Agenda, decisions and minutes

Bradford and Airedale Health and Wellbeing Board
Tuesday, 13th November, 2018 10.00 am

Venue: Ernest Saville Room - City Hall, Bradford. View directions

Contact: Fatima Butt - 01274 432227 

Items
No. Item

15.

DISCLOSURES OF INTEREST

(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.

 

Minutes:

No disclosures of interests were received.

 

16.

MINUTES

Recommended –

 

That the minutes of the meeting held on 4 September 2018 be signed as a correct record (previously circulated).

 

(Fatima Butt – 01274 432227)

Minutes:

That the minutes of the meeting held on 4 September 2018 be signed as a correct record.

 

17.

INSPECTION OF REPORTS AND BACKGROUND PAPERS

(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)

 

Minutes:

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

 

18.

HAPPY, HEALTHY AND AT HOME - A HEALTH AND CARE PLAN FOR THE BRADFORD DISTRICT AND CRAVEN

Previous Reference:  Minute 28 (2017/18)

 

The Board at its meeting held on 13 February 2018 considered a PowerPoint presentation on the financial position of the health and care economy.

 

The Board 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.

 

As requested at the above meeting a presentation will be provided which

presents an update and re-assurance on the efficiency plan progress with

delivery of identified savings across the health and care system.

 

                                                            (Julie Lawreniuk – 01274 237642)

                                                            (Andrew Crookham – 01274 433656)

 

Decision:

Resolved-

 

(1)       That Finance Directors continue their engagement with the partnership work undertaken through the Integration and Change Board and the Health and Care Partnership Boards relating to the delivery of savings across the health and care system, so that there is a shared understanding of delivery against organisational and whole system plans.

 

(2)       That partners consider the development of a shared system position statement which can be communicated to Government about the forthcoming spending review.

 

(3)       That the Leader’s regular meetings with Chairs of local organisations include consideration of the financial position and the impact of planned efficiency savings.

 

Action:           Assistant Director Finance

 

                                                                        (Julie Lawreniuk – 01274 237642)

                                                                        (Andrew Crookham – 01274 433656)

 

Minutes:

 

Previous Reference:  Minute 28 (2017/18)

 

The Board at its meeting held on 13 February 2018 considered a PowerPoint presentation on the financial position of the health and care economy.

 

The Board 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.

 

As requested at the above meeting a presentation was provided to Members

which presented an update and re-assurance on the efficiency plan

progress with delivery of identified savings across the health and care

system.

 

It was reported that:

 

·         The information presented to the Board in February 2018 showed that there was a financial gap before cost savings of £262m over a four year period to 2020/21.

·         After planned cost savings of £210m, there was a remaining financial gap of £52m (CCGs - £2m, NHS Trusts - £50m, Local Authority - £nil) over this period.

·         Since then, 2018/19 financial plans for NHS organisations had been revised to take into account the additional funding for the NHS announced in the Autumn Budget (2017) and actual performance for 2017/18 had been confirmed for all Bradford Place organisations.

·         Plans would need to be further updated to take into account the long term funding settlement for the NHS announced in June 2018 and therefore this update concentrated on the 2018/19 position and the underlying position taken forward into 2019/20.

·         Current year plan deficit position £10M better than original plan deficit.

·         However, current year forecast outturn £14.4m worse than plan (Bradford Teaching Hospitals Foundation Trust and the Local Authority) due to lower savings realisation and increasing service demand. So overall, £4m worse than original plan.

·         All organisations were relying on non-recurrent measures in 2018/19 to varying degrees to meet control totals or minimise the variance from the plan.

·         This meant that there was an underlying deficit carried forward into 2019/20 of £23.5m which was £6.6m higher than the original plan.

·         All Trusts, the Local Authority and Airedale, Wharfedale and Craven Clinical Commissioning Group had an underlying deficit position carried forward into 2019/20.

·         In terms of the Local Authority the majority of the pressure was related to the Demand Management Programme in Adult Social Care; Home First Strategy was working successfully with older people; longer implementation time for working age adults; IMPower were working with the Council on the design and delivery of the remainder of the programme up to 2021/22. The other major upcoming programme in the scope of these figures was Prevention and Early Help in Children’s services which was currently on target.

·         The Local Authority had to set a balanced budget even when there was a deficit at the start of the year; shortfall of 6.5m equated to half of the savings plan in 2019/20 mainly by demand management.

·         In terms of the CCG’s the increasing deficit  ...  view the full minutes text for item 18.

19.

FUTURE IN MIND: BRADFORD AND CRAVEN - A REFRESH OF OUR LOCAL TRANSFORMATION PLAN pdf icon PDF 192 KB

Future in Mind was published in 2015 by the Department of Health’s Children and Young People’s Task Force. Local Systems were to develop and publish a five year system approach to transforming mental health services through collaboration around five areas of promoting prevention, improvement of care and access to good quality of services, development of the workforce and ensuring transparency.

 

The Strategic Director, Health and Wellbeing will submit Document “F” which  describes how the local health and care partnerships have reviewed the progress, achievements and refreshed the local transformation plan.

 

Recommended-

 

That the Board are invited to:

 

·         Reflect on the progress made to date.

·         Receive and provide feedback on the refreshed transformation plan.

·         Approve the refreshed transformation plan.

 

(Sasha Bhat – 01274 237537)

Additional documents:

Decision:

Resolved-

 

(1)       That all those who attended the meeting in relation to this item be thanked for the work they undertake in this area.

 

(2)       That the impact of the Future in Mind programme be tracked through the Joint Health and Wellbeing logic models and specific measurable targets for deliverables are established, eg the number of schools participating in the programme and that mental health support for young people be provided to as many schools as possible.

 

(3)       That consideration be given to the transition from children to adults and the mental health support that is provided to them.

 

(4)       That the programme engages partners in the development of an exit plan and a plan for sustainability and additional investment in children’s mental health from local partners, in readiness for the end of the Future in Mind non-recurrent investment.

 

(5)       That the Board be provided with a case study demonstrating the way in which West Yorkshire mental health trusts have been able to work together to reduce the use of “out of area” placements, in order to improve quality, experience of services and to free up £1m for investment into local services.

 

(6)       That the refreshed Future in Mind Transformation Plan be approved.

 

Action:           Strategic Director, Health and Wellbeing

 

                                                                                    (Sasha Bhat – 01274 237537)                 

 

 

 

Minutes:

Future in Mind was published in 2015 by the Department of Health’s Children and Young People’s Task Force. Local Systems were to develop and publish a five year system approach to transforming mental health services through collaboration around five areas of promoting prevention, improvement of care and access to good quality of services, development of the workforce and ensuring transparency.

 

The Strategic Director, Health and Wellbeing submitted Document “F”  supported by a presentationwhich described how the local health and care partnerships had reviewed the progress, achievements and refreshed the local transformation plan.

 

It was reported that the Future in Mind Transformation Plan required an annual sign off by the Health and Wellbeing Board, the five themes being:

 

·         Promoting resilience, prevention and early intervention

·         Improving access to effective support: a system without tiers

·         Care for the most vulnerable

·         Accountability and transparency

·         Developing the workforce

 

Members were informed that the current governance arrangements included a Delivery Group overseen by the system wide Mental Health and Wellbeing Partnership Programme Board and reporting to the Health and Care Partnership Boards for Bradford and Airedale, Wharfedale and Craven.

 

It was reported that work being undertaken to improve mental health services for children and young people included:

 

·         Joining the system up – leadership, networking, partnership and co-production

·         Training, upskilling and expanding the workforce, apprentices and volunteers

·         Children and young people accessing a wider range of support, including peer led, which keep children at home, in school, ready to learn and reduce isolation.

·         Children and young people, families and care givers were aware and expressing their need for mental wellbeing support.

·         Nationally recognised for delivering interventions and engagement with children and families who had experienced trauma and were refugee and asylum seeking.

·         Making reductions in waiting times and the waiting lists for Child and Adolescent Mental Health Services, avoiding stays in care and hospital, and widening referral routes and pathways.

·         New models of care, linked to West Yorkshire and Harrogate work and local work to link to the First Response Service.

·         Digital connectivity – resources, tools and connectivity.

·         Established new specialist services for eating disorders and perinatal support.

 

The refresh of the Future in Mind Transformation included:

 

·         Clear vision: promoting, protecting and improving children and young people’s mental health and wellbeing

·         Co-produced with children, young people, families and services.

·         A focus of 13 priorities to deliver the 5 key theme areas, main highlights included:

 

-       Developing a district wide campaign to address the level of information, stigma and connectivity about mental wellbeing services

-       Expand the program in schools including the development of a “Schools Pack”

-       Baseline established and refresh of the Joint Strategic Needs Assessment to measure outcomes and a better focus on Special Educational Needs and Disability, infant mental health and Social and Emotional Mental Health.

-       Transform Child and  Adolescent Mental Health Services and continue to develop the specialist support via Early Intervention in Psychosis, Perinatal, Intensive Home Treatment Team, Eating disorders, Learning and Development and Ambulatory Care Experience trauma informed services  ...  view the full minutes text for item 19.

20.

CARE QUALITY COMMISSION LOCAL SYSTEM REVIEW - ACTION PLAN UPDATE pdf icon PDF 195 KB

Previous Reference:  Minute 6 (2018/19)

 

The Care Quality Commission (CQC) conducted a Local System Review of the Bradford District health and care system between January and June 2018. The findings of the review were positive, and a small number of recommendations were made. The local system, led by the Health and Wellbeing Board, has developed an action plan in response to those findings.

 

The Programme Director Integration and Change Board will submit Document “G” which reports on the progress being made in the completion of the CQC Local System Review action plan. In summary the delivery of the plan is progressing well, with a small number of actions requiring closer attention. Details are set out at Section 3 of Document “G”.

 

Recommended-

 

(1)       That the Health and Wellbeing Board notes the progress with the delivery of the CQC action plan.

 

(2)       That the ICB (Integration and Change Board) be requested to support communications, engagement and organisational development colleagues to devise a new plan for the delivery of action 3.3 of Document “G” by December 2018.

 

                                                            (James Drury – 07970 479 491)

 

 

Additional documents:

Decision:

Resolved-

 

(1)       That the Health and Wellbeing Board notes the progress with the delivery of the CQC action plan.

 

(2)       That the Integration and Change Board be requested to support communications, engagement and organisational development colleagues to devise a new plan for the delivery of action 3.3 of Document “G” by December 2018.

 

Action:           Programme Director Integration and Change Board

 

                                                            (James Drury – 07970 479 491)

 

Minutes:

Previous Reference:  Minute 6 (2018/19)

 

The Care Quality Commission (CQC) conducted a Local System Review of the Bradford District health and care system between January and June 2018. The findings of the review were positive, and a small number of recommendations were made. The local system, led by the Health and Wellbeing Board, had developed an action plan in response to those findings.

 

The Programme Director Integration and Change Board submitted Document “G” which reported on the progress being made in the completion of the CQC Local System Review action plan. In summary the delivery of the plan was progressing well, with a small number of actions requiring closer attention. Details were set out at Section 3 of Document “G”.

 

Resolved-

 

(1)       That the Health and Wellbeing Board notes the progress with the delivery of the CQC action plan.

 

(2)       That the Integration and Change Board be requested to support communications, engagement and organisational development colleagues to devise a new plan for the delivery of action 3.3 of Document “G” by December 2018.

 

Action:           Programme Director Integration and Change Board

 

                                                           

21.

BETTER CARE FUND UPDATE

The Strategic Director, Health and Wellbeing will inform Members that the Department of Health and Social Care has recently announced that Bradford Council is due to receive an additional grant of £2.3 million for winter funding, an update will be provided on the discussions that have taken place so far with health colleagues across the system and propose how monies will be best spent.

 

                                                                        (Bev Maybury – 01274 432900)

Decision:

No resolution was passed on this item.

Minutes:

The Strategic Director, Health and Wellbeing informed Members that the Department of Health and Social Care had recently announced that Bradford Council was due to receive an additional grant of £2.3 million grant aimed at easing winter pressure on the NHS.

 

It was reported that the District was awarded the money last month by the Department of Health and Social Care as part of a push to boost social care packages this winter, and prevent people from ending up in hospital at an already busy time of the year.

 

Members were informed that a decision had yet to be made on how the money would be spent.  The Strategic Director, Health and Wellbeing reported that discussions were continuing with partners on how this money could be used. Work on this was expected to be completed in the next few weeks. It was reported that so far a lot of the ideas had been quite traditional, such as boosting home care.  This funding offered the chance to be a bit more reflective of the vision of how change could take place in the community and do things in a different way.

 

No resolution was passed on this item.

22.

CHAIR'S HIGHLIGHT REPORT - HEALTH AND SOCIAL CARE PARTNERSHIP (ONE WORKFORCE UPDATE), JOINT HEALTH AND WELLBEING STRATEGY LOGIC MODELS, DISTRICT PLAN ANNUAL PROGRESS REPORT AND SUB GROUP UPDATES (ECB & ICB) pdf icon PDF 208 KB

The Health and Wellbeing Board Chair’s highlight report Document “H” summaries business conducted between Board meetings. November’s report includes an update on the Health and Social Care Partnership with a focus on the One Workforce programme, a request to sign off the logic models approach, to sign off the District Plan Annual progress report and updates from the Board’s sub- groups (ECB – Executive Commissioning Board and ICB – Integration and Change Board).

 

Recommended-

 

(1)       That in relation to One Workforce, the Board notes the progress to

            date. 

 

(2)       That in relation to JHWS (Joint Health and Wellbeing Strategy) logic model, the Board approves the logic models and the approach set out to monitor the impact of the JHWS.

 

(3)       That in relation to the District Plan, the Health and Wellbeing Board are asked to note the content of the District Plan progress report and

 

(4)       That where Health and Wellbeing Board feel that particular areas of work highlighted in the progress report need greater focus or more cross partnership co-ordination, that officers and relevant BDP Partnerships be tasked to take action as appropriate. 

 

                                                                  (Pam Bhupal – 01274 431057)

 

Additional documents:

Decision:

Resolved-

 

(1)       That in relation to One Workforce, the Board notes the progress to date. 

 

(2)       That in relation to JHWS (Joint Health and Wellbeing Strategy) logic model, the Board approves the logic models and the approach set out to monitor the impact of the JHWS.

 

(3)       That the District Plan progress report be noted.

 

Action:           Strategic Director Health and Wellbeing 

 

                                                      (Pam Bhupal – 01274 431057)

 

Minutes:

The Health and Wellbeing Board Chair’s highlight report Document “H” summarised business conducted between Board meetings. November’s report included an update on the Health and Social Care Partnership with a focus on the One Workforce programme, a request to sign off the logic models approach, to sign off the District Plan Annual progress report and updates from the Board’s sub- groups (ECB – Executive Commissioning Board and ICB – Integration and Change Board).

 

The following updates were highlighted in relation to the Health and Social Care Partnership – One Workforce:

 

An Invitation to Tender/specification was advertised in the beginning of November for  a consulting group to:

·      Establish a formal Health and Social Care Economic Partnership Board with agreed scope, structural and governance arrangements as well as the identification of plans and deliverables in the broader region in order that Bradford’s uniqueness in this sector could be recognised and celebrated

·      Develop the One Workforce Academy involving key stakeholders and partners to set out the case for change, identifying critical success factors as well as constraints to the successful development of the Academy

  • The successful consulting group would  be identified in December.
  • In the New Year their work would commence and would cover an 18 month period of time
  • Also in the New Year, Skills House would be beginning to establish their professional presence on the Health and Social Care landscape through training and recruitment working across the District with Partners, Stakeholders, other employers and unemployed people/candidates
  • Recruitment of staff to support the One Workforce Programme Director (currently interim) would begin in December so people were in post by the spring.
  • Consultancy work would produce communication and engagement plan(s) with the expectation of a One Workforce Launch in 2019.
  • Given the amount of work to establish a fit for purpose Academy (scope, negotiation, curriculum design, partner resource implications and demand on the Academy), it was expected to be mid 2020 before the One Workforce Academy was formally opened for business.

 

 

 

 

 

The following update was provided in relation to the Joint Health and Wellbeing Strategic Logic Models:

 

The final logic model was attached at Appendix 1 to the report; an annual outcomes report was in development – this would provide an update on the outcomes that were listed in the strategy, and would be prepared on an annual basis for the Health and Wellbeing Board (HWBB).  A performance framework was also in development; this would be available to the Health and Wellbeing Board on a quarterly basis, and would report on a number of process measures, giving the HWBB assurance that actions and plans were being implemented successfully (Appendix 2 to Document “H”).

 

A Member queried why some of the data was from 2016 and not more recent and suggested that a quarterly dashboard with an Annual Outcome report would be useful.

 

The update in relation to the Bradford District Plan annual progress report was highlighted at paragraph 3.3 of the report (Document “H”).

 

The updates relating to the Executive Commissioning Board and  ...  view the full minutes text for item 22.