Agenda and minutes

            The Minutes of the meeting held on 29^th March 2017 having been circulated were signed as a correct record.

            The Board considered a presentation on the development of Halton’s Rapid Clinical Assessment Team (RCAT). The development of the RCAT service arose from an approach by a Care of the Elderly Consultant, Professor Bhowmick, to the medical team at Warrington and Halton Hospitals NHS Foundation Trust. Professor Bhowmick had developed, in two locations in Wales, a rapid assessment model for older people in the community who otherwise would be admitted to hospital for consultant assessment, diagnostics and review of non-life threatening illness.

            It was noted that:

·         from August 2015 to April 2016, a model was developed drawing on nursing resources in the Rapid Access and Rehabilitation Service (RARS) and Community Matrons;

·         the RCAT service commenced on 4^th April 2016;

·         GP led Primary Care Teams had the opportunity to refer to RCAT for an enhanced Rapid Clinical Assessment; and

·         the service accepted referrals Monday to Friday 9am to 4pm and the aim was for the service to undertake an initial assessment within two hours.

            The referral criteria was as follows:-

·         Age 75+. However the team were flexible and if a GP felt that a patient would benefit from an intervention irrespective of age, then they could contact the team to discuss this; and

·         Not critically ill (e.g. Myocardial Infraction, stroke or severe sepsis etc.).

            It was reported that from the 4^th April 2016 – 31^st March 2017, 194 referrals had been made to the Service. Of those referrals made a total a total of 165 admissions were avoided during 2016/17. For NHS Halton Clinical Commissioning Group, the average cost of an emergency attendance and admission via ambulance in 2015/16 was £2,786 (age 75+). Based on this figure, a total saving of £459,690 was made in hospital avoidance. If this saving was then offset against the annual cost of the RCAT service, which was approximately £350,000, then in 2016/17 a total saving of £109,690 was made.

            RESOLVED: That the presentation be noted.

            The Board considered a presentation which provided Members with an overview of the integrated work taking place in Halton to improve infant and maternal mental health and wellbeing. Halton had received the ‘Locality award for mental health inclusion’ at the PIPUK (Parent infant partnership) infant mental health awards. The award was for the collaborative work that had taken place through the Halton Health in the Early Years group, on perinatal mental health, preparation for parenthood, and bonding and attachment. It was in recognition of the close working between the Bridgewater midwives, Family Nurses and Health visitors, and Children’s centre staff, Health improvement team, Public Health and the CCG.

            The Board considered a presentation which outlined the work that was taking place to ‘give every child the best start in life’, by supporting mums mental health and building the relationship with the child.

            RESOLVED: That the contents of the presentation be noted.

            The Board considered a report which provided an update on the outcome of the Joint Local Area Inspection of Special Educational Needs (SEN) and Disability for Halton. Between the 27^th March and 31^st March 2017, Ofsted and the Care Quality Commission conducted a joint inspection in Halton. As part of the inspection they:

·         spoke to children and young people with special educational needs and/or disabilities, parents and carers, local authority and National Health Service (NHS) officers;

·         visited a range of health and education providers including schools, Children’s Centres, Early Years settings and Riverside College;

·         considered a range of information about the performance of the local area including the local area’s self-evaluation;

·         met with the leads for health, social care and education in Halton; and

·         reviewed performance data and evidence including the local offer and joint commissioning.

            It was reported that the inspection focused on the following three areas:-

·         The effectiveness of the local area in identifying children and young people’s special educational needs and/or disabilities;

·         The effectiveness of the local area in meeting the needs of children and young people who have special educational needs/or disabilities; and

·         The effectiveness of the local area in improving outcomes for children and young people who have special educational needs and or/disabilities.

            Members were advised that Ofsted had published the outcome of the inspection in a final letter on the 16^th June and a copy had been previously circulated to Members of the Board. The letter set out both the strengths of the local area and a number of areas for further development.

            The report acknowledged what was working well, what needed to improve and emphasised the need for increased joint planning. Therefore, in order to respond to the areas for development and to further improve the outcomes for children and young people, NHS Halton Clinical Commissioning Group, the Local Authority, Impart (parent and carer organisation) and other partners were committed to working together to develop a local area joint Action Plan. Once developed the Action Plan would be monitored and reviewed by the SEN Strategic Partnership Board and a progress report would be provided to the Health and Wellbeing Board every six months.

            RESOLVED: That

            (1)       the outcome of the Joint Local Area SEND inspection be noted;

            (2)       approval be given to the development of a Joint Action Plan to address the areas of development identified by the inspection; and

            (3)       a report on progress be submitted to the Board in six months.

            The Board considered a report on the work of the Child and Family Poverty Strategic Group and how this fed into the Liverpool City Region co-ordinated approach to addressing child and family poverty.

            In 2010 Halton, alongside other Liverpool City Region leaders, agreed to adopt a City Region wide approach to tackling issues relating to child and family poverty that would build on strong local and City Region partnerships. Subsequently, in 2011, the first Child Poverty and Life Chances Strategy for the Liverpool City Region was launched.

            It was noted that whilst Halton was happy to adopt a joint strategic approach as part of the Liverpool City Region, it had agreed to develop its own Action Plan to underpin it. As a result, Halton’s Child and Family Poverty Strategic Group had hosted a workshop on the 26^th January to consider what should be included within Halton’s Child Poverty Action Plan and the outcomes from the workshop were detailed in the report.

            It was proposed that the outcomes of the strategy and the Action Plan would be reported annually to the Children and Young People’s Policy and Performance Board and the Liverpool City Region Child Poverty and Life Chances Commission.

            RESOLVED: That the report be noted.

            The Board considered a report which provided an update on the Falls Service in Halton and the work undertaken to date in the line with the Halton Falls Strategy 2013 – 2018.

            The Falls Strategy had been underpinned by a robust action plan which was agreed by all partners to drive the implementation of key objectives and to deliver evidence based, efficient, high quality services.

            It was noted that to date many key actions identified in the plan had been fully implemented and although performance was still below the national average in a number of areas, there had been a significant decrease in the gap. The report highlighted progress against the Falls Strategy Action Plan within the following areas:

·         Falls Pathways – Treatment/Prevention;

·         Workforce training and awareness raising;

·         Development of an awareness raising campaign with both the public and professionals;

·         Improved partnership working and governance; and

·         Impact on performance.

            Members were advised that progress had been made in a number of areas in line with the following key priorities:

·         to reduce emergency hospital admissions for injuries due to a fall (65+); and

·         emergency hospital admissions due to fracture of neck or femur (65+).

            However, it was reported that work needed to continue to close the gap and to reduce the numbers of people who fall in Halton. Therefore, a number of key recommendations which would support work in this area were outlined in the report.

            RESOLVED: That the report be noted.

            The Board considered a copy of the Public Health Protection Annual Report 2016/17. The report provided an overview of the current health protection situation within Halton highlighting any on-going challenges or issues. The document enabled the Director of Public Health to provide assurance to the health and wellbeing board that the health of the residents of Halton was being protected in a proactive and effective way.

            A copy of the Public Health Protection Annual Report 2016/17 had been previously circulated to the Board.

            RESOLVED: That the report be noted.

            The Board considered a report of the Director of Public Health, on the development of the Public Health Annual Report 2016/17. For the 2016/17 report the focus would be on the health of women and girls in Halton. The topic had been chosen to highlight key topics specific to female health and those issues local women and girls believed to be the most significant areas for their health.

            The final version of the report would be presented to the Board in September 2017.

            RESOLVED: That the Board

1.    note the theme and areas of focus; and

2.    raise awareness of the forthcoming report with their staff and elected Members.

            The Board considered a report of the Director of Adult Social Services, which outlined the allocation of additional funding for Adult Social Care which was announced by the Chancellor in the Spring Budget. The additional funding was to be spent on adult social care and used for the purposes of meeting adult social care needs, reducing the pressures on the NHS; including supporting more people to be discharged from hospital when they are ready and stabilising the social care provider market.

            The report set out a number of recommendations on areas where this additional funding should be allocated, including cost and predicted outcomes.

            RESOLVED: That the report be noted.