Agenda and minutes

            The Minutes of the meeting held on 3^rd October 2019, having been circulated were signed as a correct record.

            The Board considered a report of the Director of Adult Social Services, which provided an update on the key issues that the Executive Partnership Board (EFP) and the associated Operational Commissioning Committee (OCC) had been focused on progressing and monitoring over the past few months.  It was noted that the EFP had met on a quarterly basis and:

·         Work had taken place across both the Council and Halton Clinical Commissioning Group to reduce the level of projected overspend. Financial recovery action plans were in place to achieve a balanced budget by the end of the year;

·         Work had continued with all partners to help to minimise delayed transfers of care (DTOC);

·         Work had been presented to the OCC on the development of an Inter-Agency Disputes Process;

·         The current Joint Working Agreement (JWA) between the Council and Halton CCG expired on 31^st March 2019. Work was taking place on the development of a new JWA. In the meantime the current JWA would be extended for 6 months;

·         The OCC had agreed how the extra funding provided to the Council this Winter would be spent; and

·         As a result of an internal audit report of Halton Integrated Community Equipment Service, five recommendations were made and a Task and Finish Group had been set up to undertake a review with options for the future delivery of the service.

RESOLVED: That the contents of the report be noted.

The Board received a presentation from David Parr outlining the work that had taken place to date to develop the One Halton Prevention Model and Framework.

The Board was advised that the aim of One Halton was to deliver a place based health, integrated, user friendly, prevention model. It would make the most of local talents and assets, services and providers and enable people to stay well and within reason manage their own health. It aimed to improve health outcomes so that people live longer, healthier and happier lives.

The presentation outlined the benefits of the One Halton Model, revised governance arrangements, the One Halton population health achievements and its future aims.

It was noted that the next stage in the development of the model and framework would be to:

·         Develop a Provider Alliance Board;

·         Commissioners would determine the total Halton spend on health and social care and how this would be spent under a One Halton Provider Alliance model;

·         Commissioners to be clear about their joint commissioning intentions at a strategic One Halton level and “what good looks like” for Halton residents; and

·         resource the capacity to deliver a One Halton Provider Alliance model and support the GP Federations to drive forward the model.

            RESOLVED: That

1.    the revised governance arrangements for One Halton be approved; and

2.    the Board receive regular update reports on the development of One Halton.

            The Board received an update on the follow up actions that came out of the Development Day which took place in January 2019.  The development session focussed on:-

·         Describing factors in the current context that have an impact on what the Board was trying to do;

·         Assessed how its performing and identified areas for improvement;

·         Agreed priority areas of change that would improve performance;

·         Agreed specific changes that members of the Board would make; and

·         Identified actions needed to take to implement them.

            During the Development Day, the Board agreed to introduce induction for new Board Members and that a Membership and contacts list should be developed for Board Members to share. In addition, as a result of feedback from the day, the following documents had been developed and were circulated to Members for approval:

·         A revised terms of reference;

·         Updated roles and responsibilities for Board Members; and

·         A performance dashboard.

RESOLVED: That the following be approved:

1.    Revised terms of reference;

2.    The performance dashboard; and

3.    Updated roles and responsibilities for Board Members

            The Board received a presentation on the actions to date to support the Transformation of the local CAMHS offer, to identify the key drivers for the change and next steps

            Following the publication of Future in Mind (February 2015) each Borough was required to submit a Plan to transform the local current CAMHS offer to deliver on the aspirations contained within the Future in Mind document. An initial Plan was submitted to NHS England and had been subject to regular refresh.

            For 2018/19 the Plan had been refreshed jointly with Warrington CCG as many of the aims and objectives and redesign initiatives were shared.  However, the plan did provide each Borough with specific detail. 

            It was noted that the Plan had been approved by the local multi agency stakeholder group – the Emotional Health and Wellbeing for Young Peoples Partnership Group, chaired by the CCG Clinical Lead for children Denise Roberts, Deputy Chief Nurse for the Halton CCG.

RESOLVED: That

1.    the presentation be noted; and

2.    the Board approve the refreshed Transformational Plan for CAMHS

            The Board considered a presentation by the Independent Chair of the Halton Safeguarding Adults Board (SAB), which outlined the Annual Report 2017/18. The Board was advised on the role of the SAB, a summary analysis of the data gathered and how this information was used to inform the work priorities for 2018-19.

            RESOLVED: That the report be noted.

            The Board considered a copy of the CQC Local System Review Progress Monitoring Report, which was presented for information. The CQC undertook a local system review in Halton in August 2017 and the system produced an action plan in response to the CQC’s findings. Following a programme of 20 local system reviews, the Department of Health and Social Care had requested the CQC to produce progress updates for these. For Halton the progress report drew on:

·         Halton’s self reported progress against their action plan (31/10/18);

·         CQC’s trend analysis of performance against the England average for six indicators; and

·         Telephone interviews with four system leaders involved in the delivery and oversight of the action plan.

            With regard to the progress made against the six indicators, the CQC had stated that there had been no significant changes in A&E attendances and emergency admissions since the review. In terms of Emergency admissions from care homes these had increased a little during 2017/18.  Lengths of stay remained similar to the England average, whereas Delayed Transfers of Care and Emergency readmissions both increased and were higher than the England average. 

            In response to CQC’s progress report, the local system responded to CQC with regard to some improvements:

·         Emergency Admissions in quarter 3 and 4 of 2017/18 was actually below our long-term average; and

·         Emergency admissions from care homes the gap between Halton and England was now half what it was two years ago, and Halton had been below their long-term average for 4 of the last 5 quarters.

            The Board noted that CQC’s review of progress on the action plan concluded that there had been good progress made in all of the areas, with a few actions highlighted as on-going or requiring further development.

            RESOLVED: That the report be noted.

            The Board considered a report of the Director of Public Health which proposed a number of recommendations regarding the implementation of the Children and Social Work Act 2017 revised statutory guidance in relation to the Child Death Overview Panel (CDOP).

            As a result of the Children and Social Work Act 2017, Local Authorities, Clinical Commissioning Groups and Police forces have had to revise their current Local Safeguarding Children Board (LSCB) arrangements.   As part of these changes they have also been required to establish Child Death Overview Panels (CDOP) as a distinct set of arrangements rather than a subgroup of the LSCBs. 

            Under the revised guidance the new Child Death Review (CDR) partners, the Local Authority (LA) and the Clinical Commissioning Groups (CCG) had statutory responsibilities to:

·           Make arrangements to review all deaths of children normally resident in the local area and, if they considered it appropriate, for any non-resident child who has died in their area;

·           Make arrangements for the analysis of information from all deaths reviewed; and

·           Prepare and publish reports on what they have done and effectiveness of arrangements.

            The Board was advised that the current Pan Cheshire CDOP model which represented, Halton, Warrington and Cheshire West and East was working effectively and was in line with statutory guidance in relation to reviewing deaths and identifying local lessons.  Guidance required 60 cases to be reviewed each year to be viable and CDOP reviews between 55-60 cases each year making a reasonable argument to maintain this footprint.  Therefore, partners proposed that as part of the revised guidance for CDOP, the Pan-Cheshire model should be maintained. 

            In order to ensure that the CDOP continued to operate within Statutory guidance and met the needs of the CDR partners and the model supported the most effective response to Child deaths in the area, Partners would monitor its effectiveness over the next 12 months.

            RESOLVED: That

1.    Each area agrees to continue with a Pan-Cheshire CDOP approach and review effectiveness in January 2020 – this includes a commitment to the current funding and business support model.

2.    The governance for CDOP develops a more effective relationship between the Local Safeguarding Children’s Boards (LSCB) and Health and Wellbeing Boards (H&WBB) in line with local agreements.

3.    CDOP Members for each area will take responsibility for reporting into the most appropriate local forum for their area to ensure necessary activity is undertaken.

4.    A workshop of CDOP members will review any required operational changes to be in line with statutory guidance such as the undertaking of thematic reviews, policy, and practice guidance amendments.

            The Board considered a report of the Director of Public Health which provided an overview on the achievements and progress of the Champs Collaborative from April 2017 to April 2018. The Board also considered a copy of the Champs Collaborative Strategic Delivery Plan 2018/20. The Plan summarised key achievements and outlined the Programme objectives for 2018-20.

            RESOLVED: That the Board

1.    The Champs Collaborative progress update and the Strategic Delivery Plan 2018/20 (Appendix A) be noted;

2.    The implementation of the new innovative British Heart Foundation programme focusing on blood pressure and workplace health (Appendix B) be supported.

10^th July 19

2^nd October 19

15^th Jan 20

25^th March 20

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. All meetings would be held at 2pm in the Halton Stadium, Widnes:

10^th July 2019

2^nd October 2019

15^th January 2020

25^th March 2020

            RESOLVED: That the dates of future meetings be noted.