Agenda and minutes

The Chairman extended a welcome to guests:

·         Sir Jonathan Michael (Oxford University Hospitals NHS Trust) (Agenda Item 7).

·         Yvonne Taylor, Oxford Health (Agenda Item 7)

There were no apologies for absence submitted.

There were no declarations of interest submitted.

There were no requests to submit a petition or to make an address to the meeting.

To approve the Note of Decisions of the special meeting held on  16 September 2014 (HBW5) and to receive information arising from them.

With regard to Minute 35/14, Matters Arising, Jean Nunn-Price corrected paragraph 1 to read as follows (correction in bold italics);

‘In respect of Minute 25/14 (paragraph 1, page 6) – Project on Discharge – Jean Nunn – Price reminded all related partners to let Healthwatch Oxfordshire know as soon as possible who their representative would be to attend a Project Steering Group on the subject.

2:05

5 minutes

Board Member(s) responsible:      Director for Adult Social Services and Clinical Chair, OCCG

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

An update will be given, following the decisions made at the special meeting of this Board on 16 September (HWB6).

Oxfordshire had previously submitted a proposed Better Care Fund plan on 4 April 2014, following agreement by the County Council’s (OCC) Cabinet, the Oxfordshire Clinical Commissioning Group’s (OCCG) Governing Body and this Board.

At the 17 July 2014 meeting, John Jackson had presented his position paper to the Board on the Plan. The Board had noted the paper and agreed to hold a special meeting on 16 September 2014 to consider an updated Plan that reflected updated guidance, when issued, prior to submission to NHS England, thence to the Government. At that special meeting, the Board had approved an overview of the Plan for Oxfordshire for submission to NHS England, feeling it was not possible to submit a credible Plan by the deadline due to specific financial challenges in the County, to the timetable for introducing Outcome Based Contracting and in light of recent increases in the rate of emergency admissions.

The report (HWB6) updated the Board on progress with the Plan, following the national assurance process and on the next steps.

It was reported that discussions between OCC, OCCG and the providers, Oxford University Radcliffe Hospitals NHS Trust (OUHT) and Oxford Health were proving positive in moving forward and would be key to achieving a full submission by 9 January 2015. This would include the possible development of a single Health and Social Care Plan for Oxfordshire which was the subject of discussion at Agenda Item 7.

The Board AGREED to note the report and to note that a special meeting of the Board would be held in early January prior to submission of the full Plan on 9 January 2015.

2:10

55 minutes

Board Members responsible:         All Board Members

Person(s) giving reports:                Director for Adult Social Services and Chief Executive, OCCG

A presentation will be made to stimulate discussion on principles for producing a single Health and Social Care Plan. The process for drawing up the plan will be considered (HWB7). This item will include a discussion on the financial challenges facing Oxfordshire in the social care and health sector. A financial briefing paper is also attached at HWB7

Chief Executive Officers of Oxford Health Foundation Trust and Oxford University Hospitals Trust have been invited to participate in discussion of this item.

Action Required: the Board is RECOMMENDED to agree the proposed principles for the single Health and Social Care Plan for Oxfordshire as the basis for a high level conversation in the New Year, and the next steps in developing the Plan further.

John Jackson gave a presentation to stimulate discussion on the principles for producing a single Health & Social Care Plan for Oxfordshire. Discussion centred on a process for drawing up the Plan within the context of the financial challenges facing Oxfordshire in the social care and health sector.

A report and financial briefing paper was circulated at HWB7.

Sir Jonathan Michael, Oxford University Hospitals NHS Trust, and Yvonne Taylor, Oxford Health, were welcomed to the table to take part in the discussion.

Discussion involving all Board members covered the following topics:

·         The Plan was the way forward and would assist in integrating pathways. It was about ensuring that, going forward, resources were being used properly and Outcome Based Commissioning, although very challenging, could be the way forward;

·          Providers should be included in the joint enterprise;

·         If integrated budgeting was part of the Plan, good savings might be achieved.;

·         Engagement with patients and the public would be of the utmost importance;

·         Part of the challenge for the Board was to shift to a long term approach;

·         Additional principles to be added is the need for prevention, to focus on health inequality, and to consider access to services for particular groups. This work would require a significant district council input;

·         The importance of parity of esteem for people suffering from mental  illness;

·         To pick up the issues of how to engage with others including primary care providers and the university.

The Board AGREED, together with the providers present, the proposed principles for the single Health and Social care Plan for Oxfordshire as the basis for a high level conversation in the new year; and to the next steps in developing the Plan further.

3:05

20 minutes

Member(s) responsible:                  Councillor Melinda Tilley, Chairman, Children’s Trust

Person giving reports:                     Independent Chair of Children Safeguarding Board, Maggie Blyth

Maggie Blyth will present the Children Safeguarding Board Annual Report 2013/14 (HWB8). She will also provide a verbal update on work in response to increased awareness of female genital mutilation.

The Adult Safeguarding Board Annual Report 2013/14 will be presented to the 5 March 2015 meeting of this Board following its consideration at the Adult Safeguarding Board.

Action Required: to receive the above report.

Maggie Blyth, the Independent Chair of the Oxfordshire Children Safeguarding Board, presented their Annual Report 2013/14 (HWB8). She highlighted the significant changes in the report leading to increased challenges in the Board’s scrutiny role. She thanked all partner agencies for their work and looked forward to the challenges ahead.

Councillor Tilley thanked Maggie Blyth for all her hard work particularly on integration with other Boards.

In relation to the ongoing work to increase awareness of female genital mutilation, Maggie Byth reported that the Children Safeguarding Board had overseen the development of a strategy, and operational action plan. All policies were now on the appropriate websites and available for all front line staff.

Anthony Stansfeld, Police Commissioner for the South East region who had been attending the meeting as an observer, was invited up to the table for this report, in light of his special interest in this issue. He expressed his concern that no cases had been reported to the Police in his area and that it lay with the Health service to take action when necessary. He added that cases would be prosecuted when found.

It was AGREED to receive and note the reports.

3:25

15 minutes

Member(s) responsible:      Director for Adult Social Services

Persons giving report:         Councillor Mark Booty, Chairman, Health Improvement Partnership Board

Following the closure of the housing-related support proposals consultation, the Health Improvement Partnership board held an additional meeting in public on 20 October to discuss the consultation report and the proposed next steps and to make a recommendation to the Health & Wellbeing Board.

The outcome of this meeting was to:

RECOMMEND the Oxfordshire Health & Wellbeing Board to accept the proposed way forward, but to also note the summary of its discussion where more detailed concerns were raised and actions committed to.

To aid consideration the following papers are attached at HWB9.

·         Housing Related Support Consultation Report – October 2014.

·         Housing Related Support Services in Oxfordshire – proposed way forward following the consultation (report to the Health Improvement Partnership Board on 20 October).

·         A summary of notes of the 20 October Health Improvement Partnership Board meeting on Housing Related Support proposals.

·         Updated Social & Community Impact Assessment.

Action Required: to consider the recommendations of the Health Improvement Partnership Board and to advise the Oxfordshire County Council Cabinet on the way forward for the re-commissioning of housing-related support.

Following the closure of the consultation on the housing – related support proposals, the Health Improvement Partnership Board had held an additional meeting in public on 20 October 2014 to discuss the consultation outcomes and the proposed next steps; and to make its recommendations to this Board.

The outcome of the meeting was to recommend this Board to accept the proposed way forward, but to also note the summary of its discussion (HWB9) where more detailed concerns were raised and actions committed to.

Cllr Mark Booty, Chairman of the Health Improvement Partnership Board, introduced the reports.

Cllr Ed Turner expressed the City Council’s concerns at the overall level of cuts and the impact it would have for hostels and their budgets, adding also that they could not access places for their clients in hospitals. He hoped that there would be joint funding provision from the OCCG and the district councils. Cllr Turner also brought the Board’s attention to the concern of the districts at the possible loss of the Floating Support service and the possible loss of services to help victims of domestic abuse.

The Chairman noted the concerns of the districts and commented that, given the financial situation the County was in and the current unknowns about the financial settlement, it would not be possible to ring fence one service over another or increase funding for discretionary services that the County Council was providing. He added that the County Council would look at the review of services with a view to getting the best possible outcomes for Oxfordshire.

John Jackson reported the intention to begin the review on domestic abuse services next month, to continue into 2015. Following completion, officers would hold discussions with the various organisations involved prior to proposals coming to the Health Improvement Partnership Board in July 2015. The public consultation would follow from August to October 2015 and the final proposals would come to this Board for approval in December. The intention was to phase in any changes to services over a two year period.

The Board RESOLVED to agree the recommendations of the Health Improvement Partnership Board and to advise the County Council’s Cabinet accordingly.

3:40

10 minutes

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

Person giving report:           Director of Public Health

The regular review of current performance against all the outcomes set out in the Health & Wellbeing Strategy is attached at HWB10 for consideration.

The Board reviewed current performance against all the outcomes set out in the Health & Wellbeing Strategy (HWB10).

Members of the Board discussed the variations in the take-up of health checks and whether scepticism about the effectiveness of the checks was a factor among GPs. It was suggested that more patients were coming into surgeries now and asking for their health-check.

Dr McManners reported that the CCG’s Access Team were undertaking some work with a number of practices in areas with high levels of deprivation.

Cllr Biles reported that the on-going campaign to increase the take-up of health-checks was going well, adding that staff had recently given information out at high profile sports fixtures. She added her view that the delivery of Health Checks was a feature of Public Health’s prevention agenda and, however small the savings were to the County Council, the savings for the NHS were high.

In relation to 2.8 – ‘Improve the free school meals attainment gap at all key stages and aim to be in line with the national average by 2014’ – Cllr Tilley pointed out that, in respect of 5 – 7 years schools were missing out on the Free School Pupil Premium which would help to narrow the gap in attainment.

In relation to 4:4 – ‘63% of young people to achieve 5 GCSE’s at A* - C, including English and Maths at the end of the academic years 2013/14’  - Cllr Tilley pointed out that the 2014 Oxfordshire’s results were significantly above the national average (of 56.1%) at 58.6%.

The Board RESOLVED to note the report.

3:50

5 minutes

Board Member responsible:           Chair, Healthwatch Oxfordshire

Person giving report:                       Chair, Healthwatch Oxfordshire

Jean Nunn Price will present a report updating the Board on recent activities (HWB11).

The Board thanked Healthwatch Oxfordshire for their update (HWB11).

3:55

5 minutes

Board Member(s) responsible:      Chair, OCCG

Person giving report:                       David Smith, Chief Executive, OCCG

The Board is asked to sign up to the Concordat whilst asking the Mental Health Joint Management Group to oversee the ongoing work with stakeholders (HWB12).

Action Required: to

(a)  agree that Oxfordshire County Council and the Oxfordshire Clinical Commissioning Group will sign off the Declaration and Action Plan on behalf of the Board; and

(b)approve the proposed governance arrangements and submission of the final Plan prior to the 31 December 2014 deadline.

The Board was asked to sign up to the Mental Health Crisis Care Concordat and to request the Mental Health Joint Management Group to oversee the ongoing work with stakeholders (HWB12).

Cllr Ed Turner reported that the district councils would reflect further on what role they could have in relation to the Concordat.

The Board RESOLVED to:

(a)  agree that Oxfordshire County Council and the Oxfordshire Clinical Commissioning Group will sign off the Declaration and Action Plan on behalf of the Board; and

(b)  approve the proposed governance arrangements and submission of the final Plan prior to the 31 December 2014 deadline.

4:00

5 minutes

Board Member(s) responsible:      All Members

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

The new Terms of Reference for the Children’s Trust are attached at HWB13 for approval.

Action Required: to approve the Terms of Reference for the Children’s Trust.

Peter Clark introduced the new Terms of Reference for the Children’s Trust which had been reshaped to include responsibility for meeting the children’s targets for Health and Wellbeing Board.

Cllr Ed Turner asked if consideration could be given to the widening of district council representation on the Trust to include Oxford City Council.

The Board AGREED to approve the Terms of Reference for the Children’s Trust.

4:05

10 minutes

Written reports on activities since the last Board meeting in July (HWB14) from:

·         Children’s Trust;

·         Older People Joint Management Group

·         Health Improvement Partnership Board

Action Required: to receive the reports.

Councillors Tilley, Heathcoat and Booty reported on the activities of the Children’s Trust, Older People Joint Management Group and the Health Improvement Partnership Board since the last meeting.

The Board discussed on-going work on children’s mental health services which included:

·         A paper to be submitted to a future meeting of this Board on adolescent and children’s mental health services;

·         Oxford Health was sending mental health professionals into secondary schools to work with school health nurses. The OCCG expressed his hope that that the professionals would also be permitted to work with primary school staff also;

·         The Child & Adolescent Mental Health Care & Clinical Network had undertaken some work with CAMHS across the region.

In response to a query as to whether consideration was given to the location of doctor’s surgeries, it was reported that it was in the province of the Area Team to give specific guidance on the process of where health facilities should go on new housing developments. A strategy was currently being prepared.

The Board AGREED to note the reports.

The following papers are attached for information:

·         A summary of correspondence with the Chairman is attached for information (HWB15).

·         Healthwatch Oxfordshire Outline report on the ‘Patient Voice and Healthwatch Oxfordshire Discharge’ Project.

The Board noted the following reports which were submitted for information only:

·         A summary of correspondence with the Chairman (HWB15).

·         Healthwatch Oxfordshire’s Outline report on the ‘Patient Voice and Healthwatch Oxfordshire Discharge’ Project.