action and had been invited to shape national policy on health and social care integration.

·         Katie Summers took the Board through the individual schemes and progress made against them.  The success of the schemes and whether the best outcome was being achieved was monitored each year by the Wokingham Integrated Strategic Partnership (WISP).

·         It was noted that the Step Up scheme had been running 8 weeks

·         The Community Health and Social Care (CHASC) had been running since September and had seen 180 people; of these there had been 66 reductions in Non-Elective admissions and 61 less visits to A&E.

·         Councillor Dolinski commented that he had visited the Berkshire Integrated Hub and had been pleased with what he had viewed.

·         Dr Winfield indicated that the Berkshire West Accountable Care System was now known as the Integrated Care System.  Under this it was anticipated that outpatients would be redesigned and there was an aspiration for some of outpatients to be managed digitally and some also to be managed in the community.

·         Councillor Haitham Taylor questioned why KPIs had not yet been agreed for the Step Up Programme when the planned completion date was 31 January 2018.  Katie Summers commented that at the time of the review confirmation from the provider around staffing had remained outstanding, which had since been given.

·         Councillor Ashwell asked about how people were updated on the Better Care Fund messages.  Dr Winfield referred to communication work on the CCG website, including Sam’s Story.  Healthwatch Wokingham Borough were also part of the WISP and had done a lot of work to update.

 

RESOLVED:  That the progress of the Better Care Fund schemes and the continuing work to progress integration and user experience through the schemes, be noted.

66.

Proposal for Wokingham Adults Integrated Health and Social Care Governance pdf icon PDF 106 KB

To consider a proposal for Wokingham Adults Integrated Health and Social Care Governance. (10 mins)

Minutes:

The Board received a report regarding Wokingham’s Adult Integrated Health and Social Care Governance proposal.

 

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

 

·         Paul Senior, Interim Director People Services outlined the move towards integration.

·         The Board was requested to support the approach to enhance the existing Section 75 Partnership Agreement to include Partners, Berkshire Healthcare Foundation Trust and Wokingham GP Alliance in order to further progress the integration of adult health and social care services.

·         Dr Winfield commented that she was supportive in principle but discussions also needed to be had at CCG governance level.  Further work was required before such an approach was enacted.  She commented that a risk share arrangement referred to needed further clarification.

·         Paul Senior commented that it was important that the Board see a proposed direction of travel.

·         It was agreed that a further update would be provided once the proposal had been through the CCG governance process.

 

RESOLVED:  That the approach to enhance the Section 75 Partnership to include our Partners, Berkshire Healthcare Foundation Trust and Wokingham GP Alliance in order to progress the integration of adult and social care services, be supported.

67.

Update on Health and Wellbeing Board Refresh pdf icon PDF 81 KB

To receive an update on the Health and Wellbeing Board refresh. (15 mins)

Additional documents:

Minutes:

Graham Ebers, Director of Corporate Services provided an update on action being taken to refresh the Health and Wellbeing Board.

 

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

 

·         Additional support was considered to be critical in sustaining momentum to the ‘refresh’ and providing the operational capacity needed to support the Board.  The Interim Director of People’s Services had reviewed the operational support across various strategic partnerships and recognised the need to enhance support to both the Health and Wellbeing Board and the Children’s and Young People Strategic Partnership.  The Interim Director of People Services was therefore seeking to create a resource that supported both partnerships (approximately 0.5 FTE each).  A Job Description had been produced and it was hoped that recruitment would begin in February.

·         Darrell Gale would approach the Local Government Association (LGA) in order to facilitate tailored training, following a skills audit.  The scoping of this work would take place in February.

·         With regards to good practice, Board members were asked what they felt were key criteria for this.  Dr Winfield commented that the LGA had produced a document which set out good practice for Health and Wellbeing Boards, which could provide a good framework.  She also suggested having a well supported Health and Wellbeing Strategy which was underpinned by the Joint Strategic Needs Assessment and also effective participation.  Councillor Haitham Taylor suggested that influencing partnership policy and strategy, engagement with partners, strong governance and tangible delivery of the Health and Wellbeing Strategy, were key.

·         Paul Senior, Interim Director People Services commented that there was a need for genuine co-production.

·         With regards to integration and the Integrated Care System, the Board agreed that it would be helpful to have a workshop prior to the next Board meeting to discuss the implications.

·         The key priorities, objectives, timescales and milestones in respect of an integrated Health and Social Care strategy would be presented at the Board’s April meeting.

·         The Board discussed public engagement and branding.  Board members were asked what some of the Board’s key achievements were, in order to shape future promotional activity.  Councillor Haitham Taylor referred to the cost cutting agenda.  Katie Summers referred to the work of some of the partnerships such as WISP.  Darrell Gale highlighted the trust between partners particularly at a time of shrinking budgets.

·         Councillor Dolinski stated that work needed to be carried out around the size of the Health and Wellbeing Board agenda and the language used in reports in order to make the work of the Board more accessible.

·         The Board discussed KPI’s.  Katie Summers proposed that the indicators be more outcome focused and that the Sub Partnerships be asked to put forward one or two suggested indicators each.

·         Graham Ebers advised that following the progression of the integrated Health and Social Care strategy and the appointment of support to the Board, other issues around the themes of Governance and Partnership Working could be progressed.  This would lead to a complete Action Plan that would be presented at  ...  view the full minutes text for item 67.

68.

Wokingham Borough Pharmaceutical Needs Assessment 2018-2021 pdf icon PDF 1 MB

To receive the Wokingham Borough Pharmaceutical Needs Assessment 2018-2021 (10 mins)

Additional documents:

Minutes:

The Board received the Wokingham Borough Pharmaceutical Needs Assessment 2018-2021.

 

It was noted that a draft version of the Wokingham Borough Pharmaceutical Needs Assessment 2018-2021 had been presented to the Board previously.

 

RESOLVED:  That the Pharmaceutical Needs Assessment for 2018 to 2021 be approved.

69.

Health and Wellbeing Board Dashboard KPIs pdf icon PDF 53 KB

To consider the Health and Wellbeing Board Dashboard KPIs (10 mins)

Additional documents:

Minutes:

This report was not considered following discussion of Key Performance Indicators under the Update on the Health and Wellbeing Board Refresh item.

70.

Update on Director of Public Health and Public Health

To receive an update on the Director of Public Health and Public Health. (10 mins)

Minutes:

Darrell Gale, Acting Strategic Director of Public Health for Berkshire updated the Board with regards to the Director of Public Health post and the shared Berkshire Public Health service.

 

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

 

·         Dr Lise Llewellyn, former Director of Public Health, had retired earlier in 2017 and Judith Wright had been in place as Interim Director Public Health until December 2017.

·         Bracknell Forest Council was withdrawing from some of the shared Berkshire Public Health agreement functions and was looking to appoint its own Director of Public Health.  The Royal Borough of Windsor and Maidenhead was also partly withdrawing from the agreement.

·         Darrell Gale indicated that he was Acting Strategic Director for Public Health for the next 3-4 months until a permanent appointment was made. 

·         Dr Winfield expressed concern regarding the Public Health position and wanted to make sure that sufficient support was being provided by Public Health England.

 

RESOLVED:  That the update on the Director of Public Health and Public Health be noted.

 

71.

Berkshire West Healthy Weight Strategy pdf icon PDF 68 KB

To receive the Berkshire West Healthy Weight Strategy. (10 mins)

Additional documents:

Minutes:

The Board received the Berkshire West Healthy Weight Strategy.

 

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

 

·         Darrell Gale advised that the Strategy covered the Berkshire West footprint.  He commented that the production of the Strategy was timely and referred to the redesign of the School Nurse Service, the new leisure centre provider beginning in May and the Mediterranean diet pilot undertaken by Wokingham Medical Centre with Type 2 diabetics.

·         In response to a question from Dr Zylstra, Natalie Mears, Public Health Project Officer, confirmed that children and adults were separately referenced.  Dr Zylstra also asked whether schools or parents would be expected to act with regards to children.  Natalie Mears indicated that this could be detailed in the local action plan.

·         Councillor Dolinski stated that greater reference could be made to those who were underweight in the local action plan.

·         Katie Summers praised the Strategy and commented that it needed to be owned by public sector organisations such as the CCG, Wokingham Borough Council, Berkshire Healthcare Foundation Trust and the Royal Berkshire Hospital.

·         Councillor Pittock questioned whether the government could be challenged with regards to the subsidising of large sugar companies.

 

RESOLVED:  That

 

1)         the Berkshire West Healthy Weight Strategy 2018-2020 be endorsed;

 

2)         the development of a Healthy Weight action plan be supported;

 

3)         an update on the development of a localised action plan be taken to            the Board’s April 2018 meeting.

72.

Updates from Board members pdf icon PDF 57 KB

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

 

·         Community Safety Partnership;

·         Healthwatch;

·         Place and Community Partnership;

·         Voluntary Sector

 

(20 mins)

Minutes:

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

 

Community Safety Partnership:

·         The Community Safety Partnership partners had agreed to take on vulnerability and exploitation as one its priorities.  This would include linking into local modern slavery partnerships, supporting the development of services to meet the needs of vulnerable offenders and victims, and improving referral pathways to appropriate services.

·         The Domestic Violence Strategic Group had expanded its remit to include the wider violence against women and girls.

·         Substance misuse amongst young people, particularly the increased use of high strength cannabis, was being addressed.

 

Healthwatch Wokingham Borough:

 

·         Jim Stockley advised the Board of a proposal around the joint commissioning of Healthwatch services for Reading and Wokingham.

·         An Enter and View was due to be undertaken at the Berkshire Care Home.

 

RESOLVED:  That the updates from Board members be noted.

73.

Forward Programme pdf icon PDF 69 KB

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

Additional documents:

Minutes:

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

 

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

 

·         With regards to integration and the Integrated Care System, the Board agreed that it would be helpful to have a workshop prior to the next Board meeting to discuss the implications.

·         An update on the development of a localised action plan regarding the Berkshire West Healthy Weight Strategy would be taken to the April meeting.

·         The key priorities, objectives, timescales and milestones in respect of an integrated Health and Social Care strategy would be presented at the Board’s April meeting.

 

RESOLVED:  That the forward programme be noted.