(Members Code of Conduct - Part 4A of the Constitution)

To receive disclosures of interests from members and co-opted members on matters to be considered at the meeting. The disclosure must include the nature of the interest.

An interest must also be disclosed in the meeting when it becomes apparent to the member during the meeting.

Notes:

(1)       Members may remain in the meeting and take part fully in discussion and voting unless the interest is a disclosable pecuniary interest or an interest which the Member feels would call into question their compliance with the wider principles set out in the Code of Conduct.  Disclosable pecuniary interests relate to the Member concerned or their spouse/partner.

(2)       Members in arrears of Council Tax by more than two months must not vote in decisions on, or which might affect, budget calculations, and must disclose at the meeting that this restriction applies to them.  A failure to comply with these requirements is a criminal offence under section 106 of the Local Government Finance Act 1992. 

(3)       Members are also welcome to disclose interests which are not disclosable pecuniary interests but which they consider should be made in the interest of clarity.

(4)       Officers must disclose interests in accordance with Council Standing Order 44.

Recommended –

That the minutes of the meeting held on 6 April 2016 be signed as a correct record (previously circulated).

(Fatima Butt – 01274 432227)

Resolved-

That the minutes of the meeting held on 6 April 2016 be signed as a correct record.

(Access to Information Procedure Rules – Part 3B of the Constitution)

Reports and background papers for agenda items may be inspected by contacting the person shown after each agenda item.  Certain reports and background papers may be restricted. 

Any request to remove the restriction on a report or background paper should be made to the relevant Strategic Director or Assistant Director whose name is shown on the front page of the report. 

If that request is refused, there is a right of appeal to this meeting. 

Please contact the officer shown below in advance of the meeting if you wish to appeal. 

(Fatima Butt - 01274 432227)

There were no appeals submitted by the public to review decisions to restrict documents.

Previous Reference:  Minute 27 (2015/16)

The Working Better Togetherreport is a standing item at the Health and Wellbeing Board that brings regular updates on development of a whole system approach to health, social care and wellbeing; for example supporting further integration between health and social care organisations and processes and directing the health and wellbeing system to develop integrated strategies.

The Interim Strategic Director of Adult and Community Services and the Director of Collaboration Bradford City, Bradford Districts and Airedale, Wharfedale and Craven Clinical Commissioning Groups will submit Document “A” which gives an update on the development of a Mental Health and Wellbeing Strategy for Bradford, Airedale and Craven for discussion, and for Board members to provide strategic direction.

Recommended-

That the Health and Wellbeing Board receives the update paper and presentation, provides feedback to shape and inform the development of the joint strategy and schedules a further update to the Board for Autumn 2016.

                                                                        (Mick James – 01274 237290)

The Working Better Togetherreport is a standing item at the Health and Wellbeing Board that brings regular updates on development of a whole system approach to health, social care and wellbeing; for example supporting further integration between health and social care organisations and processes and directing the health and wellbeing system to develop integrated strategies.

The Interim Strategic Director of Adult and Community Services and the Director of Collaboration Bradford City, Bradford Districts and Airedale, Wharfedale and Craven Clinical Commissioning Groups submitted Document “A” supported by a power point presentation which gave an update on the development of a Mental Health and Wellbeing Strategy for Bradford, Airedale and Craven for discussion, and for Board members to provide strategic direction.

It was reported that Bradford was seen as a leading economy for its work on Crisis Care, Dementia and the Physical/Mental Health interface/Parity of Esteem agenda.

Members commented on a number of issues which included:

·        Were all agencies/partners working together to achieve the joint Mental Health and Wellbeing Strategy development

·        Airedale had not been adequately engaged; needed a more joined up approach; more acute providers could offer to help other organisations. 

·        The district spent below national spend on mental health but it was more important to ensure that investment focussed on where it was needed.

·        What was the budget involved in providing joint mental health services?

·         The budget involved was 9.1% of the health economy money but what was needed was the exact spend on mental health such as primary care; what care pathways there were and what the outcomes were; if not achieving the outcomes then more needed to be invested; emphasis was needed on outcomes.

·        Were we given a model by NHS England to follow in terms of the funding?

·        A timeline for achieving the objective and outcomes for the joint mental health strategy was needed.

·        A simple way of patients accessing mental health services needed looking at.

·        Welcomed the holistic approach but needed to be clear on what the outcomes and objectives were.

·        How would this strategy link into the West Yorkshire Mental Health work.

·        Voluntary Sector was a key player in providing mental health services and all concerned needed to ensure the VCS was involved.

In response to Members comments it was reported that:

·        All agencies and partners involved were working together and the support from the Bradford District Care Trust as a provider was very impressive especially around planning clinical pathways.

·        Acute Care was being looked at; joined up work was happening; more work will be undertaken with teaching hospitals.

·        A formula for the funding was given by NHS England; the piece of work that was being undertaken was looking at where the income flows were; voluntary sector organisations provided direct mental health services; some funded by the Local Authority; some funded through health and some through a charity.

·        Officers were working on a set of figures which included public health spend; Adult and Social Care and the three CCG’s.

·         

Resolved-

That a further  ...  view the full minutes text for item 4.

The Strategic Director, Children’s Services and the Interim Strategic Director Adult and Community Services will submit the SEND Local Offer Annual report (Document “B”) which provides an overview of activity through the Local Offer to children and young people with Special Educational Needs or Disability and their families or carers.

Recommended –

That the SEND Local Offer 2015/16 Annual report be reviewed and endorsed and the Chair provides a foreword to the report.

                                                            (Jenni Leary – 01274 439538)

The Strategic Director, Children’s Services and the Interim Strategic Director Adult and Community Services submitted the SEND Local Offer Annual report (Document “B”) which provided an overview of activity through the Local Offer to children and young people with Special Educational Needs or Disability and their families or carers.

Board Members were informed of the developments achieved so far and the feedback and next steps from the consultation undertaken as detailed in the report.

Board Members made the following comments:

·        Pleasing to see the uptake of the Local Offer; how could young people and families be engaged in designing the service?

·        How did the issues link with the previous item on the agenda on the Mental Health and Wellbeing Strategy? SEN impacted on the mental wellbeing of parents and children; needed to see how much is being spent on all the different services.

·        Was there engagement with schools in relation to the local offer?

·        What came out of the peer review of the service?

In response to the comments made by Members it was reported:

• There was a crossover between this item and the previous one discussed; needed to ensure services were integrated.
• The service worked closely with schools; it was statutory that all schools published an SEN Offer.
• The report on the peer review would be on the local offer website; there was an issue of sufficiency of places, by September the service will have options on how we can move forward with that; needed to improve on paediatric availability etc.
• Needed to look at where additional places would be required; discussions with the funding agency needed to take place.

Resolved –

That the SEND Local Offer 2015/16 Annual report be endorsed and the Foreword be signed by the Chair.

Action:          Strategic Director, Children’s Services and Interim Strategic Director Adult and Community Services                                                        

The Health and Wellbeing Chair’s highlight report summarises business conducted between meetings and business conducted at development sessions or informal meetings where these are necessary to consider material that is not yet in the public domain. 

The report (Document “C”) also provides updates from the sub groups - Bradford Health and Care Commissioners and the Integration and Change Board.

The items covered in the report are:

·        Development of the Sustainability and Transformation Plans (STP) for West Yorkshire (WY) plus Craven and for Bradford and Craven

·        An update on work by the Bradford Health and Care Commissioners Group to expand and develop the 2016-17 Better Care Fund  prior to its signoff by the Board Chair for submission to NHS England, the findings of an internal audit of the District’s Better Care Fund and quarter 4 performance for 2015-16 (Appendix 1)

·        Learning Disability Transforming Care Plan

Recommended-

(1)       That the Board accepts and supports the Better Care Fund Plan for 2016/17 and Quarter 4 performance 2015-16 and receives further progress and performance reports at future Board meetings.

(2)       That the Board notes the Draft Learning Disability Transforming Care Plan (previously circulated for 20^th June Informal Board meeting and submitted to NHS England on the 24^th June)  and that a progress report be submitted to the November  29^th Health and Wellbeing Board meeting which focuses on:

·        Improvement in outcomes

·        Budget – current spend /best use

·        Wider context – population/level of need

(Angela Hutton – 01274 437345)

The Health and Wellbeing Chair’s highlight report summarised business conducted between meetings and business conducted at development sessions or informal meetings where these were necessary to consider material that was not yet in the public domain. 

The report (Document “C”) also provided updates from the sub groups - Bradford Health and Care Commissioners and the Integration and Change Board.

The items covered in the report were:

·        Development of the Sustainability and Transformation Plans (STP) for West Yorkshire (WY) plus Craven and for Bradford and Craven

·        An update on work by the Bradford Health and Care Commissioners Group to expand and develop the 2016-17 Better Care Fund  prior to its signoff by the Board Chair for submission to NHS England, the findings of an internal audit of the District’s Better Care Fund and quarter 4 performance for 2015-16 (Appendix 1)

·        Learning Disability Transforming Care Plan update.

It was reported that in terms of the Learning Disability Transforming Care Plan the District was already making good use of community placements, with a low number of residential beds which were rarely fully occupied and made lower than average use of out of area placements.

Members were informed that the Integration and Change Board continued to oversee the development of the Sustainability and Transformation Plan (STP) for Bradford District and Craven and the progress towards and content of the latest version of the local STP and links with the West Yorkshire STP.

Alongside the STP the Local Digital Roadmap had been reviewed by the ICB to ensure this connects with the local STP.  The national Five Year Forward View made a commitment that by 2020, there would be ‘fully interoperable electronic health records so that patient’s records are paperless’.  This was supported by a Government commitment in ‘Personalised Health Care 2020’ that ‘all patient and care records will be digital, interoperable and real-time by 2020’. 

Bradford Health and Care Commissioners (BHCC) had overseen the development of the Better Care Fund for 2016/17 and its current status was ‘approved with support’ by NHS England. Work had been undertaken for the final submission, 30^th June 2016 to address feedback and be clearer about metrics and milestones.

Resolved-

(1)       That the Board accepts and supports the Better Care Fund Plan for 2016/17 and Quarter 4 performance 2015-16 and receives further progress and performance reports at future Board meetings.

(2)       That the Board notes the Draft Learning Disability Transforming Care Plan (previously circulated for 20^th June Informal Board meeting and submitted to NHS England on the 24^th June)  and that a progress report be submitted to the November  29^th Health and Wellbeing Board meeting which focuses on:

·        Improvement in outcomes

·        Budget – current spend /best use

·        Wider context – population/level of need

Action:          Interim Strategic Director Adult and Community Services/Director of Public Health

Previous Reference: Minute 40 (2014/15)

The Director of Public Health, the Interim Strategic Director of Adult and Community Services and the Clinical Chair of Bradford Districts Clinical Commissioning Group will submit Document “E” which outlines the challenges posed by overweight and obesity to health outcomes.

Recommended-

(1)       That the Health and Wellbeing Board endorses and adopts NICE Guidance to Health and Wellbeing Boards on working with communities to tackle overweight and obesity and to achieve healthy weight at a population level.

(2)       That the Health and Wellbeing Board mandates the Local Authority to lead a system-wide approach to achieving healthy weight for the population of Bradford and Airedale to include:

Board members to ensure that the policies and practices of their respective agencies that might impact on healthy weight are reviewed; that these practices and policies are further improved and developed in line with a whole system approach and that the involvement and endorsement of their governing bodies is secured.

Appropriate governance is put in place and 6 monthly updates on progress are provided to the Board.

Bradford Health and Care Commissioners to review their commissioning and to take action to ensure that commissioned activity contributes to achieving Healthy Weight at a population level, with particular emphasis on prevention and early intervention.

(3)       That the Chair of the Board writes to Bradford District Partnership seeking their endorsement and commitment to be involved in a system wide approach to achieving healthy weight.

                                                            (Ralph Saunders – 01274 434782)

The Director of Public Health, the Interim Strategic Director of Adult and Community Services and the Clinical Chair of Bradford Districts Clinical Commissioning Group submitted Document “E” supported by a power point presentation which outlined the challenges posed by overweight and obesity to health outcomes.

Members commented on a number of issues which included:

• The approach presented was not appropriate in reducing the impact on health; location of fast food takeaways did not make a difference to obesity; there was no evidence to support this; there was no evidence that sugar tax would work; focus should be on people who are obese rather than a whole population issue.
• There was a relationship between poverty and obesity; level of obesity in certain wards with a high ethnic population needed looking at; it was important that the right outcomes were looked at.
• Needed to look at why a higher proportion of children in year 6 are obese?
• Focus needed to be on early years and not just on people who were obese; agree that focus should be on outcomes that achieved the best results.
• Report not clear on where focus should be; research on Born in Bradford was missing.
• The ethnicity element was not simplistic; some of the ethnic population lived in the most deprived areas; as Cities develop the obesity rises but not in rural areas; it was about lifestyles not just culture.
• Royds had a high level of obesity but not did not have a lot of BME population in the ward; it was more about peoples lifestyles and genetics.
• Schools in the district were promoting a pilot walk a mile; would be good to see results of the programmes better start was running to reduce weight.
• Planning and transport infrastructure around cycling needed looking at.  
• Needed to speak to children in school and with their families; number of dessert parlours being opened up was ridiculous; needed to encourage young people to exercise.
• What were the reasons for improvements in the weight of 4 and 5 year olds?
• It would be useful to see the number of people and their ages in each tier of the pyramid on page 105 of the report; would like to see spend based on age; when was the last time work in this area was reviewed? What was the spend by other organisations around the table; target should be prevention rather than cure.

In response to Members comments it was reported that:

·        Needed to get the message to parents about issues on child obesity before the child starts school.

·        6 million school meals were provided by the Council which had low salt and nutritional value and operated within legislation; majority of meals prepared at schools on site; academies did not have to follow the same legislation; rules were different when children got to high schools.

·        Getting people into employment was important as people in work had better health.

·        Investment in cycling was being made such as the super cycle highway from Bradford to Leeds  ...  view the full minutes text for item 7.

The Director of Public Health will submit Document “D” which reports on the Boards draft Forward Plan for 2016/17.

Recommended-

That the draft Forward Plan be agreed.

                                                                        (Angela Hutton – 01274 437345)

The Director of Public Health submitted Document “D” which reported on the Boards draft Forward Plan for 2016/17.

Resolved-

That the draft Forward Plan be agreed subject to some items being moved to alternative dates to ensure that lead officers can attend for their items.

Action:          Director of Public Health