Apologies were received from Mr S Clee, Mrs S Lloyd, Mrs C Keetch, Mr A Neill and  Supt Susan Thomas.

DCI D Barratt for Supt S Thomas, Dr J Omany for Mrs S Doheny and Mr A Lee for Mr S Clee.

None.

To approve and sign the Minutes of the meeting held on 16 October 2014.

The Minutes of the meeting held on the 16 October were approved and signed as a correct record.

To receive questions from Members of the Public relating to matters within the Board’s Terms of Reference.

(Questions must be submitted by midday eight clear working days before the day of the meeting (ie on the Wednesday 13 calendar days before a meeting to be held on a Tuesday.))

None.

To receive a verbal updated report on the Better Care Fund.

The Board received an update on the submission of the Better Care Fund in which the following areas were highlighted:

• The Herefordshire BCF Plan had been submitted in September 2014 and was assured with a single condition that related to reaching the required financial and risk share agreements for the national conditions, and developing greater clarity on the expenditure relating to the three BCF schemes.

• a Joint BCF Task & Finish Group with membership from the Local Authority and CCG and invitations for  the Health Trust to attend, had been working to progress the BCF Plan to a state that met the National Assurance requirements.

• That currently it was proposed that a revised BCF Plan would be submitted by way of a fast track option by 28^th November.  Further dates for submission were available if required on the 12^th December 2014 and in January 2015.

Resolved: That the report be noted.

To recommend to Council amended terms of reference for the Board and agree next steps in Board development.

The Board received a report on proposed changes to its terms of reference.  The Director of Children’s Wellbeing highlighted the following areas:

·         The report outlined areas of best practice for Health and Wellbeing Boards, as provided by the Local Government Association.

·         That Appendix C of the report outlined a move to more appropriate set of roles and responsibilities for the Board and the proposed balance of membership of the Board reflected its statutory role and the effective working of the Board.

·         That Appendix B laid out an effective mechanism to engage all stakeholders not represented on the Board, but who were involved in other Boards which had wider membership.

·         That whilst providers would no longer be members of the Board, they would be represented on the Transformation Board which would provide a wide engagement for stakeholders within the County.  Reports from relevant bodies would be invited as appropriate.

·         That the intention would be to provide a report to the next meeting of Council and resolve the engagement process in order to have a plan for the Board in place by the 1 April.

Resolved

THAT:

a)    the draft terms of reference at appendix B, including proposed changes to membership, be agreed for recommendation to Council

b)    a further report be brought to the Board by the end of February 2015 on stakeholder engagement mechanisms; and

c)    authority be delegated to the Director for Children’s Wellbeing, following consultation with the Board Chairman, to progress a Board development programme supported by the Local Government Association.

To receive a report on the Health and Wellbeing Board Strategy.

The Board received a presentation on the proposed Health and Wellbeing Strategy.  The Interim Public Health Consultant.

During the ensuing debate the following points and issues were made and raised:

·           Whether or not the overarching strategy reflected sufficiently that the system worked well at a time of crisis.

·           That the Board should be aware that the function of the strategy was the broad determination of health.  This could include roads, transport, education as well as alcohol and mental health issues. 

·           That greater prominence should be given to the work of the Transformation Board and the Children’s Partnership.  Young people’s mental health issues should be seen as a priority.

·           That agreement was needed around a definition of ‘wellbeing’.  Consideration should also be given to what the wider assets were, and what solutions to problems were.

·           That care should be taken with the use of language, as the strategy was designed to be a public facing document, and not one solely for the use of the Board.  It should focus around wellbeing, and the shifts that the Board wanted to make in this area in the County in order to guide resource allocation.

·           As there was an increased confidence in the reporting of sexual crimes, that within the themes there should be a greater emphasis on domestic abuse and the inclusion of sexual violence.

·           That the voluntary sector were included in the project team that was looking at the consultation for the strategy, and were represented by hvoss.

Resolved:

That:

(a)                views on the themes identified thus far in the Health & Wellbeing Strategy be discussed;

(b)               Board Members undertook to communicate the key themes of the Health & Wellbeing Strategy within their  respective organisations, and ensure feedback be provided; and;

(c)                The Board endorsed the approach being taken.

To enable the board to provide direction to the development of the children and young people’s partnership (CYPP).

The Board received a report on Knowing Our Children: priority setting and progress of the Children and young People’s Partnership.

The following areas were highlighted:

·         That it had been considered that the Partnership had been too passive, and as a result it had been reinvigorated and there were now five key themes that had been prioritised to be effectively addressed through a transformative partnership approach.  

·         There had been a move across the Partnership away from universality to targeting activity.

·         The Partnership had established an Executive Group, that fulfilled the statutory requirements, made up of a range of partners and chaired by the Lead Member for Children’s Wellbeing.

·         Discussions were in hand with the Herefordshire Children’s Safeguarding Board regarding the safeguarding agenda and how the wellbeing aspects of this would be taken forward.

·         That the Joint Strategic Needs Assessment would provide linkages between individual needs assessments and individual interest groups.

Resolved:

That

a)    the Board note and endorse the development of the Children and Young People’s Partnership; and

b)    the Board consider how children and young people should influence the its work; and

c)    An update on the work of the Children and Young People’s partnership be considered in March 2015.

The Board received a report on the extended National Troubled Families Programme.  The Head of Commissioning highlighted the following areas:

·         The Families First programme, Herefordshire’s local branding of the national Troubled Families initiative, identified families with a range of issues affecting both children and adults in the household. The aim locally was to “Turn around” the most chaotic and challenging families within the County, improve family and community outcomes and reduce the demand on public sector services.  These aims would be achieved through a multi-agency, coordinated approach building on the eight locality teams that were already operational.

·         That since 2012 the Programme had already helped to support 242 families, with 204 families showing a reduction in crime and anti-social behaviour with their children now regularly attending school.

·         This was initially a three year national programme to March 2015 to address the needs of 120,000 families; Herefordshire had a target of 310 families. The government agreed that the programme would run for an additional five years from 2015/16 with a target of 400,000 families nationally.

·         Herefordshire’s target was likely to be around 1,000 families over the extended programme lifetime. This was a significant increase to the current profile. Based on the likely target, total grant funding that could be secured was estimated to be £2.6million over the five years of the programme.

Resolved:

That

(a)         The Board confirmed its commitment to the local Families First programme; and;

(b)         recommended to Cabinet that the Council, as lead partner, joined the extended national Troubled Families programme.

To receive assurance on the System Resilience Plan.

The Board received a report on the Hereford System Resilience Plan.  The Director of Operations Herefordshire Clinical Commissioning Group (HCCG) said that the plan had been assured by NHS England in October 2014 which had triggered the release of £1.1m in allocated monies to support targeted support in the Urgent Care system. 

Additional funding had also been allocated from central resilience funds and plans were being put together for the non-recurring £2.6m which would be available in support of the Wye Valley NHS Trust, and the £92k targeted at improving crises care and early intervention in psychosis which would extend liaison psychiatry to Community Hospitals.

The following comments were made in discussion:

·         That it was important that the monies within the System Resilience Plan should be recurring, as this would allow medium term planning; over a two year rather than a two month basis.

·         That although the funds were not recurrent, the investment that would be made would allow for transformational change.

Resolved: That the Board acknowledge the progress made on the System Resilience Plan

To monitor progress on system wide transformation. 

The Cabinet Member (Young People and Children's Wellbeing) that there would be a workshop at the next Transformation Board which would discuss the commissioning and provider plans.  He expected further progress to be made in December.

Resolved: That the report be noted

To receive a report from Healthwatch.

The Board received a report on the activities of Healthwatch.

The Director of Adults Wellbeing thanked the Independent Chairman for the work that had been undertaken by Healthwatch on Adult Social Care.  The review was undertaken in a positive manner and had provided feedback which had been incorporated into the Council’s strategy.

Resolved: That the report be noted

To receive the Board’s Work Programme and make any appropriate adjustments.

The Board received its Work Programme.

Resolved: That the work programme be noted

To receive a briefing note.

A briefing report was noted.