Agenda and minutes

            The Minutes of the meeting held on 4^th October 2017 having been circulated were signed as a correct record.

            The Board received a presentation from Chris Carlin, a representative of Halton CCG, who provided an outline of the work as part of the Well North funding programme. Well North was a partnership between Public Health England (PHE), The University of Manchester and Manchester Academic Health Science Centre; local authorities, NHS organisations, business (both big and small), community, voluntary and enterprise organisations.

            The Well North principles were to:

·         Address inequalities by improving the health of the poorest, fastest;

·         Increase resilience at individual, household and community levels; and

·         Reduce levels of worklessness.

            The Board was advised that Well Halton was one of ten regional “pathfinder” sites across the North and a place based approach had been adopted that built upon the unique nature of the Borough and capitalised on Halton’s many assets. Details of the unique projects which were being developed in various neighbourhoods, each being co-produced with the community, VCSE providers, agencies and private sector partners, were outlined in the report.

            During the first year of the Well North Halton programme, the following five strategic goals had been set:-

·         To create a Community Hub at Windmill Hill;

·         Harness the reach of the Widnes Vikings Generate Positive Change;

·         Identify and develop worldwide initiates;

·         Unit Halton Brook’s assets in a campus approach; and

·         Create a social business hub in Runcorn Shopping City.

It was noted that as part of the second year of the funding programme it was agreed to continue with the five strategic goals and to expand the stem/science partnerships with Sci-Tech Daresbury and Catalyst Museum. The presentation also provided Members with an outline of how the budget had been allocated during the first year of funding.

Members were also invited to contact Chris Carlin in order to visit any of the sites which were included in the presentation.

            RESOLVED: That the contents of the presentation and the review of the draft plan be noted.

            The Board considered a report of the Director of Adult Social Services, which provided an update on some of the changes to service delivery that had been taking place in Halton in the past two years with regard to Halton Adult Mental Services. In 2015 a whole-scale review of the way in which mental health services were delivered across the footprint of the 5Boroughs Partnership NHS Trust was commissioned by the combined Clinical Commissioning Groups (CCG’s) covering Halton, St. Helens, Knowsley, Warrington and Wigan.

            The Board was advised that the review produced a set of recommendations covering five key areas and these themes and recommendations that came from them were largely accepted by the CCGs and their partner agencies. Consequently, work streams were set up to put the recommendations into place. In Halton it was reported that the following developments had taken place in mental health services during the past two years:-

·         work had taken place locally to implement recommendations of the report in a way which created positive change for the people of Halton. The NHS Halton CCG, supported strongly by  the Council, had led Task and Finish Groups with all key partners to establish clear, care pathways through the mental health system;

·         within the North West Boroughs NHS Trust, there had been considerable local redesign;

·         there had been some changes to the delivery of Social Care Services for people with mental health problems in the Borough; and

·         the use of the Mental Health Resource Centre in Vine Street, Widnes had been redesigned;

·         the Mental Health Outreach Team had been redesigned and positive results were being reported.

            RESOLVED: That the report be noted.

            The Board considered a report of the Director of Adult Social Services, which provided an update on the Care and Quality Commission (CQC), Local System Review (LSR) of Health and Social Care in Halton. The review took place in August 2017 and examined how people moved between health and social care, including delayed transfers of care, with a particular focus on people of 65 years old in Halton. The review included an assessment of commission across the interface of health and social care and of the governance systems and processes in place in respect of management resources. Although the review did not include  mental health services or specialist commissioning specifically, they did look at the experiences of people living with dementia.

            Members noted that the final report from the CQC was published on 12^th October following a Quality Summit which took place at the Stadium on the 11^th October, which was attended by representatives from across partner agencies. The summary of the findings of the CGC review were set out in the report, together with the areas identified by CQC where they felt improvements could be made. As a system, Halton was required to submit a system-wide action plan to CQC by 9^th November. Consequently, working collaboratively across our statutory partners and with support from Social Care Institute for Excellence, an associated Action Plan was developed in response to the issues highlighted within the report.

            It was reported that progress against the actions outlined in the Action Plan would be monitored over the next few months by the Health and Wellbeing Board and Halton Borough Council’s Management Team.

            RESOLVED: That the report and associated appendices be noted.

            The Board considered a report of the Director of Public Health, which provided an update on progress against actions from the CQC Action Plan relating to the Health and Wellbeing Board. During the summer 2017, CQC were commissioned by the Secretaries of State for Health and Communities and Local Government, to undertake a programme of target system reviews in 12 local authority areas; Halton was selected as the first area for one of these reviews. Following the publication of the review on 12^th October 2017, an action plan, with a number of themes, was developed in response to issues highlighted in the report. Under the theme of Strategic Vision and Governance the following action was developed for the Health and Wellbeing Board:

            Review role of Halton’s Health and Wellbeing Board to ensure that there is enhanced challenge across the Health and Social Care system.

            In order to respond to this action, a number of areas for development were identified to be presented to the Board. These are as follows:

·         revised Membership (to include GP Federations). A copy of the revised membership list was included in the report;

·         review Terms of Reference;

·         format of Future Meetings to include Board development;

·         performance Dashboard which would focus on the local system performance (to include Delayed Transfers of Care and the performance against the national standard for A and E) and highlight system risks.

            RESOLVED: That

            (1)       the contents of the report and associated documents be noted;

            (2)       the proposed approach and revised Terms of Reference be agreed; and

            (3)       update reports be brought to future meetings of the Board.

            The Board considered a report of the Director of Public Health, which provided Members with the final version of the Pharmaceutical Needs Assessment (PNA) and a briefing on the results of the statutory 60-day consultation. Following the period of consultation, the Steering Group met on the 17^th October 2017 and agreed that the PNA should be submitted to the Health and Wellbeing Board as the final version. The following next steps were proposed:-

·         the PNA must be published no later than 1^st April 2018;

·         the attached version of the PNA was approved as the publication version;

·         the PNA should be uploaded onto the Council’s website;

·         key stakeholders and the public would be advised accordingly; and

·         the Steering Group would meet periodically to produce supplementary statements during the lifetime of the PNA.

            RESOLVED: That

            (1)       the PNA be approved for publication;

            (2)       the Steering Group be delegated to deal with a production of                        supplementary statements needed throughout the lifetime of the                     PNA;

            (3)       the continuation of Healthy Living Pharmacies be supported;

            (4)       the use of New Medicine Reviews and Medicine Management                     Reviews by pharmacists in Halton be supported; and

            (5)       Pharmacists in their stewardship role on prescribing of                                   antibiotics be supported.

            The Board considered a report by the Independent Chair of the Halton Safeguarding Adults Board (SAB), which outlined the Annual Report 2016/17. The focus of work activity addressed SAB’s priorities as identified from the 2015-2016 Annual Report, Performance Framework and Strategic Plan (2016-2018). In addition to acknowledging local and national safeguard adults emerging issues/trends/policies throughout the year.

            The report provided a summary analysis of the data gathered from both CCG and the Council Safeguarding Adults Collection and highlighted how this information informed the work priorities for 2017 – 2018. It was noted that the Halton Safeguarding Adults Board had agreed the three priority areas of work for the forthcoming year:-

·         creating a safer place to live for all adults living in Halton (Safeguarding Prevention);

·         providing the skills and knowledge to enable genuine care and understanding for adults at risk of harm (awareness raising and training);

·         gaining a greater understanding of how mental health can impact adults at risk being protected and cared for in the best possible way (mental health).

            These priorities would help shape the activity of SAB and SAB sub groups and key partners for 2017/2018 to enable the Board to continue to meet its strategic aims.

            RESOLVED: That the report and associated Appendix be noted.

            The Board considered a report of the Chief Executive, which provided an update on One Halton and the Development of an Accountable Care System (ACS).

            The Board was advised that an ACS was one in which several social and health care organisations provided all health and social care for a given population. There were three core elements to the system and significantly, the ACS would centre on the involvement of general practitioners in the network of providers delivering care along with local authorities and providers and commissioners of services.

            In 2014/15 the Council committed to the development of an integrated model of health and social care, and agreed a shared vision – One Halton. The development of an ACS fits the original One Halton concept, delivering across the Halton Local Authority footprint. The revised Halton Accountable Care Strategic Vision, attached at Appendix 1, built on an initial commitment of partners to improve the delivery of health and social care provision. It was reported that to achieve the ACS, partners had established the One Halton Accountable Care system, with a memorandum of understanding and terms of reference, both of which were attached at Appendix 2 and 3 respectively. These documents underpinned the commitment to move towards the more integrated community based system, which reduced the demand on acute services and provided care closer to home.

            At its meeting on 14^th December 2017, the Executive Board endorsed the revised One Halton strategic vision and governance structure as described and approved the recommendations as highlighted in the report.

            RESOLVED: That

            (1)       the One Halton (ACS) Vision, be endorsed;

            (2)       the memorandum of understanding for the One Halton                                  Accountable Care System Board be agreed; and

            (3)       the Terms of Reference for the One Halton Accountable care                       System Board be agreed.

28^th March 18

4^th July 18

3^rd October 18

16^th Jan 19

27^th March 19

All meetings are at 2.00 pm in the Halton Stadium, Karalius Suite.

            The following dates of future Health and Wellbeing Board Minutes were circulated to the Board:

            The Board was provided with dates of future Board Meetings to 31^st March 2019. All meetings were at 2pm in the Halton Stadium, Widnes.

            RESOLVED: That the dates of future meetings be noted.