Agenda and minutes

There were no declarations of interest.

There were no urgent items of business.

RESOLVED that the minutes of the meeting of the Health and Wellbeing Board held on 17 September 2014 be approved as a correct record and signed by the Chairman.

There were no matters arising.

In response to the following question, submitted by Mr Ed Glasson on behalf of People’s Healthwatch:

Leaving aside the conspicuous failure of the Board to respond seriously to the first part of the question tabled at its 17.09.2014 meeting, please may we have a response to the second part of the question? Namely, when will the Board consider the dire findings of  the Public Health England 2013/’14 peer local authority mortality study?

Lisa McNally, Consultant in Public Health, expressed surprise at the view that the outcomes of the Public Health England Longer Lives survey were considered to be dire particularly in light of the fact that Bracknell Forest’s rankings had improved significantly across all measures when compared with the findings of the previous Longer Lives survey which had placed Bracknell Forest bottom in most categories.

In addition, Health Profiles for the Borough showed that Bracknell Forest had the lowest number of red indicators in the Thames Valley and the recently published life expectancy data showed that Bracknell Forest had experienced the second highest rise in male life expectancy nationally.

It was stressed that whilst the Board would not be considering the survey as a separate substantive item it would be kept abreast of any developments that were considered to be relevant to the Health and Wellbeing Board as they arose.

It was noted that no substantive actions had taken place since the Board’s last meeting.

The Director of Children, Young People and Learning presented a report providing an update on the work taking place to review each tier of the Child and Adolescent Mental Health Services (CAMHS) and the work that was taking place to prepare for the re-commissioning of the service from April 2015.

The multi-agency review of CAMHS was progressing well against a changing national landscape and a joint CAHMS Action Plan would be developed to take the emerging recommendations forward.  The recently published NHS Planning Guidance 2015/16 had placed an increased emphasis on achieving parity for mental health including CAHMS provision.  It had therefore been agreed that work on the action plan’s development would be delayed to enable the full implications of this guidance to be clarified.  Notwithstanding this delay, work was progressing inside all agencies to improve CAHMS provision.

The Public Health Team was working to develop an online resource to provide help and guidance to young people.  The service had been match funded by the Clinical Commissioning Group and a twelve month contract had been entered into with a specialised provider.  The service would commence on 1 April 2015 and it was hoped that this resource would not only provide young people with an opportunity to access help and advice at an early stage before more intensive interventions might be required but also act as an on-going step down support service for those children and young people reaching the end of treatment programmes.

It was recognised that there was a stigma attached to accessing mental health diagnostic services and that the online resource should help to address this. It had been acknowledged that schools would be central to the success of the online resource and the service provider would be working closely with schools to raise awareness of the resource and help train staff to recognise those children and young people who might be at risk and those young people who could be considered to be ‘Quiet at risk’ i.e. those who struggled to cope but just got on with things in particular.

The Clinical Commissioning Group (CCG) had used funding received through the Winter Operational Resilience Fund to improve the interface between Tiers 2 and 3 and early intervention services.  Work was also taking place to raise awareness amongst schools and GPs of the help available.

It was recognised that for many young people the transition from Children’s Services to Adult Services could be an issue, with adult services requiring different thresholds for intervention and in CAMHS for example some specialist services not being provided at all in the adult health sector.  To combat this work was being started to transform the transition between the two areas into a continuous on-going process.

It was also noted that the transfer of commissioning responsibility for 0 – 5 year-olds public health services (health visitors and Family Nurse Partnerships) into local councils in October, alongside the existing 5 – 19 services, would give further opportunities over time to create more continuity.

Arising  ...  view the full minutes text for item 127.

The Board considered a report detailing the outcomes of a recent review of the Board’s processes and setting out proposals for the future membership, meeting cycle, priority setting and performance monitoring of the Board.

It was noted that the Board was reaching the end of its second year in operation (the first year operating as a shadow board and the second as a functioning committee) and that although the Board had initiated and driven forward a number of positive pieces of work for example the multi-agency review of CAMHS and the development of improved synergies and understanding between the agencies represented at the Board there were still areas for development for example:

·         Expanding the Board’s membership to include key providers representing health, social care and housing and the voluntary sector as well as the local NHS Foundation Trusts

·         Establishing priorities for the Board that focus on four or five key areas

·         The establishment of task and finish groups with a wider membership to work on the Board’s priorities

·         The development of a dashboard of performance indicators with measurable targets and parameters

It was stressed that the Board must make it clear what level of commitment would be required from new Board members as well as their expectations in relation to accountability.

It was stressed that when expanding the Board’s membership and developing priorities that the wellbeing aspect of the Board’s remit must not be lost.

It was agreed that a report setting out proposals for a new structure, expanded membership list and draft priorities and performance measures would be brought to the Board’s June meeting.

RESOLVED that the proposed membership, meeting cycle, priority setting and performance monitoring detailed in the Director of Adult Social Care, Health and Housing’s report be approved.

The Board considered a report setting out the Pharmaceutical Needs Assessment (PNA) for Bracknell Forest.

Responsibility for the development and updating of PNAs passed to Health and Wellbeing Boards following the implementation of the Health and Social Care Act 2012.   The PNA provided a statement of the needs for pharmaceutical services of a population setting out information on the pharmaceutical services currently provided and identifying gaps in the current service provision. Once approved the PNA would be used by NHS England, local Clinical Commissioning Groups and Public Health functions to help inform future commissioning decisions.

The PNA had been informed by public events and a survey.  Across the Berkshire area, Bracknell Forest had received the highest per capita return rate of all the Berkshire unitary authorities with 390 completed questionnaires being returned.

Feedback from the recent Self Care Week promotional work had identified that obtaining access to information relating to out of hours pharmacies was an issue for local residents.  It was agreed that the Public Health Team would work with the local pharmaceutical committee to develop an up to date resource and this would then be made available online and publicised by the Clinical Commissioning Group and Healthwatch.

Hospital based pharmacies were not classified as community pharmacies and did not offer the same range of over the counter services as community pharmacies.  It was acknowledged that patients taking prescriptions issued by hospitals to community pharmacies was causing a resource issue and these concerns would be taken up with the appropriate advisory committees.

RESOLVED that the Pharmaceutical Needs Assessment, attached as an annex to the Strategic Director for Public Health’s report, and its associated recommendations be approved.

Mary Purnell, Nicky Wadely and Alex Tilley gave a presentation in respect of the changes taking place to transform the delivery of primary care services.  The presentation included an overview of the new joint approach to co-commissioning, an overview of the primary care transformation programme and a summary of work to increase the future capacity of primary care services in the Borough.  Arising from the subsequent discussion the following points were noted:

·         Bracknell and Ascot CCG had received formal approval of their request to enter into co-commissioning with NHS England on 4 March 2015

·         A bid for funding to support the transformation programme in the local area had been submitted to the Prime Minister’s Challenge Fund.  It was stressed that even if the bid was not successful the CCG would still take the transformation programme forward

·         Under the terms of any co-commissioning work NHS England would retain responsibility for contract maintenance

·         Six GP surgeries in Bracknell Forest had submitted bids for Primary Care Infrastructure Funding to increase the capacity of their surgeries.  A total of £2billion would be available from the Fund and there would be three further annual funding cycles to which bids could be made in the coming years

·         The invitation to submit bids to the Primary Care Infrastructure Fund had been sent directly to GP surgeries and there had been limited input from the CCG and other agencies

The Board recognised that in order to improve the chances of success for any future funding bids that a pro-active approach must be taken and that a comprehensive plan setting out the Board’s strategic vision for its health and wellbeing services and detailing where new housing developments would be built, spatial planning matters and the range of health and wellbeing services that would be needed to meet demand in the future should be developed.  This could then be used to support any future bids and commissioning decisions. It could also be used to support engagement with the Department of Health at a political level.

It was agreed that this piece of work should be taken forward by a sub-group of the Health and Wellbeing Board.  The Sub-group would be led by the CCG with representation from the Director of Adult Social Care, Health and Housing, Planning Policy and NHS England in the first instance.  It was agreed that a report setting out the scope of the Sub-group’s work would be brought to the Board’s June meeting for consideration.

The Board thanked Mary Purnell, Nicky Wadely and Alex Tilley for their update.

The Board noted the following additions to the Forward Plan:

·         CAMHS Update (Janette Karklins)

·         Review of Health and Wellbeing Board (John Nawrockyi)

·         Development of an Infrastructure Group (Mary Purnell)