In the interest of transparency Dr Withers and Dr Akram Khan disclosed an interest as they worked in Primary Medical Care.

Action:            City Solicitor

Recommended –

That the minutes of the meeting held on 29 November 2016 be signed as a correct record (previously circulated).

(Fatima Butt – 01274 432227)

Resolved –

That the minutes of the meeting held on 29 November 2016 be signed as a correct record (previously circulated).

In April 2016 NHS England published the General Practice Forward View and through it committed to an additional £2.4billion additional investment by 2020/21 to improve patient care and access and develop new ways of providing primary care. 

The Chief Officer of Bradford and Craven Clinical Commissioning Groups will submit  Document “P” which sets out the challenges facing general practice and asks Clinical Commissioning Groups to submit plans to address those challenges.

The three CCGs have strategies in place to secure sustainable, high quality primary medical care.  Airedale, Wharfedale and Craven CCG has concentrated its approach on the role of general practice within new models of care, particularly the enhanced primary care approach.  Bradford City and Districts have developed a stand alone strategy which is appended to the report.

The Director of Public Health in Wakefield will give a presentation on their approach to accountable care.

Recommended-

That the Board notes and supports the actions being taken to ensure sustainable, high quality provision of GP services as being key to the delivery of the Board’s Joint Health and Wellbeing Strategy.

                                                                              (Helen Hirst – 01274 237788)

In April 2016 NHS England published the General Practice Forward View and through it committed to an additional £2.4billion additional investment by 2020/21 to improve patient care and access and develop new ways of providing primary care. 

The Chief Officer of Bradford and Craven Clinical Commissioning Groups submitted Document “P” supported by a presentation which set out the challenges facing general practice and asked Clinical Commissioning Groups to submit plans to address those challenges.

It was reported that the three CCGs had strategies in place to secure sustainable, high quality primary medical care.  Airedale, Wharfedale and Craven CCG had concentrated its approach on the role of general practice within new models of care, particularly the enhanced primary care approach.  Bradford City and Districts had developed a stand alone strategy which was appended to the report.

The Deputy Director of Public Health in Wakefield gave a presentation on the Wakefield approach to accountable care and the success they had with it.

She also reported that:

·         Wakefield had been developing an accountable care system for a number of years.

·         Wakefield only had one CCG and was not as complex as Bradford.

·         Bradford had a well-developed voluntary and community sector compared to Wakefield.

·         Wakefield’s key principles of accountable care approach included promoting health and wellbeing, reducing inequalities and preventing ill-health and illness progression at individual and community level; ensuring fast, responsive access to care and preventing avoidable admissions to care settings; proactive co-ordination of care, particularly for people with long term conditions.

Board Members made the following comments on the presentation:

·         When did Vanguard start and how much funding did Wakefield receive?

·         Who were partners accountable to: patients, government or NHS?  Concerned about governance issues; who made decisions and where governance sat was an important consideration.

·         What was the population of Wakefield?

·         Impressed that Wakefield’s accountable care developed as quickly as it did.

·         How was Wakefield’s relationship with NHS England and NHS Improvement?

·         Mental health issues and under 18’s were not mentioned in the presentation.

·         Reducing cost involved looking at things such as fewer buildings but not necessarily fewer people; people would be doing jobs in a different way.

·         Needed to control costs to meet the rising demands.

·         Needed to look at cost efficiency rather than cost cutting.

·         Achieving 50% outcomes after 15 years, was this the right route to take?

·         Needed to look at what worked for Bradford; effective use of money and resource; tackle prevention; for example enabling people to stay at home where needs could be better served.

In response to the above comments the Deputy Director of Public Health (Wakefield) reported that:

·         The vanguard (developing new care models) Multispecialty Community  Provider (MCP) started 3 years ago and the care home vanguard started a year ago; received £3.6million to deliver MCP and care home vanguard.

·         Accountability lied with NHS England ultimately.

·         Wakefield’s governance was through the Connecting Care Executive.

·         The population of Wakefield was 320,000.

·         It took a length of time for integration to start to develop, agreeing who held  ...  view the full minutes text for item 29.

At the September 2016 Health and Wellbeing Board meeting, members received a presentation from the Directors of Finance Group (Finance Directors from the Clinical Commissioning Groups, the main health providers and the Local Authority) that outlined  a four year financial forecast for the Health and Wellbeing sector and placed the forecast in the context of high and growing demand for services as a result of demographic changes, for example an ageing population.

On the 6^th December 2016 Council budget proposals for 2017-19 were approved for public consultation.

The Strategic Director Health and Wellbeing will submit Document “Q” which asks the Board to consider the Council’s 2017-19 budget proposals.

Recommended-

That the Board provides feedback on the 2017-19 Council Budget proposals.

                                                      (Sarah Muckle – 01274 437345)

At the September 2016 Health and Wellbeing Board meeting, members received a presentation from the Directors of Finance Group (Finance Directors from the Clinical Commissioning Groups, the main health providers and the Local Authority) that outlined a four year financial forecast for the Health and Wellbeing sector and placed the forecast in the context of high and growing demand for services as a result of demographic changes, for example an ageing population.

On the 6^th December 2016 Council budget proposals for 2017-19 were approved for public consultation.

The Strategic Director Health and Wellbeing submitted Document “Q” supported by a presentation on the Council’s 2017-19 budget proposals.

It was reported that the report provided an overview of the financial changes; the Executive’s 2017/18 and 2018/19 budget proposals; highlighting the Council’s long term financial position (4 year view).

The report was presented to ensure what the proposals mean and encourage views to be submitted through online questionnaires.

It was reported that the Budget Consultation closed on 12 February 2017.

Board Members stressed the importance of acknowledging the unintended consequences to services from the budget cuts ie cutting certain services would impact on social isolation which contributed to people’s wellbeing; importance of focusing on impact of decisions being made did not want unintended health inequalities getting worse.

No resolution passed on this item.

The Health and Wellbeing Chair’s highlight report (Document “R”) 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:

·         Better Care Fund - Quarter 2 Performance

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

·         A further update on establishing a whole system approach to Healthy Weight from the Healthy Weight Delivery Board.

Recommended-

(1) That the Board approves the Terms of Reference for the Integration and Change Board.

(2) That the Board notes the 2016-17 Quarter 2 Performance of the Better Care Fund and the preparation of the Better Care Fund Plan 2017-18.

(Angela Hutton – 01274 437345)

The Health and Wellbeing Chair’s highlight report (Document “R”) 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:

• Better Care Fund - Quarter 2 Performance
• Business conducted at the November and December meetings of the Bradford Health and Care Commissioners Group and the Integration and Change Board.
• A further update on establishing a whole system approach to Healthy Weight from the Healthy Weight Delivery Board.

Resolved-

(1) That  the Terms of Reference for the Integration and Change Board be approved.

(2) That the 2016-17 Quarter 2 Performance of the Better Care Fund and the preparation of the Better Care Fund Plan 2017-18 be noted.

Action:           Strategic Director, Health and Wellbeing