Meeting documents

To elect a Chairman for the meeting.  (It was agreed at the previous meeting that the Chairmanship would rotate amongst the three authorities and that the Vice-Chairman identified at a meeting would become the Chairman at the following meeting).

Resolved

That Councillor Rebecca Knox be elected Chairman for the meeting, in accordance with the Board’s procedures.

To appoint a Vice–Chairman for the meeting.

Resolved

That Councillor Drew Mellor be appointed as Vice-Chairman for the meeting.

To receive any apologies for absence.

An apology for absence was received from Karen Rampton, Borough of Poole.

Members are required to comply with the requirements of the Localism Act 2011 regarding discosable pecuniary interests and you should therefore:

·         Check if there is an item of business on this agenda in which you or a relevant person has a disclosable pecuniary interest.

·         Inform the Secretary of the Group in advance about your disclosable pecuniary interest and if necessary take advice.

·         Check that you have notified your interest to your own Council’s Monitoring Officer (in writing) and that it has been entered in your Council’s Register (if not this must be done within 28 days.

·         Disclose the interest at the meeting and in the absence of a dispensation to speak and/or vote, withdraw from any consideration of the item.

Each Council’s Register of Interests is available on their individual websites.

There were no declarations by members of disclosable pecuniary interests under the Code of Conduct.

To confirm the minutes of the meeting held on 6 June 2016 (attached).

Resolved

That the minutes of the meeting held on 6 June 2016 be confirmed and signed subject to two amendments in Minute 8:-

• Paragraph 3, replace ‘netter’ with better; and
• Paragraph 4, second bullet point amend to read ‘Prevention at Scale’.

Matter Arising

Minute12 – Questions

The Director of Public Health advised that the series of briefing notes would be prepared in readiness for the next meeting of the Board in November.

(a)       Public speaking

(b)          Petitions

There were no public questions or statements received and no requests to present petitions.

The receive the Joint Public Health Board’s Forward Plan.

The Board considered its Forward Plan, which identified key decisions to be taken by the Board at future meetings.

The Director of Public Health suggested additional topics for November, namely:

• More detailed discussion of commissioning intentions for drugs and alcohol, sexual health and health visiting & school nursing.
• The Director of Public Health annual report.
• Air pollution and its impact on health locally.
• Integrated community services part of the Sustainability Transformation Plan (STP).

Resolved

That the Forward Plan be agreed.

To receive a presentation from the Director of Public Health.

The Board received a presentation from the Director of Public Health, appended to these minutes for ease of reference.

The Director felt it would be helpful for members to have sight of the ‘outside world’ in respect of National and International Health.

Following a question from a member from Bournemouth Borough Council regarding the figures displayed in the communicable diseases section, the Director advised they were world-wide figures.

It was highlighted that the drivers for many communicable disease outbreaks were often changes in population & land use and ease of travel.

The Director highlighted the Childhood Obesity Strategy and questioned whether this needed to be accelerated locally. The Cabinet Member for Adult Social Care, Dorset County Council, felt it was important to get children doing things they used to do and not just participating in organised sport. 

The Chairman highlighted that the Dorset Physical Activity Strategy was due to be presented to the Dorset Health and Wellbeing Board at their next meeting on 9 November 2016.

Noted

To consider a report and receive a presentation by the Director for Public Health.

The Board received a report by the Director of Public Health which gave

members an update on the work to develop the Prevention at Scale (PAS) programme within the Sustainability and Transformation Plan (STP) for Dorset. 

The Assistant Director of Public Health, Bournemouth, summarised some of the work that had developed over the summer months. Officers were working to develop a common story of what prevention at scale would look like.

Included within the report was a presentation which described the context for closing the Health and Wellbeing gap and rationale for Prevention at Scale within the STP. It also illustrated the challenge in Dorset in regard to one of the agreed priorities; i.e. Diabetes and Cardiovascular disease (CVD), along with some ideas about how to move forward.

The differential performances across the County in the management of these conditions between localities and practices were highlighted and members felt that the Health and Wellbeing Boards needed to focus on this.

In response to a question from the Chairman the CCG were in discussions about the variations. In respect of the top performing practices, the Cabinet Member for Adult Social Care, Dorset County Council, questioned whether these practices were contacting patients to offer the services and therefore showing better figures.  The Director drew members’ attention to a slide which showed a significant number of people were undiagnosed and that an approach based on just finding cases would not be successful due to the scale of the challenge. He illustrated how significant savings might be made to both the NHS and Local Authorities if some of these variations were improved.

Following discussion, members agreed the recommendation as set out below.

Resolved

That the members of the Joint Public Health Board noted the variation between one area and another and that this be taken forward to the seminar on Prevention at Scale on 21 October 2016 and that it also be part of the Health and Wellbeing agenda.

To consider a report by the Director of Public Health.

The Board received a report by the Director of Public Health updating members on developments for Public Health Dorset’s business plan 2016-18 in the past quarter.

The Deputy Director of Public Health highlighted some key areas and noted that lengthy discussions had followed as result of a number of service reviews on drugs and alcohol which had now been agreed by the Pan-Dorset Drug and Alcohol Governance Board.

In respect of the NHS Health Checks programme, the Assistant Director confirmed that Boots provided most of the health checks for Poole, Purbeck, North Dorset and the three Bournemouth localities, the other areas of the County were provided by GPs.  There were clusters of GPs working together to provide this service on a locality basis.  The checks were offered on an open invitation process but it was found that the people who tended to take them up were from the low risk group.

The Assistant Director of Public Health updated members on the outbreak of measles locally, and advised that the numbers had stabilised and since May 2016 there had been 10 confirmed cases. She felt this was a good opportunity to remind parents and young people about their vaccination status.

Resolved

1. That members noted the progress made against the work plan priorities.

2. That the recommended set of treatment target groups, which would underpin the ongoing work to develop future service model options for drug and alcohol services be approved.

Reason for Decisions

To ensure the continued viability and effectiveness of Public Health Dorset in supporting the legal duty of local authorities in Dorset to improve the health and wellbeing of residents and reduce inequalities in health.

To consider a joint report by the Chief Financial Officer and the Director of Public Health.

The Board considered a joint report by the Chief Financial Officer and Director of Public Health which updated members on the forecast for 2016/17. This identified indicative savings of approximately £1.2m in 2016/17 and 2017/18 and a current reserve of £2.3m. It was highlighted that the reserve had been held to mitigate any risks arising from volatility in a) budget changes from the Department of Health (DoH) announced last year and b) cost and volume contracts. The report identified that there was much more stability in these areas and suggested it may be timely to consider redeploying some of these monies to priority areas better reflecting recent developments.

The priority areas which were prescribed by the DoH in the ring fenced grant were described and significantly how many of these were integral to the Prevention at Scale approach in the STP. It was suggested that the reserve in principle be moved to a PAS ‘account’ that would be enable projects to be developed by the respective Health and Wellbeing Boards to respond to the agreed STP plan. The Chairman reinforced that the monies were ringfenced and there were specific criteria where the monies could be spent.

Members from Bournemouth Borough Council advised that they had been given clear advice by their Section 151 Officer to reconsider these recommendations and to look to return the reserve to the respective authorities accounts.

The Vice-Chairman noted the advice from his Section 151 Officer was to have ultimate security of the money and for the reserve to go back to that authority (Borough of Poole). With regards to the in-year saving, he questioned whether that could be used for any business cases that came forward.

The Director advised that there were real challenges and risks in transferring monies back to general funds whilst reducing the funding of mandatory services many of which were provided by the NHS.  He indicated that this was an outline proposal about how we might best use the grant to address priority population health outcomes in line with DoH guidance on the use of the grant.

The Chairman felt that more clarity was needed; the Cabinet Member for Adult Social Care was concerned that other members had received advice from their Section 151 Officers and proposed that the Board accepted the first part of the recommendation but to then bring a report back to the November 2016 meeting following discussions with Section 151 Officers and others.

Cllr Greene from Bournemouth Borough Council seconded the proposal and noted that November 2016 would still be in time in terms of internal budget setting and agreed it would be important to get other partners involved and see what they could bring to the table. 

Resolved

That the current budget position be noted and that following discussion with Section 151 Officers a further report be considered at the meeting in November 2016.

Reason for Decision

Close monitoring of the budget position was an essential requirement to ensure that money and resources were used efficiently  ...  view the full minutes text for item 23.

To answer any questions received in writing by the Chief Executive by not later than 10.00am on Wednesday 14 September 2016.

No questions were asked by members under Standing Order 20(2).