Agenda and draft minutes

Venue: The Waterside, Sale, M33 7ZF

Contact: Alexander Murray, Democratic and Scrutiny Officer 

Items
No. Item

19.

MINUTES pdf icon PDF 157 KB

To receive and if so determined, to approve as a correct record the Minutes of the meeting held on 13 July 2018.

Additional documents:

Minutes:

The Chair of Health Watch Trafford noted a number of typos within the previous minutes and detailed them to the support officer.

 

RESOLVED: That, following the amendments highlighted by the Chair of HealthWatch Trafford, the minutes of the meeting held on 13 July 2018 be agreed as an accurate record and signed by the Chair.

20.

DECLARATIONS OF INTEREST

Members to give notice of any interest and the nature of that interest relating to any item on the agenda in accordance with the adopted Code of Conduct.

Minutes:

The following declarations of personal interest were made;

 

·         Councillor Lloyd in relation to her position as trustee of Trafford Domestic Abuse Service.

·         Councillor Harding in relation to her managing health services commissioned by Trafford.

·         Councillor Brophy in relation to her employment within the NHS.

·         The Trafford Integrated Network Director in relation to his position on the 42nd Street Board.

21.

STRATEGY AND PERFORMANCE

21a

HEALTH AND WELLBEING BOARD GOVERNANCE pdf icon PDF 154 KB

To receive an update from the Senior Partnerships and Communities Officer.

Additional documents:

Minutes:

The Head of Partnerships & Communities gave a brief presentation to the Board which covered the proposed governance arrangements that had been discussed by the workgroup. Two more detailed diagrams of the proposed structure, which had been sent out with the agenda, were displayed for information. The Head of Partnerships & Communities explained how the revised structure of the Boards agenda was to work and which areas of work were covered by each section. The Board were told that strategies were no longer to come to Board meetings for anything other than approval. A further review of the Board was planned and was to look at the possibility of having locality boards to match the council’s locality approach to delivering services.

 

RESOLVED: That the Board noted the update.

21b

PUBLIC HEALTH ANNUAL REPORT pdf icon PDF 9 MB

To receive a report from the Interim Director of Public Health.

Minutes:

The Interim Director of Public Health went through the report which had been circulated with the Agenda. The Board were informed that the report had been created by an independent body so there would be no bias towards the Council’s services and performance. The Boards attention was drawn to the statistics on ageing which showed that people’s satisfaction and fulfilment were higher for elderly people than 30 – 50 year olds. This came to a surprise Board Members who had expected that younger people would score higher for happiness than older people.

 

The report detailed the stark contrast in healthy life expectancy between the most deprived and most affluent areas across the borough. This had been highlighted as an area that required focus from all services as the personal and financial cost of this inequality were very significant. The Interim Director for Public Health went through the diagram on page 9 of the report which showed Trafford’s performance in ageing well outcomes when compared to the national average. The Interim Director for Public Health then explained the difference between loneliness and social isolation and how Trafford were good at dealing with social isolation but were still struggling to combat loneliness.

 

There were a number of areas of concern for Trafford with the main ones being a lack of physical activity amongst adults and children, smoking and the Interim Director of Public Health emphasised the benefits of quitting smoking even amongst the population above retirement age as it was still the biggest cause of preventable illness within Trafford. Despite young people drinking less there were still issues around alcohol consumption as 25% of older people were drinking over their daily allowance. The Board were told that because older people had a slower metabolism they needed to reduce their daily allowances.

 

Too many people in Trafford were dying in hospital which showed that there was a need to change the conversations which were being had within Trafford and to improve end of life planning. The Interim Director of Public Health reiterated the impact that health inequalities had upon the area affecting both rich and poor alike as rich people in areas with high inequality were shown to have a shorter life expectancy.

 

After the Interim Director of Public Health had concluded their overview of the report Board Members were given an opportunity to ask questions. The Executive Member for Adults Services stated that Trafford had an issue with the quality of Care Homes within Trafford and asked what had been done in reaction to the age well survey. The Interim Director of Public Health responded that the survey had not gone out to care homes but that this would be done following the meeting. Once all the survey results were received they would be used to create working groups in order to work through the issues identified.

 

The Chair of HealthWatch Trafford commended the reports length and accessibility. She agreed that Trafford needed to focus upon end of life planning and care.  ...  view the full minutes text for item 21b

22.

BOARD DEVELOPMENT

22a

OUR FUTURE FOR TRAFFORD EVENT

To receive a verbal update from the Chair of the Board.

Minutes:

The Chair gave a brief report to the Board on the Our Future for Trafford event highlighting the main themes and outcomes of the event. The event had been held on the previous Wednesday with partners from a variety of organisations in attendance. Those in attendance had discussed the council’s priorities for the next five years and how they could be achieved through a collaborative partnership approach. The partners at the event were happy with the seven priorities that had been selected by the Council’s leadership. The group highlighted that there needed to be a focus upon innovation and having the relevant infrastructure in place for the priorities to be achievable. Out of the seven priorities increasing healthy life expectancy was seen as the key priority by the group and early intervention and prevention was the key to delivering this priority. At the end of her update the Chair asked Members to think about how the organisations across Trafford could work together and the values that the Board should have. The Chair of the Trafford Safeguarding Board spoke about the people at risk in care homes, how they should be a priority for the Board, and the needed for the Board to bring information together to facilitate a joint approach.

 

RESOLVED: That the update be noted by the Board.

22b

HEALTH AND WELLBEING BOARD STRATEGY EVENT - 9TH NOVEMBER 2018

To receive a verbal update from the Interim Director of Public Health.

Minutes:

The Chairman told the Board that she would circulate a briefing note to all Members attending the Health and Wellbeing Strategy Event so that they can discuss the main points in more detail on the 9th November.

 

RESOLVED: That the Chair to circulate a briefing note to Board Members attending the Health and Wellbeing Strategy Event.

 

22c

RESPONSIBILITY OF BOARD MEMBERS

To receive a verbal update from the Chair of the Committee.

Minutes:

The Chair informed all Board Members that they were responsible to read all papers in advance of the meeting to be ready for discussion at the Board Meetings. Because of this all those presenting items at meetings would only cover the salient points and recommendations of the report.

 

The Chair of the Trafford Safeguarding Board asked what the legislative arrangements were for the Board regarding safeguarding. She then offered to update the Board on where the Council was up to in the transformation of the safeguarding Board and where they planned to be once it was completed. The Chair of the Trafford Safeguarding Board was not able to attend the next Board meeting in January but asked if she could deliver an update a the meeting following that one. The Chair welcomed the offer of an update on the developments of the Trafford Safeguarding Board and asked whether someone else would be able to deliver an update in January. The Chair of the Trafford Safeguarding Board responded that she would see if anyone was available but if not it would have to go to a later meeting.

 

RESOLVED:

1)    That Board Members are aware of and agreed to their responsibilities as Board Members.

2)    That an update on the Trafford Safeguarding Board Transformation is to come to the Board at the soonest convenience.

 

 

23.

UPDATES FROM SUB BOARDS

23a

START WELL BOARD

To receive a report from the Executive Member for Children’s Services.

Minutes:

The Executive Member for Children’s services informed the Board that the Sub Board had been well attended and they had agreed that the work would be focused upon five areas. One of the main areas for concern was the above average level of teenagers being admitted to A&E for alcohol related issues.

 

RESOLVED: That the minutes of the Sub Board be noted by the Board.

 

23b

LIVE WELL BOARD pdf icon PDF 26 KB

To receive a report from the Chair of the Board.

Minutes:

The Chair of the Board informed Members that the Live Well Sub Board had decided to focus upon reducing Smoking, Drinking, and increasing healthy life expectancy.

 

RESOLVED: That the minutes of the Sub Board be noted by the Committee.

23c

AGE WELL BOARD pdf icon PDF 226 KB

To receive a report from the Executive Member for Adult Services.

Additional documents:

Minutes:

The Executive Member for Adults Services informed the Board that the Age Well Sub Board had agreed that they needed to look at the way that information was gathered together to inform commissioning across the area.

 

RESOLVED: That the minutes of the Aging Well Sub Board be noted by the Board.

 

23d

MENTAL HEALTH PARTNERSHIP pdf icon PDF 173 KB

To receive a report from the Lead Commissioner for Mental Health and Learning Disabilities for Trafford CCG.

Minutes:

The Senor Partnerships and Communities Officer updated the Board on the areas that the Sub Board had agreed to focus upon going forward.

 

RESOLVED: That the minutes of the Mental Health Partnership be noted by the Board.

 

24.

TRANSFORMATION AND SUSTAINABILITY

24a

2019/20 COMMISSIONING INTENTIONS AND LCA UPDATE pdf icon PDF 141 KB

To receive a presentation from the Corporate Director of Commissioning.

Minutes:

The Director of Commissioning went through the presentation which had been circulated to the Board in advance of the meeting. She explained that the Local Care Alliance gave Trafford an opportunity to do things differently. The presentation outlined what an LCA was and how it differed from the current model. The LCA was a partnership of all health organisations within the area. The public sector part of the alliance would involve the Council, Trafford CCG, and Manchester Foundation Trust. The Board were told that the LCA was to use the Thrive Model, Social Prescribing, and move towards local care delivery model. In future want to move towards prevention in the future. It was explained that legally the LCA was more of an expression of commitment between organisations than a separate legal entity. The System Board would meet every month to set the direction and objectives of the LCA and the Provider Board was to be focused upon delivery. Underneath the Boards there were Operational Working Groups for each of the LCAS themes which would meet weekly or bi-weekly and would be responsible for operational delivery. Finally the Health and Care PMO would develop and monitor the agreed programme of work.

 

The Corporate Director of Commissioning then described the key priorities and work streams that the LCA were focused upon. One of the plans of the LCA was to provide reactive care support to all care and residential homes within the Trafford area. Work had already started on providing this service and there had been a reduction in admissions to hospital. Good feedback had been received from both staff and the owners of residential and care homes, there were also plans get feedback from residents. The streaming of patients at the front door was another key piece of work for the LCA. Clinical experts were to be placed on the front line of services to direct those who needed lower level services to those services and reducing unnecessary hospital admissions. The LCA were aware that mental health was a large issue within Trafford so they were insisting that all providers gave parity of esteem to mental health and that they treated mental health as a part of their services and not separate.

 

The Corporate Director for Commissioning explained how the creation of the LCA would help enable Trafford to take a system wide approach which would encompass the public sector reform work that the Council were undertaking. Part of this work was looking at Trafford’s community assets in a new way and commissioning in a way that would support and build upon these assets.

 

Following the presentation Board Members were given the opportunity to ask questions. The Executive Member for Adults Services mentioned the reactive care which was to be implemented from the first of November and asked what was going to look like. The Trafford Integrated Network Director responded that there were a few pieces of work ongoing in Care Homes in Trafford. They were looking to up skill care  ...  view the full minutes text for item 24a

24b

DELAYED TRANSFERS OF CARE FROM HOSPITAL AND CQC ACTION PLAN UPDATE pdf icon PDF 334 KB

To receive a presentation from the Corporate Director of Adults Services.

Minutes:

The Trafford Integrated Network Director went through the presentation which had been circulated with the agenda. The presentation detailed the process that lead to the development of the action plan. The Board were told that a number of the areas for improvement that the CQC highlighted had been identified prior to their review and Trafford were already working on solutions. The Trafford Integrated Network Director then went through the main changes that had occurred since the review including; changes at ascot house, the introduction of discharge to assess beds, and the creation of the Urgent Care Control centre

 

The Board were shown a graph which showed that during the review the average number of Delayed Transfers of Care (DTOC) in Trafford was 62. The average number of DTOC, at the time of the meeting, was down to 20 so an improvement of 40 people. Whilst this represented a great level of improvement Trafford still had a way to go to bring their performance down to the target set by the CQC.

 

The Chair of Trafford’s Safeguarding Board spoke about the interdependencies within the system and asked whether others areas could negatively impact upon the progress that had been made within Trafford. The Trafford Integrated Network Director responded that DTOC were a Trafford and Manchester issue and whilst both areas had approached this separately in the past they were now working together to find a solution to the issue. There was a Trafford and Manchester Urgent Care System meeting which focused upon working on staffing, system architecture, and market management collaboratively.

 

The Executive Member for Adults Services asked whether the figures included mental health DTOC. The Trafford Integrated Network Director responded that the numbers did not include mental health as there was a different way of classifying mental health DTOC. A Board Member added that there was an issue with this across Greater Manchester and it was something that GMMH were working on.

 

RESOLVED: That the update be noted by the Board.

25.

KEY MESSAGES

To consider the key messages from the meeting.

Minutes:

The Chair reminded Board Members that it was important for as many people involved in Health and Wellbeing from across Trafford to attend the strategy meeting on the 9th November.

 

The Interim Director of Public Health spoke about the main areas of focus for the strategy meeting which included the possible creation of a poverty strategy for Trafford and the possibility of introducing a healthy weight strategy within Trafford.

 

The Chair welcomed the public health report and the information that it displays for the area as it identified a number of areas to work on going forward. The Chair stated that happy with the level of attendance at all of the Sub Boards and added that a Member of the Children and Young People’s Scrutiny Committee should sit on the Start Well Board.

 

26.

QUESTION AND ANSWER SESSION FOR OBSERVERS

To receive questions from members of the public.

Minutes:

The Members of the Public who were in attendance were given the opportunity to ask questions of the Board. One Member of the Public pointed out that communication was still a big problem and that the AGM of Trafford CCG and MFT happened at the same time this year. They asked for the health and social care organisations across Trafford to ensure that this did not happen again next year. The Corporate Director of Commissioning responded that this was an area where the Local Care Alliance would help by bringing the organisations closer together which should avoid clashes,

 

Another Member of the public asked what the role of the CQC was. The Trafford Integrated Network Director answered that the CQC were a regulatory body that reviewed the performance of all Health and Social Care provision across the country.

 

A Member of the Public asked what savings had been made from the improvement in DTOC. The Trafford Integrated Network Director answered that is something that they would be doing analysis of but it was very difficult to quantify. The Chair asked that figures be provided for the savings compared to costs of the changes.

 

The final question from the public was what the ages of the people who were being delayed were. The Trafford Integrated Network Director answered that this was not known about at that time.

 

RESOLVED:

1)    That the publics’ questions were noted and answered.

2)    That savings figures be provided for DTOC which include the savings compared to costs of the changes.

27.

CLEAN AIR STRATEGY

Item for discussion.

Minutes:

The Chair informed the Board that the lunchtime session would be about Trafford’s clean air strategy. Air pollution was a large problem within Trafford and impacted the Health of residents across the borough. The Chair told all Board Members and observers that they were welcome to stay for the session and that any ideas or feedback would be welcomed.

 

RESOLVED: That all Board Members and Observers were informed of the topic of the lunch time session and invited to attend.