Apologies were received from Mr P Deneen, Mr B Hanford, Mrs C Keetch, Mr D Smith and Dr A Watts.

Mr K Andrews substituted for Mr P Deneen, Mr N Doverty for Mr D Smith, Ms M Pert for Mr B Hanford, Dr I Tait for Dr A Watts and Mr R Widdowson for Mrs C Keetch.

None.

To approve and sign the Minutes of the meeting held on 16 April 2013.

RESOLVED: That the Minutes of the meeting held on 16 April 2013 be confirmed as a correct record and signed by the Chairman.

To review evidence from the 2013 ‘Understanding Herefordshire’ report and discuss recommendations.

The Board reviewed evidence from the 2013 “Understanding Herefordshire” report.

The Director of Public Health gave a presentation, a copy of which has been placed on the Minute book with the agenda papers.                                                                             

In discussion the following principal points were made:

·         It was considered that the Understanding Herefordshire report continued to be a valuable resource and as such it was important that it was kept up to date, whilst noting that this had resource implications.  It was requested that the Board be informed by briefing note of proposals for the frequency with which the report was to be reviewed and updated.

·         The capacity to support and train volunteers, on whom a number of transformation proposals relied, needed to be kept under review.  Social return on investment was included as a consideration within the commissioning framework.

·         That all partners needed to focus together on core elements identified within the report to effect improvement.

·         It was reiterated that the report template for the Board should include explicit reference to links the report had to the Understanding Herefordshire report.  It was suggested other partners could also usefully take the same approach.

·         That there was scope to target issues much more effectively, for example poverty, and through rural proofing.

RESOLVED: 

That      (a)     the evidence in the 2013 ‘Understanding Herefordshire’ is used for strategic planning and commissioning decisions;

(b)      the Board’s priorities be reviewed in the light of the Understanding Herefordshire report and a report made to the next Board meeting recommending any changes; and

(c)         the Board be informed by briefing note of proposals for the frequency with which the JSNA is to be reviewed and updated.

To receive a report on considerations arising from the Mid Staffordshire NHS Foundation Trust Public Inquiry – David Farnsworth.

The Board received a report on considerations arising from the Mid-Staffordshire NHS Foundation Trust.

The Clinical Commissioning Group’s (CCG) Executive Nurse Quality and Safety (ENQS) presented the report.  He emphasised the CCG’s commitment to maintaining quality in the provider structures.  A completed action plan was to be submitted to the CCG and progress against the action plan would be reviewed.

He also commented on reports of higher mortality rates at Hereford Hospital, there having been a suggestion that Wye Valley NHS Trust performance was an outlier compared with the average.  The ENQS reported that the Trust had been transparent in its response and was seeking to ensure wider quality benefits as a result of its review of performance.  This was in line with approach advocated in the Francis report.

He added that work was also underway to address pressures on the urgent care services.

The Board considered that it should receive a further report once the CCG action plan was finalised to ensure that the Board had the requisite assurance that the measures in response to the Francis report were satisfactory.

RESOLVED:    That a further report be made to the Board once the Clinical Commissioning Group had finalised its action plan.

To receive an update on the progress of the Government’s Comprehensive Funding Review for 2015/16.

The Director of People’s Services gave a presentation on the Government’s spending review 2015/16.

A copy of the presentation has been placed on the Minute book with the agenda papers.                                                                                    

To consider and endorse the Pioneer Proposal for Herefordshire.

The Board was invited to consider and endorse the Integration Pioneer proposal.

The Director of People’s Services presented the proposal emphasising that it entailed changing systems and approaches.

RESOLVED:  That the expression of interest in becoming an Integration Pioneer be endorsed.             

To advise the Board of progress on the Next Stage Integration Project and the implications and opportunities for the health and wellbeing system and to consider opportunities for synergy between commissioners in order to achieve service transformation.

The Board was advised of progress to date on the Next Stage Integration Project and the implications and opportunities for the health and wellbeing system and invited to consider opportunities for synergy between commissioners to achieve service transformation.

The Interim Transformation Manager and the Root and Branch Programme Support Officer gave a presentation.  A copy of the presentation was included with the agenda papers.     

In discussion the following principal points were made:

·         It was important to ensure that the changes were clearly communicated.  GPs needed to understand the changes and be able to explain them clearly to patients.

·         Health and social care leaders in the County needed to work together to achieve a whole system redesign of health and social care.  It was proposed that the Health and Care Leaders Group should be established on a more formal basis and should report formally to the Board on progress in integrating services.                                                                   

RESOLVED:

That      (a)    the development of the new operating model for Adult Social Care in Herefordshire be noted; and

              (b)     the Health and Care Leaders Group should be established on a more formal basis and should report formally to the Board at regular intervals on health and social care whole system redesign.

To review development work under the Demand Management Workstream from April to June 2013.

The Board reviewed development work under the Demand Management workstream.

The Director of Public Health presented the report highlighting the priorities it was intended to focus on in 2013/14.

RESOLVED:  That priorities for focus in year 1 (2013-2014) be noted.

To review development work on the review of services and pathways for alcohol misuse.

The Board reviewed development work on the review of services and pathways for alcohol misuse.

The Consultant in Public Health/Assistant Director of Public Health presented the report and gave a presentation.  A copy of the presentation has been placed on the Minute book with the agenda papers.                                                                                     

It was suggested that there were a number of examples from other areas that could be drawn upon to help progress the proposed work.

RESOLVED: That activity on addressing the impact of the alcohol consumption priority be noted.

To review the Annual Reports of the Adult’s Safeguarding and the Children’s Safeguarding Boards.

The Board received the annual reports of the Safeguarding Boards but agreed to defer this item until October so that the independent Chair of the Safeguarding Boards could attend.

To note the Board’s work plan.

The Board noted that the following matters discussed at the meeting would need to be added to the Board’s work plan:

·         Understanding Herefordshire

·         Update on Adult Social Care – Next Stage Integration

·         Report from Health and Care Leaders Group on whole health and social care system redesign.

·         Clinical Commissioning Group report in response to Francis report

·         Annual Safeguarding Reports