Agenda item

1.    Mr Henderson and Dr Ghosh introduced a report on the report on the future role and operation of the Kent Health and Wellbeing Board, which invited members to consider and endorse proposed revisions to the Board’s Terms of Reference. The proposed changes reflected the Board’s evolving leadership role, particularly in relation to the development of a Local Neighbourhood Health Plan, changes within the NHS, and the increasing importance of partnership working to improve health outcomes and reduce inequalities across Kent.

2.    Dr Ghosh advised that the meeting marked the final meeting of the Health and Wellbeing Board in its current form, with a refreshed Board expected to be relaunched at its next meeting in September. He noted that supplementary papers had been provided setting out the findings from workshops and engagement undertaken earlier in the year on the future role and structure of the Board, and that these had informed the revised Terms of Reference where appropriate.

3.    The Board was reminded that following the establishment of the Integrated Care Board (ICB) and Integrated Care Partnership (ICP) in July 2022, the ICP had become the principal multi-agency strategic forum for health and wellbeing across Kent, resulting in the Health and Wellbeing Board meeting only annually. Dr Ghosh explained that, with the ICP due to be abolished, the Health and Wellbeing Board would resume a central role as the primary forum for strategic health and wellbeing discussions across Kent.

4.    Dr Ghosh highlighted the principal changes proposed within the revised Terms of Reference. These included confirming the Health and Wellbeing Board as Kent's principal strategic health and wellbeing partnership; strengthening its role in overseeing delivery of the Neighbourhood Health Model and Kent's Neighbourhood Health Plan; clarifying its relationship with the Health Overview and Scrutiny Committee; introducing annual priority-setting and performance reporting arrangements; enabling functions to be delegated to sub-committees; refreshing membership to reflect the Board's enhanced strategic role; and increasing the frequency of meetings to at least quarterly. The Board was advised that, as a statutory committee of the Council, the revised Terms of Reference would be required to proceed to the Selection and Member Services Committee and subsequently to Full Council for formal approval.

5.    Prior to opening the discussion, Mr Henderson (Chair) highlighted that, in addition to noting the report, members were being asked to endorse the revised Terms of Reference for the Health and Wellbeing Board. He emphasised the importance of ensuring that the proposed arrangements accurately reflected the Board’s role, responsibilities and functions within the evolving health and care system. Mr Henderson invited members to propose and discuss any amendments in turn before determining whether they should be considered for incorporation into the revised Terms of Reference. The Board was reminded that any revisions endorsed at the meeting would be subject to further consideration by the Selection and Member Services Committee before being referred to Full Council for formal approval and adoption.

6.    Further to questions and comments from Members the discussion included the following:

(a)  An amendment was proposed to increase elected member representation from Kent district, borough and city councils from three to four members, reflecting anticipated local government reorganisation arrangements and providing representation from each future local authority area

(b)  It was proposed that the membership provisions relating to NHS representation be amended to align with current NHS collaborative arrangements across Kent, with representatives nominated through the relevant provider collaboratives, including the Primary Care Alliance and acute provider collaboratives. This would ensure that Board membership reflected existing NHS partnership structures and ways of working.

(c)  It was suggested that the effectiveness of the refreshed Health and Wellbeing Board would be strengthened through a more collaborative approach to agenda setting, reflecting feedback from the earlier workshops. Involving Board members collectively in developing future agendas would help ensure discussions were aligned with strategic priorities and enable the Board to reach stronger conclusions. In response, Dr Ghosh advised that agenda-setting arrangements were already established for committees and suggested that similar mechanisms could be adopted for the Health and Wellbeing Board to provide members with opportunities to contribute to the development of future agendas.

(d)  An amendment was proposed to the voting provisions within the Terms of Reference to clarify that decisions of the Health and Wellbeing Board could not override the statutory powers, responsibilities or governance arrangements of individual partner organisations. It was noted that, whilst the Board could reach collective decisions, these could not compel Kent County Council, NHS bodies or other statutory organisations to act outside their own decision-making and accountability frameworks.

(e)  Mr Streatfield, with the agreement of the Chair, addressed the Board and welcomed the proposed revisions to the Terms of Reference. He proposed that consideration be given to including a specific focus within the Board’s mental health priority on combat veterans’ mental health and access to health services. He highlighted concerns regarding the barriers some veterans faced in accessing support and noted the opportunities presented by existing local initiatives and services, including Op Courage and the Valour Hub. Mr Streatfield also indicated his willingness to support this work through future involvement or a dedicated sub-committee structure. The Chair and Members expressed support for the proposal.

(f)   A query was raised regarding how proposed amendments to the Terms of Reference, including those of a more substantive nature, would be reflected through the governance process and whether there would be an opportunity for further review before formal approval. Members were advised that the Board's role at this meeting was to endorse the proposed amendments for onward consideration rather than to approve the final Terms of Reference. It was noted that the revised Terms of Reference would be considered through the Council's governance process, including by the Selection and Member Services Committee, and that should significant amendments arise during that process, further discussions would take place and progression to Full Council could be deferred to enable appropriate consideration before formal adoption.

7.    The Chair thanked members for their comments and noted that the amendments proposed during the meeting would be considered for incorporation into a revised draft of the Terms of Reference. Members were reminded that the Board was being asked to endorse the proposed Terms of Reference, which would subsequently be considered through the Council's governance process, including by the Selection and Member Services Committee and Full Council, before any changes could take effect.

8.    It was RESOLVED that the Kent Health and Wellbeing Board:

(a)  Note the evolving national and local context for Health and Wellbeing Boards, including the Board's anticipated leadership role in the development and oversight of the Kent Neighbourhood Health Plan and Better Care Fund arrangements;

(b)  Endorse the proposed future role, membership and ways of working for the Kent Health and Wellbeing Board as set out in this report;

(c)  Endorse the proposed changes to the Terms of Reference attached at Appendix 1; and

(d)  Note that any revisions to the Terms of Reference endorsed by the Board will be subject to consideration by the Selection and Member Services Committee prior to formal approval and adoption by Full County Council