Council and councillors

Apologies were received from Mr Simon Mutsaars, Mr Tim Sacks, Mr Will Pope and Councillor Gary Conde. Ms Kate Holt and Mr Jamie Barrett attended as substitutes.

To confirm the record of the meeting of the Rutland Health and Wellbeing Board held on 26 June 2018 (previously circulated).

The minutes of the meeting of the Rutland Health and Wellbeing Board held on 26 June 2018 were confirmed as a correct record and signed by the Chairman.

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.

No petitions, deputations or questions were received.

To receive Report No.156/2018 from the Director for People, Rutland County Council.

Report No.156/2018 was received from the members of the Rutland Health and Wellbeing Board.

Ms. Karen Kibblewhite presented the report, the purpose of which was to provide a high-level overview of the progress by Rutland’s Health & Wellbeing Board against the Joint Health and Wellbeing Strategy 2016-2020.

During discussion the following points were noted:

·         Board members had been asked for their input and it was hoped that the report reflected this.

·         Going forward, an annual report would be produced each year.

·         Members had differing views on whether an increase in the prevalence of dementia diagnoses had an impact on the figures for healthy life expectancy. Better diagnosis may improve the life expectancy element but not necessarily affect the healthy life indicator.

·         Having a target for reducing health inequalities may not be realistic as the target continually moved with median income increases. It would be more helpful to talk instead about the impact of actions taken.

·         It was important the board drove priorities rather than scrutinising items, and board members should be taking back issues and discussion points to their respective organisations. In order to re-inforce this, it was suggested that a Board development session be organised.

AGREED:

1.    The Board NOTED the progress by Rutland’s Health & Wellbeing Board against the Joint Health and Wellbeing Strategy 2016-20 as set out in the Annual Report, and APPROVED it for publication to update the public.

2.    The Board AGREED that a development session should be organised for after the 4 December meeting. This would be after final approval of the Joint Strategic Needs Assessment (JSNA) and would help inform the Strategy.

To receive Report No.157/2018 and a presentation from Chris West, Director of Nursing and Quality.

Report No.157/2018 was received from the Future In Mind project team.

Chris West, Director of Nursing and Quality, Leicester City Clinical Commissioning Group presented the report and delivered a presentation, the purpose of which was to note the progress made in relation to implementation of the Local Transformation Plan and to agree proposed next steps for 2019-21.

During discussion the following points were noted:

·         The Future in Mind team were seeking support for the revised Future in Mind transformation plan before it was submitted to NHS England in October.

·         The ambition was to establish a system-wide pathway and the team had worked more closely with partners to deliver this.

·         The Early Intervention Service was now up and running and working very effectively, currently significantly over-performing against the contract.

·         There was a need; however, to stop the ‘bouncing’ of children between services and partners have agreed to develop a triage and navigation centre to stop all children being referred and assessed via the enhanced CAMHS Access service and to ensure that they are signposted to an appropriate service. It would also facilitate self-referrals. The data suggested that 30% of children that came through to CAMHS did not require specialised services.

·         The triage and navigation service would be going out to procurement and should be established by summer next year.

·         East Leicestershire and Rutland CCG and West Leicestershire CCG had been invited to bid for money as part of the new mental health document to improve counselling in schools; the bid had been put together and submitted on behalf of STP.  The bid had been submitted on 17 September.

·         Healthwatch had previously conducted some engagement work with children which could be shared with the Board and wider engagement with children and young people had been undertaken to inform the plan and services.

·         Self-referral was not an option at the moment, other than for on-line counselling, but should be made easier by the triage and navigation service.

·         Board members were asked how confident they were, as a wider partnership, that waiting times for CAMHS were being reduced. The service had initially improved and reached the required 13 week standard but had then slipped again and since then been difficult to maintain. Children were being assessed but then going onto the waiting list as demand was so high. As evidence of this, the Early Intervention Service had only been commissioned to see 100 children but had in fact seen 225.

·         The number of Rutland users of the Kooth online counselling service had been rising which was seen as a positive measure as this indicated an increased resilience to and awareness of mental health issues.

·         Information was not yet available on escalation of issues and the impact on services but was expected to be more evident in the coming year.

·         The Strategic Director for People (DCS) requested that it be noted in the minutes that he was not confident that the existing CAMHS model worked. It was unacceptable that children who were at risk should  ...  view the full minutes text for item 270.

To receive Report No. 158/2018 from the Director for People (DAS).

Report No.158/2018 was received from the Director for People (DAS).

The Director for People (DAS) introduced the report the purpose of which was to provide an update on the status and performance of the Rutland Better Care Fund Plan for 2018-19. The Board was asked to endorse the proposals to renew the operational governance of the Better Care Fund programme and also the budget and target adjustments to the Better Care Fund (BCF) plan for 2018-19 in order to deliver against anticipated outcomes.

During discussion the following points were noted:

·         Non-elective admissions in Rutland were below national levels but a local priority would be to reduce this level further rather than for it to flatline.

·         Dr. Hilary Fox, in her role as East Midlands Better Care Fund Manager, congratulated Rutland on how well they had manged the fund. A thank you was extended to Sandra Taylor, Health & Social Care Integration Manager for attending events to talk about preventative measures that Rutland had put in place as it was motivating for those areas that were mostly ‘fire-fighting’ to see new initiatives.

·         In terms of Delayed Transfers of Care (DTOC) the Better Care Fund was taking a pragmatic approach to Rutland missing targets and moving from green to red as the figures for Rutland were so low.

·         Under the Government indicators and with weighting, Rutland was placed first in the Country for Better Care Fund implementation.

AGREED:

The Board,

1.    ENDORSED the proposed adjustments to the programme in terms of scope and targets, as recommended to them by the signatory partners (Rutland County Council and East Leicestershire and Rutland Clinical Commissioning Group)

2.    ENDORSED the proposed new governance approach, with the dissolution of the Integration Executive and the creation of the Rutland Health and Care Board

To receive Report No. 159/2018 from James Fox, Leicestershire & Rutland Safeguarding Boards Business Manager.

Report No. 159/2018 was received from the Chairmen of the Leicestershire and Rutland Safeguarding Boards.

Mr James Fox, Safeguarding Boards Business Manager presented the report the purpose of which was to present the draft Annual Reports for the Leicestershire and Rutland Local Safeguarding Children Board (LRLSCB) and Safeguarding Adult Board (LRSAB) for 2017/18 for noting and comment by the Health and Well-being Board.

During discussion the following points were noted:

·         The annual reports were presented as part of a consultation before they got finalised by the respective Boards.

·         The reports were retrospective and looked back at the work done during 2017-18 and the things that had been learnt.

·         The Boards’ work tied in with the Rutland Health & Wellbeing Board’s vision; supporting people to live healthy lives.

·         Touching on item 6 of the agenda, Future In Mind, a particular piece of work had been done on setting up a young children’s advisory board and mental health had come up as an important issue.

·         The Rapid Response unit, which picked up vulnerable people, had been an excellent example of safeguarding preventative work.

·         The Annual Report needed to stress how important the LeDeR (Learning Disabilities Mortality Review) programme was.

·         It would be imperative for the Health and Wellbeing Board to keep a careful watch on the safeguarding boards to assess how they were going to navigate the forthcoming legislative changes.

AGREED:

1.    The Board considered and NOTED the Leicestershire and Rutland Local Safeguarding Boards Annual Reports for 2017/18 and their key messages.

2.    The Board AGREED that the Safeguarding Boards should attend a meeting of the Health and Wellbeing Board in early 2019 to update members on the developments in safeguarding children as a result of the new legislative changes and requirements.

To receive Report No. 161/2018 from Mike Sandys, Director of Public Health.

Report No. 174/2018 was received from the Director of Public Health and gave an update to the Board on the progress being made in updating and renewing the Rutland Joint Strategic Needs Assessment (JSNA).

During discussion the following points were noted:

·         Five of the seven chapters of the draft JSNA were almost ready but two chapters, Mental Health and Ageing Well needed further work.

·         Members were asked to consider whether Rutland was getting fair access to current mental health services.

·         The Ageing Well chapter listed the prevalence of various diseases but needed to add what was being done in terms of prevention, including broader social services to prevent isolation and whether the diseases diagnosed were being treated in the correct environment.

·         Deprived children who received a free school meal performed worse than other year 1 pupils in the phonic screening check, one of the measures of a good level of development, but Rutland figures for this measure were in line with expected national levels.

·         The figure of zero for home educated children in Rutland was questioned but it was explained that anything below five tended to come out as a zero.

·         It was noted that the figures for obesity levels were still rising and that this should be something that was tackled because of the implied health outcomes.

·         The number of people killed in a road traffic accident was significantly higher than the national average but could be attributed to the fact that the A1 ran through Rutland.  The number recorded was for fatalities in Rutland rather than for Rutland residents.

·         The Community Safety Partnership work had embedded road safety but the grant went down each year so preventative work became more difficult.

·         A broad comment was made that some of the data in the draft chapters eg, the reablement figures in Ageing Well were out of date. Figures needed to be as up to date as possible to make sure that the correct gaps in service, in the right places were identified.

·         The Ageing Well chapter tended to be very negative and it was suggested that the more positive aspects be built on. Exercise should be seen as the ‘miracle drug’ that would enable all generations, not just the elderly, to live healthier lives.

·         It was suggested that the outputs of the JSNA be shared with other bodies, such as the Community Safety Partnership, as appropriate.

·         The projected figure attributed to air pollution should be rewritten to state that it was a modelled figure rather than an actual figure as there was no actual (as stated on a death certificate) data to support this.

AGREED:

The Board,

1.    Advised on the the draft versions particularly in relation to the unmet needs and gaps, and recommendations and ENDORSEDthe publication of the chapters.

2.    ADVISED on the scope of the ‘Mental Health’ chapter in order to develop this further by including information regarding the use and access of mental health services by residents of Rutland, including difficulties or barriers  ...  view the full minutes text for item 273.

To receive any other items of urgent business which have been previously notified to the person presiding.

Report No. 178/2018 was received from the Project Director, CAMHS, the purpose of which was to provide the background for the Board’s support for Leicestershire Partnership Trust’s proposal.

The Director for People introduced the report and the Chairman asked whether the Board was content to approve a letter of support for the permanent relocation and expansion of the local CAMHS inpatient unit because of the benefits it would bring to children and parents in Rutland.

AGREED:

The Rutland Health and Wellbeing Board AGREED to support the permanentrelocation and expansion of the local CAMHS inpatient unit.

The next meeting of the Rutland Health and Wellbeing Board will be on Tuesday, 4 December 2018 at 2.00 p.m. in the Council Chamber, Catmose.

Proposed Agenda Items:

·         Prevalence of heart disease in Rutland

·         Update on Leicestershire & Rutland Physical Activity and Sport Strategy

The next meeting of the Rutland Health and Wellbeing Board would be held on Tuesday 4 December 2018 at 2.00pm in the Council Chamber, Catmose.

Proposed Agenda Items:

·         Prevalence of heart disease in Rutland

·         Update on Leicestershire & Rutland Physical Activity and Sport Strategy

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The Chairman closed the meeting at 3.28pm

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