Agenda and minutes

To elect a Chairman for the meeting from the Dorset Council representatives.

Resolved

That Councillor Laura Miller be elected Chairman for the meeting.

To appoint a Vice-Chairman for the meeting from the BCP representatives.

Resolved

That Councillor Lesley Dedman be appointed Vice-Chairman for the meeting.

To receive any apologies for absence.

No apologies for absence from Members were received at the meeting. Apologies for absence were received from Jan Thurgood (BCP) and Vanessa Read (Dorset CCG).

To confirm the minutes of the meeting held on 3 February 2020.

Resolved

The minutes of the meeting held on 3 February 2020 were confirmed and

would be signed at the earliest opportunity.

To receive any declarations of interest.

No declarations of disclosable pecuniary interests were made at the meeting.

To receive questions or statements on the business of the committee from town and parish councils and members of the public.

No statements and questions from Town and Parish Councils or public statements or questions were received at the meeting.

To receive and consider the latest Forward Plan.

The Board’s Forward Plan was noted and, what was due to be considered

over the coming months, accepted.

To consider a verbal report by the Director of Public Health

The Director of Public Health took the opportunity to inform the Board of what had been done by Public Health Dorset (PHD) - in partnership with other heath bodies GP’s; Dorset Clinical Commissioning Group; the NHS, emergency services; and Dorset and BCP Councils - to address and manage the Coronavirus pandemic within Dorset over recent months.

The Board were given a presentation illustrating the local outbreak management plan, how it was being applied and managed and what was being done in practice, along with other associated information pertaining to the pandemic, to put what PHD was doing – and had done - in some context, this being:-

National context

•        Northern metropolitan areas and cities hit hardest

•        Low number of cases in BCP Council area and Dorset Council area

•        Impact of COVID-19 bigger in areas with higher multiple deprivation

•        BAME groups more at risk of poor outcomes, obesity, diabetes, age, male gender and occupation also key risks, as is poverty

•        Enhanced surveillance is key over the next few weeks

•        Planning for winter, and return of COVID-19 with potential for seasonal influenza also hitting hard

•        Care homes continue to be setting of highest concern nationally

Outbreak management

•        Local outbreak plans will be our first line of defence against going back to national lockdown

•        Developing key actions for high risk settings through COVID-19 Health Protection Board

•        Health and Wellbeing Board in each Council functions as Local outbreak Engagement Board

•        Relationships built during crisis and first wave will stand us in good stead if we need to respond quickly

•        Capacity planning, scaling testing quickly, good, clear communications and engagement all key actions for an effective plan

•        Supported by Test and Trace Grant in each council, worth £1.28M and £1.8M

Outbreak Management Plans

1. Level 1 (BAU) – day to day outbreak response in specific settings – plus preventive and preparatory activities, training, action cards, communications
2. Level 2 – where local outbreaks have potential for wider spread into the community requiring additional community engagement, possible LRF involvement and extra resources
3. Level 3 – local outbreak with national significance – most likely to be sustained rise in community cases that exceeds a number of triggers, including testing positivity rate >5%, 7-day case incidence rate of >50 per 100,000 pop

Next Steps

•        Regional and local assurance on readiness of plans – exercising, action cards, resourcing and capacity plan

•        Re-shaping Public Health Dorset business plan and re-prioritising into two workstreams – recovery (BAU) and response (outbreak preparedness and response)

•        Capacity and resourcing within team feels about right – short term investments in modelling capability, backfill for Environmental Health Officer support, community and voluntary sector response to support self-isolating, IPC training, testing

Given the unprecedented circumstances in having to deal with such a pandemic, it was a seen to be a credit to PHD in how this ad been managed and as a consequence how relatively successful it had proven to be. Relatively low  ...  view the full minutes text for item 46.

To consider a verbal report by the Director of Public Health

The Board considered a summary on progress with renewing the 2013 partnership agreement for Public Health Dorset, how this would be applied

and what this entailed.

Progress made, and that which was due to be made, included:-

•        renewed Terms of Reference for JPHB to make a clearer delineation from work of Health and Wellbeing Boards – post LGR

•        refreshed Partnership agreement had been developed in conjunction with legal services in each Council

•        was due for agreement at the Board before COVID-19 intervened

•        scheduled to come back to the Board – and proposed to be agreed formally - at the next meeting in November

•        minor amendment to wording being made so that an annual review of the Board’s effectiveness is built in and provided for.

The Board were acceptant of what was being proposed, and the reasons for this, and looked forward to assessing the provisions of the Partnership agreement next time, anticipating a positive outcome to benefit what Public Health Dorset was able to continue to offer.

Resolved

That the progress made, being made and how this was proposed to be done - towards renewing the partnership agreement for the Shared Service - be noted, accepted and endorsed.

Reason for Decision

To ensure that progress with renewing the partnership agreement for the Public Health Shared Service was in the best interests of all that Public Health Dorset had to offer.

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

The Board received an update on the use of each Council’s grant for public health, including the budget for the shared service, Public Health Dorset, and the other elements of grant used within each Council outside of the public health shared service. The report described how the funding was being applied and to what services and in what proportion.

Of note was:-

·       the final 19/20 outturn for the shared service budget, being an underspend of £170k.

·       following the Spending Round 2019 announcement of a real terms uplift, details of local authority allocations had been published on 17 March 2020.

·       agreed contributions to the shared service budget for Public Health Dorset in 2020/21 give a revenue budget of £28.748M, based on an indicative Grant Allocation of £33.838M.

·       Dorset Council retained £617k and BCP £4.472M of their respective 20/21 ring-fenced grants.

·       recognised underlying cost pressures, for example in drugs and alcohol, had been met through savings in other areas to date. With COVID-19 it was unclear to what extent this could continue. COVID-19 has also highlighted additional cost-pressures within public health services and for the system. These cost pressures would be met within the uplift to the shared service budget, without making a call on MHCLG additional COVID-19 funding. Tentative initial forecast outturn was therefore a £177k underspend

·       work on local outbreak management plans in response to the next phase of COVID-19 began during June. Additional DHSC funding had been allocated nationally to support these plans. Resource and capacity plans would be developed through the COVID-19 Health Protection Board, chaired by the Director of Public Health, overseen by each Health and Wellbeing Board.

·       reserves stood at £617k for Prevention at Scale and £293k uncommitted funds.

Given all that had happened with attention being given to the pandemic, it was acknowledged that there would now be a need to re-evaluate the Prevention at Scale initiative, to ensure that the investments being made in it met practical need and the importance of embedding the principles of PAS in the transformation strategies of each Council was understood.

How there came to be underspend in the budget was explained, in that whilst contractual arrangements with those services commissioned were more readily able to be determined, the budgets of the 2 councils were not so readily distinct being based more on necessity, demand and allocation . The Board had the authority to scrutinise how monies were being spent and this was a fundamental part of their terms of reference. Moreover the Section 151 Officer had the ability to scrutinise how the grant was being used, in ensuring the correct criteria was met.

Nevertheless, there was little room for manoeuvre in allocations made, with savings needing to be made, and it being prudent that reserves were built up because of recommissioning needs and re-procurement: essentially reserves were there to ensure flexibility.

For some assurance it was confirmed that the Board had the opportunity to consider documents in advance of any new tender - to ensure the business case  ...  view the full minutes text for item 48.

To consider a report by the Director of Public Health

The Board were asked to consider an extension to the three community substance misuse contracts held by Public Health Dorset which were due to expire at the end of October 2020, with them being able to be extended by up to 2 further years. There was seen to be a critical need for continuity in how the interventions and treatments beneficial to drug and alcohol dependencies could be managed effectively and what Public Health Dorset was able to do in providing for this.

It was acknowledged that performance in the Dorset Council area was progressing well, with a mature local partnership and identified areas for improvement. Accordingly, it was now being recommended that the contract for the REACH service be extended for the full two years, available to the end of October 2022. Whilst provision across BCP, inherited from the previous councils, was inequitable, with different approaches, service designs and funding per head, and commissioned by both BCP Council and Public Health Dorset, it was now being recommended that a single commissioning strategy be developed for BCP as a whole, to ensure equity and efficiency, with one organisation responsible for all relevant services. Commissioners advise that at least 12 months should be allocated for a full process of review and recommissioning.

It was therefore recommended that the contracts for services in BCP held by AWP and EDAS be extended for one year, to the end of October 2021, with the expectation that a new service (or services)would be commissioned by either one of BCP Council or Public Health Dorset in the interim.

Whilst the rebalancing of responsibilities and resources in ensuring a safe, effective and equitable service across the Council area was a priority- and seen to be essential for the treatment initiative – in BCP this was unable to be done within the constraints of the current contractual arrangements, so re-commissioning was therefore required.

As such given the inequity in resource and service provision between different areas in BCP, it was a priority that a consistent approach be developed and implemented for both young people and adults and a re-commissioning of the contracts would provide for this. Although a 12 month period was designed to initiate proceedings to determine how satisfactory the arrangements were, there would then be the opportunity to extend for a further one year.

The Board understood the need for the arrangements to be harmonised across the three BCP towns to meet their particular needs and looked forward to making a meaningful contribution in deciding how his would be achieved.

With options limited, what progress was being made on where the service could be best delivered was explained and members were hopeful this could be satisfactorily resolved in the near future. Members made some suggestion from their own knowledge of options and officers agreed to investigate these, it being acknowledged that homelessness, mental health and substance dependencies were invariably conjoined and there interventions should be harmonised. It was agreed that the respective Health and Social  ...  view the full minutes text for item 49.

To consider a report by the Director of Public Health

The Board was being asked to assess the arrangements for a range of LiveWell Dorset IT and digital service contracts which were due to expire on 31 March2021. These included:-

·       provision of IT equipment, infrastructure and support

·       LiveWell Dorset digital platform

·       LiveWell Dorset Customer Relationship Management system.

A comprehensive options appraisal process was underway to select the most appropriate sourcing model for the services in scope, including in-sourcing and commissioning options. A shortlisting process had been completed based on viability, timescales and business needs. Options involving the in-sourcing of the digital platform and CRM aspects had not been shortlisted due to an inability to meet the gateway criteria. As such, a procurement exercise was likely to be required for these services, whilst it remained feasible to consider Dorset Council IT services to provide equipment, infrastructure and support.

The options appraisal process was shown in detail, including an Appendix which highlights the longlist, shortlisting process and shortlisted options. Once a preferred option had been selected based on this process, a more detailed sourcing plan, including precise budget, would be developed. The Board was being asked to approve the progression of this preferred option based on the information in the report.

Given that it was not possible to shortlist any options that involve the in-sourcing of the digital platform and CRM. Given what was necessary to be able to deliver this, a procurement exercise for these aspects was expected, to determined whether the IT infrastructure could be in-sourced or had to be commissioned. The precise budget and procurement model will be defined based on the chosen option, further market engagement and other strategic factors. With the approval mechanisms within Public Health Dorset for doing this explained For now, approval was being sought from the Board to progress with the preferred option, including any procurement activity this might require, once the necessary approvals had been made. An update on the chosen option would be provided at the November Joint Public Health Board meeting.

The Director of Public Health considered there to be a need for continuity in this initiative so that the good work achieved continued to be maintained and it was necessary to do this now to ensure this was the case.

Members understood the reasons for this and appreciated what LiveWell had achieved so far and wanted to see this being maintained, and enhanced, where practicable. Given this, they wholeheartedly endorsed what was being proposed as it was appropriate and acceptable in the circumstances.

Resolved

1)That having been reviewed, the sourcing plan outlined in the background paper, noting the strategic context, objectives and shortlisting of options be approved.

2)That Delegated authority be given to the Director of Public Health, in consultation with the Portfolio Holders, to award any contracts required by the sourcing plan to appropriate providers on the best terms achievable and within the budget.

Reason for Decision

The LiveWell Dorset IT and digital service contracts are due to terminate on 31st March 2021. An options appraisal is underway to  ...  view the full minutes text for item 50.

To consider any items of business which the Chairman has had prior notification and considers to be urgent pursuant to section 100B (4) b) of the Local Government Act 1972. The reason for the urgency shall be recorded in the minutes.

There were no urgent items for consideration at the meeting.