Agenda and minutes

All Members who believe they have a Disclosable Pecuniary or other Pecuniary or non pecuniary Interest in any matter to be considered at the meeting must declare that interest and, having regard to the circumstances described in Section 3 paragraphs 3.25 – 3.27 of the Councillors’ Code of Conduct, leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with Paragraph 3.28 of the Code.

The Chair will ask Members to confirm that they do not have a declarable interest.

All Members making a declaration will be required to complete a Declaration of Interests at Meetings form detailing the nature of their interest.

None.

Resolved -  That the minutes of the last meeting of the Board held on 29^th January 2014 be approved as a correct record.

(Maximum 40 minutes allocated)

The Board considered a report on development of the Better Care Fund (BCF), including the implications, benefits and risks, together with the draft Delivery Plan due for signing off prior to submission to NHS England on 4^th April 2014.  Alan Sinclair, Assistant Director Adult Social Care, introduced the report and summarised the changes made since the report to the last meeting of the Board.

The vision statement for health and care services for the community for 2018/19 had been revised taking into account comments made.  Also, confirmation had been received on the funding over the next two years totalling £5.612m for 2014/15 (updated from £6.058 in the report) and £9.762 for 2015/16. The CCG match funding of £436k for each year had also been confirmed.

The Board was reminded that the BCF plan was premised on savings from fewer non-elective admissions to hospital and shorter hospital stays.  Particular investments planned for 2014/15 included:

• Infrastructure support to deliver the ambitious plans for developing integrated care services
• Investment in prevention programmes and developing integrated care services such as an improved falls service
• Supporting the reduction of admission to hospital of children and young people
• Improvements to discharge processes through early supported discharge schemes such as Post Acute Care Enablement (PACE)
• Improving the quality of care homes (eg beds at Oak House)

Members were assured that the BCF was shaping up as a good strategic document which demonstrated the effective joint working that had gone into its preparation.  It was noted that further work was needed to complete the delivery plan for submission, including finalising some decisions around priorities.  The Board suggested that the final submission should be updated to show a clear link between the investment programmes being put forward and the outcome and metrics data.  It would also assist to show the timescales for completion of the business plans underpinning the Local Delivery Plan.

Resolved –

(a)  That the benefits of the BCF planning for Slough and future planned activity be noted.

(b)  That subject to final updates and completion, the Local Delivery Plan be signed off by the Board for submission to NHS England on 4^th April 2014.

(Maximum 40 minutes allocated)

The Board considered a report presenting the draft CCG 2 year Commissioning Plan 2014 – 2017 and the 5 year Strategic Plan.  The draft Commissioning Plan was signed off by the Slough CCG on 4^th February 2014 and submitted to NHS England.

The Board reviewed the five system objectives, noting a number of points as follows:

1. To significantly reduce under 75 CVD mortality rates by 2% over 5 years

Cardiovascular deaths under 75 were significantly above the England average and the planned programme of interventions would assist in achieving the targeted reduction.

2. Increase people’s confidence in managing their long term conditions to 80% (from baseline 75%)

Particular reference was made to the programme for advance management of diabetes, and the significant improvements made at many surgeries on COPD, heart failure etc.

3. Increase number of older people living independently at home

The target was a 3% year on year improvement, to be achieved by care co-ordination through integrated care teams and case management.

4. Improve patient experience of access in Primary Care and Community Services

This included availability of 5% additional GP appointments during winter months and better information regarding local services and 111.  The aim was to reach the regional average for patient experience.

5. Improve patient experience (Friends and Family test) and improve experience of care in a hospital setting

To be tackled by a range of measures including improving quality of services, training of professionals and highlighting safeguarding issues.

The Board suggested some targets could usefully be expressed by reference to a specific number (eg a 2% reduction in mortality rate equals how many people, 5% more appointments equals how many).  It was pointed out that little prominence was given in the Plan to the impact of exercise and physical activity but further work on this was in progress.  The view was expressed that the relationship of objectives to priorities could be made clearer, possibly by showing it diagrammatically, as well as referencing links to other policies/groups such as the Community Safety Plan, Local Safeguarding Board, Domestic Abuse Group etc.  It was important that the Commissioning Plan should become embedded within the suite of Wellbeing policy documents for Slough.

Resolved –

(a)  That the Slough CCG Commissioning Plan for the next 2 years and the 5 year Unit of Planning Summary be noted.

(b)  That the 2 and 5 year Commissioning Plans and their overall direction be endorsed, subject to the comments above, in line with the Wellbeing agenda.

(Maximum of 20 minutes allocated)

The Board considered a report on progress under the strategic themes and objectives set out in the ‘Healthy Lives, Healthy People, Healthy Slough Strategy’ for 2013-16.

Significant progress in the first year of the Strategy was reported and welcomed by the Board.  Particular achievements had been made under the headings of prevention, early intervention and targeted intervention.  For MMR immunisations, work with GP Surgery Practice managers had shown uptake to be better than previously indicated after more accurate way of extracting data from the recorded figures had been found.  This was backed up by SMS texting reminders and the offer to attend drop-in clinics for immunisations.  The number of GP practices offering Healthchecks had doubled from 5 to 10 over the last year, and uptake rates were encouraging.  The Healthy Hearts service had also increased uptake and the numbers participating in led walks and other forms of physical activity were being collated.

The Board noted that two supporting strategies had also been developed: the diabetes and the physical activity strategies.  These reported through the Health Priority Delivery Group which would review progress made.

Although some good results had been reported by the Stop Smoking service, it was estimated that Slough still had 21,000 smokers of whom 2,300 were considered ‘high risk’ smokers.  There were high numbers of young smokers, including expectant and young mothers.  Illegal cigarettes remained a big problem despite proactive enforcement work by the trading standards team.  More work was needed on the provision effective information/education which would be influential in achieving a change in habits.  The Fire and Rescue Service were working with the Public Health team on smoking cessation as well as a wider initiative on this.

The Board suggested that the 14 key objectives in the Health Strategy should be prioritised, since this seemed too many to tackle at once.  With fewer top priorities, action in a more in depth manner should be possible, targeted where it was likely to have the most impact.

Resolved –

(a)  That the consultation that has taken place to inform the Healthy Slough Strategy be noted.

(b)  That the development of a performance scorecard view of the reported actions to underpin the longer term outcomes be noted.

(c)  That the partnerships work and strategy for 2014-16 be endorsed, subject to a further report to  develop a prioritised list of key objectives and an order in which they are to be tackled.

(Maximum of 15 minutes allocated)

The Board considered a report putting forward a baseline health profile for the upgrade to the Slough Trading Estate Multifuel site together with recommendations for air quality updates for residents with respiratory conditions.  The proposal under consideration was an upgrade of the existing Trading Estate site to develop a new, larger combined heat and power facility which will convert waste derived fuel into low carbon electricity and heat.  As well as supplying heat and electrical power to Slough Trading Estate and up to 110,000 homes, it would assist in reducing landfill costs by processing local Slough waste.

The Multifuel project was being planned by SSE who had been consulting widely on its proposals over the last year.  A draft environmental impact assessment (EIA) had already been presented to the Council and other key stakeholders for comment.  Air quality and noise impacts had been modelled.  The Environment Agency is the responsible regulatory authority; Public Health England’s specialist team at the Centre for Radiation, Chemicals and Environmental Hazards (CRCE) and the Council’s expert advisors (Atkins) have been consulted and have made recommendations to improve the proposal.  The Board would be a statutory consultee on the planning application, which SSE was expected to submit to the Council in the near future.

The Board noted that the review of the proposals to date had illustrated the scope for local practices, the hospital and community services to promote a low cost air quality alert system to local residents with respiratory problems to reduce emergency admissions.  A particular opportunity was available to implement a cost effective and clinically effective intervention for improving asthma management in children which can be promoted by Board partners.  A short task and finish working group will be established to scope the evaluation of the project.

Resolved –   That the report be noted, and in particular the following:

• The health risks of the proposal are low and will be controlled and monitored through the EIA process and subsequent controls in the construction phase.
• The impact of traffic pollution through the relationship of particulates on key health outcomes such as respiratory and cardiovascular admissions, excess mortality and deaths from all causes has been modelled and estimated.
• That no separate health impact appraisal (HIA) be requested at this stage.

The Board was advised that plans were proceeding for an annual review and development workshop, facilitated by the Kings Fund, on a date to be arranged following the Council elections in May.  Details of the agenda for the workshop and the funding for it had yet to be finalised.

Resolved -  That the action progress report and future work programme be noted.

The Board received a Members’ attendance record for meetings held during 2013/14.

14^th May 2014

Dates of meetings of the Board for the year ahead have been programmed as follows:

Wednesday, 16^th July 2014

Wednesday, 24^th September 2014

Wednesday, 12^th November 2014

Monday, 2^nd February 2015

Wednesday, 25^th March 2015

Wednesday, 13^th May 2015

The date of the next meeting was confirmed as 14^th May 2014.