Venue: The Conference Room, Dorchester Fire Station, Peverell Avenue West, Poundbury, Dorchester DT1 3SU
Contact: Helen Whitby 01305 224187 - Email: helen.whitby@dorsetcouncil.gov.uk
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Election of Chairman To
elect a Chairman for the year 2019-20.
The Board's terms of reference state that the Chairman of the Health and
Wellbeing Board shall be appointed by Full Council unless Full Council
otherwise determines but the Full Council did not identify a Chairman when it
met on 16 May 2019. Minutes: Resolved That Councillor Rebecca Knox be elected Chairman for the year 2019/20. |
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Appointment of Vice-Chairman To
appoint a Vice-Chairman for the year 2019-20.
The Board's terms of reference state that the Vice-Chairman of the
Health and Wellbeing Board shall be appointed by Full Council unless Full
Council otherwise determines but the Full Council did not identify a
Vice-Chairman when it met on 16 May 2019. Minutes: Resolved That Forbes Watson be appointed Vice-Chairman for the year 2019/20. |
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Apologies To receive any apologies for absence. Minutes: Apologies for absence were received from Ben Ansell, Louise Bate, Julie Fielding, David Haines, Karen Kirkham, Patricia Miller, Sarah Parker, John Sellgren, Claire Shiels and James Vaughan. The Chairman welcomed Councillors Spencer Flower and Laura Miller, Mathew Kendal as Executive Director of People - Adults at Dorset Council, and Eugine Yafele, NHS Provider, to their first meeting of the Board. Members were also reminded of the importance of them completing a register of interest form in order to take a full part at Board meetings. |
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Terms of Reference and Membership To note the Board's Terms of Reference as follows:- (a)
The Health and Wellbeing Board shall be primarily responsible for: (i) the development and updating of a Joint
Strategic Needs Assessment, any Pharmaceutical Needs Assessment and the Better
Care Fund; (ii) assisting in the development and
overseeing of various other plans and strategies with relevance to health; (iii)
providing a link to and encouraging
integration and collaboration with and other key health stakeholders including
NHS England and any other health and wellbeing board; and (iv) ensuring that a patient/service user voice
is effectively heard in connection with relevant decisions. (b)
The Health and Wellbeing Board will consist of 18 persons made up of: (i) 3 Members (all of whom shall be
nominated by the Leader, of which 1 may be the Leader); (ii) 4 Officers made up of the Director
responsible for adult social services; the Director responsible for children’s
services, the Director responsible for public health and 1 other Officer with a
responsibility for the economy; (iii)
7 NHS representatives made up of 3
from Locality Executive Teams (GPs), 1 from the Dorset Clinical Commissioning
Group Board, the Clinical Commissioning Group Accountable Officer; 1 from NHS
England and 1 from the Local NHS Provider
Trust; and (iv) 4 others made up of 1 from the Local
Healthwatch organisation, 1 from the voluntary sector, a representative of the
Police and a representative of Dorset and Wiltshire Fire Authority. (c) The quorum of the Health and Wellbeing
Board shall be 5 persons at least 3 of whom are Members of the Council and/or
Officers of the Council. (d) There shall be power to appoint
substitutes for both Members and non-Members to the Health and Wellbeing Board.
A non-Member substitute must be from the same organisation as the non-Member. Appointment
of Chairman and Vice-Chairman The
Chairman and Vice-Chairman of the Health and Wellbeing Board shall be appointed
by Full Council unless Full Council otherwise determines. Meetings (a) The number of ordinary meetings of the
Health and Wellbeing Board each year will normally be six unless otherwise
determined by Full Council. (b) The Chairman of the Health and Wellbeing
Board shall have the power to call one or more special meeting(s) of the Health
and Wellbeing Board. (c) The Chairman of the Health and Wellbeing
Board may determine that a meeting should be cancelled for insufficient
business. (d) There shall be power to appoint substitutes
to the Health and Wellbeing Board. Delegated
powers and powers of recommendation of the Health and Wellbeing
Board (a) The Health and Wellbeing Board shall have
the powers as set out in Functions of the Council - Part 3(1) of the
Constitution. (b) For the avoidance of doubt the Health and
Wellbeing Board and any of its Sub-Committees can delegate any of their powers
to any Officer. Minutes: It was explained
that the Board's terms of reference had been embraced in the review of the new
Dorset Council and it had received strong support for its way of working in the
future. The Council could make minor
tweaks to the terms of reference but it was suggested
that the current arrangements be given time to bed in. Any suggested changes could be made via the
minutes and would be dealt with in due course.
It was suggested and agreed that in view of the Board's statutory role
in promoting integration and prevention that (a)(iii) be amended to reflect
this. Reference was made
to changes to locality arrangements and whether clinical directors and the new
primary care networks needed to be part of the Board's membership. The Board could consider this once the new
arrangements were in place. Recommended That the Board's
terms of reference be amended to reflect its statutory role in promoting
integration and prevention as set out above. |
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Declarations of Interest To receive any declarations of interest. Minutes: No declarations of disclosable pecuniary interests were made at the meeting. |
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Public Participation To receive questions or statements on the business of the
committee from town and parish councils and members of the public. Minutes: No statements or questions had been received from Town and Parish Councils or members of the public. |
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Better Care Fund - Report for Q4 2018/19 and Update on planning for 19/20 PDF 474 KB To consider a report by the Executive Director for People - Adults, Dorset Council. Minutes: The Board considered
a report by the Executive Director for People - Adults, Dorset Council, which
set out the performance of the previous Dorset Health and Wellbeing Board area against
the 2018/19 Better Care Fund (BCF) Plan and provided an update on planning for
2019/20 although final detailed national policy requirements had not yet been
published. Significant progress
had been made last year in a number of areas - development of a joint brokerage
function, alignment of budgets, joint quality approaches, successful
implementation of two joint frameworks with a spend of approximately £650m over
five years and joint provider market management. Plans for an integrated approach to place
shaping had also been progressed but further integration of commissioning
functions and the pooling of budgets had provided more of a challenge. For 2019/20 there were opportunities to take
forward integration through the refresh of the Integrated Care System and the
Sustainability and Transformation Plan (STP).
In summary, although improvements had been made in all areas targets had
not been met and work needed to continue to improve performance. With regard to
whether performance was going in the right direction, it was explained that
performance fluctuated over the year and final end of year figures are not yet
available.. Once they are it would be possible to compare Dorset's
performance to that of other areas and see whether Dorset mirrored national
trends. As the timetable for
completion of the BCF plan 2019/20 does not fit with Board meetings, a
delegation was sought to sign off the BCF plan outside of Board meetings. The Chairman added that, because of the
funding involved, she had previously consulted the appropriate Cabinet member
as part of the signing off process and intended to do the same this year. The Chief Operating
Officer of the Dorset Clinical Commissioning Group welcomed improved
performance with regard to delayed transfers of care. The investment in primary care had improved
patient flow, but peaks created pressure in the system and every part of the
health and care system had a part to play in trying to prevent pressure
building. Members noted that
work was continuing to prevent people being admitted to hospital in the first
place, one of the key aspects being housing and the need for more suitable
housing to be provided in order to prevent hospital admissions. Partners had a role to play in this. There was a brief
discussion about the need to be able to measure levels of activity and ongoing
work in primary care was noted. The
refresh of the STP also provided an opportunity to develop outcome measures
beyond the BCF metrics. Resolved 1. That authority is delegated by the Health and Wellbeing Board to the Chair of the Board and the Executive Director for People - Adults to agree Dorset's 19/20 Better Care Fund plan update. This is in order to ensure plans can be submitted in line with the national timetable if the deadlines, once published, do not align with scheduled Health and ... view the full minutes text for item 7. |
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To consider a report by the Public Health Senior Registrar. Minutes: The Board considered a report by the Public Health Senior
Registrar which provided an update on progress with the pan-Dorset Suicide
Prevention Plan. The National Suicide Prevention Plan had been refreshed in 2017. In 2018 the Dorset Clinical Commissioning Group had brought partners together to agree a way forward and develop their own action plans and this work had resulted in greater progress being made since April 2019. The plan included six key areas - reduce suicide in high risk groups, tailor approaches to improve mental health in specific groups, reduce access to means, postvention support, zero suicide ambition for mental health inpatient settings which was linked to the national strategy, and leadership. These areas would be addressed over the period of a year. Members noted that national data was now available and this would provide an opportunity to look at the micro level in Dorset. By September 2019 there would be a better understanding of Dorset's suicide rate and where resources should be focused. It was suggested that a further report on progress and future planning be provided in March 2020. In discussion the importance of links between education, health, children and young people and mental health services was highlighted as was the need for clarity about who had the lead role. It was hoped that putting mental health teams into schools would help linkages in future but there was a need for a more joined up approach across the whole system. In Dorset rurality and the large ex-military population provided a higher risk of suicide so early identification of risk and early access to support was important. One member drew particular attention to concerns in Weymouth and Portland about the lack of mental health service provision. Resolved That a further report on progress and future planning be provided in March 2020. |
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Sustainability Transformation Plans with a focus on Prevention at Scale PDF 1 MB To consider a report by the Consultant in Public Health. Minutes: The Board considered a report by the Consultant in Public
Health which provided an update on key highlights from across the
Sustainability and Transformation Plan as a whole and progress on prevention at
scale since the Board meeting held on 13 March 2019. The future importance of the Primary Care Network in the delivery of prevention at scale work was highlighted as were opportunities the two new councils might provide and progress with regard to the four programme areas (starting well, living well, ageing well and healthy places). In discussion members welcomed the fifty registered nurse
degree apprenticeships as a means of growing our own workforce; highlighted the
need for the Fire Service to be included in conversations relating to
vulnerable people in communities; the need for prevention at scale outcomes to
be measured; and social care opportunities to make linkages across the system.
Reference was also made to the fact that over 25,000 people had now used the
Livewell Dorset service. A reminder was given that not everyone had digital
access or was digitally capable, however there is a Dorset Council digital
inclusion project supporting people to build these skills, and it is less of a
barrier than people believe and not necessarily age related. Resolved 1. That the update on STP highlights and highlighted progress on prevention at scale be noted. 2. That the ongoing work be supported, within the Board and back in their respective organisations and communities. |
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Our Dorset and the Long-Term Plan To receive a
presentation by the Director of Organisational Development and Participation,
Dorset Healthcare, on the refresh of the Sustainability and Transformation Plan
(STP). All Integrated Care Systems and Sustainability and Transformation Partnerships
in England are required to develop a five-year plan to respond to the NHS Long
Term Plan which was published in January 2019. This provides a unique
opportunity to integrate the Corporate Plans of the two new Councils, Health
and Well-being Strategies and health strategies. By integrating our plans to
focus on addressing the wider determinants of health within our neighbourhoods
and reducing the inequalities that exist across Dorset, we will be better
placed to achieve our vision of improving the health and wellbeing outcomes of
residents of Dorset. Minutes: The Board received a
presentation from the Consultant in Public Health on Our Dorset and the Long
Term Plan. All Integrated Care Systems and Sustainability and Transformation Partnerships
in England were required to develop a five-year plan to respond to the NHS Long
Term Plan which was published in January 2019. This provided a unique
opportunity to integrate the Corporate Plans of the two new Councils and Health
and Wellbeing Strategies so as to focus on addressing the wider determinants of
health, reduce inequalities and improve outcomes for Dorset residents. The
Sustainability and Transformation Plan's (STP) key features, aims and vision
were explained. Engagement with staff,
stakeholders and the public would take place over the Summer 2019 with the
finalised plan being submitted in October 2019. Members noted that national template guidance was still awaited but
this would not change the timeline for submission of the STP. The first plan had been good but could be
improved so it was important for all partner organisations to consider,
contribute to and support the draft STP prior to its submission. A large engagement exercise was planned and
members were encouraged to look out for it. Noted |
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Annual Director of Public Health Report To receive a presentation by the Interim Director of Public
Health on the Annual Director of Public Health Report. The 2018/19 report
focuses on children and the work undertaken to prevent complex challenges to health,
including emotional health and wellbeing and obesity. Minutes: The Board received a presentation from the Interim Director
of Public Health on the Annual Report 2018/19. The Annual Report focused on children and identified a number of measures to give every child the best start in
life - smoking cessation in pregnancy, early help focus on the whole family,
doubling the number of schools signed up to the Daily Mile, the sharing of
intelligence to prevent exploitation and building on the mental health first
aid training approach. Members were
encouraged to read the report when it was published. Members commented that the Annual Report's message was
simple and made sense. It was suggested
that the daily mile should be promoted by communications to encourage more
schools to take part. It was also noted
that many schools were doing similar activities but
these were not necessarily recorded. Noted |
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Dorset Young Researchers Findings and Recommendations PDF 196 KB To consider a report by the Executive Director for People - Children, Dorset Council. Minutes: The Board considered a report by the Executive Director for
People - Children, Dorset Council, which provided a summary of key findings and
recommendations of the work of the Dorset Young Researchers which were relevant
to the work of the Board. The Assistant Director Schools and Learning explained that
Dorset Young Researchers had undertaken a survey of a large
number of young people. The
survey showed that 8% of those surveyed felt they had mental health issues,
that a lack of confidence seemed to underpin everything
and young people thought there was a lack of safe places. The findings would inform Children's Services
future actions and decisions. The Board
were then shown a video of the results of the survey. Members were interested to see the results and in particular that young people did not want emotional
wellbeing support through schools but rather from their families. The Chairman asked that the video be presented to Dorset
Council's People Overview Committee. Resolved That the video be presentation to Dorset Council's People Overview Committee. |
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Beat the Street To receive a presentation by Intelligent Health on Beat the Street, a programme which was held in three localities across Dorset (Purbeck, Weymouth and Portland, and Poole) with the aim to improve the health and wellbeing by getting people of all ages moving. Minutes: The Board received a presentation from Marc Harris of
Intelligent Health on Beat the Street, a programme held in Purbeck and Poole
and Weymouth and Portland with the aim of improving health and wellbeing by
getting people of all ages moving. The presentation showed the Beat the Street methodology, how
it addressed health inequalities, results with regard to adult behaviour change
post game and after six months, participation by children, their behaviour
change, reducing anxiety levels and qualitative insight information. A further
survey would be undertaken after 12 months and members were invited to submit
questions to be included in this. One member explained that schools in the Purbeck area had
very limited time in which to take part and this may have been reflected in the
results. The Assistant
Director of Public Health added that Public Health had wanted to be part of
Sport England's evaluation of whether Beat the Street was successful. The programme focussed on the South West of
England and the East Midlands. It had
created a lot of competition between schools and parents at the time. The follow up reports after the game had been
particularly interesting as were the experiences reported by the participants
at the presentation evenings. Mr Harris explained
that a further survey of participants would be undertaken after 12 months and
this would show any significant shifts in physical activity. In areas of deprivation, a stronger shift in
physical activity might be seen. He was
happy to share anonymous data and help with analysis. The slides would be circulated to Board
members. Noted |
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To consider the Board's work programme. Minutes: The Board considered its work programme. Noted |