Agenda and draft minutes

To receive apologies for absence and notification of any substitutes

Apologies for absence were received from   Dr Armstrong, Mr Carter, Dr Chaudhuri, Ms Cox,  Mr Dunkley, Dr Kumta and Ms Selkirk.  Mr Collins attended as substitute for Mr Dunkley.

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 last meeting are correctly recorded and that they be signed by the Chairman.

Xanten Brooker and Emma Hanson (Senior Commissioners) were in attendance for this item

(1)  Xanten Brooker and Emma Hanson introduced the report which provided an update on the Learning Disability Section 75 Agreement that had been established to host integrated commissioning arrangements between Kent County Council  and the seven clinical commissioning groups.  They also gave a short presentation which had been circulated with the agenda papers.

(2)  Penny Southern  said that the Learning Disability Alliance had, on the whole, been successful and that it was important to ensure services for people with learning disabilities were not lost as a result of changes to Integrated Care Partnerships and to consider how they could be further developed.

(3)  In response to questions and comments, Xanten Brooker and Emma Hanson provided further information about responsibility for patient referral within the Learning Disability Alliance, the provision of annual health checks; and assessments made under the Care Act.  Mr Gough and Mr Collins answered questions about the register of elective home-schooled children.

(4)  Resolved that the report be noted.  

Jo Frazer, STP Lead, Adult Social Care and Health was in attendance for this item

(1)  Jo Frazer introduced the report which provided an annual update on the progress of the Kent Better Care Fund.

(2)  Resolved that the report be noted and, if any further submission is required for the extension of the BCF plan, that the sign off be delegated to the Chairman.

Dr Abraham George (Consultant in Public Health) was in attendance for this item

(1)  Andy Scott-Clark introduced the report by saying that in 2018 the Kent and Medway STP had published an updated Case for Change and that this drove the work for transforming health and care services in Kent and Medway.  He said the findings of the needs assessment highlighted in the paper would be reflected in the refreshed STP Case for Change which would be aligned with the NHS Long Term Plan. 

(2)  Abraham George said this report was the sixth Kent Joint Strategic Needs Assessment Exceptions Report to be presented to the Health and Wellbeing Board. He drew the Board’s attention to the principal issues raised in the report.

(3)  Members of the Board expressed disappointment that health inequalities appeared to be widening across Kent.  Members also said it was important to hold the whole system to account and that consideration be given to making high-level strategic objectives relevant and meaningful to health practitioners, particularly those in deprived areas. The importance of a whole system approach to reducing liver disease, excessive alcohol consumption and obesity was acknowledged.

(4)  Mr Douglas said it was important to identify the approaches to tackling strategic issues which worked best and to re-use those approaches in other areas.

(5)  Resolved that:

(a)  a system-wide focus on prevention, especially the continued whole-system focus on the reduction of smoking prevalence, particularly for women who smoke during pregnancy be endorsed;

(b)  the continued focus on local populations with the lowest life expectancy be endorsed;

(c)  work be undertaken to ensure whole systems are communicating systematically and effectively in order to gain the best outcomes, particularly to address multiple long-term conditions and both physical and mental health, across the life course;

(d)  the focus on improving Stroke and Cancer pathways from prevention through diagnosis, treatment, rehabilitation and palliative care be continued;

(e)  key highlights and emerging issues be embedded into the reiterated Kent and Medway Case for Change;

(f)   a report on addressing health inequalities be considered at the Health Reform Public Health Cabinet Committee in June 2019  and at a meeting of the STP Board.

(1)  Stuart Collins introduced the report which provided an annual update on the progress of the 0-25 Health and Wellbeing Board.

(2)  In response to questions from the Board, Mr Collins said that health visitors were co-located in Children’s Centres in Ashford and would soon be co-located in Children’s Centres in Dartford. He also said that 98% of early years services had been assessed as good or better. 

(3)  Members of the Board broadly welcomed the report.

(4)  Resolved that:

(a)  the report, the progress to date and the proposed direction of travel set out in the Forward Plan be endorsed;

(b)  the 0-25 HWB’s plans for the identification of further opportunities to strengthen partnership working be supported.  

Dave Holman (Head of Mental Health Commissioning, NHS West Kent CCG) and Adam Wickings (Deputy Managing Director West Kent CCG and MNWK CCGs) were in attendance for this item

(1)  Dave Holman introduced the report which provided an update on the commitments made in the Mental Health  Crisis Care Concordat across Kent and Medway.  The report included information about progress to date and drew attention to the increase in the number of  admissions under Section 136 of  the Mental Health Act which remained high despite a range of initiatives.  Adam Wickings spoke about the work underway to reduce the number of admissions and the deep dive undertaken earlier in the year.

(2)  Resolved that the progress be noted and that planned work across agencies be supported.

Allison Duggal (Deputy Director of Public/ Public Health Consultant) was in attendance for this item

(1)  Allison Duggal introduced the report which described the current process for updating the Pharmaceutical Needs Assessment, asked the Board to agree to formalise the process and delegate responsibility to the Pharmaceutical Needs Assessment Steering Group.

(2)  Resolved that the Pharmaceutical Needs Assessment Steering Group be given delegated responsibility to consult, collate and respond to all written requests from NHS England in relation to the PNA and the provision of pharmaceutical services on behalf of the Health and Wellbeing Board.

To agree that the next meeting of the Kent Health and Wellbeing Board will take place on 26 February 2020.

Resolved that the next meeting of the Kent Health and Wellbeing Board be held on 26 February 2020.