Agenda and minutes

            The minutes of the meeting held on the 12^th March 2014 were taken as read as a correct record.

            The Board received a presentation on behalf of R U different from Gary Lovatt, who outlined to Members details on:

·         the aims of the project, how they engaged with young people in a positive way;

·         how young peoples’ attitudes and perceptions could be identified and be positively changed;

·         the range of risk taking behaviours in young people covered;

·         how surveys were used to assess young peoples’ current attitudes and perceptions;

·         examples from recent surveys with young people which highlighted their perception on a number of issues such as percentage of young people who had smoked tobacco, used alcohol and drugs compared with actual percentages of those who had;

·         initiatives previously adopted in secondary schools in the Manchester area such as poster campaigns designed by young people, electronic quizzes, enterprise days, barcodes which can be scanned with mobile phones and an app which can be used by parents; and

·         how changing a young person’s perception had changed risk taking behaviour.

RESOLVED: That the presentation be received.

            The Board received a presentation from Eileen O’Meara, Director of Public Health which provided details on the recent Health and Wellbeing Shape the Future Event. The purpose of the day was to:

·         to provide progress on the health and wellbeing priorities;

·         agree new actions against the priorities;

·         provide information on the integration of health and social care; and

·           launch the community health champions awards.

            Members of the Board were also provided with details on the five presentations around the health and wellbeing priorities which were delivered at the event and the new actions against the priorities which were agreed. It was noted that feedback had been received from those who attended and a high level of satisfaction with the event was noted.

            RESOLVED: That the presentation be noted.

            The Board considered a report which outlined details of performance issues identified at the Warrington, Halton, St. Helens and Knowsley Breast Screening Programme. National guidelines stated that 90% of women invited should be offered an appointment within 36 months of their previous screening, 90% of women should receive their appointment within two weeks and a minimum of 90% of women must (if required) be assessed within three weeks. At present, the programme was currently under-performing in all three of these areas and it was recognised that unless this situation was quickly addressed performance would continue to show a deteriorating picture.

            The Cheshire, Warrington and Wirral Local Area Team of NHS England (CWW) Screening Lead had given assurances that the programme performance issues had been identified early, a recovery plan was in place and would be achieved by October 2014. It was noted that:

·         the service ensured that all women that had results most suggestive of malignancy were expediated into assessment to minimise the risk of clinical impact from delay;

·         Warrington/St. Helens Breast Screening Service had historically experienced robust performance results and had consistently achieved above the 90% minimum target;

·         the recent slippage in performance was the result of a combination of radiographic staffing issues that had impacted upon radiographic capacity;

·         breast screening performance recovery had been prioritised within the Trust and resources were being made fully available; and

·         a sustainable workforce plan to minimise the risk of similar repeat had been developed.

            RESOLVED:  That

(1)  the content of the report be noted; and

(2)  the Board note a recovery plan was under way and there was judged to be minimal clinical impact.

            The Board considered a report which outlined the role of the Director of Public Health in providing oversight of local Health protection arrangements and the development of the Health Protection Forum to support this. Under the Local Authorities Regulations 2013 unitary and upper tier local authorities had a new statutory duty to carry out certain aspects of the Secretary of State’s duty to take steps to protect the health of the people of England from all hazards, ranging from relatively minor outbreaks and contaminations, to full scale emergencies, and to as far as possible prevent those threats emerging. Directors of Public Health were responsible for the exercise of local authorities’ new public health functions.

            Members were advised that a Halton Health Protection Forum was created to improve integration and partnership working on health protection between the Local Authority, NHS, Public Health England and other local services and to provide assurance to the Health and Wellbeing Board on behalf of the population of Halton, that there were safe, effective and locally sensitive arrangements and plans in place to protect the health of the population. The Executive Board Portfolio for Health and Wellbeing and a representative from Healthwatch were also invited to the Forum.

            It was proposed that the Halton Health Protection Forum would produce quarterly reports to the Health and Wellbeing Board.

            RESOLVED: That

(1)  the contents of the report be noted;

(2)  the development of a Health Protection Forum be supported; and

(3)  the systematic approach to the overview of public health governance in Halton be supported.

            The Board considered a report of the Director of Public Health which provided an update on the progress with the Health and Wellbeing Child Development Action Plan. Improving levels of child development was one of the five key priority areas covered by Halton’s Health and Wellbeing Strategy. The overall target set for the action plan was a 2% year on year increase in children achieving a good level of development at age 5 (Baseline 2011 – 49.9%). Unfortunately, due to changes in the Early Foundation Stage curriculum and assessment, the measure of child development in 2013 was not comparable to previous years, and therefore a year on year increase could not be identified.

            However, as the Action Plans had now been in place for over 12 months, a recent review took place to gauge progress on each of the outcomes covered. In order to do this, action plan leads were asked to rate each outcome using the Red, Amber, Green system. The results of the exercise were included within the report and a summary of progress on key developments was as follows:-

·         100% of families had access to antenatal sessions;

·         92% of women booked in to see a midwife by 12 weeks and 6 days;

·         100% of women were screened for mental health issues after birth, and vulnerable women were targeted through the offer of home visits;

·         targeted work was underway for vulnerable women, through specialised midwives and development health visitor pathways for specific groups;

·         an increase in Health Visitor numbers was on target;

·         Breast feeding rates had increased to 21.2% and Bridgewater Community Health Care Trust had achieved UNICEF’S Baby Friendly initiative stage 2.

·         improvements had been seen in infant mortality, the rate was now similar to the England average; and

·         improvements had been achieved in the number of babies born with a low birth weight, the rate was now similar to the England average.

            In addition, a new Family Nurse Partnership service was being commissioned and would start in Halton in October 2014. It was a targeted programme that built a strong relationship between the nurse and the family and included regular home visits.

            RESOLVED: That the contents of the report and the action plan be noted.

            The Board considered a report of the Strategic Director, Communities, which presented the latest AQuA North West (NW) benchmarking data and associated comparisons. The latest data provided by AQuA demonstrated excellent performance in the following areas:-

·         Permanent admissions to residential/nursing care (although it should be noted that there had been an increase in permanent admissions to long term care since September 2014); and

·         the proportion of Local Authority Adult Social Care spend on residential/nursing care (Halton had previously been ranked the best in the North West in relation to this area. However, according to March 2014 information, Halton had now been ranked 2^nd, this linked to the increase in permanent admissions outlined above).

            Due to the increase in these areas over the past few months, work was currently taking place to investigate the reasons why. Halton Urgent Care Working Group (UCWG) had established a short term task and finish group to review and develop further the frailty pathways out of acute care. The task and finish group would consist of representation from across the Urgent Care system to explore where improvements could be made and make recommendations to the UCWG.

            The report also provided information on areas that were improving but still presented significant challenges, areas that remained as significant challenges and also those areas that remained static.

            RESOLVED: That the report and associated appendices be noted.

            The Board considered a report of the Strategic Director, Children and Enterprise, which outlined the progress so far on the new Halton Children and Young People’s Plan (CYPP) 2014 – 17.

            It was reported that CYPP was a joint strategy of the partners within Halton Children’s Trust, which detailed how they would co-operate to improve children’s wellbeing. It represented Halton’s local vision and aspirations for children and young people in the Borough, provided strategic direction and determined how the Children‘s Trust Board would work together to commission services to address locally identified needs and better integrate provision.

            Members were advised that Halton’s first CYPP had been published in June 2006. Although it was no longer statutory as of June 2010, the need for a CYPP to remain in place was universally agreed locally in Halton to provide the strategic direction for the continuing Children’s Trust arrangements. Following extensive consultation, the priorities for Halton Children’s Trust for the period 2011-14 were agreed and were set out in the report for further information.

            It was noted that in Autumn 2013, it had been agreed to develop a new CYPP to frame the work of the Trust from 2014. On this basis, a working group was established from November 2013 to develop the plan based around the agreed priorities which detailed in the report for consideration. The Task and Finish Working Group met bi-weekly and following the development of a short project brief, a number of agreements were made around the approach to take for the new CYPP, including:-

·         primarily web-based but with a limited number of copies produced for stakeholders and inspection purposes;

·         shorter chapters and simplified language;

·         chapters should be different in their approach to that found in other documents;

·         the advantages of having a web-based document would be explored, for example being able to link other documents; and

·         the involvement of young people.

            RESOLVED: That

(1)  the contents of the report be noted; and

(2)  the Board supports the roll out of the CYPP and work in order to meet its priorities over the next three years.