Agenda and minutes
PDF 21 KBVenue: Town Hall, Moorgate Street, Rotherham S60 2TH
Contact: Dawn Mitchell 01709 822062 Email: dawn.mitchell@rotherham.gov.uk
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Declarations of Interest Minutes: There were no declarations of interest made at the meeting. |
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Questions from members of the public and the press Minutes: There were no members of the public or the press present at the meeting. |
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Communications Minutes: There was nothing to report under this item. |
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Minutes of previous meeting Minutes: The minutes of the previous meeting held on 8th March, 2011, were noted.
It was noted that the Health Inequalities Scrutiny Review BMI>50 (Minute No. 55 refers) was to be considered by Cabinet on 25th April. Disappointment was expressed at the front page head line in the previous week’s local press taken from the report which could further isolate this subject group. |
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Health and Wellbeing Board - minutes of meeting held on 29th February, 2012 Presentation by Councillor Wyatt, Cabinet Member for Health and Wellbeing Additional documents:
Minutes: The minutes of the Health and Wellbeing Board held on 29th February, 2012, were noted.
2 workshops had since been held to develop the Health and Wellbeing Strategy which included the Joint Strategic Needs Assessment.
Councillor Wyatt, Cabinet Member for Health and Wellbeing, then gave the following powerpoint presentation on tackling health inequalities and responding to change:-
Health and Social Care Act - Received Royal Assent on 27th March, 2012 took forward the areas of Equity and Excellence: Liberating the NHS (July 2010) which required primary legislation - Covered 5 themes Strengthening commissioning of NHS services Increasing democratic accountability and public voice Liberating provision of NHS services Strengthening public health services Reforming health and care arms length bodies - Highly controversial and included significant changes to the way things were done
Health and Wellbeing Board - Local authorities would lead the co-ordination of health and wellbeing through the creation of high level ‘Health and Wellbeing Boards - Key responsibilities included:- Joint Strategic Needs Assessment Joint Health and Wellbeing Strategy Improving health and reducing health inequalities Integrating health, social care and public health Productivity and efficiency
Rotherham’s Board - Now established as a Sub-Committee of the Council, Chaired by the Cabinet Member for Health and Wellbeing - Direct reporting links to the LSP as well as links to other local Boards (including Adults, Children’s) - Terms of Reference agreed and work plan being developed
Vision for Health and Wellbeing - For everyone in Rotherham to be happy and healthy and have the adequate resources to participate in their community
Core Membership of the Board - Cabinet Member for Health and Wellbeing (Chair) - Cabinet Member for Adult Services - Cabinet Member for Safeguarding Children and Adults - Director of Public Health - Chief Executive, RMBC - Strategic Director of Neighbourhoods and Adult Services - Strategic Director of Children and Young People’s Services - Strategic Director of Environment and Development Services - Chair of Clinical Commissioning Group (CCG) - Chief Operating Officer, CCG - Chair of PCT Cluster Board (until April, 2013 when position will be reviewed) - Voluntary Action Rotherham - Rotherham HealthWatch (once in place 2013)
NHS Commissioning - Devolved responsibility for the majority of commissioning to local Clinical Commissioning Groups - Supported and held to account by an independent national NHS Commissioning Board - Rotherham Clinical Commissioning Group now established - CCG had a statutory place on the Health and Wellbeing Board
Public Health - Local authorities would take on statutory duty for Public Health - Full transfer of responsibilities and resources by April, 2013 - Ringfenced budget allocation provided in ‘shadow’ form April, 2012 - Directors of Public Health jointly appointed between local authority and Public Health England from April 2013 - Director of Public Health to be added to the list of statutory Chief Officers in the Local Government and Housing Act (subject to Parliament) - Director of Public Health had a statutory place on the Health and Wellbeing Board
HealthWatch - HealthWatch England would ... view the full minutes text for item 62. |
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Public Health Transition - Nagpal Hoysal, NHSR Additional documents: Minutes: Dr. Nagpal Hoysal, NHSR, gave a powerpoint presentation on the Health and Social Care Act 2012 and the local authority duties and responsibilities as follows:-
Cause of Disease - 60% of the causes of the disease burden in Europe was caused by 7 risk factors:- High blood pressure (12.8%) Tobacco (12.3%) Alcohol (10.1%) High blood cholesterol (8.7%) Overweight (7.8%) Low fruit and vegetable intake (4.4%) And physical inactivity (3.5%) - Diabetes, which was directly related to obesity and lack of exercise, was also a major risk factor and trigger for cardiovascular disease - Risk factors frequently cluster and interact – particularly in disadvantaged socio-economic groups
Public Health 2012 Act - SoS duty as to protection of public health - Duties as to improvement of public health were functions of local authorities and SoS - Each local authority must take such steps it considered appropriate for improving the health of people in its area
Duties as to improvement of Public Health Local Authority Functions - Providing information and advice - Services or facilities designed to promote healthy living - Services and facilities for the prevention, diagnosis or treatment of illness - Providing financial incentives to individuals to adopt healthier lifestyles - Providing assistance (including financial assistance) to help individuals minimise any risks to health arising from their accommodation or environment - Making available the services of any person or any facilities
Mandatory Services (Public Health White Paper) - Ensuring NHS commissioners receive the Public Health advice they need - National Child Measurement Programme - NHS Health Check assessment - Appropriate access to sexual health services
Discretionary - Tobacco Control and Smoking Cessation Services - Alcohol and Drug Misuse Services - Public Health Services for children and young people aged 5-19 (including Healthy Child Programmes 5-19) (and in the longer term all Public Health Services for children and young people) - Interventions to tackle obesity such as community lifestyle and weight management services - Locally-led nutrition initiatives - Increasing levels of physical activity in the local population - Public Mental Health Services - Dental Public Health Services - Accidental injury prevention - Population level interventions to reduce and prevent birth defects - Behavioural and lifestyle campaigns to prevent cancer and long term conditions - Local initiatives on workplace health - Comprehensive Sexual Health Services - Local initiatives to reduce excess deaths as a result of seasonal mortality - Public Health aspects of promotion of community safety, violence prevention and response - Public Health aspects of local initiatives to tackle social exclusion - Increasing levels of physical activity in the local population - Supporting, reviewing and challenging delivery of key Public Health funded and NHS delivered Services such as Immunisation and Screening Programmes - Local initiatives that reduced Public Health impacts of environmental risk
Commissioning Agencies and Structure - Local Authority Social Care Public Health Environment - Clinical Commissioning Group Hospital and Community Services Commissioning Some GP services GP Group + Governing Body - NHS Commissioning Board Establish CCGs General Practice contracts ... view the full minutes text for item 63. |
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Rotherham Clinical Commissioning Group Update - presentation by Sarah Whittle, NHSR Minutes: Sarah Whittle, NHS, gave the following powerpoint presentation on the Clinical Commissioning Group:-
The Health Bill/Act - Abolished Primary Care Trusts by April, 2013 - Clinical Commissioning Groups (CCGs) formed in shadow form from 1st October, 2011 - Fully authorised by April, 2013 - Public Health responsibilities to transfer from NHS to RMBC (April, 2013) - GP/Dentist/Pharmacists’ contracts and special commissioning to be managed by National Commissioning Board (currently Cluster) - HealthWatch to be formed to promote the views of patients and service users - NHS Commissioning staff in Rotherham reduced by 48%
Budget - NHS Rotherham £460M - RMB Public Health £20M - Rotherham CCG £330M - NHS Commissioning Board – GP/Dentists/Pharmacists £120M
CCG Structure - CCG Committee/Board - GP Reference Group - Strategic Clinical Executive - Operational Executive - Strong clinical focus
CCG Authorisation – 6 domains - Clinical focus and added value - Engagement with patients and communities - Clear and credible plans - Capacity and capability - Collaborative arrangements - Great leaders
Finance - Need to generate £75M of efficiencies over the next 4 years - Expected to make the efficiencies by:- Managing long term conditions patients more efficiently and cost effectively Making sure only appropriate patients were referred to hospital Making GP prescribing more efficient and cost effective Reducing commissioning staff by the Government target of 48%
Partnerships with RMBC - Local Strategic Partnership - Health and Wellbeing Board - Adults Board - Long Term Conditions/Unscheduled Care - Children and Families Partnership - Think Family - Safeguarding - Public Health |
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Implications of the Health and Social Care Bill on the Foundation Trust - presentation by Peter Lee, RFT Minutes: Peter Lee, Chairman of the Rotherham Foundation Trust, gave a powerpoint presentation on the implications for the Trust, its Directors, Governors and members of the Health and Social Care Act 2012:-
Where we start from - Combined hospital and community services - Income £225M from 1 year contract - Over 4,000 staff - Cost improvement programme 2012/13 (£14M) - FRR – 3 (1-5) and Governance – Green (green/amber/red) - Lowest waiting times - Infection control record – excellent
New Commissioning Regime - Present position – Primary Care Trust until April, 2013 - Future position – Clinical Commissioning Group from 2013 - Transitional arrangements exist - CCGs – locally managed and directed – all primary care providers had to be members – regulatory supervision – obligations to be transparent - CCGs – mandated to continuously improve services – reduce inequalities – promote patient involvement and patient choice – innovation – research and the integration of health and social care
New Initiatives - Promotion of Section 75 NHS Act 2006 arrangements - Every provider of health services would need to be licensed - Changing role for Monitor (Foundation Trust regulator) - Increasing role of Council of Governors - Duty to promote the NHS Constitution - Caps and conditions to non-NHS income - Foundation Trust Board meetings to be held in public
New Roles and Responsibilities – Governors - To hold the NEDs individually and collectively accountable for the performance of the Board - To represent the interests of the members (as a whole) and the interest of the public - To require the Directors to attend Council of Governors to supply information regarding the performance of their duties and functions - Any amendment to the Constitution of the Trust regarding the powers or duties of the Governors (or their role) was subject to a Members’ vote. More than 50% of those voting must be in favour and the motion must be put by a member of Council of Governors - Any other amendments to the Constitution of the Trust were subject to more than 50% of the Directors voting in favour and more than 50% of those Governors actually voting being in favour - Constitution could be changed to specify partnering organisations which may appoint one or more members of the council
New Roles and Responsibilities – Directors - General duty to act with a view to promote the success of the Trust so as to maximise benefits for the members (as a whole) and for the public - Must supply Governors with meeting agendas prior to their meetings and minutes as soon as practicable after meetings - Constitution must be amended to provide for meetings to be open to the public and may provide for exclusion of the public for special reasons - Obligation to promote the NHS Constitution to members of the public in discharging the Trust’s functions - Ensure that the Governors were equipped with the skills and knowledge required in their capacity as such, to discharge their duties ... view the full minutes text for item 65. |
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Achieving an Effective Health and Wellbeing Structure in Rotherham Minutes: A question and answer sessions on the 4 presentations ensued as follows:-
Was the culture of the Health and Wellbeing Board built upon principles of transparency, involvement, accountability, trust and respect between the Health and Wellbeing Board members? There were a number of requests from a range of organisations wanting to join the Board. However, there was a need for the membership to be focussed and ensure that the representatives were able to represent their organisations and act on their behalf as written into the Terms of Reference.
There had to be wider engagement with the community as it would be one of the tests of success or failure as to how effective the engagement with communities was.
There were good examples of work in the Health Inequalities Strategy and the 2 recent workshops had tried to be as inclusive as possible by inviting the wider representative groups rather than just Health and Wellbeing.
With regard to the relationship with Scrutiny, Rotherham had been involved in various projects with the Centre for Public Scrutiny; looking at scrutiny within the context of the health reforms and how to develop successful working relationships.
How would the Board work together as well as with the people who actually used services to tackle difficult issues such as Service reconfiguration? How could Scrutiny best support this? Any Service changes, in accordance with procedure, had to be submitted to the Select Commission for comment.
With regard to the required wider engagement activities, there was a need to use all the mechanisms in place such as the Foundation Trust network. Rotherham had some very good engagement groups across the Local Authority and Health but there was duplication and a need to know what each partner was consulting on; communication was seen as key to ensuring this happens.
Do you feel Health and Wellbeing partners were able to identify potential conflicts straightaway and were there agreed ways of dealing with them? Strong partnership working would help ensure that conflicts were easily dealt with, in an open and honest manor.
Having a comprehensive and jointly agreed Joint Strategic Needs Assessment and Health and Wellbeing Strategy would also ensure a common purpose and agreed goals, which should reduce any potential conflicts and issues between agencies.
A key message from the 2nd Health and Wellbeing workshop had been the importance of a joined up approach on communications.
What evidence was there that health and wellbeing partners worked well together outside of formal Board meetings? The Joint Service Centres were an example where GPs and Council worked alongside but there was a need for further joint work as resources diminished. This was critical to the transition of Public Health and protocols required.
Other good examples of good joint working included: learning disability services, mental health and the Early Help agenda with children and families.
There were concerns that joint working was not always as effective as it should be, issues such as not having co-located teams and IT systems that did ... view the full minutes text for item 66. |
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Councillor Jack Minutes: This was Councillor Jack’s last meeting as Chair of the Select Commission. She thanked officers for their support.
Members wished Councillor Jack best wishes for the future. |
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Date and Time of Future Meeting:- - Thursday, 31st May, 2012 at 9.30 a.m. Minutes: Resolved:- That a further meeting be held during on 31st May, 2012, commencing at 9.30 a.m. in the Town Hall. |