No disclosures of interest in matters under consideration were received.

Recommended –

That the minutes of the meeting held on 19 September and 19 October 2016 be signed as a correct record (previously circulated).

(Fatima Butt – 01274 432227)

Resolved-

That the minutes of the meeting held on 19 September and 19 October 2016 be signed as a correct record.

Action:          City Solicitor

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

The process of developing Sustainability and Transformation Plans (STPs) as mandated in NHS Planning Guidance for 2016/17 – 2020/21 has been ongoing at a local level in Bradford District and Craven since early January 2016 and also as one of six constituent parts of a wider West Yorkshire and Harrogate STP.

The local STP process includes work between NHS Clinical Commissioning Groups, NHS providers, Local Authorities and the Voluntary and Community Sector to identify how the health and wellbeing of the population can be improved and how, care and quality standards can continue to be improved all within the financial resources available in the next 4-5 years.  This work has built on and brought up to date the Five Year Forward View for the Bradford District and Craven Health and Care Economy 2014-19 and is supported by the Better Health - Better Lives priority of the new District Plan.

The Chief Officer Bradford Districts and Bradford City Clinical Commissioning Groups will submit Document “K” which provides an update on the Sustainability and Transformation Planning process for health and social care in Bradford District and Craven, the Clinical Commissioning Groups and health providers in Bradford District and Craven.

Recommended -

(1)       That the update on the Bradford District and Craven and West Yorkshire and Harrogate Sustainability and Transformation Planning processes be noted.

(2)       That the Board suggests ways to contribute to the operational planning process.

(3)       That the board provides feedback on the published draft of the West Yorkshire Sustainability and Transformation Plan as previously circulated and provided as Appendix 1 to Document “K” or through the links.

                                                            (Rebecca Malin – 01274 237290)

The process of developing five year Sustainability and Transformation Plans (STPs) was mandated in NHS Planning Guidance for 2016/17, development started at a local level in Bradford District and Craven in early January 2016. This  local plan forms one of six constituent parts of a wider West Yorkshire and Harrogate STP which is submitted to NHS England.

The local STP development process has included work between NHS Clinical Commissioning Groups, NHS providers, Local Authorities and the Voluntary and Community Sector to identify how the health and wellbeing of the population could be improved and how, and care and quality standards could continue to be improved within the financial resources available in the next 4-5 years.  This work had built on and brought up to date the Five Year Forward View for the Bradford District and Craven Health and Care Economy 2014-19 and is also reflected by the Better Health - Better Lives priority of the new District Plan.

The Chief Officer Bradford Districts and Bradford City Clinical Commissioning Groups submitted Document “K” which provided an update on the Sustainability and Transformation Planning process for health and social care in Bradford District and Craven, the Clinical Commissioning Groups and health providers in Bradford District and Craven.

Board Members were informed that:

·        The STP process had been built on the acknowledgment that there would be a significant gap between the available budget for health and social care services in the years to 2020/21 and the current level of spend created by high demand for health and social care services in the Bradford District and Craven.

·        Efficiencies would need to be matched by shifting the emphasis of service provision further towards improving the health and wellbeing of the population – supporting people to become and remain healthy and independent for longer to reduce demand to delay the need for social care services as a result of ill-health.

·        It was not clear when the STPs would be finalised, they were likely to be subject to continued revision to meet annual NHS planning guidance.

·        An overview of the operational plans for providers and commissioners would be considered at the Health and Wellbeing Board’s development session next week.

·        It was acknowledged that there had not been enough public engagement on the STP.

·        As part of the STP planning process an operational plan for each NHS commissioner and provider organisation must be submitted to NHS England by 23 December. In addition we have committed to producing a cross-system operational plan to reflect the ambition for whole system working within the Bradford and Craven health system.

·        Due to the timing of Local Authority budget decisions, assumptions have  had to be made in the operational plans which would be submitted to NHS England in late December about resources which wouldl require revision once the LA budget is agreed in late February.

Members agreed that operating a local control total for the Bradford District and Craven STP would be beneficial(i.e. a total budget for  ...  view the full minutes text for item 22.

The Strategic Director, Health and Wellbeing and the Strategic Director Children’s Services will submit Document “O” which reports progress on the Bradford Safeguarding Children Board (BSCB) and the Safeguarding Adult Board (SAB).  The report outlines in brief the main areas covered by the annual reports and highlights areas of focus where joint approaches to policy and practice are in operation or are being considered for development across children’s and adults’ safeguarding arrangements.

Recommended-

That the Board receive the annual reports of the Bradford Safeguarding Boards.

                                                            (Bernard Lanigan – 01274 432900)

The Strategic Director, Health and Wellbeing and the Strategic Director Children’s Services submitted Document “O” which reported progress on plans made by the Bradford Safeguarding Children Board (BSCB) and the Safeguarding Adult Board (SAB) in 2015-16.  The report outlined in brief the main areas covered by the annual reports and highlighted areas of focus where joint approaches to policy and practice were in operation or were being considered for development across children’s and adults’ safeguarding arrangements.

Safeguarding Adults Board

The Chair of the Safeguarding Adults Board (SAB) referred to high numbers of referrals from care homes in 2015-16 and reported that SAB wished to focus on:

• Commissioning for quality across the sector, and may bring this issue back to Health and Wellbeing Board at a later date.

·        It was acknowledged that there are safeguarding issues which overlap between children’s and adults’ safeguarding including managing risk as young people move into adulthood,

·        SAB welcomes the Mazars report on the Southern Health Trust and its wider review of unexplained and premature deaths of people within mental health or learning disability services.

·        The two Safeguarding Boards would be working together to respond to the areas of abuse outlined in the 2014 Care Act such as Female Genital Mutilation and modern formsof slavery.

• SAB would like to see the 2017 revision of the Health and Wellbeing Strategy describe what good personalised care services was, primary care and acute services looked like to ensure there was whole system understanding for staff ; so that the public and staff could understand what personalised care was.

Members made the following comments:

·        The Chair of the Board emphasised the importance of providing good personalised care that meets needs as early as possible.

·        Public Health acknowledged that the Joint Health and Wellbeing Strategy could provide tools to help commissioners decide what to provide and how best to provide it.

·        It was reported that the Risk Enablement Panel was an open and transparent process to share issues and reduce alerts relating to personal care.

·        It was acknowledged that we need to improve the quality of care and that personalised care is often the least risky for individuals but the most challenging to commission. Adult Social Care will be looking at ways to address care needs and concerns about care earlier, to pre-empt safeguarding alerts by working with people and providers to develop a quality premium that goes beyond the Care Quality Commission judgements.

·        Members expressed concern after reading the Mazars report on the enquiry into the Southern Health Foundation Trust that we need as a sector to ensure that vulnerable people were receiving appropriate healthcare and were not dying prematurely as a result of poor care.

·        It was acknowledged that the District had a good track record on not using out of area placements for people with Learning Disabilities.

A detailed presentation was provided to the Board by the Director of Health at Mazars (External Auditors) on the findings of their enquiry into the deaths of people  ...  view the full minutes text for item 23.

Members are reminded that progress updates on developing a Mental Wellbeing Strategy were received at Board meetings in July and again in September 2016 when it was agreed that the final strategy would return in November 2016.  The Board resolved:

“That the Board receives the update and provides feedback to further shape the strategy and encourages wide participation in consultation on the draft strategy through its constituent organisations.”

The Strategic Director of Health and Wellbeing and the Chief Officer of Bradford City, Bradford Districts and Airedale, Wharfedale and Craven Clinical Commissioning Groups will submit Document “N” which reports that the Mental Wellbeing Strategy for Bradford District and Craven 2016 - 2021 has been developed through intensive collaborative work during April – October 2016.  It is presented to the Health and Wellbeing Board for approval and to request views on the proposed approach to implementation.

Recommended-

(1)  That the Board supports the Mental Wellbeing Strategy as the vision for the development of services and community assets to improve mental wellbeing in Bradford district and Craven.

(2)  That the Board provides views on the initial implementation plans detailed in Section 3.1 of Document “N”.

                                          (Ali Jan Haider – 01274 237290)

Members were reminded that progress updates on developing a Mental Wellbeing Strategy were received at Board meetings in July and again in September 2016 when it was agreed that the final strategy would return in November 2016.  The Board resolved:

“That the Board receives the update and provides feedback to further shape the strategy and encourages wide participation in consultation on the draft strategy through its constituent organisations.”

The Strategic Director of Health and Wellbeing and the Chief Officer of Bradford City, Bradford Districts and Airedale, Wharfedale and Craven Clinical Commissioning Groups submitted Document “N” supported by a presentation which reported that the Mental Wellbeing Strategy for Bradford District and Craven 2016 - 2021 had been developed through intensive collaborative work during April – October 2016.  It was presented to the Health and Wellbeing Board for approval and to request views on the proposed approach to implementation.

It was reported that the Mental Wellbeing Strategy would be launched on 19 January 2017.

Members commented on the following:

·        Needed to look at psychotherapeutic support for victims of abuse.

·        Needed to look at physical health and mental health jointly, needed to try and alter funding arrangements; needed to look at mental health and autism.

·        Commended the strategy; strategy could be updated as more current data was available.

It was reported that work was on going for children with autism; a separate autism strategy was being looked at which would come to the Board at some point in the future.

Resolved-

(1)       That the Mental Wellbeing Strategy as the vision for the development of services and community assets to improve mental wellbeing in Bradford District and Craven be approved.

(2)       That the public launch of the strategy in January 2017 be supported.

(3)       That the Board note the priority areas for implementation and that the detail to support these will be published alongside the strategy at the January launch.

Action:          Strategic Director, Health and Wellbeing

The Health and Wellbeing Chair’s highlight report (Document “M”) summarises business conducted between meetings: where for example reporting or bid deadlines fall between Board meetings or business conducted at any meetings not held in public where these are necessary to consider material that is not yet in the public domain.

Reporting through a highlight report means that any such business is discussed and formally minuted in a public Board meeting. 

The report covers:

·        A brief outline of each schemes contained within the Better Care Fund for Bradford District and Craven to provide background information for Board members and performance against outcomes for Quarter 2 2016-17.

·        Business conducted at the September and October meetings of the Bradford Health and Care Commissioners Group and the Integration and Change Board.

·        A short update on establishing a whole system approach to Healthy Weight, reporting to the Health and Wellbeing Board.

·        Update on an issue raised at Children’s Overview and Scrutiny in respect of young carers.

·        Progress on the West Yorkshire Sustainability and Transformation Plan

Recommended-

That the update be noted.

(Angela Hutton – 01274 437345)

The Health and Wellbeing Chair’s highlight report (Document “M”) summarised business conducted between meetings: where for example reporting or bid deadlines fell between Board meetings or business conducted at any meetings not held in public where these were necessary to consider material that was not yet in the public domain.

Reporting through a highlight report meant that any such business was discussed and formally minuted in a public Board meeting. 

The report covered:

·        A brief outline of each schemes contained within the Better Care Fund for Bradford District and Craven to provide background information for Board members and performance against outcomes for Quarter 2 2016-17.

·        Business conducted at the September and October meetings of the Bradford Health and Care Commissioners Group and the Integration and Change Board.

·        A short update on establishing a whole system approach to Healthy Weight, reporting to the Health and Wellbeing Board.

·        Update on an issue raised at Children’s Overview and Scrutiny in respect of young carers.

·        Progress on the West Yorkshire Sustainability and Transformation Plan.

Resolved-

That the update be noted.

The Strategic Director for Health and Wellbeing will submit Document “L” which reports that the Terms of Reference for the Health and Wellbeing Board have been reviewed, in order to reflect changes in the scope of the Board’s responsibilities and recent changes to the Council Directorships and Portfolios as currently referenced in the Terms of Reference and to ensure that Board membership remains fit for purpose.

Recommended-

(1)       That the amended Terms of Reference for Bradford and Airedale Health and Wellbeing Board be agreed.

(2)       That the amended Terms of Reference are submitted to Governance and Audit Committee and through Members own governance routes.

                                                            (Angela Hutton – 01274 437345)

The Strategic Director for Health and Wellbeing submitted Document “L” which reported that the Terms of Reference for the Health and Wellbeing Board had been reviewed, in order to reflect changes in the scope of the Board’s responsibilities and recent changes to the Council Directorships and Portfolios as currently referenced in the Terms of Reference and to ensure that Board membership remained fit for purpose.

Members commented on the following:

·        Why not invite both GP Federations?

·        Concerned the board would be too large; there were other organisations that were not represented such as Housing, Employment, Private Sector, Social Care Housing, but adding all of these would result in the Board becoming too large and it would be difficult to remain strategic.

·        Care providers were not represented and should be.

·        It was agreed that Primary Care was the most significant sector missing from the current Board’s membership in the current context of redeveloping our approach to health and social care services and that the two Community Interest Companies should be invited to agree which of them would represent the primary care sector on the Board.

Resolved –

(1)       That the amended Terms of Reference for Bradford and Airedale Health and Wellbeing Board be corrected to note that ‘GP Federation’ should read ‘Community Interest Company (CIC)’ and be agreed.

(2)       That the amended Terms of Reference are submitted to Governance and Audit Committee and through Members own governance routes.

Action:          Strategic Director, Health and Wellbeing