Present: Councillors Dudley (Chairman) and Mrs Quick.

Brian Huggett, Dr Pat Riordan, Cliff Turner, Dr Adrian Hayter and Christabel Shawcross.

Also Present: Graham Box, Carolyn Finlay and Rutuja Kulkarni.

Officers: Michaela Helman, Michael Kiely, Catherine Mullins, John Scaife, Keith Skerman, David Scott, Genny Webb and Angela Wellings.

01/11 APOLOGIES FOR ABSENCE

Apologies were received from David Williams.

02/11 DECLARATIONS OF INTEREST

There were no declarations of interest.

03/11 TERMS OF REFERENCE AND GOVERNANCE ARRANGEMENTS

The Director of adult and community Services explained that the Borough was an early adopter of Health and Wellbeing Boards and that this was one of the first Boards to actually meet, as such there may be the need to revisit the Terms of Reference and the Governance arrangements in the future as the Health & Social Care Bill goes through Parliament. She explained that she had responsibility within the Borough for NHS changes. It was noted that there would be the opportunity to extend membership by co-option.

After brief discussion, the Terms of Reference were agreed.

RESOLVED: Unanimously that the Terms of Reference be adopted.

04/11 PROGRESS AGAINST 2010/11 JOINT STRATEGIC NEEDS ASSESSMENT (JSNA)

The Board received the report which summarised the progress made by the PCT against the 2010/11 JSNA and explained the legislative requirement for a joint strategic needs analysis. The requirement was aimed at identifying local health needs of the population, the inequalities that are shown and the assessment of trends.

It was explained that there were broad determinants of health, and the importance of the role of the local authority was underlined.

During the discussion the following comments were made:

Ø The 2010/11 JSNA was produced with the Marmot themes of needs assessment across the life course. The Health Select Committee response on 14^th July 2011 supported the continued use of Marmot themes in JSNAs.
Ø The clinical commissioning groups would be required to have regard to JSNAs within their commissioning plans and the JSNAs would continue to be produced on an annual basis.
Ø Each JSNA would have a related detailed action plan.
Ø It was expected that the JSNA would be considered again at the November meeting of the Board.
Ø In addition to the JSNA there would also be annual report by the Director of Public Health. The action plan would be developed with Borough colleagues and other stakeholders at an early stage.
Ø It was suggested that the JSNA was fundamental to future progress, and that it should have a wider brief to include social care and welfare. There would also be a need to involve other stakeholders.
Ø A variety of data sources would be drawn upon to identify specific issues or geographical areas of need.
Ø There would be an increased need to spend money on prevention measures for older people.
Ø The need to support carers should not be overlooked.
Ø Areas for review for children and young people included mental health and wellbeing, teenage sexual health and families with complex needs.
Ø At the November meeting of the Board there would be an opportunity to review progress and plan for 2012/13.

RESOLVED: Unanimously that:

a) The JSNA for 2011/12 continues with Marmot themes of needs assessment across the life course.
b) The 2011/12 JSNA informs the Health and Wellbeing Strategy that will be later developed through the Health and Wellbeing Board.
c) For 2011/12, the JSNA focuses on two areas for detailed needs assessment, namely, children and older people.
d) That the JSNA is presented to the Health and Wellbeing Board with an action plan in November 2011.

05/11 LOCAL AREA AGREEMENT REWARD MONIES

The Board received the report which stated that the government had awarded additional funds for investment in health and social care under the Local area Agreements in 2010/11. These were 50% less than previously allocated by government. The Primary Care Trust Executive had agreed in June 2011 to the allocation of funds set out in the report.

The Board had been given delegated powers by RBWM Cabinet to agree these funds on a non-recurring basis.

During the discussion the following comments were made:

Ø It was noted that all funding bids had to be linked to the JSNA.
Ø Each bid recommended for funding was briefly described to the Board.
Ø Successful bids would be monitored by the development of performance indicators. It was agreed that the targets should be proportionate and realistic
Ø There would be a need to collect data on actual outcomes, rather than just activities carried out.
Ø Projects thought to have long-term value could later be funded from core budgets.

RESOLVED: Unanimously that:

a) The Health and Wellbeing Board approve the allocation as set out in the report, i.e. £97,700 to adults; £37,290 to children’s services (Total £134,990).
b) The unallocated funds of £16,908 be delegated to the RBWM Health and Social Care Executive to select under the same criteria as used in the process and recommend to the next Health and wellbeing Board.

06/11 DEVELOPMENT OF THE JOINT HEALTH AND WELLBEING STRATEGY

The Board received the report which explained that one of its main duties would be to produce and publish (with GP Clinical Commissioning Groups) a population level Joint Health and Wellbeing Strategy (JHWS).

It was explained that there was no template available upon which to base the production of the strategy, although further guidance will be issued by central government later in the year.

It was agreed that there was a need to prioritise resources and set out a clear timetable to ensure the strategy was completed.

RESOLVED: Unanimously that the Strategic director for Adult and Community Services be delegated to lead on the development of the Joint Health and wellbeing Strategy with essential partners and report back to the Board in February 2012.

07/11 TRANSITION FROM CHILDREN TO ADULT HEALTH AND SOCIAL CARE

The Board received the report which summarised the approach recently taken to improve the long term care and support that is developed for and with children, young people, and their carers. The range of needs covered included autism, learning disabilities, mental health and physical disabilities, especially whenever any of these combined in complex difficulties.

The Board had responsibility to promote the integration of health and social care and was therefore asked to comment on and endorse the approach set out in the report.


During the discussion the following comments were made:

Ø The Board was pleased to note the establishment of a Transition Steering Group.
Ø Further proposals would be submitted to the RBWM Cabinet and other key decision makers in Autumn 2011.
Ø Pilot schemes could be used to work with professionals, schools and families to improve facilities.
Ø There was an opportunity to work in partnership with colleagues in other Berkshire authorities.
Ø Families experienced difficulties in different ways. There would be an opportunity to explore the use of existing facilities in different ways, or to check if new facilities were needed.
Ø There would be an opportunity to review national expertise on behavioural issues.
Ø There was a need to provide better information on how to access education, training and accommodation.
Ø Members welcomed the proposals. It was hoped that they would help to focus efforts to improve the health and wellbeing of the individual, the family and their carers.
Ø There were links to the Transforming Adult Social Care agenda.
Ø Autism was a particular issue in the Borough. It was noted that the Borough had worked well with Berkshire Autistic Society.

RESOLVED: Unanimously that:

a) The recommendations from the National Development Team for Inclusion and the Council Commissioners of Health and Social Care be supported.
b) The project to produce specific outline business cases for investment and improvement to children and adult services for people with autism, learning, and complex disabilities with health and social needs be endorsed.

08/11 GP / CLINICAL COMMISSIONING – UPDATE ON PROGRESS

The Board received the report which described the work that had taken place to date to introduce GP led commissioning in Windsor, Ascot and Maidenhead. It was noted that as a result of the ‘pause and listen exercise’ the bodies would be known as clinical commissioning groups once they became statutory bodies.

In a brief presentation the following comments were made:

Ø Twenty Windsor, Ascot and Maidenhead practices had got together. Three Ascot practices had aligned with Bracknell Forest.
Ø In March 2011 six GPs got together to form a Development Panel to lay the foundations for the formation of the shadow commissioning consortium. The Panel had met on a weekly basis and had begun the process of engagement with the local authority, GP surgeries, patient organisations, acute providers, the PCT, the Strategic Health Authority and other locality commissioning groups.
Ø There was a need for working GPs to lead the change and engage more with the people they served.
Ø Quality of care needed to be embedded in all of the work.
Ø The shadow commissioning consortium would be established by some form of election process. It was expected to be in place by early Autumn 2011 but would not have any statutory powers at that stage.

In the ensuing discussion, the following comments were made:

Ø Acute services were being fully involved in the process. This included a review of the Heatherwood and Wexham contract negotiations.
Ø One of the ‘pause and listen exercise’ outcomes was the creation of a Clinical Senate. Senates would have a degree of independence and would be multi-disciplinary. They would advise on the redesign of clinical pathways.
Ø It was acknowledged that as the Health and Social Care bill passed through Parliament there would be further changes to it.
Ø It was noted that the Director of Public Health was likely to sit on three shadow health boards to ensure all residents were represented.

RESOLVED: Unanimously that:

a) The work that has been undertaken to date be noted.
b) The challenges that are faced in managing the changing environment are recognised.
c) The opportunities presented by new approaches to the commissioning of healthcare be considered.

09/11 PLANNED AGENDA ITEMS AND ITEM SUGGESTIONS FOR FUTURE MEETINGS OF THE BOARD

The following items for future meetings were discussed:

4 November 2011
Department of Health Transfer of Funds
Physically Active Children
JSNA update and planning for 2012/13
GP / Clinical Commissioning Update
Update on the White Paper
Proposals for Charles Ward (invite the PCT, Bev Searle, Director of Partnerships and Joint Commissioning)

3 February 2012
Dementia Action Plan and Dementia Advisor
Health and Social Care Outcomes
LAA Reward Monies progress update


10/11 MEETING

The meeting, which began at 2.00pm, ended at 3.45pm.


CHAIRMAN …………………………..


DATE …………………………………..