Meeting documents

Having received the Public Health Dorset Monitoring Report, based on the Business Plan for 2018/19, at its September meeting and endorsing the approach being taken, the Board asked that trend data be included with future reports so as to have a more meaningful understanding of what improvements or otherwise were being made. The report had subsequently been updated on performance for Quarter 2 on that basis.

The report also highlighted national work underway in providing more publicly available information resources that could be used to compare local authority public health delivery.

The Board were pleased to see that direction of travel was now indicted for each activity so that improvements being made, or otherwise, could be readily identified. In observing how services were being delivered, particular mention was made of the way in which progress was being seen to be made in the delivery of health checks and the means by which this was being done, in the collaborative approach between General Practices and pharmacies, with each having an essential part to play.

In line with sentiments recently expressed by the newly appointed Health Secretary, the Rt Hon Matt Hancock MP, that "prevention was better than cure", Public Health Dorset was looking to see that this might be reflected in the receipt of the necessary funding going forward to ensure the work being done remained sustainable, particularly in terms of supporting the cessation of smoking and efforts being done in this regard. It was commonly acknowledged that the advent of vaping devices had contributed significantly to those trends being achieved. 

The Board considered a report by the Acting Director of Public Health summarising the findings by the Joint Public Health Board Task and Finish Group on the future of the Public Health Dorset Partnership. There was wholesale agreement amongst that Group about the successes and achievements of the Partnership to date and future areas for improvement. The report identified some key development areas arising from the Task and Finish Group’s findings, and presented recommendations from the moderation meeting as to how the Partnership should evolve under Local Government Reorganisation (LGR).

The Task and Fishing Group’s findings were that:-

·        the delivery of Public Health as a shared service was being well managed and performing well,

·        how services had been commissioned had improved significantly by those arrangements,

·        key strengths included leadership and particularly the work to embed prevention within the Sustainability and Transformation Plans. The benefits of operating the shared service at scale, pan-Dorset, were emphasised too, and

·        future development should include understanding the importance of public health to the future success of the wider business of Councils and the NHS.

Members understood that collaboration with the Task and Finish Group on devising a clear set of proposals on how the Board should operate post LGR was necessary in order to better differentiate it from the work of the two Health and Wellbeing Boards. The Board understood what this entailed and the means by which it would be delivered, agreeing that any work should ensure regular representation from the Dorset Clinical Commissioning Group (CCG) and in exploring the potential for the future joint appointment of the substantive Director of Public Health between the CCG and the Dorset councils. The Board noted that the Joint Public Health Board should focus more on governance and accountability for the delivery of public health services, and the use of the Grant. This would make the Health and Wellbeing Board’ strategic role in improving health and wellbeing clearer.

The Board recognised that it was critical that members of the two new councils had a fundamental understanding of what Public Health Dorset did and what its work entailed. As mentioned at the previous meeting, the opportunity should be given for an

improvement and enhancement of public health activities, in that there was a need

to expand accessibility to other councillors about what the Partnership did and how it

operated. This could be better achieved by ensuring that any future report included

reference to a public health impact assessment, which would draw attention to the

integral part public health played in each and every service. Members of the Board considered they had a part to play in conveying this message as best they could.

Moreover, it was still to be determined what model of governance should be adopted for the Board and the new councils would have a part to play in determining this. 

 The Board understood that contracts for a range of Community  Health Improvement Services (CHIS) were due to expire at the end of March 2019. Given this, a series of options had been considered to determine which procurement model would best suit the needs of the CHIS in order to maximise efficiency and effectiveness of the services, with agreement of the Board being sought to progress arrangements on that basis.

The Board were informed of the background and rationale for what was being done; what options there were; the Framework Model and how this had been devised; risk and mitigation plans; budgets and timelines and what the preferred procurement option was. The Board were also being asked to agree to procure and award following successful completion of tender.

The Board acknowledged that the preferred option - Option 4: Any Qualified Provider (AQP) under an agreed framework - meant that any provider could deliver the service - provided they met specific criteria - and would be paid according to activity. This model would offer a high level of efficiency, as it was a simple process, developed as a single framework with all six lots being included, being open to any qualified provider, and placed the power in the hands of the end user to access services where they chose.

The Board recognised the need for flexibility in the delivery of these services and the choice this would give service users provided for equity, efficiency and effectiveness in meeting those needs. It would provide for a pool of assets being made available to ensure that there was the greatest opportunity for take up as necessary.

The benefits of Option 4 were readily understandable to members and, given this, they were minded to support this means of procurement, as being both sustainable and reasonable. However the new arrangements would not necessarily provide such scope for accountability as those currently did. Nevertheless, there was an expectation that there would be a good prospect of collective responsibility by potential service providers in seeing that what was being done would be for the good of their communities.

The Board were keen to see that, if at all practicable, an assessment could be made of how successful interventions and activities were in meeting the needs of individuals and in delivering what was hoped for from the Public Health agenda.  Officers were satisfied that there were means by which this could be successfully demonstrated and work was progressing to ensure this could be the case.

Whilst there was no national register for the purposes of recording who had been offered interventions, what the take up rates were nor what the outcomes from this were, there appeared to be some scope for outcomes from interventions to be recorded on the Dorset Care record given that GP surgeries had that information available to them but there was a need for this to be securely and rationally managed.

The board considered that the procurement exercise had taken ito consideration all that it  ...  view the full minutes text for item 53.

 The Board were provided a high-level summary of performance for LiveWell Dorset, smoking cessation, weight management services, health checks and children and young people performance, with supporting data in the report’s appendices.

The Board were pleased to see the decrease in the levels of smoking seemingly evident and acknowledged that the advent of vaping devices might well being playing some part in that decrease being seen.

The Board were satisfied with what was being achieved and the means by which it was being done.