Agenda and minutes

To elect a Chairman of the Health and Wellbeing Board from among the Councillors on the Board, for the forthcoming year. 

Councillor Brake was elected as Chairman for the forthcoming year.

To elect a Vice-Chairman of the Health and Wellbeing Board for the forthcoming year. 

Dr Peter Green was elected Vice-Chairman for the forthcoming year.

Apologies for absence were received from Councillor Mike O’Brien (Portfolio Holder for Children’s Services) , Pennie Ford (Director of Assurance and Delivery, NHS England), Lesley Dwyer (Chief Executive, Medway NHS Foundation Trust), Malcolm McFrederick (Executive Director of Operations, KMPT),  Dr Mike Parks (Medical Secretary, Kent Local Medical Committee), and Martin Riley (Managing Director, Medway Community Healthcare).

To approve the record of the meeting held on  28 April 2016.

The record of the meeting held on 28 April 2016 was agreed, subject to the following amendment:

Minute no 954/2016: second bullet point to be amended to read:

·         While it was important that the potential for poor outcomes from surgery was explained to patients who were smokers, they should not be given the impression that surgery would be denied to them because they smoked. There should not be a perception that this initiative was financially driven; it was directly linked to improving the safety and effectiveness of care.

There were none.

Disclosable pecuniary interests

There were none.

Other interests

Councillor Maple declared an interest as a Director of the Medway Credit Union in relation to agenda item 9, Research into the Needs of the Armed Forces Community in Kent and Medway, as he advocated promotion of the use of credit unions for service leavers rather than payday lenders.  He remained in the room and took part in the discussion.

The Chairman welcomed Councillor Gary Etheridge and Helen Greatorex, Chief Executive of Kent and Medway NHS and Social Care Partnership Trust, to their first meeting of the Board. He also noted that this would be Barbara Peacock’s last meeting before taking up her new role as Executive Director of People at the London Borough of Croydon. On behalf of the Board, the Chairman wished Barbara well in her new role. 

A presentation will be given on delivering the Five Year Forward View incorporating an update on the development of the Kent and Medway Sustainability and Transformation Plan.

Discussion:

The Sustainability and Transformation Plan (STP) Director gave a presentation on Delivering the Five Year Forward View.  It incorporated an update on the development of the Kent and Medway Sustainability and Transformation Plan.  Key issues within the presentation included:

·         The national planning context which required a five year STP together with a one year operational plan.

·         How the STP would improve health and wellbeing, transform quality of care delivery, deliver sustainable finances and establish more robust system leadership.

·         The anticipated allocation of place based funding and also sustainability and transformation funds.

·         The challenges for Kent and Medway including population change, housing development, unacceptable health inequalities, recruitment concerns, reshaping service delivery to provide more out of hospital services and to concentrate on preventative support and managing the deficit budget.

·         The performance against targets where particular attention was drawn to poor performance in the following areas: the estimated diagnosis rate for people with dementia; the four hour target for A&E.

·         Population characteristics including highlighting special concerns around higher levels than average in Medway of obesity, smoking prevalence and related illnesses.

·         Improving the governance.

·         The need to concentrate on four main themes: increasing self care and prevention; strengthening primary care and integrated out of hospital care; developing a clearer acute hospital strategy focusing on an East Kent Strategy Board, the A21/A229 corridor and pan Kent and Medway services for example in stroke and vascular services; and cost reductions.

Members of the Board raised a number of issues which were responded to, including:

·         What steps were being taken to ensure “total place” financial models could work in terms of delivering savings? It was noted that this continued to be a complex issue which was being explored at a national level. Very different mechanisms were needed for a joined up single budget.

·         Whether significant additional finance would be available to the NHS following the EU referendum. It was concluded that it would be a matter of having to await developments although additional funding would not have a significant impact without an increased workforce.

·         The timing of a review of acute services. The Board was advised that more detailed modelling was required to establish the baseline position;  The review was due for completion in March 2017.

·         The importance of engagement which would include further reports to the Board and concern about this being led by NHS England. The Board was assured that there was a significant level of involvement from Medway health partners which had resulted in the current version of the Plan better reflecting Medway’s needs. The STP steering group included several Health and Wellbeing Board members and a wide range of stakeholders would be invited to workshop events.

·         Concern that the per capita financial settlement disadvantaged Medway residents.

·         It was vital to concentrate on core requirements rather than what might be seen as “vanity projects”.

·         It was vital to demonstrate that existing resources were being properly and efficiently applied in order to persuade the Government that additional finance was necessary. It was  ...  view the full minutes text for item 89.

The Board considered four related papers on mental health services in Medway.

This report provides an update on the commitments made in the Mental Health Crisis Care Concordat across Kent and Medway and also an overview of  the work that has been completed and that is ongoing as part of the action plan.

Discussion:

Decision:

The Board:

(a)       supported the work of Kent and Medway Mental Health Crisis Care Concordat; and

(b)       agreed the governance framework of the concordat group including a requirement to report annually progress to both the Kent and Medway Health and Wellbeing Boards.

This report informs the Board of the mental health services provided by Medway Council.

Discussion:

Decision:

The Board noted the report.

This report summarises some of the key programmes of work on mental health for Medway CCG, its objectives and the challenges it faces.

Discussion:

The Accountable Officer, Medway CCG and the Head of Mental Health Commissioning, Medway CCG, presented a report which summarised some of the key programmes of work on Mental Health for Medway CCG, the CCG’s objectives and some of the challenges that were faced.

Members of the Board raised some points which were responded to, including the following:

·         The need to improve signposting to services, especially psychological therapies (IAPT), to improve prevention. Ensuring people accessed health checks would improve secondary prevention.

·         Assurances were sought that weekend provision would be a target for improvement given that mental health issues were most likely to arise at this time.

·         It was noted that that reputational issues needed to be addressed if organisations such as schools were to buy into the service under commissioning arrangements.

·         It was noted that successful early intervention would not only be beneficial to patients but would also result in better use of NHS resources.

·         A workshop with KMPT had been arranged on the development of an integrated pathway for patients that would avoid breaks in support.  

·         It was important that children’s mental health issues were addressed and emotional wellbeing services were very active in schools. The number of schools moving to academy status presented a funding challenge.

·         It was noted that 16 additional mental health beds would be provided in Kent by October 2016, bringing the total to 190.

·         Concern was raised about the use of acute mental health beds in out of area facilities and how this related to the recommendations of the Crisp Report.

·         An away day or workshop was proposed to discuss the development of an integrated approach towards mental health.

·         In future there should be a single mental health report to the Board rather than four separate ones.

Decision:

The Board:

(a)       noted the report; and

(b)     agreed unanimously to support the development of an away day or workshop on developing an integrated approach to metal health involving all relevant partners across all sectors.

This report provides a strategic overview of KMPT’s mental health services 2016/17 and beyond.

Decision:

The Board:

(a)       noted KMPT’s commitment to radical and whole-system change within Medway and Kent; and

(b)       noted the content of this report in support of its wider multi-agency discussion around mental health services 2016-17 in Medway.

This report summarises the findings of the research commissioned by the Kent & Medway Civilian Military Partnership Board into the needs of the armed forces community.

Discussion:

Decision:

The Board considered the results of this research, provided comments and agreed that this should be fed into the Joint Strategic Needs Assessment and used to inform any other strategic development where consideration of the needs of the armed forces community is key.

This report relates to the development of Medway’s social care strategy, “Getting Better Together”.

Discussion:

This report details the progress made to finalise the Section 75 Agreement and the Better Care Fund Plan for 2016/17

Discussion:

Decision:

The Board endorsed the individual schemes and services included within the scheme specifications of the draft Section 75 Pooled Fund for the Better Care Fund for 2016/17, as set out in Appendix 1 to the report.

The purpose of this report is to provide an update to the Board on Joint Health and Wellbeing Strategy (JHWS) indicators.

Discussion:

Board members raised some issues and received responses including the following:

·         Over the next few years £2.5m would be invested in the provision of cycle routes.

·         It was noted that there was a vital need to encourage people to present themselves for treatment at an early stage. 

·         It was questioned whether European Social Fund programmes would be able to continue. The Board noted that many other funding streams existed including charitable sources.

·         It was suggested that workplace health initiatives should be made a priority given that the NHS and the Council were the two biggest employers in Medway.

Decision:

The Board noted the indicator updates.

This report provides a briefing on the work being done to make Medway NHS Foundation Trust (MFT) smoke free.

Discussion:

Members of the Board raised some issues and responses were given, including the following:

·         E-cigarettes would not be permitted.

·         The role of champions to promote this initiative was a challenging one and there were potential problems in respect of conflict resolution.  Training and support would be provided.

·         A commitment from Councillors to look at potential funding for the initiative for 2017-18.

Decision:

The Board noted the report.

Discussion:

The Board reviewed the current work programme.

Decision:

The Board noted the current work programme for 2016-17.