In introducing the meeting, the Chair welcomed Geraldine Howley, Group Chief Executive of Incommunities as a newly appointed member.

No disclosures of interest in matters under consideration were received.

Recommended –

That the minutes of the meeting held on 19 December 2017 be signed as a correct record (previously circulated).

(Fatima Butt – 01274 432227)

Resolved –

That the minutes of the meeting held on 19 December 2018 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 23 (2016/17)

The Chief Officer of NHS Airedale, Wharfedale and Craven CCG, NHS Bradford City and NHS Bradford Districts CCG will submit Document “K” which will be supported by a presentation provides the Health and Wellbeing Board with the local picture of how lessons are currently learned from deaths across the health and social care system, the challenges ahead and how the system plans to work together to utilise learning from deaths.  It was prepared at the request of the Board, which, early in 2017, asked for an overview of how learning from deaths takes place in the Bradford and Airedale system.  The presentation, will do the following:

§  Enable key healthcare providers to summarise their own work on developing systems and processes to learn from deaths. 

§  Summarise how providers and commissioners have collaborated to learn from deaths of people with a learning disability

Recommended-

(1)       That the progress already made in response to guidance and commitment to further explore solutions to the challenges be noted.

(2)       That the contribution and commitment which needs to be made by the whole system to learn openly from deaths, to translate learning into improving how care is delivered be considered.

                                                                        (Kate Varley – 01274 256088)

The Chief Officer of NHS Airedale, Wharfedale and Craven CCG, NHS Bradford City and NHS Bradford Districts CCG submitted Document “K” which was supported by a presentation, providing the Health and Wellbeing Board with the local picture of how lessons are currently learned from deaths across the health and social care system, the challenges ahead and how the system planned to work together to utilise learning from deaths.  It was prepared at the request of the Board, which, early in 2017, asked for an overview of how learning from deaths took place in the Bradford and Airedale health and care system.  The presentation, outlined the following:

• Enable key healthcare providers to summarise their own work on developing systems and processes to learn from deaths and,

• Summarise how providers and commissioners have collaborated to learn from deaths of people with a learning disability

In synopsis, the PowerPoint presentation outlined that a total of 4,571 deaths had been registered in Bradford, 2016 which was an increase of around a 100 from the previous year. Bradford had seen the highest number of deaths since 2004 and there were over 150 more deaths per 100,000 population in Bradford in comparison to the national average hence the mortality rates being higher, both regional and on a national basis. Bradford had the highest still birth rate in the region and there had been 55 still births in 2016 compared to 50 in 2015.

A further detailed breakdown of data was covered on the aforementioned, information which had been acquired from Bradford Teaching Hospitals NHS Foundation Trust; Bradford District NHS Foundation Trust; Airedale NHS Foundation Trust; Bradford Metropolitan District Council; NHS Airedale, Wharfedale and Craven CCG; NHS Bradford City CCG; and, NHS Bradford Districts CCG.

During the discussion, the following comments had resulted:

• It was paramount that health and care records accurately reflect the needs of people with learning disabilities, to support their care and subsequent learning by the health and care;
• There were a significant number of people with a learning disability and complex needs in Housing Associations and there was a lack of detailed information on such vulnerable people
• The integration of information sharing between the health and housing sectors would be a significant step for professionals towards learning from deaths across the system;
• Due to the nature of confidentiality, personal information of individuals was not always shared between agencies. Eliminating obstacles to the sharing of data to enable safe high quality care was a key objective for progression towards the Board’s ambition;
• It was important to learn from deaths in order to prevent people from dying prematurely. This would be the ideal overall ambition for the Bradford District;
• A further paramount factor was to have an insight in the everyday living of vulnerable people in communities;
• It would be ideal to pull together the wider determinants of health, data to include information on localities working, information sharing, clarity on safeguarding and to equally have information on people with multiple complex needs;
• Further work is  ...  view the full minutes text for item 26.

The Senior Responsible Officer for Bradford Transforming Care Partnership for Learning Disabilities and Autism will submit Document “L” which provides an update to the Board on the progress made in the Transforming Care Programme (TCP).

 The report highlights key pieces of work that will improve the quality of life and opportunities for people with a learning disability and autism in the district. In doing so, it highlights the need for changes in service delivery across health and social care.

Recommended-

That the progress already made in delivering the national transforming care programme for people with learning disabilities and autism and to be aware of the identified financial risks as they are currently understood be noted.

                                                            (Mairead O’Donnell – 01274 431517)

The Senior Responsible Officer for Bradford Transforming Care Partnership for Learning Disabilities and Autism submitted Document “L” which provided an update to the Board on the progress made in the Transforming Care Programme (TCP).

From within the report, the officer gave the following synopsis:

·         The programme had reached its final year (from an NHS England perspective) and the March programme board had been dedicated to the wider issues facing people with learning disabilities and/or autism and seek to broaden the scope of our programme going forward. This required changes in the current organisation and governance arrangements. The intent behind changes was sustainability and improvement;

·         Bradford’s plan for people with Learning Disabilities across the three CCGs and the Local Authority, was wider than the national NHS England agenda of the TCP programme in that Bradford was working to develop a community provision for all people with learning disabilities and/or autism by ‘building the right support’ for people, not just those who found themselves in in-patient beds.  However, the national focus on the programme had meant a closer concentration on those who were in beds, both within area and out of area and in particular those who had been an in-patient for over five years;

·         The report highlighted other key pieces of work that could improve the quality of life and opportunities for people with a learning disability and autism in the district. In doing so, it highlighted the need for changes in service delivery across health and social care;

·         Bradford did not have a local forensic community service to support people returning to the area form secure services. National Health Service England (NHSE) Specialised Commissioning was developing a regional ‘Forensic Outreach Liaison Service’ (FOLS) to support local TCPs where local forensic community support was not available. The aim was to have this service ‘referral-ready’ by March 2018;

·         Work is underway to develop a single pathway for children and young people that will sit across Children’s, Adults, Education and Health. The transforming care programme was linking into this work; and,

·         In June 2016, a national 3 year campaign (STOMP) was started to ensure that people had medication reviews with a focus on reducing anti-psychotic medications when these were prescribed inappropriately. 

Following delivery of presentation, a clarification was sought on how could all elements be configured with one another as sharing hubs for all involved. In response, it was explained that a Liaison and Diversion process, funded by NHSE existed, the sole purpose to identify vulnerable people early in order to improve health. Also an Assessment and Treatment Unit was in process, involving a specialist assessment and treatment ward for adults over 18 with moderate to severe learning disabilities and mental health problems whose needs were not supported at home, in the community or in other adult mental health wards. The service was support to help individuals meet daily living needs and maintain independent skills. The process ensured that the care was personalised to meet the needs and that a person was  ...  view the full minutes text for item 27.

Previous Reference:           Minute 19 (2017/18)

Members are reminded that the Board at its meeting on 19 December 2017 considered a first draft of a Health Care Plan for Bradford District and Craven for early discussion and feedback. It was resolved amongst other things that a finance report be presented to the Board in February 2018.

In response to the above a presentation will be provided to the Board Members on the information requested.

                                                            (Julie Lawreniuk – 01274 237642)

                                                            (Andrew Crookham – 01274 433656)

Members were reminded that the Board at its meeting on 19 December 2017 considered a first draft of a Health Care Plan for Bradford District and Craven for early discussion and feedback. It was resolved amongst other things that a finance report be presented to the Board in February 2018.

A PowerPoint presentation was provided to the Board Members on the financial position of the health and care economy. In summary, the local health system projected a £12.7m deficit at the end of the 2017/18 year, which could be managed through one-off measures. It was noted that the plans of local organisations for the next four years had been refreshed in November and would require challenging levels of efficiency to be delivered.

It was noted that plans would require efficiencies of £262m to be achieved over the next four years, and that £210m opportunities had been identified against this, leaving a predicted gap of £52m after four years.

It was noted that for the first time in many years cash flow and liquidity was planned to become a more significant challenge for local organisations over the coming year, and that this emphasised the importance of pace in delivery of efficiency schemes.

In response the Board advised that they would wish to be kept appraised of progress with the delivery of efficiencies by all parts of the local health and care system. The Programme Director highlighted that he wished to work with professionals across the system and therefore the right mechanisms of resources, planning and monitoring was required.

Resolved –

(1)       That the Health and Wellbeing Board receives assurance via      regular updates in the Chair’s highlight report on progress with       delivery of identified efficiency savings across the health and care       system.

(2)       That appropriate programme management arrangements are put          in place to ensure necessary clarity, support and challenge for the      delivery of system efficiencies.

LEAD:            Programme Director, Integration and Change Board

The Health and Wellbeing Board Chair’s highlight report (Document “M”) summaries business conducted between Board meetings. February’s report includes the Pharmaceutical Needs Assessment, an update on Localities, prevention and Early Help, a proposal on the Future Governance of the Health and Wellbeing Board, a letter from Duncan Selbie (National Chief Executive of Public Health England) and updates from the Board’s sub- groups.

Recommended-                                                                       

That the report be noted and the Pharmaceuticals Needs Assessment (Appendix “A” to Document “M”) be approved.

                                                                        (Bev Maybury – 01274 432900)

The Health and Wellbeing Board Chair’s highlight report (Document “M”) summarised business conducted between Board meetings. February’s report included the Pharmaceutical Needs Assessment, an update on Localities, prevention and Early Help, a proposal on the Future Governance of the Health and Wellbeing Board, a letter from Duncan Selbie (National Chief Executive of Public Health England) and updates from the Board’s sub- groups.

Resolved –

That the report be noted and the Pharmaceuticals Needs Assessment (Appendix “A” to Document “M”) be approved.

LEAD: Strategic Director, Health and Wellbeing