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Royal Borough of Windsor and Maidenhead
Document Title: Minutes of the Shadow Health and Wellbeing Board – 28 September 2012
Author: Liz Hornby
Creation Date: September 2012
Present: Councillors Simon Dudley (Chairman – Cabinet Lead Member for Adult and Community Services), Eileen Quick (Cabinet Lead Member for Children’s Services) and Lynda Yong (Deputy Lead Member for Health).

Dr Adrian Hayter, Brian Huggett, Dr Jackie McGlynn, Christabel Shawcross and Angela Wellings.

Officers: Liz Hornby, Sally Kemp, Catherine Mullins, David Scott and Dr Angela Snowling

01/12 APOLOGIES FOR ABSENCE

Apologies were received from Pat Riordan and David Williams.

02/12 DECLARATIONS OF INTEREST

None

03/12 MINUTES

RESOLVED: That the minutes of the meeting of the Panel held on 18 May 2012 be approved

04/12 PUBLIC HEALTH TRANSFER OF RESPONSIBILITIES AND NATIONAL UPDATE

The Board considered the report on the Public Health Transfer of Responsibilities and National Update and noted that the Local Authority (LA) was taking up the public function from 2013 and that the published paper was already out of date due to the speed with which issues were evolving. It was noted that through the Shadow Health and Wellbeing Board and Cabinet it was agreed that each unitary authority Board would have its own team with the formal process being led by Bracknell Chief Executive. It was noted that a new post of Director of Public Health would be created for Berkshire and that interviews would take place for the unitary consultant post week of 22 October 2012 and it was noted that Councillor Mrs Quick and Christabel Shawcross would be a part of the panel. Adrian Hayter suggested a CCG GP representative and this was welcomed.

It was noted that in relation to funding, definite allocation would not be known until December 2012 although the Department of Health (DoH) were giving assurances despite known issues
. SHADOW HEALTH AND WELLBEING BOARD – 28.09.12
RESOLVED UNANIMOUSLY: that the recommendations be noted.

05/12 THE JOINT HEALTH AND WELLBEING STRATEGY – AGREEMENT TO THE DRAFT PUBLIC CONSULTATION

The Board considered the report on the Joint Health and Wellbeing Strategy – Agreement to the Draft Public Consultation and noted that the report dealt with the development of the Joint Health and Wellbeing Strategy (JHWS) and the setting of strategic priorities for joint / integrated action by the CCG and the LA. It had been agreed that the MARMOT Life Course would be used. The Panel noted that they were being asked for agreement to undertake a consultation. It was explained that national guidance had not yet been given as it had been out to consultation which came to an end on 28 September 2012 after which time following collation of responses, guidance would be given and it would known if a draft would be required before April 2013. Members noted that a sub-group of the Board would be set up during October. The consultation would take place in November and December with feedback being assessed in January 2013 and from there the priorities would be recognised. It was noted that the LA had a duty to have the strategy in place by April 2013 but that the Government recognised it was late.

The strategy document would give local people the opportunity to have some influence and be involved. The consultation would be an opportunity to ask people what they know about the Act and what they wanted. The Board noted that following the consultation process that a final version of the report would be brought before them at their February 2013 meeting.

The Board agreed that to enable the consultation to reach all residents, space be booked in Around the Royal Borough. It was also noted that other forms of communication needed to be identified to ensure that the consultation would be accessible, such as Talking Newspapers and making use of other technology that was available. It was noted that when the report was first taken to Cabinet it was recommended that three events be booked and that a meeting would be held on 11 October 2012 to agree this. It was agreed that Social Media also be used, and as the Royal Borough had an account with Survey Monkey, an online survey programme, that this also be used. The Board also noted that GP surgeries who sent newsletters to their patients could use this form of communication to promote the consultation. They also agreed that younger people try and be reached, through WAMSTER on the Borough’s website, as well as young mother’s and Children’s Centres. This work would be undertaken by the sub-group of the Board.

RESOLVED UNANIMOUSLY: that the recommendations be noted and the consultation be undertaken.

06/12 UPDATE ON TRANSITIONS FOR PEOPLE WITH LEARNING DISABILITIES AND THE ACTION PLAN

The Board received the report on the Update on the Transitions for People with Learning Disabilities and the Action Plan and noted that the report focused on a project with the National Development Team for inclusion (NDTi) to analyse the needs, options and plans for commissioning better services and associated recommendations made to the Royal Borough. It was noted that the report paid tribute to the amount of work that had gone into the report.

The Borough would try and develop good quality local provision which would then able out of Borough placements to be relied on less although it was noted that because the LA was a relatively small unitary the work involved would be a big undertaking. It was hoped to bring the referral age down to 13 rather than 17, as this would enable those with needs to be recognised earlier with earlier intervention and help. The Board noted the case studies which had been circulated as an appendix to the main report.

It was noted that the Berkshire College of Agriculture (BCA) was working with pre and post-16 students as was the East Berkshire College (EBC). It was hoped to limit the number of ISP’s due to the number of colleges which were a big burden on the public purse and it was hoped to try and place youngsters locally rather than be sent out of Borough.

The Board noted that within the LDC, twenty young people were being helped and that Looked After children had also been identified. The nine people who were being tracked were between the ages of 14 to 19-years. It was confirmed that some hours through Ways Into Work had been ‘bought’ which helped develop independence and that changes had already been identified in some individuals.

The Board noted that the scheme was currently in pilot form which runs until the end of December 2012. It was noted that some ways which worked before had been changed and were working better. The outcomes from the pilot would be brought before the Board at a future date. It was also noted that the paper was required to go before Cabinet for a decision on funding for 2013/14.

RESOLVED UNANIMOUSLY: that the recommendations be noted and endorsed.

07/12 UPDATE ON THE OFSTED INSPECTION AND ACTION PLAN

The Board considered the report on the Update on the Ofsted Inspection and Action Plan and noted that the inspection was carried out in March 2012 and reported to Cabinet in May 2012. Since then the Action Plan had been worked on and implemented and that a report was planned to be taken to Cabinet in November 2012 with a further update at the next meeting of the Board.

One of the issues the Inspector raised was that there was no special housing and support for Care Leavers and at time of inspection one person being housed in Bed and Breakfast (B&B) accommodation. It was noted that a retender was being investigated and that no young people were currently being housed in B&B accommodation. Progress of Looked After Children was being monitored by Childrens Services as there were one hundred within the Royal Borough.

08/12 UPDATE ON THE WINDSOR, ASCOT AND MAIDENHEAD CCG AUTHORISATION PROCESS

The Board received a presentation by Dr Adrian Hayter on the Update on the Windsor, Ascot and Maidenhead CCG Authorisation Process and noted the following –

Ø That the CCG was formed as part of the NHS health and Social Care Act.
Ø There were twenty practices within Windsor, Ascot and Maidenhead who were in daily contact and part of the community and who have a real knowledge of local issues.
Ø There was a clinical Chair and Vice Chair and that it covered a population of 150,000 people, both registered and unregistered.
Ø The vision of the CCG was working together locally to deliver sustainable excellence in healthcare.
Ø Values included working openly and honestly with transparent actions; listening to their patients and colleagues; supporting each other, co-operating and willing to change; respecting colleagues and patients; using best clinical evidence and looking for innovation.
Ø The PCT was allowing the CCG to plan themselves and that there was good representation from GP’s and patients alike.
Ø Benefits included that members were in daily contact with patients, were part of the community and had real knowledge of the local service. This therefore meant that decision were taken with real local experience and targeted local issues and needs.
Ø It was hoped that there would be a strong clinical leadership due to there was a strong group in place who were working closely with the Royal Borough. It was noted that medicine was ever changing and evolving and that practices needed to be able to keep up with those changes. Therefore continuous audits were taking place.
Ø Feedback from patients, public and stakeholders had been gathered via local events.
Ø The process was currently in Shadow form and working as part of the PCT and that once authorisation had been received there would be a national process to ensure that it was ‘fit for purpose’; that evidence would be collated against six domains; 360 degree feedback from September 2012; submission of evidence would take place 1 October 2012 with a site visit on 13 November 2012.
Ø This would go live in April 2013.

In answer to some queries from the Board, it was confirmed that a meeting had been held recently between the Shadow Healthwatch Project Manager, two lay members and a governance lay member.

09/12 SHAPING THE FUTURE – UPDATE ON THE FUTURE OF HEALTHCARE IN EAST BERKSHIRE

The Board received a presentation on Shaping the Future – Update on the Future of Healthcare in East Berkshire and noted the following –

Ø This was being led by three East Berks CCGs and the PCT who were working closely with Heatherwood and Wexham Park and Berkshire Healthcare NHS Foundation Trusts
Ø Aiming to find long-term solutions for future healthcare in East Berkshire.
Ø To date, engagement on early thinking October / November 2011; pre-consultation on emerging vision and ideas, including roadshows in June / July 2012; 400+ responses had been analysed in an independent engagement report.
Ø There were three specific proposals affecting Heatherwood services which were Maternity, Minor Injuries and Rehabilitation.
Ø That consultation proposals had been put in place.
Ø In respect of public consultation business case was signed off by the Boards of the CCGs / PCT and SHA and formal consultation would run from 15 October 2012 to 31 January 2013.
Ø That Councils were being consulted on the consultation document and questionnaire.
Ø That seven clinically-led consultation events would be held to explore proposals in more detail, including two in the Windsor and Maidenhead area.

10/12 PCT TRANSFER OF FUNDS COMMISSIONING PAPER

The Board agreed that this item would be considered at the same time as the Care and Support White Paper item (below).

11/12 SEXUAL HEALTH SERVICES IN EAST BERKSHIRE

The Board welcomed Dr Angela Snowling from the PCT, and considered the report on Sexual Health Services in East Berkshire and noted that that Table 1 dealt with Contraceptive services which quoted numbers of 18-31 returns without breaching confidentiality. The Board noted that the Borough was above average when compared nationally. In relation to HIV services, in particular protection services, where high risk groups would be screened, it was noted that screening had been launched in Slough and would be launched in the near future in the Royal Borough especially as HIV was now treatable. The Board noted that the Royal Borough became responsible for overall care of Sexual Health Services in April 2013. The Council’s commissioning services were currently at St Mark’s Hospital in Maidenhead where 8 to 10 people attended.

The Board noted that HIV notch treatment would be retained but that SDI services and contraception and screening would become the responsibility of the Borough. The Board also noted that pregnancy prevention had been successfully used in the Royal Borough as there was now a low rate of teenage pregnancies.

12/12 THE CARE AND SUPPORT WHITE PAPER

The Board considered the report on the DOH Care and Support White Paper as well as the PCT Transfer of Funds Commissioning Paper and noted that they were important papers as it would prevent or delay people from needing our services in a crisis situation after an incident has happened. And have better outcomes for to help residents retain independence.

PCT Transfer of Funds Commissioning Paper – there was a joint agreement between the Royal Borough and the CCG on the transfer of funds to deliver the agenda and this paper set out what had been agreed. It was noted that a Memorandum of Understanding was in place and that a final report would be published in March 2013 followed by a White Paper. It was also noted that the PCT had additionally transferred over £287,000 in March 2012 with agreed priorities within the Council’s Adult Social Care under an agreement on similar terms.

The Board noted that it was expected that stakeholders would be engaged with in 2013/14 when a meeting would be proposed to go through the White Paper. The Paper would be close scrutinised in particular relation to a new legal framework.

The DoH had recognised that the Royal Borough was leading the way with the CareBank initiative and that this would be evaluated.

It was noted that there was still much work to do in relation to both papers and that the CCG recognised the work involved. A report would be taken to Cabinet in January 2013 and therefore it was hoped that all issues would be overcome by December 2012.

RESOLVED UNANIMOUSLY: that the reports be noted and endorsed.

13/12 DATES OF FUTURE MEETINGS AND PLANNED AGENDA ITEMS FOR FUTURE MEETINGS

The following dates were proposed:

Ø 7 December 2012
Ø 8 February 2013

The following items for future meetings were proposed:

Ø Update on Stroke Care Pathway
Ø The Joint Health and Wellbeing Strategy Update
Ø The Autism Strategy / Update
Ø Public Health Update
Ø Suicide and Self Harm Prevention

14/12 MEETING

The meeting, which began at 2.05pm, ended at 4.05pm.