Agenda item

2:10

60 mins

 

(a)  The draft Joint Health & Wellbeing (HWB) Strategy will be presented by Dr McWilliam for discussion and approval prior to wider engagement (HWB7) (10 minutes).

 

The Board is RECOMMENDED to approve the Strategy.

 

(b)  Engagement Plan for the Joint HWB Strategy – This paper sets out an outline engagement plan for the updated Health & Wellbeing Strategy. (HWB7(b)) (5 minutes). Catherine Mountford (CCG) to present.

 

The Board is RECOMMENDED to approve the Plan.

 

(c)  Priorities for the Oxfordshire Health & Wellbeing Strategy

 

(1)  Improving the resident’s journey through the health and social care system as set out in the CQC action plan.  A presentation on the CQC Action Plan Highlight Report and Evaluation Framework will be given by the system leaders on behalf of the Integrated System Delivery Board (HWB7(c)1). The Director for Adult Social Services will also give verbal feedback from the CQC’s follow-up review which takes place on 11 November (10 minutes)

 

(2)  Planning for future population Health and Care needs – Proposed Framework Approach. Members of the Board are invited to consider the approach to meeting current and future population needs as set out in the report. Lou Patten, Chief Executive, OCCG, will present the report (HWB7(c)2) (15 minutes).

 

The Board is RECOMMENDED to approve the framework approach to meeting current and future population needs, as set out in the report.

 

(3)  Agreeing plans to tackle critical workforce shortages. The Director of Adult Social care will report verbally (10 minutes).

 

(4)  Current and Future Opportunities for Prevention. Dr Collison and Dr McWilliam will present an outline of the cross cutting theme of prevention, including population health management, healthy place-shaping and aligning prevention initiatives across the system (HWB7c(4)) (10 minutes).

 

The Board is asked to discuss and note these initiatives.

 

 

 

Prior to consideration of this item, the Board was addressed by Cllr Augustine. She expressed her concern at the perceived ‘lack of transparency’ in respect of the workshops held in private to establish the Board’s ways of working together in the future. She also pointed out her concern that the venue for this meeting was the Clinical Commissioning Group’s offices and not County Hall as was usual; which, in her view, reflected the fact that the CCG were increasingly in control. It was also Cllr Augustine’s view that the CCG’s policy of engagement with the public was unacceptable and ‘opaque’, thus making valued scrutiny impossible. 

 

Draft Health & Wellbeing (HWB) Strategy (HWB7(a))

 

Dr McWilliam presented the draft Health & Wellbeing Strategy (HWB7(a)) for discussion and seeking approval for engagement with the public. He stated that this was an example of true collaboration of organisations working together for the people of Oxfordshire. He added that the Strategy covered a wide number of topics which concerned all the wider determinants of Health, that in turn influenced housing, green spaces, highways etc, thus giving a clear direction for all.

 

In presenting the Strategy he highlighted four priorities at Board level:

 

-       Prevention;

-       Emphasis on place-shaping;

-       The vital importance of the residents’ journey; and

-       The workforce.

 

Comments from Board members relating to the challenges and goals for the Board in the future included:

 

·         The Board should continue to promote DToC;

·         The Board should promote specifics in relation to its goals in order to ensure accountability, a strategic vision and measures of success. For example, engagement with staff who were as important as engagement with the public and the establishment of a five - year plan and action logs in order to enable the setting and monitoring of achievable targets and goals;

·         The emphasis on prevention was welcomed, but more work needed by the sub-groups to come up with targets on how to promote personal responsibility in people for their own health;

·         To welcome the focus in the Strategy on the workforce challenges, despite the available resources, on health inequalities and on mental health.

 

Diane Hedges asked to what extent should the Board set out what it wanted to do in detail, pointing out that this could be treading a difficult line. The Board was doing well in its endeavours to set the middle ground and it was already very sighted on achieving the children and adolescent targets. There was still an opportunity to shape the Strategy for further engagement.

 

The Board AGREED to approve the draft Health & Wellbeing Strategy for wider engagement with the public.

 

Engagement Plan for the Joint Health & Wellbeing Strategy (HWB7(b))

 

Catherine Mountford (OCCG) introduced the outline engagement plan from the updated Health & Wellbeing Board (HWB7(b)).

 

Cllr Stratford asked how could it be ensured that sufficient people engage with the Plan in order to be confident that the people spoken to was a fair representation. Catherine Mountford responded that all the organisations represented on the Board would utilise all the networks available to them for publishing purposes. Staff members would be engaged with, together with staff members from the communities.

 

Professor Smith made reference to the Healthwatch Oxfordshire website which featured a ‘Trip Adviser’ style facility which collected comments and views from the public for GP surgeries, community hospitals etc.

 

The Board AGREED to approve the Engagement Plan.

 

Priorities for the Health & Wellbeing Strategy (HWB7(c)

 

Improving the resident’s journey through the health and social care system (HWB7(c)(1)

 

The Board had before them a Highlight report and Evaluation Framework from the Integrated System Delivery Board (ISDB). The Director of Adult Social Services, Kate Terroni, gave a verbal feedback report from the recent CQC follow-up inspection which had been provided to the system leaders verbally. Observations included:

 

·         relationships at senior level were much improved;

·         the evaluation of winter pressure schemes was good;

·         positive work in respect of the workforce had taken place with good examples of best providers;

·          there was recognition of the current work around the implementation of service provision for ‘stranded patients’

·         there were still a few confusing pathways and some duplications if service

·         insufficient work to date on the integration of Health and Social Care;

·         the work required on self - funders had not as yet been concluded – advice on the website was in place but there had been no brokerage on this function;

·         further work was required with carers;

·         Oxfordshire had the best and most vibrant voluntary service provision, but there was no coherent way established for working with them.

 

Dr Holthof suggested that there be an amendment to the presentation of the indicators to the effect that there had been a significant amount of progress made and much ground – work done in building trust in respect of patients leaving hospital in a timely way.

 

The Board AGREED to:

(a)  (unanimously) endorse the evaluation framework and the suite of indicators listed on page 48 of the report, as amended above; and

(b)  note that the CQC would be returning to a meeting of the Board on 29 January 2019 in order to deliver formal feedback on the inspection.

 

Planning for future population Health and Care needs – proposed framework approach (HWB7(c)(2)

 

Diane Hedges presented the approach to meeting current and future population needs, as set out in the report 7(c)(2).

 

She reported that the proposed framework approach had been tested with the Oxfordshire Joint Health Overview & Scrutiny Committee who had been supportive of the way forward. One of its observations had been to recommend the Board to draw together innovative and best practice in order to deliver care locally.

 

Suggestions made by members of the Board included the following:

 

-       there was a need to include timings in order to ensure parity;

-       there needed to be meetings held with the public, particularly with those living in the rural communities, and parish, district and county councillors needed to have an involvement in these. Diane Hedges responded that decisions had yet to be made on how many meetings should be held and where;

-       demographic data was required in respect of who was moving into developing areas, such as Bicester and Didcot, together with future needs. The latter could be gleaned from surveys undertaken by university students, for example. This was a strategic framework involving many partners, it required a co-production based on demographics and involving place;

-       more evidence – based work was required on complicated issues such as migrations and the splitting up of households; and

-       any decisions in relation to health and care needs would require some work across the borders on patient flows.

 

The Board AGREED to approve the framework approach to meeting current and future population needs, as set out in the report.

 

Agreeing plans to tackle critical workforce strategies (HWB7(c)(3)

 

The Director for Adult Social Services reported that a large amount of work was taking place with providers, in a much more co-ordinated way, to tackle the recruitment and retention of staff in Oxfordshire. There had also been developments in nurses training, including apprentice training in a co-ordinated way as a means of attracting people to come to Oxfordshire. In addition, a strand of the work was to look at affordable housing in relation to Homeshare. She added that the workforce group would be requested to come along to the March 2019 meeting of the Board to give a presentation on work so far.

 

Current and future opportunities for prevention (HWB7(c)(4)

 

Dr Collison and Dr McWilliam presented an outline of the cross-cutting theme of prevention, including population health management, healthy place-shaping and alignment of prevention initiatives across the system.

 

Councillor Ian Corkin explained his newly-gained portfolio as a Cabinet member of Oxfordshire County Council, to deliver the Cherwell District Council/Oxfordshire County Council partnership. He highlighted healthy place-shaping in particular as a very important priority, where the most benefit for residents could be realised. For this to be successful there needed to be the right people in the same room in order to break down silos; and also the profile of projects which had proved beneficial for residents to be raised at these meetings, for example, the blue walking lines in new developments in Bicester and the inclusion of sports pitches etc in plans.

 

The Board AGREED to note these initiatives.