No disclosures of interests were received.

Recommended –

That the minutes of the meeting held on 28 March 2017 be signed as a correct record (previously circulated).

(Fatima Butt – 01274 432227)

Resolved-

That the minutes of the meetings held on 28 March 2017 be signed as a correct record (previously circulated).

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

documents.

The Strategic Director, Children’s Services will submit Document “A” which asks the Board to:

·         Take note of the proposals for SEND Transformation 0-25

·         Support the SEND transformation to provide additional capacity within the Early Years Enhanced Specialist Provisions (EYESP) to meet the complex health needs of some children with SEND, for example, through providing additional capacity from school nursing.

Recommended-

(1)       That the proposals outlined in Document “A” be noted and that Board Members and their organisations be asked to contribute to the formal consultation.

(2)       That the Board notes that the Strategic Director, Children’s Services in consultation with the Portfolio Holder is authorised to consider consultation findings from partners, stakeholders, staff, children and their families and implement the proposals.

                        (Lynn Donohue/Angela Spencer-Brooke – 01274 439610)

The Strategic Director, Children’s Services submitted Document “A” which asked the Board to:

·         Take note of the proposals for SEND Transformation 0-25

·         Support the SEND transformation to provide additional capacity within the Early Years Enhanced Specialist Provisions (EYESP) to meet the complex health needs of some children with SEND, for example, through providing additional capacity from school nursing.

A powerpoint presentation was also provided to support the report. Board Members were informed that the current position was:

·         There was both a growing population of children and young people in Bradford  and a growing population of children and young people with SEND

·         The complexity of special needs in Bradford was increasing – as a result there was a need for more specialist places in early years and education settings but Bradford was a highly inclusive local authority; only 1% of the school population was in Special Schools

·         Increasing the number of specialist places for SEND alongside a predicted population growth would still only result in around 1% of SEND pupils attending specialist provision

·         Working in a challenging and changing financial and educational landscape

·         With this came the opportunity to transform delivery of specialist provision and support for SEND in the District – intervening early to reduce costly intervention later in the life of a child or young person

The proposed model would continue to make a range of specialist services available across the district for children and young people with SEND and had been based on the evidence and findings of the SEND Strategic Review in Bradford 2016. Formal consultation received 79 responses containing a total of 16 comments and 144 questions.

The aim of the proposal was to improve outcomes and life chances for all children and young people in Bradford by ensuring the following:

·         Early identification, early assessment and early intervention of children with SEND

·         Increase in high quality places to meet a growing need for SEND

·         Effective use of the outstanding practice and provision across the district

·         Use of e specialist knowledge, skills and expertise in meeting the need of children and young people with SEND.

A proposal was outlined based on a two-locality model. Each locality providing 50 early years specialist places across two locations for children aged 2-5 years, with capacity for children aged up to 7 where appropriate; located in geographically accessible areas to serve the highest areas of SEND across the District  further places would continue to be provided in in  mainstream early years and educational settings. A SEND Specialist Centre of Excellence would be co-located with one provision in each locality.

The SEND Specialist Centres of Excellence would  comprise a range of SEND specialist practitioners, for example specialist teachers of autism, cognition and learning and behaviour, family support workers, portage home visitors, who would provide consultation, support, training and outreach work for all SEND early years children across all types of early years setting.

It was reported that there were currently 3 nursery schools (Canterbury, St Edmund’s, Strong Close across the District already  ...  view the full minutes text for item 4.

The Health and Wellbeing Board Chair’s highlight report (Document “B”) 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 July report covers:

·         Business conducted at meetings of the Board’s subgroups: the Integration and Change Board. There is no update from the new Integrated Commissioning Executive which is in development.

·         Better Care Fund – Update on performance and progress on the 2017-19 Plan

·         Care Quality Commission – Review Guidance

·         2016-17 Health and Wellbeing Board Annual Report to Bradford District Partnership

Recommended-

(1)       That in relation to section 3.1 of Document “B” (Better Care Fund) the Board is asked to:

·         Note the position in relation to the local area progress in refreshing the local Narrative Plan and Planning Template for 2017/18 and 2018/19.

·         Note the establishment of the Executive Commissioning Board.

·         Note the requirement to submit revised BCF Plan by the 11^th September 2017.

·         Agree delegated authority to the Chair of the Board in consultation with the Leader of City of Bradford MDC and a nominated representative of the three CCGs to authorise submission of the Better Care Fund Plan on behalf of the Health and Wellbeing Board.

(2)       That in relation to Section 3.5 (Document “B”) the Board is asked to:

Note that the 2016-17 SEND Local Offer Annual Report has been agreed by the Chair of the Board and published on the SEND Local Offer website.

                                                            (Angela Hutton – 01274 437345)

The Health and Wellbeing Board Chair’s highlight report (Document “B”) 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 July report covered:

• Business conducted at meetings of the Board’s subgroups: the Integration and Change Board. There was no update from the new Integrated Commissioning Executive which was in development
• Better Care Fund – Update on performance and progress on the 2017-19 Plan
• Care Quality Commission – Review Guidance
• 2016-17 Health and Wellbeing Board Annual Report to Bradford District Partnership

Better Care Fund

It was reported that the Better Care Fund Performance for Quarter 4 of 2016/17 had been approved by the Chair since the last Board meeting in March and had been submitted to NHS England.

Members were informed that in 2017/18 the BCF included a new element, the Improved Better Care Fund (iBCF) for which additional requirements were detailed in Appendix 1.

A new composite performance measure had been introduced to measure the effectiveness of joint working between social care and health services. The measure looked at emergency admissions, transfers of care and reablement.  Bradford was currently ranked second of 152 Health and Wellbeing Areas nationally under the new composite measure.

It was reported that the iBCF would consist of two elements in 2017/18. The Bradford Allocation being £1,565,946 of previously announced monies and a further £10,479,875 announced in the 2017 spring spending review. Members asked for clarification on the breakdown of how the additional £10 million would be spent. The following areas had been agreed:

·         Bradford and Airedale Community Equipment Scheme – Home First Strategy

·         Winter pressure beds

·         Intermediate Care Reviewing Team

·         Transformation and Assistive Technology

·         Increased Home Care Capacity

·         Protecting Social Care

A Member emphasised that areas of good, local performance such as being ranked second of 152 areas nationally should be promoted. The Chair and another Board member supported the appreciation of this good performance but acknowledged that there was further work to do to improve people’s experiences of services and to reach a sustainable position where people were not admitted into hospital or residential care unnecessarily; and where better community support was needed.

 It was reported that the Care Quality Commission would undertake 20 reviews of delayed transfers of care in health and social care systems. Five were likely to be identified from the best performing authorities and 15 from the worst performing. Bradford would look at best practices from those reviews as they took place.

In response to Members’ questions it was reported that an Executive Commissioning Board was in development to replace Bradford Health and Care Commissioners.

The Chair requested that the Bradford Districts and Craven Health and Wellbeing Plan Tracker (Appendix 1 to Document “B”) be  ...  view the full minutes text for item 5.

The Chief Officer, Bradford City, Bradford Districts and Airedale, Wharfedale and Craven Clinical Commissioning Groups will submit Document “C” which presents a progress update on the delivery of the Bradford Districts and Craven Health and Wellbeing plan. The components of the delivery are:

·         A joint operational plan

·         The progress and achievements of the transformational programmes and work streams

·         The performance dashboard and report (‘tracker’)

·         Involvement on work streams at West Yorkshire and Harrogate STP level

Recommended-

That the Board notes and supports the actions being taken to develop an integrated Health Plan for Bradford Districts and Craven as being a key element of ensuring the sustainability of the health, care and wellbeing sector and of the Board’s forthcoming Joint Health and Wellbeing Strategy.

                                                                        (Christine Walters – 01274 237290)

The Chief Officer, Bradford City, Bradford Districts and Airedale, Wharfedale and Craven Clinical Commissioning Groups submitted Document “C” which presented a progress update on the delivery of the Bradford Districts and Craven Health and Wellbeing plan. The components of the delivery were:

• A joint operational plan
• The progress and achievements of the transformational programmes and work streams
• The performance dashboard and report (‘tracker’)
• Involvement on work streams at West Yorkshire and Harrogate STP level

Members were informed that:

·         In 2017/18 there was a system financial risk of £36 million; £10 million attributing to Social Service within the Council

·         Partners were continuing to work across the health and care system to continue commissioning the right local services; but to stop the slide from already difficult decisions into possible choices partners needed to have a realism about what could be delivered; needed to support local decision making on how to allocate resources, with recognition that this would include doing things differently to improve patient care, and optimising cost effectiveness and continue to deliver the efficiency plans

·         In order to reduce the deficit the health service was reducing elective spend where treatment was not clinically effective; reducing inappropriate out-patient appointments; reducing A&E attendance; reducing non-elective activity; reviewing practice referrals; transformation of services/care for patients nearer to home.

The Chair of the Board stated that Bradford Council had a process to address the £10 million deficit, and asked the NHS Trusts to feedback on plans and progress to reduce their deficits.

In response to the Chair’s question the representatives of the NHS Providers for Bradford and Airedale reported that:

·         Ability to reduce demand would be by way of managing demand and reducing costs but that this would be very challenging  as demographic changes were driving demand.

·         Workforce was the biggest issue and expense, it was proving difficult to recruit specialist staff meaning continuing reliance on temporary and agency staff which was costly.

·         More collaborative working in terms of demand management was needed.

·         Individual providers had been provided with a target level of savings, once these were reached access to sustainability funding was possible.

The Chair requested that the Board received an update in December on the issues of reducing the deficits.

Resolved-

That the Board notes and supports the actions being taken to develop an integrated Health Plan for Bradford Districts and Craven as being a key element of ensuring the sustainability of the health, care and wellbeing sector and of the Board’s forthcoming Joint Health and Wellbeing Strategy.

Action:           Strategic Director, Health and Wellbeing

The Director of Public Health will submit Document “D” which reports that the Director of Public Health has responsibility for strategic leadership of the health protection function in their local authority area.Health protection is one of the four domains described in the Public Health Outcomes Framework. The paper proposes that an assurance group is established to ensure local coordination of the different aspects of Health Protection.

Recommended-

(1)     That a multi-agency health protection assurance group be established as a forum for bringing together the local health protection responsibilities.

(2)     That the group meets quarterly and reports into the Health and Wellbeing board as required, or as agreed with the board.

                                                            (Sarah Muckle – 01274 432805)

The Deputy to the Director of Public Health submitted Document “D” which reported that the Director of Public Health had responsibility for strategic leadership of the health protection function in their local authority area.Health protection was one of the four domains described in the Public Health Outcomes Framework. The paper proposed that an assurance group was established to ensure local coordination of the different aspects of Health Protection.

Resolved-

(1)     That a multi-agency health protection assurance group be established as a forum for bringing together the local health protection responsibilities.

(2)     That the group meets quarterly and reports into the Health and Wellbeing board as required, or as agreed with the board.

Action:           Deputy to the Director of Public Health