Agenda and minutes

Apologies were received from the Chair, Councillor Rachael Blake (Dr David Crichton in the Chair), Richard Parker (Karen Barnard deputised), Kathryn Singh (Joanne McDonough deputised), Councillor Cynthia Ransome and Karen Curran.

There were no announcements by the Chair.

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

In addressing the Board, Councillor Derek Smith referred to the question he had asked at the last meeting with regard to the number of District Nurses available to treat patients during the night in Doncaster and pointed out that he was still awaiting a response.  He added that he had heard that the number of District Nurses could be as low as 2 across the Borough.

In reply, Joanne McDonough began by stressing that the Community Nursing service was not an emergency service.  With regard to response times for visiting patients, Joanne confirmed that the service was commissioned and resourced to respond within 2 hours for urgent referrals.  She explained that daily reviews were undertaken to assess demand and ensure that the needs of patients were met.  In terms of numbers of nurses available, she confirmed that for both the evening shift, which was from 7.30 p.m. to midnight, and the night-time shift, there were 3 registered nurses available, supported by 3 or 4 health care assistants, depending on demand.  She explained that while there was an element of flexibility in terms of numbers of nurses and assistants available, it could be challenging at times in respect of providing end of life care and administering pain relief.  All calls were triaged for urgency based on clinical need and all end of life patients were prioritised, especially in relation to pain relief.  If the service was unable to respond more quickly than the 2 hours and patients were in pain, then discussions were held about changing the way that pain relief was administered, for example from injections as and when required to a steady administration via a controlled mechanism such as a syringe driver. 

In reply to a further question from Councillor Smith, Joanne McDonough confirmed that she was of the opinion that there was a sufficient number of District Nurses available at night, but she stressed there was a need to ensure that the service could deal with peaks in respect of end of life patients, hence the need for daily reviews.

No declarations of interest were made.

RESOLVED that the minutes of the Health and Wellbeing Board held on 2nd November 2017 be approved as a correct record and signed by the Chair.

The Board considered a report which provided an update on the Outcomes Framework being developed for the Health and Wellbeing Board.  It was noted that the Outcomes Framework, once agreed, would allow the Board to drive delivery and be sighted on the key outcomes and indicators identified as important for the Board.

In presenting the report, Allan Wiltshire explained that there were two assumptions that could be made in linking this Board’s outcomes to other frameworks.  Firstly, that the starting well age categorisation would be delivered by the Children and Young People’s plan outcomes framework, to be monitored by the Children and Families Executive Board.  Secondly, the Indicators that were currently in the Doncaster Growing Together outcomes framework would need to be monitored by the Health and Wellbeing Board.

Members noted that a set of statements had been devised for each section of the matrix to be clear about what the Board was trying to achieve in each matrix cell i.e. what was important in the Prevention category and in the Ageing Well life course category.  These statements described what each cell of the matrix meant to Doncaster residents as well as outcomes that would demonstrate success.  Appendix A to the report listed these statements for the Board’s endorsement.  Appendix B to the report gave an example of how the reporting against key indicators against each cell of the matrix might look, as well as showing the range of indicators that would be used.  It was noted that there would be a clear scheduling of reports back to this Board to aid monitoring of the outcomes throughout the year.  The Board was being asked to endorse the framework proposals prior to receiving a more detailed report at its meeting in March.

In answer to a question, Allan Wiltshire explained the reason why there was no assessment against the benchmarks in relation to some of the indicators in the matrix, and pointed out that, over time, it was hoped that these gaps would be filled as more data was collected. 

During subsequent discussion, Members made various observations/comments on the proposed Outcomes Framework, including the following:-

·       It was felt that it would be useful if the matrix could also show details of trends upwards or downwards, perhaps by using arrows against each indicator;

·       While it was acknowledged that there was a need for benchmarking, it was also vital that the quality of services provided for the people of Doncaster was considered at all times;

·       With regard to the case for using local performance data as opposed to national data, it was acknowledged that the main benefit of using national benchmarks was that it allowed a more consistent approach in measuring against the performance indicators.  It was noted that in instances where performance against a particular indicator looked awry, there would be the option of drilling down to more local data and compare this against the national picture;

·       Arising from discussion on the need to make connections and ensure that the HWB made  ...  view the full minutes text for item 40.

The Board received and noted a presentation by Paul Tanney on the links between health, housing and the Doncaster Growing Together (DGT) programme.  The Board noted that a Housing (Homes for all) Programme Board had been established under the DGT theme of ‘Doncaster Living’.  Members were informed of the key projects and initiatives being pursued by the programme board under its 5 work streams, which comprised:

1. Housing Delivery
2. Care Leavers Accommodation
3. Older Peoples Housing
4. Homeless and Rough Sleeping
5. Accommodation for People with Learning and Physical Disabilities.

During subsequent discussion, the Board noted that, with regard to meeting Affordable Housing need, 1200 houses per year had been provided in Doncaster over the last 2 years.  This exceeded the target of 940 that had been set.  Members also acknowledged that sometimes people with complex needs were in need of larger accommodation, such as when they needed to be supported by a live-in carer. 

After the Board had discussed various issues in relation to housing, including the importance of designing homes for life, and the use of S106 monies for health and social care facilities, in addition to affordable housing, it was

RESOLVED to note the information provided.

Dr John Woodhouse, Independent Chair of Doncaster Safeguarding Adults Board (DSAB), presented the Annual Report of the DSAB for 2016/17, detailing what the Safeguarding Adults Board had done during the year to achieve its main objectives and implement its strategic plan and what each constituent has done to implement the strategy.  The Annual Report also set out the findings of any Safeguarding Adults Reviews and Lessons Learned Reviews completed during the year and the subsequent actions arising from the reviews.

In introducing the report, Dr Woodhouse outlined the current priorities and areas of development that the DSAB was focussing on, which included further work on enabling people to feel safe.

After some brief discussion, during which Members commended the DSAB on its production of a very accessible Annual Report, it was

RESOLVED to note the multi-agency activities undertaken during 2016-17 by the Doncaster Safeguarding Adults Board to safeguard adults at risk and prevent abuse from occurring wherever possible, and also receive the multi-agency performance and training statistics for this period.

Dr Rupert Suckling presented details of the Healthy Doncaster Framework 2017-18, which was a collaborative approach to addressing the complexity of the challenge that obesity brought to Doncaster.  It was reported that the Framework would provide an annual assessment of work streams which supported the obesity/healthy weight agenda in line with the Board’s revised outcomes framework.

Dr Suckling summarised the key work streams and initiatives identified under the themes of:-

• Delicious Doncaster;
• Get Doncaster Moving;
• Environment;
• Children & Young People and Families;
• Workplaces; and
• Weight Management Services.

The Board noted, in particular, that significant progress had been made under the theme of Get Doncaster Moving, in the area of Physical Activity, with the launch of a new Physical Activity and Sport Strategy and Doncaster’s success in being selected by Sport England to take part in a pilot scheme aimed at making it easier for people to access sport and physical activity to help reduce levels of inactivity.  This Scheme would enable the Borough to access £18 million of lottery funding.

After Dr Rupert Suckling had informed the Board that the national Workplace Charter run by Public Health England had been withdrawn at the end of last year, and that work was currently being undertaken to develop a South Yorkshire model and toolkit to take its place, it was

RESOLVED to endorse the Healthy Doncaster Framework and agree to receive reports as required.

The Board considered a report by Dr Victor Joseph which recommended some low-cost preventative initiatives aimed at helping to raise awareness of the benefits of healthy lifestyles and support people who wanted to make lifestyle changes.

It was reported that throughout the day people had countless opportunities to start healthy conversations with their colleagues, clients, patients or family members.  A short 30 seconds to 2 minutes conversation when an opportunity arose could start someone’s journey to a healthier life.  Doncaster’s Making Every Contact Count (MECC) programme would give frontline staff the confidence and knowledge to start conversations around healthy eating, smoking, physical activity and alcohol.  The training programme would overcome some of the barriers to having healthy conversations such as lack of confidence, knowledge and skills.  Essentially, by creating a workforce which was comfortable and confident in having healthy conversations, the aim was to reduce the burden on primary and secondary care services and promote early help and prevention as well as self-management.  The MECC training would not only raise awareness around risks associated with unhealthy behaviours but also promote local and national services that people could access in their communities.  It was also proposed to establish a Self-Management Working Group for Doncaster, which would outline specific aims and priorities in response to the local needs and use limited funding for the self-care and prevention projects and initiatives.

After Dr Joseph had answered questions on the proposed training, and the Board had questioned the need to establish an additional new working group to lead on this piece of work, it was

RESOLVED:

(1)        to endorse the face-to-face Train the Trainer programme for Making Every Contact Count in Doncaster across partner agencies; and

(2)        that it be suggested that an existing forum should be identified to take the lead on driving this initiative forward, as an alternative to establishing a Self-Management Working Group, as proposed.

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 particular, the report included updates for the Board on:

·             Board Development (the Board considered a number of Board Development  recommendations detailed in the report which had arisen from a recent Board Development day);

·             Pharmaceutical Needs Assessment;

·             Loneliness; and

·             Forward Plan for the Board.

Members noted that copies of the minutes from the October and November 2017 meetings of the South Yorkshire & Bassetlaw Sustainability and Transformation Partnership Collaborative Partnership Board, which had been omitted from the report, were available at the meeting and would be circulated for information on the subsequent decision summary.

After the Board had discussed and supported the key recommendations that had arisen from the Board development day, and also discussed the problem of Loneliness and the role which Elected Members could play in proactively dealing with loneliness in their Wards, it was

RESOLVED that:

(1)        the update from the HWB Steering Group be received and noted;

(2)        the Board development recommendations listed on page 89 of the report be agreed; and

(3)        the proposed Forward Plan, as detailed in Appendix A to the report, be agreed, subject to noting that the venue for the Board’s workshop on 8 February will be The Point, South Parade, Doncaster.