Agenda and minutes

Councillors Rory Palmer (Chair due to unforeseen circumstances), Adam Clarke and Abdul Osman (Leicester City Council), Francis Craven (Strategic Director Children’s Services), Professor Azhar Farooqi (Vice Chair Leicester City Clinical Commissioning Group), Chief Supt Sally Healy (Head of Local Policing Directorate, Leicestershire Police), Sue Lock (Managing Director Leicester City Clinical Commissioning Group), Dr Avi Prasad (Leicester City Clinical Commissioning Group) and Trish Thompson (Locality Director, Central NHS England).

RESOLVED:

That the Director of Public Health be appointed Chair for the meeting due to Councillor Palmer’s unforeseen absence.

Members are asked to declare any interests they may have in the business to be discussed at the meeting.

Members were asked to declare any interests they may have in the business to be discussed at the meeting.  No such declarations were received.

The Chair to invite questions from members of the public.

The Chair invited questions from members of the public.

Ms Jean Burnage asked a number of questions relating to Better Care Together.  The Chair suggested that these be taken as part of the presentation on the Better Care Together later on the agenda.

Mr Martin Trainer asked why the University Hospitals of Leicester NHS Trust was not represented on the Board.

In response the Chair stated that Councillor Palmer had recently written to Board members with a view to reviewing the Board’s membership and that changes would be announced in due course.

Wendy Hoult (BCF Implementation Manager, NHS England Central Midlands) stated that other Health and Wellbeing Boards within her area of responsibility had representatives of major health service providers on their Boards.

To note the membership of the Board for 2016/17 approved by the Council on 19 May 2016:-

City Councillors

Councillor Rory Palmer - Deputy City Mayor – Chair

Councillor Adam Clarke – Assistant City Mayor – Energy and Sustainability

Councillor Abdul Osman – Assistant City Mayor - Public Health

Councillor Sarah Russell – Assistant City Mayor – Children, Young People and Schools

NHS Representatives

Professor Azhar Farooqi – Co-Chair of the Leicester City Clinical Commissioning Group

Sue Lock, Managing Director - Leicester City Clinical Commissioning Group

Trish Thompson - Director of Operations and Delivery, Leicestershire and Lincolnshire NHS England

Dr Avi Prasad - Co-Chair of the Leicester City Clinical Commissioning Group

City Council Officers

Andy Keeling - Chief Operating Officer

Frances Craven - Strategic Director – Children’s Services

Stephen Forbes - Strategic Director - Adult Social Care.

Ruth Tennant - Director of Public Health

Local Healthwatch and Other Representatives

Karen Chouhan - Chair, Healthwatch Leicester

Chief Supt Sally Healy - Head of Local Policing Directorate

Professor Martin Tobin - Professor of Genetic Epidemiology and Public Health

The Board noted its membership for 2016/17 as approved by the Council on 19 May 2016as follows:-

City Councillors

Councillor Rory Palmer - Deputy City Mayor – Chair

Councillor Adam Clarke – Assistant City Mayor – Energy and Sustainability

Councillor Abdul Osman – Assistant City Mayor - Public Health

Councillor Sarah Russell – Assistant City Mayor – Children, Young People and Schools

NHS Representatives

Professor Azhar Farooqi – Co-Chair of the Leicester City Clinical Commissioning Group

Sue Lock, Managing Director - Leicester City Clinical Commissioning Group

Trish Thompson - Director of Operations and Delivery, Leicestershire and Lincolnshire NHS England

Dr Avi Prasad - Co-Chair of the Leicester City Clinical Commissioning Group

City Council Officers

Andy Keeling - Chief Operating Officer

Frances Craven - Strategic Director – Children’s Services

Stephen Forbes - Strategic Director - Adult Social Care.

Ruth Tennant - Director of Public Health

Local Healthwatch and Other Representatives

Karen Chouhan - Chair, Healthwatch Leicester

Chief Supt Sally Healy - Head of Local Policing Directorate

Professor Martin Tobin - Professor of Genetic Epidemiology and Public Health

To note the Board’s Terms of Reference approved by the Council on 19 May 2016.

The Board noted its Terms of Reference that were approved by the Council on 19 May 2016.

The Minutes of the previous meeting of the Board held on 2 February 2016 are attached and the Board is asked to confirm them as a correct record.

AGREED:

The Minutes of the previous meeting of the Board held on 2 February 2016 be confirmed as a correct record.

At 10.30am it was agreed to adjourn the meeting for 15 minutes as the Programme Director Better Care Together had been delayed at an earlier meeting.

At 10.45am the meeting resumed with all those who had been present when the meeting adjourned.  The Programme Director Better Care Together was also present.

To receive a report from the Programme Director Better Care Together (BCT) that provides an update on the progress of the BCT health and social care change programme for Leicestershire, Leicester and Rutland.

A copy of a presentation from the Programme Director Better Care Together giving an overview of the programme is also attached.

The Programme Director Better Care Together (BCT) presented a report that provided an update on the progress of the BCT health and social care change programme for Leicestershire, Leicester and Rutland.  Members also received a presentation that gave an overview of the programme.

During the presentation it was noted that:-

a)         The BCT programme was run through a series of work-streams considering a specific area for improvement in quality of care and sustainability. 

b)         BCT was in its third year of planning and had now become part of the process to produce a Sustainability and Transformation Plan (STP) announced earlier this year.  The BCT provided a platform for producing the STP which other parts of the country did not have as their BCT programmes were not as advanced.

c)         Work-streams were currently being reconfigured.

d)         There was a Partnership Development session later in the week and representatives from the city were encouraged to attend.

e)         There had already been changes to some services which did not require public consultation but those involving the overall changes to UHL and the future of the General hospital site, maternity services and the changes to community hospital services would require public consultation before any changes could be made.

f)          The consultation process for BCT had been delayed by the introduction of the STP process.  No consultation could take place until the financial elements of the STP had been approved by NHS England later in the autumn.

In response to the questions asked by a member of the public earlier it was noted that:-

a)         Although the stroke unit was moving to the Evington Centre, this building was still on the General Hospital site.

b)         The savings targets identified in the pre- business case were indicative targets to indicate the funding gap that would exist in five years’ time if no service improvements were made.  Treating patients in the acute sector was the most expensive way of treating patients and BCT was looking to provide different ways of coping with the extra demands being made on services within the future financial envelope.     

c)         The Mental Health Team were working to improve the availability of mental health services to patients before they reach a crisis point. This involved supporting patients arriving at UHL with early access to mental health services, rehabilitation centres were providing patients with new skills to enable them to integrate back into society more easily. Work was also under way to review out of county placements to see if treatment could be provided nearer to home.

Members of the Board received the following responses to their questions:-

a)         Prevention and promoting wellbeing were important threads of BCT and as it moved forward federations and the voluntary sector would have an important part to play in shaping services to enable a reduction in patients being admitted to the acute sector.

b)         The Police were keen to be involved in shaping mental health services as they had regularly had early engagement in dealing with people  ...  view the full minutes text for item 9.

To receive a report from Sarah Prema, Director Strategy and Implementation, Leicester City Clinical Commissioning Group  providing information on the development of the Sustainability and Transformation Plan (STP) for Leicester, Leicestershire and Rutland. 

A presentation on the Sustainability and Transformation Plan Checkpoint Submission is also attached.

Sarah Prema, Director Strategy and Implementation, Leicester City Clinical Commissioning Group presented a report that provided information on the development of the Sustainability and Transformation Plan (STP) for Leicester, Leicestershire and Rutland.  Members also received a presentation on the Sustainability and Transformation Plan Checkpoint Submission.

It was noted that the STP was a place based plan to accelerate the implementation of the Five Year Forward View required in the NHS Planning Guidance 2016/17 – 2020/21.   The STP covered all areas of CCG and NHS England commissioned services including specialised services and primary medical care.  The plan also covered the better integration with local authority services. 

The Better Care Together programme would form an integral part of the STP and Leicester, Leicestershire and Rutland were ahead of many areas of the country in developing the BCT programme.

In developing the STP each area has to show how they are going to ensure sustainability in the following areas:-

·         Health and Wellbeing

·         Improving care and quality

·         Ensuring financial sustainability

The feedback from NHS England on the initial submission in April had been positive and further work was ongoing to develop where LLR can go further on the three areas listed above.  A detailed submission has to be submitted to NHS England by 30 June 2016 and this will be based upon both the BCT Programme and the STP emerging priorities. 

The emerging priorities for the STP were:-

·         BCT Phase 1 service reconfiguration.

·         Public sector efficiency.

·         Prevention.

·         Urgent and emergency care.

·         Mental Health.

·         Integrated place based community teams.

·         Primary medical care.

·         Digital technology.

·         Public sector estate.

·         Health and care workforce.

·         LLR place based system approach.

These priorities would be developed by the 6 STP work-streams of:-

·         Improving health outcomes and independence.

·         Delivering care in the right place.

·         Making better use of resources.

·         Integrated place based teams.

·         Resilience in primary care.

·         System leadership.

It was expected the STP would not be finally approved until late autumn.  As part of this process the pre-consultation business case for the BCT was being refreshed.  As a consequence, public consultation on BCT could not start until this business case had been approved.

Following questions from members the Director Strategy and Implementation commented that:-

a)         There was patient participation involvement through the BCT Programme and the Chair of the Patient Participation Group would be in attendance at the meeting on BCT referred to earlier in the meeting.

b)         There was a transformation fund available for 2017/18 to reconfigure services; but access to this was dependent upon producing satisfactory plans.

c)         BCT and STP provided an opportunity to work with community and voluntary sector groups to contribute to health service provision especially within the prevention strategy.

In response to the Chair’s question on how the Board can add value to this work, it was noted that the demand on the acute sector from city residents was higher than other areas of LLR and the Board’s should be involved in assisting to stem the demand and ensuring the plans for public  ...  view the full minutes text for item 10.

To receive a report from the Managing Director, Leicester City CCG on the Leicester City Better Care Fund 2016/17.

Sarah Prema, Director Strategy and Implementation, Leicester City Clinical Commissioning Group presented a report on the Leicester City Better Care Fund (BCF) 2016/17.

It was noted that:-

a)         The BCF approval process required each area to submit a 2 part plan; a planning templated detailing activity, finance and a metrics plan and a narrative plan providing a detailed description of plans for 2016/17.

b)         Both parts the plan were jointly produced by the CCG and Council and approved by the Joint Integrated Commissioning Board and the Chair of the Board prior to submission.

c)         The plans were submitted through the Regional Assurance and Support process and the review panel indicated that the submission highlighted the ongoing commitment to the BCF programme and the narrative descriptors gave confidence that plans were in place to deliver against the BCF outcomes in 2016/17.

d)         There would be ongoing monitoring through the Joint Integrated Commissioning Board and further reports would be submitted to this Board.

e)         The delivery model was based upon 3 key priority areas of:-

·         Prevention, early detection and improvement of health related quality of life.

·         Reducing the time spent in hospital avoidably.

·         Enabling independence following hospital care.

These were now an integral part of the BCT work-stream.

The Central NHS England representative commended the plan and the work the city had done on the BCF and observed that the review and revision of the plan had been very effective.

It was noted that the number of non-elective admissions among the younger population was growing and that it may be beneficial to increase investment in a prevention-focused life-style hub for people over 40 years old to meet those challenges.

RESOLVED:

That the two components of the Leicester City better Care Fund Plan 2016/17 be approved.

The Board to begin discussions on developing a new approach to prevention for Leicester’s health and care system.

It was noted that the Deputy City Mayor had intended to lead on this item and the Board agreed to defer it to a future meeting. 

To note that future meetings of the Board will be held on the following dates:-

Monday 1st August – 2.00pm

Monday 10th October – 3.00pm

Thursday 15th December – 5.00pm

Monday 6th February 2017 – 3.00pm

Monday 3rd April 2017 – 2.00pm

Meetings of the Board are scheduled to be held in Meeting Room G01 at City Hall unless stated otherwise on the agenda for the meeting.

It was noted that future meetings of the Board would be held on the following dates:-

Monday 1st August – 2.00pm

Monday 10th October – 3.00pm

Thursday 15th December – 5.00pm

Monday 6th February 2017 – 3.00pm

Monday 3rd April 2017 – 2.00pm

Meetings of the Board were scheduled to be held in Meeting Room G01 at City Hall unless stated otherwise on the agenda for the meeting.

There were no items to be considered.

The Chair declared the meeting closed at 11.42am.