To elect a Chairman/woman for the remainder of the Municipal Year.

Councillor Stockman was elected Chairwoman for the remainder of the Municipal Year.

(Councillor Stockman in the Chair)

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

Apologies for absence were received from Liz Thomas, Pat Harris was represented by Kevin Dixon and Nick Roberts was represented by Paul Johnson.

To confirm as a correct record the Minutes of the Health and Wellbeing Board held on 7 September 2017.

The Minutes of the Meeting of the Health and Wellbeing Board held on 7 September 2017 were confirmed as a correct record and signed by the Chairwoman.

To consider any other items that the Chairman/woman decides are urgent.

The Board was informed that the Council, Torbay and South Devon NHS Foundation Trust and partners were the winners of the Health and Social Care category in the 2018 national Local Government Chronicle Awards.  The award was national recognition for the creation of an Integrated Care Organisation.

To note a briefing from the Chair of Devon’s Local Pharmaceutical Committee.

Members received and noted a presentation from David Bearman, Chairman of Devon Local Pharmaceutical Committee re the role of Pharmacies within the local Care services.  David advised Members that at a Sustainable Transformation Programme (STP) level there is a desire for a flexible workforce capable of working across multiple settings in multidisciplinary teams however in the primary care setting the deployment of pharmacists is limited.  There is a material shortage of primary care workforce restricting the ability to deliver new models of care.  David explained that pharmacies could assist by making pharmacy a key contributor to the sustainability of primary care both through direct support in the practice and by the redesign of community pharmacy to be a key partner in community service provision could remove strain from the system.

David explained that there were areas of work that could be covered in the pharmacy element of the model such as repeat authorisation/management, patient monitoring, screening, falls prevention, care home support and domiciliary support.  He concluded by saying that the pharmacist workforce is a substantial asset in the community in the short term able to provide some significant additional capacity alongside practices.  Pharmacists in practice are a key element in gelling together and driving the broader medicines agenda with Primary Care Home presenting an excellent next stage vehicle to maximise the potential of integrating community pharmacy.

Actions:

1.     Joint Executives across NHS and LA and the LCP in time to explore the following – Anne Wagner and Paul Johnson 

ii.            Work to explore if pharmacies could work better together with the care model and primary care development work

iii.           Explore the feasibility of some of the proposals including possible an audit of how ready pharmacies are to play such a role

2.    Data on the levels of medication which could lead to addiction to be made available by geographical areas.  Paul Johnson

3.    That the Chairwoman of the Health and Wellbeing Board write to NHS England about the broader issues of pharmacies being part of a new care model.

To consider a report that seeks approval of the Pharmaceutical Needs Assessment.

The Board considered a report that sought approval for the publication of the Pharmaceutical Needs Assessment (PNA).  The Acting Head of Public Health Improvement informed the Board that the PNA was a comprehensive assessment of the current and future pharmaceutical needs of the local population for community pharmacy, dispensing appliance contractors, and dispensing doctors in rural areas.  The Board were advised that the PNA for Torbay 2018-2021 presents a picture of community pharmacy need and provision in Torbay and links to Torbay’s Joint Strategic Needs Assessment.

Resolved:

i)         That the Pharmaceutical Needs Assessment be approved; and

ii)      The Pharmaceutical Needs Assessment be published on the Torbay Council website by 1 April 2018.

The Board considered a report that set out the priorities for the health and wellbeing system in Torbay. The priorities were considered and discussed as well as how these areas would form the work plan of the HWBB and what the level of involvement would be according to the following criteria.

·         Focus items – specific issues of concern for inclusion within the Action Plan of the Joint Health and Wellbeing Strategy.  These issues will then form the basis of meetings of the Board, enabling proactive debate, leading to solutions owned by the system;

·         Sponsor items – areas where the HWBB would take an enhanced interest. Here highlight reports would be presented twice a year with lead organisations being asked to identify any blockages within the system. This will enable the Board to discuss potential solutions building on its role to promote integration across the system; and

·         Watch items – areas where the HWBB has oversight only. Performance monitoring reports to be presented twice a year for these areas.

Members discussed and agreed what priorities aligned to which of the above 3 areas to inform the workplan

The Board were also asked to consider expanding their membership to:

·         Safer Communities Torbay

·         Torbay Safeguarding Children Board

·         Torbay Safeguarding Adults Board

·         Torbay Together

Actions:

1.    That the priorities for the Board be approved;

2.    That a Work Programme be developed around the principles of areas to watch, areas to sponsor and areas of focus and that an updated JHWS would be produced to reflect these areas as in the diagram in the briefing paper

3.    That the membership be expanded to include;

Safer Communities Torbay;

Torbay Safeguarding Children Board;

Torbay Safeguarding Adults Board;

Torbay Together;

Devon and Cornwall Police; and

Executive Head of Community Safety

4.    That the frequency of the Board be increased to quarterly and where possible, the Board meetings be hosted at venues other than the Town Hall.

5.  That the first area of focus would be a deep dive on the drivers of vulnerability to include parental wellbeing within families linking to the priority – ‘support those who are vulnerable and living complex lives and to the priority around early help and addressing outcome inequalities in children.

To comment upon the discussion document.

The Board considered a paper that had been developed to create the opportunity for discussion and contribution from local partners and stakeholders as we work together on strengthening our partnership on the next step in the health and care integration journey.  Members were advised that the development of a Local Care Partnership for South Devon and Torbay is set within the context of an emerging Devon Integrated Care System (ICS).  The ICS is not the creation of a new organisation, but rather a strengthening of partnership working with health and care organisations working more closely together than ever before to the benefit of our population.  Members noted that whilst organisations were already working closely together through the Integrated Care Organisation there were other areas of the care system which would benefit from a closer working relationship and that a Local Care Partnership was definitely an opportunity rather than a threat.

To consider a report that seeks approval for the publication of the Joint Strategic Needs Assessment.

The Board considered a report that sought approval for the publication of the Joint Strategic Needs Assessment (JSNA).  Members were advised that the JSNA highlights the key challenges and issues facing the population of Torbay across the life course, as well as highlighting areas of spend and opportunity.  They congratulated the Public Health Specialist – Intelligence Officer on the level of data contained within the JSNA but suggested that data also needed to be translated into a patient’s story.

Actions:

That the Joint Strategic Needs Assessment be:

i)       Referenced in the Children and Young Peoples Plan and plans around sufficiency of placements; and

ii)    That the JSNA be published on the Council’s website and shared with partners and stakeholders.

To note the report.

The Board noted the report and raised concerns regarding flu vaccination, in particular vaccination of care providers and hospital staff and requested an update on the preparations for the forthcoming flu season.

Action

That Flu plans be presented to a future meeting of the Health and Wellbeing Board.

To consider a report on the above.

Any AAThe Director of Adult Services advised Members that the Better Care Fund was a term used by central government for money that had been pooled to aid integration.  The issue that needs addressing is the demand in the system therefore the Better Care Fund will be spent on schemes that will remove demand from the system.  The Board were very supportive of the identified schemes and welcomed updates on the progress of the projects.

Resolved:

That the Board agreed to support:

i)             A commitment to transformative care learning from the initiatives and taking the momentum from successes to date to deliver the Triple Aim and deliver the goals of the Five Year Forward View;

ii)            The recognition of the pace of change required with the demographic workforce and care demand drivers being faced; and

iii)           In principle the proposals made in Appendix 1 of the attached report, for them to be taken through due governance, to deliver a transformation in Torbay’s care provision for the wellbeing of the population including those working and caring within it.

1.    It was suggested that the venue for the HWBB moves out into the community and in different partner or community venues;

2.    That the board considers a story from the community to set the scene at Board meetings; and

3.    That the ICS Outcome framework comes to a future HWBB.