Agenda and minutes

(1)       The Chairman said that a response had been received to a letter he and Mr Gibbens had written to Alistair Burt, Minister of State for Community and Social Care regarding pharmacies and that it would be circulated in due course.

(2)       Mr Gough welcomed Penny Graham who was a HealthWatch volunteer to the meeting.

(3)       Mr Gough said he had met with the chairs of the local health and wellbeing boards and that they were keen to have a role in the preventative agenda.

To receive apologies for absence and notification of any substitutes

(1)       Apologies for absence were received from Mr Ayres, Dr Kumta, Dr Lunt, Cllr Pugh and Cllr Watkins. 

(2)       Cllr Aldridge attended as substitute for Cllr Pugh.

To receive any declarations of Interest by Members in items on the agenda for the meeting

There were no declarations of interest.

To receive and agree the minutes of the last meeting

Resolved that the minutes of the meeting held on 25 May 2016 are correctly recorded and that they be signed by the Chairman.

To receive a report on the Kent Environment Strategy, links with the Health and Wellbeing Strategy and the work of Clinical Commissioning Groups.

(1)       The Chairman said that the Kent Environment Strategy embraced a range of outcomes including ones relating to health and that it would be useful for the Board to consider areas of overlap.  He then invited Carolyn McKenzie (Head of Sustainable Business and Communities) to present the report. 

(2)       Ms McKenzie said that over the previous 12 months the Kent Environment Strategy had been reviewed within KCC and with partners across Kent and Medway with a new plan agreed in November 2015.  District Councils were now adopting the plan in accordance with their individual governance arrangements and a new annual implementation plan was being developed.

(3)       Over the course of the previous Kent Environment Strategy a joint strategic needs assessment and sustainability appraisal chapter had been developed in conjunction with Public Health that identified issues and outcomes that were shared between environment and health. The Kent Environment Strategy had been one of the first to include a JSNA chapter and had been used as a national case study.  As a result the revised Kent Environment Strategy included more health outcomes and had become a strategy for the environment, health and the economy.

(4)       Ms McKenzie outlined the structure of the Kent Environment Strategy, drew the Board’s attention to Domains One and Two of the Public Health Framework and Outcome Two of the Kent Health and Wellbeing Strategy which had the strongest links between health and environment and suggested that the Board agree a number of priority areas, encourage health and environment professionals to work together and to jointly commission services for mutually beneficial outcomes.  

(5)       Ms McKenzie tabled a summary of the UK Climate Change Risk Assessment 2017 Evidence Report which is available on-line as Appendix A and Appendix B to these minutes.

(6)       The report, and particularly the direction of travel, was generally welcomed and comments were made about:

·         The need for cycle paths to meet the needs of cyclists;

·         The Kent Warm Homes Scheme; 

·         The role local health and wellbeing boards could play particularly in identifying local priorities and in tailoring initiatives to meet local needs;

·         The relationship of the Kent Environment Strategy to the place-based Sustainability and Transformation Plans;

·         The role of the environment in tackling health inequalities as set out in the Marmot Report.

(7)       It was also confirmed that NHS England was represented on the Kent Environment Champions’ Group, Public Health England had offered technical advice and support to Public Health for improvements to air quality in several areas of the County and that Kent related issues that needed to be raised nationally could be done through Ms McKenzie who sat on the National Adaptation Advisory Panel.

(8)       Resolved that:

(a)          Local health and wellbeing boards be asked to identify key personnel to work with the Kent Environment Strategy team to take forward public health and environment initiatives locally;

(b)          Local health and wellbeing boards be asked to identify areas where more support was required by health partners from the Kent Environment Strategy team.

To note progress and support planned work across agencies

Dave Holman (Head of Mental Health Commissioning – NHS West Kent CCG), Rachel Ireland (Chief Superintendent Head of Strategic Partnership Command – Kent Police) and Sarah Holmes-Smith (Kent and Medway NHS Social Care Partnership Trust) were in attendance for this item.

(1)       Mr Holman introduced the report which provided an update on the commitments made in the Mental Health Crisis Care Concordat across Kent and Medway.  He referred in particular to paragraph 2.3 of the report which set out the four domains around which outcomes should be designed and measured and to paragraph 4 which outlined a number of initiatives supporting patients in crisis and preventing avoidable attendance at Accident and Emergency.

(2)       Chief Superintendent Ireland said the main focus of the crisis prevention agenda was to reduce the number of Section 136 admissions.  A detailed review of 134 cases from May 2016 had shown that decisions made by the Police to admit under Section 136 were reasonable at the time and that five individuals were responsible for 17 detentions.  The results of the review as well as amendments to the use of Section 136 arising from the Police and Crime Bill were to be considered by the next meeting of the Crisis Concordat Steering Group on 21 July 2016 with a view to determining the next steps.

(3)       In response to questions it was confirmed that:

·         Options other than S136 detentions would be considered at the Crisis Care Concordat Steering Group meeting;

·         The terms of reference of the detailed review did not require consultation with those detained but the importance of looking at an individual’s circumstances and the support they were accessing prior to detention under S136 was acknowledged;

·         The report to the Crisis Care Concordat Steering Group included consideration of alternative places of safety especially in relation to complex needs;

·         Alternative modules of care such as the Sanctuary model in use in Manchester and the Richmond model in use in Sussex had been investigated and over the coming weeks a desired model for Kent and Medway would be agreed;

·         The proposals in the Police and Crime Bill would have the effect of reducing the use of Police custody for Section 136 detentions;

·         The KMPT Single Point of Access (SPOA) had received more than 10,000 calls since it came into operation in April 2016 and patients with urgent or emergency need were referred to appropriate services;

·         The Police have access to professional advice through the SPOA and of the 134 cases reviewed 7 officers did not get a response on the phone;

·         The feasibility of improving and expanding the S136 Place of Safety for children and young people in Dartford was being considered;

·         Responding to a crisis was also included in the CAMHS Strategy and commissioning plan.

·         Data at the local level was available and could be shared.

(4)       Comments were made about the risk of designing and commissioning services without the involvement of clients and the need to ensure that any provision of places of safety was underpinned  ...  view the full minutes text for item 230.

To receive an overview on Outcome 2 of the Kent Health and Wellbeing Strategy and plans for the future Kent Mind the Gap Action Plan aimed at reducing health inequalities.

(1)       Andrew Scott-Clark (Director of Public Health) introduced the report and gave a presentation which is available on-line as Appendix C to these minutes. 

(2)       In response to questions and comments, he said that health needs assessments could be conducted at community level to inform a place based approach to service delivery and acknowledged the statistical difficulties and  risks inherent in dealing with small numbers.  He also said it was expected that work currently underway to reduce health inequalities in pockets not large enough to feature in the map on slide 7 of the presentation would continue and assurance at a strategic level that plans were progressing and having an impact would be required.  Mr Scott-Clark said that reducing health inequalities required a systematic, place based and disproportionate response targeted at the most deprived communities. 

(3)       The need to involve district councils in the STP development process, particularly, in relation to the impact of their planning and licensing polices on health outcomes was acknowledged.

(4)       Resolved that:

(a)       The renewed approach to reducing health inequalities in Kent be endorsed;

(b)       Local health and wellbeing boards take a place based approach and that local plans encompass population, service and community development based approaches;

(c)        Regular reporting of progress be shared with the Kent Health and Wellbeing Board;

(d)       The Kent Health and Wellbeing Board takes an overview on county-wide progress.

To agree a Forward Work Programme

Resolved that the Forward Work Programme be approved.

To note the minutes of local health and wellbeing boards as follows:

Canterbury and Coastal – 10 May 2016

Dartford, Gravesham and Swanley – 6 April 2016

South Kent Coast – 17 May 2016

Thanet – 26 May 2016

Resolved that the minutes of the local health and wellbeing boards be noted as follows:

Canterbury and Coastal – 10 May 2016

Dartford, Gravesham and Swanley – 8 June 2016

South Kent Coast – 17 May 2016

Thanet - 26 May 2016