Agenda and minutes

(1)          The chairman welcomed those present and obtained agreement that the Kent Health and Wellbeing Strategy Update and Engagement listed on the agenda as item 7 be brought forward and considered following consideration of the minutes of the meeting held on 26 March 2014.

(2)          The chairman welcomed Mr Oakford to the meeting and advised the HWB that he would be taking over from Mrs Whittle with effect from 2 June 2014. 

(3)          The chairman said he had received a letter from the Martello Medical Practice, Dymchurch, seeking a view on the way forward for the practice following the retirement of the sole GP.  The chairman said he had consulted with the relevant CCG, Healthwatch and others and would circulate his draft response to members of the HWB.

(4)          The chairman said the Dr Abraham George and Mr Shakeel Mowla continued to develop integrated intelligence to aid the strategic commissioning process.  They had already been in contact with some partner organisations and were suggesting that each local health and wellbeing board nominated a priority area.  Further discussions would continue in June with a view to presenting a proposal to the HWB at its next meeting on 16 July 2014.

(5)          The chairman said that, in addition to strong patient input, the Healthwatch Reference Group would welcome clinical input in its work overseeing the work of Healthwatch.

Apologies for absence were received from Dr F Armstrong, Cllr A Bowles, Dr D Cocker, Mr G Gibbens, Dr M Jones, Mr S Inett and Mrs J Whittle.  Cllr K Pugh, Mr C Smith and P Oakford attended as substitutes for Cllr A Bowles, Mr G Gibbens and Mrs J Whittle respectively.

There were no declarations of interest.

Resolved that the minutes of the meeting of the Kent HWB held on 26 March 2014 are correctly recorded and that they be signed by the chairman.

(1)          Marcus Chrysostomou (Head of External Communications), Malti Varshney (Consultant in Public Health) and Mark Lemon (Strategic Business Adviser) introduced the report which said the current Kent Health and Wellbeing Strategy had been agreed by the Shadow HWB on 30 January 2013 and that it was now due for renewal.  A new strategy would be presented to the next meeting of the Kent HWB on 16 July 2014 and this would enable the final strategy to be endorsed in time to inform the next round of commissioning that would start in autumn 2014.

(2)          Mrs Varshney said a workshop had been held with key stakeholders on 30 April and the key issues to emerge were: a need for strategic alignment across the system; the identification of priorities and their connection with outcomes; the need to be more specific about children’s issues and a clear statement of the case for change. She drew the HWB’s attention to the key points of the refreshed strategy which were: to provide a strategic platform for change across the system; a revision to the wording of Outcome 5 to reflect holistic support for people with dementia and the stronger connections between outcomes and priorities.  She also said the strategy took into account the views of Kent residents about the changes they would expect such as: timely access to support; and improvements to professional communication. She also sought the views of the Board on whether to use national targets and benchmarking or to set stretch targets.

(3)          The Kent HWB supported the approach outlined in the report and emphasised the need for this strategy to be a high-level strategic document that would inform the commissioning plans of partner organisations which, in turn, would include detailed targets.  It was suggested that it was important: to make strong links with the Joint Strategic Needs Assessment; to be very explicit about the quality of outcomes for both existing services and for services that would be integrated through Better Care Fund initiatives and to explain that different priorities might be identified at the local level.  It was also suggested that a simplified version of the Health and Wellbeing Strategy be produced for residents and patients,

(4)          Mr Chrysostomou outlined the plans for engagement with the public and stakeholders including publication of the strategy on-line, appropriate press releases, use of social media, simplifying the document and seeking feedback from the public on the accessibility of the document. 

(5)          It was recognised that this was a key opportunity to engage with residents and stakeholders about the future of health and social care and the intention to provide services around the user and closer to home.

(6)          Resolved that:

(a)       The first draft of the Kent Health and Wellbeing Strategy be taken to wider engagement and consultation;

(b)       The proposal for communications and engagement and the associated key messages for all stakeholders be endorsed;

(c)        The final draft version of the strategy be received at the next meeting of the HWB on 16  ...  view the full minutes text for item 79.

(1)       Andrew Scott-Clark (Interim Director of Public Health) and Karen Sharp (Head of Public Health Commissioning) introduced the report which set out the commissioning programme for public health in 2014/15 and asked the HWB to comment on the plan.  They also gave a presentation which set out information about the context and legacy of public health, the transition of public health from the NHS to Kent County Council during 2013-2014 and priorities for future commissioning.  They said the approach to be adopted for future commissioning was based on four key principles: working in partnership through a whole system approach; making the best use of the public health grant; effective communications with the public, workforces and targeted campaigns; and having evidence-based, locally flexible and targeted services with maximum integration.

(2)       The HWB considered it important that: the commissioning plan made strong connections between inputs and outcomes; expenditure was properly evaluated and demonstrated clear changes in behaviour; programmes commissioned county-wide were delivered and integrated locally; the need to invest more in disadvantaged communities in order to bring about change be recognised; and acknowledged that the local health and wellbeing boards had an important role to play in setting local priorities, facilitating conversations with local champions and integrating service delivery.

(3)       Resolved that the Public Health commissioning intentions for 2014-15 be noted.

(1)          The chairman, in his introductory comments on the plan, said that at this stage the plan was a KCC focussed document as the levels of integration in children’s services were not as well developed as those for adult social care.  However he also thought it was important that the HWB viewed this as a first step towards fuller service integration.

(2)       Mark Lobban (Director of Commissioning) introduced the report which presented the Children’s Commissioning Plan. The purpose of the report was to present high-level information about the Children’s Commissioning Plan as part of a review of commissioning plans being undertaken by the HWB.  He referred to the overarching strategic document “Every Day Matters” which set out four key outcomes and strategic priorities for the Health, Social Care and Wellbeing Directorate and the Education and Young People’s Directorate.

(3)       Concerns were expressed that the Children’s Commissioning Plan did not adequately define outcomes to enable commissioning to take place.  Views were also expressed that: it was important to streamline services which were currently fragmented; work on the development of the Joint Strategic Needs Assessment in relation to children’s services had been key to providing evidence of need; the establishment of task and finish groups to address concerns regarding mental health services for children and adolescents as well as discussions regarding the establishment of an integrated commissioning body and the establishment of a children’s health and wellbeing board would all contribute to service transformation and integration.

(4)       Resolved:

(a)  That the Children’s Commissioning Plan be noted

(b)  That a report on the integrated commissioning of health, social care and children’s services be consider at a future meeting of the HWB.

(1)          Mark Lobban (Director of Commissioning) gave a presentation on the Accommodation Strategy which covered the rationale for having a strategy, an overview of the strategy, an analysis of the accommodation needs of older people and the next steps.

(2)          Comments were made about the gap between the current position and the delivery of the strategy, the need to involve all members of the HWB in any launch to the market and in efforts to communicate planned changes in service provision to the public as well as the implications for quantitative and qualitative provision of nursing in the community and in care homes.

(3)          Resolved that the proposed Accommodation Strategy be endorsed.

(1)          Malti Varshney (Consultant in Public Health) introduced the report which provided a summary of the assurance framework indicators where concerns or improving performance had been noted and asked the HWB to make decisions on the points raised in section 3.

(2)          Resolved that:

(a)       The establishment of a multi-agency group responsible for proposing and reviewing targets and where analysis of the data and context can be discussed at monthly meetings be endorsed;

(b)       The proposed set of stress indicators for children’s services including CAMHS and SEN be endorsed for inclusion in Section 6 - Stress Indicators;

(c)        The alternative metrics for Outcome 5 (people with dementia are assessed and treated earlier) be endorsed;

(d)       CCG members discuss with their constituent members the importance of complete data collation and timely submissions of infant feeding continuation statistics;

(e)       Assurance be sought from Public Health England/ NHS England about plans to improve the uptake of flu vaccinations in 2014/15.

(f)        The availability of reports in July 2014 for local Health and Wellbeing Boards, with indicators at a lower geographical area, be noted;

(g)       The discussions within the Social Care, Health and Wellbeing Directorate to ensure the most relevant and appropriate metrics are being used be noted and that indicators associated with and from the ASCOF might be subject to amendment;

(h)       In accordance with the HWB’s previous recommendations, the inclusion of new metrics on excess weight in children and adults, and physically active adults in Outcomes 1 and 2 be noted;

(i)            The addition of statistics for Medway Foundation Trust to indicators 6.8 and 6.9 surrounding bed occupancy rates and A&E attendances due to the identification of Swale residents accessing Medway Hospital be noted.