Agenda and minutes

30.1  The Chairman welcomed Board Members, Officers and Members of the Public to the meeting.

Members and officers must declare any pecuniary or personal interest in any business on the agenda.  They should also make declarations at any stage such an interest becomes apparent during the meeting. 

Consideration should be given to leaving the meeting if the nature of the interest warrants it; if in doubt contact Democratic Services before the meeting.

31.1  None.

32.1  None.

The Board is asked to confirm the minutes of the meeting of the Health and Wellbeing Board on 12 July 2018.

33.1  Resolved that the minutes of the meeting of the Health and Wellbeing Board held on 12 July 2018 were agreed.

A presentation will be given, at the meeting, by Crawley Borough Council on the work this Council has been doing on Dementia with a quick overview of health issues that are relevant to Crawley residents.

34.1 The Board received a presentation from Carrie Burton, Transformation Manager, Crawley Borough Council. This provided an overview of the health and well-being issues and initial key priorities that were relevant to Crawley residents. (Presentation tabled at the meeting and available on the website)

34.2   The Chairman invited comments and questions on the information received requesting a focus on how the Board could help support Crawley’s Health Priorities.  Key Points highlighted were:

·         There was disparity between the positive employment, earned income, and productivity figures and the challenges that faced the Crawley population.  It was pointed out that although Crawley had a successful economy, with too many jobs for the population, people who commuted into Crawley earned higher salaries than residents. Similarly, although Crawley had a national average of high salaries the town also had the poorest social mobility.

·         The Board commended the Social Prescribing Pilot funded by Crawley Borough Council and Crawley NHS Clinical Commissioning Group. The impact of this pilot had been measured in terms of the reduction in demand on general practice, reductions achieved in A&E attendances, demands on other secondary care services and the social return on investment (SROI) can have a monetary value on the return of benefits to all stakeholders, not just health. Following request, it was agreed that the pilot’s results would be circulated to Board Members. Members were also informed that a South East Social Prescribing Conference would be held on 22 November, details of which would be circulated following the meeting.  

·         The challenges presented by an ageing population were outlined. Crawley Borough Council undertook Dementia Friendly work and used partnership/community networks to improve social isolation.  The same type of engagement processes were being used to build relationships with partners with a focus on support for the children and young people. The Board discussed how they could work together to facilitate this work, enabling Health and Wellbeing Teams to work with young people, children and families and commit to partnership working as opposed to a contractual relationships.  It was agreed creative thinking, flexible working and early intervention would be required. Comment was made that small, simple initiatives could be used to make a huge difference.

·         The Board were particularly interested in Crawley Borough Council’s work on creating a Dementia Friendly Town – Crawley was noted as a national and international exemplar. It was noted that other towns such as Worthing, Bognor Regis and Horsham were Dementia Friendly and this approach would be good for West Sussex as a whole. 

·         Discussion was held on upskilling Crawley’s population as a workforce that could be attracted to working in Health. Ongoing work was being undertaken with the college to offer appropriate courses.

34.3   The Chairman thanked Members for their input. In summing up, the importance of the Board’s role in understanding local health and well-being priorities was noted, as well as the need to continue to develop relationships between the Board and the District and Borough’s Health and Wellbeing Partnerships.

35.1   The Chairman introduced this part of the meeting that would focus on Workforce Priority Reviews. It was stated that Board Members would receive a number of presentations and reports on workforce priorities on the themes of Making Every Contact Count, Adult Social Care Workforce, NHS workforce development, supporting Informal Carers and the Childcare Workforce.  Board Members were requested to ask questions at the end of the Workforce Priority Review session and discuss with particular emphasis on how the Health and Wellbeing Board could assist with workforce development across the spectrum. 

(a)    Making Every Contact Count

35.2   The Chairman introduced Dan Barritt, West Sussex County Council Programme Manager (Workplace Health and Emotional Wellbeing) who provided a presentation on Making Every Contact Count MECC (copy of the slides appended to the Agenda and available on the Website).  The presentation:

·         provided an overview of the West Sussex approach to MECC;

·         updated on the MECC activity that has taken place to date, the range of partners  worked with and the outcomes achieved;  and

·         highlighted system wide challenges and how the Board could assist with solutions to those challenges and the next steps.  

35.3   Board Members were informed that MECC was an approach that enabled individuals and organisations to develop a different way of working with people to promote and support health & wellbeing.  Board Members were informed that MECC is about learning how to spot opportunities to talk to people about their health & wellbeing.

It was noted that MECC enabled workforces to:

·         utilise a holistic, person-centred approach to service delivery.

·         deliver ‘very brief’ or ‘brief’ evidence-based interventions for lifestyle behaviour change focusing on the key elements of stopping smoking, drinking alcohol sensibly, increasing physical activity, maintaining a healthy weight and diet and promoting emotional health & wellbeing

·         know about local support services and how to signpost people to them where appropriate.

35.4  MECC related skills were noted as transferable and could be used within a workplace health context. It was stated that the pressures faced by Local Authority, health and social care and voluntary sector workforces were well known, and MECC offered a pragmatic solution to scaling up a transformational shift toward prevention as part of organisational culture change. MECC could equip workforces at all levels to be more confident in discussing lifestyle related issues with each other as well as the people they work with.  

35.5  The report’s recommendations requested that the Board:

1)   became or identified a strategic MECC Champion using  positions, relationships, visibility and influence to promote a MECC approach, engaging important leaders, and identifying operational MECC Champions to lead their own MECC implementation plans; and

2)   Identify key services, active leaders and operational Champions, to embed MECC within existing service delivery structures, pathways, and commissioning plans to mobilise MECC within  work areas.

35.6  Board Members were informed that Public Health West Sussex would support this by providing MECC resources, support with training Champions and support with developing and implementation plans. Tailored workshops and presentations could be delivered to senior leaders  ...  view the full minutes text for item 35.

A Recent governance review has taken place to refine, clarify and improve governance arrangements. These are inclusive, initially focused on the NHS organisations within the partnership.  Discussions are underway around the future of commissioning across the STP. This follows the creation of the Central Sussex Commissioning Alliance and a shared Accountable Officer across Clinical Commissioning Groups. The Board will receive a presentation on the partnership as attached.

36.1  The Board received a presentation from Dominic Wright, a Board Member and representing Coastal West Sussex Clinical Commissioning Group,  on the Sussex and Surrey Transformation Partnership (STP) (slides appended to the Agenda and available on the website)  that outlined the recent Governance review that had taken place to refine and clarify governance arrangements.  These were  inclusive and  initially focused on the NHS organisations within the partnership.  It was noted that discussions were underway around the future of commissioning across the STP. This followed the creation of the Central Sussex Commissioning Alliance and a shared Accountable Officer across the Clinical Commissioning Groups.

36.2  It was stated that the new arrangements included the formation of an Operational Delivery Group, which was described as the “engine room” of the STP where the work of the workstreams was co-ordinated and discussed.  Due to the changing nature and dynamics of STP development, the new arrangements would be regularly reviewed to ensure they are working effectively and remain fit for purpose.

36.3 The The workstreams were aligned to the agreed immediate priorities of the STP and outlined as:

•       Mental Health

•       Urgent and emergency care

•       Medicines Management

•       Clinically Effective Commissioning

•       Continuing Healthcare

•       Back office functions

•       Estates

•       Digital

•       Workforce

•       Communications and Engagement

•       Finance

36.4  It was reported that some workstreams were more advanced than others – particularly the Mental Health and the Clinically Effective Commissioning Programme. The mental health workstream had formed an STP Programme Board and a case for change.   The Clinically Effective Commissioning Programme was a Sussex-only piece of work but assurance was given that it was working very closely with the Surrey Collaborative to ensure there would be consistency across the boundaries.

36.5  Board Members were informed that a review of the STP governance had taken place and refined arrangements had been designed, developed and accepted by the STP Executive, Programme Board and Oversight Group.  These arrangements aimed to define and embed roles and responsibilities of the STP leadership, give greater clarity around accountability and provide assurances around progress and delivery of STP programmes and local plans. The arrangements were intended to compliment the accountability of individual partner organisations.

Due to the changing nature and dynamics of STP development, the new arrangements would be regularly reviewed to ensure that they were working effectively and remained fit for purpose.

36.6  It was concluded that the STP Executive were discussing the strategic and longer-term priorities of the STP for the year ahead. Work was underway to develop a case for change for the STP, which identified the key challenges and areas that needed improvement across our local health and care system.   It was reported that a lot of work had taken place around the case for change within local transformation plans and specific areas, such as mental health, but this was the first time a unified case for change had been developed across the STP.  It was noted that this was being led by the  ...  view the full minutes text for item 36.

The Board will receive a report as attached from the West Sussex Better Care Fund Coordination Team. This report details progress towards each of the four national conditions of the Better Care Fund. The Board is asked to comment on the report.

37.1  In the absence of the report’s author, Dominic Wright, Coastal West Sussex Clinical Commissioning Group, presented an update on the West Sussex Better care Fund (report appended to the agenda and available on the website).  The Board noted this update.

The West Sussex County Council Director of Public Health will provide a verbal update on the Joint Health and Wellbeing Board Strategy, outlining the emerging vision, principles of working, the leadership model whilst highlighting the work being undertaken on refreshing the strategy and how public engagement will be incorporated.

38.1  The Director of Public Health presented her report on the Joint Health and Wellbeing Board Strategy Refresh (report tabled at the meeting and available on the website). 

38.2  The report provided an update on the process of the Joint Health and Wellbeing Strategy (JHWS) refresh and Health and Wellbeing Board (HWB) role development.  It was outlined that the HWB was in the process of refreshing its JHWS to replace the current 2015-2018 strategy. The Board used this strategy refresh process as an opportunity to engage with various stakeholders and encourage greater ownership of the strategy. It was noted that the updated JHWS was due for publication in April 2019.

38.3 The Chairman referred Board Members to the recommendations and sought agreement.

38.4  Resolved that the Board:

a)   noted the progress made in the refresh of the JHWS and the next steps;

b)   would advise on further opportunities for engaging and consulting partners, patients, services users and other stakeholders in the JHWS consultation and implementation; and

c)   noted the draft vision, guiding principles and the proposed systems leadership model.

The Board invites questions and comments from the public observers present at the meeting.  Those with more complex issues are asked to submit their question before the meeting (ideally several days) in order to allow a substantive answer to be given.  Contact Erica Keegan on Tel: 033022 26050 (a local call) or via e-mail: erica.keegan@westsussex.gov.uk

39.1  The Chairman invited comments and questions from those observing the meeting. There were no comments or questions.

 The next meeting of the Board will be held at 2.00pm on 24 January 2019 at a venue to be confirmed.

40.1  The next meeting would be held on 24 January 2019 at 2pm at a venue to be confirmed.