Agenda and minutes

          The Minutes of the meeting held on 9 September 2014 having been printed and circulated were signed as a correct record.

        The Board was advised that no public questions had been received.

The Minutes of the Health and Wellbeing Board of its meeting held on 9 July 2014 and 17 September 2014 were submitted to the Board for consideration.

The Board noted that some of the reports that fell within the remit of the Health PPB, and were therefore subject to scrutiny, had not been considered by the Board prior to them being considered by the Health and Wellbeing Board.  The Board agreed requested that such reports in the future be presented to the Health PPB for consideration prior to the Health and Wellbeing Board. 

The Board considered a report of the Strategic Director, Communities which highlighted that 5BP had recently been awarded the contract to provide the Improving Access to Psychological Therapies (IAPT) service which went live on 1 August 2014.  It was reported that 5BP were the principal provider but were also working in partnership with Self Help Services (SHS) to deliver the service.

The Board was advised that IAPT was the Department of Health’s (DoH) mandated model for providing talking therapies for anxiety and depression in primary care.  The main principles of the service were:-

·       Improving access;

·       Improving quality; and

·       Demonstrating effectiveness.

The Board was further advised that the IAPT model stated that provision should be the least intrusive intervention first i.e. start with brief therapy, if this was not successful, offer more intensive therapy.  The three steps are as follows:-

·             Step 1 - GP interventions;

·             Step 2 (provided by the IAPT service) - Guided self help, between 6 and 8 half hour sessions with lots of things to read and do between sessions; and

·             Step 3 (provided by the IAPT service) - “Traditional” therapies, between 12 and 20 hour long sessions and Cognitive Behaviour Therapy (CBT).

It was reported that referrals for the service came in writing from GPs.  Clients were written to and asked to call the service for an appointment and were usually assessed within a week and placed on an appropriate waiting list.

It was reported that 45 days was the average time on the waiting list and work was taking place to reduce this to 28 days.  It was also reported that 45% of people recovered after receiving therapy.  Evening appointments were also popular and consideration was being given to offering the service on Saturdays.

The following comments arose from the presentation:-

·             It was noted that therapies ranged from three weeks to 20/25 weeks;

·             It was noted that there were  ...  view the full minutes text for item 29.

The Board considered a report of the Strategic Director, Communities, which gave Members an update and sought their views on the potential developments within the Council’s social care provision for adult mental health services.

The Board was advised that there were currently two services provided by Halton Borough Council for residents with complex mental health needs: the mental health social work service, based at the Brooker Unit in Runcorn, and the Mental Health Outreach Team, based in the Mental Health Resource Centre in Vine Street, Widnes.

The Board was advised that the model of service delivery described in the report had been in place for many years, and had achieved positive outcomes for many people. However there had been a number of changes, both in terms of national policy and local service delivery, which have meant that the ways in which the services were delivered needed to be reconsidered. The changes included:-

• New national policy guidance which stressed the extent to which people could be supported to recover from severe mental illness;

• In the same national guidance, there was a strong emphasis on the need to develop services which prevented mental health conditions, or which intervened at a much earlier stage to stop them from getting worse;

• The decision of the Halton Health and Wellbeing Board to treat mental health as a key local priority;

• Changes in the way key partner organisations deliver services;

• Increasing numbers of people being assessed for detention under the Mental Health Act; and

• Changing demands on the services from other partners, such as children’s services, who needed support with families with complex needs where there may be a mental health problem and the police, who need appropriate community support for people who might otherwise enter the criminal justice system.

The Board was further advised that within the social work service, the recent development of the Acute Care Pathway within the 5Boroughs had meant that the 5Boroughs now focused its work only on the people with the most complex needs and levels of risk. As a result of this, the social work caseloads had fallen, although other work, such as Mental Health Act assessments, had increased considerably, in line with national patterns.

It was reported that there was now some capacity within the team to develop a small service which works more directly with people who are known only to primary care services and who had not been referred to specialist hospital mental health services. One of the social workers already undertakes some of this work, working with people who are referred by a range of agencies who might be at risk without support, and a proposal was to be prepared to extend this service, using existing resources. In addition, it was reported that this approach would build on some ongoing work within the Mental Health Outreach Team, and which would be the subject of a more detailed report to the Board.

Furthermore, it was reported that there had been some effective work by partner agencies  ...  view the full minutes text for item 30.

The Board considered a report of the Strategic Director, Communities, which gave Members an update regarding the safeguarding work being undertaken across the Borough.

The Board was advised of the following areas:-

·             The Care Act 2014 had been heralded as ‘an historic piece of legislation that would make a difference to some of the most vulnerable people in society for many years to come’.  The Act aimed to put adult safeguarding on a statutory footing.  The Board noted the main areas of safeguarding adults responsibilities contained within the Act and an action plan had been developed to ensure that Halton was compliant which HSAB would monitor progress;

·             Safeguarding Adults Board were required to produce an annual report, which summarised all of the key achievements and priorities which they had been working towards over the previous year.  In Halton this as an activity that had been undertaken annually and the Annual Report 2012/2013 had been published.  The Board noted the four key priorities which the Annual Report had focussed on;

·             An updated Inter-Agency Policy, Procedure and Good Practice Guidance had been produced by the Integrated Adults Safeguarding Unit, in conjunction with members of Halton Safeguarding Adults Board.  The document provided all agencies involved with safeguarding in Halton, with a practical and informative policy, which would ensure that procedures between statutory agencies were consistent across the whole of Halton;

·             The Safe in Town project and Halton Speak Out had been awarded almost £5k from the Cheshire Police and Crime Commissioner, which was subsequently match funded by the Halton Clinical Commissioning Group earlier in the year.  This funding was agreed on the principle that the types of beneficiaries and premises signed up to the scheme would widen; and

·             The Board noted that the Annual Report set out in Appendix 1 to the report described how organisations and individuals across all sectors were working together to safeguard vulnerable people.

The following comments arose from the discussion:-

·             the Board noted the new offence for providers of supplying false or misleading information regarding information that they were legally obliged to provide.  However, it was noted that this situation had not been an issue in Halton;

·             the importance of unannounced visits to care homes and at key times was noted. Clarity was also sought on the latest time that a visit would be undertaken.  In response, It was reported that visits were undertaken outside of normal working hours and if an alert had been raised it would depend on the type of alert i.e. if it was in relation to night staff, a late night or early morning visit would take place;

·             it was reported that there had been an increase in the number of alerts raised by care staff which highlighted that training and awareness raising was proving to be successful;

·             it was noted that individuals could report their concerns anonymously;

·             it was noted that Halton were taking part in a making safe project which would gather information of the service users experience of the  ...  view the full minutes text for item 31.

  The Board considered a report of the Director of Public Health which provided Members with information on the 2013-14 Public Health Annual Report ‘Drinking Less and Living Longer’. The draft Annual report was attached as Appendix 1 to the report.

The Board was advised that this year’s Public Health Annual Report focussed on the topic of alcohol-related harm and set out how work was taking place in partnership to reduce alcohol harm for individuals, families and communities. It was reported that alcohol-related harm affected all age groups within Halton. The report was therefore written from a life-course perspective and set out key actions that would be taken for each group.  A communities chapter was also included which covered issues that affected people of all ages e.g. crime and community safety, alcohol availability and price.

The Board was further advised that reducing alcohol-related harm was chosen as a topic as it demonstrated the importance of working in partnership and what could be achieved when organisations worked together across organisational boundaries. It was also timely as the public health team were currently working in partnership to develop a local alcohol harm reduction strategy. In addition Halton was also one of only twenty areas in the country to be awarded the status of being a Local Alcohol Action Area.

It was reported that Chapters included in the report were as follows:-

·             Starting well: Promoting an alcohol free pregnancy and protecting Halton babies and toddlers from alcohol-related harm;

·             Growing well: Reducing underage drinking in Halton;

·             Living well: Promoting safe and sensible drinking among adults;

·             Aging well: Promoting safe and sensible drinking among older people; and

·             Keeping our local communities safe from alcohol-related harm.

Each chapter outlined the current levels of alcohol-related harm, described current local activity to reduce alcohol-related harm, outlined gaps in current activities and made recommendations for future actions.

The following comments arose from the discussion:-

·       The Board congratulated the Director of Public Health on the excellent report;

·             In respect of alcohol spectrum disorders, it was suggested that real life stories from young people who had suffered as a result from drinking alcohol during pregnancy would help to raise awareness of the consequences of alcohol abuse;

·             Clarity was sought on the progress on establishing an alcohol free bar in Halton.  In response, it was reported that a new organisation Umbrella were undertaking work on local café’s opening later and information had been requested from the organisation with a view to establish if they could become alcohol free bars;

·             The significant cost in respect of alcohol admissions as a result of alcohol abuse in Halton was noted; and

·             The Board noted the significant number of older people abusing alcohol and recognised the challenges that it presented.

RESOLVED: That

(1)        the report and comments raised be noted; and

(2)        the recommendations of PHAR be supported.