Agenda and minutes

The Chairman, Roger Gough, Cabinet Member for Business Strategy, Performance and Health Reform (KCC), welcomed everyone to the meeting of the Shadow Health and Wellbeing Board.

The following apologies were received and noted:

Councillor Lesley Ingham, Mr Paul Carter and Ms Ann Sutton

There were none.

The Board agreed that the Minutes of the meeting held on 21 March 2012 were a correct record and that they be signed by the Chairman.

Matters Arising

Children’s Centres

The Shadow Health and Wellbeing Board reminded the supporting officers that a map showing the location of the Children’s Centres across Kent was required.

The Late Mark Worrall

The Board noted with sadness the recent death of Councillor Mark Worrall, Leader of Tonbridge and Malling Borough Council and placed on record their recognition for his contribution to the Shadow Health and Wellbeing Board.

The Board noted and endorsed its terms of reference previously agreed by the Shadow Health and Wellbeing Board on 28 September 2011.

(1)         Further to Minute 36 the Chairman informed the Board of the ongoing work in developing the Health and Wellbeing Strategy.  The Shadow Health and Wellbeing Board noted that there would be a Strategy in place by the Autumn.

(2)          The Chairman informed the Board that both Meradin Peachey and he had attended some National Learning Set meetings which had indicated that many other places are operating to a similar timescale concerning the Strategy.

(In attendance Sue Gratton, Deputy Associate Director, Integrated Commissioning, NHS Kent and Medway, Anne Tidmarsh, Director Older People and Physical Disabilities, Kent County Council and Evelyn White, Associate Director, Integrated Commissioning, NHS Kent and Medway)

(1)       Dementia is one of the main long term conditions of later life which has a huge impact on the capacity for independent living.  In the United Kingdom it was estimated to cost over £19 billion per year with an projected doubling of the number of people who have dementia in the UK over the next 30 years.  The report updated the Shadow Health and Wellbeing Board on:

(i)     needs analysis in relation to dementia in Kent;

(ii)   achievements to date;

(iii)gaps identified; and

(iv)  the Integrated Commissioning Plans for Dementia

(2)               The Board noted that the Prime Minister had recently published a “Challenge on Dementia” which sets down a number of areas for action to make life better for people with dementia and their carers.  The Challenge focussed on three key areas:

(a)   driving improvements in health and social care;

(b)   creating dementia friendly communities that know how to help; and

(c)   better research

(3)               The report before the Board sought to see that the Challenge was being addressed through the Commissioning Plans and what more could be done across Kent to meet the Challenge.  Whilst considerable progress had been made in redesigning the services in order to reinvest in more universal preventative and early intervention support there remained a significant challenge to ensure that the growing number of people who will develop dementia over the coming years will be well supported and can continue to enjoy life with their dementia.  The Plans were in line with the National Dementia Strategy and also take into account the Kent County Council Select Committee on Dementia.

(4)               The Shadow Health and Wellbeing Board noted that the work was being led through the Health and Social Care Integration Board. The Board’s role was important to ensure integration between health and social care but equally important was the joined up working with the independent and voluntary sector to ensure integrated care across all providers and all stages of the pathway of care.

(5)               The Chairman invited Roger Kendall representative of Kent LINk on the Shadow Health and Wellbeing Board to receive their report setting out their views on Dementia Services in Kent (May 2012).

(6)               Particular reference was made to a number of projects undertaken by Kent LINk in which dementia services had featured including:-

(a)   West Kent Enhanced Dementia Crisis (2009);

(b)   A User’s Perspective of Day Centres in East/West Kent (2009/10);

(c)   Monitoring Quality of Residential Homes in East Kent (2011);

(d)   Monitoring Quality of Residential Homes across Kent (2012); and

(e)   Care of Older People in Hospitals (2012)

(7)               The recommendations of Kent LINk which they would like to see the Shadow Health and Wellbeing Board taking into consideration were:

(a)   looking into further services for people with dementia, with a particular emphasis  ...  view the full minutes text for item 47.

(1)   Mark Lobban, Director of Strategic Commissioning, Kent County Council  gave the Board a presentation leading to a workshop and table discussion on “Adult  Social Care Transformation and Integrated Commissioning”.

(2)   The presentation covered:

(a)   Meeting the challenges through transformation to use more effectively the adult Social Care Budget (net) in 2011/12 of £352 million;

(b)   The opportunities for more effective service delivery thorough “co-production”

(c)   What a future model may look like;

(d)   Taking transformation forward;

(i)                 April to June – to understand the business as a platform for transformation; understand how different parts of the business affect each other; identify spend that can be influenced, and spend that cannot

(ii)               July to September – plan the work of the programme and allocate resources; develop and finalise a performance framework to monitor change; deliver plans for appropriate agreement; ensure programme management resources are in place

(iii)             September 2012 – co-produce changes with stakeholders; re-design business processes to implement changes; develop clear role and responsibilities;

(iv)              Develop tools to support people to make changes; and

(v)                September 2012 – 2015 – Monitor people, processes and outcomes to check that expected benefits are realised; evaluate the effectiveness of the transformation programme.

(3)   The Shadow Board noted the intentions for Countywide Integrated Commissioning including the interface and opportunity to add value between NHS Kent and Medway’s “Towards Sustainable Care for Kent and Medway” and Kent County Council’s “Adult Social Care Transformation Programme Blueprint and Preparation Plan”

(4)   The presentation also covered the opportunity for Local Integrated commissioning e.g. creating a virtual joint commissioning team for Dover and Shepway which would work towards a joint commissioning strategy (local Health and Wellbeing Strategy and the production of a Joint Commissioning Plan for Kent). The strategy for Local Integrated Commissioning was to create a major shift from acute to community care:

(a)   drive hard the efficiency of existing community services

(b)   release money to invest in more community services

(c)   reduce demand on acute services

(d)   opportunity to invest further in community services

(e)   not always about radical new services

(f)     radical change is getting the whole system to work together

(g)   integrated structures and pooled budgets may be a natural progression.

(5)        The table discussions covered the following points:

The vision is to have a healthcare partnership to be proud of and therefore the aim is to create an environment for change. We should be making it easier for people to do the right thing.

The way people work is one of the biggest barriers for change. It is difficult to overcome the view that the safest place is in hospital or a care home. Community nurses, paramedics etc will be disciplined if they do not follow procedure. Issue is around professional decision making and risk levels.

Acute admissions should be seen as a failure to deal with long term conditions.

There needs to be joint targets, incentives and penalties across agencies. There should be penalties written into contracts.

The issue for  ...  view the full minutes text for item 48.