Agenda and minutes

The Chairman extended a welcome to:

• Dr Joe McManners in his role as the Oxfordshire Clinical Commissioning Group’s (OCCG) Clinical Chair and Vice - Chairman of the Board;
• Ian Wilson, interim Chief Executive, OCCG, who is ‘in attendance’ to the Board alongside Joanna Simons;
• Larry Sanders in his new formal role as Chairman of Healthwatch Oxfordshire and member of the Board.

The Chairman took this opportunity to thank Dr Stephen Richards on behalf of all the members of the Board for the considerable part he has played in developing the partnership aspect to clinical commissioning within the County via the Shadow and the statutory Health & Wellbeing Board and for all his valuable hard work and dedication to this.

James Drury attended for Matthew Tait, Frances Craven for Jim Leivers, and apologies were received from Dr Mary Keenan and Joanna Simons.

There were no declarations of interest submitted.

There were no petitions submitted or any requests to address the meeting.

To approve the Note of Decisions of the meeting held on  21 November 2013                      (HBW5) and to receive information arising from them.

The Note of Decisions of the meeting held on 21 November 2013  (HWB5) was approved and signed as a correct record.

2:05

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

Person giving report:                        Peter Clark, Head of Law & Culture, OCC

There is a requirement to amend the OCC Constitution (Health & Wellbeing Membership) to reflect changes within the Oxfordshire Clinical Commissioning Group. These changes are such that the former Chief Executive role will be split into two separate roles ie. the Chief Executive and the Clinical Chair, to reflect the challenges facing health services in Oxfordshire.

Following an election for Clinical Chair, Dr Joe McManners has been appointed as the OCCG’s new Clinical Chair. Dr McManners is currently a member of the Oxfordshire Health & Wellbeing Board by virtue of his office as Vice Chairman of the Adult Health & Social Care Partnership Board. 

Dr Stephen Richards has formally resigned from his role as Accountable Officer (Chief Executive Officer) of the OCCG and the Board are advised that Ian Wilson, as Interim Chief Executive, will be taking on the role of Accountable Officer to the OCCG temporarily, whilst a permanent officer is recruited.

The OCCG Governing Body have notified us that Dr McManners will take on the Vice-Chairmanship of the Health & Wellbeing Board and the Interim Chief Executive will join Joanna Simons in the role of ‘In Attendance’ to the Board.

Action Required: in order to reflect the above changes the Board are RECOMMENDED:

(a)        to agree that the current wording of the Terms of Reference for the Board to be amended from (amendments underlined):

‘Meetings of the Board will be chaired by the Leader of the Council and the Vice-Chairman will be the Chief Executive of the Clinical Commissioning Group’ to:

‘Meetings of the Board will be chaired by the Leader of the Council and the Vice-Chairman will be ‘either the Chief Executive of the Oxfordshire Clinical Commissioning Group or its Clinical Chair as notified to the Monitoring Officer of Oxfordshire County Council’

(b)              that a nomination be sought from the OCCG for a GP representative to join the Adult Health & Social Care Partnership Board; and

(c)               to thank Dr Stephen Richards for the considerable part he has played in developing the partnership aspect to clinical commissioning within the County via the Shadow and the statutory Health & Wellbeing Board and for all his valuable hard work and dedication to this.

The Board were asked to approve an amendment to the Oxfordshire County Council Constitution (Health & Wellbeing Membership) to reflect the changes which had recently occurred within the Oxfordshire Clinical Commissioning Group.

It was AGREED that in order to reflect these changes:

(a)         to amend the current wording of the Terms of Reference for the Board from (amendments underlined):

‘Meetings of the Board will be chaired by the Leader of the Council and the Vice-Chairman will be the Chief Executive of the Clinical Commissioning Group’ to:

‘Meetings of the Board will be chaired by the Leader of the Council and the Vice-Chairman will be ‘either the Chief Executive of the Oxfordshire Clinical Commissioning Group or its Clinical Chair as notified to the Monitoring Officer of Oxfordshire County Council’

(b)               that a nomination be sought from the OCCG for a GP representative to join the Adult Health & Social Care Partnership Board.

2:05

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

Person giving report:            Director of Public Health

To consider a report (HWB7) on trends in local data which impact on health and wellbeing. It includes recommendations for updating the Joint Health & Wellbeing Strategy.

The Board is RECOMMENDED that:

(a)              the findings highlighted in this report are used in the process of updating and revising the Joint Health & Wellbeing Strategy (JHWBS);

(b)              the outcomes achieved in 2013-14 and set out in the performance report (agenda item 9) are also taken into consideration in affirming and setting a concise set of outcome measures for 2014-15; and

(c)               a revised draft Joint Health & Wellbeing Strategy for 2014-15 is brought to the next meeting of the Health & Wellbeing Board on 17 July 2014 for discussion and adoption.

The Board considered the Joint Strategic Needs Assessment report (HWB7) on trends in local data which impact on health & wellbeing. The report also included recommendations for updating the Joint Health & Wellbeing Strategy.

In response to a question on population, John Jackson highlighted the work the County Council were doing with Oxford City Council looking at projections of housing growth, which had informed the strategic housing market assessments.

There was general support amongst the Board for the need in the future to analyse all data at a local level in order to produce a clearer picture of how service needs could be met in local areas.

The Board AGREED that:

(a)               the findings highlighted in this report are used in the process of updating and revising the Joint Health & Wellbeing Strategy (JHWBS);

(b)               the outcomes achieved in 2013-14 and set out in the performance report (agenda item 9) are also taken into consideration in affirming and setting a concise set of outcome measures for 2014-15; and

(c)               a revised draft Joint Health & Wellbeing Strategy for 2014-15 is brought to the next meeting of the Health & Wellbeing Board on 17 July 2014 for discussion and adoption.

Board Member(s) responsible: All Members of the Board

Person giving report:                  Director of Public Health

A report is attached (HWB8) advising the Board on work in progress in relation to the production of a Pharmaceutical Needs Assessment for Oxfordshire on behalf of the Health & Wellbeing Board.

The Board is RECOMMENDED to:

(a)              agree to the process set out in this paper and delegate authority to the Director of Public Health, in consultation with the Chairman and Vice Chairman of the Health and Wellbeing Board, subject to financial and legal approvals, to procure and manage the service of a contractor to produce a Pharmaceutical Needs Assessment for Oxfordshire on behalf of the Health and Wellbeing Board; and

(b)              consider a progress report on this work at the July 2014 meeting.

The Board considered a report (HWB8) which advised on work in progress to produce a Pharmaceutical Needs Assessment for Oxfordshire on behalf of the Health & Wellbeing Board.

The Board RESOLVED to:

(a)               agree to the process set out in this paper and delegate authority to the Director of Public Health, in consultation with the Chairman and Vice Chairman of the Health and Wellbeing Board, subject to financial and legal approvals, to procure and manage the service of a contractor to produce a Pharmaceutical Needs Assessment for Oxfordshire on behalf of the Health and Wellbeing Board; and

(b)               consider a progress report on this work at the July 2014 meeting.

2:20

Board Members responsible:          Members of the Health & Wellbeing Board

Person giving reports:                      Director of Public Health

There will be a review of current performance (HWB9) against all the outcomes for 2012 – 13 set out in the Health & Wellbeing Strategy.

Performance for each Partnership Board will be presented in turn:

• Children & Young People Partnership Board (Jim Leivers and Dr Mary Keenan)
• Adult Health & Social Care Partnership Board (John Jackson and Cllr Mrs Judith Heathcoat)
• Health Improvement Partnership Board (Dr Jonathan McWilliam and Cllr Mark Booty)

The Board had before them a Performance Report (HWB9) which reviewed the third quarter (1 October – 31 December 2013) performance against all the outcomes set out in the Health & Wellbeing 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.

It was AGREED to note the report.

2:40

Board Member responsible:            Clinical Chair, OCCG

Persons giving report:                      Interim Chief Executive Officer, OCCG and Clinical Chair, OCCG

To agree the Oxfordshire Clinical Commissioning Group 5 Year Plan prior to its submission to NHS England by 4 April 2014. A presentation will be given on the draft Strategic Plan (HWB10) and the Board will receive information on outcome based commissioning.

The Board is RECOMMENDED to agree the Oxfordshire Clinical Commissioning Group Strategic Plan.

Ian Wilson, interim Chief Executive of the Oxfordshire Clinical Commissioning Group (OCCG), gave a presentation on the draft OCCG 5 Year Plan. The Board were requested to comment on it and endorse it prior to its submission to the OCCG Governing Body and then to NHS England on 4 April.

Mr Wilson reassured members of the Board on the robust nature  of the Plan to eradicate the CCG’s budget deficit adding that a rigorously tested project management approach had been adopted.

Mr Wilson gave his reassurance that the  OCCG was looking closely at where the areas of need were and how the public could best be served. The OCCG had initiated plans to help primary care to develop networks which would enable enhanced access. This included a variety of solutions suited to different areas in the localities.

Members of the Board welcomed the ambition contained in the Plan to tackle inequalities, asking if there were similar ambitions to raise the quality of mental health services. Mr Wilson pointed out that  the mental health area was leading the way in the new Outcome Based Commissioning method in contracting services, leading to a more integrated way of working with other mental health services.

The Board noted that the outcomes of a recent survey of access to GP’s by Healthwatch Oxfordshire was currently being analysed. In addition, a survey of Oxford University students had also been carried out by Oxfordshire Healthwatch on their experiences of the Accident & Emergency service during 2013. Information on these surveys would be passed to the appropriate people/organisations on completion.

It was AGREED to:

(a)               approve the OCCG Quality & Performance Committee’s two possible measures for improving the quality of commissioned services which were:

·        developing a measure to improve prescribing;

·        developing a measure to improve electronic clinical communication

and to delegate to the OCCG Governing Body any final decision on which measure to adopt; and

(b)               approve the draft OCCG 5 Year Plan, taking the above comments of the Board into account and to delegate the sign off of the final document to the Chairman & Vice-Chairman of this Board.

3:05

Board Members responsible:          Director for Social & Community Services, OCC and Clinical Chair, OCCG

Persons giving report:                      Director for Social & Community Services and Clinical Chair, OCCG

To seek agreement from the Health & Wellbeing Board on the proposed use of the Better Care Fund in Oxfordshire (HWB11), prior to submission to NHS England (as an integral part of the Oxfordshire Clinical Commissioning Group’s Strategic and Operational Plans) by 4 April 2014.

The Board is RECOMMENDED to:

(a)  agree the Better Care Fund Plan for Oxfordshire for submission to NHS England by 4th April 2014, subject to subject to the inclusion of any necessary changes which may be required following consideration by County Council Cabinet and Clinical Commissioning Group Governing Body as agreed by Chairman and Vice Chairman of the Health and Wellbeing Board;

(b)  in so doing, to agree the use of the Health Transfer to Social Care Funding in 2014/15 as set out in the financial template, and for this to form the basis of a section 256 agreement following legal review by the County Council and NHS England and as agreed by the Director for Social & Community Services following consultation with the Cabinet Member for Adult Services; and

(c)    to receive an updated plan in March 2015 prior to implementation, reflecting performance in 2014/15 and any emerging pressures and priorities.

The Board had considered a background paper on the Better Care Fund Plan at its previous meeting. Formal approval was now sought on the proposed use of the Fund in Oxfordshire, prior to its submission to NHS England (as an integral part of the OCCG’s Strategic and Operational Plans) by 4 April 2014.

John Jackson introduced the Plan (HWB11) which had its focus on the pressures arising from the rising numbers of older people with complex conditions. It had been built on the existing Older People Joint Commissioning Strategy 2012  - 2016 and produced together with the Oxford University Hospitals NHS Trust and a number of users and carers.

Larry Sanders  commented that it had been found that there were better results from the reablement service when people were helped to connect with local networks. He added that he had been very encouraged by the community development work carried out by Age UK. He called for a greater emphasis on care for the carers via short breaks etc. John Jackson responded that discussions were ongoing with the OCCG with regard to the Community Health Service (Reablement) and a review of the community service interface with patient coming out of acute care was progressing. A report would be made to a future meeting. The County Council were also looking to carry out a review of information and advice. Its focus was also to reach more carers. The Care Bill would make it a legal requirement for carers to have an assessment and it was anticipated that this would be addressed through the Better Care Plan.

A plea was made for GPs, Schools and Social Workers to give more help and support to young carers and also for patients to be discharged to facilities near to their families on leaving acute care.

It was AGREED:

(a)   to agree the Better Care Fund Plan for Oxfordshire for submission to NHS England by 4th April 2014, subject to the inclusion of any necessary changes which may be required following consideration by County Council Cabinet and Clinical Commissioning Group Governing Body as agreed by Chairman and Vice Chairman of the Health and Wellbeing Board;

(b)   in so doing, to agree the use of the Health Transfer to Social Care Funding in 2014/15 as set out in the financial template, and for this to form the basis of a section 256 agreement following legal review by the County Council and NHS England and as agreed by the Director for Social & Community Services following consultation with the Cabinet Member for Adult Services; and

(c)    to receive an updated plan in March 2015 prior to implementation, reflecting performance in 2014/15 and any emerging pressures and priorities.

3:30

Board Member responsible:            Clinical Chair, OCCG

Person giving report:                        Dr Paul Park, OCCG

To consider a proposal to set up a multi-agency group to enable collaboration on Information Management and Technology (HWB12).

The Board is RECOMMENDED to endorse the proposal.

Dr Paul Park, OCCG, presented a proposal to set up a multi-agency group to enable collaboration on Information Management and Technology (HWB12).

It was AGREED to endorse the proposal.

3:40

Board Member responsible:            Larry Sanders, Chair of Healthwatch, Oxfordshire,

Board Member giving report:          Larry Sanders, Chair of Healthwatch, Oxfordshire

Larry Sanders will give an update (HWB13) on recent developments. Issues raised will include:

• The mortality gaps for people with mental health problems and/or learning disabilities
• Monitoring the combined effects of Social Care cuts, NHS efficiency savings and benefits changes
• Care data.

Larry Sanders, Chair of Healthwatch Oxfordshire presented an update on recent developments (HWB13). He undertook to take any comments and suggestions from the Board to the Healthwatch Board.

Members of the Board were very supportive of 10.2 – to encourage the Health & Wellbeing Board to take steps to monitor the impact of the changes taking place associated with social care cuts, Health efficiency savings and other changes (for example, to benefits) on homeless services. They were also supportive of the initiative to establish a pilot set of representation groups for relatives in four care homes with a view to compiling a subsequent best practice guide to promulgate the establishment of such groups more widely in care homes.

It was suggested that Healthwatch may wish to also work with groups who represent users and carers in various care networks, reporting on the patient and carer perception of services.

Board members were very appreciative of the paper and wished Healthwatch all the very best in the future under his chairmanship.

3:50

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

• The Chair of the Children & Young People Partnership Board, Dr Mary Keenan
• The Chairman of the Adult Health & Social Care Partnership Board, Cllr Mrs Judith Heathcoat
• The Chairman of the Health Improvement Partnership Board, Cllr Mark Booty

Action Required:     To receive updates from each Partnership Board.

Councillors Melinda Tilley, Mrs Judith Heathcoat and Mark Booty each gave an oral progress report on recent activity of each of the Partnership Boards.

Children & Young People’s Partnership Board

Councillor Tilley, Vice Chairman, reported the following:

• The February meeting had been cancelled due to sickness and adverse weather conditions;
• The new Terms of Reference for the Partnership Board had now been agreed and work was ongoing to clarify the relationship the Board had with the Oxfordshire Children’s Safeguarding Board, their roles and responsibilities and how they differed, particularly with regard to performance management;
• Interviews had been held for a representative from the voluntary sector on the Partnership Board, the outcome of which was not yet known;
• The Partnership Board had held an extended meeting to begin development of the new Children & Young People’s Plan 2014 – 18 which had been attended by over 20 representatives from the public and the voluntary sector, the outcomes of which were:

-                      a proposal to extend the existing Plan until November 2014 (to take account of a range of complex issues which would impact on its development in the next few months);

-                      to establish a multi-agency sub – group to develop a new Plan for 2014 – 18 to ensure that it had true ‘buy – in’ from a range of partners; and

-                      the Partnership Board to agree the Plan in October 2014 and then submission to the Health & Wellbeing Board in November 2014.

• The Partnership Board had decided to look at methods of working in light of the extra social workers taken on to lessen social worker caseloads. This was explained by rising levels of children on care plans and increased referrals from schools; and
• The Partnership Board were looking forward to the establishment of a multi – agency Safeguarding Hub (MASH).

Adult Health & Social Care Partnership Board

Councillor Mrs Judith Heathcoat, Chairman of the Partnership Board, reported the following:

• The OCCG were in the process of finding representatives to sit on the Board following recent staffing changes;
• A refreshed Joint Commissioning Strategy would guide how OCC and the OCCG pooled budget for Adults with a Learning Disability was spent over 2015 – 18. A Learning Disability workshop had been held on 19 December 2013 on the next ‘Big Plan’ for the support of adults with a learning disability in Oxfordshire. A good mix of people had attended, including users carers, service providers, commissioners and other partners. Several areas of action were identified which included working with support provider employers and Councils to increase employment opportunities and more promotion of healthy lifestyles, for example through sporting opportunities and healthy eating education;
• In January the Board had held a joint workshop with the Health Improvement Partnership Board on prevention of premature death and enabling healthy older age. Loneliness was identified as a key issue which the Board agreed to take forward. Paul Cann (Age UK Oxfordshire and the Campaign to End Loneliness in Older Age) set the context for discussion and Ann  ...  view the full minutes text for item 14/14

• Summary of communications received by the Chairman of the Board from November 2013 to February 2014 by the Chairman of the Board and how it was responded to (attached).