Agenda and minutes

No declarations were made.

To welcome Iain Harrison to the Board representing RBFRS, and to formalise the membership of Alan Sinclair (Interim Director of Adult Social Services) and Krutika Pau (Interim Director of Children’s Services) as statutory members.

The Board noted that Iain Harrison would be the new representative of Royal Berkshire Fire & Rescue Service following the recent retirement of Dave Phillips.

It was also confirmed that Alan Sinclair, Interim Director of Adult Social Services and Krutika Pau, Interim Director of Children’s Services formally join the Board following the departure of Jane Wood from the Council.  It was a statutory requirement for the local authority directors of adult and children’s services be members of the health and wellbeing board.

Resolved –

(a)  That Iain Harrison be welcomed to the Board as the representative of Royal Berkshire Fire & Rescue Service.

(b)  That it be noted that Alan Sinclair, Interim Director of Adult Social Services, and Krutika Pau, Interim Director of Children’s Services, be confirmed as statutory members of the Board.

Resolved –  That the minutes of the meeting held on 21^st January 2016 be approved as a correct record.

A report was considered that summarised the position of the 2015/16 Better Care Fund (BCF) programme to the end of the third quarter; the planning for 2016/17 BCF Plan; and work to develop an integration strategy by March 2017.

Slough’s was considered to be performing well in the implementation of the BCF programme for 2015/16.  In the period to the end of December, non-elective admissions activity was 340 above the 2015 target but was 1.4% below the 2014 baseline.  Performance was strong in other metrics such as admissions to residential care and discharge from hospital into reablement services.  BCF was forecast to come in on budget for the financial year, taking account of some reinvestment to support new pilot activity released from either delayed or unapproved schemes.

A draft of the BCF Plan 2016/17 was tabled and considered.  The plan needed to be submitted by 25^th April and it was requested that the BCF Joint Commissioning Board be given delegated authority to sign off the final plan.  A detailed review of schemes had been undertaken by the BCF delivery group as part of the planning process for 2016/17 and the Board noted the schemes making a significant impact that would be continued, pilot activity and the schemes that had not performed as expected and would be closed or redesigned.  The 2016/17 programme would broadly continue the current programme of activity and also focus on out of hours transformation and establishing an integrated point of referral for professionals into short term services through the existing Health Hub.

(Dr O’Donnell joined the meeting)

A range of issues were discussed on both current performance and next year’s BCF plan including the payment for performance mechanism and impact of BCF within the wider health and social care system.  The Board welcomed the work undertaken to review schemes to ensure that resources were focused on strongly performing schemes and pilot activity.  Integration, transformation and embedding new ways of working through the programme were key to sustaining improvement when BCF funding itself came to an end in 2010.  Slough was considered to be in a good position in terms of its joint working, but needed to influence other authorities and partners locally within the health system.

It was also agreed that future reports to focus on high level summary position of progress, and crucially the impact made by BCF, with more detailed reporting to Health PDG and BCF Commissioning Board.

Resolved – 

(a)  That the progress report of the Better Care Programme for 2015/16 be noted;

(b)  That the proposed outline plan for the BCF for 2016/17 be circulated via email and approved in principle;

(c)  That the BCF Joint Commissioning Board be given delegated authority to sign off the final plan to be submitted by 25 April 2016.

The Board received a report on Slough Clinical Commissioning Group’s updated 5-year plan and 2-year operational plan and a presentation was delivered by Paul Sly, Interim Chief Officer at the Clinical Commissioning Group on the emerging System Sustainability and Transformation Plan (STP).

The STP was an overarching plan which aimed to set out how services would be transformed and how system sustainability would be reached.  An intensive period of engagement between local communities, partners and local authorities would be undertaken to develop the new plan by June 2016 across the Frimley Health footprint.  An agreed STP was required in order to access the £2bn national Sustainability and Transformation Fund from 2017.  Sir Andrew Morris would take the lead role in the development of the plan.

The Board emphasised the importance of ensuring the plan reflected both the distinct needs of local communities across the Frimley Health footprint and drew upon the examples of best practice locally.  The importance of the STP was recognised and it was discussed how partners could be best engaged in the forthcoming workshops and consultation process prior to sign off in the summer, including by the Slough Wellbeing Board.  Members would receive an update report in May and were encouraged to contribute to the development of the plan in the coming weeks as the timescales were tight.

The 2-year operational plan was then discussed and Dr O’Donnell summarised the key points.  Positive progress was being made in reducing avoidable hospital admissions and there was national interest being taken into the good work being done in Slough.  Significant work had been done to redesign primary care to provide longer appointments for those patients who could benefit most.  These issues had been discussed recently with the Health Scrutiny Panel in relation to the proposed changes to the Slough Walk-In Centre and the importance of clear communication with residents was considered to be of crucial importance to successful implementation.

Resolved –

(a)  That progress to date on the CCG 2 year operational plan be noted.

(b)  That the refreshed CCG 5 year plan be noted.

(c)  That progress be noted on the development of the System Sustainability and Transformation Plan (STP) being developed across the ‘Frimley footprint’.

(d)  That partners be engaged in the development of STP and that a further report be considered by the Board at its meeting in May 2016.

(Chief Inspector Wong left the meeting)

A report was discussed on the provision of online sexual health services such as ordering home screening kits for sexual transmitted infections and notification of results via modern communications.  Such services were being delivered successfully online in other parts of the country, such as SH:24 available in Southwark and Lambeth, and the Board considered how best this could be delivered in Slough.

Sexual health services were currently commissioned at a Berkshire wide level, recognising there were different needs in each area.  Sexual health outcomes were improving but Slough remained below key national indicators.  NHS led services in Slough were primarily delivered face to face from the Garden Clinic.  The shared public health team had explored the current good practice for increased digital delivery of services.  A local website had been developed and new content was being added.  It was recognised that there were potential benefits to shift some lower level services away from specialist provision, for example the distribution of home screening kits would be more efficient and some people may prefer to access services in this way.  However, it was emphasised that digital services needed to be properly integrated into the existing local services to ensure people accessed the appropriate professional support from nurses and doctors.

The Board discussed a range of issues including the experience and evidence of SH:24 in delivering some services online.  Public health consultants in Berkshire would be receiving a presentation from SH:24 in the near future which would assist in considering how best online access could be taken forward locally.  Members generally felt that it was important to increase online access both because customers would want and expect to be able to receive basic services in this way, and because it could free up resources for more specialist support.  It was recognised that online access needed to be introduced carefully to ensure it was properly joined up with existing local services and this would be taken forward as part of the specification for the recommissioning of sexual health services in Berkshire over the next two years.

There was also a discussion about how the existing services from the Garden Clinic could be better integrated with other local services, particularly primary care, and further consideration of this would be needed.  Improving data sharing was highlighted as an example of where improved joint working and communication could improve outcomes for patients.

At the conclusion of the discussion, the Board agreed to support increase online delivery of services in principle and encourage Public Health to seek to implement as soon as possible, recognising the importance of integration with existing services.  It was agreed to receive a further report once Public Health had reviewed the issues and options.

Resolved –

(a)  That the report be noted.

(b)  That the Board’s support in principle for increased provision of online sexual health services in Slough be noted.

(c)  That the Board receive an update report on progress following further work by the Public Health team to review the options and issues, primarily integration between online and other services.

The Board received the 2015/16 Annual Report of the Director of Public Health and were asked to approve publication of draft as set out in Appendix A to the report.  The report was a statutory requirement and was intended to stimulate discussion about some of the key challenges and inequalities, particularly focused on children and young people.

Board Members were invited to send any comments on the draft directly to the Director of Public Health by 1^st April.  The Board noted the report and agreed that the document be published.

Resolved –  That the Draft Public Health Annual Report, as at Appendix A to the report, be noted and published, subject to any comments from Members.

The final draft of the Slough Wellbeing Board Annual Report 2015/16 was considered.  Since the discussion at the previous meeting Members had been invited to make further comments and these had been incorporated.  The document had also been considered by the Health Scrutiny Panel.

The Board made a number of further comments which are summarised as follows:

·  Appendix 4 – section on health to include reference to the links between the Leisure Strategy and wider health and wellbeing agenda.

·  Housing – Members raised the issue of strategic housing development in the borough and particularly the mix of developments.  Whilst there was a large number of high occupancy development coming through, board members highlighted the importance of ensuring the needs of families and older people could also be met.  It was agreed to bring a report to a future meeting or development session on housing strategy and Local Plan.

The Board approved the Annual Report 2015/16 and agreed to recommend endorsement to full Council.

Resolved –

(a)  That the Slough Wellbeing Board Annual Report 2015/16 be endorsed, subject to the incorporation of comments agreed at the meeting.

(b)  That the Annual Report be recommended to Council for endorsement at its meeting on 19th April 2016.

The Board received an information report providing an update on the work of the Children & Young People’s Partnership Board.  The report set out how the progress in delivering the priorities identified in the Children & Young People’s Plan and stated that the Partnership arrangements would be reviewed in light of the findings from the recent Ofsted inspection and SWB review.

Resolved –  That the report be noted.

Resolved –  That the Report and Future Work Programme be noted.

Resolved –  That the attendance record 2015/16 be noted.

11^th May 2016

The date of the next meeting was confirmed as 11^th May 2016.