Meeting Details

Apologies were received from:

Also regretting that they were unable to attend:

The minutes of the meeting held on 26 October 2016 were agreed and signed as correct.

Councillor Rolfe declared a Code interest as a Director of Procurement at the East of England NHS Collaborative Procurement Hub.

 The Chairman reminded members of the Board that in addition to making any relevant declarations at the meetings they should also keep their registers of interests up to date.

 There were no questions from members of the public.

 The members of the Board received a verbal update from Clare Morris from Anglia Ruskin Health Partnership and a presentation from Alison Foster from Pi Ltd - Analytics. The members also noted that they had been provided with a written narrative, entitled Essex Data Analytics, distributed prior to the meeting.

Members were reminded that two years previously, money had been received from the Government for the Transformation Challenge Award and there were a number of projects undertaken using that funding, such as supporting ongoing work around domestic abuse. Clare Morris, Ian Stidston and others have been part of the TCA Steering Group which sits under the Essex Partnership Board, recently renamed Essex Partners, and this project has been quietly progressing in the background for some time.

The project is reaching an exciting point. Alison Foster demonstrated the opportunities afforded by the risk stratification tool in using data to predict trends, allow intervention and potentially cut costs.

Members of the Board discussed the merits of the Data Sharing Platform and expressed concern that the programme did not include partners in both Southend-on-Sea and Thurrock as only by their inclusion could the data be complete. They also agreed that the NHS should be encouraged to co-operate.

Resolved

1.  That the verbal update be noted,
2. That there be an exploration of the opportunities to include Southend and Thurrock in the initiative in order that it can maximise its effectiveness across the whole health economy of Essex; and
3. That a letter be sent by the Chairman of the Essex Health and Wellbeing Board to all Chef Executives encouraging the ??? of health providers

 The members of the Board received a report (HWB/01/17) from Barbara Herts, Essex County Council, and considered the key concepts in the new pan-Essex, multi-partner strategy for Mental Health and Well-being that outlined the strategic direction of travel for the mental health system over the next 5 years.

The members of the Board considered the options as described in the report and determined to adopt the Southend, Essex and Thurrock Mental Health and Well­being Strategy.

Members were informed that the Strategy was also being sent to the Southend, and Thurrock Health and Wellbeing Boards for endorsement in January 2017.

Resolved

1.  To Adopt the Southend, Essex and Thurrock Mental Health and Well-being Strategy in the form as shown in Appendix 3 to the report.
2. To acknowledge and thank Christine Dickenson for her input to the Strategy and achievements in leading the mental health system in North Essex, prior to November.
3. Additionally, the members of the Board wished to put on record their gratitude to Barbara Herts for her work and commitment, as she was moving to work elsewhere.

 The members of the Board received a report (HWB/02/17) from Rebecca Jarvis, Essex County Council.

The report asked the Health and Wellbeing Board to adopt the new pan­Essex, multi-partner strategy for Dementia which outlined the strategic direction of travel for the dementia system in Essex, over the next five years.

The members were reminded that the UK population was ageing; people were living longer and as a result the number of people experiencing ill health and being diagnosed with long term health conditions, such as dementia, was growing, with further growth predicted.

The Board was asked to approve the Strategy and to use its influence to ensure that organisations across Greater Essex were united in its implementation. It was designed to improve outcomes for people with dementia and their families.

Resolved

To adopt the Southend, Essex and Thurrock Dementia Strategy in the form appended to the report.

 The members of the Board received a report (HWB/03/17) from Barbara Herts, Essex County Council.

The purpose of the report was to seek endorsement from the Health and Wellbeing Board for 'Open Up, Reach Out' which is the Southend, Essex and Thurrock Children's Mental Health Local Transformation Plan and the Emotional Wellbeing and Mental Health Needs Assessment on Children and Young People.

In response to questions the Board were advised that:

• there was a clear need to identify early those children that need intervention,
• feedback from young people highlights the importance of being able to talk to someone to minimise isolation,
• working with parents, families and schools is helping to reduce stigmatisation and bring the subject out into the open,
• working with children in order to promote the opportunity for self-help is also important.

Members were advised that recently the Duke and Duchess of Cambridge had visited the Sewards Centre in Harlow to see some excellent examples of good practice. Other initiatives and examples of best practice include:

• The Epping Youth Council, which should be replicated across Essex,
• The work of the Young Essex Assembly to showcase best practice,
• The funding a radio station that is breaking down the stigma around emotional health and wellbeing,
• The development support programme being piloted in North Essex, and
• The work of the Young Minds and Heads-Up Charity.

The members of the Board were advised that the Chairman of the Essex Health and Wellbeing Board, Councillor Butland, would soon be sending a letter to CCGs to encourage more progress on integration, and that there should be better engagement with local Health and Wellbeing Boards.

It was also suggested that in Tendring, rather than dealing piecemeal with individual local members, there should be contact specifically with the portfolio holder in Tendring, Councillor Linda McWilliams.

Resolved

1. To endorse the refreshed five year transformation plan 'Open Up, Reach Out', as set out in Appendix 1 to the report.
2. To endorse the Emotional Wellbeing and Mental Health Needs Assessment on Children and Young People across Southend, Essex and Thurrock, as set out in Appendix 2 to the report.

 The members of the Board received a verbal update and presentation from Andrew Geldard, West Essex Clinical Commissioning Group, entitled 'A Healthier Future' that presented the

• STP National Aims,
• Ambitions
• Context
• Herts and West Essex Financial Overview,
• Solutions,
• Workstreams,
• Enablers,
• Governance Structure,
• Prevention work across the STP Primary and Community Approaches,
• Priority Areas/Pathways, STP  Acute Workstream Programme Structure and,
• Next Steps.

Members of the Board were presented with a copy of the presentation.

He suggested that Hertfordshire and West Essex had a faltering start to their STP and recognised that theirs was not the strongest of STP submissions but what they have got so far is a good start. There is an ongoing review about how they can get more vigour into delivery and then how to supplement some of the initiatives with better practice and to address financial and demand pressures.

Concerning governance, it was noted that Cllr Graham Butland, Chairman of the Essex Health and Wellbeing Board had written to each of the Chairs of the STPs and suggested that the relevant Chairs of the Essex, Southend and Thurrock Health and Wellbeing Boards should meet regularly so there is a formal place for the HWBs in the governance.

The members of the Board received a verbal update and presentation from Andy Vowles, NHS England.

Issues that he mentioned included:

• All the STPs have now been published,
• Also published are the clinical senate reports for the Mid and South Essex STP, which is a review of some of the hospital proposals,
• Engagement, user/patient/staff workshops,
• Options appraisal,
• Further development of the group model of the three hospitals within the STP footprint.          ·

He suggested that there was commonality between all STPs which have very similar proposals. But here concentrated on three main areas:

• the prevention agenda,
• building local networks and
• the potential for service reconfiguration in the three hospitals.

Issues that are currently being faced are, firstly, about how to use data proactively to identify people who need better case management and would thereby benefit from prevention and self-care? Secondly, how tointegrate primary care, mental health and other services? Thirdly, what is the future of primary care? It would appear that there are opportunities afforded by larger networks, to build and expand capacity and to rebalance our economies overall.

Hospital reconfiguration is the principal focus at present. The STP have been articulating options for the future configuration of the three hospitals in Mid and South Essex ,organising them differently, to assist in clinical workloads and workforce planning. Options are around different combinations of a specialist emergency hospital, elective centre and hosipital(s) with some emergency, specialist and elective care. Next month a panel of user groups, clinical and finance experts will appraise the evidence for reconfiguration.  Once this appraisal has been completed  a business case will be finalised.

In response to questions he confirmed that the modelling has gone beyond five years to take account of housing, demographic change and population growth.

The members of the Board received a verbal update from Gary Sweeney, North East Essex Clinical Commissioning Group.

The members of the Board were advised that the STP plan had been submitted, published and feedback from NHS England had been received.

Those leading on the development of the plan have:

• recognised the need to enhance capacity around an Independent Chair and have appointed Alan Burns as Independent Chairman as well as Susanna Howard as Programme Director,
• met Essex Overview and Scrutiny Committee,
• intend to meet Essex and Suffolk HOSCs,
• firmed up a Governance framework, starting a Chairs' Group and proposing that there should be a STP/HWB link group, possibly (if agreed) to meet in March.

The plan is on target for all of its milestones and most of the ongoing work was planned anyway. However acute reconfiguration work around Colchester and Ipswich hospitals is new, and that is currently being scoped.

Resolved

The verbal reports were noted.

 The members of the Board received a report (HWB/04/17) from Sheila Norris, Essex County Council.

The members of the Board were informed of the new BCF planning requirements for 2017/18 and 2018/19.

It was noted that neither the new BCF Policy nor the Policy Guidance had yet been issued by NHS England at the time of writing the report. However, it was expected that it would be on the same footprint as previously and the financial allocations to specify the minimum allocations required.

Members were informed that there was to be an 'improved' BCF but this was not additional money. In fact, as the formula for calculation was inversely linked to that which can be raised through local taxation it was anticipated that Essex would not obtain any new money.

In response to a question, members of the Board were advised by Kim Cole, Principal Lawyer, Essex County Council, that (in order to expedite sign-off within a limited opportunity, and to avoid the necessity for an additional special meeting) a virtual sign-off or endorsement by email was permissible because the final BCF offer would go before the ECC Cabinet for approval. However, there must be sufficient endorsements to be a number equivalent to a quorum of the HWB.

Resolved

1. To  approve,  retrospectively,  the  contents  of  the  Quarter  2  report  for  BCF 2016/17  which was submitted  to NHS England  on 25 November  2016, (as shown in Appendix 1 of the report),
2. To  note  the  requirements  for  the  new  BCF  Plan  covering  2017/18                        and 2018/19,
3.  To approve the use of an electronic procedure by the Board to sign off the 2017/18 and 2018/19 BCF following circulation  of the BCF plan to all Board members.

The members of the Board received a report from Mike Gogarty, Essex County Council and Ian Davidson, Tendring District Council regarding the recent review of the Essex Health and Wellbeing Board's role and to make recommendations for reform.

The members of the Board considered the report and it was

Resolved

• That the proposals to support and enhance the role of locality Health and Wellbeing Boards, as set out in paragraph 3.8 and Appendix 1 of the report,

• That there shall be created an Essex Strategic Co-ordination Group, as set out in paragraph 3.19, and Appendices 2 and 3 of the report,

• That HWBB chairs meet regularly with STP chairs to support more integrated work, as set out in paragraph 3.25 of the report,

• That there be a transfer of oversight of in-depth analysis to the ESCG,

• That lead organisations be identified to take forward 'deep dive' topics, including named contacts, and provide accountability,

• That there be a change to quarterly reporting of CCG scorecards with a review of content, and there be included recommendations on content and

• That the ESCG be directed to develop a plan for consultation and development of a new JHWS (after the current JHWS expires in 2018) setting out core strategic priorities, with active leadership and collaboration from the District HWB Boards, involving the EPB and liaising with STP leads.

 The members of the Board noted that the next meeting would be on: Wednesday 8 March 2017 at 2pm in the Civic Suite in Rayleigh and that the further meetings for 2017 will take place on:

• Thursday 11 May 2017 at 2pm, CR1, County Hall, Chelmsford,
• Thursday 6 July 2017 at 10am, Causeway House, Braintree,
• Tuesday 12 September 2017 at 2pm, CR2, County Hall, Chelmsford and
• Tuesday 7 November 2017 at 2pm, CR1, County Hall, Chelmsford.