Agenda and minutes

Health and Wellbeing Board - Thursday, 17 September 2015 2.00 pm

Venue: Sparkenhoe Committee Room, County Hall, Glenfield

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

Items
No. Item

212.

Minutes and Action Log. pdf icon PDF 162 KB

Additional documents:

Minutes:

The minutes of the meeting held on 16 July 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.

 

213.

Urgent Items.

Minutes:

There were no urgent items for consideration.

214.

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.

215.

Position Statement by the Chairman. pdf icon PDF 496 KB

Minutes:

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

 

  • Local Developments;
  • The Development of Health and Wellbeing Boards;
  • National Developments.

 

The Board was assured that the quarterly Better Care Fund return had been assured by the Integration Executive and submitted in accordance with the national deadline set out by NHS England.  It was noted that there was still underperformance with regard to the target of reducing emergency admissions by 2,041 admissions by 31 December 2015.

 

A copy of the position statement and the Better Care Fund return is filed with these minutes.

 

216.

Mental Health and Wellbeing of Children and Young People - Better Care Together Workstream Update. pdf icon PDF 317 KB

Additional documents:

Minutes:

The Board considered a report and presentation from the Director of Children and Family Services which set out the progress of the Better Care Together workstream for the mental health and wellbeing of children and young people.  A copy of the report, marked ‘Agenda Item 5’, and the slides forming the presentation is filed with these minutes.

 

Arising from discussion the following points were raised:-

 

(i)    Significant improvements had already been made to the service officer for children and young people with mental health needs.  Waiting times for the Child and Adolescent Mental Health Service (CAMHS) had reduced and the crisis response service was now more effective.

 

(ii)   There was no additional capacity to deliver the Transformational Plan for children and young people’s mental health services; its success would depend on partners working together.  It was suggested that the report should be distributed to district council health and housing leads to ensure that they were engaged in this area of work.

 

(iii)  The aim of the Transformational Plan was to build on initiatives that were already in place.  For example, there was already a local offer in place regarding information and signposting.  The Plan could also maximise the opportunities available through the Healthy Schools scheme.  It would be important to ensure that there was a consistency of message across the initiatives.

 

(iv) Work was ongoing to consolidate the elements of work on child and adult mental health into Better Care Together workstreams, particularly with regard to the transition between services.  The specific project work to improve services in this area was yet to be mapped out.

 

(v)  The development of the Transformation Plan had included using data to identify the groups of children and life stages most likely to be affected by mental health issues.  More work was needed to translate this evidence into targeted work.

 

(vi) Learning from the pilot currently taking place in Rutland, providing a range of support for young people with mental health issues, would be rolled out to Leicestershire in a number of ways.  The young people involved in the pilot would work with youth councils to help them develop the skills that they need.  Schools would also engage in peer to peer learning with Leicestershire schools.

 

RESOLVED:

 

(a)  That progress with the Better Care Together workstream for children and young people’s mental health and wellbeing, including the development of the Transformational Plan, be noted;

 

(b)  That a report on progress be submitted to the next meeting of the Health and Wellbeing Board.

 

217.

Learning Disabilities and Autism Update. pdf icon PDF 159 KB

Minutes:

The Board considered a report of the Director of Adults and Communities which provided an update on progress in relation to the Joint Health and Social Care Assessment for Learning Disability (Transforming Care) and the Leicester, Leicestershire and Rutland Autism Strategy and Action Plan.  A copy of the report marked ‘Agenda Item 6’ is filed with these minutes.

 

It was confirmed that the ‘at risk’ register for those with learning disabilities and/or autism who were at risk of admission to an inpatient mental health setting would be in place by October 2015.  Leicestershire had committed to having a whole age register but would operationally keep two separate registers.  There was multi agency involvement in the establishment of the registers.  The Board emphasised the importance of having the right interventions in place to prevent the people on the register from being admitted.

 

The Joint Health and Social Care Self-Assessment Framework for Learning Disability was rated as amber because of issues regarding employment and the number of health checks that were being carried out.  Due to the way that the targets were set, nearly 100 percent compliance with the targets was needed in order for the Framework to be rated as green. 

 

The Board was assured that significant progress had been made in response to the Transforming Care Action Plan and the numbers of people with learning disabilities in inpatient settings was now very low.

 

RESOLVED:

 

That the progress on the development of provision for people with learning disabilities and autism be noted.

 

218.

Urgent and Emergency Care Vanguard and Current Performance. pdf icon PDF 168 KB

Additional documents:

Minutes:

The Board considered a report of the Leicester, Leicestershire and Rutland System Resilience Group which provided details of the successful application for the Urgent and Emergency Care Vanguard Programme.  A copy of the report marked ‘Agenda Item 7’ is filed with these minutes.

 

With regard to ambulance handovers at the Leicester Royal Infirmary, it was noted that UHL and EMAS had undertaken a review and developed a plan for transformational change which was now being implemented, however it was recognised that this was a complex set of issues to address and included some constraints on the physical environment at A&E which would not be resolved fully until the new department was in place.  Improvements were also needed to the ‘front door’ of the Emergency Department, particularly when patients were referred by GPs or the Urgent Care Centre.

 

The Urgent Care Board met fortnightly to consider the current performance of the urgent care system and oversee a multiagency action plan which addressed inflow into UHL, flow within UHL itself and outflow (e.g. discharge pathways).  Current year-to-date performance of the 4 hour wait target was 92 percent although there was still a lot of variation in performance on a daily basis.  Progress against the action plan was considered at each meeting of the Urgent Care Board which included representation from all providers and commissioners operating in the urgent care system in Leicester, Leicestershire and Rutland (LLR), including all Local Authorities, the regional NHS 111 provider, EMAS, NHS England and the Trust Development Authority

 

The Health and Wellbeing Board was advised that with LLR joining the national Urgent Care Vanguard programme additional governance arrangements to drive the delivery of the future model of urgent care would also be established, and more detail about this would follow later in the year. The Board would be kept abreast of these developments.

 

RESOLVED:

 

(a)  That the successful application for the Urgent and Emergency Care Vanguard Programme be welcomed.

 

(b)  That a report on the performance of the urgent care system during Winter 2015, along with development and implementation of the Vanguard be submitted to the Health and Wellbeing Board in January 2016;

 

 

219.

Healthwatch Annual Review 2014-15. pdf icon PDF 448 KB

Additional documents:

Minutes:

The Board considered a report and presentation from Healthwatch Leicestershire which presented the Annual Review 2014-15 and provided details of the Winter Tour.  A copy of the report marked ‘Agenda Item 8’ and the slides forming the presentation is filed with these minutes.

 

Health and Social Care settings were selected for ‘Enter and View’ visits by using a range of data.  This included intelligence received from the Care Quality Commission, issues flagged up through Healthwatch’s signposting service and information from the Quality Surveillance Group, of which Healthwatch was a member.  It was important that only three or four issues were focused on during a visit to ensure that the findings could be really focused and would make a difference to how the service was delivered in the future.

 

The funding to Healthwatch had reduced but the Chairman of Healthwatch was satisfied that the organisation was performing to a high standard within the available funds.  Healthwatch was also trying to raise funds from elsewhere, such as through the SIMTEGR8 project to evaluate the schemes within the Better Care Fund.

 

Healthwatch had produced a signposting directory in partnership with a private company.  The latest version would be shared with the Health and Wellbeing Board.  It would be possible to produce a directory aimed at young people as this could be funded by revenue raised from advertising.

 

RESOLVED:

 

(a)  That Healthwatch Leicestershire’s Annual Review 2014-15 be noted;

 

(b)  That Healthwatch Leicestershire’s representation as Participating Observers and Representations on a wide range of key stakeholder Committees and Boards be noted;

 

(c)  That Healthwatch Leicestershire’s contribution to the development of national Quality Standards for the Healthwatch network and the involvement of members of the Health and Wellbeing Board in the 360 degree stakeholder survey be noted;

 

(d)  That the signposting directory be circulated to members of the Board.

 

220.

Insights from Healthwatch.

Minutes:

This was considered as part of minute 219 above.

 

221.

Annual Reports of the Leicestershire and Rutland Local Safeguarding Children Board and Safeguarding Adults Board. pdf icon PDF 224 KB

Additional documents:

Minutes:

The Board considered a report of the Independent Chair of the Safeguarding Board which presented the draft Annual Report 2014/15 for the Leicestershire and Rutland Safeguarding Children Board and the Leicestershire and Rutland Safeguarding Adults Board.  A copy of the report marked ‘Agenda Item 10’ is filed with these minutes.

 

Arising from discussion the following points were raised:-

 

(i)    The Board sought assurance that UHL had put measures in place to improve its compliance with the safeguarding audits and was advised that all agencies that did not demonstrate compliance were asked to put together an action plan which was then monitored by the Safeguarding Effectiveness Group, a subgroup of the Safeguarding Boards.

 

(ii)   With regard to the increase in Deprivation of Liberty Standards (DOLS) assessment, the Board was advised that the purpose of the assessment was to test whether a person had capacity to make decisions if they were deprived of their liberty. Due to the increase in the number of people requiring an assessment, a number were now outstanding.  The Board was assured that this did not mean that a person waiting for an assessment received poor care, although for some people it could be very useful to have a relevant care plan in place.  It was also important to note that not all people who underwent an assessment would need to be deprived of their liberty.

 

(iii)  Concern was expressed that legal highs were not given sufficient recognition as a problem, particularly given the potential mental health implications.  The Board was assured that the Safeguarding Boards had recognised the risks of legal highs and had incorporated them into their action plan and performance framework.  Partners were also working together to address issues related to legal highs through the single substance misuse service currently being procured across Leicester and Leicestershire.

 

RESOLVED:

 

That the Annual Reports of the Leicestershire and Rutland Safeguarding Children Board and Safeguarding Adults Board be noted.

 

222.

Annual Reports of the Independent Reviewing Officer Service 2014-15. pdf icon PDF 146 KB

Additional documents:

Minutes:

The Board considered a report of the Director of Children and Family Services which set out the 2014-15 annual report of the Independent Reviewing Officer Service.  A copy of the report marked ‘Agenda Item 11’ is filed with these minutes.

 

RESOLVED:

 

That the Annual Reports of the Independent Reviewing Officer Service and improvements and developments planned for 2015-16 be noted.

 

223.

Private Fostering. pdf icon PDF 146 KB

Minutes:

The Board considered a report of the Director of Children and Family Services which set out the current arrangements across Leicestershire regarding private fostering.  A copy of the report marked 'Agenda Item 12’ is filed with these minutes.

 

It was noted that it was a statutory requirement that after 28 days, a local authority should be notified of a private fostering arrangement.  It was felt that more could be done to raise awareness of private fostering amongst GP practices, particularly through the locality meetings.

 

RESOLVED:

 

That the GP Representatives on the Health and Wellbeing Board be asked to consider how the need to identify private fostering arrangements can be promoted more effectively to GPs.

 

224.

Dates of Future Meetings.

Future meetings of the Health and Wellbeing Board will be held at 2.00pm on the following dates:-

 

19 November 2015

7 January 2016

10 March 2016

5 May 2016

7 July 2016

15 September 2016

17 November 2016.

 

Minutes:

It was noted that future meetings of the Board would be held on the following dates:-

 

19 November 2015;

7 January 2016;

10 March 2016;

5 May 2015;

7 July 2015;

15 September 2015;

17 November 2015.