To receive any apologies for absence, including notifications of any changes to the membership of the Committee.

An apology for absence was received from Graham Lockerbie (NHS England).  The Board was advised of a change to its membership following changes to the political balance of the Council.  Councillor Morey was no longer a member of the Health and Wellbeing Board, Councillor Davies would be representing the Non-Coalition Group with Councillor Doggett representing the Liberal Democrat Group.

To confirm as a correct record the Minutes of the Health and Wellbeing Board held on 12 February 2014.

The minutes of the meeting of the Health and Wellbeing Board held on 12 February 2014 were confirmed a correct record and signed by the Chairman.

Councillor Doggett declared a non-pecuniary interest as he is a lay member of the Clinical Commissioning Group – Medicine Management Team.

To consider a report on the above.

The Board considered a report that set out a market position statement (MPS) for adult social care and support in Torbay.  Members were advised that the MPS was a joint statement for Torbay Council and South Devon and Torbay Clinical Commissioning Group.  The MPS would have a key role in influencing both the market for services and commissioning plans.  The MPS identifies opportunities for the market by:

·         Describing current and future demand;

·         Analysing current supply of services, how well they meet needs and aspirations and what needs to change;

·         Outlining future high level commissioning intentions.

The Board was informed that the MPS articulates the commissioning vision and intentions for the area as outlined in the Joint Health and Wellbeing Strategy.  MPS data will inform future commissioning strategies as well as development of future health and wellbeing strategies.  Members welcomed the development of an MPS and future aspirations to include a greater range of services targeted at health, care, support and wellbeing across adults and children.

Resolved:

i)     That the Market Position Statement for Adult Social Care and Support in Torbay 2014+ be adopted but that it be recognised that the Statement will need to be reviewed in coming months in light of emerging legislation.

ii)    that the role of the Market Position Statement in service transformation, as described in the report, be endorsed.

To consider a report on the above Strategy.

Members received a presentation and considered a report that set out ‘2013-2016 Living well with a learning disability in Devon – making progress’ which was a high level, overarching strategy for people with Learning Disabilities.  The strategy had been prepared jointly on behalf of South Devon and Torbay Clinical Commissioning Group, Northern, Eastern and Western (NEW) Devon Clinical Commissioning Group, Torbay, Plymouth City and Devon County Councils.  Shona Charlton informed Members that the core principle underpinning the strategy was a commitment to improve the health outcomes of people with a learning disability.

Members noted that the strategy had been agreed in principle by the Torbay Learning Disability Partnership Board and was to be considered by the Learning Disability Redesign Board.

Members referred to the difference between the recorded and estimated number of adults with a learning disability and challenged whether a collective view across all services may aid the identification of people with a learning disability.  It was felt that further work with front line staff across all agencies would help to reduce the differential.

Resolved:

i)     That the Health and Wellbeing Board endorses the high level joint commissioning strategy for Learning Disability for South Devon and Northern, Eastern and Western Devon Clinical Commissioning Groups and Plymouth City, Torbay and Devon County Councils as set out at Appendix 1 to the submitted report; and

ii)    that the Health and Wellbeing Board agrees to a cohesive approach to the development of a more detailed improvement plan.

To consider a report on the above.

The Board considered a report and received a presentation on the ‘Operational Commissioning Strategy for People with Learning Disabilities.  Steve Honeywill, Jo Davis and Si Langridge were present to aid the discussion and responded to Member’s questions.  Members were informed that upon endorsement of the strategy by the Health and Wellbeing Board, officers would be seeking to engage service users to design and shape services and that there would be changes to services.

Members challenged the adult focus to the strategy, explaining that children also live with learning disabilities and felt that further discussions were needed to ensure that the strategy encompassed the entirety of a person’s life.  Richard Williams, Director for Children’s Services, suggested discussions be held with the Children’s Disability Steering Group in order for the strategy to fully address the needs of children with a learning disability.

Members felt that there should be a more explicit reference to how safeguarding concerns about people with learning disabilities should be raised.

Resolved

i)     That the Health and Wellbeing Board endorses the Operational Commissioning Strategy’s aims and principles which mirror the values and outcomes included in the emerging ‘high level’ commissioning strategy for South Devon, Torbay and Northern, Eastern and Western Devon Clinical Commissioning Groups and Plymouth City, Devon County and Torbay Council’s; and

ii)    that the Health and Wellbeing Board agrees the general approach to co-producing service specifications and evaluating potential providers with service users and their carers.

To consider the submitted report on the above.

The Board considered a report that set out proposals for the future operation of the Health and Wellbeing Board.  Members of the Board had been asked to complete a questionnaire the responses to which were considered during a desk top exercise which took into account the role of the Health and Wellbeing Board as defined in legislation, barriers and success factors of other Boards around the Country and identified how the Board may need to change as the health and social care system within Torbay evolves.  Members were advised that having ‘taken stock’ the Board needed to agree its priorities for 2014/2015, its work programme and whether the Board membership should be expanded.

Members challenged the priorities for 2014/2015 and felt that an additional question of ‘Do plans address the needs of children, young people, adults and families?’ should be included in ‘The questions that the Board needs to ask’ section of the work programme.  The Board were unable to reach a consensus as to whether the membership should be expanded and requested a further options appraisal be undertaken.

Resolved:

i)       subject to the priorities for 2014/2015 being amended to include Children’s and Adults Safeguarding, the priorities for 2014/2015 be agreed as set out in the submitted report and the Joint Health and Wellbeing Strategy be refreshed as necessary;

ii)      that subject to the inclusion of an additional question as detailed in the preamble above, the Work Programme set out in Appendix 1 be agreed;

iii)     that a further options appraisal detailing the rationale for expanding the membership be prepared for the next meeting of the Health and Wellbeing Board; and

iv)     that the proposed relationship between the Health and Wellbeing Board and the Joined Up Board, as set out in Appendix 2 to the submitted report, be noted.

To receive an update on Pioneer.

Members received an update and overview of the Pioneer and JoinedUp plans.

Resolved:

That the Torbay Health and Wellbeing Board accepts the progress to date in respect of Pioneer and JoinedUp and endorses the method proposed for future reporting, as outlined in the submitted report.

To receive an update on the above.

The Board received a report that provided the Health and Wellbeing Board with an update on the work of the Torbay Safeguarding Board (TSCB) for children and young people.

The Independent Chair of the TSCB, David Taylor, advised members that the TSCB had recently undergone a self evaluation and subsequently amended its model of operation and created an executive that meets regularly to deal with the more detailed business and a wider Board that has the opportunity to drill down and look at specific areas of safeguarding activity.

Members were advised that the topic at the next meeting of the TCSB would be mental health.  There were concerns about the way that Children’s Social Care and Adult Mental Health services work together in respect of safeguarding vulnerable children where the parent has a mental health or substance misuse problem.  Whilst the issue was being addressed by relevant managers the issue needed to be more firmly embedded in any commissioning arrangement.

Feedback had also been received from practitioners that the Children and Adolescent Mental Health Service (CAMHS) was perhaps too remote from other services in respect of children and young people and there appeared to be a gap in service.  In addition the lack of an out of hours assessment service and the placing of children with overt mental health problems in acute children’s ward was a matter of considerable concern.  Richard Williams, Director of Children’s Services, advised that he would refer the concerns raised to the Children’s Redesign Board to address.

TCSB acknowledged that the Joint Strategic Needs Assessment (JSNA) had recently been refreshed and sought for the JSNA to include:

·         A triangulation of data in respect of safeguarding and early level help and how this relates to perceived levels of need;

·         Further information on self harm and incidences of mental ill-health and suicide amongst young people; and

·         Indicators which may estimate the likely level of child sexual exploitation.

Caroline Dimond, Interim director of Public Health gave an assurance that these points would be addressed in the emerging JSNA.

Resolved

That the report be noted.

To receive an update on adult services.

The Board noted the update on Adult Services.

To receive an update on the above.

The Board noted the update from the Police and Crime Commissioner.

To receive an update on the current position of the Clinical Commissioning Group.

The Board noted the update from the South Devon and Torbay Clinical Commissioning Group.

To receive a verbal update on the current position of Public Health.

The Board noted the update on Public Health.

To receive an update on the current position of Healthwatch.

The Board noted the update from Healthwatch Torbay.