To approve as a correct record the minutes of the Health and Wellbeing Board meeting held on 8 September 2017.

The minutes of the Health and Wellbeing Board held on 8 September were approved as a correct record.  

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972.

There were no urgent items provided in advance of the meeting. 

There were no declarations of interest.

Paper to be presented by NHS England partner

            Tom Abell, Deputy Chief Executive and Chief Transformation Officer, Basildon and Thurrock University Hospitals FT and Wendy Smith, Interim Communications Manager, STP, NHS England provided board members with an update on the STP.  Key points included:

·         During the engagement period over the summer concerns were raised by a range of stakeholders about proposals for all ‘blue light’ ambulances going to Basildon.  Proposals have now been revised which ensure ambulances continue to convey patients to their nearest A&E.  Once seen by doctors in the local A&E, stabilised, diagnosed and treated, patients would then either be: discharged; referred for follow-up treatment; admitted locally for further tests and treatment; or transferred if needed to a specialist team, which could be in a different hospital for some patients.

·         The three main hospitals (Basildon, Chelmsford and Southend) are now working together as a group and this offers opportunities to improve patient care by taking advantage of a greater scale for some services.

·         The Mid and South Essex STP is finalising a business case for potential service changes over the next five years, including proposals to reconfigure some hospital services.

·         It is envisaged that public consultation will commence at the end of October 2017. The business case and consultation plans will be presented to the national committee of NHS England on 4 October.

During discussions the following points were made:

·         It was recognised that the acute element of the STP is predicated on the success of a capital bid for financial resources being submitted to NHS by November 2017.  It is envisaged that a capital investment of £120million will be necessary in addition to between £20m - £30m for health and social care service provision.

·         The importance of ensuring that the public are provided with opportunities to engage and provide their views on STP proposals was reinforced by Board members.  The STP team provided a commitment to working with Thurrock CCG and Thurrock Healthwatch to ensure that the STP consultation exercise is meaningful and accessible for the people of Thurrock. 

RESOLVED:  Health and Wellbeing Board members noted the update and welcomed further progress reports at future meetings

Item to be presented by Helen Horrocks, Strategic Lead, Public Health

Helen Horrocks, Strategic Lead, Public Health provided Board members with a PowerPoint presentation.  Key points included:

·         The whole system obesity map set out within the Forsyth Report describes the complexity of tackling obesity and ensuring that more people are of a healthy weight which includes but is not restricted to the physical environment, cultural, social, physiological, economic and political drivers.

·         NICE reports that for every 1000 employees, obesity in employees equates to more than £126,000 a year in lost productivity.  In Thurrock, using a median hourly wage of £14.28 (NOMIS, 2016) and applying on-costs to the employer at 30%, this could result in up to £170,343.26 a year in lost productivity.

·         There appears to be a correlation between deprivation and obesity.

·         A number of recommendations have been made as part of the JSNA which include:

o   Shifting from treating the individual to promoting small lifestyles changes at a population level;

o   Considering the options around restriction of the proliferation of fast food outlets in Thurrock;

o   Ensuring the nutritional quality of food in early years settings and school remains high quality;

o   Improving the quality and quantity of local sport and leisure, green spaces and pitch and play provision;

o   Giving greater strategic focus to Physical Activity

During discussions the following points were made:

·         Board members welcomed the robust and comprehensive whole systems obesity JSNA and accompanying presentation.

·         It is important to ensure high quality parks and leisure facilities are available for Thurrock residents.  It was acknowledged that some of the high quality facilities are situated in more deprived parts of Thurrock. and that it is important that the facilities remain accessible to the public.

·         The merits of integrating and collocating future sport and leisure facilities alongside existing facilities were acknowledged by Board members. 

·         Board members agreed with the need to ensure that services are available to facilitate individuals being referred to services that are suitable for their specific needs.

·         Board members welcomed Public Health providing a commitment to work with education colleagues to identify how to increase the proportion of school children having school meals (currently 54%) and how to reduce a pack lunch culture where meals may have more limited nutritional value.

·         The importance of creating and sustaining links with relevant healthcare professionals was acknowledged by Board members.  It was agreed that Michelle Stapleton will consider relevant partners to engage within Basildon and Thurrock University Hospitals Foundation Trust and provide feedback to Public Health colleagues.

Action Michelle Stapleton BTUH and Public Health

·         It was agreed that Public Health should consider providing the whole system obesity JSNA presentation to the Headteacher’s Forum.

Action Public Health

RESOLVED: Health and Wellbeing Board members supported recommendations made in the JSNA for whole systems obesity and supported the report’s publication.

PowerPoint Presentation to be provided by Clare Culpin (BTUH).  Copies of the presentation will be made available in hard copy for members on the day

Clare Culpin Managing Director Basildon and Thurrock University Hospitals Foundation Trust provided Board members with a PowerPoint presentation.  Key points included:

·         The BTUH leadership team has a full complement of Directors to manage the hospital site, overseen by Clare Culpin.

·         A balanced score card has now been introduced to monitor performance on quality, workforce, finance and operations.  Performance is monitored on a monthly basis.

·         There has been a steady increase in the number of patients who have attended the hospital as emergency patients - an additional 18 patients per day including the weekends (Q1 this year compared to Q1 last year).

·         The cancer waiting list continues to reduce.  There are currently no patients waiting in excess of 104 days to receive treatment.

·         BTUH have considered resilience. Following a review of the entrances to the hospital it was established that patients end up being cared for in the safest space available rather than in a ward or department best suited to their needs. To address this, BTUH are creating more ‘front doors’ to stream patients more effectively and better facilitate patient flow. 

During discussions the following points were made:

·         Members received confirmation that BTUH is continuing to work towards achieving the target of 85% of patients receiving treatment for cancer within 62 days from the first referral.  

·         Board members welcomed progress that has been made in addressing issues raised by Thurrock Healthwatch about the quality of service being provided at BTUH.  Complaints that have been raised by Thurrock Healthwatch have been managed by advocates and feedback has been positive.

·         Board members learned that BTUH site leadership team focus on operational management of the hospital while the Joint Executive remain focussed on the strategic shift stimulated by the STP, ensuring that the three hospitals can continue to work closely together and align service provision.

RESOLVED:  Health and Wellbeing Board members welcomed the positive progress that has been made by BTUH with addressing concerns previously raised by Thurrock Healthwatch. 

Health and Wellbeing Board members noted the future work plan and proposed agenda items for future meetings.

            RESOLVED:  The Health and Wellbeing Board workplan was noted by members.