Health and Wellbeing Board 14 June 2013

Venue:  Function Room 1, Civic Centre, Scunthorpe

Time:  2.00 pm

AGENDA

1.  Welcome and Introductions.

2.  Substitutions.

3.  Declarations of Disclosable Pecuniary Interests and Personal or Personal and Prejudicial interests.

4.  Appointment of Vice – Chairman.

5.  North Lincolnshire Health and Wellbeing Board Governance and Accountability Arrangements – Report by the Director of Policy and Resources, North Lincolnshire Council.

6.  North Lincolnshire Joint Strategic Needs Assessment – Report by the Director of Public Health, North Lincolnshire Council.

7.  North Lincolnshire Joint Health and Wellbeing Strategy 2013/2018 – Report by the Director of Public Health, North Lincolnshire Council.

8.  NHS North Lincolnshire Clinical Commissioning Group Commissioning Plan 2013/2014 – Report by the Chief Officer, – Clinical Commissioning Group.

9.  Section 75 Partnership Agreement to underpin more integrated commissioning between the Clinical Commissioning Group and North Lincolnshire Council – Joint Report by the Director of People, North Lincolnshire Council and the Chief Officer, Clinical Commissioning Group.

10.  Winterbourne View: Transforming Care and Winterbourne Concordat – Joint Report by the Director of People, North Lincolnshire Council and the Chief Officer, Clinical Commissioning Group.

11.  Healthwatch North Lincolnshire Update – Report by the Chief Executive, New Horizons.

12.  Expression of Interest to become a Pioneer to Deliver Integrated Services – Joint Report by the Director of People, North Lincolnshire Council and Chief Officer, Clinical Commissioning Group.

13.  Dates and Times of future meetings –

3 September, 2013 – 2.00 p.m.

10 December, 2013 – 10.00 a.m.

25 March, 2014 – 2.00 p.m.

Any other items which the Chairman decides are urgent by reason of special circumstances which must be specified.

MINUTES

PRESENT:  Councillor Waltham in the chair.
Statutory Members
A Cooke, F Cunning, S Driver, D Hyde and T Smith

Non-Statutory Members

K Alcock-Murtagh, C Bain, C Blacksell, K Fridlington, D Hall, K Jackson, A Orrey, A Tyrell, A Usher and G Lusty

Councillors Whiteley and Wilson attended the meeting in accordance with Procedure Rule 1.36b.

D Gillon, R Mell, J Poole and S Twemlow also attended the meeting.

The meeting was held at the Civic Centre, Scunthorpe.

1.  WELCOME AND INTRODUCTIONS – The chairman welcomed all those present to the first meeting of the fully constituted board, and invited all members and officers to introduce themselves.

2.  DECLARATIONS OF DISCLOSABLE PECUNIARY INTERESTS AND PERSONAL OR PERSONAL AND PREJUDICIAL INTERESTS – There were no declarations of interests.

3.  APPOINTMENT OF VICE-CHAIRMAN – Resolved – That A Cooke be and she is hereby appointed vice-chairman of the board.

4.  (1)  NORTH LINCOLNSHIRE HEALTH AND WELLBEING BOARD GOVERNANCE AND ACCOUNTABILITY ARRANGEMENTS – The Director of Policy and Resources submitted a report which referred to decisions taken by the cabinet (minute 1020 refers) and council at its annual meeting (minute 2181 refers) to establish a Health and Wellbeing Board in accordance with the Health and Social Care Act 2012. The statutory minimum functions of the board were also set out in the report, which reiterated that further functions could be given to the board in line with local circumstances.

The Director in his report reminded board members that as the board was a committee of the council it would be governed by the council’s procedure rules, and that any necessary changes to the council’s constitution and procedure rules should be made to reflect the board’s establishment as a committee of the council. Also attached as appendix to the report was a proposed Memorandum of Understanding which outlined the statutory basis and the council’s commitment to working to fulfil the key obligations as set out in the Health and Social Care Act 2012, and to improve health and wellbeing outcomes for the people of North Lincolnshire. The Memorandum of Understanding detailed all the working arrangements for the board, including those that were included in the council’s Constitution, and set out the current membership and all necessary details of how the board would function, including its Terms of Reference.

Resolved – (a) That the decision of the council to establish the board as a committee of the council to discharge its statutory core functions from 1 April 2013 be noted, and the membership of the board be acknowledged, and (b) that the governance and accountability arrangements and working arrangements, as outlined in the previous reports to cabinet and council, and set out in the Memorandum of Understanding attached as appendix, be endorsed.

5.  (2)  NORTH LINCOLNSHIRE JOINT STRATEGIC NEEDS ASSESSMENT – The Director of Public Health submitted a report reminding members that the Health and Social Care Act 2012 gave the board specific functions which included the requirement to prepare a Joint Strategic Needs Assessment (JSNA) which was a duty of local authorities and Clinical Commissioning Groups, together with a Joint Health and Wellbeing Strategy (JHWS). JSNAs were local assessments of current and future health and social care needs that could be met by local agencies. They were unique to the area and should encompass current and future health and social care needs of all ages across the life stages, including a rigourous analysis of children and young people’s needs. JHWSs were prepared to meet the health and social care needs identified in the JSNA. The strategy was produced by the Health and Wellbeing Board and set priorities for joint action to tackle needs identified in their JSNA which made a real impact on people’s lives across all life stages.

The Director in her report described the current process for refreshing the JSNA which had been underway since 2012 and considered by key partnerships, boards and groups. The shadow board at its meeting on 23 October 2012 had agreed the JSNA in principle, subject to inclusion of further information identified in the report. Those changes had now been made by the Joint Strategic Assessment (JSA) Working Group in collaboration with wider colleagues, and the group had undertaken work to develop the JSNA suite of documents which included –

  • JSNA Executive Summary
  • JSNA Evidence Base
  • Summary Document
  • Infographic Sheets for each of the life stages, population, place and vulnerable groups
  • Stories across all life stages, and
  • Presentation

The above documents were attached as appendices to the report, and the Director responded to members’ questions on their content.

Resolved – (a) That the final version of the JSNA be accepted and the suite of documents listed above be acknowledged; (b) that the dissemination of the information and key messages be supported, and (c) that the board receive updates and recommendations from the JSA Working Group as appropriate.

6.  (3)  NORTH LINCOLNSHIRE JOINT HEALTH AND WELLBEING  STRATEGY 2013/2018 – The Director of Public Health submitted a report  requesting the board to consider and approve the draft Document 1 – Joint Health and Wellbeing Strategy (JHWS) and draft Document 2 – JHWS  Reference/Technical Document, attached as appendices, and to agree a timeframe for further development of draft Document 3 – Priority Action Delivery Plans.

The report set out the statutory requirements for the development of a ‘joint health and wellbeing strategy’ and summarised work carried out following Health and Wellbeing Board (HWB)/ partnership consultation, development and networking events, which had provided evidence to identify six Priority Outcomes. Subsequently, five Priority Actions had been identified for partnership action under the auspices of the JHWS with clear links to the priority outcomes. The five priority actions were set out in the report and focussed upon adding value. All actions were agreed in partnership with the exception of priority action 1, which was a late addition, and was based on feedback from members of the board during the draft consultation period.

Resolved – (a) That the draft Strategy (including Document 2 – Reference/Technical Document), Priority Outcomes and the five Priority Actions be approved, noting that it will be complete and ready for wider distribution by 30 June 2013; (b) that the Delivery Plans (Document 3) be presented to the next meeting of the board, along with a completed Integrated Impact Assessment, and (c) that Health and Wellbeing Board members take responsibility for the engagement of lead commissioners and key decision makers within their organisations.

7.  (4)  NHS NORTH LINCOLNSHIRE CLINICAL COMMISIONING GROUP COMMISIONING PLAN 2013/14 – The Chief Officer, Clinical Commissioning Group (CCG) submitted a report informing the board that the final draft commissioning plan for 2013/14 had been approved by the NHS North Lincolnshire CCG Committee on 14 March 2013, subject to finalisation with NHS England North Yorkshire and Humber Area Team. The final version had been submitted to them on 6 April 2013 in line with national timescales. The plan had been developed taking into account the JSNA and the draft JHWS and set out the CCG’s vision for services responsible for, with plans to use the resources allocated by NHS England, and actions planned in 2013/14.

The Chief Officer CCG in her report confirmed that CCG’s were also expected to produce a prospectus setting out their plans for the local population and stakeholders, which should be agreed by the local Health and Wellbeing Board, and had been published on line by the required 31 May 2013 deadline.

CCG plans, which had taken into account the JHWS, were set out in the following appendices to the report –

  • Appendix A – ‘Plan on a page’ a one page summary of the CCG’s strategic aims and priorities for 2013/14 contained with the Commissioning Plan;
  • Appendix B – ‘Prospectus’ providing a fuller summary of the CCG’s plans and published to provide a clear guide for stakeholders and the public, and
  • Appendix C –  the full Commissioning Plan 2013/14.

Resolved – (a) That the CCG plans for 2013/14 be received; (b) that the published ‘Prospectus’ at appendix B of the report be endorsed; (c) that the board is assured that the CCG’s plans take account of the JHWS, and (d) that the CCG be supported by the board in their delivery of their plans.

8.  (5) SECTION 75 PARTNERSHIP AGREEMENT TO UNDERPIN MORE INTEGRATED COMMISSIONING BETWEEN THE CLINICAL COMMISSIONING GROUP AND THE LOCAL AUTHORITY IN NORTH LINCOLNSHIRE – The Director of People and Chief Officer, Clinical Commissioning Group submitted a joint report setting out proposals for joint commissioning between the Clinical Commissioning Group (CCG) and the local authority, together with the legal proposed partnership agreements that would underpin them, including the use of a revised partnership agreement under Section 75 of the National Health Service Act 2006.

The joint report explained that one of the core functions of the Health and Wellbeing Board was to encourage closer integration between the commissioners of health and social care.  Section 195 of the Health and Social Care Act (HSC) 2012 specifically identified the role of the board to support the use of Section 75 partnership agreements to support effective integration. This was detailed in appendix 1 of the report.

Also, there was an established commitment to partnership working in North Lincolnshire between health commissioners (Primary Care Trust up to March 2013 / from April 2013 CCG) and North Lincolnshire Council. This work had been underpinned by a Section 75 Partnership Agreement. The current partnership agreement however did not reflect the new HSC Act framework and expectations, and it no longer met partners’ requirements.  In lieu of this, a new partnership agreement was required to reflect the new governance arrangements.

Consequently, in order to reflect new governance arrangements, duties and responsibilities for the CCG and local authority commissioners with a focus on outcomes for service users, it was proposed to revise the existing partnership agreement. Section 195 of the HSC Act also stated that the board ‘must, in particular, provide such advice, assistance or other support as it thinks appropriate for the purpose of encouraging the making of arrangements under section 75 of the National Health Service Act 2006’.

A proposed ‘Statement of Intent’ confirming the continued commitment of the health and local authorities working in partnership, underpinned by agreed principles identified in the joint report, was attached as appendix 2.

Resolved – (a) That the statement of intent, attached at appendix 2, confirming the CCG’s and local authority’s commitment to working in partnership be endorsed; (b) that the proposal to revise the section 75 partnership agreement that will facilitate joint commissioning across the life stages be agreed, and (c) that the proposed revised 75 partnership agreement be presented to the September 2013 meeting of the board.

9.  (6)  WINTERBOURNE VIEW – TRANSFORMING CARE AND WINTERBOURNE CONCORDAT – The Chief Officer, Clinical Commissioning Group and the Director of People submitted a joint report updating the board on the short and long term actions required to implement recommendations from the Department of Health following the review of the abuses at Winterbourne Hospital.

The joint report summarised the content and actions contained within two Department of Health reports in response to the case. ‘Transforming Care’ and ‘The Winterbourne View Concordat’ recommended a fundamental change to the way care was commissioned and provided for people who had leaning difficulties and autism.

The Chief Officer and Director in their joint report addressed those actions from the reports that would have local implications. A project group had been established on 1 February 2013 to take forward the recommendations of the Winterbourne reports and also review the North Lincolnshire Complex Care Review action plan.

The report also confirmed that a letter had been sent from the Minister of State for Care and Support, Department of Health in May 2013 to chairs of Health and Wellbeing Boards, Chief Executives of Local Authorities and CCGs on ‘Delivery of Winterbourne Concordat and review commitments’. The letter, attached as an appendix to the report, affirmed statutory duty in delivering the actions of the Winterbourne View Concordat.  It sought a commitment to collaborative working including a joint strategic plan to commission local health, housing and care support services to meet the needs of children, young people and adults with challenging behaviour.  This could be considered as part of the local Joint Strategic Needs Assessment (JSNA) and the Joint Health and Wellbeing Strategy (JHWS).

Resolved – (a) That the report be noted; (b) that the Health and Wellbeing Board agrees to sign up to the principles of the Winterbourne Concordat; (c) that the Health and Wellbeing Board receive regular updates on phase three of the Winterbourne View Concordat, and (d) that the board confirms its commitment to collaborative working in response to the letter from the Minister of State for Care and Support, Department of Health, and requests that the Integrated Commissioning Partnership takes forward the development of the strategic plan.

10.  (7)  HEALTHWATCH NORTH LINCOLNSHIRE UPDATE – The Chief Executive of New Horizons on behalf of the Chair of the Healthwatch Board, submitted a report which updated the board on progress of the implementation of Healthwatch North Lincolnshire.

The report explained that the Health and Social Care Act 2012 made Healthwatch the new consumer champion for publicly funded health and social care. All local authorities subsequently had a statutory function to commission a local Healthwatch for their area. Healthwatch now existed in two forms: local Healthwatch of which there were 152 in England, and Healthwatch England.

Following a period of public and key stakeholder consultation and an open procurement process Healthwatch North Lincolnshire (HWNL) had now been successfully commissioned by North Lincolnshire Council, and the new organisation was established on 1st April 2013. Meeting New Horizons Community Interest Company (CIC), a trading arm of Hull CVS had been awarded the contract to develop HWNL as an independent CIC. The council’s role has now moved  from procurement to performance management and providing initial developmental support to the new organisation. A key part of this was to ensure relationships were brokered and maintained between Healthwatch and their key partners.

Healthwatch England was a statutory committee of the Care Quality Commission (CQC), and provided leadership, support and guidance to local Healthwatch. Healthwatch England has also developed an information hub. The hub was an online environment for the Healthwatch network to store and share information, intelligence and reports as well as network and share ideas.  Healthwatch England would use this aggregated data at a national level to build their evidence base to report to both the Department of Health and the CQC.

The Chief Executive in his report stated that at a regional level the council’s Healthwatch Contract Manager continued to meet with other Healthwatch Commissioners in the Yorkshire and Humber area. This group had been developing a common outcomes framework for the region and a local performance monitoring agreement based on this, as well as locally set Key Performance Indicators agreed with the provider. Meeting New Horizons has also secured the contract to deliver Healthwatch Hull and Healthwatch East Riding.

The report also summarised the following information under the headings –

  • Heathwatch functions (including the ‘Healthwatch Status Report May, 2013’, which was attached as an appendix;
  • Healthwatch North Lincolnshire: Implementation Plan, and
  • Partnerships

Resolved – (a) That the board carries out its duty to involve local Healthwatch as a partner on the board; (b) that the report be noted, in particular the board’s future role in supporting Healthwatch to develop a realistic work plan; (c) that the role that Healthwatch can offer to support the board to meet its priorities as outlined in the Health and Wellbeing Strategy, and to fulfil its statutory duty to involve local people and be accountable to the community be supported; (d) that Healthwatch be promoted to staff within the council and its partners to raise awareness, and encourage individuals to volunteer with Healthwatch, and (e) that suggested working protocols from Healthwatch England be developed locally and be submitted to a future meeting of the board for consideration.

11  (8)  EXPRESSION OF INTEREST TO BECOME A PIONEER TO  DELIVER INTEGRATED SERVICES – The Director of People and Chief Officer, Clinical Commissioning Group submitted a joint report which sought agreement for North Lincolnshire to make an expression of interest to become a pioneer to deliver integrated services, gave consideration to creating an associated small project management team, and explored what form the resource might take to ensure effective change management.

The Director and Chief Officer in their joint report explained that at the end of May 2013 the Department of Health, issued a call to action to all partners in the public sector to become pioneers to accelerate progress on the delivery of integrated services that would improve the outcome and experience of local citizens. Consequently, the members of the Integrated Working Partnership (IWP) and the Integrated Commissioning Partnership (ICP), the working groups of the Health and Well-being Board, carefully considered the proposals.  Both working groups independently and unanimously agreed that North Lincolnshire Health and Wellbeing Board should be given the opportunity to consider the merit of an Expression of Interest being submitted on behalf of North Lincolnshire.

The report outlined the basis for what the expression of interest would be for, the timescale for its development and submission, and proposed the establishment of a small project management team to coordinate its progression and development.

Resolved – (a) That an Expression of Interest to become a pioneer as detailed in the report be agreed and submitted; (b) that the submission of an Expression of Interest be and is supported by all members of the board, together with their work and contributions to its development; (c) that a small project management team be established to explore what form the resource might take to ensure effective change management, and (d) that the Integrated Working Partnership explore what form the resource might take and submit its recommendations to the next meeting of the board.

12   DATES AND TIMES OF FUTURE MEETINGS – Resolved – That the dates and times of future meetings of the board be held as follows –

3 September 2013 at 2:00pm

10 December 2013 at 10:00am

25 March 2014 at 2:00pm