Present: Councillors Coppinger (Chairman) and Carroll (Deputy Lead Member for Public Health).

Dr Adrian Hayter (Vice Chairman), Christabel Shawcross, Alison Alexander, Mike Copeland, Dr Lise Llewellyn, Mary Purnell.

Nick Davies, Rutuja Kulkarni, Hilary Hall, David Mason, Helen Mackenzie

Officers: Wendy Binmore and Catherine Mullins.

1/15 APOLOGIES FOR ABSENCE

Apologies were received from Councillor Natasha Airey, Rachel Pearce and Dr Jackie McGlynn

2/15 DECLARATIONS OF INTEREST

Cllr Carroll – Declared a Pecuniary interest as he worked for a pharmaceutical company called Biogen.

3/15 MINUTES

RESOLVED: That the minutes of the meeting of the Meeting held on 12 March 2015 be approved

The Chairman, in agreement with all Members, agreed to amend the running order of the agenda.

4/15 CCG ANNUAL REPORTS WAM AND B&A CCG ANNUAL REPORTS FOR 2014/15 – VERBAL UPDATE

Dr Hayter and Mary Purnell gave a brief verbal update on commissioning ambitions. Members noted that there is the opportunity to co-commission some primary care services with NHS England. WAM CCG and Bracknell and Ascot CCG have aligned working together in areas such as local commissioning and co-commissioning. The agenda was to address significant issues, including things like as the workforce development and service requirements in General Practice and Optician Services still being a big issue. Most CCGs were looking at Co-Structural Transitional Phase in partnership with NHSE. They were looking to build resources for residents and that meant there was a need to recognise some quite challenging workforce issues. There was a national shortage of GPs and the desire was for GPs to work seven days per week in line with national health policy.

5/15 CHILD SEXUAL EXPLOITATION - THE CSE STRATEGY AND PROTECTING YOUNG PEOPLE FROM HARM

Members received a presentation on child sexual exploitation which also outlined the Ofsted inspection on Services for children in need of help and protection, children in care and care leavers. Members noted the following key points:

Update on addressing the risks of Child Sexual Exploitation (CSE):
o CSE had a high profile nationally – Rochdale and Oxford court cases; Jay and Casey reports in relation to Rotherham MBC.
o Ofsted thematic inspections of eight local authorities took place in September 2014.
o Key finding of the inspections: responding effectively to CSE is highly complex, requires full commitment of statutory agencies, voluntary sector and the wider community and sharing intelligence.
Commissioned:
o Internal audit investigation within local authority – focus on how services using statutory powers to address the risks – January 2015.
o External review of statutory partners’ response in the Royal Borough to CSE and the extent of working effectively together – February 2015.
o Windsor and Maidenhead Local Safeguarding Children Board’s Missing Children/Young People and Child Exploitation Strategy – May 2015.
Update on Progress:
o Systematic assessment and planning for children and young people identified at risk:
All referrals to the Missing Persons/CSE Operational Panel immediately subject of a single assessment by Children’s Safeguarding.
Includes the completion of the CSE screening tool.
o Systematic data monitoring and management n place which includes:
A new suite of indicators for Council’s Integrated Performance Management Report.
Development of multi-agency set of indicators.
o Comprehensive programme of community awareness raising:
Posters and banners in Council Offices.
Production and distribution of ‘cue cards’ for young people, for parents/carers and for professionals.
Awareness raising materials produced and distributed to all hotels, licensed premises and taxis.
Rolling programme of Tweets through the Council’s Twitter Feed.
o Nationally acclaimed ‘Chelsea’s Choice’ theatre production in 12 of 14 schools and community performances.
Future activities:
o Community awareness raising programme with specific focused events during the summer and Christmas.
o Multi-agency conference on 14 October 2015 to expand knowledge of the complex issues of CSE and identify priorities for the future.
Actions for the Health and Wellbeing Board:
o All Members commit to:
Training their workforce.
Sharing information to protect children and young people.
Early identification of children and young people’s needs and those who are vulnerable – notifications to RBWM MASH.

The Ofsted inspection highlighted the overall judgement of Children’s Services to be requiring improvement in the following areas: safeguarding of young people, children in care, adoption performance, progress of care leavers and leadership, management and governance. However, there were also many strengths found within the service which included being proactive and ambitious, well engaged and knowledgeable, early help being well targeted and coordinated and referrals to social care being appropriated. Ofsted found the following areas required priority and immediate action:

Only close or step down children’s cases when sufficient progress was made in meeting needs and reducing risk.
Undertake assessments of 16 and 17 year old young people presenting as homeless in line with case law.
Strengthen assessment for children who are privately fostered.
Review the effectiveness of MARAC and the identification of cases to be presented at MARAC.

There were several areas for improvement highlighted, Members noted some of those areas included improving recording and analysis of return interviews for children who have been missing; improve timelines of recording core groups; improved the quality of care plans and improve adoption performance to meet timescales.

The actions requested to the Health and Wellbeing Board included:

Resource a RBWM MASH.
Deliver their statutory functions for children in care and care leavers.
Provide appropriate procedures for mental health.
Operate appropriate procedures for managing allegations against professionals.
Actively support strategic commissioning activity, e.g. early help and Innovation Fund

RESOLVED: The HWB agreed that there would be an update on progress for the CSE work at the next meeting and to support an engagement event that would be hosted in the Autumn and include other key policy changes under the Care Act, such as human trafficking and modern slavery.

6/15 HEALTH AND WELLBEING BOARD DEVELOPMENTS

Catherine Mullins explained a paper had been circulated that looked to get a Task and Finish Group to revisit and refresh the Joint Health and Wellbeing Strategy (JHWS) and Terms of Reference for the HWB at the same time. The recommendation was that the Health and Wellbeing Board agreed there would be a Task and Finish Group to review the TOR. Within the paper, on the last page was a list of actions which had been produced from the Kings Fund session with the HWB members which would aim the HWB to keep up to date with the national policy changes for HWB.

One action was to raise awareness of the Board which also fit into the partnerships protocol and looking at how different Boards and Groups could work together. There was already involved working with Healthwatch to support the refreshing of the JHWS. Catherine was looking at different venues where the Health and Wellbeing Board meeting could be held so it was in the community and more accessible to residents.

Catherine Mullins confirmed she would bring an update on progress back to the Board in September 2015.

RESOLVED UNANIMOUSLY: The Health and Wellbeing Board fully endorsed the recommendations:

i) To form a task and finish group to look at the Joint Health and Wellbeing Strategy refresh, which will be tasked to –
a. agree the focus and contents of the Strategy
b. support the identification of the key priority areas that HWB will give its collective support to achieving
c. set the measures so that the JHWS continues to be a document where the success against outcomes can be identified

ii) That the task and finish group also support the collective redesign of the Terms of Reference for the HWB
iii) That the task and finish group report back to the formal HWB meeting in September for formal approval of the actions they have been tasked to complete
iv) Consider the contents and delivery of the action points identified The Kings Fund development session with the Health and Wellbeing Board

7/15 BETTER CARE FUND

Nick Davies, Head of Strategic Commissioning for Adult Social Care and Housing gave a presentation to the Health and Wellbeing Board which summarised the Better Care Fund metrics performance up to June 2015. Members also noted the RBWM / WAM Group A schemes in Prevention Activity Summary.

There was a rise in non elective activity forecast which exceeded targets set, however; Windsor and Maidenhead had less non elective admissions than the national average. Non elective admissions from GP practices were also forecast to be decreasing. Members noted all statistics within the presentation and agreed there was more work to be done in reducing non elective admissions and falls prevention.

It was requested that the different CCG performances were identified so that the two CCGs would be able to be identified across the whole reporting framework

8/15 THE CARE AND SUPPORT ACT

Christabel Shawcross, Interim Managing Director and Strategic Director of Adult & Community Services gave a presentation to update the Board on the Care and Support Act. Members note Phase one of the Act was implemented by April 2015. Phase two would be in place by October 2015, though there are bigger discussions taking place across central government about the financially viability of Phase Two. The timescales were challenging but, the plans are on track to have Phase two completed by April 2016.

The total number of carers who received Council support in 2014/15 was 285. A total number of carers assessed during April and May 2015 had reached 71 with the total number of carers from that 71 who were eligible for services were 45. As part of the Joint Carers Strategy, the development of a carers information pack had been carried out for carers and professionals with commissioning of a ‘Support to Care’ programme being set up. There was also the introduction of carer personal budgets and the launch of WAM CCG Carers website which was accessible to the public and GPs.

Key actions for 2015/16 included:

Re-commissioning of carers information, advice and support service – joint working across Berkshire.
Young Carers Memorandum of Understanding and awareness raising.
Review of technology opportunities to assist carers in their caring role and address loneliness/social contact.
Evaluation of communication through technology pilot and benefits for carers. How the use of Skype is assisting carers to stay in contact with cared for at a distance.

9/15 MENTAL HEALTH CRISIS CARE - UPDATE

David Mason, Interim Head of Adult Social Care & Health Partnerships and Helen McKenzie from Berkshire Healthcare Foundation Trust gave a joint update on Mental Health Crisis Care, including the findings of the recent CQC Thematic Review of Mental Health Crisis Care. Members noted that areas of good practice included:

Good multi-agency working and a commitment to joint working to facilitate positive outcomes for people in mental health crisis.
Undertaking audits and taking action to address findings that resulted in better services and support to the section 136 guidance under the Crisis Care Concordat.
Positive working relationships with the police at both strategic and operational levels.
No groups are excluded from health based place of safety.
Streamlined 24 hour access to services through the Central Point of Entry service.

Areas for development included:

Development of joint training initiatives including input from service users and carers. For example, police and GP training.
Review of psychiatric liaison service response times to the accident and emergency department at Wexham Park.
Review processes in place that gather feedback from carers to ensure these are effective in listening and responding to their needs.
To investigate why the number of section 136 detentions have increased and if appropriate put actions in place to address this.

10/15 PUBLIC HEALTH ACTIONS UPDATE

Lise Llewellyn provided an update on Public Health Actions and Members noted the following key points:

The Public Health Outcomes Framework performance information had been refreshed and new areas highlighted of where performance had changed.
There are a few areas which were significantly worse than the national average such as Year one pupils attainment levels. The areas were improving but, there was a lot more to do.
There were also some areas which were significantly above the National average.
There was a slight increase of smokers in the Borough, but still among the lowest in England. That should be a key issue for the Health and Wellbeing Board to increase smoking cessation.
RBWM performed well overall.
A Mental Health Objectives and Work Plan for 2015 - 2017 had been produced which aimed to develop a range of tools to support residents to manage their own mental wellbeing.
Improve physical health of people with mental health problems
Develop kite mark concept for mental wellbeing friendly workplaces.
There were also a number of Public Health actions which included better communication with information on the website and a social media campaign.
WAM Get Involved – advice for local voluntary and community sector, link to the NHS Choices website.
Children’s Services – tailored PHE advice for schools and early years settings regarding preparedness and response.
Adult services - tailored PHE advice and information to all Borough Care Homes and day care centres
WAM Healthwatch – advice and guidance .through their website and communications channels
Town centre partnerships and Tourism team - tailored PHE advice /information and for organisers of large events
PH Shared Team liaising with CCG colleagues and local hospitals re advice on preparedness and response.

Dr Hayter commented that it was five year data and that the PCT was a late starter in checking. King Edward and St Marks hospitals had nurses offering services that GPs were unable to offer due to that lack of resources. Lise Llewellyn responded there had been progress in those areas.


11/15 ADDITIONAL ITEMS FOR THE HEALTH AND WELLBEING BOARD

There were no additional items noted by the Health and Wellbeing Board

Letters to the Health and Wellbeing Board Chair

There have been no letters to the HWB Chair since the last meeting

54/14 POTENTIAL FUTURE AGENDA ITEMS

Members noted potential future agenda items. No comments were received.

55/14 MEETING

The meeting, which began at 2.00pm, ended at 4.19pm.