Agenda and draft minutes

West Sussex Health and Wellbeing Board - Thursday, 30th January, 2020 10.30 am

Venue: Garden Room, Southwick Community Centre, 24 Southwick Street, BN42 4TE

Contact: Erica Keegan on 033 022 26050  Email:  erica.keegan@westsussex.gov.uk

Items
No. Item

39.

Chairman's Welcome pdf icon PDF 187 KB

Minutes:

39.1 In welcoming Board Members, Officers and Members of the Public to the meeting the Chairman referred to the tabled paper circulated at the meeting which provided updates since the last meeting which included contact details should there be any questions. (Copy appended to the signed minutes).

 

39.2 The Chairman introduced colleagues from Adur District and Worthing Borough Council who would be updating on the work the authority is undertaking on health and wellbeing issues across their communities.

 

39.3 It was announced that the ‘floating seat’, reserved for Voluntary Sector participants, would be filled by Chris Cook, Chief Executive Officer, Sussex Clubs and Young People.

 

 

 

40.

Declaration of Interests

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.

Minutes:

40.1 None.

41.

Urgent Matters

Items not on the agenda that the Chairman of the Board is of the opinion should be considered as a matter of urgency by reason of special circumstances.

Minutes:

41.1 The Chairman put forward an item on the Health and Wellbeing Board’s Terms of Reference as a matter of urgency. It was explained that the Chairman was keen to revise the Terms of Reference to allow for two seats to be taken up by representatives from the NHS acute trusts working in West Sussex.

 

41.2 Resolved that the Health and Wellbeing Board recommend that the Council’s Governance Committee agrees that the Board’s terms of reference be revised to include two seats for NHS acute trust representation.

 

 

 

42.

Minutes pdf icon PDF 316 KB

The Board is asked to confirm the minutes of the meeting of the Health and Wellbeing Board held on 10 October 2019.

Minutes:

42.1 Resolved that the minutes of the meeting of the Health and Wellbeing Board held on 10 October 2019 be agreed and signed as a correct record by the Chairman.

43.

Public Forum

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 Telephone: 0330 222 6050 (a local call) or via email:  erica.keegan@westsussex.gov.uk

Minutes:

43.1 The Chairman invited questions from the public and observers present at the meeting. A member of the public asked a question on the support available, from diagnosis to living with a neurological condition, such as Epilepsy.  The Director of Public Health agreed to provide a written response following the meeting.

 

44.

Health and Wellbeing in Adur and Worthing pdf icon PDF 132 KB

A presentation will be given by Adur & Worthing Borough Council on the work this Council has been doing with respect to health issues relevant to the residents in Adur and Worthing.

 

The Health and Wellbeing Board is asked to:

 

1)   hear and acknowledge the work that has been done, especially around Find it Out Plus; and

 

2)   Consider how this way of place-based working can be supported to grow and embedded across West Sussex to support Starting Well and a Children First approach.

 

Additional documents:

Minutes:

44.1 The Board received a presentation from Tina Favier, Head of Wellbeing, Adur and Worthing Councils with partnership colleagues; Dr Rick Fraser (Sussex Partnership NHS Foundation Trust), Julia Harrison (YMCA), Julie Hodson (Clinical Commissioning Group) and Aaron Gain, West Sussex County Council.  (Presentation appended to the agenda and available on the website).

 

44.2 The presentation focused on the work that had been carried out in Adur and Worthing by leaders in the system around Starting Well and Children First. It set out some of the issues in relation to wellbeing and mental health and was centred on the need for a place based approach, in order to bring about the changes required for young people. The presentation also highlighted the work that had been achieved around Find It Out Plus. It was noted that consultation had been carried out with approximately 1,200 young people with further work planned.

 

44.3 The presenters outlined the work the Council was undertaking in respect of mental health issues in children and young people. It is recognised that 15-24 years old is the peak age at which young people suffer from a mental disorder but pathways for this cohort to access health resources are limited. This age group appear to underuse GP services and there is also concern surrounding the transition from children to adults’ care. It was noted that current mental health systems are confusing for young people to access.

 

44.4 The Board was informed that Adur and Worthing are exploring community-based approaches for supporting good mental health for young people and are also addressing concerns surrounding groups identified as high risk.  Adur and Worthing experience the highest rates of self-harm in West Sussex and so are working with Child and Adolescent Mental Health Services (CAMHS), the Voluntary Sector, Schools and GPs to design support around prevention as well as an integrated support approach.

 

44.5 There are a number of key workstreams being provided to achieve the aim of a ‘Thriving Youth’ in the area. These have been identified by using the Young People’s Voice with a survey of 1,124 respondents and the development of a Young People’s Advisory Group. The focus is on developing protective and preventative measures with early intervention.  These area identified as:

 

·         Skills for Parents – to develop the skills and resilience of parents as well as offer support

·         Communication between Primary Care and Schools

·         Find It Out Plus – provision of a welcoming space so that an early approach can be taken in exploring what a young person needs in terms of existing support and help without the need of a referral

·         Use of the Peer Support value

·         Online Resources – so that quality information can be accessed

 

44.6 In discussing the presentation the Board:

 

·      agreed that multi-agency working and bringing systems together would assist in the provision of accessible support for young people. It was recognised that this approach would be effective, reducing duplication.

·      welcomed the early intervention focus with the aim of improving the experience for a  ...  view the full minutes text for item 44.

45.

Change to the Order of the Agenda

Minutes:

45.1 The Chairman announced that the report presenter for the Children First item at Agenda Item 7 was delayed, so the Board agreed to return to this item later in the meeting.

 

 

46.

Child and Adolescent Mental Health Services (CAMHS) pdf icon PDF 136 KB

This paper provides an update on Children’s Emotional Wellbeing and Mental Health.

 

The Health and Wellbeing Board is asked to:

 

1)   Note the plans for presentation of the Sussex wide review of children’s emotional wellbeing and mental health; and

2)   Note that the Local Transformation Plan for West Sussex has been assured by NHS England and the Making Progress summary as circulated.

 

 

Additional documents:

Minutes:

46.1 The Director of Public Health presented the report on Child and Adolescent Mental Health Services (CAMHS). This report informed that partners across Sussex had commissioned an independent review of children’s emotional wellbeing and mental health. The review had concluded its engagement and research phase and recommendations were being prepared for a final report. The report also informed that NHS England required local areas to produce a Local Transformation Plan for investment in children and young people’s emotional wellbeing and mental health. The proposals for this plan had been presented to the Board and the plan had been assured by NHS England and was now being implemented.

 

46.2 The Health and Wellbeing Board received the commissioning team’s Making Progress summary which set out developments and performance to date. It was noted that the final report would be submitted to the Board at the next meeting.

 

46.3 In receiving this update the Board:

 

·       highlighted the Health and Adults Scrutiny Committee’s concerns around nursing staff vacancy data across West Sussex. The Committee had sent letters to Western Sussex Hospitals NHS Foundation Trust and Sussex Partnership NHS Foundation Trust, dated 24 January, pointing out these concerns;

·       discussed the commissioning of services to ensure young people could be referred for effective support quickly and easily. The Joint Strategic Director of Commissioning acknowledged the need for improvement stating that work had reached the stage of engaging with the voluntary sector and embracing co-production. It was noted that whilst progressing core services commissioning, the aspirations of the Health and Wellbeing Board would be taken into account so that the commissioning landscape in the community could continue to develop; and

·       provided examples of where changes could be made such as a focus on preventative services for bereaved children, perhaps by the offer of earlier support at the end of life care stage, and services to support Looked After Children in transitional care with services such as housing support which, in turn, would support good mental health.

 

46.4 The Chairman welcomed the feedback and gave the Board’s support for a joined up approach in making progress.

 

46.5 Resolved that the Health and Wellbeing Board;

 

1)   noted the plans for the presentation of the Sussex wide review of children’s emotional wellbeing and mental health; and

2)   noted that the Local Transformation Plan for West Sussex had been assured by NHS England and the Making Progress summary as circulated.

 

 

47.

Healthwatch Youth Pack pdf icon PDF 131 KB

This presentation concerns overview of the new Youth Pack resource which will be made available to all stakeholders later in the Spring.

 

The Health and Wellbeing Board is asked to promote awareness and endorse use of the Youth Pack to facilitate engagement with young people in ways that are meaningful for them, to test new ideas and evaluation services at an early stage of planning.

 

Additional documents:

Minutes:

47.1 The Board received a presentation (available on the website, appended to the agenda) from the Healthwatch Chief Officer, West Sussex detailing an overview of the new Youth Pack resource which will be made available to all stakeholders later in the Spring.

 

47.2 It was reported that, following engagement with Young People in 2019, Healthwatch determined that Young People actively want to be part of developing solutions for their own mental and emotional and physical health. Healthwatch had coproduced this pack in response to identifying a gap in current engagement activities.  It was noted that the draft pack had been tested with schools, colleges and youth groups and Healthwatch planned to make the pack available, as a free downloadable resource, to all relevant stakeholder and community partners.

 

47.3 In receiving the report and presentation the Board were shown sample packs and praised this good quality resource which was also noted as being available online later in the Spring. Board Members agreed to assist in the distribution of the pack across West Sussex to appropriate stakeholders.

 

47.4 In discussing accessibility to the Youth Pack resource it was suggested that the use of an App could be explored. It was acknowledged that the digital offer to youth, across West Sussex, was minimal and there were ongoing conversations to be had on how digital access could be advanced.

 

47.5 The Chairman thanked the Chief Officer of West Sussex Healthwatch for the report.

 

47.6 Resolved that the Health and Wellbeing Board promotes awareness and endorses the use of the Youth Pack to facilitate engagement with young people in ways that are meaningful for them, to test new ideas and evaluate services at an early stage of planning.

 

 

 

 

 

48.

Children First Improvement - Review of Commissioner's Report and Service Update pdf icon PDF 137 KB

 

This paper explains the response to the Ofsted ‘Inadequate’ judgement of West Sussex Children’s Services in May 2019, and the subsequent appointment of a Commissioner to make recommendations as to whether the service should remain under the County Council’s control.

 

The Health and Wellbeing Board is asked to:

 

1)   note the Commissioner’s recommendations (Section 1), and the actions already undertaken as part of a continuing improvement narrative (sections 2 & 3);

2)   note the next steps in the improvement journey (Section 4); and

3)   Continue to support the County Council through the partnership in enacting the necessary changes.

 

 

Additional documents:

Minutes:

48.1 Upon the arrival of the Head of Children’s Social Care the Chairman moved the meeting to Agenda Item 7 on the agenda.

 

48.2  The Board was reminded that on 20 June 2019 the Health and Wellbeing Board received a report explaining the initial response to the ‘Inadequate’ Ofsted judgement of Children’s Services and the County Council’s creation of a Practice Improvement Plan to address the 10 key recommendations for service improvement that Ofsted had made. 

 

48.3 It was reminded that the June 2019 report explained that the Department for Education (DfE) on behalf of the Secretary of State for Education, had appointed a Children’s Services Commissioner, to judge the County Council’s capability and capacity to return the service to a satisfactory level. 

 

48.4 It was stated that the Commissioner’s report was published on 17 December 2019, and the report received at this meeting summarised the Commissioner’s findings and explained how his recommendations were being addressed.  It also provided a broad summary of all the service improvements and developments that had been in progress during the second half of 2019 and it looked towards further improvement planned in 2020. Hampshire County Council has been appointed as a Partner in Practice to in order to provide service development support in the period before an alternative delivery model can be formally created. 

 

48.5 The Head of Children’s Social Care highlighted seven work streams that would be a focus for improvement; Early Help, Multi-Agency Children in Need, Vulnerable Children, Children with disabilities, Looked after Children, Fostering/Adoption and Independent Review Officers. There will be a strong emphasis on leadership and improved staff engagement so that the work force is being listened to and there is a common understanding of the improvement journey. It was noted that the OFSTED Monitoring visit in December 2019 mirrored the team’s own self-assessment which was seen as positive because internal performance monitoring is on track. 

 

48.6 Board members were informed that staff morale had improved along with stabilising the work force, listening to staff and reducing social work caseloads.

 

48.7 It was explained that although improvements were being made there was a lot more work needed including improvements around private fostering arrangements and developing a strategy around neglect. 

 

48.8 The Cabinet Member for Children and Young People stated that it was important that the service was quality assured so that good practice was made clear. The Cabinet Member acknowledged that although teams were working at speed to make improvements, collaborative and multi-agency support would be required. Board members were informed that the Cabinet Member for Children and Young People is now chairing the Corporate Parenting Panel which aspires to include District and Borough Council representation at some point in the near future. The Cabinet Member stated that all West Sussex Councillors would be required to know what is expected of them and as such an LGA Corporate Parenting Members Day had been arranged. The Cabinet Member is keen to strengthen the role of Social Workers, retaining a happy workforce  ...  view the full minutes text for item 48.

49.

Community Based Models of Access to Health Services pdf icon PDF 149 KB

This paper concerns the award of Public Health England grant monies, to test community based models of access to health services.

In West Sussex, the grant will fund a twelve month project - the Hospital Admission Reduction Pathway (HARP). This will improve access to health services for adults with co-occurring substance misuse and mental health needs who are experiencing or at risk of returning to rough sleeping.

 

The Health and Wellbeing Board is asked to:

 

1)   Acknowledge background and work to date;

2)   provide strategic leadership and governance of the twelve month project; and

3)   receive regular updates through the life of the project and consider learning from its implementation and delivery.

 

 

Additional documents:

Minutes:

49.1 The Chairman welcomed the Chief Executive Officer of Stonepillow to the meeting and thanked her for presenting the report on the award of Public Health England grant monies that will deliver a pilot for community based models of access to health services.

 

49.2 It was reported that in May 2019, Public Health England (PHE) announced the availability of £1.9million revenue funding to be awarded in 2019/20 and sought expressions of interest from partnerships between local authorities and clinical commissioning groups.  It was explained that the aim of the funding was to test community based models that would improve access to health services for adults with co-occurring substance misuse and mental health needs who are experiencing or at risk of returning to rough sleeping.

 

49.3 The Board was informed that the West Sussex bid had been successful with an award of £345 529 revenue which is non-recurring. This was a partnership bid drawn up with input from: Turning Tides; Stonepillow; Change Grow Live; Emerging Futures; Crawley Open House; A&E Consultant at Worthing Hospital; Primary Care; NHS Coastal West Sussex Clinical Commissioning Group and West Sussex County Council. The West Sussex Health and Wellbeing Board was identified as the local body that would provide strategic leadership and governance.

 

49.4 It was noted that in West Sussex, the grant would fund a twelve month project - the Hospital Admission Reduction Pathway (HARP). This would aim to improve access to health services for adults with co-occurring substance misuse and mental health needs who are experiencing or at risk of returning to rough sleeping. HARP would be monitored by Public Health England for one year in order to evaluate outcomes.

 

49.5 In receiving this report the Board;

 

·       welcomed the grant and the associated partnership working to improve provision for Rough Sleepers;

·       noted that the Board would provide strategic leadership and governance;

·       acknowledged the project’s go live date as 1 February 2020 when front line triage would be coordinated between Worthing based Turning Tides, Worthing Accident and Emergency and St John’s Ambulance nursing staff. The project would then be delivered in Chichester, Bognor Regis and Crawley from April 2020;

·       praised the project which would work with people where they felt at ease being treated, reducing health issues on the streets with proactive care such as providing appropriate vaccinations and alcohol/substance misuse monitoring; and

·       discussed measures of success and anticipated a reduction in numbers attending A&E as well as reducing the risk of Rough Sleepers being discharged from hospital on to the streets.

 

49.6 In thanking the Stonepillow Chief Executive for presenting the report, the Chairman welcomed this positive project.

49.7 Resolved that the Health and wellbeing Board;

 

1)   acknowledges background and work to date;

2)   would provide strategic leadership and governance of the twelve month project; and

3)   would receive regular updates through the life of the project and consider learning from its implementation and delivery.

 

 

 

 

 

 

 

 

 

 

 

50.

West Sussex Joint Dementia Strategy 2020-2023 pdf icon PDF 162 KB

This paper concerns the refresh of the Dementia Framework 2014-19 and development of the new Joint Dementia Strategy 2020-23.

 

The Health and Wellbeing Board is asked to:

 

1)   review the draft West Sussex Joint Dementia Strategy 2020-23 and support its launch in the spring;

2)   provide ongoing oversight, of progress against the strategy; and

3)   champion the new Dementia Strategy and the need for additional investment to maximise the preventative value of supporting those living with dementia to remain as independent as possible.

 

Additional documents:

Minutes:

50.1 The Board received a report from the Senior Commissioning Officer (Adults and Health) and the Commissioning Manager Mental Health and Dementia Horsham and Mid Sussex CCG and Crawley CCG, Coastal West Sussex CCG on the refresh of the Dementia Framework 2014-19 and the development of the new Joint Dementia Strategy 2020-23 (copy appended to the agenda and available on the website). The report set out the work that has been done to review the progress that has been made to date as well as identify gaps in the pathway.  The paper also summarised what had been done to ensure the new strategy had been developed collaboratively with statutory and voluntary sector partners, family and friend carers and individuals living with dementia.

 

50.2 It was reported that there had been some progress since the launch of the Dementia Framework in 2014. An example given was the diagnosis rate that had increased from 43% in 2014 to 63.4% in November 2019. It was noted that there had been an improved offer of post-diagnostic support for the individual and their family carers from Dementia Advisers and Dementia Support Workers and dementia friendly communities had grown and extended their reach and there were now 9 Local Dementia Action Alliances in the county.

 

50.3 The Board was informed that there are nine thousand people living with dementia along the county’s coastline and there is still more to do to improve the experience of those affected.  Findings from the review had been used to refresh the Dementia Framework and set priorities for the Dementia Strategy 2020-23.

 

50.4 The economic cost and impact on social care and health budgets was highlighted. It was stated that there was currently no additional funding identified for the implementation of the new Dementia Strategy and so the council and its partners had looked at what could be achieved in the current financial climate and what could be achieved if there is more funding available in the future. The vision is to ensure that all providers from health and social care, both statutory and voluntary as well as the community sector, work collaboratively to support Dementia Friendly Communities to become sustainable whilst extending their reach and spread.

 

50.5 In highlighting the Dementia Strategy 2020-23, it was explained that a number of gaps in the pathway for someone with dementia had been identified and therefore a joined up approach would be needed to address provision in line with available budgets.  The refreshed Strategy would be set around five elements:

 

·       Preventing Well – what could be done in a more effective way;

·       Diagnosing Well – ensuring that family, friends and carers were made aware of support;

·       Supporting Well – live well at home for as long as possible;

·       Living Well – ensuring that people with dementia live well, keeping fit and active; and

·       Dying Well – advanced care plans and bereavement support.

 

50.6 In discussing the report, the Board;

 

·       suggested that commissioned services needed to provide flexibility to assist with tight budgets and  ...  view the full minutes text for item 50.

51.

West Sussex Better Care Fund pdf icon PDF 148 KB

This paper provides a summary of the funding sources and expenditure plan for the West Sussex Better Care Fund in 2019/20 along with the regular monitoring of performance against the 4 national metrics for Quarters 1 and 2, 2019/20.

 

The Health and Wellbeing Board is asked to:

 

1)   note the West Sussex Better Care Fund funding sources and expenditure plan;

2)   note the West Sussex performance against the national metrics at Q2 2019/20; and

3)   note the 2019/20 schedule for quarterly returns. 

 

Additional documents:

Minutes:

51.1 The Board received the report on the Better Care Fund for noting.  In receiving the report, the Board requested that, in future, this item be added to the Agenda as an item for discussion with presentation by an appropriate representative so that the Board’s collaborative work can be successfully undertaken across this cross-cutting partnership which spans the NHS and Local Government.

 

51.2 Resolved that the Health and Wellbeing Board;

 

1)   noted the West Sussex Better Care Fund funding sources and expenditure plan;

2)   noted the West Sussex performance against the national metrics at Q2 2019/20; and

3)   noted the 2019/20 schedule for quarterly returns. 

 

52.

Date of Next Meeting

The next meeting of the Board will be held at 10.30am on 30 April 2020, at a venue to be confirmed. 

Minutes:

52.1 The next meeting of the Board would be held on 30 April 2020 at a venue to be confirmed.

 

 

The meeting ended at 13.55