PLEASE NOTE:

Apologies have been received from the Chair, Councillor Roger Begy.

This meeting will therefore be chaired by Councillor Richard Clifton, Vice-Chair of the Rutland Health and Wellbeing Board and Rutland County Council’s Portfolio Holder for Health and Adult Social Care.

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In the absence of Mr Begy as Chair; the Vice-Chair, Mr Clifton chaired the meeting.

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To confirm the record of the meeting of the Rutland Health and Wellbeing Board held on Thursday, 17^th November 2015 (previously circulated).

The minutes of the meeting of the Rutland Health and Wellbeing Board held on the 17^th November 2015, copies of which had been previously circulated, were confirmed 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.

No petitions, deputations or questions were received from members of the public.

To receive Report No. 26/2016 from Mark Andrews and Sandra Taylor

Input from the Health and Wellbeing Board is invited on the draft BCF plan 2016-17 prior to the initial plan submission on the 8^th February 2016.

Report No. 26/2015 was presented by Mr Andrews which briefed the attendees on the current draft of the Better Care Fund plan and budget for 2016-17.

During discussion the following points were noted:

a)    The first draft of the plan was due for submission on the 8^th February 2016 BUT as yet no guidance had been received regarding the plan so the submission date might change.

b)    The plan contained one major change – ‘non-elective admissions’ are no longer subject to the national ‘payment for performance’ arrangement. The national focus is shifting to reducing ‘delayed transfers of care’, with some of the details of requirements here still to be announced in the national technical guidance. Building on progress to date, the draft programme itself also includes a stronger focus on communication, self-care and the management of long term conditions.

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Ms Dewar joined the meeting at 2.06 p.m.

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c)    The questions listed on page 11 (item 3.3) were discussed as follows:

i)     Does the revised Better Care Fund vision reflect Rutland’s health and social care needs and aims?  YES

ii)    Are the proposed priorities clear, coherent, relevant, ambitious and realistic?  YES Is anything missing from the programme?  Workforce development needs to be stronger.

iii)   Is the Better Care plan brave enough (pace, scope, innovation)? YES

iv)   Are we clear on the key success factors and are they in place e.g. does programme governance need to change to drive the programme more effectively and to connect into wider programmes of change (e.g. BCT and the Vanguard)? Does the partnership want to consider a risk sharing agreement for DTOC?  The indicators don’t need major changes but they do need amending slightly.

d)    A summary of the discussion at the Integration Executive Group meeting on the 21^st January 2016 regarding the BCF Plan 2016-17, was distributed to attendees for their attention.

AGREED:

1.    The Board NOTED the process for drawing up the 2016-17 Better Care Fund plan; the associated national timetable and the Board’s role in approving the plan.

2.    The Board NOTED that the current draft Better Care Fund plan was provisional and might be subject to change as national technical guidance and funding allocations were still to be published.

3.    The Board ENDORSED the current draft Better Care Fund plan and budget for 2016-17 for initial submission.

1.    The Board AGREED the final approval process for the plan which might require the HWB to approve the plan outside its normal meeting timetable.

To receive Report No. 23/2016 and Report No. 24/2016 from Paul Burnett, Chair of the Leicestershire and Rutland Safeguarding Children and Adults Boards regarding the consultation and input required for the proposed safeguarding business plans.

Report No. 23/2016 was presented by Mr Burnett and he invited attendees to consult and comment on any implications that the proposed business plans might have for the health and wellbeing strategy.

 During discussion the following points were noted:

a)    There were three business plans:

i)     The Safeguarding Adults Board Business Plan

ii)    The Safeguarding Children Board Business Plan

iii)   Joint Business Plan for the Safeguarding Adults Board and the Safeguarding Children Board.

b)    There were 5 priorities for the Safeguarding Adults Board:

i)     Building Resilient Communities – that can safeguard themselves but know how to report risk when it arises

ii)    Securing consistent application of safeguarding thresholds

iii)   Championing and securing the extension of ‘Making Safeguarding Personal’ across the partnership to improve service quality and outcomes for service users

iv)   Assuring robust safeguarding in care settings – including health care at home, residential and nursing care settings

v)    Tackling neglect and omission

c)    There were 6 priorities for the Safeguarding Children Board:

i)     Early Help

ii)    Evidencing the impact of the threshold protocol and outcomes from our Learning and Improvement Framework (including Serious Case Reviews [SCRs] and Domestic  Homicide Reviews [DHRs])

iii)   Local Authority Thresholds

iv)   Signs of Safety

v)    CSE

vi)   Neglect.

d)    There were 3 priorities shared between the Safeguarding Children Board and the Safeguarding Adults Board:

i)     DomesticAbuse

ii)    Reducing safeguardingrisk arising from mental health issues – includingmonitoring of the implementation of the MentalCapacity Act (MCA) andDeprivation of Liberty Safeguards (DoLS) and its application to 16-18 yearolds

iii)   Prevent Strategy

a)    All the business plans linked with the priorities in the Better Care Fund.

b)    There were ongoing concerns regarding issues at CAMHS.

c)    Service user perspective was difficult to obtain.  The Safeguarding Boards had worked with Healthwatch but would like to work with other partnerships.

d)    The delay in processing Deprivation of Liberty Safeguards (DoLS) was a key issue but significant investment was being made into the DoLS Team at Leicestershire County Council.

e)    The transition between children’s services and adults’ services needed to be flexible.

f)     The Business Plans needed to focus on key objectives and how these objectives were measured.

AGREED:

1.    The Board NOTED the attached Business Plans for 2016/17

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Mr Burnett left the meeting at 2.40 p.m.

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To receive Report No. 25/2016 from Mike Sandys, Director of Public Health  and Vivienne Robbins, Consultant in Public Health.

Report No. 25/2016 was presented by Mike Sandys and he briefed attendees on the Sexual Health Strategy executive summary which was specific to Rutland.

During discussion the following points were noted:

a)    The changes to the strategy proposed specific service implications:

i)          Work with local clinical commissioning groups (CCGs) and NHS England commissioners to reduce fragmentation across the system. Development of a bi-annual sexual health commissioners meeting.

ii)         Agreement of a local tariff arrangement for out of area specialist sexual health services in particular Peterborough services.

iii)       An increased role of primary care in delivering uncomplicated sexual health services (in particular contraception).

iv)       Reduction in opportunistic chlamydia screening and conversion into a full online STI screening service.

v)         Provision of parity across LLR for young people’s sexual health services including development of an LLR C-Card (condom distribution scheme) and increased Rutland access into the core integrated sexual health service.

vi)       Increased focus on groups at high risk of poor sexual health especially on men who have sex with men.

vii)      Increased focus on relationship and sex education across Rutland schools, including utilisation of the Leicestershire and Rutland RSE toolkit.

viii)     Increased access to HIV testing for at-risk groups (including men who have sex with men).

b)    A large number of GPs would be coming up to retirement age in the near future. New staff would need to be recruited and trained but using existing sexual health centres and expanding staff hours was discussed as an alternative.

c)    The sexual health consultation details can be found on the web at:

http://www.rutland.gov.uk/health_and_social_care/sexual_health_consultation.aspx

AGREED:

1.    The Board APPROVED the Rutland Sexual Health Needs Assessment.

2.    The Board SUPPORTED implementation of the recommendations across portfolio areas (in particular CCG support, children’s, substance misuse etc.)

3.    The Board APPROVED the Sexual Health Needs Assessment and draft strategy for public consultation.

To receive a 10 minute verbal update from Mike Sandys, Director of Public Health, regarding the plans and strategy for the new service.

Mike Sandy briefed attendees on the plans and strategy for the new service.

During discussion the following points were noted:

a)    The new service comes into effect in April 2017.

b)    A new contract for school nursing has been negotiated.

c)    It is planned that school nurses and health visitors would become more community centred so that they work together as an integrated 0-19 service.  This would lead to a more coherent service whilst decreasing costs.

d)    The changes in the school nursing service have been positively received by staff and pupils.

e)    Do the school nurses link with their equivalent in the private schools?

No urgent business

The next meeting of the Rutland Health and Wellbeing Board will be on Tuesday, 22^nd March 2016 at 2.00 p.m. in the Council Chamber, Catmose.

PROPOSED AGENDA ITEMS:

1.    Better Care Fund 2016-17 – final submission

Final Better Care Fund 2016-17 plan for the Health and Wellbeing Board to sign off, following regional review and assurance.

2.    Learning Disability Self-Assessment: ANNUAL REPORT       

Results of the Rutland LA & CCG annual self-assessment submitted to Public Health England

Report from Emma Jane Perkins

3.    Director of Public Health: Annual Report 2015   

This year’s report describes the role of communities and community-centred approaches to improving health and wellbeing in Rutland.      

Report from Mike Sandys

4.    Personal Health Budgets Strategy 

CCG Strategy on the implementation and extension of Personal Health Budgets 2016-2020         

Report from Yasmin Sidyot

5.    Rutland Health and Wellbeing Board: Future Priorities and Planning for the Development Session

Item requested for discussion at the HWB meeting held on the 17^th November 2015 

Report from Karen Kibblewhite

6.    EMAS: Quality Accounts

Report from Annie Palmer, External Relations and Engagement Manager, East Midlands Ambulance Service NHS Trust

The next meeting of the Rutland Health and Wellbeing Board would be on Tuesday, 22^nd March 2016 at 2.00 p.m. in the Council Chamber, Catmose.

AGREED:

The following items would be included on the next agenda:

1.    Better Care Fund 2016-17 – final submission

Final Better Care Fund 2016-17 plan for the Health and Wellbeing Board to sign off, following regional review and assurance.

2.    Learning Disability Self-Assessment: ANNUAL REPORT

Results of the Rutland LA & CCG annual self-assessment submitted to

Public Health England

Report from Emma Jane Perkins

3.    Director of Public Health: Annual Report 2015

This year’s report describes the role of communities and community centred approaches to improving health and wellbeing in Rutland.

Report from Mike Sandys

4.    Personal Health Budgets Strategy

CCG Strategy on the implementation and extension of Personal Health

Budgets 2016-2020

Report from Yasmin Sidyot

5.    Rutland Health and Wellbeing Board: Future Priorities and Planning for the Development Session

Item requested for discussion at the HWB meeting held on the 17^th November 2015

Report from Karen Kibblewhite

6.    EMAS: Quality Accounts

Report from Annie Palmer, External Relations and Engagement Manager,

East Midlands Ambulance Service NHS Trust