Agenda and minutes

          The Minutes of the meeting held 10 March 2015 having been printed and circulated were signed as a correct record.

          The Board was advised that no public questions had been received.

The Minutes of the Health and Wellbeing Board of its meeting held on 11 March 2015 were submitted to the Board for information.

HWB44 – The Board noted that Widnes Vikings had received recognition for its work with the community by receiving the Super League Cup 2014 award.  In addition, clarity was sought on whether there was a cost incurred for working with schools and it was reported that this information would be circulated to Members of the Board.

RESOLVED: That the minutes be received

The Board received a report and presentation from Mr D Chow, Engagement and Involvement Manager, NHS Halton CCG which shared the range of engagement that was being undertaken to influence commissioning decisions; highlight good practice and joint working in engagement and consultation.

The Board was advised that NHS Halton CCG was committed and had a duty to engage widely with local people to ensure that services were commissioned in line with local peoples need. Promoting opportunities, wellbeing and good health for people locally was a key target within the Joint Strategic Needs Assessment and NHS Halton CCG 2 year plan and 5 year strategy. The report provided an overview of some of the projects and programmes to continually engage people locally both in their own health and the work of NHS Halton CCG and partners over the last financial year 2014/2015.  A presentation of events and projects was attached as Appendix 1 to the report.

The Board discussed the issue and challenges of legal highs and noted that Safer PPB had established a Topic Group to look at ways of addressing this matter in the Borough. 

The Board noted that all GP Practices had established a Patient Participation Group.  However, it was also noted that some were not as effective as others as they did not meet frequently and the CCG would be meeting with the Chairs of the Group to address this issue.

The Importance of raising young people’s awareness of the seriousness of diabetes was raised.  In response, it was reported that next week a Halton Real Comic on Type 2 Diabetes would be distributed widely in the community.  A Halton Real Comic - Health Checks was circulated at the meeting.  It was reported that they would be available in all schools, libraries, patient groups and links to ipads and Apps would be available.  In addition, it was anticipated that in the near future a Mental Health and SEND comic would also be available.

RESOLVED: That

(1)        The report, presentation and comments raised be noted; and

(2)        Mr Chow be thanked for his informative presentation.

Note:  Councillor M. Lloyd Jones declared a Disclosable Other Interest in the following items of business HEA4, HEA5, HEA8 and HEA9 as her husband is a Governor of Warrington and Halton  Hospital Foundation Trust and Bridgwater Community Health Care Trust.

The Board considered a report of the Strategic Director, Communities, which presented the progress of key performance indicators, milestones and targets relating to Health in Quarter 4 of 2014-15. 

          A verbal update on the performance monitoring targets was given at the meeting, highlighting that the majority would be achieved by the end of the year.  In addition, an update was given on the indicators that had not met their target; the reasons why and the actions being taken to address this matter.

          Page 59 – Homelessness: Clarity was sought on who would be monitoring the Pan Merseyside Bond Scheme and more information was requested.  In response, it was reported that this information would be circulated to all Members of the Board.

          Page 65 – CCC6 – The number of households living in temporary accommodation – The Board agreed to monitor this target in light of the introduction of Universal Credit and the impact it would have on residents in the Borough.

RESOLVED: That the report and comments raised be noted.

The Board considered a report of the Strategic Director, Communities, which presented the Annual Report for the Health Policy and Performance Board for April 2014- March 2015 attached as Appendix 1 to the report.

          It was reported that during 2012 -13 the Board had looked in detail at many of Halton’s Health and Social Care priorities. Further details of these were outlined within the Annual Report set out in Appendix 1 to the report.

The Chairman, on behalf of Councillor E Cargill, took the opportunity to thank Officers and Members for their contribution to the Board and Working Groups during the last municipal year.

RESOLVED: That the report be noted.

The Board considered a report of the Strategic Director, Communities, which provided feedback on issues discussed at the last meeting in respect of the presentation of the Care at Home Scrutiny Review 2014/15.

The Board was advised that the Care and Home Scrutiny Review 2014/15 report that was presented to last meeting of the Board took into account current Community Nursing Services and as part of the review Members received a presentation from the Clinical Manager of Halton Community Nursing and the Service Manager for Adult Community Nursing the Community Nursing services regarding the service that was currently delivered in Halton.  The presentation focussed on such areas as current staffing levels, referrals, quality and safety aspects and patient feedback and Members expressed concerns about the perceived lack of capacity within the Community Nursing Service.

The Board was further advised that In order to provide Members with appropriate assurances, the following was an update on the posts affected and the actions taken to ensure a safe workforce was in place:-

·           A Band 7 evening service District Nurse sister had returned from long term sick leave week commencing 12^th April 2015 on a 4 week phased rehabilitation return to work programme;

·           A vacant 0.4 FTE Band 5 Community Nurse post had been recruited to and a start date was expected to be confirmed imminently following the completion of recruitment checks;

·           2 x 0.4 Band 5 post interviews had taken place on 28th April 2015 and recruitment checks for the successful candidates had commenced;

·           A Band 7 District Nurse sister had left the Trust on the 26th April 2015; however she would be remaining on the nurse bank for night duties. The post was being advertised and, until it had been recruited to, the Trust had taken on a very experienced agency nurse working 2 to 3 nights per week who was also interested in applying for the post; and

·           There was no capacity issues in the District Nursing Out of Hours Service. Staff within the service occasionally reported issues when the evening staff had handed over patients if they had been delayed with an end of life patient which impacted on their workload. This was because the community nursing service prioritised end of life patients and this had been discussed and agreed with staff.

The Board noted that the service was currently fully staffed.

RESOLVED: That

(1)        the report be noted; and

(2)        the steps taken to ensure the community nursing service has capacity to provide a safe and efficient Community nursing service be noted.

The Board considered a report of the Strategic Director, Communities, which provided Members with the 2015-2018 IM&T strategy for Halton.

The Board was advised that document had been carried out in collaboration with a number of key stakeholders.  Following engagement with stakeholders the strategy aimed to identify what both local priorities were in relation to IM&T and also the wider healthcare economy priorities which spanned a number of organisations and which were likely to span the life of the strategy.

The Board was further advised that the workstreams had been identified by first specifying the need that was not currently being met and then identifying the possible solutions that could meet this need.  Their potential impact on outcomes and also their ease of implementation was also mapped.

It was reported that the strategy had been presented to the CCG Service Development Committee in February 2015 and had been approved via the Governing Body in March 2015.  The workstreams were now being developed into a number of detailed project plans to be progressed over the coming months.

Furthermore, it was reported that the identified workstreams within the IM&T strategy were now being planned in collaboration with the relevant stakeholders and detailed project plans being developed.  These would form a monitoring dashboard that would be discussed monthly at the IM&T working group and form the basis for the quarterly IG Committee report.

The Board noted the current position and next steps of the IM&T Strategy, set out in the report.

          The Board noted the significant challenge and opportunities of the IM&T Strategy and the excellent work that had been undertaken to date.

RESOLVED: That the Strategy and the Year 1 priorities within the Strategy be noted.

The Board considered a report of the Strategic Director, Communities, which gave Members an update in relation to the Urgent Care/System Resilience agenda within Halton, including an update on the Urgent Care Centre developments.  Appendix 1, to the report gave information on Halton’s System Resilience Group Membership and the System Resilience Performance Dashboard for February 2015.

The Board was advised that System Resilience Group (SRG) which was designed to be reflective of the whole system of health and social non-elective and elective care within Halton.

Ms C McNally (Runcorn UCC) and Ms S Doyle (Widnes UCC) attended the meeting to give Members an update on the two Urgent Care Centres.

It was reported that Runcorn UCC had been operational since 9 February 2015 and due to recruitment problems was only operating Monday – Friday 9 am – 5 pm.  However, it would be fully operational on 1 July 2015 and would operate from 8 am – 10 pm seven days a week.  In addition, it was reported that to date, the UCC had been successful in reducing the number of people attending A&E and reducing the need for people in Halton going out of the Borough to access urgent care.

In respect of Widnes UCC, it was reported that work had commenced on site on 4 February 2015 and there were two phases.  Phase 1 would be completed by the end of this week and it was hoped that Phase 2 would be completed by 5 July 2015.   Once work had been completed, it would operate under the agreed Service Delivery Model as Runcorn UCC.  It was also reported, that staffing levels at the site were also improving and would continue to do so over the next few weeks. 

Furthermore, it was reported that there had been very positive feedback on the service to date and there would be a launch of the service to the public in July 2015.

Members raised concern that Runcorn UCC was currently operating reduced hours and was not available seven days a week.  In response, it was reported that there had been recruitment problems and therefore it had not been possible to extend above the current operating hours.  However, there had been extensive staff training; clinicians with extended nursing and assessment skills, including the prescription of drugs were available, and nurse practitioners to complement the staff.

The Board noted the challenges in respect of recruitment nationally.  The Board discussed the Dashboard information and it was agreed that it be circulated with the Health PPB Briefing, prior to the agenda despatch.  It was also agreed that feedback on both UCC’s be presented to the 8 November 2015 meeting outlining the impact it had on the reduction in Halton A&E patients and why they had attended A&E rather than the UCC.

RESOLVED: That the report and comments raised be noted.

The Board considered a report of the Strategic Director, Communities, which presented Members with information on Making a difference: A strategy for transforming Care Management in Halton 2015-2020.

        The Board was advised that Making a difference: A strategy for transforming Care Management in Halton 2015-2020 had been developed within a range of national and local policies and themes including the Care Act 2014. The Act placed additional responsibilities on the Council through the ’wellbeing principle’ and the wider focus on the whole population in need of care rather than just those with eligible needs or who were funded by the state.

        The Board was further advised that implementation of the Care Act had significant implications for the roles of the Adult Social Care workforce as the way people accessed the care and support system changes and demand increased for assessments and support plans from self-funders and carers.

It was reported that the strategy set out a framework to build on the existing care management model and construct a professional, skilled care management service that was fit for purpose and responsive to the future demand.

Furthermore, it was reported that implementation of the strategy action plan required Workforce Capacity Planning and this was underway supported by Skills for Care as one of their pilots. The project would explore how social workers were deployed, how many would be needed (for the expected increase in assessments) and how assessments were undertaken. This would then inform the right mix and numbers of social workers and community care workers with the right skills and knowledge to implement care and support reform.

In conclusion, it was reported that the action plan would be delivered through the newly established Professional Capabilities Forum (page 23 of the strategy) chaired by the Principal Social Worker (Divisional Manager Care Management and Assessment). The Strategic Director and Operational Director Prevention and Assessment would form the “Professional Leadership” and have an overview of progress in implementing the strategy.

          The Board had a discussion on the model of brokerage and consultation that had taken place.  It was noted that this was not the final document, and further consultation would take place with service users and staff.

          RESOLVED: That the Care Management Strategy for Halton 2015-20; supporting evidence be noted.