Apologies were noted. The Chair welcomed Andrew Pike to his first meeting of the Health and Wellbeing Board as Managing Director BTUH. 

To approve as a correct record the minutes of the Health and Wellbeing Board meeting held on 8 June 2018.

The minutes of the Health and Wellbeing Board meeting held on 8 June 2018 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 raised in advance of the meeting. 

There were no declarations of interest.

A verbal update will be provided to members

Mandy Ansell, Accountable Officer, Thurrock CCG provided members with a verbal update.  The following points were made:

·         All recommendations made in response to the STP consultation exercise had been passed by the CCG Joint Committee.   

·         A commitment has been provided that services continue to be provided in Orsett until they can be delivered elsewhere including within IMCs.

·         A People’s Panel is to be created to help inform the relocation of services and ensure continued community engagement.

·         It has been agreed that services provided to Thurrock residents by Orsett will remain available in Thurrock.

RESOLVED:  HWB members noted the update and provided comments.

Item to be presented by Rahul Chaudhari, Director of Primary Care, Thurrock CCG

Rahul Chaudari, Director of Primary Care, Thurrock CCG introduced this item.  Key points included:

·         Current high level modelling across the STP shows that there is an existing, and growing, demand and capacity gap for Primary Care services.  This is more prominent in Thurrock as one of the most under-doctored boroughs nationally.

·         5 CCGs across the Mid and South Essex STP footprint have developed a collective Primary Care Strategy.

·         A key part of the Strategy is to expand and change the primary care workforce so that there is a shift from a service that is GP delivered to one that is GP led.   A key priority is to recruit more GPs and nurses, but also a wide range of other professionals to provide multi-disciplinary teams in general practice.  Members were advised that a recruitment exercise was planned to Tilbury and Chadwell following workforce analysis that will create an additional 17 FTE posts, facilitating an additional 1500 additional appointments per week.

·         The Strategy also aims to accelerate progress in practices coming together to form localities covering populations of roughly 30-50,000 people.  Progress is being made with 8 practices having signed a MOU to collaborate.

·         Positive feedback has been provided by NHS England on the Strategy

During discussions the following points were made:

·         Members welcomed the Primary Care Strategy and would have welcomed additional references to Adult Social Care and interventions such as social prescribing.  It was also suggested that the Strategy could have been bolstered by referencing the management of Long Term Conditions and how treatment management of LTCs will provide cost savings for the system.

·         Members welcomed the focus on the preventative approaches outlined in the Primary Care Strategy.

RESOLVED: Health and Wellbeing Board members:

·         Noted and commented on Primary Care Strategy

Item will be presented by Roger Harris, Corporate Director Adults Housing and Health, Thurrock Council

Roger Harris, Corporate Director Adults Housing and Health introduced this item.  Key points included:

·         Thurrock invited the LGA to undertake the Peer Review and an expert team was assembled.  The Peer Review team undertook extensive consultations with staff, members, users, carers and third sector groups as part of their on-site investigations.

·         The review team identified following discussions with services users, third sector organisations and Thurrock Healthwatch that the demand for mental health support was growing but that people were finding it hard to access services when they wanted them.

·         Recent initiatives such as Inclusion Thurrock, the Recovery College and Local Area Co-ordination (although not specifically a mental health focussed offer) were getting very good feedback from service users but it was felt that the whole pathway need an external check and challenge to ensure that it was fit for purpose.

·         Some areas for consideration proposed by the Peer Review Team included:

o   Commissioners to develop an improvement plan in partnership with EPUT as a provider in Thurrock;

o   Develop joint commissioning arrangements between the Council and the CCG;

o   Commission for the “middle” of mental health needs; and

o   Create a Mental Health Programme Group, including children and transition, to ensure the elements of an improvement plan are coordinated to overcome current fragmentation of initiatives, including the JSNA recommendations.

During discussions the following points were made:

·         Members acknowledged that more needs to be done to ensure that individuals who do not meet thresholds for more formal mental health support can access support that is necessary

·         A Mental Health Operational Group has been established and there is merit in ensuring that Children’s Directorate are represented on the Group.

·         It is important to ensure that adolescent services support children through the transition to adulthood.  Members were informed that EPUT created a new protocol in January 2018 to support transition.

RESOLVED:  Health and Wellbeing Board members provided comments on the Mental Health Peer Review findings and agreed to a further report being considered at the Health and Wellbeing Board meeting in September 2018.

Catherine Wilson strategic Lead Commissioning and Procurement Adult Social Care

Irene Lewsey Head of Transformation Thurrock CCG will introduce the item to members

Catherine Wilson, Strategic Lead Adults Social Care Commissioning, introduced this item.  Key points included:

·         It is estimated that the number of people within Thurrock aged 65+ with dementia could increase by 75% between 2017 and 2030.  The 85+ age group have the greatest prevalence of dementia.  People in this age group with dementia more than doubles during this period from 660 to 1355

·         This strategy is for everyone in Southend, Essex and Thurrock who is living with dementia or supporting someone who is. It describes what we want support for people with dementia to look like in the future and it describes nine priorities for action to make this happen.

·         In order to deliver the Southend, Essex and Thurrock Dementia Strategy 2017 to 2021 it was agreed at the Essex wide implementation group that locality implementation plans should be developed.  The Thurrock Implementation Plan identifies each priority area noted above; the outcome to be achieved against that priority and the success measures that will evidence the priority has been met. Within the Thurrock Implementation plan we have identified some positive areas of working including:

o   The Alzheimer’s Society has developed our local Dementia Action Alliance.

o   The implementation of the Older Adult Wellbeing Service provided by North East London Foundation Trust (NELFT). This is a multi-disciplinary integrated approach to the care and support of older age adults including people living with dementia. The aim of the service is to support people to remain as independent as possible for as long as possible in their local communities and at home. This has proved to be very successful. The nurses within the team deliver Dementia Nursing support within our residential care homes and within the community.

o   Diagnostic services provided by Essex Partnership Trust (EPUT) and a clear pathway for referral post diagnosis to the Older Adult Well Being Service.

o   The Dementia Crisis Support Team has been extended so that the team can support individuals for longer at home in their own communities.

During discussions the following points were made:

·         Members welcomed the local action plan and the increased profile of dementia across Thurrock, Essex and Southend

·         Members welcomed the approach to considering individuals who fall through the net due to not meeting necessary thresholds to secure more formal support.

RESOLVED Health and Wellbeing Board members noted and agreed the Thurrock Implementation Plan for the Southend, Essex and Thurrock Dementia Strategy 2017 to 2021.

A PowerPoint presentation will be provided to members

Ian Wake Director of Public Health introduced this item, supported by Goal Sponsors.  Key points included:

·         The annual report is a stand-alone document that:

o   Explains the Health and Wellbeing Board’s function, membership and how it drives forward the development and implementation of the Health and Wellbeing Strategy;

o   Describes Thurrock’s Health and Wellbeing Strategy and reports year two key achievements; and

o   Sets out progress made against Key Performance Indicators, approved by the Health and Wellbeing Board in November 2018

·         All Early Years settings have achieved an Ofsted rating of good or outstanding.

·         76% of children achieved a good level of development at the end of the Early Years Foundation Stage, exceeding the trajectory target of 73% and the national average of 71%.

·         62% of children are achieved the national standard in Reading, Writing and Maths at the end of Key Stage 2, exceeding the trajectory target of 57%, consistent with the national average of 61%.

·         2.1% of 16/17 year olds are not in employment, education or training, achieving the trajectory target of 5%. This data is based on 16/17 year olds and therefore considerably exceeds the trajectory target that was set for 16-19 year olds.

·         The under 18 conception rate in Thurrock continues to decline year on year and 2018 target for 2016 conceptions (23.2 per 1,000) was achieved.

·         In 2015, 17.4 % of children are living in poverty (0-19 years) - exceeding our target of 19.28%.  

·         There were 3 Parks and Play sites improvement projects to encourage greater use during 2017/18.

·         52 % of adults aged 19+ are physical active achieving our target of 52%.

·         The number of micro enterprises operating in Thurrock is 55, exceeding the trajectory target of 25.

·         61.6 % of parents achieving successful outcomes from early intervention prevention parenting programmes. 

·         At the of June 2018 there have been 1050 families attached to the Troubled Families Programme with the target of 2525 families supported by the TF programme when it ceases in March 2020.

·         71% of GP practices have a CQC rating of at least “good’’ exceeding the trajectory target of 40%.  Overall CQC Rating of good achieved for BTUH. 

·         The percentage of children in year 6 that are measured as being overweight or obese in year 6 at school was 36.9% for school year 2016/17. The target for 2017 was to achieve 37% and for 2018 to achieve 36.5%.

During discussions the following points were made

·         Members welcomed that Thurrock has the 2nd fastest falling rate of teenage pregnancy across the country.

·         The outcome framework appears to measure participation for children at sixth form.  It was agreed that an additional Key Performance Indicator would be developed to measure attainment post sixteen for those students completing sixth form.

Action Children’s Directorate

·         It was agreed that Planning Directorate should consider planning for schools give due consideration to open spaces which can be utilised by schools and local communities

·         Consideration should be provided to creating a Key Performance Indicator that is outcome focussed for Local Area  ...  view the full minutes text for item 9.

Item will be introduced by Darren Kristiansen, Business Manager, Adults Housing and Health Directorate, Thurrock Council

Darren Kristiansen Business Manager Adults Housing and Health Directorate presented this item.  Key points included:

·         The revised Terms of Reference had:

o   Been subject to minor amendments to accurately reflect membership

o   Been amended to include the Board’s subgroups and governance arrangements

·         Members were asked to agree to delegate responsibility for responding to applications to consolidate pharmacies to Public Health on their behalf.

RESOLVED:  HWB members approved the refreshed Terms of Reference

Item to be introduced by Leigh Nicholson, Strategic Lead - Development Services,  Place Directorate, Thurrock Council

Leigh Nicholson, Strategic Lead, Development Services, Place Directorate will introduce the item as one of the joint Chairs of the Group.  Key points included:

·         The Health and Wellbeing Board’s Housing & Planning Advisory Group is a multi-agency group which considers the health and well-being implications of major planning applications, and provides advice and guidance on the health, social care and community impacts of proposed new developments.

·         The Advisory group comprises representatives from Thurrock Clinical Commissioning Group (CCG), NHS England (Essex Area Team), the Community and Voluntary Sector (Thurrock CVS), as well as Planning, Housing, Adults, Health and Commissioning, Public Health, Regeneration, Children’s Services and Essex Police.  It has a significant role in articulating the Health and Wellbeing Board’s vision and priorities in relation to housing and the built environment.

RESOLVED:  HWB Members:

·         Noted the work that HPAG has undertaken in the last year and the proposed work-plan for 2018/19

·         Agreed to the Terms of Reference and the proposal for an annual report to be provided to the Board in July of each year.

To consider and be provided with an opportunity to comment upon ICE minutes from meeting of 26 April 2018

RESOLVED:   Members considered and noted ICE minutes for meetings that took place in April 2018

To provide Board members with an opportunity to consider and inform the Board’s work programme

RESOLVED: The Board noted the future work programme.