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Agenda and minutes

Venue: Town Hall, Sheffield S1 2HH

Contact: Jason Dietsch, Democratic Services  Email: jason.dietsch@sheffield.gov.uk

Items
No. Item

1.

Apologies for Absence

Minutes:

 

Apologies were received from Jayne Ludlam, Dr Zak McMurray, John Mothersole, Professor Chris Newman and Judy Robinson. Margaret Kilner, Sheffield Healthwatch, attended as the appointed deputy in place of Judy Robinson.

 

 

 

2.

Declarations of Interest pdf icon PDF 88 KB

Members to declare any interests they have in the business to be considered at the meeting.

Minutes:

 

There were no declarations of interest from members of the Health and Wellbeing Board.

 

 

 

3.

Public Questions

To receive any questions from members of the public.

Minutes:

 

There were no questions received from members of the public.

 

 

 

4.

Sheffield's 2017/18 and 18/19 Draft Better Care Fund Narrative Submission pdf icon PDF 217 KB

A joint report of the Executive Director People Services, Sheffield City Council and the Chief Officer, NHS Sheffield Clinical Commissioning Group.

Additional documents:

Minutes:

 

The Board considered a joint report of the Executive Director Communities (now People Services), Sheffield City Council and the Chief Officer, NHS Sheffield Clinical Commissioning Group (CCG). Peter Moore, the Director of Strategy and Integration, Sheffield Clinical Commissioning Group introduced the report together with Rachel Dillon, Sheffield CCG.

 

 

 

The CCG and City Council were required to submit a plan for 2017-2019 to describe plans and targets by 11 September. The Health and Wellbeing Board would need to approve the narrative plan for Sheffield’s Better Care Fund 2017/18 and 2018/19.

 

 

 

The Board was informed that the Better Care Fund was key to bringing about parts of the transformation the NHS, the Local Authority and local communities and was linked to public sector reform, place based plans and the Shaping Sheffield plan. There were challenges both at national and local level which related to Sustainability and Transformation Plans and integration. Nonetheless, Sheffield had remained clear to its outcomes. There had also been successes, including a pooled mental health budget, a pooled budget for equipment, the building of stronger relationships and the delivery of care through the development of community partnerships.   The adoption of a neighbourhood model would mean that care could be delivered by groups of clinical and social care teams and allow earlier intervention and prevention and early diagnosis.

 

 

 

There were challenges around provider integration and the involvement of providers. There was also enabling work to be done in relation to infrastructure such as ICT. The financial position was also challenging and the Board had to be mindful of that and an example of a positive response was the planning of a pooled budget for mental health services. Sheffield was to receive an additional £24m non-recurrent funding in total over 3 years to spend on adult social care services. It was intended to progress the inclusion of provision for Children and Young People into the pooled budget from April 2018. There was also a plan relating to reducing delayed transfers of care out of hospital and in relation to management and governance. The ambition was to move to a more fully integrated system.

 

 

 

Members of the Board were asked to consider whether they were satisfied that the plans would progress the Board’s ambition to transform the health and care landscape, reduce health inequalities and deliver better outcomes for Sheffield people; and to identify where there might be further opportunities for integration and joint working, in particular reference to commissioners and providers working together as an Accountable Care Partnership.

 

 

 

Members of the Board asked questions and commented on the issues and the comments and responses are summarised below:

 

 

 

It was hoped that with a less fragmented approach to commissioning of health and social care, there would also be less fragmented provision. The challenge was to use the existing resources more efficiently and not a reduction in the overall amount spent. There were some interventions, such as social prescribing, which provided benefit in other parts of the system, including secondary and tertiary care.  ...  view the full minutes text for item 4.

5.

Urgent Primary Care pdf icon PDF 259 KB

Report of the Director of Strategy and Integration, Clinical Commissioning Group.

Additional documents:

Minutes:

 

The Board considered a report of the Director of Strategy and Integration, Sheffield Clinical Commissioning Group concerning Urgent Primary Care. The item was presented by Kate Gleave, Sheffield CCG.

 

 

 

The report stated that the Clinical Commissioning Group’s Strategy for Urgent Care articulated a need to improve urgent care services, in recognition of national policy to improve access and because people found the existing service arrangements confusing and difficult to use appropriately.

 

 

 

The Strategy recognised that local urgent primary care and services needed to be reorganised and the CCG had considered how this might be achieved with a view to agreeing a set of options for the delivery of services on which to consult from September 2017. The report summarised the case for change and the principles upon which the options had been based and it outlined the timescales involved.

 

 

 

The Board was informed that engagement with patients had found that patients did not always access urgent care based on the level of need and patients were confused as to what services to use and when. There was inequality and a differing experience and knowledge of services depending on where people lived in Sheffield. People were not always treated by the most appropriate service and there were issues relating to systems not operating cohesively and with regard to communication. The cost of travel on public transport was a barrier for some people, as were language issues.

 

 

 

The Board was asked to consider whether it could confirm that the objectives of the Urgent Primary Care review and redesign were in line with its own objectives; whether the Board would support and inform the formal public consultation; and whether the Board supported disproportionate re-investment into the areas of greatest need.

 

 

 

Members of the Board made comments and asked questions with reference to the questions outlined above and these are summarised below:

 

 

A question was asked about the consequences of moving financial resources if there was disproportionate re-investment into the areas of greatest need. The response to this was that the NHS would usually make the same service offer to everyone. In this case, it had been identified that greater resource could be deployed to where need was greater and the need/demand was something which could be shown geographically and was highlighted in relation to urgent care. Such an intervention and investment in those communities would provide the best value for money and it would lead to improved health outcomes. 

 

 

It would be considered helpful to communicate what changes to urgent care provision would mean for people and for particular groups of people. There was support for differential investment based on a clear understanding of need and there would also need to be transparency and consistency with regards to services which were available.  The Board might also look at engagement in a similar way and apply disproportionate effort or investment to mobilise people and also ensure that they had a voice. 

 

 

 

It was not intended that capacity for planned care would be adversely affected  ...  view the full minutes text for item 5.

6.

Public Health Strategy pdf icon PDF 664 KB

Report of the Director of Public Health.

Minutes:

 

The Board considered a report of the Director of Public Health concerning the Public Health Strategy. The City Council’s Cabinet agreed a Public Health Strategy at its meeting on 15th March 2017. Greg Fell, the Director of Public Health, explained that the strategy aimed to describe the Council’s ambition to redress inequalities and, specifically, the 25 year difference in healthy life expectancy through the totality of its functions.

 

 

 

A key feature of the strategy was a focus on the concept of Health in All Policies in order to make explicit and increase health gain from policies and service areas that are not traditionally considered as “health” related. There was also an acknowledgement that to deliver such an approach, it would be necessary to change the way the organisation thinks and does its business.The four objectives of the Strategy related to: health inequalities, health in all policies, health protection and healthy lifestyles. There were 10 specific areas within the Strategy upon which the Council would initially focus as set out in the Strategy.

 

 

 

The Health and Wellbeing Board was asked to consider how this approach could be developed.

 

 

 

The Board was asked to consider a number of questions, namely: whether priority areas identified in the Strategy were the right areas to be focusing on, and if there were any that were of more immediate interest; were there other areas we should be looking at; what role the Health and Wellbeing Board could play in maximising the impact of the strategy; how the Health and Wellbeing system in Sheffield could build upon this direction to improve wellbeing in the city; and how the Health and Wellbeing Board could work with the Council’s Scrutiny function to support the delivery of the Strategy?

 

 

 

Members of the Board asked questions and commented on this item of business, as summarised below:

 

 

 

There was a significant amount of activity in addition to the Public Health Strategy, including in relation to smoking cessation and prevention and air quality. The Strategy also had links to the Joint Strategic Needs Assessment and the Annual Report of Director of Public Health.

 

 

 

The Board expressed a number of different observations about the respective merits of having a broad strategic document as opposed to one which covered greater detail about activity, projects and operational matters.

 

It was consider that, whilst the Public Health Strategy was broad, it might be useful to identify where it could influence (and where it would not) and for the Board to consider some of the ten priority areas in greater detail and what organisations other than the Council were expected to contribute in this regard. It would also be helpful to say, if the priorities as set out in the Strategy were achieved, what was expected to happen to indicate that these were indeed the right priorities and how would we know that we had made a difference.

 

 

 

In relation to a work and health strategy, the three main issues were firstly, employability (i.e.  ...  view the full minutes text for item 6.

7.

Sheffield Health and Wellbeing Board Terms of Reference pdf icon PDF 236 KB

To consider revised Terms of Reference for the Board.

Minutes:

 

The Board considered revised the Terms of Reference for the Board and were asked to comment as appropriate.

 

 

 

It was expected that deputies would be in attendance at meetings of the Board on an exceptional basis and agreed that this should be made clear in the Terms of Reference at paragraph 3.2.

 

 

 

In terms of the authority of representatives, it was accepted that each of the organisations represented on the Board were sovereign and that some decisions or representations would need to be made in accordance with the governance arrangements of individual organisations. 

 

 

 

It was RESOLVED that:

 

1.     the Terms of Reference of the Board are amended as follows:

 

·       The addition at paragraph 3.2 of the words “in exceptional circumstances” following the words “… attend a meeting and vote in place of the member.”

 

·       The addition at paragraph 3.5 of the words “and/or representations” after the words “It is accepted that some decisions”

 

2.     The revised Terms of Reference are circulated to Members of the Board.

 

 

 

8.

Health and Wellbeing Board Forward Plan pdf icon PDF 44 KB

To consider the Health and Wellbeing Board’s Forward Plan.

Minutes:

 

The Board considered its forthcoming Work Programme as circulated.

 

 

 

The Board RESOLVED:

 

1.     to note the Programme as submitted and the expected times and dates of Strategy Meetings (from 2pm to 5pm) and those Meetings of the Board to be held in public (from 3pm to 6pm).

 

2.     to note the addition of cancer services to the list of topics for future consideration.

 

 

 

9.

Minutes of the Previous Meeting pdf icon PDF 116 KB

Minutes of the meeting of the Board held on 30 March 2017.

Minutes:

 

It was RESOLVED that the minutes of the meeting of the Board held on 30 March 2017 be approved as a correct record.

 

10.

Date of Next Meeting

Minutes:

 

It was noted that the next meeting of the Health and Wellbeing Board would be held on Wednesday 27 September 2017, starting at 3.00pm.