Agenda and minutes

The Chair welcomed Paul Tanney to his first meeting of the Board following his appointment as the new Chief Executive of St Leger Homes of Doncaster.  The Chair also welcomed Chief Superintendent Tim Innes, District Commander for Doncaster, to his first meeting as a Board Member.

Apologies were received from Councillor Nuala Fennelly, Kathryn Singh, Steve Helps, Paul Moffat (Jacqueline Wilson deputised), Peter Dale, Kim Curry (Jon Tomlinson deputised) and Karen Curran.

It was proposed by Councillor Glyn Jones and seconded by Councillor Cynthia Ransome that Dr David Crichton be appointed as Vice-Chair of the Board for the remainder of the 2016/17 Municipal Year.

Upon being put to a vote, it was unanimously

RESOLVED that Dr David Crichton be appointed as Vice-Chair of the Board for the remainder of the 2016/17 Municipal Year.

The Chair advised the Board that Mike Pinkerton was stepping down from his role as Chief Executive of Doncaster and Bassetlaw Hospitals NHS Foundation Trust later this month, so sadly this would be his last meeting as a member of the Health and Wellbeing Board.  On behalf of the Board, the Chair expressed her sincere thanks to Mike for the significant contribution he had made to the work of the Board and wished him all the very best for the future.  She added that Richard Parker, who was in attendance at today’s meeting, would be the Interim Chief Executive following Mike’s departure, so the Board would look forward to welcoming Richard as a formal Board Member at its next meeting in March.

The Chair also confirmed that, since the last meeting, Norma Wardman had tendered her resignation from the Board, due to the impending closure of Doncaster CVS.  She therefore wished to place on record the Board’s thanks both to the CVS for its work in the past and to Norma for the contribution she had made as a member of the Board.

On behalf of the Board, the Chair congratulated RDaSH on receiving an overall rating of ‘good’ following a re-inspection by the Care Quality Commission.

(A period not exceeding 15 minutes for questions from members of the public.)

Mr Doug Wright referred to the contents of the Sustainability and Transformation Plan (STP) at agenda item 8 (minute number 100) and stated that he was concerned over the lack of detail provided as to where the savings would come from to make up the financial shortfall of £571m that had been identified.  He also stressed the importance of carrying out public consultation on the proposals.  He asked whether the implementation of the STP could be temporarily halted to enable a listening exercise to be carried out between the clinicians and the public.

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Parish Councillor Stephen Platt expressed concerns over how the shortfall of £571m quoted in the STP would be met, particularly in light of the current reported problems in the NHS, such as a lack of resources, bed shortages and long waiting times for patients in hospitals and at a time when it was clear that the NHS needed more funding.

On a different subject, Parish Councillor Platt explained that Angela Curtis, who had asked a question about air pollution at the Board’s last meeting, was unable to attend today’s meeting.  He confirmed that Mrs Curtis had received a letter from Dr Rupert Suckling following the Board’s meeting outlining some of the measures being taken in the Borough to tackle the problem of air pollution.  Parish Cllr Platt expressed the view that these measures alone would not reduce pollution to an adequate extent and he stressed that what was needed was a change in everyone’s habits and behaviours.  He also suggested that air pollution should be a standing item on every HWB agenda in order that the Board could monitor progress in this area.

Parish Cllr Platt concluded by highlighting the valuable contribution that community libraries and parish councils could make in helping to publicise health awareness campaigns such as those which encouraged people to live healthier lifestyles.

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Parish Councillor Lynette Chipp asked Dr Rupert Suckling whether any progress had been made with regard to establishing an air pollution steering group, as referred to in the minutes of the Board’s last meeting.  In response, Dr Suckling confirmed that a meeting had been arranged with the Council’s Chief Executive and Pollution Control Officers to discuss this issue with a view to moving things forward.

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Mrs Anne Gilbert referred to the STP and stated that she shared the concerns of the previous speakers regarding the financial position.  She was particularly interested in how the STP would link GPs with Social Care and hoped that the presentation later in this meeting would address these points.

In thanking the members of public for their questions, the Chair explained that all of the points raised regarding the STP would be addressed under agenda item 8 (minute number 100).

There were no declarations of interest made at the meeting.

RESOLVED that the minutes of the Health and Wellbeing Board held on 3rd November 2016 be approved as a correct record and signed by the Chair.

The Board received and noted presentations by Jackie Pederson and Jon Tomlinson which provided updates on progress with the implementation of the Sustainability and Transformation Plan (STP) and the Better Care Fund (BCF).

In addressing the points raised under public questions, Jackie Pederson explained that the Doncaster Place Plan had been received by the Board at its previous meeting, and this outlined a commitment by providers to work together in new ways to provide services for health and social care through joint commissioning and with greater integration in future.  She confirmed that the Place Plan would link with the STP and that testing on this new model would commence across Doncaster soon.

In outlining the scale of the financial challenge and where the required savings were to be made, Jackie explained that if the STP proposals were successfully implemented, then it was hoped that these measures would go a long way towards making up the deficit, but she stressed that this would be a huge challenge.

With regard to public engagement in the process, Jackie confirmed that a listening exercise was due to commence in February.  She explained that Healthwatch Doncaster, along with other voluntary sector organisations, would be heavily involved in the public consultation exercise on the STP and therefore suggested asking Steve Shore to report back to a future meeting of this Board on the outcome of the consultation.

During subsequent discussion, the Chair explained that Doncaster Council’s Cabinet had discussed the Place Plan at length at its meeting in December 2016, but had only noted the overall direction of travel within the Plan at this stage, pending the outcome of the consultation to be held with staff, patients and the public during December and January.  Following the completion of the consultation exercise, a further report would be submitted to Cabinet for further discussion.

Councillor Glyn Jones referred to a recent article which had quoted the view expressed by the Chair of the BMA that STPs, proffered as the solution to the NHS deficit, had “revealed a health service that is in fact unsustainable without urgent further investment, and with little capacity to ‘transform’ in any meaningful way other than by closing services on a drastic scale”.  Councillor Jones suggested that it would be helpful if a Due Regard Statement was produced to measure the impacts of the STP proposals.  He also expressed the view that the STP was high level in terms of its content and there was little detail in the Plan to allow people to come to an informed decision about the proposals and he looked forward to seeing the results of the consultation exercise.

In response, Jackie Pederson agreed to take back to colleagues the suggestion in relation to producing a Due Regard Statement.  In terms of the content of the STP, Jackie stated that it was hoped that further clarity and details on the proposals would be available soon.

Following the presentations, the Board discussed a wide range of issues that had been  ...  view the full minutes text for item 100.

The Board considered a report which provided the latest performance figures for the Quarter 2 period, 2016-17. 

It was reported that a refreshed ‘outcomes based accountability’ (OBA) exercise was completed parallel to the refresh of the Health and Wellbeing Strategy. The five outcome areas remained and a new outcome on drugs had been introduced for 2016-17.  A number of specific indicators had been identified which would measure progress towards these outcomes in 2016-17.

Further information and narrative around the performance was set out in Appendix A to the report.

The Board discussed the key points and narrative behind the latest performance figures for each outcome area in turn, as summarised below:-

Outcome 1:  All Doncaster residents to have the opportunity to be a healthy weight 

In response to a comment regarding the absence of data beyond 2014/15 in relation to the obesity performance indicators, Allan Wiltshire explained that this data was produced nationally and more recent performance figures were very difficult to obtain.  He added that this point highlighted the need to identify ways of collecting relevant data locally.

Councillor Cynthia Ransome expressed the view that there was still much work to be done in tackling Obesity and felt that more measures were needed, such as  discouraging children from visiting fast food outlets on the way home from school.  Damian Allen stated that a ‘whole system’ approach was needed in order to address this issue, examining all contributing factors such as locations of fast food outlets, their opening hours and pricing of their food products.  He added that a report by the Independent Commission on Education and Skills in Doncaster had identified the need to develop a ‘Healthy Schools: Healthy Workplaces’ Kitemark, recognising that health underpinned educational success, future wellbeing and economic prosperity.

Outcome 2:  All people in Doncaster who use alcohol do so within safe limits

In response to a request as to whether a more detailed breakdown could be provided in relation to the data for alcohol-related attendance at A&E (Doncaster residents), such as the proportion of these that were people under the age of 18, Allan Wiltshire undertook to investigate whether this would be possible for future reports.

In reply to a question regarding the success of the trial of a Safe Haven in Doncaster Town centre during December 2016, Dr Rupert Suckling confirmed that at least 50 people had been treated who would have otherwise visited the A&E department.  He added that the trial, which was still being evaluated, had received positive comments from the Police and other organisations.

With regard to the figures for alcohol related violent crime, Chief Superintendent Tim Innes confirmed that there would be a marked increase in the number of recorded crimes over the coming months, due to changes in recording methods within the police force.

Outcome 3:  Families who are identified as meeting the eligibility criteria in the expanded stronger families programme see significant and sustained improvement across all identified issues

During discussion on these performance indicators, Jacqueline  ...  view the full minutes text for item 101.

The Board received a presentation and paper by Andrew Maddox outlining the work being carried out in relation to a whole service review of the delivery and provision of physical activity and sport.

This work would ensure that fully aligned strategies and policies were adopted by all partners at the highest level which would improve the approach to the development of sport and physical activity across the Borough.  Once adopted, these key pieces of work would place Doncaster at the forefront of Physical Activity and Sport provision, enabling a step change to developing an active population to “Get Doncaster Moving”.

Currently with partners the following had been commissioned:

• Stakeholder & Commissioning Project;
• Review of Doncaster Active Partnership;
• Physical Activity and Sports Strategy;
• Leisure Facility Review; and
• Playing Pitch Strategy.

During subsequent discussion, the Chair queried whether the decline in participation levels of people swimming was due to the aging pool facilities in the Borough.  In response, Andrew Maddox explained that a range of factors could affect participation trends in swimming and these needed to be identified, although he added that the state of the facilities was likely to be an influence.

After Members had acknowledged the need to give physical activity and sport greater prominence and recognition when formulating strategies and policies, such as the Doncaster Place Plan, it was

RESOLVED to endorse the report and review, and agree that the Doncaster Active Partnership be formally tasked with taking forward the delivery of the review and be held accountable for its delivery.

The Board considered a report which provided an update on the work of the HWB Steering Group to deliver the Board’s work programme and also provided a draft Forward Plan for future Board meetings, as set out in Appendix A to the report.

In presenting the report, Dr Rupert Suckling drew particular attention to the date of the Board’s Time-out and Development Session on 9th February 2017 and asked Members to note this date in their diaries.

Dr Suckling also informed Members that the first walk of the ‘Get Doncaster Walking’ 2017 program would be taking place at Lakeside, Doncaster on 21st January 2017 and would be led by Paratrooper, L/Cpl Ben Parkinson MBE and everyone was welcome to come along.

RESOLVED to:

(1)          note the update from the HWB Steering Group; and

(2)          agree the proposed Forward Plan, as detailed in Appendix A to the report.

The Board received and noted a briefing paper on the use of licensing powers to secure health improvement, as requested at the last meeting.