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

Apologies for absence were received from David Somerfield, Caroline Taylor who was represented by Judy Grant, Liz Thomas, Alison Botham, Alison Brewer, Pat Harris who was represented by Jonathan Drew, Keith Perkin who was represented by Howard Brugge, Matt Johnson who was represented by Mark Cottrell and Councillor Parrott.

To confirm as a correct record the Minutes of the Health and Wellbeing Board held on 23 May 2018 and 12 July 2018.

The Minutes of the Board held on 23 May 2018 and 12 July 2018 were confirmed as a correct record and signed by the Chairwoman subject to Minute 59 being amended from ‘the Care Trust’ to ‘the Torbay and South Devon NHS Foundation Trust’.

To respond to written questions and statements from Members of the Public which have been submitted in accordance with Standing Order A24.

The Board was made aware of a number of questions that had been submitted by a Member of the Public.  The following response was provided by the Chairwoman:

The Health and Wellbeing Board is not a commissioning body for health and wellbeing services, though those bodies are represented on the board. The focus of the board is strategic in nature and does not choose to focus on a detailed examination of NHS waiting lists. The detailed understanding of waiting lists is the responsibility of the relevant service commissioner within the health and social care commissioning organisations.  As the Department for Health Statutory Guidance on Joint Strategic Needs Assessments states: “JSNAs are assessments of the current and future health and social care needs of the local community – these are needs that could be met by the local authority, CCGs, or NHS England. Local areas are free to undertake JSNAs in a way best suited to their local circumstances – there is no template or format that must be used and no mandatory data set to be included.” The Torbay JSNA contains over 3,000 different items of data covering different aspects of health and wellbeing at Ward, Town and Local Authority geographies.  Whilst the Torbay JSNA does not contain waiting list information NHS England publishes a great deal of information on waiting times for NHS services which can be accessed at a provider trust level from  https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times

Question 1) No, this is an activity which is monitored by the commissioners of the services in question as part of their core role.  Waiting lists will be discussed at the board only in as much as they influence strategic direction. Estimates on the cost of clearing waiting lists would involve complex statistical modelling and will be undertaken only when it is believed there would be a cost benefit.  This activity would, again, be the responsibility of the commissioning organisation.

Question 2) No, this is an activity which is monitored by the commissioners of the services in question as part of their core role.  Waiting lists will be discussed at the board if they are brought to the attention of the board as being an exceptional local issue.

Question 3) No.  It would not be appropriate for the board to approach the Secretary of Health in this manner.  The monitoring of waiting lists and associated targets are a mechanism for holding commissioned providers to account.  They are not a reflection of effectiveness of a strategic board such as this one.

To consider and discuss the draft Mental Health and Wellbeing Strategy.

Members considered a report that sought the Board’s views on the draft STP Mental Health and Wellbeing Strategy.  Members were advised that the Mental Health and Wellbeing Strategy was developed by the STP Mental Health Programme with the programme group agreeing engagement should be undertaken to inform further development of the draft strategy.  In recognition of the short timescale the STP Mental Health Programme Group also set the expectation that continuous, meaningful engagement in the implementation of the strategy should become routine, the programmes set out in the strategy will be iterative to enable meaningful impact and involvement.

Members felt the strategy didn’t make a strong enough case for change to ensure the shift from services into the community actually happened.  Members believed the strategy read like a provider strategy that was prevention light that focused on a place of consequence rather than the journey pre-illness.  Members referred to the potential opportunity to save c£55m from the Devon health system over the next five years as well as improving outcomes and health and wellbeing by investing in evidence-based integrated mental health services and posed the challenge to the STP Board as to what services will we cease funding in order to bring about change.

The Board requested partners share further feedback via email account (d-ccg.mhwbstrategyengagement.nhs.net).

To consider a report on the above.

The Board considered a discussion paper on the opportunity to work together on strengthening existing partnership arrangements in designing and developing the next stage of the integrated care system in Devon.  The Board were advised that a development day had been held to determine what partners wanted to achieve through an integrated care system resulting in a plan on a page.  There are a number of issues to work through such as exploring how partners work collaboratively, where do Health and Wellbeing Boards sit within a Devon wide integrated care system and what is their role and what can the Board’s role be. 

Members were advised that the Board needed to ensure the emerging integrated care system was aware of the Board’s priorities with respective Health and Wellbeing Strategies influencing what the integrated care system does.  That members of the three Health and Wellbeing Boards be invited to a facilitated meeting to discuss their future role.

To note the update on the 2018/19 Vaccination Plan.

The Board noted a report that outlined Torbay’s Influenza Vaccination Plan for the 2018/19 flu season.  The plan sets out a co-ordinated and evidence based approach to planning for and responding to the demands of flu across the country, taking account of lessons learnt during previous flu seasons.  It aids the development of robust and flexible operational plans by local organisations and emergency planners within the NHS and Local Government.

Action: Rachel Bell to approach the Older Person’s Assembly to be flu champions.

Action: Caroline Dimond to raise flu vouchers for Torbay Council staff with the Senior Leadership Team.

To note the report.

Members of the Health and Wellbeing Board noted a report on the implementation of the Adult Social Care Eligibility Policy.  Members further noted that the publication of the policy and guidance had been delayed due to the impending change program, and the probability that process will slightly alter therefore it was prudent to delay publication in order to ensure that messages to the public, partners and staff are consistent and clear.

To note the report.

Members considered an update on projects developed to promote active ageing.  Members received a presentation on the development of an Older Persons’ Assembly and Positive Ageing Charter.  Members were advised that the proposals built on commitments given from the statutory partners at the Big Vision event held in January where there was overwhelming support to work together on developing plans to secure Age Friendly status and to support the development of a sustainable Older Persons’ Assembly.  The Assembly had a clear set of aims, functions and potential structure with the charter setting out aspirations, key commitments and values.

By consensus the Health and Wellbeing Board:

i)       Recognised that the ‘Positive Ageing Strategy’ was a necessary step towards Age Friendly status;

ii)      Strongly encourages each constituent agency member to nominate a Senior Responsible Person or non-Executive Officer, to work on finalising the ‘Positive Ageing Charter’, including developing the ‘how’ and agreeing actions during the next two months;

iii)     That the Positive Ageing Charter be endorsed and the Health and Wellbeing Board encourage individuals, departments and organisations to sign up to the Charter for the benefit of our residents;

iv)     That the Older Persons Assembly be invited to nominate one person to become a member of the Health and Wellbeing Board;

v)      Recognised the Assembly as a valued resource mechanism to either inform the development of new services or policies or the review of existing services and strategies, within a realistic timeline;

vi)     Agrees to hold members to account in terms of the Positive Ageing Charter and the Assembly;

vii)    Begin working with the Assembly and other partners towards Age Friendly status;

viii)   Encourages partners to consider giving a representative of the Assembly a seat on their governing committees and boards; and

ix)     Supports the development of an Age Friendly kit mark which will endorse services and organisations that adopt the Positive Ageing Charter values and guidelines.