To approve as a correct record the minutes of the Health and Wellbeing Board meeting held on 15 September 2016.

The minutes of the Health and Wellbeing Board held on 15^th 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.  Councillor Halden reminded members that Thurrock Council’s constitution requires Health and Wellbeing Board members to complete a declaration of interest form as this is a Committee of the Council.   Members who have not returned their declaration of interest forms were asked to do so.

Item to be presented by Ian Wake using a Microsoft PowerPoint presentation.

Later papers published

Ian Wake, Director for Public Health, provided Board members with an overview of the Annual Public Health Report which included:

·         Acknowledging that Thurrock comprises an ageing population and that the proportion of older people in Thurrock is set to increase, placing increased pressure on Adult Social Care services.

·         That the annual deficit in hospital and local authority funding is increasing and is made worse by an unsustainable increase in unplanned hospital activity and an over-reliance on agency staff to maintain clinical and operational safety

·         A whole system approach is necessary which considers the most cost-effective system wide solutions to reduce demand on the most expensive parts of the system.

During discussions the following points were made:

·         It is important to raise awareness of challenges faced across Thurrock through the Annual Public Health Report (APHR)

·         Health and Wellbeing Board members were reminded that Domiciliary Care was currently experiencing challenges to recruit enough carers to meet demand, resulting in poor care being provided in some areas.

·         It is important to understand patient pathways as part of creating a whole system approach and ensuring that patients are supported by the most appropriate services.

·         Patients should be engaged to ensure that they use the health service in the most appropriate way, supporting effectiveness and timely service provision.  Practitioners and patients should be deferred from referring and accessing accident and emergency services unless absolutely necessary.

Action Plans and copies of presentations are included within papers. 

Microsoft PowerPoint presentations to be provided as follows: 

Action Plan and presentation for objective C1:  Give parents the support they need

Sue Green

Action Plan and presentation for objective C2:  Improve children’s emotional health and wellbeing

Malcolm Taylor / Helen Farmer

Action Plan and presentation for objective C3:  Reduce isolation and loneliness

Les Billingham

Action Plan and presentation for objective C4:  Improve the identification and treatment of depression, particularly in high risk groups

Funmi Worrell

Roger Harris introduced the item as corporate sponsor for Goal C by explaining that the Health and Wellbeing Strategy contains five Strategic Goals.  The Item in Focus for this meeting Goal C (Better Emotional Health and Wellbeing), comprises four objectives:

·         C1 Give parents the support they need

·         C2 Improve the emotional health and wellbeing of children and young people

·         C3 Reduce social isolation and loneliness

·         C4 Improve the identification and treatment of depression, particularly in high risk groups.

Action Plan C1 was presented by Sue Green, Strategic Lead Children’s Commissioning and Service Transformation.  During the presentation the following points were made: 

·         There are a range of support services available across agencies including evidence based, accredited parenting programmes.

·         Demand for commissioned Early Offer of Help services outstrips supply.  Parenting support is provided for 180 places and there is currently a waiting list of 60 places.

·         273 families are being worked with as part of the Troubled Families programme, working towards the 2016/17 target of 370 families

·         140 parents per year who have been subjected to domestic abuse and violence are accessing support to improve parenting capacity through awareness, resilience building and safety and support planning

During discussions the following points were made:

·         The joined up multi-agency approach being adopted to provide holistic support to families was welcomed and endorsed by Board members.

·         Board members acknowledged the benefits of preventative focussed support for families and how the early offer of support through parenting programmes reduced the likelihood of statutory service support being required.

·         It was agreed that specifications would be explored for commissioned services to ensure support is available in the community and easily accessible to families in Thurrock

Action Sue Green

Action Plan C2 was presented by Malcolm Taylor Strategic Lead - Learner Support and Helen Farmer, Senior Commissioner for Children, Young People and Maternity Services, Thurrock CCG. During the presentation the following points were made:

·         1 in 10 children will be identified with a mental health disorder during their childhood

·         75% of conditions experienced in childhood continue through a child’s life as they become adults.

·         Young people that experience mental health challenges achieve lower educational outcomes

·         The local Transformation Plan Open Up, Reach Out describes how Thurrock now provides a single integrated service across seven localities, providing increased access to services.

·         Schools will be helped to support children at risk of suicide or self-harm by continuing to receive ongoing support provided by Thurrock Council in partnership with NELF and that guidance will be distributed to schools by March 2017

During discussions the following points were made:

·         The limited opportunity for young people to access support for bullying was acknowledged and the work being taken forward in partnership with Public Health was welcomed by Board members.

·         It is important to effectively manage the transition between children and adult services to ensure that support is sustainable for individuals

Action Plan C3was presented by Les Billingham, Head of Adult Social Care and Community Development.  During the presentation the following points were  ...  view the full minutes text for item 5.

ESR / STP Update Item paper to be accompanied by Microsoft PowerPoint Presentation provided by Andy Vowles

Key Principles for ESR / STP to be presented by Councillor Halden

Cllr Halden, informed Board members about the key principles document that has been agreed between himself as Chair of Thurrock Health and Wellbeing Board, and Cllr Salter and Cllr Butland as respective Chairs of Southend and Essex Health and Wellbeing Boards. 

Cllr Halden explained that the key principles aimed to ensure that:

·         Any Sustainability and Transformation Plan proposals are reported to the appropriate Health and Wellbeing Board(s), particularly those that directly affect the planning, commissioning and provision of health and social care services

·         Solutions and services would be aggregated up where it makes sense not the other way round. Pan-STP working should be against clearly defined principles and certainly not the default position.

·         There is a democratic input and voice into the process through Health and Wellbeing Overview and Scrutiny Committee, Cabinet and the Health and Wellbeing Boards.

Andy Vowles, Programme Director, Essex Success Regime provided the Board with an update on the Essex Success Regime (ESR) and the Mid and South Essex Sustainability and Transformation Plan (STP).   In summary:

·         The key principles agreed by Thurrock, Southend and Essex Health and Wellbeing Board Chairs are welcomed by Dr Donley (Chair of the STP) and will be shared at the next STP Board meeting.

·         The timeline has been amended with public consultation on the STP/ESR likely to commence in May 2017.

·         There is likely to be some pump priming funding made available to support areas next year.  Budgets are currently being determined at a national level and transformation funds will be administered by NHS England.

During discussions the following points were made:

·         Members agreed that Ian Wake would work with Roger Harris and his Directorate Management Team and with Mandy Ansell, Jeanette Hucey and Mark Tebbs from Thurrock CCG to develop a business case as part of developing the ‘Thurrock Ask’ and funding that will be necessary to support the STP/ESR Transformation. 

Action Ian Wake

·         Concern was raised about NHS England not responding to speculative press articles adversely presenting the ESR/STP.  Board members were advised that misplaced speculation will be addressed through the publication of the STP, providing transparency for the public.

·         Concern was raised that Adult Social Care did not appear to be featured predominantly enough within the STP

RESOLVED:

The update was noted and the Board agreed to continue participating in discussions within the Mid and South Essex Success Regime and STP engagement and consultation programmes, which include stakeholder meetings and meetings of the Essex, Southend and Thurrock Health and Wellbeing Boards.

Health and Wellbeing Board members endorsed the key principles presented by Cllr Halden.

The current work programme for the Health and Wellbeing Board was noted.

Item to be presented by Jane Itangata

Jane Itangata (Senior Commissioning Manager – Mental Health and Learning Disabilities, Thurrock CCG) provided the Board with an update.  In summary:

·         Nine out of ten adults with mental health problems are supported in primary care. Whilst there is significant expansion in access to psychological services since the introduction of the national IAPT programme (Improving Access to Psychological Therapies) there is still considerable variation in services with waiting times varying from 6 to 124 days.

·         The CCG, Local Authority and Public Health commissioners are working together on developing a Mental Health Joint Strategic Needs Assessment product that will inform the Thurrock Implementation Plan of the Essex, Southend and Thurrock Mental Health Strategy and this will be aligned to Thurrock’s Health and Wellbeing Strategy.

·         A psychological therapies’ service for people with Long-Term Conditions has now been commissioned and is embedded in teams in the community. The service has also been skilling up other professionals e.g. District Nurses in screening for depression and anxiety as part of core patient care and ensuring support is provided as flexibly as possible.

·         In response to sign up to the Crisis Care Concordat in December 2014, a Pan Essex Crisis Care Concordat multi-agency group (now Urgent Care Mental Health – UCMH) was set up to take forward the mandate of addressing the gaps in service for managing people in a mental health crisis.

RESOLVED:

The Health and Wellbeing Board noted the content of this report that defines Thurrock’s response to the recently published recommendations of the “Five Year Forward View for Mental Health” strategy and subsequent “Implementing the Five Year Forward View for Mental Health” guidance.

The Health and Well Being Board noted the progress of the work on the Mental Health Crisis Care Concordat – development of the approach to a 24/7 Mental Health Crisis Response pathway.

RESOLVED:

            The minutes of the Integrated Commissioning Executive were noted.