Agenda item

4.1

The Board considered a joint report of the Leader of Sheffield City Council, Chair of the NHS Sheffield Clinical Commissioning Group and Director of Quality and Nursing, NHS England. The report outlined the Health and Wellbeing Board’s priorities for Sheffield in 2014-15; presented the plans of the organisations represented on the Board; and outlined the plans for integrating health and social care, including in relation to use of the Better Care Fund. Approval was sought to the plans for the use of the Better Care Fund as set out at Appendix D to the report.

The Board was asked to consider the following four questions, together with the recommendations set out in the report now submitted:

·         Do the plans contribute enough to delivering the Joint Health and Wellbeing Strategy?

·         Are there areas for greater joint working between the four organisations on the Health and Wellbeing Board (and others) in 2014-15 and looking to the 2015-16 budget setting process?

·         Does the Board have any specific comments to make regarding any of the organisations’ plans?

·         What role is there for Healthwatch Sheffield over the coming year in assisting with the implementation of these plans?

4.2

Members of the Board commented upon the content of the plans, as summarised below:-

It was welcome that all the plans of constituent organisations were in one document, which was a reflection of co-ordinated joint planning. Nonetheless, there were also opportunities to do more. 

Particular attention was drawn to the themes relating to “a good start in life” and health inequalities, which were intrinsic to other plans. Integrated health and social care commissioning plans included children and young people and community and intensive support. Sheffield’s ‘Best Start’ bid to the Big Lottery fund represented a more integrated approach.

The plans as presented had been informed by patient and public involvement throughout. However, in the proposed transformational changes, there appeared to be no measures by which to evaluate how the changes will affect people.

It was confirmed that discussions had taken place with regards suitable metrics to facilitate evaluation.     

In relation to the NHS England plans, as outlined at appendix 4 (iv), these were presented as a high level document and reassurance should be given to people that the plans of NHS England were joined with those of the City Council, a fact that may not be apparent from the plans as presented.

The high level plans would be supplemented by more detailed 2 year operational plans, which would be submitted to NHS England on 4 April and would then be made publically available when the final version was completed. It was intended that the plans would align with those of the Council.

The NHS England Plan as it stood could be perceived as relating to South Yorkshire and more detailed plans, specific to Sheffield and also reflecting NHS England’s public health and commissioning role were desirable.

Whilst the plan as presented was at a high level, as the detailed plans developed, there would be more local discussion, which had in fact already begun. The local detail would be contained in five year plans.

It was important for the Board to hear what the community and patients’ views were regarding the plans and in that context Healthwatch was most important. Work was being done to ensure that the voice of children and young people was heard.

Healthwatch Sheffield had a role in relation to monitoring the Health and Wellbeing plans and looked forward to working with the City Council, CCG and NHS England.

It was not clear where financial cuts would be made owing to financial pressures and the public should know where, as a result, there would be substantial change.

There was a desire to involve people and the CCG was launching an involvement network and was working with Healthwatch Sheffield.

Financial resources were decreasing and, therefore, the City had to prioritise use of resources and plan accordingly. The reduced level of resources was a problem which people and organisations in Sheffield should understand and own and there should be open discussion about the issue. The plans did contribute to addressing delivery issues within the Health and Wellbeing Strategy. There were also areas in relation to which more joint working could take place.

In Sheffield, it was considered that the social model of health and wellbeing was important. Some public health resources were deployed to do things specific to health and other initiatives concerned the wider issues, such as smoking and obesity, which might be contributed to by lifestyle, where people live and the environment. Activity Sheffield was contributing to health improvement and it was recognised that better health was the result of a wide set of factors.

The public health grant in 2014 was £31 million and it would be used to address matters including health inequalities, people’s lifestyles and the root causes which led to ill health and early death. Other Council initiatives also contributed to better health, such as reducing the number of road safety accidents.

The Better Care Fund related to funding which the CCG had already been allocated and was not new money. The emphasis was on using these resources differently.

The Board should be given credit for putting forward ambitions in relation to integration, which were quite well developed in comparison to other places in the country.

4.3

RESOLVED that:

(1)    The Board formally approves the plan for the Better Care Fund as outlined in Appendix D to the report now submitted; and

(2)   Members of the Board and the Board’s constituent organisations commit to working together in an integrated way over the coming year.