The Chairman welcomed everyone to the meeting.

The Board was updated on the Community Beds Review.  In addition, it was reported that Biggleswade Hospital was being used by patients to help Bedford Hospital cope with the anticipated increased demand for beds due to the winter period.

To approve as a correct record the Minutes of the last meeting held on 5 September 2013 and note actions taken since that meeting.

(circulated separately)

RESOLVED

that the minutes of the meeting of the Central Bedfordshire Health and Wellbeing Board held on 5 September 2013 be confirmed and signed by the Chairman as a correct record.

The Board considered a report that proposed the transfer of funding from  NHS England (NHSE) to Central Bedfordshire Council (CBC) to support Adult Social Care.  The Section 256 funding proposal supported the priorities set out in the Health and Wellbeing Strategy and the needs identified in the Joint Strategic Needs Assessment.  The Bedfordshire Clinical Commissioning Group (BCCG) supported the proposal.

To enable the funding to be monitored, the Board requested that a breakdown of costs be part of the frail elderly priority update report submitted to the Health and Wellbeing Board.

RESOLVED

1.      that the broad outline of the transfer of funding from NHSE to CBC to support Adult Social Care be approved;

2.      to delegate the final decision on the use of the funding to the Director of Social Care, Health and Housing, in consultation with BCCG and NHSE; and

3.      that the sign off of a Section 256 legal agreement between CBC and the NHSE be supported.

The Board considered a report that set out the 2013 Executive Summary of the Joint Strategic Needs Assessment (JSNA) for Central Bedfordshire.  The Executive Summary was the most frequently accessed and used part of the JSNA, and therefore needed to paint a concise picture of significant current and future needs in Central Bedfordshire.  The JSNA was refreshed regularly and was updated and available online as and when data became available.  The Executive Summary would be re-written each autumn to reflect any changes to the needs assessed.

The refresh had confirmed a number of areas which were already in the Joint Health and Wellbeing Strategy (JHWS).  A number of areas that needed to be strengthened were ensuring that every child had the best start in life (particularly in the antenatal and post natal period) and effective management of long term conditions and reducing variation in care.  It was anticipated that the Children’s Trust would maintain their leadership of educational attainment and employment for young people.

The Board highlighted areas where it felt that the Summary needed strengthening, such as preventing adults and children from smoking,  child abuse and the percentage of residents suffering from dementia across Central Bedfordshire.

The Board acknowledged the importance in encouraging providers to ensure that employees at risk from influenza be vaccinated as soon as possible.

RESOLVED

1.      that the 2013 Executive Summary of the JSNA be endorsed; and

2.      that the summary be used to ensure that commissioning plans and strategies address the needs identified to secure high quality and equitable health and wellbeing outcomes for the population of Central Bedfordshire.

The Board considered a report that provided information about the health of Looked After Children and proposed ways in which to enhance the current system and future proof it against increasing numbers and changed timescales.  Following an Ofsted inspection of Safeguarding and Looked After Children services in February 2012, a programme of remedial action had been adopted including the commissioning of an enhanced health service.

RESOLVED

1.      that the Bedfordshire Clinical Commissioning Group (BCCG) ensure, if necessary by additional commissioning, that Children and Young People who were Looked After out of area,  were able to access appropriate health reviews in a timely manner;

2.      that the BCCG monitor increasing demand as part of their commissioning responsibilities to ensure that resources were available for this aspect of Looked After Children’s health; and

3.      that the BCCG Commissioning Team and the Looked After Children Service review the appropriateness of levels of provision to support the new legal process timescales.

The Board received a presentation on the implications for Central Bedfordshire on the Children and Families Bill, which extended the Special Educational Needs system from birth to 25 and gave children, young people and parents’ greater control and choice in decision making and ensuring needs were properly met.  The Government were due to publish a Code of Practice during Autumn 2013 with an implementation date of 1 September 2014.

A Support and Aspiration Programme Board was in place to ensure that the Council, partners and stakeholders responded appropriately to the Bill.

NOTED

the presentation.

The Board considered the Annual Report of the Central Bedfordshire Safeguarding Children Board (CBSCB).  The Annual Report set out the activity and interventions carried out by the Council and its partners to secure children’s safety and manage their circumstances in a safe and effective manner, where they were deemed to be at risk of, or likely risk of, harm.

The Board noted that the strategic priorities had been pursued and that the performance in relation to child protection key indicators had remained good throughout 2012/13 and was reviewed regularly by the LSCB.  The priorities for 2013/14 had been revised and were set out in the Business Plan of the LSCB for the year ahead.

NOTED

the report.

The Board considered a report that set out the plan to deliver better outcomes for people identified with long term conditions in Central Bedfordshire.  The evidence suggested that there needed to be improvement across the three domains of prevention, early diagnosis and treatment. 

Compared with the comparator authority areas, Central Bedfordshire had higher rates of premature mortality from cancer, heart disease, strokes and lung disease.  Only liver disease showed that Central Bedfordshire had a lower rate of premature mortality within the comparator group. 

Following the Board’s meeting on 18 July 2013, actions had been identified to attempt to reduce the rates of premature mortality. 

NOTED

the plan to deliver better outcomes for people identified with long term conditions in Central Bedfordshire.

A verbal update on the current position.

The Chief Operating Officer, Bedfordshire Clinical Commissioning Group provided an update on Bedford Hospital.

Bedford Hospital had reviewed staffing structures, including employing new nurses to support safe staffing levels.  A chief resident (senior medical trainee) had been appointed to support junior doctors.  A Quality Review Scheme had been launched to allow external partners to review and assess the quality of care provided by the Hospital’s wards and departments.  The Trust’s governance structure and key policies had been revised and updated to reflect new ways of working.

However, a review of acute and community services would now take place between December 2013 and May 2014.  In view of this, the paediatric review would be paused.  The review would involve CBC and other partners affected by services delivered by Bedford Hospital.

It was anticipated that the CQC would visit the Hospital in the near future to carry out a further inspection, but it was hoped that they would see significant improvement. 

The Board considered a report that identified priorities for Healthwatch Central Bedfordshire (HCB).  An interactive session held at the HCB launch on 20 September 2013 had been designed to obtain feedback from delegates regarding their priorities for HCB.  The HCB was now working on the priorities identified at the launch.

NOTED

the report.

To receive an update on progress.

The Board considered a report that set out details of the Systems Leadership Programme and the background to the challenge around improving outcomes for frail older people.  Two experienced leadership development ‘enablers’ had been recruited to work with the Central Bedfordshire Health and Wellbeing Board.

The Chairman of Luton and Dunstable University Hospital (LDUH), Spencer Colvin, provided an update of the Care Quality Commission’s (CQC) inspection of the LDUH that had taken place in September.  The CQC had found that LDUH had an effective system in place to assess, identify and monitor the quality of service provision across the Trust and that there were effective risk management systems in place. 

The Board considered a report from the Chief Executive, Central Bedfordshire Council that set out a suggested work programme for 2013 – 2014.  The Board acknowledged that a development session had been scheduled for the 13 February 2014.

The Board noted that the BCCG Bedfordshire Plan for Patients 2014/15 would need to be programmed into the Health and Wellbeing Board work programme, as well as the BCCG’s commissioning intentions.

RESOLVED

that the work programme for the Health and Wellbeing Board be approved subject to the above.