To update the Health and Wellbeing Board on the work to improve health and wellbeing through the Herefordshire and Worcestershire Sustainability and Transformation Partnership (STP), and its local delivery mechanism the ‘One Herefordshire’ transformation programme.

To confirm the strategic priorities for the board's focus as an output of a workshop held in November 2017 identifying priority health and care themes.

The One Herefordshire director of transformation presented the paper, making the following key points:

·         The Herefordshire and Worcestershire sustainability and transformation partnership (STP) was part of the national NHS programme, and Herefordshire was represented on the regional board by the director for adults and wellbeing.

·         The purpose was to deliver the ‘triple aim’ of improved population health and wellbeing, high quality services, and financial sustainability and efficiency.  

·         STPs were being encouraged to progress towards becoming integrated care systems. These were intended to be place based and to focus on providing a wellbeing service to keep people well but being available to support when unwell.

·         The developments presented significant cultural changes with closer working with partners.

·         One Herefordshire was the delivery mechanism for Herefordshire, and started with the health and social care elements and working closely across the public sector, initially focused on adults and looking holistically at the individual in their own surroundings.

Responding to a question from the vice-chair about the functioning of the system in the context of reductions to the public health budget, it was explained that this was about the wider approach across the system where wellbeing was everyone’s business. The principle of ‘making every contact count’ was essential to the prevention agenda and to prioritising resources. An example to illustrate the approach was around smoking cessation, which should be picked up by any professional in contact with an individual, captured in public messages and extended to employers in promoting healthy workplaces. These were the areas to establish the best approach to target in a co-ordinated way.

The director for adults and wellbeing pointed out that public health grant was set to reduce to £8million over the next few years and would eventually be phased out completely, as it would be subsumed into the council’s wider revenue. It was therefore less helpful for it to be a ring fenced grant because it did not represent the reality of what was spent by the overall system on public health, so it was imperative that all expenditure made by the council, and indeed wider partners, had positive impact.

The incoming director of public health added that the public health grant was a small concern and the key message was about the whole picture and where influence was needed.

The CCG accountable officer commented that gradual reorganisation within the system was an opportunity to reconsider the relationship with neighbours, especially with Worcestershire, moving from a transactional relationship to a consensus. It was hoped that a new culture would help to bring about the changes. There were risks but also some opportunities so it was important to take the opportunity to deliver the changes that were needed. Although it was not an easy concept to explain, the key was to bring providers into the way of working to move to a partnership based approach, where all took responsibility for the system as a whole achieving the triple aim, rather than one of commissioner and provider. 

The chairman noted that the  ...  view the full minutes text for item 150