Agenda and minutes

Please refer to the explanatory notes below.

To receive the minutes of the meeting held on 7 January 2015.

Resolved – That the minutes of the meeting held on 7^th January 2015, be confirmed and signed as a correct record.

          The Board received a report of the Director of Public Health setting out the initial findings of the Sight Loss Joint Strategic Needs Assessment Profile, and setting out the current position of people living with sight loss in Swindon together with possible policy proposals moving forward.

          Penny Marno, Registrar in Public Health Medicine, introduced the report referencing (a) recommendations set out within the action plan (paragraph 3.10 of the report), (b) current data and projections for sight loss in Swindon, (c) joint work with the Clinical Commissioning Group, including a workshop on sight loss to be held on 13^th March 2015, (d) consultations undertaken with the voluntary sector, and (e) access to and the provision of services.

          After the presentation of the report, Board Members asked questions and made observations on the following issues:

·       The monitoring of work undertaken on a cross agency basis and of work relating to the findings set out in paragraph 3.10 of the report of the Director of Public Health.

·       The identification of oversight responsibility, for example whether schools or parents were responsible for children’s eye tests, and how such oversight would be reported to the Board.

·       The active promotion of information arising from work undertaken through the promotion of the recommendations set out in the report.

     Resolved – (1) That the findings of the Sight Loss Joint Strategic Needs Assessment Profile be noted.

     (2) That commissioners be requested to take note of the recommendations set out in paragraph 3.10 of the report of the Director of Public Health.

          The Director of Public Health submitted a report updating Members on the Adult Autism Joint Strategic Needs Assessment and seeking the Board’s support for the recommendations contained in the Assessment.  The Director of Public Health drew Members’ attention to (a) that the assessment updated the “Think Autism Fulfilling and Rewarding Lives, the strategy for adults with autism in England” Strategy published in April 2014, (b) the findings of the profile  of people with autism in Swindon, (c) the ten recommendations within the JSNA made for future work to improve the lives if people with autism in Swindon, (d) the implementation plan arising from the recommendations made by the JSNA, (e) the fifteen priority challenges for action within the Think Autism National Strategy, and (f) how these priorities and recommendations informed Swindon policies.

          Members discussed the flowing issues:

·       Awareness of Services availability.

·       The role of DASH indicators in Service provision and in creating awareness of Autism in Swindon.

·       Referral times and the effect on individuals and service provision.

·       The fifteen priority challenges of the Think Autism National Strategy set out on page 63 of the report and how these might inform the Swindon Strategy.

·       The future role of DASH given the charity was now only open 5 days a week when demand for its services was increasing and the possibility of additional assistance to support its work.

·       How autism was diagnosed in Swindon, the current waiting lists for assessment within the Borough and the need to monitor waiting times.

·       The current take-up of the Wiltshire Autism Card given the generally positive feedback from card holders.

          Resolved – (1) That the recommendations set out within the Adult Autism JSNA Bulletin, as set out in Appendix 1 to the report be noted and agreed.

          (2) That the development of an Adult Strategy for Swindon, in line with the national policy, statutory guidance and local needs (as identified through this JNSA) be supported.

          (3) That, further to (2) above, it be noted that the strategy would be led by the Swindon Autism Partnership Board.

          The Director of Public Health submitted a report reviewing the Swindon Joint Health and Wellbeing Strategy for the period 2014/15. The Director of Public Health drew Members attention to (a) performance over the previous 18 month period and (b) trends and direction of travel.

          Members of the Board discussed:

·       The criteria used in determining the success of the Strategy.

·       How Swindon measured against comparator authorities for breast feeding.

·       Improved detail and presentation within the report.

·       The variance in reporting data between national and local figures (which used admittance rates) for alcohol issues locally and how these figures and the effect of alcohol on medical conditions might be raised in a manner that leads to greater awareness.

          Resolved – (1) That the Joint Health and Wellbeing Strategy Update Report 2014/15 be noted.

          (2) That progress to date against the priority outcomes and the areas where particular challenges affect the achievement of long term aims and the overall strategy vision be noted.

          (3) That it be agreed that a review of the Joint Health and Wellbeing Strategy priorities, as informed by the report, and reflecting the latest Joint Strategic Needs Assessment findings, be undertaken.

          The Board received a report of the Director of Public Health setting out the Get Swindon Active Strategy.  Director of Public Health introduced the report and drew Members’ attention to (a) that the previous physical activity strategy had been completed in 2009, (b) that the strategy was targeted at both a Swindon and National problem, the plan focused primarily on the six priority areas of (i) promoting forms of exercise that could be built into everyday life, (ii) supporting neighbourhoods, communities and voluntary organisations with initiatives to promote physical activity, (iii) influencing the built environment so that being active becomes an easy choice for Swindon residents, (iv) Encouraging employers to promote healthy work places and to encourage physical activity, (v) encouraging frontline professionals to promote physical activity, and (vi) continuing to provide easily accessible information  on opportunities for physical activity within Swindon, (c) work to ensure information on the strategy and physical activity options was accessible to the public, and (d) the establishment of a working group to implement and oversee the action plan.

The Board Members asked questions and commented upon:

·       Actions by leisure providers to promote physical activity.

·       The Get Swindon Active Action Plan.

·       The remit and work of the working group being established to to implement and oversee the action plan.

·       Encouraging greater use of Swindon’s green spaces.

·       Joitn work with the Council’s Planning Department and Transport team to promote opportunities and engagement.

          Resolved – (1) That Swindon Borough Council Cabinet and the Governing Body of Swindon Clinical Commissioning Group be recommended to approve the adoption of the “Get Swindon Active” Strategy.

          (2) That the Board supports on-going work to raise awareness of the importance of physical activity for health and wellbeing within their respective member organisations.

          The Chief Operating Officer – Swindon Clinical Commissioning Group submitted a report setting out the draft NHS Swindon Clinical Commissioning Group Annual operating Plan 2015/16 which took account of the JNSA key priorities.

          The Board discussed:

·       The priorities set out in section 8 of the report, capacity planning and urgent care.

·       Discussions with social care regarding access times for crisis and care and a single point of access.

·       Discussions with General Practices regarding working together on a neighbourhood basis to provide better services.

·       On-going discussions with General Practices regarding contract processes.

          Resolved – That the draft Swindon Clinical Commissioning Group Annual Operating Plan for 2015/16 be noted and supported.

          The Associate Director of Commissioning submitted a report updating Members on the Crisis Concordat. The Chief Operating Officer, Swindon Clinical Commissioning Group drew Members’ attention to (a) working arrangements between organisations to ensure people receive the support they required if they suffered a mental health crisis, (b) the current position of the Concordat, (c) an update on joint working on the Concordat, (d) the action plan set out in appendix 2 to the report highlighting progress  against meeting agreed standards and identifying who was responsible for leading work within the Concordat.

          Resolved - (1) That the Swindon Mental Health Concordat be approved and it be agreed that the Clinical Commissioning Group monitor the delivery of the multi-agency Action Plan through the established multi-agency Swindon Concordat Action Plan forum.

          (2) That it be noted that the Police and Crime Commissioner would liaise with the Director of Public Health regarding reporting on Emergency response times to mental health situations (Action Point 11 of the Concordat Action Plan).

          The Manager Healthwatch Swindon submitted a report updating Members on progress and current activities of Healthwatch Swindon.  The Board was advised of the new work plan and was provided with examples of joint working arrangements.

          Resolved – That the report be noted.

Report to follow.

          The Director of Public Health reported that the Draft Joint Commissioning Intentions 2015/16 were being finalised by Swindon Borough Council and the Clinical Commissioning Group and, that once approved, this document would underpin the Section 75 Agreement.

          Resolved – That the draft Joint Commissioning Intensions 2015/16 report be circulated to Members of this Board for comment and that a final document be submitted to this Board in May 2015 for endorsement.

          The Director of Public Health submitted a report setting out the draft Swindon Pharmaceutical Needs Assessment.  The Board was updated regarding (a) the public consultation on the Swindon Pharmaceutical Needs Assessment, (b) the development of the Assessment through the Joint Strategic Needs Assessment Steering Group, (c) the proposed monitoring of the Swindon Pharmaceutical Needs Assessment through the JSNA Steering Group, (d) an overview of the 14 responses received through the public consultation, (e) the recommendations arising from the Swindon Pharmaceutical Needs Assessment, as set out in the report, (f) the establishment of a working group to develop an action plan for the implementation of the Assessment.

          The Board discussed:

·       The lack of a 24 hour community pharmacy in Swindon and the resultant pressures on out of hours services and the hospital’s accident and emergency department.

·       That the placement of a 24hour pharmacy facility on the hospital site was likely to lead to additional pressures on the hospital and its staff.

·       That the logical placement of a 24hour pharmacy facility was within the town centre area which offered the best available public transport services.

Resolved – (1) That the report be noted.

          (2) That this Board would not wish to see the establishment of a 24 Hour pharmacy at the Great Western Hospital but believes that the placement of any such service is better suited in the town centre area.

          (3) That, subject to (2) above, the conclusions and recommendations from the Swindon Pharmaceutical Needs Assessment, as set out in the report, be approved.

          (4) That, subject to (2) above, officers be authorised to publish the Swindon Pharmaceutical Needs Assessment by 1^st April 2015.

Report to follow.

            The Director of Public Health Submitted a report setting out updated Terms of Reference for the Health and Wellbeing Board.

            The Director of Public Health drew Members attention to paragraph 6 (Membership) of the revised Standing Orders and advised Members that in addition to the Membership listed and noted that it was proposed that Swindon Borough Council’s Cabinet Member for Children’s Services and the Executive Nurse of the Clinical Commissioning Group  should also be added to the Membership.  The Director of Public Health also confirmed to the Board that Officers of Swindon Borough Council listed in Paragraph 6 of the Terms of Reference would become non-voting Members on the Board.

            The Director of Public Health also brought to the Board’s attention proposals to replace the Joint Commissioning Board with a newly formed Joint Commissioning Group which would feed into the Health and Wellbeing Board.

            Councillor David Renard advised the Board that the proposed Terms of Reference for the Health and Wellbeing Board had been discussed at a meeting of the Council’s Corporate Governance Working Group. At this meeting the Council’s Labour Group representatives had requested, that should the Cabinet member for Children’s Services be appointed a Member of the Health and Wellbeing Board that the Health and Wellbeing Board also be requested to appoint the Shadow Cabinet Member for Children’s Services.

            Dr. Peter Crouch indicated that whilst he was content that the Cabinet Member for Children’s Services be appointed to serve on the Health and Wellbeing Board he was concerned that not only was the Board Membership growing but that the clinical/non-clinical Membership was in danger of becoming unbalanced.

            The Board discussed:

·        Representation on the Board.

·        How educational issues would be reported to the Board.

·        The appointment of GP elected locality Chairs to rebalance the clinical/non-clinical Membership of the Board.

            Resolved – (1) That, subject to the amendment of Paragraph 6 to include the Cabinet Member for Children’s Services and the Executive Nurse of the Clinical Commissioning Group as Members of the Board, Swindon Borough Council and the Clinical Commissioning Group be recommended to approve the revised Terms of Reference for the Health and Wellbeing Board, as set out in Appendix 1 of the Report of the Director of Public Health.

            (2) That, further to (1) above, the Director of Public Health be requested to submit a report to the Next meeting of this Board addressing (a) the request to appoint the Shadow Cabinet Member for Children’s Services as  a Member serving on this Board, and (b) how the Clinical/Non-Clinical representation on this Board might be rebalanced.