Solihull Health & Wellbeing Board - 29 March 2016
Solihull Health & Wellbeing Board
29 March 2016
Present: / Councillor KMeeson (Chair)Dr Anand Chitnis- Solihull Clinical Commissioning Group (CCG)
Dr Patrick Brooke- Solihull Clinical Commissioning Group (CCG)
Sally Hodges - Director for Children's Services and Skills
Sue Davis - Chair, Birmingham and Solihull Mental Health Foundation
Trust
Anne Hastings- Voluntary and Community Sector
Chief Superintendent Alex Murray - West Midlands Fire Service
In Attendance:
Christine Howell – Solihull Clinical Commissioning Group (CCG)
Tina McGrath – Interim Assistant Director forEarly Years
Faisal Hussain – Head of Community and Voluntary Relations
Tony Griffin - Interim Assistant Director for Children’s Services
Karen Murphy – Assistant Director Planning, Performance and
Commissioning
Sangeeta Leahy – Senior Public Health Specialist
Liz Kiely – Democratic Services Officer
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1. Apologies
Councillor Windmill, Jacqueline Aldred and Dr Neeta Manek (Healthwatch), Louise Minter (Strategic Accountability Board), Dave Smithson (West Midlands Fire Service), Ian James (Director of Communities and Adult Social Care) and Dr Stephen Munday (Director for Public Health and Commissioning).
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2. Declarations of Interest
Sue Davis (Chair, Birmingham and Solihull Mental Health Foundation Trust) declared an interest in Agenda Item 11- Partner Updates with reference to the Extension of SIAS Contract.
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3. Minutes Of Meeting HELD ON 26 January 2016
The minutes of the meeting held on 26 January 2016 were submitted.
RESOLVED:
The minutes of the meeting held on 26 January 2016 were confirmed as a
correct record, subject to the following amendments:-
· The sixth paragraph of minute 4 – HEFT – Quality of Care to read:
“from the North being treated at Heartlands Hospital” not “being
referred to”.
· The seventh paragraph of minute 4 HEFT- Quality of Care to read :
“signing off on all complaints” not “singing of on”.
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4. Health and Wellbeing Board Strategy 2016 - 2019
The Senior Public Health Specialist presented the revised format for the Solihull Health and Wellbeing Strategy 2016-2019. She advised that the four priorities would focus on two broad themes and would include new initiatives, as well as ‘business as usual’. There would also be a Scorecard which would be outcome focussed.
The Board noted that the revised Strategy would be subject to a period of extensive consultation which would commence after purdah.
The Senior Public Health Specialist reported that the revised draft did not incorporate the ICASS scorecard as a separate item. Members felt that as the Board had overall responsibility for the operation of ICASS a scorecard be submitted to the Board as a standing item.
In response to question, the Senior Public Health Specialist advised that mental health had been referenced under Best Start in Life as well as being mentioned under Alcohol and Dementia.
Dr Chitnis suggested that it would be beneficial to split those issues which were specific to Solihull from those which were wider spread, such as childhood obesity. Similarly, it would be helpful to identify what had been achieved and what the Board still wanted to achieve.
RESOLVED:
(i) That the draft Solihull Health and Wellbeing Strategy for 2016-2019 be noted and approved, subject to the points raised by the Board being incorporated and the outcome of consultation with stakeholders being undertaken after ‘purdah’
(ii) That the final version of the Strategy be submitted to the next Board meeting for approval
(iii) That ICASS continue to report to the HWBB via a quarterly scorecard.
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5. Sustainability and Transformation Plan
Dr Brooke presented a report on the Sustainability and Transformation Plan and the impact on the Birmingham Health and Social Care system. He advised that both NHS providers and commissioners were required by NHS England to produce two separate but linked plans:
· A five year Sustainability and Transformation Plan place based and driving the Five Year Forward View, covering October 2016 to March 2021
· One year Operational Plan for 2016/17 organisations based but consistent with the STP.
Dr Brooke reported that the STP was linked to the allocation of transformation monies from NHS England and that the monies would be allocated following an assurance period. Mark Rogers, Chief Executive of Birmingham had been appointed as System Lead for the STP, which was based on a Birmingham/Solihull footprint. His role was anticipated to be one of a ‘critical friend’ and would be supported by an independent chair of the Chief Executive’s Group.
The Board noted the proposed governance framework with resources having been identified in the form of a Programme Director and Governance Lead. Work had also commenced to try to identify funding gaps and actions required, this would include programmes around ICASS and the Better Care Fund.
The first submission of the STP was due in April 2016 which would be followed by the submission of a robust Plan in June 2016.
Members generally expressed concern over the haste in which this had been done and the need to ensure that Solihull was not side-lined. It was also stressed that Solihull had a very different and distinct profile which should be reflected in any arrangements.
Dr Brooke advised that in order not to lose sight of the transformation plan an STP Plus was likely to be created in order to focus on the Greater Birmingham and Solihull LEP (GBSLEP) requirements regarding hospital expansion related to population growth and UK Central.
The Chairman referred to the role of Independent Chair and asked whether this position would be advertised. Dr Brooke explained that this post had been funded by Birmingham City Council based on selection of someone of sufficient standing and experience who could focus the Group on what they needed to deliver.
The Chairman drew attention to the Statutory Role of Health and Wellbeing Board’s and referred to discussions which he had had with both the Chief Executive of Birmingham City Council and Chair of Birmingham’s Health and Wellbeing Board. These had highlighted significant differences in the scope and way each Board operated. He also stressed the need for activities and implications arising from the STP to be included on the Health and Wellbeing Board’s agenda’s.
Dr Chitnis also pointed out that the CCG had statutory responsibility for commissioning healthcare for patients and there needs to be clarity around how this was recognised in any new arrangements.
RESOLVED:
(i) That the updates on the Sustainability and Transformation Plan be noted and further regular updates be presented to the Board.
(ii) That the arrangements recognise the statutory responsibilities of
HWBB’s and CCG’s.
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6. Better Care Fund 2016/17
Christine Howell from the CCG reported on the draft Better Care Fund Plan for 206/17. The national guidance had only recently been published and the short time-scale for submission of the BCF Plan was extremely challenging. She advised that this year there were eight conditions attached to the Plan and that Condition 7 had changed from last year in that the performance related element to payment had been removed. The BCF Local Plan had to identify how it would reduce emergency hospital admissions and secure the necessary out of hospital services to help achieve this. A risk share agreement was required to share the financial burden should the target of admissions not be met.
The Assistant Director for Commissioning reported that much of the work was already underway in the form of projects or schemes in the ICASS programme or Urgent and Emergency Care Vanguard. Work had also commenced on a Plan for Reducing Delayed Transfer of Care with discussions being held to try to understand the problems and set targets. There was also a separate piece of work being undertaken to look at issues around re-admissions. The Assistant Director reported that Governance for these projects would continue as at present with additional reporting through the Joint Commissioning Board as appropriate. The Joint Commissioning Board would also retain oversight of the use of pooled funds in the Better Care Fund Plan.
The Board noted that there had been concerns expressed amongst providers about the safety of patients being discharged back into Care Homes too early in their recovery process. Too often this resulted in people having to be readmitted to hospital and the Assistant Director confirmed this was an issue being discussed with hospital manamement.
The Assistant Director suggested that updates be provided to each Health and Wellbeing Board with a more detailed progress report after six months.
In relation to the Vanguard Value Proposition, the Assistant Director reported that any additional Vanguard funding would help ensure that projects were able to be progressed more quickly, if funding was not forthcoming then changes would need to be made in terms of what was included in the Fund.
Christine Howell advised that due to budget deficits being identified by Partners there was a likelihood that they would come out as being High Risk which would mean that they would be classed as Assured with Support or Not Assured. Given the financial position there was only a slight chance of being ranked as Assured.
The Chairman expressed concern about the delays in the receipt of information NHS England and the short timescales for responses. This meant that officers of the Council and the CCG had been faced with an unreasonable amount of detailed work in order to meet the submission deadline and some of the Plan still had to be finalised. The Chair of Birmingham and Solihull Mental Health Foundation Trust suggested that if any changes were required prior to submission deadline these be delegated to the Chairman in consultation with the Vice Chair for final approval.
Dr Chitnis suggested that for ease of reference any changes were clearly set out.
RESOLVED:
(i) That the direction of travel indicated in the draft BCF Plan, be approved, subject to the Chairman of the Solihull Health and Wellbeing Board in consultation with the Vice- Chair being authorised to approve any changes that may be forthcoming prior to submission of the final plan.
(ii) That the Cabinet Member for Health and Wellbeing approve the final sign off on 13 April 2016 prior to the submission deadline of 25 April 2016.
(iii) That a detailed report be submitted to the HWBB in the autumn with an update.
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7. Healthwatch Solihull Position Statement and Planned Next Steps
The Head of Community and Voluntary Relations provided the Board with a position statement and planned next steps in relation to Healthwatch. He reported that a Shadow Board was formed on 1 November 2012 to replace the former Links and this then guided the development of the new local organisation known as Healthwatch Solihull. A contract was awarded to Healthwatch Solihull and commenced on 1 April 2013, initially for a two year period with the option to extend for a further two years subject to achieving set levels of performance targets and measures.
Healthier Communities Scrutiny Board received annual reports, as part of the performance cycle over the last three years and whilst this showed that Healthwatch Solihull was meeting some of its performance measures, some key areas of activity were well below expected levels. The Council extended the contract for one year from April 2015 to 31 March 2016 even though there had been known key performance issues.
The Head of Community and Voluntary Relations reported that over the last 18 months Healthwatch Solihull (HWS) had gone through regular cycles of poor performance which had been compounded by not having a Chief Executive in post to provide the necessary leadership required to turn things around and take the organisation forward for the benefit of the local people. .Although the Healthwatch Solihull Commissioner invested additional time and effort to assist the organisation and its Board, this only resulted in superficial improvements and the deep rooted issues remained.
On that basis briefings were held with key stakeholders and recommendations were formulated for the contract with Healthwatch Solihull not to be extended when the current contract expired on 31 March 2016. Following endorsement by the Procurement Board on 15 December, Healthwatch Solihull was formally advised of that decision on 18 December 2015. Subsequently, Healthwatch had been issued with a Transfer Plan and Exit Strategy to help facilitate a smooth close down of the contract by 31 March 2016.
The Head of Community and Voluntary Relations explained that the decision to terminate the contract had not been taken lightly but it provided the opportunity for the Council and partners to assess how healthwatch functions could be effectively delivered in the longer term. To this end it was proposed not to rush to put out a new tender and secure a new contract quickly, but rather to take time to learn from experiences to date, look at best practice from elsewhere and review the options with key stakeholders. This had been discussed with Healthwatch England (which licensed local Healthwatch bodies) and with the
Local Government Association.
To this effect, a workshop with voluntary sector groups had been held recently and had been well received. An option was to appoint one organisation as the lead body but with delivery of element by different partners.
The Chairman explained that whilst HWS had been committed to delivering on its obligations, there had been difficulties early on with the loss of its Chief
Executive and subsequent staffing and Board issues. He had met with the Board and officers had given considerable support but had to look at how Healthwatch Solihull was delivered in the future. Anne Hastings advised that she was aware of the difficulties, although Healthwatch had appeared to be working well in the last year and this was due to Community involvement.
Dr Chitnis advised that there was a need to take stock of all the service providers and service users that the Council had, and to work with them to see whether they have any views as to how Healthwatch could be run in the future.
The Head of Community and Voluntary Relations advised that one of the recommendations of the Scrutiny Board was that they would like to see Member representation at Healthwatch.
Chief Superintendent Murray advised that he would welcome the idea of community involvement and suggested that it might be helpful to have a Citizens Champion who would be able to hold the Board to account.