Agenda and minutes

The Chair, Councillor Caan welcomed Professor Caroline Meyer, Warwick University who was attending her first Board meeting following the resignation of Professor Sudesh Kumar. He placed on record his appreciation for all the work and support provided by Professor Kumar during his time as a Board member.

The Chair also welcomed Liz Gaulton, acknowledging her new appointment as Acting Director of Public Health.

RESOLVED that a letter be sent to Professor Kumar from the Chair, Councillor Caan, on behalf of the Board, thanking him for his valuable contribution to the work of the Board. 

There were no declarations of interest.

The minutes of the meeting held on 28^th November, 2016 were signed as a true record.

Further to Minute 89 headed ‘Sustainability and Transformation Plan Engagement Workstream’, clarification was requested on whether there was a new engagement strategy and when engagement was likely to commence. At the last Board meeting Members had been informed that the ‘Big Conversation’ phase on pre-consultation relating to maternity care was due to commence at the end of November. Gail Quinton, Executive Director of People reported that the engagement strategy had been considered at the joint Boards Development Day and that the issue would be considered at the next Board meeting. She clarified that it was the intention to consult on the individual proposals and this included reporting to the Health and Wellbeing Board.

RESOLVED that the STP engagement strategy be considered at the next Board meeting on 10^th April, 2017.   

The Board received a brief update on the Health and Care System Transformation work streams.

Proactive and Preventative Care

Gail Quinton, Executive Director of People and the workstream lead, reported on the Proactive and Preventative Care workstream indicating that this had been the subject of detailed discussion at the Joint Boards Development Session on 16^th January, 2017 to understand how the Boards could support delivery of this major area of work. The workstream was key to the work of the Board, as it centred on health and wellbeing, upgrading prevention work to deliver long term sustainability. Three strands had been identified: embedding proactive and preventative care across the work of all the partner organisations; building resilience and capabilities within communities; and providing out of hospital support closer to home.

Members expressed support for the partner organisations taking ownership of the proactive and preventative work. A request was made for written update reports from the workstream leads to be submitted to future meetings. Clarification was also requested about the recruitment and funding of the STP Director post. Dr Adrian Canale-Parola, Deputy Chair referred to the high level governance structure for the STP, highlighting the importance of ensuring that the Board had a pivotal role to play in bringing everyone together to ensure that the work streams were progressed.

Josie Spencer, Coventry and Warwickshire Partnership Trust (CWPT) reported on the following workstreams:

Urgent and Emergency Care

The Board were informed that the Urgent and Emergency Care (U & EC) workstream was being led by Glen Burley, South Warwickshire Foundation Trust. The workstream team had been meeting for 3-4 months and, aligned to the national U & EC review, were tasked with developing of an integrated and emergency care network and reviewing the sustainability of the current system.

Planned Care

The Planned Care workstream was being led by Debbie Pook, Warwickshire North CCG. Initial work involved pathway redesign starting with musculoskeletal (MSK), considering patients being able to manage their condition with support from their GP or the surgery route

Maternity and Paediatrics

Meghana Pandit was leading on the Maternity and Paediatrics workstream which was to look at future provision being delivered locally and complying with national strategy.

Productivity and Efficiency

The Board noted that the Productivity and Efficiency workstream was being led by Kim Li, South Warwickshire Foundation Trust which involved delivering services within resources whilst ensuring best value for money.   

Members raised further concerns about the unavailability of reports.

RESOLVED that written progress reports from each of the individual STP workstream leads be submitted to future meetings of the Board. 

Simon Gilby, Coventry and Warwickshire Partnership Trust will report at the meeting

The Board noted an update from Sharon Binyon, Coventry and Warwickshire Partnership Trust (CWPT) on the work undertaken to date to ensure that the Coventry and Warwickshire ambition to transform the provision of mental health and emotional wellbeing services, informed by the Mental Health five year forward view, was delivered through the Sustainability and Transformation Plan (STP).

The Board were informed that under the current STP structure there was no individual workstream for mental health however mental health ran through the four workstreams detailed in Minute 100 above.

Reference was made to the workshop held on 21^st November, 2016 that brought together system leaders in mental health. The workshop aimed to answer the question ‘What is our vision for mental health services in Coventry and Warwickshire in five years’ time’. Structured discussions were held with key stakeholders to determine what the group believed constituted the hall marks of high quality Mental Health services across four identified layers of response: Community Resilience, Primary Care, Specialist Care and Acute and Crisis Care. Further work was currently underway based on the outputs from the workshop.

The workshop recommended that in order to ensure appropriate focus on mental health in the STP workstreams, partners should continue to work together under the auspices of a Mental Health Steering Group and input to each workstream as appropriate.         

Report of Simon Gilby, Coventry and Warwickshire Partnership Trust

The Board considered a report from Simon Gilby, CWPT which drew attention to the launch of the report ‘Thrive West Midlands’ of the Mental Health Commission established by the West Midlands Combined Authority (WMCA) on 31^st January, 2017. A copy of this report was attached at an appendix to the report. The Board were asked to receive the report, considering its fit with local strategic priorities and any actions that Board would want to take.

The report indicated that the WMCA established the Mental Health Commission in late 2015. The WMCA had identified poor mental health and wellbeing as a significant issue for the region, not only in terms of the effects for individuals and families but more widely on the communities and the economy of the area. It identified the enormous distress for people, greater demand for public services and reduced productivity as key factors and identified improving mental wellbeing as a priority area where the WMCA could deliver public sector reform.

The Commission was made up of independent and respected experts drawn from the fields of mental health and was chaired by the Rt. Hon. Norman Lamb MP. To advise it, the Commission established a Citizens Jury comprising people with experience of mental ill health. Support was also provided by a Steering Group set up to ensure links with the broader stakeholder community. Senior representatives from local authorities, CCGs, health trusts and the police provided additional advice.

The Board were informed that, alongside taking submissions from stakeholders, a number of engagement events were held.

The report was described as an Action Plan for Change and set out how the region could reduce the impact of mental health, build happy thriving communities and supporting those who experienced mental ill health. The key themes covered supporting people into work and whilst at work; providing safe and stable places to live, mental health and criminal justice; developing approaches to health; and getting communities involved.

In advance of the public launch on 31^st January, the Commission Chair had written to stakeholders asking for commitment to the proposed actions through signing up to a Concordat.

Members of the Board raised a number of issues in response to the report including:

·  Support for the work undertaken by the WMCA

·  Acknowledgement of how the issues in the report dovetailed to the three priorities of the Board

·  The work undertaken at the Council to skill up staff to support employees with mental health issues

·  Clarification about the thresholds included in the mental health assessments to be able to access support

·  The role of the two universities in relation to mental health including preventative and proactive actions currently being undertaken to support students and the wider community

·  Further information about the links to the STP and the future commissioning arrangements

·  Clarification that once partners had signed up to the concordat then work would commence on the development of a detailed action plan

·  Concerns about the issue of homelessness since this often  ...  view the full minutes text for item 102.

Presentation by Chief Inspector Danny Long, West Midlands Police. A copy of the Project Initiation Document is attached

RESOLVED that, in the absence of Chief Inspector Danny Long, West Midlands Police and the lead Member, the presentation on the Multiple Complex Needs Progress Update be deferred to the next meeting of the Board on 10^th April, 2017.

Report of Liz Gaulton, Deputy Director of Public Health

The Board considered a report of Liz Gaulton, Acting Director of Public Health which sought endorsement of the steer from the Joint Health and Wellbeing Board Session for the Board to participate in the Local Government Association (LGA) Peer Challenge with Warwickshire Health and Wellbeing Board, which was proposed to take place between 14^th and 16^th March, 2017. Agreement was also sought for the focus of the Peer Challenge.

The report referred to the Coventry and Warwickshire Health and Wellbeing Alliance Concordat which set out the principles for joint working between the two Boards, with an emphasis on delivery of the Sustainability and Transformation Plan (STP). Reference was also made to the two joint development sessions for the two Boards held in October, 2016 and January, 2017.

The Board were reminded of the purpose of the second session, to look at the STP and understand the governance arrangements in relation to it. The session had also focused on the Proactive and Preventative work stream of the STP to understand how the Boards could support the delivery of this. One of the recommendations from the day was the creation of a Joint Working Group to identify and implement ways to improve joint working between the two Boards. From Coventry’s perspective the following membership was suggested: Chair of the Board (or nominee), partner agency and officer lead for the Board.

The report drew attention to the Peer Challenge offer from the LGA. The new System Wide Care and Health Peer Challenge was in pilot phase and had been developed in consultation with national partners. The aim of the review would be to:

i)  Provide a constructive assessment of the current and potential value to the health and wellbeing system of the Coventry and Warwickshire Boards, independently and together

ii)  Understand the contribution individual organisations, as members of the Boards, can make in bringing the spirit and commitment to the Coventry and Warwickshire Alliance Concordat to life.  

An appendix to the report set out detailed information on the proposed peer challenge.

RESOLVED that:

1. The steer from the Joint Health and Wellbeing Board Development Session to participate in the joint LGA Peer Challenge be endorsed.

2. The proposed focus on the joint LGA Peer Challenge be noted.

David Peplow, Independent Chair of the Coventry Safeguarding Children’s Board has been invited for the consideration of this item

a)  Annual Report of the Safeguarding Board

b)  Signs of Safety

The Board considered a joint report which presented the Coventry Safeguarding Children Board (CSCB) Annual Report for 2015-2016, a copy of which was set out at an appendix to the report. David Peplow, Independent Chair of the Safeguarding Board, attended the meeting for the consideration of this item. 

The report indicated that the production of the annual report was a statutory requirement under the Children Act. The latest annual report covered the period September 2015 to September 2016. It outlined the achievements and challenges of the Board and assessed progress on outcomes for children and young people in respect of safeguarding. It evaluated the impact of Coventry’s Safeguarding Services on outcomes for children and showed how the work of the Board had contributed to improving outcomes. Progress in implementing priorities was also highlighted.

The Board were informed that David Peplow had been appointed as the new Independent Chair from August, 2016 and the Board were now reviewing their priorities. It was the intention to publish a mid-year report in April 2017 to summarise progress since September and set out a new direction for the Board for 2017/18. From this date, future Annual reports would then tie in with the financial year.

The Board noted that, at their January 2017 meeting, the CSCB had agreed to the ‘Signs of Safety’ approach to child protection case work being the preferred model for Coventry. This was an innovative strength based safety organised approach allowing different organisations to work collaborately and in partnership with families and children.

Members raised a number of issues in response to the Annual report, matters raised included:

·  The availability of safeguarding training for school governors

·  Potential links with the work being undertaken by Warwick University

·  Support for ‘Signs of Safety’ as the best practise preferred model for Coventry.

Gail Quinton, Executive Director of People, informed the Board that, at their meeting on 12^th January, 2017, the Education and Children’s Services Scrutiny Board (2) considered the Coventry Safeguarding Children’s Board Annual Report. Part of the discussion included baby boxes and the work done to prevent baby deaths in Scotland. The Scrutiny Board had requested that the Health and Wellbeing Board be asked to investigate the possibility of Coventry providing baby boxes for all new born babies in the city.

The Executive Director reported that she had already raised the request with Andrea Green, Coventry and Rugby CCG who had lead responsibility for this area. 

Members raised the issue of the financial implications if it was decided to provide the baby boxes. Attention was drawn to Sandwell Council who had started a pilot scheme in January, 2017.

RESOLVED that:

(1) The Annual Report for 2015/16, including the progress made and the areas for future development, be noted.

(2)  The members be requested to encourage their organisations to embrace Signs of Safety and to promote this way of working.

(3) Officers from the CCG be requested to investigate the pilot baby boxes scheme introduced within Sandwell.  

Annual Report of Dr Jane Moore, Director of Public Health is submitted for information

The Board considered a report of Dr Jane Moore, Director of Public Health which presented her Annual report for 2016 ‘Shape Up Coventry’, a copy of which was set out at an appendix to the report.

The Annual report was a statutory and independent report produced each year to inform local people about the health of the population as well as providing necessary information for decision makers in local health services and authorities on health gaps and priorities that needed to be addressed.

Excess weight among children was one of the most challenging and complex issues facing the UK with around a third of 10-11 year olds being overweight and obese. In Coventry, one in ten 4-5 year olds were in the more extreme ‘obese’ weight category. The Annual Report recommended that the city adopted a whole systems approach to address childhood obesity.

The Board noted that a series of three workshops were held between September and November with a number of organisations to start to develop the whole systems approach to addressing childhood obesity. A number of priority themes were established which were detailed in the Annual report.

The report proposed that the Childhood Obesity Alliance continued to meet and develop an action plan to deliver change. It was intended that the Alliance operated to a whole systems approach, providing an emphasis on continually understanding the local system, building relationships between partners, building capacity and innovation, enabling feedback and continuous learning and delivering a range of actions in order to make the existing system operate more effectively.

Members expressed support for the user friendly report. The Chair, Councillor Caan drew attention to the reference to places for exercise in the Annual Report which indicated that Coventry had an abundance of open spaces with around 3 in 5 of families living within 250 metres of a green space at least the size of a football pitch. He expressed appreciation for all the work undertaken by Public Health to promote outdoor exercise.

RESOLVED that:

(1) The ambition of the Childhood Obesity Alliance be supported.

(2) A progress report be submitted to a future meeting of the Board in 12 months time.  

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

The Deputy Chair, Dr Adrian Canale-Parola, raised concerns that West Midlands Ambulance Service were not represented on the Board. It was reported that the Ambulance Service had been a member of the initial Shadow Board however attendance had been an issue in light of the significant number of Health and Wellbeing Boards within their region. It was agreed that contact be made with the Ambulance Service to canvass their views on the issue of membership.

RESOLVED that officers re-visit the appointment of a representative from the West Midlands Ambulance Service to the Health and Wellbeing Board and report back to a future meeting.