Agenda and minutes

1.1

Apologies for absence were received from Councillor Jackie Drayton, Councillor Paul Wood, Phil Holmes, Laraine Manley, Alison Knowles, Jane Ginniver, David Hughes, Jayne Brown, Alison Metcalfe, Chris Newman and Nicki Doherty.

2.1

There were no declarations of interest made.

3.1

There were no questions from members of the public.

4.1

Kathryn Robertshaw, Joint Interim Accountable Care Partnership Director, presented the CQC System Review Action Plan update.  The position was more favourable than the previous quarter and good work had taken place regarding delayed transfer of care.  There was now a draft integrated workforce strategy for Older People and a more holistic view was being taken of the user experience through the system.  The Joint Commissioning Committee had now been established.

4.2

Areas of concern included: the new relationship with the voluntary sector, the commissioning focus on multi morbidity and reviewing digital inter-operability.  There was a need to ensure that the correct names were associated with actions on an ongoing basis.

4.3

John Mothersole, Chief Executive, SCC, noted the importance of delivering actual change, rather than treating the Action Plan as a tick box exercise. 

4.4

RESOLVED: That the areas of good practice be noted.

5.1

Kathryn Robertshaw, Joint Interim Accountable Care Partnership Director, presented the report which detailed the production of the Shaping Sheffield Plan.  The plan was strategically rooted within the Health and Wellbeing Strategy and would be a dynamic document which would change as work-streams changed.

5.2

The plan had been updated to reflect feedback from the ACP, Executive Delivery Group (EDG) and Health and Wellbeing Board, feedback from all partner organisations, feedback from Healthwatch and the ACP Service User Advisory Group and contributions from individuals and teams across the system.  It was now time to move to the delivery stage of the plan. The need for good communications was discussed.

5.3

Dr. Tim Moorhead welcomed the plan and noted that the Health and Wellbeing Strategy was looking for sponsors and there was a possibility that the two documents could be aligned.  The next step was to consider how to take the plan forward.

5.4

The Chair asked whether any consultation had been carried out with Trade Unions and Kathryn Robertshaw explained that consultations had been carried out with all the main unions and a meeting with the GMB had taken place regarding their online learning resource.

5.5

The next step was to take the plan to all the ACP Boards and to look at how the plan could be implemented alongside the Health and Wellbeing Strategy.

5.6

RESOLVED: That:-

(a)  Full partner support and ownership of the plan be confirmed and;

(b)  The timetable for final sign off through system and partner boards, be noted as agreed by EDG and set out below:

6.1

Jennie Milner, Better Care Fund Programme Manager, presented the report which gave an update on:

·         Progress on the Better Care Fund Programmes against the 17/19 narrative plan.

·         Performance against the agreed Better Care Fund KPI’s.

·         The financial performance of the Better Care Fund pooled budget for 2018/19.

·         Better Care Fund programme budget and high level plans for 2019/20.

6.2

The report also included details of system challenges within the year, the need to improve fragmented services and full details of the budget including overspend.  The programme was in the best position for the last two years regarding delayed transfer of care, but the target on non elective admissions had not been met and it was felt that the target had been too ambitious and should be amended.  Additional KPI’s were also being proposed to measure performance.

6.3

John Mothersole, Chief Executive SCC, agreed that the target had been too ambitious, but that the figures were still heading in the wrong direction.  It was hoped that the new Joint Commissioning Committee could help with issues such as this.  He suggested that it may be useful to look at what would constitute a good distribution of resources would look like in 2021 to create a blueprint.

6.4

Sarah Burt, Sheffield CCG, welcomed the possibility of a blueprint of resources.  Social investment provided a good opportunity to help manage pressures within the system.

6.5

The Chair stated that the report was a good representation of where we were now and it was hoped to spend the Better Care Fund more strategically in the future.

6.6

RESOLVED: That:-

(a)  in considering the two questions set out in the report in relation to the Better Care Fund Update, the Board’s answers be as follows:-

(1)  Is the progress to date on the way we work together sufficient? The Health and Wellbeing Board noted that progress was ongoing.

(2)  Considering the latest joint Health and Wellbeing Strategy, feedback from the CQC Local System Review and the agreed action plan, does the Health and wellbeing Board require any additional information to the updates on the 2019/20 priorities?  It was felt that the Health and Wellbeing Board had sufficient oversight.

(b)  The update on the programme, be noted;

(c)  The outturn budget for 2018/19, be noted;

(d)  The establishment of the Joint Commissioning Committee and its alignment to the Accountable Care Partnership to add pace and scale to address the financial overspends, be noted;

(e)  The delayed NHS England (NHSE) guidance and final template for the 2019/20 plan, be noted and;

(f)   The proposed budget and priorities for 2019/20 be noted and final responsibility for approval be delegated to the Chair of the Health and Wellbeing Board, as it was subject to the published NHSE guidance and template.

7.1

Dawn Walton, Director of Commissioning, Inclusion and Learning, SCC, presented the report which gave an update on transitions and SEND.  This was the second update to the Board and lots of activity had taken place.

7.2

A Preparation for Adulthood project team had been established, the results from the Ofsted and CQC SEND inspection and the written statement of action had been approved and published.

7.3

Other actions included:

·         Further work in early years services to ensure a child’s additional needs are identified at the earliest opportunity and support put in place.

·         Developing a package that supports the transition from nursery into primary school, with primary schools given details about their new SEN cohort in advance – to enable more effective planning/support to be put in place earlier on.

·         Vulnerable Learner Reviews to more effectively identify the support children need in advance and during key transition stages – including the move from primary to secondary school and into adulthood – and for those at risk of exclusion.

·         Developing the post-16 offer for young people with SEND, to include meaningful activities for those unlikely to move into employment.

·         Greater involvement from health and social care at transition points.

·         Developing clearer and smoother pathways from children’s to adults services.

7.4

Greg Fell, Director of Public Health, SCC, noted that there was beginning to be a distinction between a principles approach and a service approach.  Dawn Walton replied that work was still needed to change the culture, but the right mechanisms were in place.

7.5

Dr. Tim Moorhead asked how much engagement there had been with families.  Dawn Walton felt that there had been a lot of engagement, including with the Parent and Carer Forum.

7.6

There was still a challenge between adhering to the statutory framework and being meaningful.  All new plans were completed within the 20 week statutory timescale, but there was a need to ensure that the right provision was available.

7.7

RESOLVED: That the update be noted.

8.1

Kathryn Robertshaw, Joint Interim Accountable Care Partnership Director, presented the report which provided an overview of the programme activities.  The leadership of the ACP was going through some changes and a review of the chief executive sponsorship and workstreams was ongoing.  The report also included details of the Risk Log.

8.2

A two day development session had given workstreams an opportunity to focus on developing delivery plans and to make connections between their areas of work.

8.3

The report gave an outline of the work in the following areas:

·         Elective Care

·         Urgent and Emergency Care

·         Long Term Conditions and New Model of Care

·         Mental Health and Learning Disabilities

·         Primary Care and Population Health Management

·         Childrens and Maternity

·         Digital

·         Workforce/Organisational Development

·         Pharmacy Transformation

·         Communications and Engagement

·         Payment Reform

8.4

It was noted that all the ACP Boards needed to be better aligned and there was a need to ensure that reports to the Health and Wellbeing Board should be more strategic.

8.5

RESOLVED: That the following be noted:-

(a)  Shaping Sheffield Plan had been developed with good cross system engagement and was now ready for final sign off by the ACP Board and Health and Wellbeing Board;

(b)  Re-visioning work was underway for the LTC Board and;

(c)  The Risk Log be noted.

9.1

RESOLVED: That the minutes of the meeting of the Board held on 28th March 2019, be approved as a correct record.

9.2

Further to Minute No. 4, Greg Fell, Director of Public Health, SCC, reminded Board Members of the Health and Wellbeing Strategy launch event to take place next week.

10.1

It was noted that the next meeting of the Health and Wellbeing Board would be held on Thursday 26th September 2019, starting at 3.00pm.