Agenda and minutes

Venue: Jubilee House, 5510 John Smith Drive, Oxford Business Park, Oxford, OX4 2LH

Contact: Deborah Miller, Tel: 07920 084239  Email: deborah.miller@oxfordshire.gov.uk

Items
No. Item

13.

Welcome by Chairman, Councillor Ian Hudspeth

Minutes:

The Chairman welcomed all to the Meeting and in particular Stephen Chandler, the Director for Adult Services and Ansaf Azhar, the Director for Public Health.

14.

Apologies for absence and Temporary Appointments

Minutes:

With the consent of the Chairman, Roz Pearce attended for Professor George Smith.  Apologies for absence were received from David Radbourne and Councillor Steve Harrod.

15.

Declarations of Interest

Minutes:

There were no declarations of interest at the Meeting.

16.

Petitions and Public Address

Minutes:

There were no requests to address the Board or to receive a petition.

17.

Note of Decisions of Last Meeting pdf icon PDF 382 KB

To approve the Note of Decisions of the meeting held on 13 June 2019                    (HBW5) and to receive information arising from them.

Additional documents:

Minutes:

The Minutes of the Meeting held on 13 June 2019 were approved and signed as an accurate record of the Meeting.

18.

Integrated Care System Plan for Delivery of NHS Long Term Plan pdf icon PDF 5 MB

10:10

 

To receive a summary of the Integrated Care System 5 Year Plan and discuss priorities for Oxfordshire.

Minutes:

The Integrated Care System 5 Year Plan was before the Board for discussion on priorities for Oxfordshire (HWB6).  

 

Louise Pattern in introducing the report, explained that most work took place within Oxfordshire and would continue to do so, but that there were areas of commonality where it made sense to come together at scale and do work, such as key areas around prevention and significant workforce issues (such as how housing could be influenced or a Oxfordshire weighting).  The plan was very Strategic looking at areas of commonality between places when planning care that would be fit for the 21st Century.

 

Ian Hudspeth reported that there had been some concern around the BOB, in particular everything being decided at a very Strategic level.  He asked if Louise could give the Board some assurances around whether there would be three different workings, whether Sovereignty would remain with Oxfordshire, and that, although the timetable appeared to be very tight and driven; whether there would be the ability for everyone to be engaged and have an input?

 

Louise explained that the aim was to get the local Oxfordshire Place sorted by developing a Partnership Board.  At the moment, there was the ISDB, which needed to change shape to look at a different membership: commissioners, providers and public to start to look at how integration was started.  It would not be a different organisation, but a way to facilitate through system leadership and distributive leadership to get integration going.  At the moment, the current thinking was that they would pick some key areas to look at how services could be integrated and share information about the cost of care versus the money that was available for care to make those resources stretch, including delegated budget for Mental Health and Primary Care and Community Services, with oversight at the Health & Wellbeing Board.

 

Ian Hudspeth commented that there was a need to be careful that it was not about one area propping up another, but about coming together to provide the best outcome for patients.

 

Roz Pearce spoke in support of the comments around the need to keep decision making retained at Oxfordshire level.  She pointed out that Healthwatch had not been mentioned in the documentation. She further commented that as the five Health watches were not in agreement, they would not be signing it off at the moment.  She questioned what the long-term impact on the overview roles of Health & Wellbeing Boards and Scrutiny would be and how scrutiny would work at BOB level, together with how strategies could be aligned across the Health & Wellbeing Boards to integrate with BOB.

 

Louise explained that there was still a commitment to align with the local authority boundries across BOB, as that was where there was shared accountibilty for safeguarding and shared ways of working and overview & scrutiny and that there were no plans to change that.

 

Roz Pearce expressed concern that there was very little about Social Care in the plan and that it  ...  view the full minutes text for item 18.

19.

Family Safeguarding Service pdf icon PDF 671 KB

10:30

 

To inform the Board of the work being undertaken for discussion (HWB7).

Additional documents:

Minutes:

Hannah Farcombe, Deputy Director Children’s Social Care, gave a presentation, (a copy of which is attached to the signed copy of the minutes), which informed the Board on the ambitions of the Family Safeguarding Plus model, which was based on best practice and would increase engagement with families by working with multi-agency teams to increase the help families receive (specifically around parental domestic abuse, parental mental health & parental substance/alcohol abuse). Comments were then sought from Board Members.

 

In response to comments from Councillor Hudspeth, Hannah Farncombe confirmed that having secure tenure and good quality stable affordable housing for everyone, was essential to reduce the cycle and for any family to thrive and was a very important aspiration for the future.

 

Ansaf Azhar welcomed the project and in particular the focus on prevention and working across organisational boundaries.  In relation to drug and alcohol abuse, public health currently had around 1,000 to 2,000 people in treatment currently, which meant there were 10,000 to 20,000 out there who were drinking heavily not being picked up.  The project would help pick those up and presented a fantastic opportunity to tap into that population group.  He stressed the importance of having a strong evaluation thread on the project.

 

Councillor Andrew McHugh spoke in support of the project.  He expressed the importance of tapping into schemes such as the scheme by Thames Valley Police had just received money to reduce knife crime and were going to use the money to look into tactical problem solving to divert the children who were likely to offend or be the victim of knife crime and the importance of tapping into such projects.

 

Councillor Ian Hudspeth pointed out that the Fire Service also presented an excellent opportunity for reporting back to the Council through their community work.

 

Stuart Bell welcomed the initiative and drew attention to the kingfisher Team who worked with a sub-sect of children, showing how working between agencies and across disciplines could be very powerful and effective.  There was a need to map out the whole range of things that were happening that speak to the space, such as the police, agencies such as the Family Nurse Partnership that did work with teenage families and general adult metal health services.  He cautioned that there would be a need to align our investment decisions with it.

 

Yvonne Rees, speaking as the district council’s representative welcomed the pilot as a fantastic opportunity to join up services and supported the points made by Councillor Hudspeth on the issues around housing.  She expressed the importance of proving the concept through the pilot to be able to make it a County-wide offer.  She indicated that she would be changing her services to reflect what needed to be delivered in the future.

 

Councillor Stratford endorsed the scheme and in particular that it supported the prevention programme but felt that the impact on educational opportunities for young people was not covered in the document and the role the school nurses could play in  ...  view the full minutes text for item 19.

20.

Better Care Fund Plan 2019-20 pdf icon PDF 116 KB

10:50

 

The Better Care Plan for 2019-20 is before the Board for discussion and approval (HWB8).

 

Health & Wellbeing Board is RECOMMENDED to:

 

(a)       delegate approval regarding the national submission of the Better Care Fund Planning template to the Director for Adult Services, Oxfordshire County Council and the Chief Executive, Oxfordshire Clinical Commissioning Group;

(b)       ask officers to bring a report outlining this plan, and trajectory against the performance measures to the next meeting of the Health & Wellbeing Board.

 

 

Minutes:

Stephen Chandler, Corporate Director of Adults Services, introduced the report (HWB8) which updated the Board on the Better Care Fund which was a programme spanning the NHS and local government, seeking to join up health and care services, so that people could manage their own health & wellbeing and live independently in their communities for as long as possible. This included the Improved Better Care Fund which was paid to local government for funding of local care services and reducing pressures on the NHS

.

The Better Care Fund had invested £50,361,088 in the Oxfordshire System in 2018-19 to improve health and social care outcomes for local people. In 2017 local systems were asked to produce two-year plans outlining their intentions for delivering outcomes from the Better Care Fund; the Oxfordshire plan was approved by the Health & Wellbeing Board on 11 September 2017.

 

On 27 July 2019, the planning template for Better Care Fund plans was issued to local areas. The report before the Board provided an update regarding the planning process and future opportunities for the Better Care Fund going forward.  He reported that from next year onwards, he would be returning to the transformation agenda and would be using the better care fund as part of the support for some quite radical transformation work, including focusing energy on the prevention agenda, district housing, voluntary working with community groups, work with the Primary Care Network and recommissioning the home care system, which would be managed and evaluated through the joint management boards.

 

The Board were asked to agree that officers come back to the next work shop with ideas worked up in part and delegate approval regarding the national submission of the Better Care Fund Planning template to the Director of Adult Services, Oxfordshire County Council and the Chief Executive, Oxfordshire Clinical Commissioning Group.

 

Louise Pattern added that the Council’s better care metrics had been challenged for some time and that as an authority we did not benchmark well.  There was a need to drastically think how we could do this as a whole system and move the agenda forward.

 

Roz Pearce welcomed the proposal to look at the community as a whole and supported the work with the voluntary sector, as they were aware of the needs within their communities.  She queried whether Stephen Chandler had agreed to fund the work with the voluntary sector and made a plea to ensure that it was not just focused on one or two organisations but support the whole sector.  Stephen Chandler confirmed that he had given a commitment to funding.

 

The Board thanked the Corporate Director for his report and RESOLVED:  to:

 

(a)        delegate approval regarding the national submission of the Better Care Fund Planning template to the Director for Adult Services, Oxfordshire County Council and the Chief Executive, Oxfordshire Clinical Commissioning Group;

(b)        ask officers to bring a report outlining this plan, and trajectory against the performance measures to the next meeting of the Health & Wellbeing Board.

 

 

 

 

 

 

21.

Prevention Framework pdf icon PDF 3 MB

11:00

 

The Board is asked to accept the report (HWB9) and discuss priorities for Prevention work in Oxfordshire.

Additional documents:

Minutes:

Ansaf Azhar, Dr Kiren Collinson and Jackie Wilderspin presented a working draft of the Oxfordshire Prevention Framework (HWB9) which had been drawn together by assessing what the local prevention priorities were; what was being done already; how the gaps could be filled and what resources were available to achieve it. 

 

In introducing the report, Ansaf Azhar explained that the ICS was a fantastic opportunity to carry out prevention at a high level that was unique to the place.  For the very first-time place partnership was taking place with local organisations pooling resources and prioritising resources towards prevention, asking why people are being presented and what can be done upstream.  The prevention framework would look across the whole spectrum from Healthy Place Shaping to preventative services.

 

Dr Collinson explained that the prevention framework presented an opportunity to get prevention moving.  The framework had pulled together what the local need was, what the nationally recommendations were, what was already being done locally and what the gaps were.  Prevention was everyone’s business and needed to run through every work stream.  The framework would also help to solve health inequalities in the County.  The next steps were to work out what the priorities were and how to tackle them.

 

Jackie Wilderspin took the Board through the checklists that would enable the board to navigate through the evidence.  The check lists drew together all the elements that could be worked on for prevention, such as healthy life styles, socio economic factors or how services were designed and delivered to help people see how they could contribute.  She asked the Board to consider whether they would wish to see anything else added to the check lists.

 

The next steps were looking for processes to look at innovative and practical ways to turn the checklists into action, bringing actions to communities.

 

Dr Kiren Collinson stressed that targeting inequalities was at the heart of the framework, defining priorities and bringing it down to the small level where they could really start to make tangible change and that the leadership of the prevention framework would need to come from each organisation. She asked the Board for input on what the priorities should be and moved the following recommendations:

 

The Health & Welling Being Board is RECOMMENED to:

 

Ensure that the implementation of the Joint Health and Wellbeing Strategy (2019-24) in Oxfordshire delivers a wide-ranging prevention agenda so that each individual, organisation and partnership can play their part;

 

Set priorities for each year for the whole system to address, while also implementing business as usual and new initiatives at organisational level.

 

Councillor Hudspeth welcomed the framework and noted that the new Local Transport Plan 5 would be a good basis for delivering for clean air and reducing the need for people to be in their cars.  There were many schemes with segregated cycle and pedestrian facilities, making it safer for people to walk and cycle.

 

Lucy Butler welcomed the framework which made a huge area of work achievable.  She noted that  ...  view the full minutes text for item 21.

22.

Healthy Place Shaping

11:20

 

A presentation will be given to inform and update the Board on work for Healthy Place Shaping in the County.

Minutes:

Rosie Rowe and Bev Hindle gave a presentation (a copy of which is attached to the signed copy of the minutes) which informed the Board about the Healthy Place Shaping Work in the County.

 

The Presentation provided an update on the strategic priorities set by the Board the previous year and took a look ahead at how they were going to scale things further to include the Arc.  Rosie Rowe reported that, despite the NHS funding stopping in March last year, the Healthy Shaping work continued in Barton and Bicester and Cherwell District Council had given additional funding to extend it to further communities including Kidlington and Banbury.  The presentation further detailed external funding received from Sport England and the work being undertaken to influence the work on the Growth Deal to ensure it reflected some of the ambitions of Healthy Place Shaping.  She gave assurances that the work being undertaken on Healthy Place shaping aligned with the strategic priorities, approach and framework that sits with the Health & Wellbeing Board around prevention, early intervention and local support to promote independence and that they were trying to deliver some of the Board’s Strategic Priorities.

 

She highlighted the work being undertaken around increasing the built environment as an enabler, including influencing the local plan, local industrial strategy and LTCP5, providing outdoor gyms, green routes, communities’ facilities and walking routes and the work of bringing different sectors together and community activation – daily mile, breakfast clubs, tackling food and eating habits, digital and online community activation and evening courses with communities.  She outlined the monitoring being undertaken and the work around the PCN prevention work and the new post of a Healthy Place Officer.

 

She detailed planning a number of district and county workshops to look at operational detail.

 

Bev Hindle talked about how to do the work at scale, looking at what could be done at policy level, national context Regional and Sub-Regional context to take some of this learning and embed it in policy.  He talked about the need for developments to prevent the need for cars rather than mitigate the increase in cars.  He further talked of the need for post monitoring of developments.

 

He referred to OxCams and the ability to use the economic viability of a region to influence on a local and larger scale to create a real change in dynamics to support and sustain ourselves through Healthy Place Shaping, so that the landscape becomes a way of life.  Leaders were beginning to draw a plan together for the area bringing together four workstreams: productivity, place making, connectivity and environment, with a hope to add health in the near future.

 

There was a need for the Growth Board and Health & Wellbeing Board to come together to achieve Healthy Place Shaping. 

 

The Board thanked officers for their presentation.

 

 

23.

Healthwatch Report

11:50

 

To receive a verbal report from Healthwatch Oxfordshire including an update on plans for the Stakeholder Network.

Minutes:

Roz Pearce, on behalf of Proffesor George Smith, gave a verbal update on the latest from Healthwatch Oxfordshire (HWO).

 

Further to the Health & Wellbeing Board asking HWO to set up a Network, Healthwatch Oxfordshire would now be holding a meeting of the Oxfordshire Wellbeing network on 18 November 2019 with a theme of ‘Healthy Living and what does this mean to our communities? HWO would be encouraging many different communities to attend the event to have their voice heard, either by attending or on-line or by writing in.  The event would have a pre-prepared toolkit, asking what was being done in their communities and what could be done better.  At the end of the network meeting, they were hoping that 2 or 3 key messages would emerge for HWO to focus on.  HWO would like members of the Board to attend the meeting to engage and inform HWO what they should be looking at their next meeting.

 

Dr Collinson welcomed the update and questioned how HWO were going to engage with hard to reach/other groups.  In response, Roz Pearce acknowledged that it was a challenge, to reach those groups but that they would be going out into communities to talk with community leaders, faith leaders, the next task was to decide which communities they were going target.  HWO would be judged in a year on how well they were doing.

 

The Board thanked Ms Pearce for the update.

 

 

 

 

 

24.

Performance Report pdf icon PDF 168 KB

12:00

 

To monitor progress on agreed outcome measures (HWB12).

Minutes:

The Board agreed that this item would be coverd under Agenda Item 13.

25.

Reports from the Partnership Board pdf icon PDF 254 KB

To receive updates from the partnership boards, including details of performance issues rated red or amber in the performance report (above) (HWB13).

 

(a)      Report form the Children’s Trust;

(b)      Report from the Older People Joint Management Group;

(c)       Report from the Adults Joint Management Group;

(d)      Report from the Health Improvement Board;

(e)      Report from the Integrated Services Delivery Board.

 

 

Close of Meeting – 12.25 pm

Additional documents:

Minutes:

The Board received updates from the Board’s Partnership Board (HWB13). The following was drawn to the attention of the Board:

 

Children’s Trust – Lucy Butler reported the following:

 

-             Following the CPC and Ofsted giving Oxfordshire a written Statement of Action for COD, it was very likely that there would be a re-visit in October/November.  There were five area for improvement and progress had been made on all of them.

-             Two areas remained challenging, the timing around EHCP, there had been progression and they were now at Nation level and the quality of EHCP also remained a challenge.

-             Children missing out on Education - the Children’s Trust and the Safeguarding Board monitor it in detail.  They had recently received an annual report which showed progress within the area – attendance figures had improved from last year, for children missing education, there was a much more effective tracking process and they now knew where all children were and monitored them.

-             For children that are electively home educated, numbers had increased, but not to the extent of the National increase.  This was a challenging are, but they had been carrying out a lot of work with parents and schools, including cool down periods.

 

Health Improvement Board

 

Councillor Andrew McHugh, Chairman, highlighted the following:

 

-             He reported that progress in relation to the development in the Strategy on Domestic Violence was now on track and going well.

-             On the last dashboard MMR had been red and was now amber, but they were not being complacement.

-             Rough sleeping remained red, but they were awaiting an updated report and were keeping a close eye on the area.

 

 

All were thanked for their updates.