Agenda and minutes

Cllr Hilary Hibbert-Biles

Dr Matthew Gaw attended for Dr Mary Keenan

There were no declarations submitted.

There had been no requests to address or to petition members of the Board.

To approve the Note of Decisions of the meeting held on 25 July 2013                      (HBW5) and to receive information arising from them.

To approve the Note of Decisions of the meeting held on 25 July 2013 (HWB5) subject to an amendment to the phrase ‘would be free to ‘ in page 4, paragraph 4, line 4 with the word ‘should’ to read as follows:

‘The individual partnership boards should ‘drill down’ into inequalities issues at sub county level (whether geographical or affecting specific vulnerable groups.’

2:05

20 minutes

Person(s) responsible:         Members of the Health & Wellbeing Board

Person giving report;            Director of Public Health

There will be a review (HWB6) of current performance against all the outcomes set out in the Health & Wellbeing Strategy. Performance of each Partnership will be presented in turn:

• Children & Young People (Jim Leivers and Cllr Melinda Tilley (in Dr Keenan’s absence)
• Adult Health & Social Care (John Jackson and Cllr Mrs Judith Heathcoat)
• Health Improvement Board (Dr. Jonathan McWilliam)

Action Required: The Board is asked to note the report and presentations and to consider any action required.

The Board had before them a Performance Report reviewing current performance against all the outcomes set out in the Health & Wellbeing Strategy (HWB 6).

This was the first report against the new measures agreed at the last meeting as part of the refreshed strategy. A table showing the agreed measures under each priority in the Joint Health & Wellbeing Strategy, expected performance and current performance was attached at Appendix A.

With regard to target 6.2, Members of the Board discussed the various measures being taken by the NHS organisations and the County Council to tackle the number of delayed transfers of care within the County. The Oxfordshire Joint Health Overview & Scrutiny Committee were due to scrutinise this issue at their 5 December meeting at which all organisations were to be represented.

It was requested that section 256 arrangements feed into the Performance Report.

It was AGREED to note the report.

2:25

10 minutes

Person(s) responsible:         Chief Executive Officer, OCCG; Director for Social & Community Services

Person giving report:            Director of Public Health

To discuss the current systems for monitoring quality and proposed developments (HWB7).

Following public consultation and discussion at the Health & Wellbeing Board it had been agreed that the revised Joint Health & Wellbeing Strategy should include some specific work on assurance of quality in service.

Dr. McWilliam introduced the joint report HWB7 which gave an overview of current quality assurance systems operated by partners in the Health & Wellbeing network on a local, regional and national basis in Oxfordshire.  Current working arrangements and systems of reporting should continue as they were. The report set out for discussion and ratification a number of proposals for how the Board could develop its responsibility to provide a strategic focus on quality.

The Board AGREED:

(a)    quality leads from partner organisations to produce annual summary reports from the local and regional quality assurance groups listed in the report: to include an overview of common issues and concerns raised in the groups and a summary of issues reported by regulators;

(b)   to continue to receive reports on national issues of concern as they arise, with information on the situation in Oxfordshire as reported by the Quality leads from partner organisations; and

(c)   that the role of Oxfordshire Healthwatch will develop alongside the operational quality assurance systems providing a strong and independent network to raise issues of concern across health and social care both directly to this Board and in other forums.

2:35

5 minutes

Person(s) responsible:         Chief Executive Officer, OCCG; Chief Executive, Thames Valley Area Team, NHS England; Director for Social & Community Services, OCC

Person giving report:            Dr Stephen Richards, Chief Executive Officer, OCCG.

To brief the Health and Wellbeing Board on the financial performance of the OCCG for the 2013 -14 financial year to September 2013 and the ongoing financial challenge now faced (HWB8).

Action Required:     To note the report.

Dr Stephen Richards introduced, and the Board discussed the report HWB8 which provided a briefing on the financial performance of the OCCG for the 2013 – 14 financial year to September 2013 and the ongoing financial challenge now faced. A deficit situation had been declared at present with a forecast of an outturn around 6m in deficit. This was being addressed internally via the OCCG’s Financial Challenge Programme Board and external support had also been commissioned. These initiatives aimed to ensure sufficient capacity and capability to address the challenges of the current financial position for the current year and in planning for future years.

Dr Richards stated that OCCG were doing everything they could to diminish the deficit. Patient and public views were being sought as part of this effort. Matthew Tait reported that the Area Team were working closely with the CCG and had accepted that a deficit was the most likely outcome for Oxfordshire.

The Board AGREED to note the report.

2:40

15 minutes

Persons responsible:           Director for Social & Community Services, OCC; Chief Executive Officer, OCCG.

Persons giving the report:    John Jackson, Director for Social & Community Services; Dr. Stephen Richards, Chief Executive Officer, OCCG.

To establish the process by which the Health and Wellbeing Board can agree a plan to use the resources allocated to Oxfordshire through the Integration Transformation Fund by April 2014 (HWB9).

Action Required: to

(a)  agree the proposed process as set out in paragraphs 18-23; and

(b)  agree to consider the final Integration Transformation Fund plan at its meeting on 13 March 2014, alongside proposals for the Health to Social Care funding transfer for 2014/15.

The Board considered a joint report of the OCCG and OCC (HWB9) seeking to establish the process by which the Health & Wellbeing Board could agree a plan to use the resources allocated to Oxfordshire via the Integration Transformation Fund by April 2014.

The Board AGREED

(a)               to approve the proposed process as set out in paragraphs 18-23 of the report, subject to the planning template being emailed around all members of the Board for comment in advance of its approval by the Chairman and Vice-Chairman; and

(b)               to consider the final Integration Transformation Fund plan at the 13 March 2014 meeting of this Board, alongside proposals for the Health to Social Care funding transfer for 2014/15.

2:55

15 minutes

Person(s) responsible:         Chief Executive Officer, OCCG

Person giving report:            Dr. Stephen Richards, Chief Executive Officer, OCCG

OCCG has prepared a strategic overview document entitled ‘ Improving the Health of Oxfordshire’ that is out for consultation (a copy of which is attached to the Agenda and colour copies will be available at the meeting). 

This is aligned to seeking views on the NHS England ‘Call for Action’. A report is attached at HWB10 which provides an outline of this forthcoming national consultation on priorities in the light of restricted funding.

The following background documents are attached – for information only and not for discussion at the meeting.

• Letter to CCG Clinical Heads from Professor Robert Harris, Director of Strategy, NHS England
• Slideset ‘A Call to Action – A Briefing for HWB’
• ‘Consolidated Strategy – Planning Products by Process Box.’

Dr Richards introduced, for discussion and questions,  the OCCG’s draft strategic overview document entitled ‘Improving the Health of Oxfordshire’ which was currently out for consultation (HWB10).

This was aligned to views which were currently being sought on the NHS England ‘Call for Action’. The Board also had before them at HWB10 a report which provided an outline of this forthcoming national consultation on priorities in the light of restricted funding. It was accompanied by a number of background documents which were for information only.

Comments on the overview document from individual members of the Board included:

• A suggestion by a district council representative that the OCCG may wish to work with the district councils on one of their priorities to reduce health inequalities by providing a strong locality focus to address local variation in health outcomes (page 58);
• A suggestion that as the majority of Oxfordshire residents were in good health, this should be reflected more in the document with more of a focus on the prevention agenda;
• More people would attend and engage with the consultation if further evening consultation meetings were to be planned into the process.

The Chairman asked Board members to feed through to the OCCG any further comments they may have.

3:10

20 minutes

Persons responsible:           Andrea Hickman and Donald McPhail, Independent Chairs of the Children’s (OSCB) and the Adults Safeguarding Boards (OSAB) respectively

Persons giving reports:        Vice - Chairman of OSCB, Peter Clark and John Jackson and Hugh Ellis (in Chairman of OSAB, Donald McPhail’s absence)

To present the Annual reports from the OSCB and the OSAB respectively (attached at HWB11)

Action Required:     To receive the reports.

Peter Clark, Vice-Chair of the Oxfordshire Safeguarding Children’s Board presented their Annual Report in the interim Chair, Paul Burnett’s absence and made himself available for questions.

John Jackson presented the Annual report for the Oxfordshire Safeguarding Adults Board in Chair, Donald McPhail’s, absence and made himself available for questions.

Dr Richards made the Safeguarding Board aware that there were slide sets available from the Government to help explain their response on the Francis Inquiry.

The Board AGREED to receive the reports.

3:30

10 minutes

Persons responsible:           The Oxfordshire Health & Wellbeing Board

Person giving report:            Jim Leivers, Director of Children’s Services

The Oxfordshire Children & Young People’s Plan 2013/14 was considered by the Children & Young People’s Partnership Board on 24 October 2013. It is attached at HWB12 for approval.

Action Required: to approve the Children & Young People’s Plan 2013/14.

The Oxfordshire Children & Young People’s Plan 2013/14 had been considered by the Children & Young People’s Partnership Board on 24 October 2013. It was now before the Board for consideration and approval (HWB12).

The Director of Children’s Services explained that although there was no longer a statutory obligation to produce this three year plan, it was considered that an overarching strategic document should be put in place to give guidance and direction. If approved by the Board it would act as a sister document to the Health & Wellbeing Strategy and other associated documents in order to keep work as streamlined as possible.

It was AGREED to approve the Children & Young People’s Plan 2013/14.

3:40

10 minutes

Persons responsible:           Larry Sanders, Chairman of Healthwatch, Oxfordshire and David Roulston, Director of Healthwatch Oxfordshire;

Director of Social & Community Services, OCC

Persons giving reports:        Larry Sanders, Chairman of Healthwatch Oxfordshire and John Jackson, Director for Social & Community Services, OCC

The Chairman of Healthwatch, Larry Sanders,  will give an oral update on recent developments.

John Jackson will also deliver an oral update on the procurement of Healthwatch, Oxfordshire from April 2014.

The Chairman of Healthwatch Oxfordshire, Larry Sanders, gave an oral report on activities and short-term priorities. These included:

• An interim Director, David Roulston, had been recruited and had been able to start immediately;
• The full Board had now been recruited;
• 15 applications had been received for small projects including an application received from a group of carers of people with a learning disability to inform a possible project on how mental health difficulties are experienced by people with a learning disability. A questionnaire on health and social care amongst students had recently gone live. Also an application had been received from an Asian women’s group;
• Some priorities for review had been set. These included access to GP appointments; work with Oxfordshire relatives and residents associations on older people’s experience in care homes; domiciliary care; and whistle blowing;
• Oxfordshire Healthwatch also had an interest in fuel poverty and issues around the insulation of homes; working with the Oxford & District Child Poverty Group; the Government’s response to the Francis Report; and what are the issues for people who do not receive access to advocacy.

Larry Sanders was thanked for his report.

The Director of Social & Community Services reported that officers were currently in the process of looking for expressions of interest to run Oxfordshire Healthwatch from 1 April 2014.

3:50

10 minutes

Oral reports on activities since the last meeting in July will be presented by:

• The Vice - Chairman of the Children & Young People Partnership Board, Cllr Melinda Tilley (in Dr Keenan’s absence);
• the Chairman of the Adult Health & Social Care Partnership Board, Cllr Mrs Judith Heathcoat; and
• the Chairman of the Health Improvement Partnership Board, Cllr Mark Booty.

Action Required:     To receive updates from each Partnership Board.

Councillor Melinda Tilley, Councillor Judith Heathcoat and Dr Joe McManners each gave oral progress reports on recent activity of each of the three Partnership Boards.

Children & Young People’s Partnership Board

Councillor Tilley reported on a meeting to be held with members of the Partnership Board and the Chair and Vice-Chair of the Oxfordshire Safeguarding Children’s Board to clarify roles. Further work was also underway to ensure the functions previously held by the Children’s Trust were covered appropriately. Changes to the membership had also occurred to include new PIN  and Young Persons representatives and a representative from the voluntary sector.

The Board had considered the following:

• A paper on outcomes based commissioning for maternity services in Oxfordshire which was now being taken forward;
• The Children & Young People’s Plan for Oxfordshire 2013/14;
• The Oxfordshire Safeguarding Children’s Board Annual Report 2012/13
• Integrated Pathway and Multi Agency Safeguarding Hub (MASH).

It had been proposed to hold an extended meeting of the Partnership Board shortly to drive forward the development of the new Children & Young People’s Plan 2014-18. This would engage a wider range of partners.

Adult Health & Social Care Partnership Board

Councillor Mrs Heathcoat and Dr McManners reported on membership changes to include two new Public Involvement Network representatives.

The Partnership Board had considered the following:

• Work that Oxford City Council and Oxfordshire County Council were doing on welfare reform. It had been agreed that the Partnership Board had agreed to monitor the impact of welfare reform for vulnerable groups and a report would be brought back to a future meeting;
• The Older people’s Housing Strategy – Needs Analysis, one of the indicators in the priorities for the Health & Wellbeing Board – the Partnership Board were keen to ensure that the work was being taken account of in other strategies, in particular the district council housing strategies and the work of the OCCG;
• The Joint Health & Wellbeing Strategy – Report on Performance Targets – highlighting the challenges raised by the increase in demand and the changes to services as a result. The Partnership Board had supported the multi-agency approaches and the work being carried out to address the indicators that were not meeting targets;
• The Oxfordshire Joint Older People’s Commissioning Strategy – Programme Board update.

A Mental Health workshop had been jointly organised in October by the Partnership Board and the Better Health in Oxfordshire Programme Board and had been attended by over 60 professionals, service users and carers. It had focused on the links between mental health and physical and other conditions. A number of key actions had emerged from the event. These were:

-           a need for better co-ordination of services, communication between professionals and integration of mental health and drug and alcohol services;

-           Improving of information and setting up information management systems;

-           Reviews about a person’s mental health to be informed by physical health;

-           A mental health lead to be in all GP practices;

-           Consider pooling budgets for mental health and drugs and alcohol; and

-           Closer  ...  view the full minutes text for item 14/13