To confirm the record of the meeting of the Rutland Health and Wellbeing Board held on 5 December 2017 (previously circulated).

The Record of the meeting of the Rutland Health and Wellbeing Board held on 5 December 2017 were confirmed as a correct record and were 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.

Dr Hilary Fox declared an interest in item 5 of the agenda as she was a partner at Uppingham Surgery until December 2017.

Mr Tim Sacks declared an interest in item 5 of the agenda as he was a resident of Ketton.

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.

Two questions had been received from Mr Nancarrow. The Chair was asked to answer the following questions.

Question 1:

Was the Board aware of the content of the survey questionnaire issues in hard copy and on line by the Uppingham Surgery?

Question 2:

Does the Board agree that the questionnaire is not fit for purpose for any one of more of the following reasons:

·         There is no indication of where the respondent lives, which seems to be essential for the evaluation of the responses.

·         There is no mechanism to prevent fraudulent responses. There is no reference to the impact of public transport timetables, which are crucial for those without their own transport.

·         No alternative is suggested other than complete closure of the facility.

·         The link originally given to the on-line questionnaire was incorrect, so that the full consultation period for those wishing to respond on-line was circulated.

The Chair, Mr Walters, responded to the questions. The response is shown below.

Answer

Question 1:

The Board was made aware of the consultation and the content of the survey questions by Uppingham Surgery when the consultation began on 1 February.

The Board was not aware of the content of the survey questionnaire ahead of the consultation. As the HWB does not have auditing role, we didn’t expect to have sight of the survey ahead of the consultation.

The Board is aware that Rutland County Council was informed of the process and the decision made by the CCG to allow the practice to begin a public consultation.

Question 2:

It is not the responsibility of HWB to agree or disagree with the questions being asked in the survey. However, we have passed those questions to the CCG and practice and would urge them to consider the concerns of local residents. We have received the following statement from the practice and CCG:

The survey questions were put together by the practice and checked over by CCG and NHS England staff with expertise in communications and consultation. The practice designed the questions to:

·         Find out whether respondents are in favour of the proposed move

·         Identify any risks or concerns that people have for example, in relation to transport and putting measures in place where possible, to mitigate these if a decision is made to close the branch surgery

·         Find out from respondents what services they currently use and gather this information to make decisions on how services can be delivered more efficiently and utilising GP time more effectively.

·         Gather data to ensure that any decision supports the sustainability of the branch surgery and Uppingham Surgery.

In light of feedback in relation to the survey the practice and CCG will undertake a review and provide a formal response in due course.

To receive an update.

Mr Tim Sacks, Chief Operating Officer, East Leicestershire & Rutland Clinical Commissioning Group, introduced the report, the purpose of which was to provide the Health and Wellbeing Board with a framework on the Uppingham Surgery Business Case presented to East Leicestershire and Rutland Clinical Commissioning Group (ELR CCG) on the proposal to close their branch location.

During discussion the following points were noted:

      i.        Mr Williamson-Noble, Healthwatch Rutland, noted that he had attended a drop-in session held at Ketton surgery as part of the consultation, where many valid points were raised. Mr Williamson-Noble would like to see re-issue of the questionnaire that was send out, with careful thought as to what was included. It was also noted that Healthwatch Rutland had offered to contribute to the questionnaire, however the offer was declined.

    ii.        It was noted that at the most recent Adults and Health Scrutiny Panel it was agreed that there would be a special Scrutiny Panel dedicated to discussion regarding the proposed closure, with Uppingham Surgery in attendance.

   iii.        Mr Sacks noted he had been in contact with the surgery and asked if they would be able to attend the Parish Council meeting in Ketton.

The Chair invited Mr Gary Conde, Ward Member for Ketton, to comment

Mr Conde noted that there was no public transport from Ketton to Empingham, and also commended and endorsed Mr Nancarrow’s questions.

AGREED

That the Board NOTED the report.

To receive a presentation from Louise Bettany, Acting Regional Director Leicester, Leicestershire and Rutland, Thames Group Limited

A presentation was received from Tracy Hodgkiss, Jo Mulvey, and Joanna Clinton from TASL. The presentation can be found attached to the minutes.

During discussion the following points were noted:

      i.        There was discussion as to who was responsible for booking patient journeys. Mr Williamson-Noble raised an issue regarding Rutland residents registered with GPs outside of Rutland not being able to book transport. Ms Clinton confirmed that patient transport continued to be commissioned on a ‘registered’ population, therefore Rutland residents registered with GPs outside of Rutland would still have access to transport as it would be booked by their GP from that local area’s provider.

    ii.        Improvement had been seen in the past 4-6 weeks, but it was still a work in progress.

   iii.        It was noted that their biggest concern was quality, they had not been assured of quality assurance as no reports had been received. There had also been a lot of changes in terms of staffing which needed to be strengthened.

   iv.        Ms Hodgkiss noted they needed to get smarter with cross boundary journeys.

    v.        It was noted that all improvements would be taken into effect by June 2018.

To receive a verbal update from Tim Sacks, Chief Operating Officer, East Leicestershire and Rutland Clinical Commissioning Group

Mr Sacks provided a verbal update. There was nothing further in the public domain, but a lot of re-working had been done. There was a revised chapter on community hospitals with links to the one public estate project and plan for community beds. Government policy was still being awaited, there was no indication as to when consultation would take place.

To receive Report No. 46/2018 from Mike Sandys, Director of Public Health

Mr Mike Sandys, Director for Public Health, introduced the report, the purpose of which was to improve the health and wellbeing of the people of Rutland.

The recommendations within the report reflected discussion that was held at the Adults and Health Scrutiny Panel, Informal Cabinet, and the Strategic Management Team meeting.

During discussion the following points were noted:

      i.        Work was being done with the housing and planning teams within RCC to work on demographics in regards to impact in relation to the St George’s Barracks project.

AGREED

That the Board SUPPORT the recommendations within the report.

To receive Report No. 49/2018 from John Morley, Head of Adult Services, Rutland County Council

Mr Andrews introduced the report, the purpose of which was to seeks to respond to the issues related to caring that have been highlighted locally and set out how the partners signed up to the strategy would work together to address them.

Mr Andrews noted that when it was taken to the Adults and Health Scrutiny Panel in November, a number of changes were suggested, the Scrutiny Panel supported the vision of the strategy and thought it would be beneficial to have a Rutland specific delivery plan produced which may add weight to priorities that were not specifically highlighted in this strategy.

AGREED

The Board NOTED the report and AGREED for a delivery plan to be brought back to the Board.

To receive Report No. 47/2018 from Mike Sandys, Director of Public Health

Mr Sandys introduced the report, the purpose of which was to inform on the findings of the Pharmaceutical Needs Assessment (PNA) and to submit the report to be published for approval.

During discussion the following points were noted:

      i.        Dr Fox enquired about the role of Dispensing Doctors. While it was included in some aspects of the report, the Doctors would also be doing reviews. Dr Fox also suggested there be detail regarding who had access to the Dispensing Doctors. Mr Sandys would check to see if there was a comprehensive picture of dispensing surgeries.

    ii.        Mr Williamson-Noble noted that a number of residents in Rutland would get their prescriptions outside of Rutland and whether this was included in the statistics. Mr Sandys confirmed that the software used for collecting data could not record those going outside of the border.

AGREED

That the Board NOTED the report.

That the Board APPROVED the publication of the Pharmaceutical Needs Assessment 2018 subject to changes asked by the Board.

To receive Report No. 48/2018 from Mike Sandys, Director of Public Health

Mr Sandys introduced the report, the purpose of which was to highlight the responsibility of the Health and Wellbeing Board to publish a Joint Strategic Needs Assessment (JSNA), the timescale to do so, and the proposed governance structure to enable production of the JSNA.

During discussion the following points were noted:

      i.        Mr Sacks noted he would welcome being a member of the JSNA Reference Group as suggested in the report.

    ii.        Dr O’Neill suggested that Community Safety could be tied in to the JSNA. Mr Sandys welcomed the idea and asked whether it would be worthwhile taking the report to the Community Safety Board.

AGREED

That the Board NOTED the report.

That the Board APPROVED the proposal to form a JSNA Reference Group and the draft terms of reference for the JSNA Reference Group.

To receive Report No. 50/2018 from Sandra Taylor, Health and Social Care Integration Manager, Rutland County Council

Mr Andrews introduced the report, the purpose of which was to update the Health and Wellbeing Board on progress with the 2017-19 Better Care Fund Programme.

During discussion the following points were noted:

      i.        Dr Fox asked whether those that had fallen had been on falls prevention. Mr Andrews noted it was difficult to say due to the data they received. It was noted that further data may be able to be sought for the next Health and Wellbeing Board meeting.

AGREED

That the Board NOTED the report.

The Chair asked the Board for comments on proposed items for the next meeting.

During discussion the following points were noted:

      i.        Mr Williamson-Noble suggested that assuming the bid for Rutland Armed Forces role was successful, it would be appropriate for a talk regarding plans for this.

    ii.        Dr O’Neill suggested the Board could look at the Children’s Mental Health Transformation Plan which had previously gone to the Children and Young People Scrutiny Panel.

The date of the next meeting of the Rutland Health and Wellbeing Board is to be confirmed.

Proposed Agenda Items – future meetings:

1.    CYPF Plan 2016-19: Progress Report (Information – Bernadette Caffrey)

2.    Leicestershire and Rutland Local Children and Adults Safeguarding Boards

3.    Leicester, Leicestershire and Rutland End of Life Programme

4.    Leicester-shire & Rutland Physical Activity and Sport Strategy 2017-2021: Update

5.    HWB Annual Report

6.    STP Business: LLR Dementia Strategy

7.    Sustainability and Transformation Plan: Rutland Memorial Hospital

8.    Sustainability and Transformation Plan: Integrated Community Services

9.    Rutland Health Care Service Review

10. Local Health Plan

The dates of future meetings would be decided at the Annual Council meeting on Monday 14 May 2018.