Agenda and minutes

The Chairman extended a welcome to:

·         David Smith, Chief Executive, Oxfordshire Clinical Commissioning Group (OCCG) who is ‘in attendance’ to the Board alongside Joanna Simons;

·         Jean Nunn – Price in her role as Chair of Healthwatch Oxfordshire (HWO).

The Chairman took the opportunity to thank Larry Sanders, the outgoing Chair of HWO on behalf of all the members of the Board for his contribution to the work of this Board.

James Drury attended for Matthew Tait, Lucy Butler for Jim Leivers and apologies were received from Councillor Melinda Tilley.

There were no declarations of interest submitted.

Tracey Taylor, Trustee, ‘My Life My Choice’ charity addressed the meeting expressing, on behalf of the charity, its major concerns about the Board’s failure to again meet the health check target for people with a learning disability. She added that people with a learning disability tended to suffer the worst health and were thus one of the most vulnerable groups in society. For this reason she called for a fresh look to be taken as a matter of priority to address how the targets could be met.

District Councillor Anna Badcock, addressed the Board in relation to the proposal at agenda item 11 to dissolve the Adult Health & Social Care Partnership, of which she was a member. She agreed that an important factor behind the proposal to dissolve the Board was that of replication with the work of the Older People’s Joint Management Group, but commented that the JMG, a decision making body, comprised mainly of officers (and insufficient external members) who were held to account by other officers. In light of this she asked that her proposal that the district council’s should each identify one member to sit on one of the JMGs be considered at item 11. She added that the City Council would be happy to take the lead to assist in the co-ordination of this.

To approve the Note of Decisions of the meeting held on 13 March 2014                      (HBW5) and to receive information arising from it.

The Note of Decisions of the meeting held on 13 March 2014 (HWB5) was approved and signed as a correct record.

It was AGREED that Agenda Item 8, the Refreshed Joint Health & Wellbeing Strategy would follow Agenda Item 11 ‘Reports from Partnership Boards’ – ‘Future of the Adult Health & Social Care Board’ - in order to avoid any unnecessary delegations to officers to make any consequential changes to the Health & Wellbeing Strategy.

2:05

Board Members responsible:         Members of the Health & Wellbeing Board

Person coordinating reports:         Director of Public Health

There will be a review of current performance (HWB6) against all the outcomes for 2013 – 14 set out in the Health & Wellbeing Strategy.

Performance for each Partnership Board will be presented in turn:

·         Children & Young People Partnership Board (Lucy Butler and Cllr Melinda Tilley)

·         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 reviewed the end of year Performance Report (HWB6) against all the outcomes set out in the Health & Wellbeing Strategy. Current performance had been generally good, with just over half (51%) of targets being met and exceeded for the year. Appropriate action was being taken where performance did not meet expected levels.

The Board noted that end of year performance information had not yet been received for 6 indicators, nor had it been possible to RAG (red, amber, green) rate a further four indicators (listed in report).

With regard to indicator 6.8 – 60% of the expected population (4251 of 7086) people) with dementia will have a recorded diagnosis (currently 49.6% or 3516 people), Dr McManners commented on the disappointingly slow progress in respect of this challenging target in spite of some improvement. He undertook to submit a report to a future meeting on the initiatives that had been put in place to reach the targets set for this year.

With regard to indicator 5.4 – At least 60% of people with learning disability will have an annual physical health check by their GP (currently 45.7% for 2012/13) - James Drury reported an end of year (2013/14) figure of 58.6% (target of 60%) which was a significant improvement. Dr McManners commented that the OCCG looked forward to future joint working with the NHS England Community Service Team focusing in particular on the variation in different parts of the county.

In respect of indicators 6.1 and 6.2 relating to delayed transfers of care or discharge, David Smith pointed out that the numbers were decreasing as a result of a whole raft of actions, but not as speedily as he would like. He undertook to bring a report on what was causing some of the problems in the system to the next meeting in November. Councillor Turner welcomed this, commenting that district councils, in their capacity as housing authorities had a legitimate part to play in the work being done.

With regard to 8.1 - At least 60% of those sent bowel screening packs will complete and return them (ages 60 – 74 years) – it was agreed that Public Health would work with NHS England and continue to work with GPs to improve performance.

NHS England were congratulated on the targets met at priority 11 – Preventing infectious disease through immunisation.

It was AGREED to note the report.

2:15

Board Members responsible:         Clinical Chair, Oxfordshire Clinical Commissioning Group (OCCG), Director for Social & Community Services

Persons giving report:                     Chief Executive, OCCG and Director for Social & Community Services

The OCCG 5 Year Strategy for 2014/15 – 2018/19 and Implementation Plan is before the Board at HWB7 for sign off prior to its approval by the OCCG Board.

A position paper on the Better Care Fund is also attached at HWB7.

Action Required:    to

(a)  agree the OCCG 5 Year Plan prior to its approval at the OCCG Board;

(b)note the changes to the Better Care Fund and the implications for plans in Oxfordshire;

(c)   agree to hold an additional meeting of the Board at an appropriate time to consider an updated Better Care Fund Plan that reflects updated guidance prior to submission to Government.

David Smith introduced the refreshed Strategy and Plan for the Oxfordshire Clinical Commissioning Group (OCCG) for the period 2014/15 – 2018/19 (HWB7) which incorporated the OCCG’s response to feedback from NHS England following its initial submission. The fundamentals of the Plan had not been changed but additional information had been added with regard to the following:

·         Revised financial situation

·         Parity of esteem in mental health

·         Provider market strategy

·         Better Care Fund

·         Organisational Development Plan

John Jackson presented his position paper on the Better Care Fund Plan for Oxfordshire (HWB7). He pointed out that significant work would be needed between the County Council, the OCCG and NHS providers to develop robust schemes that would meet revised national conditions and this work was already underway. Guidance to assist with this was yet to be published.

Jean Nunn-Price requested that a draft of the new Plan be submitted to Healthwatch Oxfordshire prior to the sign-off process.

It was AGREED to

(a)  agree the OCCG 5 Year Plan prior to its approval at the OCCG Board;

(b)  note the changes to the Better Care Fund and the implications for plans in Oxfordshire; and

(c)   agree to hold a special, additional meeting at an appropriate time to consider an updated Better Care Fund Plan that reflects updated guidance prior to submission to Government.

2:45

Board Members responsible:         Clinical Chair, OCCG; Director for Social & Community Services and Director for Children’s Services.

Persons giving reports:                   As indicated below.

(a)  Review of Adult Learning Disability Health & Social Care Services – A report outlining the review of Adult Learning Disability Health & Social Care Services (HWB9) will be presented by the Director for Social & Community Services and the Clinical Chair, OCCG.

The Health and Wellbeing Board is asked to note the background and reasons for proposing to review learning disability services in Oxfordshire and agree the approach being taken by Oxfordshire County Council and Oxfordshire Clinical Commissioning Group. The majority of learning disability health and social care services in Oxfordshire are currently provided by Southern Health NHS Foundation Trust (Southern Health).

(b)  Care Quality Commission (CQC) - A summary report of the recent CQC inspection on Oxford University Hospitals NHS Trust (OUHT) will be presented by Sir Jonathan Michael, Chief Executive, OUHT (HWB9).

(c)  OFSTED Inspection of Children’s Services – A report (HWB9) and presentation will be given by the Deputy Director for Children’s Social Care & Youth Offending Service on the outcomes of the recent OFSTED inspection of the County Council’s Children’s Services.

The full report can be found at the following link:

http://www.ofsted.gov.uk/local-authorities/oxfordshire

(d)  Winterbourne View – A summarised shared Improvement Plan and covering report is before the Board (HWB9).

The Health and Wellbeing Board is asked to note the strategic intentions of the Winterbourne Improvement Plan for Oxfordshire and monitor delivery of the action plan.

Action Required:    to receive the reports and to approve any recommendations contained within them, as indicated above.

Four reports were presented to the Board on quality issues:

(a)  Review of Adult Learning Disability Health & Social Care Services

John Jackson presented the report outlining the review (HWB9).

It was AGREED to note the background and reasons for proposing to review learning disability services in Oxfordshire and agree the approach being taken by Oxfordshire County Council and the Oxfordshire Clinical Commissioning Group. The majority of learning disability health and social care services in Oxfordshire are currently provided by Southern Health NHS Foundation Trust (Southern Health).

(b)  Care Quality Commission (CQC)

The Board noted the summary report (HWB9) of the recent CQC inspection of the Oxford University Hospitals NHS Trust which was presented by Sir Jonathan Michael, Chief Executive.

Sir Jonathan assured the Board that there would be no complacency when addressing the actions required. He agreed to share with members of the Board the final version of the report stating what action would be taken to meet essential standards.

Sir Jonathan was thanked for his presentation and congratulated on the ‘good’ inspection.

(c)  OFSTED Inspection of Services for Children in need of help and protection, children looked after, care leavers and the review of the effectiveness of the local safeguarding children board

Lucy Butler, Deputy Director for Children’s Services gave a presentation on the findings of the Inspection (HWB9). She assured the Board that there would be no complacency and that the Council would be addressing all the required actions as cited in the report.

It was AGREED to note the report.

(d)  Winterbourne View

John Jackson presented a summary of the shared Improvement Plan and covering report (HWB9).

It was AGREED to note the strategic intentions of the Winterbourne Improvement Plan for Oxfordshire and monitor delivery of the action plan.

3:35

Board Member responsible:           Jean Nunn - Price, Chair of Healthwatch Oxfordshire

Person giving report:                       Jean Nunn - Price

Jean Nunn - Price will present the report of Healthwatch Oxfordshire (HWB10) which includes findings from recent research and issues of concern.

Action Required:    to note the report.

Jean Nunn-Price presented the latest Healthwatch Oxfordshire (HWO) update which included findings from recent research and issues of concern. She reported that since the update had been published, it had been decided that there would be a public debate on the care data programme and that it would be chaired by Dame Fiona Caldicott, Chair of Governors of Oxford University Hospitals NHS Trust.

She undertook to make the HWO Annual Report available to members.

The Board enquired why reports published under the sponsorship of HWO were not submitted to this Board given the shared aspect of the recommended actions. Jean Nunn-Price undertook to report further on this issue.

It was AGREED to note the update.

3:50

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

·         The Vice - Chairman of the Children & Young People Partnership Board;

·         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

The Board is asked to consider a report HWB11 on the future of the Adult Health & Social Care Partnership Board.

Action Required:    to

(a)   receive updates from each Partnership Board; and

(b)consider the recommendations contained in the report HWB11 with regard to the future of the Adult Health & Social Care Partnership Board.

Councillors Mark Booty and Mrs Judith Heathcoat and Lucy Butler each gave a brief oral progress report on recent activity of each of the Partnership Boards.

Health Improvement Board (HIB)

The Health Improvement Board had held three meetings since the last report to this Board. These were:

·         A closed meeting was held in May 2014 to discuss proposals for changes in housing related support. The meeting was attended by HIB members and the housing portfolio holders/officers from all the districts and the County Council. The proposals were now out to consultation with stakeholders and the HIB would receive a report at their September meeting on the next steps in the process;

·         At the May 2014 Board meeting there was a discussion on future priorities and a review of performance. The HIB now looks at performance at county level but also the best and worst outcomes. As a result of this greater understanding of variation across the county, many of the outcomes proposed for the year ahead would address equality issues which had been identified. For example, work was in progress to improve the uptake of NHS Health Checks across the county and also to ensure that there were no localities lagging behind the county average. It was agreed also at this meeting that the new Alcohol and Drugs Partnership would report to the Board as well as to the Safer Communities Partnership.

·         A joint workshop with the Children & Young People Partnership Board was held in July 2014to develop action plans for the Healthy Weight Strategy. The workshop was well attended and officers and councillors worked together on ideas for helping people maintain a healthy weight and prevent obesity. The action plan was due for discussion at the HIB in September.

Children & Young People Partnership Board (CYPPB)

Lucy Butler described the proposed changes to the Board which were currently under discussion to improve its effectiveness by clarifying its role, responsibilities and relationships with other Boards, with particular regard to the Oxfordshire Safeguarding Children Board. The changes also linked in with comments made by the recent OFSTED inspection.

A workshop was held on 28 May 2014 to agree how to ensure the partnership arrangements overseeing the delivery of key outcomes for children and young people over the next 3 years were as effective as possible; and to secure clarity about the role of the of the CYPPB  within these arrangements. A number of proposals were made for change to the CYPPB, for recommendation to the Health & Wellbeing Board at its November meeting. These included:

·         that the Board be renamed the Children’s Trust, to reinforce its broader remit and strategic role in driving the delivery and improvement of services for children and young people;

·         Changes to be made to the working protocol between the Children’s Trust and the Oxfordshire Safeguarding Children’s Board (OSCB) to ensure clarity in responsibility and relationships; and

·         There should be one multi-agency Quality Assurance Group and Performance Management sub-group supporting both the Children’s Trust and the OSCB to avoid  ...  view the full minutes text for item 26/14

2:25

Persons Responsible:        Members of the Health & Wellbeing Board

Persons giving reports:       Director of Public Health, Director for Children’s Services and Director for Social & Community Services.

A revised draft version of the Strategy (HWB8) is presented for discussion and decision. This will include proposed outcomes for 2014-15 to show progress in delivering improvement in priority areas.

Comments from the Oxfordshire Joint Health Overview & Scrutiny Committee which met on 3 July are attached at HWB8.

Action Required:    to approve the revised Health & Wellbeing Strategy for 2014 -15

A revised draft version of the Strategy (HWB8) was presented to the Board for discussion and decision.

Jean Nunn – Price commented that Healthwatch Oxfordshire endorsed and welcomed the refreshed Strategy but made reference to the lack of a cohesive action plan to achieve targets, particularly those at 6 and 7. She urged the Board to consider looking outside of the meeting to ways of achieving targets, perhaps from a patient’s perspective.

It was AGREED to approve the revised Health & Wellbeing Strategy for

2014 – 15.

4:05

Board Members Responsible:       All Members of the Health & Wellbeing Board

Person presenting report:               Director of Public Health

A protocol between the Health & Wellbeing Board and the Adult and Children’s Safeguarding Boards is presented for agreement (HWB12).

Action Required:    to agree the principles and further work required as set out in this paper to formalise and improve the relationships between the Health and Wellbeing Board and two Safeguarding Boards, and to delegate responsibility to the Director for Children’s Services and the Director for Social and Community Services to work with the respective Chairs of the Safeguarding Boards to take this forward.

The Board considered a proposed framework and protocol within which to secure effective joint – working between the Health & Wellbeing Board, Oxfordshire Safeguarding Children Board and the Oxfordshire Safeguarding Adults Board. The proposed protocol also referred to the relationship between the Safeguarding Boards and other partnership forums in Oxfordshire.

It was AGREED:

(a)  to agree the principles and further work required as set out in this paper to formalise and improve the relationships between the Oxfordshire Health & Wellbeing Board and two Safeguarding Boards, and to delegate responsibility to the Director for Children’s Services and the Director for Social & Community Services to work with the respective Chairs of the Safeguarding Boards to take this forward; and

(b)  in light of the decision made at Agenda Item 11 to dissolve the Adult Health & Social Care Partnership Board, to authorise the Director for Children’s Services to make any consequential changes to the Protocol, following consultation with the Chairman and Vice – Chair of this Board.

4:15

Board Member Responsible:         Director of Public Health

Person giving report:                       Director of Public Health

A report is before the Board at HWB13.

Action Required:    to note progress with this work and to delegate the authority to approve the draft PNA document for consultation to the Director of Public Health, following consultation with the Chairman and Vice – Chairman of this Board.

As reported in March 2014 the Health & Social Care Act (2012) gave Health & Wellbeing Boards the statutory duty to develop and publish Pharmaceutical Needs Assessments (PNA) for their areas by 1 April 2015. The Board had before them a progress report (HWB13) on this work.

It was AGREED to note progress with this work and to delegate the authority to approve the draft PNA document to the Director of Public Health, following consultation with the Chairman and Vice-Chairman of this Board.

A written summary of communications received by the Chairman of the Board since the last meeting and responses given (attached).