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 Jane Kelly be elected Chairman for the meeting.

To appoint a Vice–Chairman for the meeting.

Resolved

That Councillor Rebecca Knox be appointed Vice-Chairman for the meeting.

To receive any apologies for absence.

Apologies for absence were received from Councillors Nicola Greene (Bournemouth Borough Council),  Karen Rampton (Borough of Poole), Dr David Phillips (Director of Public Health), Jane Portman (Executive Director Adult and Children's Services, Bournemouth Borough Council) and Steve Hedges (Group Finance Manager, Dorset County Council).

In hearing that the Director was currently in poor health, the Board asked that their best wishes be made known to him for a speedy recovery.  

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 interest under the Code of Conduct.

To confirm the minutes of the meeting held on 21 November 2016 (attached).

The minutes of the meeting held on 21 November 2016 were confirmed and signed.

Matter arising - Air Pollution

Arising from minute 35, the Board asked that a briefing note be made available to the 3 constituent councils on the research undertaken into air quality and pollution and what perceived effect this had on public health. This could in turn help shape future town centre planning considerations.

Public speaking

To consider any public questions and/or public statements or requests for public speaking in accordance with standing Order 21(2).

There were no public questions received at the meeting in accordance with Standing Order 21(1).

There were no public statements received at the meeting in accordance with Standing Order 21(2).

The Board’s Forward Plan identifies Key Decisions to be taken by the Board and items that are planned to be considered in a private part of the meeting. The current Forward Plan was published on 6 January 2017 and includes items that will be considered either on or following the Board’s meeting on 6 February 2017 (attached).The next Forward Plan will include items to be considered on or following the Board meeting on Monday 5 June 2017 and will be published on 5 May 2017 and what is due to be considered at that meeting is indicated too.

The Joint Board considered its draft Forward Plan, which identified key decisions to be taken by the Joint Board and items planned to be considered during 2017, which had been published on 6 January 2017.

Noted

To consider a report by the Director of Public Health (attached) and to take the opportunity to discuss the future of Public Health in Dorset and how it might be best delivered – (30 minutes scheduled).

The Board considered a report by the Director of Public Health proposing a future focus for the work of Public Health Dorset given budget uncertainties, the requirement to deliver Prevention at Scale and integration as part of the Sustainability and Transformation Plan (STP). Given this, changing the format of future JPHB meetings to incorporate a ‘Part 2’ - to function as an Advisory Board for Prevention at Scale - was being recommended.

The Board was informed that the reasoning for this proposed approach was to ensure that Public Health Dorset continued to focus its work in support of the wider

health and care system challenges, including the delivery of Prevention at Scale and

associated STP programmes. It was also designed to complement the Local Government Reform process as discussions continued on how best to deliver place-based improvements to health and wellbeing through the STP.

It was envisaged that the proposed changes to how the Board operated would support parallel recommendations going to each Health and Wellbeing Board (HWB), which recommended that they start to function as local delivery boards for Prevention at Scale and other STP programmes.

Integral to the success of the future Health and Wellbeing Board arrangements was a emphasis being placed on prevention - so that there would be a lesser need for, or reliance on, clinical care - and integration – with public health and social care both playing a part in how interventions were made and in a coordinated and complementary way. The Board recognised the benefits to be gained for health care and social care integration.

Operating the Joint Public Health Board as a Prevention at Scale Advisory Board was considered to be beneficial in delivering the necessary changes and the Board acknowledged the reasoning for the way in which arrangements for future meetings were now being proposed and that the JPHB had a fundamental and important part to play in setting the scene and influencing the direction in which the two H&WBs might go. Members considered this to be a pragmatic and practical means of addressing the issues and challenges which lay ahead. However, in order for the Board to be able to be seen to be playing its full part in contributing to the process and, particularly, to the work of the H&WBs, there was a need for its role to be on a more formal footing, as an integral component of how the H&WB’s were run. 

In order that CCG’s were made aware of this approach the Vice-Chairman intended to made the Chairperson of the Dorset CCG, Dr Forbes Watson, aware of this direct and the Deputy Director of Public Health agreed that further would be undertaken in carrying out the Board’s considerations, with Phil Richardson, Director of Transformation at the CCG. In order to help in the better understanding of the relationship between health bodies, a diagram would be provided for this purpose.    

Resolved

That the internal re-focusing of Public Health Dorset to meet the requirements of  ...  view the full minutes text for item 8.

To consider a report by the Chief Financial Officer and the Director for Public Health (attached) – (10 minutes scheduled).

The Board considered a joint report by the Chief Financial Officer and Director of Public Health which updated on the outturn forecast for 2016/17, which currently stood at £1.377m underspent. However, potential volatility of around £100,000 remained. The draft revenue estimate for Public Health Dorset in 2017/18 was £28.51m. The sums to be borne by each partner under cost sharing arrangements were set out in Appendix 2 of the report .The basis for the budget was explained in the report and officers outlined how public health funding was allocated and what this spending was designed to achieve. The Board understood the arrangements for how the funding was to be allocated in order to deliver the relevant services, together with the part each constituent authority partner played in the process.

The report explained the main drivers and factors influencing the estimates and the opportunities that there might be to redistribute the underspend in the budget to support early years and health protection. 

Councillors understood the need to achieve further significant savings during 2017/18 and beyond as a consequence of the funding allocation and the implications of Local Government Reform.

Recommendation

That the draft estimates for 2017/18 be endorsed by the three partner constituent authorities.

Reason for Recommendation

Close monitoring of the budget position was an essential requirement to ensure that money and resources are used efficiently and effectively.

To receive a PowerPoint presentation from Sam Crowe, Deputy Director of Public Health (attached)– (20 minutes scheduled).

The Board received a visual presentation from Sam Crowe, Deputy Director of Public Health, on development projects within Public Health, covering:-

• The growing voluntary sector involvement in the Primary Care project -  How a network of Practice champions could play their part in community development, this being designed to contribute towards what services general practice were able to provide to deal with demand by better understanding what mattered to people to help them with their care and support. The importance of the voluntary sector within patient and public engagement was recognised and how this approach would help ease the pressure on GP’s and the practices they ran. Person and Community centred approaches to health were seen to be a practical solution to the demand being faced by GP’s and it was anticipated that this positive step would be appreciated by GPs in providing for maintaining a sustainable system of care.
• Prevention at Scale and the Dorset STP – Designed to recognise the importance of preventative work in addressing public health issues at an early stage before there was a need for the intervention of clinical and acute services. The Board’ s attention was drawn to NHS England’s principles for new models of care and what these entailed and were designed to achieve.  

The Board recognised the part that volunteers played was critical to the success of the delivery of care. Members highlighted the importance of not diluting the current pool of volunteers identified for other activities. They recognised existing schemes in Dorset such as care navigators within adult care, as a means of integrating social care and clinical care provision in a coordinated and complementary approach. There was need to take this into consideration for commissioning issues for Adult Social Care and that the work being done by Dorset Partnership for Older People Programme (PoPPs) could be aligned with this. They considered that it was in the interests of all for this approach to be successful and that all parties should play their part in ensuring this was the case. It was anticipated that all participating practices could be encouraged to embrace this and realise its value. 

The Board endorsed the approach being taken and would watch with interest the progress being made. More information would be circulated in due course.

Members thanked Mr Crowe for this useful insight into what was being done within the Service.

Noted

To answer any questions received in writing by the Chief Executive by not later than 10.00am on Wednesday 1 February 2017.

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

Resolved

That under Section 100(A)(4) of the Local Government Act 1972 the public be excluded from the meeting for the business specified in minute 17 because it was likely that if members of the public were present there would be a disclosure to them of exempt information as defined in paragraphs 1, 3 and 4 of Part 1 of Schedule 12A of the Act and the public interest in withholding the information outweighed the public interest in disclosing that information.

To consider a report by the Director for Public Health (attached) – Not for publication - (15 minutes scheduled).

The Board considered a report by the Director of Public Health which summarised commissioning model arrangements for Health Visiting and School Nursing and what these entailed. The report set out the service transformation timelines and outlined  three possible future commissioning options – with Option 3 being the preferred option. What the role of the school nurse entailed was outlined and the need for any commissioning arrangements to take this into account were acknowledged. 

It was felt that Option 3 was, on balance, the most appropriate option as it provided the means for flexibility and scope in addressing the necessary responsibilities and in a pragmatic way. The Integration of Health and Social Care was fundamental to any successful commissioning arrangements. Consideration was given to how the nursing arrangements should be described, with "Children’s Nursing" considered to be more appropriate terminology.

Resolved

That further scoping work on Option 3 be approved as a means of delivering a sustainable service.

Reason for decision

To ensure that the health visiting and school nursing arrangements were fit for purpose and designed to be sustainable.

To consider a report by the Director for Public Health (attached)) – Not for publication - (15 minutes scheduled).

The Board considered a report by the Director of Public Health which described the proposed collaborative approach for recommissioning the Drugs and Alcohol Services across Bournemouth, Dorset and Poole to meet the changing needs, demands and commissioning priorities of the three local authorities in a more focused way.

The Assistant Director of Public Health explained what the Plan entailed, the rationale for recommissioning and the proposed procurement model. The proposals were designed to achieve efficiencies, maintain effectiveness and deliver equity of service provision across the geographic County. Emphasis was now being placed on addressing integrated services and how these were best applied, so that all needs of an individual could be met at one source and in one appointment, if practical.

The report contained proposed arrangements for the way in which the provision of services for Christchurch should be progressed and the Board considered this to be the right approach.

The Board noted what progress had been made with the Drug and Alcohol Programme and considered that these new commissioning arrangements would provide the means for the Service to be managed in a sustainable way and meet the needs of those it was designed to assist.

Resolved

1.            That the commencement of the commissioning process, as set out in the Director’s report, be approved.

2.            That the proposed approach for the provision of services in Christchurch be approved.

Reason for Decisions

To achieve efficiencies, maintain effectiveness and deliver equity of service provision.