Agenda and minutes

Apologies for absence were received from Mark Dornan, Mark Adams, Emma Nunez, Councillor R Beadle, Elizabeth Saunders and Sally Young.

The minutes of the meeting held on 10 June 2016 are attached for approval.

RESOLVED        -       That the minutes of the meeting held on 10 June were agreed as a correct record, subject to it being noted that Emma Nunez had submitted her apologies and they were not recorded.

Matters Arising

Members of the Board were invited to attend a workshop on the Development of a 10 Year Plan for Tobacco Control.  The workshop had a very disappointing turnout.  If we are going to create a vision for Gateshead we need to work together.  The Chair advised the Board that she would ask Iain Miller to re-organise a meeting as we all need to work together to be able to tackle the issues and achieve ambitions.

The government have confirmed we have the go-ahead for the 17/18 plans.  They have been fully approved with the focus being on delivery.

At the last meeting we looked at the STP and the analysis of the gap in funding led to the discussion that leadership meetings need to take place the Chair informed the Board that she had met with leaders of Newcastle and Gateshead and Chief Executive and they did agree that we need to work more closely around public health and that a system leadership meeting is needed.

Chief Executives have been tasked with getting a meeting together and this will be fed into the Health and Wellbeing Board.  It was also noted that the Association of Directors of Social Care have put together a toolkit of integration of health and social care which it may be useful to look at.

The Action List following from meeting held on 10 June is attached for approval.

RESOLVED   -           That the Action List incorporating actions from 10 June meeting be noted.

Members of the Board to declare an interest in any particular agenda item.

There were no declarations of interest.

Presentation by Catherine Horn, Newcastle Gateshead CCG

The Board received a presentation on Child and Adolescent Mental Health Services.  The Board were informed that Newcastle and Gateshead Council are working collaboratively with the CCG.  In February 2015 consultations were undertaken with professionals and key stakeholders.  It had been identified that waiting lists nationally for Tier 2/3 treatments was 26 weeks.  In Gateshead, waiting list times were 15 weeks and that has been brought down to 9 weeks.  NTW has a target to receive 70% of children and achieved 86% of their target re referrals.

The scope of the project was to look at Tier 2 and Tier 3 services and it was an opportunity to come together as partners to improve services.

A baseline was established and case for change transformation document was produced.  Work is currently ongoing looking at the data.  This led to the Expanding Minds/ Improving Lives Project with a listening exercise taking place involving children, young people and parents.  Several consultation events took place involving schools and multi-agency partners.  An online survey was also developed.  There are still some focus groups taking place over the next few weeks.

The key messages (and National Policy) are telling us that we need to develop a model that:

·         Is focused on prevention and early intervention

·         Responds to the needs of  children and young people

·         Has clear routes to the right support at the right time in the right place

·         Has a recovery focus

·         Has a shared care approach - “No Bounce”

·         Allows for ease of access and choice

·         Provides appropriate escalation when necessary

·         Has clear roles and responsibilities

·         Has integrated working at its heart

Further work is to be undertaken to develop the model and by the end of August is it anticipated that a half day workshop will be held.  Engagement with governing bodies is planned for September with testing out of the model between December and March.  It is important that this is done over a phased approach.

RESOLVED -That the current position be noted and the Board receive further updates as required.

Report of the Director of Public Health

The views of the Health and Wellbeing Board were sought on the Draft Substance and Alcohol Misuse Strategy 2016-2021.  Gateshead currently has the 7^th highest rate of alcohol related admissions to hospital in England.  Though recent figures show early indicators of a positive downward trend in recent years.  However, despite this overall decrease the rate of admissions for women has increased by 30.3% since 2008/09.

For young people the rate of admissions for under 18s has decreased by 54% to 58.8 per 100,000, since the 2006/07 to 2008/09 period. 

The Vision is to reduce the harms caused by substance misuse and make Gateshead, a safer and healthier place where less alcohol and no substances are consumed, and where:

·         Recovery is visible, bringing about enduring change to local communities

·         Substances are no longer a driver of crime and disorder

·         Professionals are confident and well-equipped to challenge behaviour and support change

·         There is a reduction in the health inequalities between socio-economic groups

As previously reported to the Board, there has been a spike in drug related deaths in recent years with 17 in 2015 and 15 deaths so far this year.  The local figures however, do mirror the national trend.

This is the first combined strategy for several years.  The strategy has joined these two issues due to the many similarities in the actions required to address this agenda.  The joint approach is highlighted by the proposed shared aims and objectives below.

REDUCE DEMAND / PREVENTION ACROSS THE LIFE COURSE

Aim:  to ensure that a coordinated ‘whole family’ approach is taken for initiatives working with children, young people, working age, older people, individuals, families and communities, protecting those most affected by substance misuse.

REDUCE SUPPLY PROTECTION AND RESPONSIBILITY

Aim:  to ensure all sections of the trade promote responsible retailing to support a reduction in substance misuse-related harm.  To mitigate the role of substance misuse in fuelling Crime, Anti-Social Behaviour, Violence and Domestic Abuse.

BUILD RECOVERY / HEALTH AND WELLBEING SERVICES

Aim:  to ensure an evidence based ‘health and wellbeing’ focussed prevention, treatment and recovery approach is employed to address the needs to service users and their families experiencing alcohol related issues.

Despite the integrated strategy it is acknowledged that some distinctively different approaches are also required to address drug and alcohol harm.  Alcohol required a population approach to address availability, acceptability and safer use.  Substance misuse relates to a more specific client group and has a greater crime and disorder focus.  This strategy therefore has two chapters, one for alcohol and one for drugs., to outline the specific work relating to each area.

The strategy also identifies the need for high level, strategic action.  It is proposed that the work to address these objectives and actions is led by the Health and Wellbeing Board and the Community Safety Board and activity at both strategic and operational levels is reported at the Substance Misuse Strategy Group.

RESOLVED -      (i)     That the comments of the Board be noted.

                            (ii)    That the  ...  view the full minutes text for item HW54

Report of the Director of Public Health

The Board received a presentation on the evaluation of Live Well Gateshead.  An embedded researcher role was funded by Gateshead Council Public Health Team which aimed to provide qualitative evaluation of Live Well Gateshead, focus on what works for whom, which elements of the LWG model are effective in improving Health and Wellbeing and how, access to wide FUSE expertise / brokering links, developing the skills of the Public Health team in research and evaluation and inform the development of other public health interventions.

The underpinning principles of Live Well were that it fitted with the Council Plan, it was a mixture of group work and 1:1 and it targeted the 35% of the most deprived communities.

The research identified areas which hinders access including, awareness of the programme, embarrassment and fear (lack of confidence), privacy and dignity and gender sensitivity.

The Live Well Gateshead project increased knowledge and skills including changes of habits and attitudes, it improved mental and physical health and physical activity, it reduced social isolation and increased connectivity and access to funding and resources, however, there was some fragmentation.  

The evaluation has highlighted some recommendations:

·         Make use of the evaluation findings

·         Address gaps in monitoring data

·         Overcome fragmentation in the model to ensure co-ordination

·         Jobs/budget cuts/efficiencies

·         Links with AMT / transformation agenda / adult social care model

·         Staff morale at times of change

·         Use what we know works – collaboration

RESOLVED - That the presentation be noted.

Report of Newcastle Gateshead CCG

A report was presented to the Board to provide a briefing on the next steps for primary care co-commissioning.

Primary care co-commissioning is one of a series of changes set out in the NHS Five Year Forward View, Co-commissioning aims to support the development of high quality integrated out of hospital services based around the needs of local people.

In November 2014 NHS England released ‘Next Steps towards primary care co-commissioning’ offering CCGs the opportunity to take on additional responsibilities for the commissioning of primary care services.  There were three levels that CCGs could assume from 1 April 2015:

·         Level 1: Greater CCG Involvement in NHS England decision making

·         Level 2: Joint Decision Making (Joint Commissioning) by NHS England and CCGs

·         Level 3: CCGs taking on delegated responsibilities from NHS England

Newcastle Gateshead CCG undertook a process by which member practices voted for their preferred option.  The result of this vote was that the CCG would enter into Joint Decision Making with NHS England on 1 April 2015.  Since then, the Joint Committee has been established and business is being conducted via that forum.  A subsequent practice vote to move to level 3 was undertaken in October 2015.  Member practices voted to remain at level 2.

The CCG Executive are now seeking to move to co-commissioning level 3 with a member practice vote by 20 September 2016 after a members meeting on 13 September.  This will ensure sufficient time to engage member practices in the process.

RESOLVED -That the comments of the Board be noted and further updates be made available as and when they are required.

Report of the Strategic Director, Care Wellbeing and Learning

The Board was presented with an initial draft Forward Plan and meetings schedule to steer the work of the Board during 2016/17.

The Health and Wellbeing Board is in its fourth year as a statutory Board.  A draft forward plan has been developed to guide and shape the work of the Board during 2016/17.  It reflects issues which have been identified by the Board to-date and relates to 5 key areas of focus:

·         Strategy, policy development and commissioning intentions

·         Transformation agenda, integration and ways of working

·         Health and care service developments and reviews

·         Performance Management

·         Assurance Issues

An indicative timetable has been produced for these issues to come to the Board.  It also sets out potential items for consideration which have not been slotted into the meetings schedule.  These items are to be discussed with partners prior to the next meeting.

It is proposed by the September Board meeting to:

·         Confirm the ‘big issues’ which should form the core of the Board’s business during 2016/17, when they should come to the Board and the lead organisations

·         Identify any preparatory work that will need to be undertaken and/or arrangements put in place to facilitate this

A final draft 2016/17 Forward plan and supporting timetable will then be brought to the Board for endorsement on 9 September.

RESOLVED    -           (i)         That the comments of the Board be noted;

                                    (ii)         That the final draft Forward Plan 16/17 be brought to the Board on 9 September.

Report of Healthwatch Gateshead

The Board received a presentation from Douglas Ball, Chair of Healthwatch Gateshead.  He set out the vision and role of Healthwatch and how they give residents of Gateshead a voice by conducting research, asking for views, empowerment and information, consultations and representation and working with partners.

Healthwatch Gateshead encourage residents to input their views, and try and create good relationship with partners and stakeholders to work with them to ensure better health outcomes for residents.

Healthwatch Gateshead have held some major consultation events and produced reports from these to highlight any issues raised.

The team are small but also carry out signposting activities, including sending to volunteers programmes.

Some issues for residents include the number of consultations which are web based, this has a tendency to disenfranchise.  Often there can be glossy brochure confusions, people thinking it’s a done deal, rather than users being involved.

Gateshead Healthwatch future strategy is to:

·         Continue to promote prevention

·         Encourage commissioners and service providers to focus on the recipients

·         Represent residents views/concerns

·         Deliver agreed contractual obligations

·         Work with the North East Commission for health and social care integration

·         Work with Joint Integrated Care Programme Board to try and make the Sustainable Transformation Plan less institutional based

·         Promote wellbeing and self-responsibility

Healthwatch have some plans for future research to look at:

·         Housing and its impact on health and wellbeing

·         Issues around hospital discharge and social care provision

·         End of life practices in hospitals and care homes

·         Barriers to improving the health of children

RESOLVED - That the presentation be noted.

Report of the Strategic Director, Care Wellbeing and Learning

The Board received an update report on performance within health and social care to enable the Health and Wellbeing Board to gain an overview of the current system and to provide appropriate scrutiny.

An initial Performance Report was considered by the Board on 18 July 2015.  That report proposed a suite of indicators to form the basis for a Performance Management Framework for consideration by the Health and Wellbeing Board on a regular basis.

Because of the diverse range of indicators included in the Framework, the frequency with which metrics are updated.  The report included the latest available data for each indicator to be reported.

The Board should be re-assured that where there are areas which are showing as under-performing, there are plans in place to address this. 

Performance is strong overall in the children’s agenda, there has been a slight dip in GCSE results, an increase in the number of children on a Children Protection Plan, the number of looked after children has increased but the stability of placements I strong.

Adult Social Care is showing variable performance, in terms of A&E at the QE, they are a victim of their own success, although the vast majority of patients are Gateshead residents.

RESOLVED - That the information contained within the report be noted.

It was noted that there has been a decision regarding the outcome of the Deciding Together consultation, there will be in-patient beds in Newcastle which is a good outcome as opposed to patients and their families having to travel to Morpeth or Sunderland.

Congratulations were given to John and all of those who have worked on the BCF.

Friday 9 September 2016 at 10am