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

Apologies for absence were received from Richard Williams, Mayor Oliver, Nick Roberts, Tony Hogg who was represented by Joanna Robison and Martin Oxley who was represented by Simon Sherbersky.

To confirm as a correct record the Minutes of the Health and Wellbeing Board held on 3 December 2015.

The Minutes of the Health and Wellbeing Board held on 3 December 2015 were confirmed as a correct record and signed by the Chairman.

Councillor Doggett declared a non-pecuniary interest as he is a lay member of the Joined Up Medicines Optimisation Group.

Councillor Parrott declared a non-pecuniary interest as he is a member of the Community Development Trust and Integrated Care Organisation.

To receive a presentation on the above.

The Board received a presentation from Emma Herd, Head of Planning for the South Devon and Torbay Clinical Commissioning Group.  Members were advised that following instruction from NHS England the Sustainability and Transformation Plan (STP) was required to cover a wider area than South Devon and Torbay.  Therefore officers were developing an STP with the Northern, Eastern and Western Devon CCG (NEW Devon), Devon County Council and Plymouth City Council, covering a population of around 1.2 million people.

All local health and care systems are required to develop a five year STP with NHS providers being required to develop and submit one year operational plans for 2016/17.  The plans have to be consistent with emerging STP’s and in time to enable contracts to be signed off by the end of March 2016.  The STP has to include a single set of strategic objectives and priorities for the STP geography, an engagement plan around the whole local strategic context, STP wide service/clinical programme strategies that deliver national and local policy requirements and a set of local implementation plans that respond to local need.

Members expressed great concern regarding the impact the STP would have upon the existing Integrated Care Organisation (ICO) and outside influences destabilising the arrangements.  Members were extremely anxious that local developments were not slowed as local people were expecting change and the momentum needed to be sustained.  Members were advised that the CCG were being looked upon by NHS England to lead the process, however CCGs recognised that partners needed to be engaged as the plan was place based, therefore partners were important if the plan was going to succeed.

Members felt that previously the ‘bottom up’ approach had been working well and partners were transitioning into what looked like a good place, with the public being taken on the journey.  Members were anxious that the STP felt like a ‘top down’ approach being enforced by ‘big brother’ with service users being overridden.  Members were advised that the South Devon and Torbay Clinical Commissioning Group (SD&T CCG) had similar feelings, with the STP potentially replacing some element of the Joined Up Plan, it was important that both the SD&T CCG and the Health and Wellbeing Board had a voice in order to influence the development and implementation of the STP.

To consider a report that presents the updated and refreshed Market Position Statement.

The Board considered a report that presented the updated and refreshed Market Position Statement (MPS).  The Head of Partnerships, People and Housing informed Members that the MPS had previously focused on Adult Social Care and Support but this year Children’s Services information had also been included.  The MPS was designed to provide information and analysis of benefit to providers of care and support services in Torbay.  It was intended to help identify future demand for care and support on the basis of what we know about our local population, services and funding.

Resolved:

That the updated Market Position Statement be approved.

To consider the annual report of the Director of Public Health.

Members received the Director of Public Health 2015 Annual Report, the Director of Public Health advised Members that the report focused on how environment and place affects health and how partners can work together to ensure Torbay is a healthy place to live, with well-being at the core of all policies.  This year’s report touches on the particular challenge of deprivation and makes some recommendations for how we can respond to the relatively worsening deprivation in Torbay.

Resolved:

i)       That the Annual Report of the Director of Public Health be noted; and

ii)      That the Health and Wellbeing Board urge that:

·      The recommendations of the Marmot Report be embedded within partners plans;

·      Partners contribute and build on the system challenges set out in the 2015 report; and

·      Partners consider place and its impact on health in all that they do.

To consider three reports that seek to provide the Board with assurance against delivery of the current Joint Health and Wellbeing Strategy.

Members received a series of reports that were presented to provide the Health and Wellbeing Board with assurance against delivery of the current Joint Health and Wellbeing Strategy.  The reports comprise:

·         A written progress report against the priorities in the joined-up plan

·         The performance framework for Healthy Torbay

·         An exceptions report for the outcome frameworks across Public Health, Social Care and the NHS.

The Board proceeded to receive updates from fellow Board Members on the priority areas set out in the performance framework.

Resolved:

That the Joint Health and Wellbeing Strategy and its associated performance framework be kept under review alongside the development of the Sustainability and Transformation Plan.

To consider the above.

This item was withdrawn from the agenda.

To receive an update on Domestic Abuse, following the seminar on 3 December 2015.

The Board considered a report that informed Members of a Torbay wide ‘re-think’ to its strategic approach to domestic and sexual violence and abuse (D&SVA), so that Torbay can tackle the problem more effectively.  The Board were advised that there were a variety of additional drivers for this work, such as, an increase in evidence (much of which demonstrates a compelling case for prevention as well as identifying the need for early help identification services) and two consecutive inspections noting that Torbay has ‘insufficient services for domestic abuse’ and that, ‘domestic abuse continues to be an area for development in Torbay’.

Members were informed that there was growing appetite among Torbay agencies to address concerns around D&SVA recognising that people’s experience of D&SVA negatively impinges upon other areas of health and local authority commissioning.  Formerly governance of the work on D&SVA was undertaken by the Community Safety Partnership (CSP).  However, CSP governance ‘frames’ D&SVA as a crime and disorder issue, which does not represent the entirety of D&SVA with emerging evidence ‘re-framing’ D&SVA as a vulnerability.  Therefore, going forward, the Health and Wellbeing Board may be a more appropriate governance structure.

Resolved:

i)       that the proposed future direction of travel for addressing Domestic and Sexual Violence and Abuse in Torbay, as set out in Appendix 1 to the submitted report, be noted;

ii)      that the Health and Wellbeing Board takes the role of lead partnership for strategic work in relation to Domestic and Sexual Violence and Abuse in Torbay and Martin Oxley Community Development Trust Chair of Trustees, and Co-opted Member of the Health and Wellbeing Board, be asked to be the Board’s lead on Domestic and Sexual Violence and Abuse;

iii)     that the monitoring of work in relation to the Domestic and Sexual Violence and Abuse be undertaken by the Health and Wellbeing Board through its regular Assurance Reports; and

iv)     that a Health Needs Assessment for Domestic and Sexual Violence and Abuse be undertaken by Public Health with contributions from all partners and that this be presented to the Health and Wellbeing Board following its completion.

To note a report that informs and engenders support for culture, health and wellbeing.

The Board noted a report that informs and engendered support for culture, health and well-being collaborative activities, to ensure the successful delivery of a key element of Torbay’s ten year cultural strategy.  The Executive Director of the Torbay Culture Board advised Members that an increasing amount of academic research evidences the beneficial clinical and social outcomes culture can provide, within both health and care pathways.

The Executive Director of the Torbay Culture Board outlined a number of projects that aim to tackle wellbeing through culture such as a men’s mental health creative project (suicide prevention).  Members were advised that we all innately look after our own mental wellbeing through culture, culture is what links all areas of society together the difficulty is proposing a strategic approach that secures more than ‘one off’ projects.