Agenda and minutes

Agenda and minutes

Venue: Council Chamber, Priory House, Chicksands, Shefford

Items
No. Item

24.

Chairman's Announcements and Communications

To receive any announcements from the Chairman and any matters of communication.

Minutes:

 

The Vice-Chairman welcomed everyone to the meeting.

 

 

25.

Minutes pdf icon PDF 90 KB

To approve as a correct record the Minutes of the last meeting held on 18 July 2013 and note actions taken since that meeting.

Minutes:

 

RESOLVED

 

That the minutes of the meeting of the Central Bedfordshire Health and Wellbeing Board held on 18 July 2013 be confirmed and signed by the Chairman as a  correct record, subject to the amendment of recommendation 1 at Minute HWB/13/18 which should read as follows:

 

1.            that the actions being taken to address the decrease in performance in three key mental health outcome measures be noted.

 

 

26.

Reducing Teenage Pregnancy pdf icon PDF 100 KB

To receive and comment upon the current position and progress towards delivering this priority within the Joint Health and Wellbeing Strategy.

Additional documents:

Minutes:

 

The Board considered a report which provided an overview of the work being carried out to reduce teenage pregnancy in Central Bedfordshire.  It was noted that teenage pregnancies were influenced by personal, social, economic and environmental factors.

 

The Director of Public Health informed the Board that the collection of data had been disaggragated since 2010 between Bedford and Central Bedfordshire.  The level of teenage pregnancy was measured by under 18 conception data and the target was to reduce the 15 -18 aged females to 30.8 per 1000 which would be a reduction of 5.13% between the 2013 and 2009 figures.  The results would be published in early 2015 as there was a data lag of approximately 18 months.

 

Central Bedfordshire’s annual rate was below the regional and national rate but there were six priority hotspots identified in the area: Manshead, Tithe Farm, Houghton Hall, Parkside, Northfields and Planets.  The rate of teenage pregnancy reduced by 23.8% between 2010 and 2011 and the percentage of conceptions leading to abortion had reduced from 58% to 56% between 2010 and 2011.

 

The Board was assured that young people were consulted regularly on how they find the support available. 

 

The Aspire programme has been commissioned by Children’s Services and Public Health to support young people at higher risk of teenage pregnancy.  The programme tackled some of the underlying causes of teenage pregnancy across targeted Middle and Upper Schools within the priority hotspots.  Eleven new Aspire Programmes had been commissioned for 2013/14. 

 

The Deputy Chief Executive and Director of Children’s Services, CBC confirmed that work with the NHS was ongoing for vulnerable children to support their mental health and wellbeing.  The emotional satisfaction of vulnerable children was a priority.  The Board acknowledged the role of sports and other activities as an alternative source of entertainment.

 

The process for referring children to CHUMS was being reviewed to ensure that services were targeted to those in greatest need. 

 

RESOLVED

 

1.                  that the content of the reducing teen pregnancy report be noted, including the interdependency of partners’ shared responsibilities in continuing to reduce teenage pregnancy.

 

2.                  that the following actions be  agreed:

 

a.      That the expansion of the early intervention programmes (such as Aspire) through joint commissioning in 2014/15.

 

b.     That the Central Bedfordshire, Bedford Borough and Luton Safeguarding Children’s Boards “Sexual Abuse through Exploitation Protocol” be disseminated and embedded, as appropriate, to increase awareness amongst all professionals in universal and specialist services of their role in identifying and addressing sexual abuse of children and young people through exploitation.

 

a.      That the key aspects of the Central Bedfordshire Sexual Health Strategy be disseminated and embedded, as appropriate,  within Board Member’s teams / organisations – specifically addressing the need for young people to be able to access to high quality information, advice and guidance on sex and relationships, and sufficiently early.

 

 

27.

Understanding the Impact of the Welfare Reform in Central Bedfordshire pdf icon PDF 41 KB

To receive and comment on the Welfare Reforms.

Minutes:

 

The Board considered a report which provided with an overview of the impact of Welfare Reforms on residents of Central Bedfordshire and the steps being taken in response.

 

The Board were mindful that a winter had not occurred since the reforms had been implemented and that this was likely to have a discernable impact which needed to be monitored closely.

 

The Chief Clinical Officer, Bedfordshire Clinical Commissioning Group (BCCG) acknowledged the importance of soft intelligence from GPs in helping to access the impact of the reforms and would discuss with the Council how best this could b fed into the process.

 

RESOLVED

 

1.            that the work being undertaken to understand the impact of the Welfare Reforms be noted.

 

 

28.

Improving Outcomes for Frail Older People- Steps, Milestones and Delivery Mechanisms pdf icon PDF 104 KB

To receive the progress report on Improving Outcomes for Frail Older People.

Additional documents:

Minutes:

 

The Board considered a report on the work being done to improve the outcomes for frail, older people which was a priority in the Joint Health and Wellbeing Strategy.

 

The Assistant Director, Commissioning, Central Bedfordshire Council (CBC) made a presentation to the Board which highlighted the work underway to improve outcomes. 

 

The Director of Social Care, Health and Housing, CBC confirmed that more would need to be done to bring the outcomes to a more acceptable level and ensure that services were truly focused on individuals.  The following issues were highlighted:

·        What should we be investing in and where?

·        How to change from the old ways of working?

·        Sharing agencies’ commissioning programmes

 

The Board agreed that this work would link with the System Leadership Programme (see Minute No. HWB/13/32 refers) which would be discussed later in the meeting. 

 

The Director of Public Health provided an example of where integrated working could have a greater impact, which was flu vaccination for over the 65s.  GPs would receive support to help deliver the vaccination campaign and social marketing through multi agency promotion of consistent and coherent messages. 

 

RESOLVED

 

1.            that the progress made towards priorities identified by the Health and Wellbeing Board to improve outcomes for frail older people be noted.

 

2.            that the challenges and opportunities that exist, next steps, key milestones and delivery mechanisms be noted.

 

 

Prior to consideration of Item 7 Cllr Versallion left the Chamber

29.

Integrating Health and Social Care - Pioneer Bid and Funding pdf icon PDF 90 KB

To consider the call to local areas to become Integrated Health and Social Care Pioneers. 

Additional documents:

Minutes:

 

The Board considered a report on Central Bedfordshire’s Integrated Heath and Social Care Pioneer Bid submission.

 

The Government had earmarked £3.8b to the Integration Transformation Fund (ITF)  to support integration.  The Director of Finance, NHS England confirmed  that the £3.8b ITF was not new money.

 

The Director of Social Care, Health and Housing, Central Bedfordshire Council (CBC) informed the Board that whilst the Bid had been unsuccessful, significant work had been undertaken as part of its preparation which  included speaking to two major service providers in Central Bedfordshire who were keen to work differently. 

 

The Chief Operating Officer, Bedfordshire Clinical Commissioning Group (BCCG) welcomed the Board’s endorsement to continue working towards integration. 

 

The Deputy Chief Executive and Director of Children’s Services, CBC was pleased to learn that the Department for Education (DfE) and Department of Health (DoH) were working closely together on this issue.  It was further noted that the Disability Hub in CBC was an excellent example of integrated working.

 

The Board acknowledged that whilst the bid had been unsuccessful it had enabled the crystallisation of thinking about integration locally.  The Board would receive proposals for ITF funding at its 7 November meeting.

 

RESOLVED

 

1.                  that the outcome of the Expression of Interest to be a ‘Pioneer in Integrated Care and Support’, submitted to the Department of Health on 28 June 2013, be noted.

 

2.                  that the national framework document on integration “Integrated Care: Our shared commitment, which sets out a clear directive to achieve the integration of health and social care by 2018, be noted.

 

3.                  that the creation of a Health and Social Care Integration Transformation Fund (ITF) of £3.8 billion, as part of the 2013 spending review settlement to join up care around people’s lives, be noted.

 

4.                  that the Board receives progress reports on the integration of health and social care and plans for the Integrated Transformation Fund at the November Health and Wellbeing Board.

 

 

30.

Winterbourne View Progress Report pdf icon PDF 92 KB

To receive an update on the progress and key work streams which are being undertaken by health and social care partners in Central Bedfordshire following the Winterbourne View

Additional documents:

Minutes:

 

The Board considered the Winterbourne View Progress Report which identified progress to date and key work streams being undertaken by Health and Social Care partners in Central Bedfordshire.

 

The Head of Mental Health and Wellbeing, BCCG confirmed that the stock take had been completed and all other requirements were on target.  The Board were assured that the work carried out had been used to tighten up service specifications and to ensure people received the appropriate services.  It was also hoped that the 8 people affected would be brought back into the community settings following the changes.

 

The focus for June 2013 to June 2014 was on:

·        in patient hospital review processes

·        development of Joint Strategic Plan and Service Developments

·        monitoring Quality of Service Delivery and Care

 

additional work streams will included:

·        safeguarding

·        Winterbourne View stock take

·        Children’s and Adult Services Commissioning

 

RESOLVED

 

That the Central Bedfordshire Health and Wellbeing Board asks:

 

1.            the Healthier Communities and Older Peoples Board (HCOP) to receive regular progress reports on the alternative care and accommodation support packages being arranged for the 8 individuals moving from inpatient hospital settings.

 

2.            the Healthier Communities and Older Peoples Board (HCOP) to receive regular reports on the joint strategic plan for Bedfordshire Clinical Commissioning Group which covers the development of pooled budget arrangements.

 

3.            the Healthier Communities and Older Peoples Board (HCOP) to receive regular reports on the development of the service specification and implementation of the Bedfordshire wide specialist community support service for people who’s behaviours may be a challenge.

 

4.            the Healthier Communities and Older Peoples Board (HCOP) to receive a progress report on work with the Children’s Services around the transition process.

 

 

31.

Bedford Hospital

A verbal update on the current position.

Minutes:

 

The Chief Operating Officer, Bedfordshire Clinical Commissioning Group (BCCG) provided an update on Bedford Hospital and the recent Care Quality Commission’s (CQC) report.

 

Health Education England had been advised of concerns in the training of specialty Registrars in Paediatrics at Bedford Hospital. 

 

A risk summit had been convened and a course of action taken to ensure patient safety and some services were suspended.  The BCCG was working with the Hospital to ensure that additional transport support was provided for patients and the public kept informed of what was happening. 

 

Bedford Hospital is undertaking an independent external review to understand how the problems arose.

 

In fulfilling its legal public duty, BCCG would be:

·         Working with the Hospital to ensure that it is prepared for the increased demand associated with the rise in respiratory problems in winter

·         determining with local people how to provide services to meet the local need

·         Consulting with both the Health and Wellbeing Board and the Social Care Health and Housing Overview and Scrutiny Committee.

 

The CQC inspected Bedford Hospital, focusing on, paediatrics, stroke ward, A&E, older people ward.  Significant non-compliance was found in 8 out of 9 areas.  The Hospital is preparing an action plan in response to the report. 

 

The Executive Member for Social Care, Health and Housing, CBC asked where the Hospital went from here and about the relevant timescales.  The Chief Operating Officer, BCCG explained:

·         that CQC will be expecting to see improvements by 31 October 2013 after which they will re-inspect the Hospital without notice

·         better delivery of services long term

·         BCCG and CBC will help with the response to CQC’s concerns

 

In addition to addressing the immediate issues at the Hospital, there was a need for a strategic review of the way forward and clarity of the timescales for strategic work would be provided, if possible,  at the 7 November meeting of the Board. 

 

 

32.

System Leadership Programme pdf icon PDF 254 KB

To inform the Board of the successful application for system leadership support.

Minutes:

 

The Board received a report which detailed the successful application by the Central Bedfordshire Health and Wellbeing Board to participate in the System Leadership Programme.  The System Leadership Programme was a collaboration between Public Health England, National Skills Academy for Social Care, NHS Leadership Academy, Virtual Staff College, Local Government Association and the Leadership Centre.

 

The Chairman had submitted the application on behalf of the Board due to time constraints.  The letter of application was attached at Appendix 1 to the report.  The Board would work with an ‘Enabler’ and also have access to:

 

·        learning networks hosted by the King’s Fund

·        participation in Future Vision – a national leadership development programme

·        access to the knowledge-hub where information from across the places involved in the programme will be shared

·        a number of free consultancy days from a limited range of private sector partners

·        participation in the Commissioning Academy.

 

RESOLVED

 

That the successful application for System Leadership Programme be endorsed and that the Board fully participate in the design and delivery of the programme in order to improve outcomes for local residents.

 

 

33.

Establishing Healthwatch Central Bedfordshire - Translating the Vision into Reality pdf icon PDF 68 KB

To receive an update.

Minutes:

 

The Chairman of Central Bedfordshire Healthwatch provided the Board with an update on the establishment of the Healthwatch.  Healthwatch was working on having a meaningful dialogue with younger people and would be speaking to the Youth Parliament and inviting them to have a voice on the Healthwatch Board.

 

Three additional areas of work which have begun since the agenda was published were as follows:

 

·         supporting the mobilisation and deployment of 111.  Healthwatch would support the procurement by taking part in scoring the ITT questions to ensure transparency and patient representation.  In addition, Healthwatch would have an active role on the programme board.

 

·         Bedford Hospital had agreed with Healthwatch visiting various wards and speaking to staff, patients and relatives to provide independent views and also the Hospital would provide updates on staffing levels.

 

·         Healthwatch was one of 10 to contribute to the methodology of the Care Quality Commission (CQC) for acute inspections.  The focus was on ‘how we judge whether a service is caring and responsive – what matters most to people and their families and how local Healthwatch can help the CQC judge this’.

 

The official launch of the Central Bedfordshire Healthwatch would be on 20 September 2013 and members were encouraged to attend.

 

 

34.

Further Development in Central Bedfordshire pdf icon PDF 1 MB

To receive a presentation.

Minutes:

 

The Board received a presentation which provided an overview of the impact of development in Central Bedfordshire with a view to identifying the associated implications and opportunities for health. 

 

A copy of the presentation is attached the Minutes at Appendix B.

 

The Director of Finance, NHS England confirmed that a team had been established to look at planning and would provide a unified approach with councils and the Bedfordshire Clinical Commissioning Group (BCCG).  Also the Capital Allocation for 2013/14 would be reported. 

 

The Chairman of Healthwatch asked if facilities for people with dementia were being considered.  It was noted that provision of housing for different groups of people with special requirements were being considered.

 

The Chief Operating Officer, BCCG suggested that opportunities to incorporate health facilities into new developments and shopping areas be considered especially pharmacies. The Board received a presentation which provided an overview of the impact of development in Central Bedfordshire with a view to identifying the associated implications and opportunities for health. 

 

A copy of the presentation is attached the Minutes at Appendix B.

 

The Director of Finance, NHS England confirmed that a team had been established to look at planning and would provide a unified approach with councils and the Bedfordshire Clinical Commissioning Group (BCCG).  Also the Capital Allocation for 2013/14 would be reported. 

 

The Chairman of Healthwatch asked if facilities for people with dementia were being considered.  It was noted that provision of housing for different groups of people with special requirements were being considered.

 

The Chief Operating Officer, BCCG suggested that opportunities to incorporate health facilities into new developments and shopping areas be considered especially pharmacies.

 

 

35.

Public Participation

To receive any questions, statements or deputations from members of the public in accordance with the Procedure as set out in Part A4 of the Constitution.

Minutes:

 

There were no questions, statements or deputations made by members of the public.

 

 

36.

Board Development and Work Plan 2013-2014 pdf icon PDF 58 KB

To consider and approve the work plan.

 

A forward work plan ensures that the Health and Wellbeing Board remains focused on key priorities, areas and activities to deliver improved outcomes for the people of Central Bedfordshire.

Additional documents:

Minutes:

 

The Board considered a report from the Chief Executive, Central Bedfordshire Council that set out a suggested work programme for 2013 – 2014.

 

The Board noted that the following item would be added to the programme for the 7 November meeting:

 

The plans for Integrated Transformation Fund and emerging approaches for integration of health and social care.

 

Bedford Hospital

 

RESOLVED

 

That the work programme for the Health and Wellbeing Board be approved.