To confirm the record of the meeting of the Rutland Health and Wellbeing Board held on 29^th November 2016 (previously circulated).

The minutes of the meeting of the Rutland Health and Wellbeing Board held on the 29^th November 2016, copies of which had been previously circulated, were confirmed as a correct record and signed by the Chair.

In accordance with the Regulations, Members are invited to declare any personal or prejudicial interests they may have and the nature of those interests in respect of items on this Agenda and/or indicate if Section 106 of the Local Government Finance Act 1992 applies to them.

No declarations of interest were received.

To receive any petitions, deputations and questions received from Members of the Public in accordance with the provisions of Procedure Rule 93.

The total time allowed for this item shall be 30 minutes.  Petitions, declarations and questions shall be dealt with in the order in which they are received.  Questions may also be submitted at short notice by giving a written copy to the Committee Administrator 15 minutes before the start of the meeting.

The total time allowed for questions at short notice is 15 minutes out of the total time of 30 minutes.  Any petitions, deputations and questions that have been submitted with prior formal notice will take precedence over questions submitted at short notice.  Any questions that are not considered within the time limit shall receive a written response after the meeting and be the subject of a report to the next meeting.

One question had been received from Mrs K Reynolds regarding the Leicester, Leicestershire & Rutland Sustainability and Transformation Plan.  At the suggestion of the Chair and with the agreement of the Board and Mrs Reynolds, it was decided to discuss the question after the updates regarding the Leicester, Leicestershire and Rutland and the Cambridgeshire and Peterborough Sustainability and Transformation Plans. 

To receive  Report No. 31/2017 from Tim Sacks, Chief Operating Officer, East Leicestershire and Rutland Clinical Commissioning Group regarding the submission of the Sustainability and Transformation Plan

Report no. 31/2017 was received from Tim Sacks, Chief Operating Officer, East Leicestershire and Rutland Clinical Commissioning Group.

During discussion the following points were noted:

a)    The Sustainability and Transformation Plan (STP) would focus very clearly on the ‘Home First Model’ with a new integrated service model for urgent and out-of-hours care. 

b)    The STP proposed to move maternity services to one site namely Leicester Royal Infirmary (LRI).  Integrated health care services would maximise opportunities for high quality patient benefits.

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2.10 pm Dr Tim O’Neill joined the meeting

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c)    The aim was to ensure a single system for patients as regards details of who to contact, how and where to access services etc.

d)    The need to use money more effectively was emphasised rather than cut funding.

e)    Two engagement events had been held (24^th and 26^th January) both of which had been well attended.

f)     It was noted that this was still a draft plan in the early stages of consultation.  Public consultation should hopefully begin in summer 2017.

AGREED:

1.    The Board NOTED the Sustainability and Transformation Plan for Leicester, Leicestershire and Rutland.  

To receive Report No. 32/2017 from David Astley, Independent Chair, Sustainability and Transformation Programme System Delivery Unit, Cambridgeshire and Peterborough NHS Trust giving an overview of the priorities of the Sustainability and Transformation Plan for Cambridgeshire and Peterborough

Report No. 32/2017 was received from David Astley, Independent Chair and Aidan Fallon, Senior Communications and Engagement Manager from the Sustainability and Transformation Programme System Delivery Unit, Cambridgeshire and Peterborough NHS Trust.  During discussion the following points were noted:

a)    The Cambridgeshire and Peterborough STP had the same drivers as the Leicester, Leicestershire and Rutland STP with both locations facing financial challenges.

b)    The plan was to bring together ‘health’ and ‘local government’ in the provision of services to the public.

c)    The aim was to avoid hospital admissions where necessary and instead deliver care to people through other means e.g. at home, health centres or GP surgeries.

d)    There was a need to reinvigorate primary care.

e)    A governance group had been established to manage the delivery of the STP.

f)     A local ‘Urgent Care Board’ had also been established which included colleagues from Leicestershire, Rutland, Cambridgeshire and Lincolnshire in order to ensure integrated working.

AGREED:

1.    The Board NOTED the Cambridgeshire and Peterborough Sustainability Transformation Plan.

To receive Report No. 39/2017 from Sandra Taylor, Health and Social Care Integration Project Manager

Report No. 39/2017 was received from Sandra Taylor, Health and Social Care Integration Project Manager and was presented by Mark Andrews, Deputy Director for People.  During discussion the following points were noted:

a)    All targets were on track.  Delayed Transfers of Care (DTOC) figures had risen in the last quarter but upon analysis this was an issue with the recording of mental health patients, which had now been resolved.

b)    A second IN Reach Nurse was now employed and good links had been established with Leicestershire and Peterborough.

c)    There were some issues regarding Lincolnshire but discussions were ongoing regarding costs.

d)    A Better Care Fund (BCF) Workshop had been held on the 5^th January 2017 in order to review the impact of the Rutland BCF programme activity so far and to feed into future priorities for the 2017-19 programme.  Feedback had been very positive.

e)    There would be no increase in the budget for the BCF for Rutland.

f)     There was a need to integrate fully with primary care.

g)    The integration of services done so far had been very successful and positively received.

h)   The four GP services in Rutland had been successful in their ‘Vanguard’ bid.  This was a good example of integration work providing joint frontline patient services. The four services merging to become one ‘multi-speciality provider’, was being investigated with great enthusiasm by the Rutland GP’s.  This was excellent work in progress.

i)     The provision of mental health services needed to be kept as a priority.

AGREED:

1.    The Board NOTED the report.

2.    The Board AGREED the need to publicize the successes of the BCF programme.

To receive Report No. 33/2017 from Maria Smith, Strategic Lead for Personal Health Budgets on behalf Leicester City, West Leicestershire and East Leicestershire and Rutland Clinical Commissioning Groups detailing the local personal health budget offer from the three Leicestershire CCGs and the plans to expand the personal health budget offer

Report no. 33/2017 was received from Maria Smith, Strategic Lead for Personal Health Budgets on behalf of Leicester City, West Leicestershire and East Leicestershire and Rutland Clinical Commissioning Group.   During discussion the following points were noted:

a)    Personal Health Budgets are an alternative way of using existing resources within healthcare services.  Careful planning and a phased approach have been taken to implement personal health budgets in order to maintain financial stability and the sustainability of services.

b)    From 1^st April 2016 those with Learning Disability and/or Autism who had a Significant Health Need were able to request a PHB and CCGs were required to continue to support the process for Education Health and Care Plans, ensuring that those that are eligible for a personal health budget are offered this as part the process, to be integrated with personal budgets from education and social care. 

c)    The report stated that the CCG’s uptake of PHB’s within Continuing Healthcare (CHC) was currently 13.8% of all individuals eligible for CHC and living in the community including Fast Track patients.  Maria clarified that this related to a number of 758 CHC eligible individuals across LLR living in the community, of which 105 adults currently have PHBs. However, the report explained that fast track eligible individuals would not routinely be offered a PHB. Therefore if these individuals are removed from the figures there are 420 individuals remaining. This meant that the percentage of these individuals who were both eligible and most likely to benefit was a PHB that were already in receipt of one is 25%.  These figures did not represent the total number of people receiving CHC funding.  These figures were the number of people (as at October 2016) who lived in the community and were therefore most likely to benefit from a PHB.  It did not include those people living in residential or nursing homes.

d)    Section 117’s current packages were being reviewed which would take time so PHB’s were not being considered but could be in the future.

e)    It was confirmed that a Rutland County Council representative (the Head of Families Support) attended PHB meetings.

f)     A ‘GP Champion’ would be recruited to discuss PHB’s with GP’s and how work from a budget perspective.

AGREED:

1.    The Board NOTED the progress made in relation to the local personal health budget offer

2.    The Board AGREED the plan for further expansion of the personal health budget/integrated personal budget offer into 2017 and beyond          

3.    The Board AGREED that Tim Sacks and Maria Smith would meet to further discuss the role of ‘GP Champion’.

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3.37 pm Maria Smith left the meeting

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A new ‘Register of Interest’ form needs to be completed by each member of the Rutland Health and Wellbeing Board

Jane Narey reminded members that they (excluding current Councillors of Rutland County Council) would need to re-new their Register of Members’ Interests form.

AGREED:

1.    The Board AGREED that Jane would email members a Word version of the form for them to complete and return to her.

There was no urgent business.

The next meeting of the Rutland Health and Wellbeing Board will be on Tuesday, 28^th March 2017 at 2.00 p.m. in the Council Chamber, Catmose.

Proposed Agenda Items:

1.    Local Safeguarding Children’s Board and Safeguarding Adults’ Board: Business Plans

Report from Paul Burnett, Chair of the Leicestershire and Rutland Safeguarding Children and Adults Boards

Consultation and input required for the proposed safeguarding business plans

2.    Director of Public Health: Annual Report

Report from Mike Sandys, Director of Public Health for Leicestershire & Rutland

3.    Health Protection Board: Annual Report

Report from Vivienne Robbins, Consultant in Public Health.

Annual report to provide assurance from the LLR Health Protection Board that it is meeting its statutory functions

4.    Congenital Heart Surgery (CHS) Services in Leicester

Report from Will Huxter, Regional Director of Specialised Commissioning (London), NHS England.

Discussion regarding the issues relating to the CHS service in Leicester

5.    End of Life Care

Verbal update from Mark Andrews, Deputy Director for People, Rutland County Council

Discussion regarding the letter from the Department of Health in response to the independent review of choice in end of life care

The next meeting of the Rutland Health and Wellbeing Board would be on Tuesday 28^th March 2017 at 2.00 p.m. in the Council Chamber, Catmose.

AGREED:

The following items would be included on the next agenda:

1.    Local Safeguarding Children’s Board and Safeguarding Adults’ Board: Business Plans

Report from Paul Burnett, Chair of the Leicestershire and Rutland Safeguarding Children and Adults Boards

Consultation and input required for the proposed safeguarding business plans

2.    Director of Public Health: Annual Report

Report from Mike Sandys, Director of Public Health for Leicestershire & Rutland

3.    Health Protection Board: Annual Report

Report from Vivienne Robbins, Consultant in Public Health.

Annual report to provide assurance from the LLR Health Protection Board that it is meeting its statutory functions

4.    Congenital Heart Surgery (CHS) Services in Leicester

Report from Will Huxter, Regional Director of Specialised Commissioning (London), NHS England.

Discussion regarding the issues relating to the CHS service in Leicester

5.    End of Life Care

Verbal update from Mark Andrews, Deputy Director for People, Rutland County Council

Discussion regarding the letter from the Department of Health in response to the independent review of choice in end of life care