Meeting documents

To receive any apologies for absence.  Members are encouraged to inform the clerk of the meeting of their apology for absence at the earliest convenience so that reserve member attendance can be sought.

Apologies for absence were received from Ben Ansell who was represented by Seth Why, Steve Butler who was represented by Andrew Kerby, Tim Goodson, Mike Harries, Jill Haynes, Helen Horsley who was represented by Paula Bennetts, Rebecca Kirk who was represented by Graham Duggan, Sarah Parker who was represented by Simon Fraiz-Brown, James Vaughan and Simone Yule.

Members are required to comply with the requirements of the Localism Act 2011 regarding disclosable pecuniary interests.

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

·         Check that the interest has been notified to the Monitoring Officer (in writing) and entered in the Register (if not this must be done on the form available from the clerk within 28 days).

·         Disclose the interest at the meeting (in accordance with the County Council’s Code of Conduct) and in the absence of a dispensation to speak and/or vote, withdraw from any consideration of the item.

The Register of Interests is available on Dorsetforyou.com and the list of disclosable pecuniary interests is set out on the reverse of the form.

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

To confirm and sign the minutes of the meeting held on 7 November 2018.

The minutes of the meeting held on 7 November 2018 were confirmed and signed.

Matter Arising

Minute 81 - Strategic planning for the future, including implications of the Integrated Care System and Local Government Reorganisation

This item was deferred at the last meeting and would now be considered after the forthcoming change to local government.

To receive any questions or statements by members of the public.

Public Speaking

There were no public questions, statements or petitions received at the meeting in accordance with Standing Order 21.

To consider a report by the Interim Transformation Lead for the Adult and Community Services, Dorset County Council.

The Board considered a report by the Interim Transformation Lead for the Adult and Community Service, Dorset County Council, which provided an update on Quarter 3 performance for the Better Care Fund.

Members were informed that the expected National Guidance on the Better Care Fund was still awaited.  Work with the Dorset Clinical Commissioning Group (CCG) was being undertaken to set out what would be delivered for 2019/20, which would be reported to the Board's June 2019 meeting.

In terms of the four key performance areas delayed discharges had improved but were not quite on track to meet the target; admission to residential and nursing homes was not quite on track and there was likely to be a further deterioration by the end of Quarter 4; reablement was on track; and performance for delayed transfers of care was the best performance ever in Dorset although there was still the potential for the target not to be met.  Overall performance had improved as a result of significant efforts made by staff but there was still the potential for targets not to be met.

The NHS representative reported that even though delayed discharge performance had improved, performance during the current quarter was double that experienced in December 2018.  Although steps had been taken to bring packages of care on line more quickly to reduce delays, consideration needed to be given to how performance could be made more consistent for the next financial year.  This and consistency of approach would be addressed through the joint working group consisting of providers, the NHS, the CCG and the local authority.

Members were keen to learn more about this group and closer working between health and social care.  They asked for a summary report on the group's achievements to be provided for the meeting in June 2019.

In view of the Fire Service's work in connection with vulnerable people, it was suggested that they be included in the membership of the Urgent Care Board and that they be included in Dorset County Hospital's discharge checklist.

Reference was also made to the need for closer working with South West Ambulance Service as they did not form part of the collaboration work with health and social care.  The Vice-Chairman would raise this at the Sustainability and Transformation Board.

Attention was drawn to a recent publication from Healthwatch Dorset on discharges     from hospital.  The learning from this exercise was transferable to other hospitals and the clerk was asked to forward details to members following the meeting.  Attention was also drawn to the role that the voluntary sector could play as a conduit in connecting organisations, services or seeking information or help.

Resolved

1.  That a summary report on the joint working group's achievements be provided for the meeting in June 2019.

2.   That the inclusion of the Dorset and Wiltshire Fire and Rescue Service in the membership of the Urgent Care Board be progressed by the Interim Transformation Lead for the Adult and Community Service, Dorset County Council,

3.  ...  view the full minutes text for item 5.

To consider the Dorset Safeguarding Adults Board Annual Report.

The Board considered the Dorset Safeguarding Adults Board Annual Report for 2017-18.

The Independent Chairman presented the report highlighting areas of particular interest to the Board, including joint training with the Community Safety Partnership and the Children's Board, the recent audit of Section 42 inquiries and actions being taken to ensure a more consistent approach to safeguarding, care sector concerns, increased cases of domestic abuse, safeguarding issues for rough sleepers, and alignment of work with the health and wellbeing strategy and prevention at scale.

Although there had been no contact with Dorset County Council's Safeguarding Overview and Scrutiny Committee to date the Chairman stated that this would need to be addressed as a priority for the new Dorset Council.

With regard to links to prevention at scale, safeguarding related to the work programme for keeping well and the Interim Director of Public Health would discuss this further outside of the meeting.

There was a need for better stakeholder involvement and the voluntary sector representative stated that she would be happy to exert pressure to enable this.

Noted

To consider a report by the Consultant in Public Health.

The Board considered a report by the Consultant in Public Health which provided an update on the Sustainability and Transformation Plan (STP), with a focus on Prevention at Scale (PAS).

Members recognised progress to date and the continuing need to better communicate the prevention at scale message and for the whole health and social care system to engage with it.

With regard to the recent Beat the Streets exercise, a six month follow up questionnaire was to be sent out to those who took part in order to gain information about any subsequent change in behaviours.  This would be reported to the Board's June 2019 meeting.

There was some discussion about children excluded from school or educated at home and how difficult it was to identify them, especially as there was no duty on parents to register children being taught at home.  It was also recognised that children out of school were more prone to health issues.

Resolved

1.   That the update on STP highlights and highlighted progress on prevention at scale; and to support ongoing work, within the Board and back in their respective organisations and communities be noted.

2.   That an update report on Beat the Streets be provided for the June 2019 meeting.

To receive the Board's Forward Work Plan.

The Board considered a report by the Director for Adult and Community Services, Dorset County Council, that updated members on the current Forward Plan for Board meetings and events.

The Chairman reminded members that they could add items to the Forward Plan by forwarding these to the Clerk and that actions could be undertaken outside of meetings.  An item on Safewise was to be added to the June 2019 meeting.

Resolved

That reports be provided for the June 2019 meeting as set out in minutes 5 and 7 and in the minute above.

Thanks

The Chairman explained that Healthwatch Dorset would no longer be provided this service with effect from 1 April 2019.  She thanked Mrs guy for her valuable contributions to the work of the Board and wished her well for the future.

The Chairman also thanked the Interim Transformation Lead for Adult and Community Services for her valuable contribution to the work of the Board, her work on health and social care integration and her prioritisation of partnership working.

The following dates have been identified for future meetings:-

Wednesday, 26 June 2019

Wednesday, 11 September 2019

Wednesday, 27 November 2019

Meetings will start at 2.00pm.  Venues have yet to be identified.

Members noted future dates for meetings as follows:-

Wednesday, 26 June 2019

Wednesday, 11 September 2019

Wednesday, 27 November 2019

In summing up, the following points emerged with regard to prevention at scale:-

·         the message was spreading

·         communities had a pivotal role to play

·         everyone had a part to play

·         members could spread the message through their organisations but the private sector should also be involved

·         the need to be able to measure change

·         patients were increasingly aware but it was too early to evidence changes

·         the county council was the biggest employer in Dorset and could influence the health of the population

·         that people's behaviour affected those around them

·         housing had a big effect on people's health and wellbeing

·         the need for all Council reports to have the section on health and wellbeing to be completed

·         the need for health and wellbeing to be embedded in everything Councils undertook