Agenda item

Roger Gough (Cabinet Member for Education and Health Reform, Kent County Council) and Tristan Godfrey (Policy and Relationships Adviser (Health), Kent County Council) were in attendance for this item.

(1)       The Chairman welcomed the guests to the Committee. Mr Gough began by outlining the report which covered the work of the Kent Health and Wellbeing Board in 2014/15. He explained that the Board’s core mandate included the production of the Joint Strategic Needs Assessment (JSNA) and the Joint Health and Wellbeing Strategy (JHWS); ensuring the commissioning plans of the CCGs and Kent County Council (social care and public health) reflected the needs and priorities of the JSNA and JHWS; and to promote the integration of health and social care. He noted that when the Board came into being in 2013, an initial short-term strategy was created; a long-term strategy for 2014 – 2017 was produced in 2014 with five main outcomes: children, prevention, long term conditions, mental health and dementia. He reported that the current strategy was reviewed with stakeholders at an event in the summer in preparation for the new strategy in 2017. A further event was held in September to evaluate how the JSNA could be of more value to commissioners. The Board was looking to ask commissioners to bring their commissioning plans earlier to the Board to provide assurance that the plans reflecting the needs of the JSNA and priorities of JHSW before sign-off. 

(2)       Mr Gough explained that the Board had overseen the introduction and implementation of the Better Care Fund (BCF) as part of its role to promote integration. He stated that the BCF was a mixed blessing; whilst it forced detailed thinking and collaboration by all health and social care organisations, it was a clunky process and there was lots of pressure for it to succeed. He noted that the Government had committed to the continuation of the BCF through extra funding announced in the recent Comprehensive Spending Review.  The Board was also involved in the development of the New Models of Care as part of NHS England’s Five Year Forward View and how they were being implemented in Kent. He reported that the Whitstable Medical Practice (Estuary View) had been one of 29 sites to be awarded Vanguard status. He stated that Vanguard status would have significant impact on how the CCG would operate in that area and the role of the Board going forward. He also noted that the Ebbsfleet development had been awarded Healthy New Towns status which would benefit from a programme of support. He also reported that the Board was tackling structural problems, such as workforce and housing developments, with partners including KCC, CCGs, district councils and Healthwatch.

(3)       Members of the Committee then proceeded to ask a series of questions and make a number of comments. A number of comments were made about the number of substantive items on the Board’s agendas relating to mental health and dementia, Mr Gough explained that the five JHWS’ outcomes were regularly reviewed. He noted that the Board also received the assurance framework which was not listed as an Agenda item; the framework showed the stress points within the health and social care system. He acknowledged that the Board had last considered dementia in July 2014 and it was something it should look at again. He highlighted significant progress in diagnosis rate – a 13% increase in Kent from 2013/14 to 2014/15 and the recruitment of the KCC Cabinet as Dementia Friends. He stated that he was keen to bring back a major review of Outcome 4 of the JHWS – Mental Health following the implementation of the Crisis Care Concordat. He noted that the Children’s Health and Wellbeing Board had been involved with the development of the Emotional Wellbeing Strategy and had reported back to the main Board.

(4)       Members enquired about the recruitment and retention of workforce in Kent. Mr Gough reported that a Workforce Task & Finish Group had been established by the Board to look at what could be influenced and controlled in Kent. The Task & Finish Group had a particular focus on multi-skilled workforce; building capacity at Canterbury Christ Church University; and promoting Kent as a place to live and work. Mr Godfrey stated that there was a desire for a whole system approach to workforce through the Task & Finish Group; the organisations involved had committed to working together in a more coordinated fashion, they had previously been chasing the same staff groups. In response to a specific question about student nurse bursaries being replaced by loans, Mr Godfrey explained that even if retention and recruitment of nurses was improved and all of the nursing training places were filled, there would still be a gap between supply and demand. The Task & Finish Group was looking at different ways for the gaps to be closed such as the use of Health Care Assistants and Physician Associates. A Member enquired about a proposal for collaboration between EKHUFT and London trusts to provide a two way flow of nurse placements which had been discussed on Radio Kent. Mr Godfrey stated that he would ask EKHUFT; he noted that Darent Valley Hospital was part of a collaborative of hospitals in London which made it easier to transfer from one organisation to another. He noted that Kent was attractive to staff when they wanted to buy a house or start a family. The Task & Finish Group was looking how to make Kent attractive for the whole of a medical professional’s career.

(5)       A number of questions were asked about the delegation of the Board’s functions and the impact of growth. Mr Gough explained that page 34 of the Agenda detailed the Board’s structure. He noted that the main Board had set up a network of local Health and Wellbeing Boards; the main Board focused on national initiatives whilst the local Boards looked at the implications in their areas and taking the detailed work forward. He stated that the local boards had varying levels of development. He reported that informal bodies had also been developed such as the North Kent Executive Programme Board, bringing together the commissioners and providers, which looked at the outcomes of the BCF. Mr Gough highlighted that two rounds of the Growth Infrastructure Framework had been bought to the main Board in the last six months. He reported that local boards were being encouraged to look at these; the Dartford, Gravesham and Swanley local board was looking at the implications of the Ebbsfleet development particularly funding and the development of new models of care. He noted that whilst there was a more established pattern of growth in Ashford than in North West Kent, there were still opportunities for innovative health services. He stated that the aim was for the core data to be presented to the main Board through the Growth and Infrastructure Framework and the local Boards to look at the implications in their areas. He noted that with new developments, there was a threat that existing health services would not be able to expand to meet the demand but there was also an opportunity to do something different with health services.

(6)       A Member enquired about the added value of the Board and its relationship with HOSC. Mr Gough reported that the establishment of Health and Wellbeing Boards was the least controversial and most welcome element of the Health & Social Care Act 2012.  He reported that the main Board was a hub for collaboration and integration and provided a framework for commissioning through the JHWS. He stated that the scrutiny of service reconfiguration was for the HOSC; the Health & Wellbeing Board was instead working with the CCGs on wider issues such as the pattern of sustainable acute services.

(7)       RESOLVED that:

(a)       the Committee notes the report;

(b)       the Chairman of the Health and Wellbeing Board be requested to attend in future years with the Health and Wellbeing Board annual report;

(c)        the Committee be presented with a paper on the Workforce Task and Finish group at the appropriate time.