Agenda and minutes

            The Minutes of the meeting held on 13^th January 2016 having been circulated were signed as a correct record.

            The Board considered a report which advised on developments for integrating Children’s Services. An Integrating Child Health in Halton Workshop was held on 8^th May 2015 with local acute trusts, community trusts, children’s services, NHS CCG Halton and Public Health. The key note speaker was Dr. Hilary Cass President of the Royal College of Paediatric and Child Health. The outcome was consideration to pilot an innovative programme of joint working between providers and the placement of a local paediatrician in the local community. The report outlined the drivers for change towards an integrated service and the aims and outcomes which an integrated service could achieve.

            Members were advised that the next steps in Halton would be to:

·         agree a financial plan and work plan for a paediatrician in the community;

·         agree GP hosts and pilot sites; and

·         liaise with Health Education England for recognition as a pilot site.

            RESOLVED: That the the Board –

1.    note the contents of the report; and

2.      note that a paediatrician is available to work in the Halton Community from Warrington and Halton Hospital Trust.

            The Board considered a report which provided information on the successful Well North bid that Halton Partners had submitted. The Board was advised that Well North was a Department of Health (DH) response to the Due North Report which highlighted the disparity in wealth and circumstances between the North and the South of England. The DH Well North team had allocated up to £9m to be available to nine local areas to improve health via innovative approaches.

            It was noted that the programme must be delivered in wards in the top 10% of Index of Multiple Deprivation and the approach was to develop, test and pilot a set of linked interventions to improve the health of the poorest. The Well North methodology would involve co-production between Halton’s partners and the Well North team.  Full details of Halton’s successful bid were outlined in the report.

            As part of the next steps, a team of Halton staff from across key agencies and service areas would work with local communities and the Well North team through an initial stage to further define the proposals and intended outcomes for Halton. Initial sessions and visits had already taken place to provide a sense of place for the Well North team and a trip to Bromley by Bow for Halton partners to see a successful Wellness Place based approach in action. It was proposed that a two day workshop would be programmed for May 2016 to develop plans.

            RESOLVED: That

1.    the contents of the successful Well North bid and an update of commencement of implementation be noted; and

2.    any comments be fed back to the Director of Public Health and Director of Commissioning and Service Delivery.

            The Board was advised that the National Health and Care Bodies in England had come together to publish shared NHS Planning Guidance for 2016/17 – 2020/2021, setting out the steps to help local organisations deliver a sustainable, transformed Health Service and improve the quality of care, wellbeing and NHS finances. A copy of the guidance had been previously circulated to Members of the Board.

            As part of the new planning process, NHS organisations had been asked to develop two plans.

            1)         A wider health and care system “Sustainability and Transformation Plan, covering the period October 2016 to March 2021; and

            (2)       A plan by organisation for 2016/17.

            It was noted that the guidance had indicated that planning by individual organisations would increasingly be supplemented with planning by place for local populations. Providing a Sustainability and Transformation Plan (STP) on a larger geographical footprint would encourage a joint approach. On the 29^th January it was confirmed that Halton would form part of the Cheshire and Merseyside STP footprint.

            Members were advised on access to future transformation funding which was outlined in the Government Spending Review as an additional dedicated funding stream for transformational change, building up over the next five years. The most compelling and credible STPs would secure the earliest additional funding from April 2017 onwards. In addition the report also set out the timetable for submission of the Operational Plan and completion of the five year Cheshire and Merseyside STP. It also outlined nine “must do” priorities for local health economies which NHS England and the other NHS organisations had identified.

            RESOLVED: That

1.    the contents of the report be noted; and

2.    the Council works collectively with Halton CCG and One Halton delivery partners to develop a local 5 year Sustainability and Transformation Plan with accompanying 12 month Operational Plan and contribute to the wider Cheshire and Merseyside footprint Sustainability and Transformation Plan.

            The Board considered a report which detailed the arrangements for the introduction of Multi-Agency Front door as part of Complex Dependency Early Intervention model in Halton.

            One of the key aims of the Complex Dependency Early Intervention project was to create a single, multi-agency front door for identification and assessment of complex individuals, Children and Families. In order to deliver a multi-agency front door in Halton, the process and practice of the current Contact and Referral Team (CART) had been reviewed. Through the implementation of the revised front door the aim was to provide a proportionate, timely and co-ordinated partnership approach to children, families and vulnerable adults. This approach should lead to a more appropriate allocation of resources to those children, families and vulnerable adults that required additional support due to them having multiple and complex needs.

            Members of the Board were advised on staffing roles within the new integrated team, known as I-CART and noted that there would be a soft launch of the new approach at the end of March 2016.

            It was noted that the aim of I-CART the aim was to see less inappropriate and repeat referrals, closer partnership working and clearer accountability, supported by information sharing protocols and pathways, improve confidence for those who access the service, identification of possible gaps in service and cost benefits.

            RESOLVED: That the Board notes the progress to date in implementing a multi-agency front door and recognise the benefit of a defined route to services through a single point of access by a dedicated multi-agency team.

            The Board considered a report of the Chief Officer, NHS Halton CCG, which presented a summary of the outcomes of the first wave of CQC inspections of general practices in Halton undertaken in September 2015. Of the eight practices inspected, seven received an overall rating of good, and one an overall rating of outstanding. An overview of each general practice inspection was detailed in the report.

            RESOLVED: That the good outcomes of the first wave of CQC inspections of GP practices in Halton be noted.

            The Board considered a report from NHS England, which provided an update of the national, regional and local programme of work with regard to Transforming Care for people with Learning Disabilities. The Transforming Care programme was a national programme of work, aimed to improve care for people with learning disabilities and/or autism and behaviour that challenged (learning disabilities). The five areas in the Transforming Care programme were –

·         Empowering individuals;

·         Right care in the right place;

·         Regulation and inspection;

·         Workforce; and

·         Data and information.

In the absence of a representative from NHS England, Sue Wallace Bonner agreed to report back the Board’s queries with regard to pooled budgets and reduction of beds.

            RESOLVED: That the report be noted and the Board support the implementation.

            The Board received an update on the development of the Halton Public Health Annual Report (PHAR) from the Director of Public Health.  The Annual Report was the Director of Public Health’s professional statement about the health of local communities, based on sound epidemiological evidence and interpreted objectively.

            Each year a theme was chosen for the PHAR and for 2015 – 16 it was noted that the report would focus on the work on the Public Health Evidence and Intelligence Team. This topic had been chosen to highlight some key pieces of work and how they had been used or would be used by Halton Borough Council and its partner organisations. The final version of the report would be presented to the Board in July however, prior to this an electronic copy would be circulated to Members of the Board for feedback.

            RESOLVED: That the theme and development of the Public Health Annual Report be noted.

            The Board considered a report of the Strategic Director, People and Economy, which provided an update on the activity of the positive Behaviour Support Service (PBSS), which had been operational since November 2011. The service was jointly funded by NHS Halton CCG and was a specialist service for children and adults with the primary purpose of improving life quality for those individuals who present with behaviours that challenged services. Eligibility criteria for the service were moderate to severe Learning Disability, including those with a diagnosis of Autistic Spectrum Condition. The service was currently supporting 15 adults and 18 children in the Halton area. In addition, it would also be supporting the return of 6 adults to Halton from out of borough placements in January 2016.

            It was noted that the cost of the PBSS to Halton was less than the savings achieved. The report detailed examples of annual savings to the Council.

            RESOLVED: That the report be noted and the ongoing work of the PBSS be supported.