Agenda and minutes

Apologies for absence were received from Vicky Buchanan, Interim Director of Children’s Services and Education, Dr.Rob Caudwell, Chair NHS Southport and Formby CCG, Richard Freeman NHS England, Dr.Craig Gillespie, Chair NHS South Sefton CCG, Maureen Kelly, Healthwatch, Lorraine Webb Venus and Every Child Matters Forum representative, and Angela White Sefton CVS.

RESOLVED:

That the Minutes of the meeting held on 11 September, 2019 be confirmed as a correct record.

Members are requested at a meeting where a disclosable pecuniary interest or personal interest arises, which is not already included in their Register of Members' Interests, todeclare any interests that relate to an item on the agenda.

Where a Member discloses a Disclosable Pecuniary Interest, he/she must withdraw from the meeting room, including from the public gallery, during the whole consideration of any item of business in which he/she has an interest, except where he/she is permitted to remain as a result of a grant of a dispensation.

Where a Member discloses a personal interest he/she must seek advice from the Monitoring Officer or staff member representing the Monitoring Officer to determine whether the Member should withdraw from the meeting room, including from the public gallery, during the whole consideration of any item of business in which he/she has an interest or whether the Member can remain in the meeting or remain in the meeting and vote on the relevant decision.

No declarations of any disclosable pecuniary interests or personal interests were received.

The Board considered the report of the Chief Executive, which provided the Board with an overview of a recent review of the Governance of the Health and Wellbeing Board and the need to update some aspects of its governance.

To ensure correct governance, the following enhancements were identified:

·       Performance Dashboard required: the second Health and Wellbeing Strategy for Sefton would be published in January 2020, with effect from April 2020 to March 2025. This refreshed strategy roll-out would include the establishment of a performance dashboard that would be received and reviewed by the Board at each meeting from its June 2020 meeting onwards.

·       Website update: a recent regulatory inspection highlighted the need to update the website for the Health and Wellbeing board to be clear on membership, purpose, achievements and plans. Updates were agreed by the Health and Wellbeing Strategy group in August 2019 and are now in the process of being put in place.  It was envisaged that further and routine edits to this would be required following the establishment of the 2020 – 2025 Health and Wellbeing Strategy.

·       The representation of Police and NHS to be included on the Board: the Chief Executive had written to the Chief Constable of Merseyside Police Force to extend this invitation. A response had been received and future membership was agreed. It was also recommended to strengthen the Board with additional NHS Trust membership, with the Chief Executives from Alder Hey and North West Boroughs NHS Trust both proposed as new members of the Board. This would provide additional expertise in children and young people services and the wider public health and protection agenda, as well as mental health services.  Members may wish to consider further membership.

·       Subgroups to feedback routinely: the Board had five established sub-groups which it was proposed would routinely submit written updates to the board to be collated in a report to be tabled as a standard item at the start of each agenda.

Board Members suggested that the Sefton Partnership for Older People should be added to the governance structure, under the ‘Adult Forum’ branch.

RESOLVED: That

(1) the contents of the report be noted; and

(2) the governance updates, as detailed within the report, be approved.

Report of the Director of Public Health

Further to Minute No.26 of this meeting , the Board considered the report of the Director of Public Health that provided an update and a summary of activity from the five identified sub-groups as outlined in the Health and Wellbeing Governance report:

·       Sefton Health Protection Forum
The Health Protection Forum sought assurance from partners around the quality and coverage for the NHS Screening programmes and immunisation programmes in Sefton.  The group also sought assurance on health protection incidents, clusters and outbreaks in Sefton, and activity undertaken to prevent or prepare for health protection risks.

·       The Adult Forum
The forum had not meet since the last verbal update received by the Board in June 2019. The next meeting was scheduled for the 18, December, 2019.

·       Special Educational Needs and Disability Continuous Improvement Board
The SEND Continuous Improvement Board (SENDCIB) was set up to ensure that a robust special educational needs and disabilities (SEND) improvement plan was in place and delivered to respond to the joint OFSTED/CQC revisit.  The main purpose was to improve outcomes and demonstrate impact for children and young people and to support parents and carers. 

·       Health and Wellbeing Board Executive Group
The group was designed to build resilient relationships between senior leads with the CCGS and Local Authority for Sefton, providing the strategy oversight for schemes delivered through the Better Care fund and to give approval and strategy guidance to the Integrated Commissioning Group work programme.

·       Children and Young Peoples Partnership Board
The Children and Young People Partnership Board, formerly Children and Young People’s Continuous Improvement Board (CYPCIB), currently met bi-monthly and was a Sefton Council focussed Board.  It had recently been reviewing the Terms of Reference to ensure other agencies were represented and a key responsibility would be to hold all agencies to account for the delivery of multi-agency service agreed standards as well as any improvement plans as appropriate. 

RESOLVED:

That the content of the reports be noted.

Presentation from John Kemp, Alzheimer’s Society, Regional Public Affairs and Campaigns Officer – North West

The Board received a presentation from John Kemp Regional Public Affairs and Campaigns Officer for the North West and Val Metcalf Service Manager for Sefton from the Alzheimer’s Society. The Society was the UK’s largest dementia charity, and supported people living with dementia. This was met in three main ways.

·       As a service provider – the Society provided support and information for people living with dementia to help them manage dementia and live better.

·       Funding research into the cause, cure, care, and prevention of dementia. 

·       Campaigning to affect policy and legislative change to improve the way people living with dementia were supported.

Dementia in Sefton:

·       There were an estimated 4,119 people over the age of 65 living with dementia in Sefton.

·       By 2025, it was projected that there would be 5,344 people over the age of 65, and 1,991 people between 30-64, living with dementia in the North West.

·       The diagnosis rate in Sefton was 70.4% (as at April 2019). This meant that there was an estimated 1,219 people living with dementia undiagnosed.

Mr.Kemp added that the Society recommended that:

·       Councils ensured their healthy living messaging referenced dementia, alongside heart disease and cancers, recognising that what was good for the heart was good for the head.

·       Councils, working with Health and Wellbeing Boards, should develop and affect a clear action plan to increase the invitation and take-up rates of NHS Health Checks year-on-year

·       Where they did not currently exist, councils develop a Dementia Strategy that mapped current and future needs along the well pathway and included tangible actions to improve the health of, and support available to, people affected by dementia

Mr. Kemp summarised by emphasising the Society’s aims to promote strategies to:

·       Prevent well

·       Diagnose well

·       Live well

·       Support well

·       Die well

RESOLVED:

That Mr.Kemp, and Ms.Metcalf be thanked for their presentation.

Report of the Paula St.Aubyn, Sefton LSCB Independent Chair

The Board considered the Sefton Local Safeguarding Children Board (LSCB) Annual report for 2018-19. Paula St. Aubyn, Chair of the LSCB presented the report.

The report explained that Sefton LSCB existed to coordinate and ensure the effectiveness of what was done locally to safeguard and promote the welfare of children and young people. It was a statutory body established under the Children Act 2004. It was independently chaired and was required by statute and consisted of senior representatives of all the main agencies who worked together to safeguard our children and young people. Underpinning all of the work of the Board, was the drive and determination to safeguard our children and young people built around the Board’s vision and value base.

Key Statistics:

There were 56,758 0-18 year olds in Sefton, of which:

·       7% children were of a black, asian, or minority ethnic group heritage

·       10% children had special educational needs or disabilities

·       1.2% children were looked-after by the Local Authority

·       0.9% children went missing during the year

RESOLVED:

That Sefton Local Safeguarding Children Board (LSCB) Annual report for 2018-19 be noted.

Report of the Chair of Sefton Partnership for Older Citizens

The Board considered Sefton’s Older Persons’ Strategy, which was presented by Councillor Cummins, and Mr Andrew Booth, Chief Executive of Sefton Pensioners Advocacy Centre 

The paper explained that Sefton was already experiencing issues of an ageing population which would in due course affect the rest of the country and to some extent the world. Sefton already had more than 63,000 people aged 65 or over. Within a decade this was projected to rise by over a fifth.

The strategy was the result of consultation with older people and stakeholders from across Sefton. The strategy hoped to enable focus on the areas that really mattered and embed Age-Friendly principles into future developments.

The strategy also linked closely to the themes of the Sefton 2030 Vision:

·        Together a stronger community

·        A borough for everyone

·        A clean green beautiful borough

·        Living, working and having fun

·        On the move

·        Visit, explore and enjoy

·        Ready for the future

·        Open for business

Councillor Cummins and Mr. Booth answered questions from Board members.

RESOLVED:

That the Sefton Older Persons Strategy be noted.

Report of the Head of Communities

The Board considered Sefton’s Early Help Strategy, which was presented by Councillor John Joseph Kelly.

The paper explained that the strategy was central to the delivery of a shared ambition that all children, young people, and families in Sefton would be safe, healthy and happy, and would aspire to be the best they could be. The strategy was co-produced with partners, in recognition that early help was a collaborative approach, not just an isolated service provision. 

RESOLVED:

That Sefton’s Early Help Strategy be noted.

Report of the Director of Public Health

The Board considered the report of Director of Public Health that presented the draft Health and Wellbeing Strategy 2020 – 2025. The report detailed the process and next steps toward adoption on the 1 April 2020.

The report explained, that the overarching aim of the strategy is to achieve a confident and connected borough that offers the things we all need to start, live and age well, where everyone has a fair chance of a positive and healthier future.

The report explained that the living well in Sefton strategy 2020-25 in key principles were:

Principles and ways of working

·       Priorities are based on the Joint Strategic Needs Assessment, and shaped by our consultation and engagement activity

·       Health and life chances are significantly shaped by the four main determinants of health.

·       (the wider determinants of health, health and social care system, lifestyles and behaviour,

·       the places we live and our communities)

·       Public, private, and voluntary, community, and faith sectors all need to work together to address these priorities

·       Priorities are high level, and informed by evidence and guidance where possible

·       Adopting a proportionate universalism approach (delivering services for everybody that step-up and down depending on need)

·       Embedding prevention in everything we do

·       Safeguarding the most vulnerable.

Ambitions

·       Start Well

o   Every child achieves the best start in their first 1001 days

o   Education and training enabled every young person to unlock the door to future choice and opportunity

o   Every child and young person had a successful transition to adulthood

·       Live Well

o   Health, care and wellbeing services across the Sefton system need to work together

o   Everyone has a fulfilling occupation which can support their needs

o   Ensure the Sefton system strengthens its role in prevention

·       Age Well

o   Older people stay active, connected and involved

o   As people grow older they are provided with support tailored to their needs

o   Ensure environments meet the needs of people as they get older

·       All Age

o   The places where we live make it easy to be healthy and happy, with opportunities for better health and wellbeing on our doorstep

Making it happen

o   The Health and Wellbeing Board (HWB) will hold the system to account

o   There will be a performance monitoring framework which will allow the HWB board to be assured of impact and progress

o   The activity of the HWB will be reviewed regularly, priorities reviewed, and progress will be shared with key stakeholders and residents of Sefton

The Director of Public Health circulated the latest version of the strategy to the Board at the meeting.

RESOLVED: That

(1)       the draft strategy be approved;

(2)       the Chair and the Director of Public Health be authorised to agree a final version prior to submission to the Cabinet and Council in January 2020; and

(3)    the progress be monitored against the strategy at each meeting from September 2020 onwards.

Report of the Interim Director of Children’s Social Care and Education

The Board considered the report of the Head of Children’s Social Care on the most recent draft of the proposed Children and Young Peoples Plan 2020 – 2025.

The report detailed the steps taken to produce the draft, the ongoing work, and the final process to agree a final version before approval of Cabinet was sought and the plan became operational on April 1st 2020.

The report was presented to the Board to give the opportunity for feedback before the final version was produced.

RESOLVED:

That the content of the report, and the draft of the Plan be noted. A request that further emphasis on Young Carers will be considered in the final version.

Report of the Interim Director of Children’s Social Care and Education

The Board considered the report of the Interim Director of Children’s Services and Education, which presented the final version of the Children and Young People’s Joint Continuing Care Protocol for South Sefton CCG, Southport and Formby CCG, Sefton Council and the Midlands and Lancashire Commissioning Support Unit

The report gave a summary of the local arrangements for Continuing Care and the process of development of this protocol and the next steps for the continued development of the process  and improved joint working in Sefton.

RESOLVED: That

(1)      the report be noted; and

(2)      the protocol be approved and adopted for Sefton.

Report of the Director of Public Health

The Board considered the report of the Director of Public Health, which provided an update on the work to tackle the harm caused by alcohol in our communities and which sought the Board’s support to participate with other similarly minded authorities across the North to build support amongst the public and politicians for the introduction of Minimum Unit Pricing (MUP).

RESOLVED: That

(1)           the report be noted; and

(2)           the decision for Sefton to participate with other similarly minded, authorities across the North of England, to build support amongst the public and politicians for the introduction of Minimum Unit Pricing (MUP) be supported.

Report of the Interim Director of Children’s Social Care and Education

The Board considered the report of the Chief Executive that provided updates on actions taken and progress made with regard to the improvements required following the Ofsted and Care Quality Commission joint local area special educational needs and/or disabilities (SEND) revisit.  The report detailed the key actions and responses being taken.

The Cabinet Member Adult Social Care confirmed that Sefton Parent Carer Forum were represented on the SEND Continuous Improvement Board and took an active role in challenge progress.

The Chair of the Health & Wellbeing Board sought an update on performance against the 20-week compliance since the time of writing the report.  Head of Strategic Support confirmed performance had improved again and explained how performance is measured.  The Chief Executive stressed the importance of the work being done around quality is of significant importance too, but this will take time to change.

The Chair of the Health & Wellbeing Board sought clarity on performance of health waiting times and how this is measured.  The Chief Operating Officer explained the current position has improved and the information relates to performance in that month.

The Chair of the Health & Wellbeing Board sought further clarity on what does this mean for longest time waiting.  The Chief Operating Officer confirmed the current position with regard to this matter.

RESOLVED:

(1)       the Department for Education approval of the Improvement Plan, detailed within the report, be noted; and
 

(2)       the information provided, the progress made, and the fact that the impact of some of the changes made were not yet visible, be noted.