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 4 paragraph 4.6 of the Councillors’ Code of Conduct, leave the meeting while the matter is discussed.

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.

Item 4 – Slough Pharmaceutical Needs Assessment 2018-2021 – Dr O’Donnell declared that he was a partner in a surgery which jointly owned a pharmacy on Farnham Road, Slough.

Item 6 – Themed Discussion:  Homelessness – Naveed Ahmed declared that he was involved in a company set up to provide key worker housing and he would not raise any issues related to this during any discussion.

Resolved –  That the minutes of the meeting held on 25^th January 2018 be approved as a correct record.

The Action Progress Report was received that updated the Board on the recently completed and outstanding actions arising from previous meetings.

Resolved –  That the Action Progress Report be noted.

The Acting Strategic Director of Public Health introduced a report seeking formal approval of the Pharmaceutical Needs Assessment (PNA) for Slough for 2018 to 2021.

The PNA was a statement of the needs for pharmaceutical services for the population in the area and set out the current provision and any gaps in provision.  The document had last been agreed in March 2015 and it was requirement for a PNA to be agreed before 1 April 2018.  The Board discussed the consultation and stakeholder engagement process that had been undertaken.  The relationship with the national consultation on over counter medication and the promotion of self-care was also raised.  It was noted that the PNA was based on needs and access on the current position, however, there were other activities through the prevention programme and Sustainability & Transformation Programme which aimed to increase self-care and reduce the pressures on primary care.

At the conclusion of the discussion, the PNA was agreed.

Resolved –

(a)  That the PNA for 2018 to 2021 be formally approved.

(b)  That the final PNA and appendices be published on Slough Borough Council’s website and be accessible for the lifespan of the report (until 31st March 2021).

(c)  That it be noted that if local pharmaceutical services change between now and 31^st March 2021, such as the opening hours, address of premises or needs of the local population, then the Council would need to publish supplementary statements to the PNA; and

(d)  That it be noted that if other significant changes occurred which impacted on the need for pharmaceutical services during the lifetime of the PNA it may result in the need to refresh the PNA.  No such changes were expected.

Sir Andrew Morris, the Senior Responsible Officer of the Frimley Health and Care Sustainability & Transformation Partnership (STP) gave a presentation that updated on the progress being made to deliver the STP plan.

The Board noted the key points of the presentation which can be summarised as follows:

·  The STP should be seen in the context of the broader plan for NHS transformation designed to maximise the efficient use of resources.

·  The STPs single operational plan would go ‘live’ on 1^st April to shape the circa £1.2bn health and social care spend locally.

·  Health, local authority and other partners had come together in the Frimley footprint area to develop, own and implement the shared plan.  The partnership did not have any legal status but was a ‘coalition of the willing’.

·  The STP would build on the progress made in recent years to better integrate health and social care services.

·  The intention was to treat people in the right setting and provide more services outside of hospital.

·  It was also a priority to achieve financial balance across the system.

·  The key initiatives and priorities had remained largely unchanged since the inception of the STP.

·  Key priority areas included mental health with a 24/7 crisis intervention service and access for children and young people.

·  The Frimley STP was amongst the furthest advanced in the country and NHS England was investing £30m in the plan.

·  The plan would be rolled out across the Frimley footprint area with circa 80% of the plan applying universally and 20% varied to meet identified local needs.

·  Early indications were that the approach was working with admissions being reduced.

(Lincoln Ball left the meeting)

The Board recognised the positive progress that had been made, and asked a number of questions including about the main challenges and whether the plan could lead to hospital closures as was the case elsewhere.  Sir Andrew commented that the Frimley STP was starting from a strong base with good partnership working.  There were financial challenges and savings would need to be made, however, it was confirmed that hospitals were not under threat.

From a local authority perspective, Alan Sinclair highlighted that the Council was closely involved in the STP and it was important to move towards the vision for greater integration.  Some of the key local challenges for Slough were how to influence people’s behaviour, for example encouraging residents to use the most appropriate care and reduce pressure on A&E and GPs.  It was acknowledged that engagement was key and work was underway to take this forward.  The Chairs of Health & Wellbeing Boards were now meeting regularly and there was a commitment to communicate and engage including through the greater use of technology.  Practical measures such as increasing volunteering in hospitals was suggested as an area for further development.

Members commented on the importance of improving mental health services for children and young people, particularly as the new 24 hour service was for adults.  Sir Andrew recognised that the issue of CAMHs capacity needed to be addressed as demand had risen significantly and the resources were not yet in place to match.  The Board agreed that further work on CAMHs services should take place as a priority.

The Board raised a number of other issues including workforce development and data.  Funding was discussed in terms of the additional money made available to the STP to invest in hubs as well as the wider medium term funding of social care services.  Board members emphasised the importance of using the additional resources to improve services in Slough where there was the greatest need.  Sir Andrew commented that Slough was the top priority in this regard and that local need was in factor considered in the business cases for the new hubs.

At the conclusion of the discussion the Board welcomed the positive progress being made and asked that its comments in relation to key priority areas such as mental health, CAHMs, resources for Slough and public engagement to encourage behaviour change be taken forward as the STP plan was rolled out.

Resolved –   That the update on the Frimley Health & Care STP be noted.

(Slough Youth Parliament Representative Raakhi Sharma joined the meeting)

The Board had a themed discussion focused on homelessness in Slough and particularly the work of the Council’s Strategic Housing Service in tackling the problem.  A presentation was made by Emma Seria-Walker, Consultant in Public Health and Wellbeing for Public Health England, on the key issues and challenges.  The Council’s service lead for Strategic Housing, Colin Moone, contributed to the discussion.

A revised chart from paragraph 6.11 of the report was tabled due a reproduction error in the version in the agenda pack.

The key points noted in the presentation were as follows:

·  Homelessness had been increasing since 2010 in Slough and elsewhere.

·  The distinction between homelessness and rough sleeping was key and it was noted that in March there were 382 households in Slough in temporary accommodation, up from 315 in November 2017.  Rough sleeping had increased from 14 in 2010 to 25 in 2016.

·  There were a wide range of factors contributing to the problem.  The vast majority of rough sleepers had experience of issues such as trauma, abuse, neglect and mental health problems.

·  There was also a high incidence of drug misuse, mental health and long term physical health problems.

·  Early years experiences were very significant influences and early intervention services were key.

The Board discussed the role of strategic housing services in the context of the wide range of partners that had contact with people who were homeless or at risk.  The thresholds for housing support were quite high and the provision of co-ordinated services for homeless households was recognised as an issue.  Members discussed how the thresholds took account of the multiple factors and deeply rooted problems that vulnerable people may have.  The vital role of the voluntary sector was raised in providing help to rough sleepers in particular and there was a discussion about how they could be better supported. The models and best practice used elsewhere were considered and it was agreed that it was important to better understand what was working.

The establishment of the Early Help Board was noted in aiming to address some of the issues of early intervention, however, it was recognised that this was a long term approach that would take many years to reduce rough sleeping in the future.  The Board discussed the potential benefits of a multi-agency group to address the problems of homelessness in Slough as they currently existed.  It would be important to better understand the homeless population and their service needs and access issues to better provide effective services to them.

During the course of the discussion, the Board recognised that there was a gap in multi-agency strategic working on homelessness and it was proposed and agreed that a Task & Finish Group be established to explore what more could be done to adopt a co-ordinated approach to tackle homelessness and rough sleeping.  It was agreed that Alan Sinclair would convene the group that would include strategic housing, public health, Thames Valley Police, primary care and the voluntary and community sector.  The outcomes of the work of the Task & Finish Group would then come back to the Board for the consideration.

Resolved – 

(a)  That the report and key points of the discussion be noted.

(b)  That a Task & Finish Group of the Board be established to explore how a more co-ordinated and strategic approach could be taken by partners to reduce the growing problems of homelessness and rough sleeping.

Members reviewed the Forward Work Programme for the Board and agreed the items for the next meeting including a themed discussion on the Director of Public Health’s Annual Report.

Resolved –  That the Slough Wellbeing Board’s Forward Work Programme be agreed.

An information report was received that updated the Board on the Council’s Five Year Plan 2018-23.

Resolved –  That the content of the Five Year Plan, and in particular the refreshed priority outcomes in the context of the Council’s ongoing commitment working to partnership working be noted.

The Board considered an early draft of the Slough Wellbeing Board Annual Report and were invited to submit any comments and case studies to the Council’s policy team prior to the document being approved at the next meeting.

Resolved –  That the draft Annual Report be noted.

An information report was received that updated on the work of the Preventing Violent Extremism Coordinating Group.

Resolved –  That the report be noted.

Resolved –  That the Attendance Report be noted.

The Board reviewed key outcomes from the meeting and learning points for future meetings.

Wednesday 9^th May 2018, 5pm

The date of the next meeting was confirmed as 9^th May 2018 at 5.00pm.