Venue: Committee Room 1, Civic Offices, New Road, Grays, Essex, RM17 6SL. View directions
Contact: Darren Kristiansen, Business Manager - Commissioning Email: Direct.Democracy@thurrock.gov.uk
To approve as a correct record the minutes of the Health and Wellbeing Board meeting held on 30 Jan 18.
As part of Welcome and Introductions the Chair noted apologies provided in advance of the meeting. The Chair acknowledged that the meeting was the last in the Municipal Calendar. The Chair wished to express his gratitude and thanked:
· All members of the Health and Wellbeing Board (HWB) who have engaged and all partners that have helped to make the Board a successful partnership.
· Tim Elwell-Sutton who is moving to new position and leaving Thurrock.
· The HWB Business manager.
The Chair made the following observations:
· The Board has considered over 3,428 pieces of paper during the Municipal Year.
· Thurrock has led way nationally over primary care reconfiguration.
· There has been a substantial increase in the diagnosis of high blood pressure. An additional 2500 people have now been diagnosed and will be receiving treatment.
· No changes will be introduced for Orsett Hospital as part of the Mid and South Essex STP, until all 4 Integrated Medical Centres have been built.
· The vast majority of residents of Thurrock appreciate the work of EPUT, NELFT, BTUH, HealthWatch, Thurrock CVS, Thurrock CCG and Thurrock Council and partners, despite concerns about personal abuse the Chair has experienced over Orsett Hospital proposals.
The minutes of the Health and Wellbeing Board meeting held on 30 January 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 provided in advance of the meeting.
Declaration of Interests
There were no declarations of interest.
Item to be presented by Jo Cripps Interim Programme Director and Claire Hankey, Interim Director of Communications
Jo Cripps Interim Programme Director and Claire Hankey, Interim Director of Communications provided members with a verbal update. The following points were made:
· The STP public consultation was launched on 30 Nov and the deadline had now been extended until 23 March.
· A range of materials and suite of documents have been made available that include supplementary documentation specifically focussed on proposals for Orsett hospital and an easy read STP consultation document. The STP consultation has a large online social media presence, is available on Facebook and also provides targeted information about the STP to specific geographical locations through paid advertisements.
· The consultation includes 15 large public events, small meetings with residents, an online survey and consultation documents. At least 600 people have attended the main consultation events and over 700 responses have been submitted to the online consultation. A telephone survey is expected to engage a further 700 individuals.
· Respondents to date tend to be within the age range of 36 – 65 years.
Early key themes that are emerging include:
· Clinical transport.
· Workforce and a transition in workforce requirements.
· Finance and access to Capital funds.
· Concerns have been raised about proposals for Orsett hospital.
· Concerns have also been raised that proposals will result in Southend hospital being downgraded.
The STP continues to engage strategic partners across the STP footprint, as demonstrated by the joint HOSC that has now been established and has met twice.
Next steps will include:
· An independent analysis of consultation responses, which will be provided to the STP programme team by a third party and is expected to be published on 8 May.
· The CCG Joint Committee will review proposals against consultation feedback and take decisions, expected early July 2018.
During discussions the following point was made:
· Healthwatch Thurrock and Healthwatch Essex have undertaken substantial engagement activity with students who are expected to respond to the consultation exercise.
Item to be presented by Maria Payne, Senior Public Health Programme Manager – Health Intelligence
Maria Payne, Senior Public Health Programme Manager – Health Intelligence presented the item to members. The following points were made:
· It is a statutory responsibility for Health and Wellbeing Boards to produce PNA and to update it every three years.
· The previous PNA was approved by Thurrock HWB in 2015
· The Pharmaceutical Needs Assessment (PNA) provides a comprehensive report on the needs for and provision of pharmaceutical services (as defined by legislation) in Thurrock. It will be used by NHS England to decide upon applications to open new pharmacies, change hours, relocate existing pharmacies or merge pharmacies, and will inform commissioners regarding the commissioning of pharmaceutical services.
· The PNA has been subject to public consultation which took place during October and December 2017. Consultation responses received were primarily submitted by professional stakeholders and contractors and tended to provide positive feedback on the pharmaceutical offer in Thurrock.
· The main finding of the PNA document was that the current number of pharmacies is sufficient to meet future pharmaceutical needs of residents over the lifetime of the document (3 years).
During discussions the following points were made:
· The quality of the PNA was welcomed by HWB members and the assessment will inform decisions about the pharmaceutical offer that will be provided in Integrated Medical Centres.
· It was reported that chemists do not appear willing to travel to rural areas to deliver or dispense medication and that residents in Bulphan, Orsett do not feel that there is sufficient provision of pharmaceutical services in their area. However, Board members learned that threshold levels which must be met to open new pharmacy have not been achieved.
· Board members acknowledged that while not within the PNA scope that staff turnover in pharmacies is quite high. It was suggested that the New Models of Care and Primary Care and a mixed skill workforce will provide opportunities to create closer links with pharmacies. Members welcomed opportunities to engage the pharmaceutical community and ensure that they have an opportunity to inform and engage in Thurrock’s transformation agenda.
· The availability of prescription medicine within pharmacies is managed by NHS England. Board members were concerned that prescription medication can often be out of stock locally but recognised that this is a national challenge.
RESOLVED: Health and Wellbeing Board members:
· Noted the contents of the PNA.
· Approved the publication of the document, thereby fulfilling its statutory obligation.
· Noted the upcoming closure of one pharmacy and the need for a future subsequent Supplementary Statement after publication of this document.
Item will be presented by Tim Elwell-Sutton, Assistant Director and Consultant in Public Health
Tim Elwell-Sutton, Assistant Director and Consultant in Public Health presented the item to members. Key points included:
· One in four people will experience a mental health condition at some point in their lives.
· The JSNA focusses on adult’s mental health. A children’s mental health JSNA is currently being developed.
· The JSNA provides a comprehensive assessment of mental ill health in Thurrock and considers the scale of the challenge, emerging trends, people likely to be affected and the causes and consequences of mental ill health.
· The JSNA identifies that there is fragmentation within the system and provides a strategic recommendation for improved integration of commissioning.
· Some challenges remain with quality of care that is provided to individuals experiencing mental ill health challenges.
· There is a huge variation between GP practices identifying mental ill health which is being addressed through the Long Term Condition profile card.
During discussions the following points were made:
· Members welcomed high quality, robust JSNA.
· Thurrock now leads the commissioning of Mental Health services for the STP footprint of mid and south Essex which has involved managing complexity between several CCGs, the County and partners. Structural Governance processes have been improved.
· The IAPT offer has been re-commissioned. However, Board members were concerned about the variation of GPs referring to IAPT.
· Roger Harris, Corporate Director for Adults Housing and Health agreed to table the JSNA at the Council’s Directors Board to ensure that its findings can be considered at a corporate level.
Action Roger Harris
· A peer review of mental health in Thurrock being arranged through the LGA in mid-June. Board members acknowledged that the current focus is provided specifically on people that meet thresholds and that some people fall through the gaps and cannot access services. Board members noted that personality disorders are not considered a mental health condition and were not referenced in the JSNA.
· Thurrock First has now employed a CPN mental health worker who is working alongside call centre staff as part of integrating services and supporting members of the public.
· A mental health summit focussed on children and young people’s mental health is being arranged. Board members recognised that providing high quality support during transition from adolescence to adulthood may improve outcomes and bridge the gap between children and adults mental health.
RESOLVED: The Board:
· Approved the contents of the JSNA document including the recommendations found in the report and that Board members use the contents and recommendations of this JSNA product to drive adult mental health commissioning strategy.
· Approved the publication of this JSNA document.
Commissioning Officer – Emotional Well Being and Mental Health
Paula McCullough, Commissioning Officer presented the item to members. Key points included:
· This is the third year of open up reach out and significant progress has been made. However, Thurrock has particular challenges and is ranked 3rd for all ten mental health risk factors (which include underweight and parents mental health).
· This year more schools outreach work is being undertaken with additional focus being provided on preventative activity.
· The Crisis Service is currently under review
· All contractors will be IAPT qualified by end of this year
During discussions the following points were made:
· Board members welcomed a proactive assessment of children’s mental health.
· It was suggested that 361 children in care are not subjected to mental health assessments until they are older and that the Strategy should clearly reference looked after children. Board members learned that from 1 December 2017 adoption panels have included a mental health practitioner. In addition, a looked after children health passport being developed by Thurrock CCG that includes mental health.
· A children’s and young people’s mental health summit is currently being organised. Thurrock Healthwatch previously engaged children and young people as part of considering the Health and Wellbeing Strategy Goal Better Emotional Health and Wellbeing. It was agreed that the report will be provided to colleagues as part of informing the mental health summit.
· Public health colleagues are in the process of developing a Thurrock specific JSNA. The SET collaborative commissioning forum, responsible for the production of “Open Up, Reach Out” commissioned a Joint JSNA covering the geographical locations of Thurrock, Southend and Essex in 2015 and this is refreshed on an annual basis.
RESOLVED: The HWB endorsed the refreshed five year transformation plan ‘Open Up, Reach Out’,
To note minutes of ICE meetings of November 2017 and 25 January 2018. To note the Health and Wellbeing Board Executive Committee minutes of 8 February 2018
RESOLVED: Members noted the Integrated Commissioning Executive (ICE) minutes for meetings that took place in December 2017 and 25 January 2018. Members noted the Health and Wellbeing Board Executive Committee minutes and action points arising at the 8 February 2018 meeting.
RESOLVED: The Board noted the future work programme.