Agenda and minutes

Health and Wellbeing Board - Thursday, 16 July 2015 2.00 pm

Venue: Guthlaxton Committee Room, County Hall, Glenfield

Contact: Mrs. R. Palmer (Tel: 0116 305 6098)  Email: rosemary.palmer@leics.gov.uk

Items
No. Item

197.

Minutes and Action Log. pdf icon PDF 159 KB

Additional documents:

Minutes:

The minutes of the meeting held on 14 May 2015 were taken as read, confirmed and signed.

 

The Board also noted the Action Log which provided an update on progress with the actions agreed by the Board during 2015.

 

198.

Urgent Items.

Minutes:

There were no urgent items for consideration.

 

199.

Declarations of interest.

Minutes:

The Chairman invited members who wished to do so to declare any interest in respect of items on the agenda for the meeting.

 

No declarations were made.

 

200.

Position Statement by the Chairman. pdf icon PDF 416 KB

Minutes:

The Chairman gave a position statement on the following matters:-

 

·       Local Developments;

·       The Development of Health and Wellbeing Boards;

·       National Developments;

·       Other publications/resources/conferences.

 

The Board congratulated Healthwatch Leicestershire for receiving a special commendation at the national Healthwatch Awards for the ‘One Week in LRI’ report and investigation.

 

It was also noted that the Urgent Care Board had submitted a vanguard application for Urgent and Emergency Care across Leicester, Leicestershire and Rutland.

 

A copy of the position statement is filed with these minutes.

 

201.

Better Care Together. pdf icon PDF 379 KB

Minutes:

The Board considered a presentation from the Better Care Together Programme Director which provided an update on the current position of the Better Care Together Programme and set out next steps for 2015/16.  A copy of the slides forming the presentation, marked ‘Agenda Item 5’ is filed with these minutes.

 

It was intended that the recovery colleges would operate as a hub and spoke model.  It was noted that two additional spokes of the recovery college for patients with mental health issues were being developed in the County, one in Loughborough and one in Market Harborough.  Options for other sites were also being explored.

 

RESOLVED:

 

That progress with the Better Care Together programme be noted.

 

202.

Better Care Together Mental Health Resilience and Recovery: Review of Third Sector Contracts. pdf icon PDF 364 KB

Minutes:

The Board considered a presentation from West Leicestershire Clinical Commissioning Group which set out the achievements to date with regard to mental health resilience and recovery and proposed next steps, including the review of Third Sector contracts.  A copy of the slides forming the presentation, marked ‘Agenda Item 6’ is filed with these minutes.

 

Arising from discussion the following points were raised:-

 

(i)    It was important that the focus on services which were outside of the scope of Better Care Together was not lost.

 

(ii)   It was hoped that this piece of work would address transition issues, particularly those between children’s mental health services and adult mental health services.

 

(iii)  There were a number of small, local projects in the County, such as ‘A Place to Grow’ in Blaby District, which were part of the voluntary sector but often overlooked.  It was expected that the Local Area Co-ordinators would be aware of these groups and make them part of the recovery pathway.

 

(iv) The County Council was reviewing its adult social care mental health pathway and would welcome the opportunity to do this jointly with health services.

 

RESOLVED:

 

That the ‘recovery journey’ be noted.

 

203.

Emotional Health and Wellbeing of Children and Young People: Better Care Together Workstream Update. pdf icon PDF 319 KB

Minutes:

The Board considered a report of the Director of Children and Family Services which provided an update on the progress of the Better Care Together workstream with regard to the emotional health and wellbeing of children and young people.  A copy of the report marked ‘Agenda Item 7’.

 

It was suggested that it would be useful for a GP to serve on the Leadership Board established to progress the local transformation plan for children and young people’s mental health and wellbeing.  The Board was pleased to note that the Leadership Board would also be addressing relevant issues raised by the Care Quality Commission report regarding services provided by Leicestershire Partnership NHS Trust as well as the need to develop a ‘place of safety’ for children and young people.

 

The importance of seamless transitions between children’s and adult mental health was emphasised.  Work in the two areas should be completely aligned in order to reduce the risks associated with transition.

 

RESOLVED:

 

That, pending the anticipated publication of the national guidance, the Leadership Board be asked to develop the Transformation Plan to draw down funding for 2015/16 and that approval of the plan be delegated to the Director for Children and Family Services and the Director of Public Health, following consultation with the Chairman of the Health and Wellbeing Board and Cabinet Lead Member for Children and Families.

 

204.

Special Educational Needs and Disabilities Reform Update. pdf icon PDF 205 KB

Minutes:

The Board considered a report of the Director of Children and Family Services which provided an update on progress to date in regard to the implementation of Special Education Needs and Disabilities (SEND) reform as part of the Children and Families Act.  A copy of the report marked ‘Agenda Item 8’ is filed with these minutes.

 

It was noted that, although GPs have records of young people with disabilities, there was no requirement for a register of young people with special educational needs to be kept.  Through the commissioning strategy, there would be a conversation with GPs regarding how data could be collected in this area.

 

RESOLVED:

 

(a)  That the progress in implementing the Special Educational Needs and Disabilities Reform be noted, particularly in relation to the integrated working and contribution made by health professionals;

 

(b)  That the intention of Ofsted to develop a specific framework to inspect local areas be noted.

 

205.

Joint Strategic Needs Assessment Refresh. pdf icon PDF 213 KB

Additional documents:

Minutes:

The Board considered a report which presented the draft 2015 refresh of the Joint Strategic Needs Assessment.  A copy of the report marked ‘Agenda Item 9’ is filed with these minutes.

 

The importance of end of life care was emphasised, particularly with regard to enabling people who wished to do so to die in their normal place of residence.  There was also a need to support people to have plans in place for end of life care at a relatively early stage.

 

With regard to alcohol related admissions, it was noted that Public Health had commissioned alcohol liaison nurses to reduce alcohol related admissions.  However, it was not certain that the correct balance had been struck between short term interventions and longer term prevention work.

 

It was noted that that JSNA formed the foundation of the Better Care Together Five Year Strategy.  It would be important to use the evidence and messages contained within the JSNA to support the public consultation on the proposed changes to health services being put forward through the Better Care Together programme.

 

RESOLVED:

 

(a)  That the Executive Summary be endorsed subject to any comments from members of the Health and Wellbeing Board that are submitted to the Director of Public Health by email;

 

(b)  That the Joint Strategic Needs Assessment, as part of the evidence base for the Better Care Together Five Year Strategy, be incorporated into the briefing for all members of the County Council on Better Care Together on 9 September.

 

206.

Healthwatch Update: Ambulance Handover at Leicester Royal Infirmary. pdf icon PDF 168 KB

Minutes:

The Board considered a presentation from Healthwatch Leicestershire which provided details of the Enter and View visit undertaken on 12 March to consider ambulance handovers at the Leicester Royal Infirmary.  The Board also received the full report on the visit.  A copy of the slides forming the presentation, marked ‘Agenda Item 10’ and the report is filed with these minutes.

 

The Board also considered a report setting out the findings of a quick poll survey regarding views about GP services, a copy of which is filed with these minutes.

 

With regard to the ambulance handovers, it was noted that the new Emergency Floor at the Leicester Royal Infirmary would be completed in 18 months and this would resolve a number of the issues relating to physical facilities.  The University Hospitals of Leicester NHS Trust would consider what actions could be taken during the period before the new Emergency Floor was in place.

 

RESOLVED:

 

(a)  That the investigation into Ambulance Handovers at the Leicester Royal Infirmary undertaken by Healthwatch be welcomed;

 

(b)  That the findings of the Quick Poll Survey regarding GP services be referred to the Clinical Commissioning Groups for consideration.

 

 

207.

Ambulance Handovers. pdf icon PDF 668 KB

Minutes:

The Board considered a joint presentation from the East Midlands Ambulance Service (EMAS), University Hospitals of Leicester NHS Trust (UHL) and Clinical Commissioning Groups (CCGs) setting out the performance issues related to ambulance handovers at the Leicester Royal Infirmary.  A copy of the slides forming the presentation, marked ‘Agenda Item 11’, is filed with these minutes.

 

The Board welcomed the collaborative approach to dealing with the challenges of ambulance handovers.  It was positive that the problem was recognised across all partners and that progress was being made with the proposed improvements to the system.

 

The Urgent Care Board had looked at both the clinical and patient risk related to ambulance handover.  The two key risks were that the condition of patients could deteriorate whilst they were waiting to get in to the Emergency Department and that there were patients in the community who needed an ambulance but there was insufficient capacity due to ambulances being delayed during handover at the Leicester Royal Infirmary.  These risks had driven the focus on ambulance handovers.

 

UHL accepted the correlation between performance and handover times.  It was acknowledged that improvements to performance were still needed in this area.  In support of this, the entrance to the Urgent Care Centre and Emergency Department was being redesigned to reduce the number of patient pathways that involved the use of assessment bays and identify ways in which certain types of patients could bypass the Emergency Department.  This would be implemented by the end of September 2015.  EMAS and clinicians from UHL had been involved in the redesign.

 

RESOLVED:

 

(a)  That the progress made to date address the performance issues related to ambulance handovers be welcomed;

 

(b)  That performance regarding ambulance handovers be included in the regular performance reports to the Board and any areas for further concern highlighted through that report.

 

208.

Progress of the Better Care Fund Emergency Admissions Avoidance Schemes. pdf icon PDF 209 KB

Additional documents:

Minutes:

The Board considered a report of the Director of Health and Care Integration which provided an update on the progress of the emergency admissions avoidance schemes funded via the Leicestershire Better Care Fund and actions being taken to improve their uptake and impact, following analysis of the performance since January 2015.  A copy of the report marked ‘Agenda Item 12’ is filed with these minutes.

 

It was reported that the Urgent Care Board had initiated a piece of work to analyse activity and trend data for hospital admissions.  A clinical case notes review would also be undertaken.  It was hoped that this would identify if there was anything further that partners could due to reverse the trend of increasing admissions to hospital.

 

RESOLVED:

 

(a)  That the action plan for the Emergency Admissions avoidance schemes be supported;

 

(b)  That all members of the Board be encouraged to provide leadership to the efforts being made within respective organisations to avoid admissions through the maximum utilisation of the alternatives in the community.

 

209.

Performance Update at the end of Quarter 4. pdf icon PDF 383 KB

Additional documents:

Minutes:

The Board considered a joint report from Leicestershire County Council and the Greater East Midlands Commissioning Support Unit which provided an update on performance against current performance priorities as set out in the Health and Wellbeing Strategy and Commissioner Performance Frameworks, based on data available at the end of quarter 4 2014/15.  A copy of the report marked ‘Agenda Item 13’ is filed with these minutes.

 

Concern was expressed that, although performance for delayed transfers of care was rated green, largely due to improvements in acute hospitals, there were still some significant delays in discharge from community hospitals.  The Care Quality Commission, in its recent inspection of Leicestershire Partnership NHS Trust, had raised concern that bed occupancy levels in community hospitals were high.  It was suggested that the Integration Executive could investigate this issue further.

 

It was noted that performance with regard to access to GP services was rated red, although patient satisfaction levels in Leicestershire were higher than the national average.   The results of the latest national patient survey had been published the previous week and the next performance report to the Health and Wellbeing Board would reflect the survey’s findings.  However, it was felt that this was an area which the Health and Wellbeing Board should investigate further, particularly given the findings of the Healthwatch Quick Poll Survey on the same issue which were tabled by Healthwatch at this meeting.

 

RESOLVED:

 

(a)  That the performance summary, issues identified this quarter and actions planned in response to improve performance be noted;

 

(b)  That the Integration Executive be asked to investigate performance related to Delayed Transfers of Care from Community Hospitals and report back to the Board on any actions agreed;

 

(c)  That a report be submitted to a future meeting of the Board on access to GP services.

 

 

210.

Personal Medical Services Review. pdf icon PDF 221 KB

Minutes:

The Board considered a report from NHS England which provided an update on the programme to review all local Personal Medical Services contracts by March 2016.  A copy of the report marked ‘Agenda Item 14’ is filed with these minutes.

 

RESOLVED:

 

That the report be noted.

 

211.

Date of next meeting.

The next meeting of the Health and Wellbeing Board will be held on 17 September 2015 at 2.00pm.

 

Minutes:

It was noted that the next meeting of the Board would be held on Thursday 17 September 2015 at 2.00pm.