Agenda and minutes

There were no declarations of interest.

Welcome and Introductions

Cllr Katie Hall welcomed members and noted apologies from Cllr Andrew Gravells (Cllr David Lee substituting), Cllr Mark Ereira (Cllr Apu Bagchi substituting), Cllr Elaine Atkinson (Cllr Bill Bentley substituting) and Cllr Jason Zadrozny (Cllr Zoe Patrick substituting).  Jane Ellison MP also sent her apologies for the meeting.

The Board noted the work carried out by Cllr Steve Bedser and Cllr Catherine McDonald on their departure from the Board and that Cllr Mohammed Khan OBE and Cllr Mrs Sue Whitaker will be attending the Board for the rest of this year.

The Chair will write to Cllrs Bedser and McDonald, to thank them for their contribution.

Andy Hollingsworth from the Solace office attended as an observer, in the absence of Dr Jo Farrar and her substitute Merran McRae who had recently been nominated by Solace as advisers to the Board.

Paul Johnstone and Ann Hoskins from Public Health England will present the report.

Dr Ann Hoskins, Director Children,Young People and Families Public Health England (PHE) presented on PHE’s role in the transfer of 0-5s public health commissioning responsibilities to local government and the opportunities that exist to improve health outcomes and services for children.

Context

·         The Healthy Child Programme for 0-5 year olds is an universal evidence based programme delivered by Health Visitors. The targeted part of the programme is delivered by Family Nurses. Universal services are essential for primary prevention, early identification of need and early intervention.  Universal services lead to early support and improves school readiness.

·         PHE has commissioned a refresh of evidence of the 0-5 year old Healthy Child Programme (0-5s HCP) as the universal support programme for children and families.

·         Public health commissioning responsibilities will transfer to LAs on 1 October 2015, with NHS England retaining responsibility for Child Health Information Systems and the 6-8 week GP check until at least 2020

·         As part of the transformation of health visiting (HV) services the Government has committed to:

o   Transforming the HCP and HV service to improve outcomes for children;

o   Investing in and increasing the HV workforce by 4200; and

o   Increasing Family Nurse Partnerships by 16,000 places.

Opportunities

The transfer presents a number of opportunities for councils and local partners to improve these services. This includes;

·         Raising the profile of children’s’ public health services within the council, at the Health and Wellbeing Board and with NHS partners;

·         Joining up commissioning with children’s social care and education;

·         Promoting continued joint commissioning with the NHS e.g. immunisation;

·         Streamlining and targeting interventions for families needing more help;

·         Joining up the 0-5 programme with the 5-19 programmes already commissioned by LAs;

PHE’s role

PHE has a role to play in the transition by;

·         Supporting commissioning by developing and sharing evidence, knowledge and intelligence and assisting workforce development;

·         Helping local areas to prepare for new responsibilities by working with the LGA and NHS England;

·         Publishing guidance on information requirements by December 2014;

·         Engaging in discussions on funding, contracts and the desirability/extent of any mandate of the 0-5s HCP services;

·         Supporting ‘light touch’ assurance to ensure each NHS Area Team is ready to ‘send’ responsibilities and that each council is ready to ‘receive’ these responsibilities by 1^st October 2015.

An LGA paper with an update on the 0-5s transfer was briefly presented and Members’ views were sought on a number of key issues.  Members’ key points included:

·         Members supported the concept of moving to a needs-based funding formula especially if, in those areas of greatest need, this was accompanied by a plan of action to improve.

·         Members recognised the important role played by health visitors, and expressed enthusiasm for the opportunity to integrate them with their existing public health services.  In some areas health visitors were reported as being already part of integrated LA/NHS teams.

·         Clarification was sought on whether the government’s wish to increase the number of health visitors by 4200 was in order to meet current targets or was over and  ...  view the full minutes text for item 2.

Oral update. Andrew Webster will be in attendance.

Andrew Webster provided an oral update on progress of the Better Care Fund (BCF).  All but one local authority had submitted their plans for review.  The sign off process (originally May-June) has been delayed due to NHS concerns that they may be bearing a significant risk if the plans fail to reduce admissions.  As a result, Clinical Commissioning Groups (CCGs) are being asked to provide further data in relation to predicted outcomes.  It was thought that 9 July may now be a likely date for ministers to announce their decisions.

In the brief discussion that followed, members raised concerns that further delay would threaten delivery of the predicted outcomes, particularly in terms of embedding action plans.

It was also noted that the pioneer authorities are undertaking some radical work that will contribute to learning in relation to the BCF programme.

Decision

Members noted the update.

Geoff Alltimes and Richard Humphries will be present for this report.

Updates on two programmes of work were presented.  The first, an update on the work of the Commission on the Future of Health and Social Care, was presented by Geoff Alltimes, commission member and LGA Associate and Richard Humphries, Senior Fellow, King’s Fund.

In particular, Geoff and Richard were keen to hear the Board’s views in relation to the proposals outlined in the Commission’s interim report.

In the discussion that followed, the Board made the following points:

·         That prevention programmes would always be a key element of any attempt to reduce costs in the long term;

·         That the principle of integration of health and social care budgets was broadly accepted and the BCF programme should inform this debate and be given time to bed down;

·         That the public must be engaged in this debate at the earliest opportunity;

·         The fact that the impact of the ageing population on health costs is a key driver and needed to be made more explicit in the paper;

·         Governance structures were seen as complex at the present time, especially in the NHS, and simplification of this, alongside clarity around health scrutiny would be welcome; and

The Board endorsed the Commission’s interim report and supports its ongoing work.  Of the Commission’s options for bringing more money into the health and social care system, Option 1 (improved productivity) was taken as a given.  Within Options 2 and 3 (raise more private funding and raise more public funding respectively) the Board agreed there were a number of ideas that warranted further exploration.  It was also agreed that this should not be at the expense of embedding the BCF or giving space and time to deliver other current initiatives on integration and prevention.

Geoff Alltimes welcomed the views expressed by the Board in the discussion and looked forward to receiving the LGA’s formal response in due course.

The second half of the paper was presented by Alyson Morley, Senior Adviser.  This paper, the detail of which is under embargo until the LGA conference, will form a central plank of the LGAs influencing work on the main issues facing local government in the run up to the next election.  The Board were informed that the policy development on the future design of adult social care and health, featured prominently in all the LGA’s influencing work.

In broad terms, the Board was reassured that:

·         Prevention and integration would be a key component of the policy messages;

·         Integration of health and social care is central to the future sustainability of local government and the NHS;

·         Public and local accountability issues would also be set out including the central role of the Health and Wellbeing Boards working with clinical leaders to engage local communities in discussions about the future shape of health and social care services;

·         Proposals for sustainable funding structures for health and social care would be set out; and

·         The key messages would be developed with the NHS national stakeholders.

Board members were invited to feed their comments to  ...  view the full minutes text for item 4.

Bill Mumford, lead Winterbourne View Joint Improvement Programme will be present for this item.

Bill Mumford, Lead, Winterbourne View Joint Improvement Programme, updated the Board on progress.

The Board was invited to comment on the issues set out in the paper and to consider how the JIP could support lead members maximise their local political influence and drive forward improvements.

A brief discussion took place on how best to work with the health sector and providers to provide more community based services, with some concern expressed that current budget reductions could impact on the issue.

Cllr Hall proposed that she write to lead members regarding their leadership role in leading the response locally.

Decision:

Members noted the report.

Cllr Hall expressed her appreciation for Cllr Ford’s support in attending a range of meetings and events on her behalf in the spring of this year.

The Board was advised that the Care Act will be the main agenda item at the next meeting.

Cllr Sue Whitaker and Cllr Bill Bentley sought clarification on the nominations for the Boards representation on the Think Local Act Personal programme. Officers agreed to return to the members concerned regarding this.

Cllr Sue Whitaker and Cllr Bill Bentley commented that they were in attendance at the last meeting as substitutes and requested that this be noted.

Decision:

Members agreed the minutes from the meeting held on 5 March 2014.