Agenda and minutes

1. To approve as an accurate record and the Chairman to sign the minutes of the meeting of the Health & Wellbeing Board held on 17 June 2013.

2. To note that the Council, having consulted the Health and Wellbeing Board (HWB) and having regard to the recommendation of the HWB,  directs that the Clinical Commissioning Group (CCG) representative and the local Healthwatch representative are entitled to vote, but that Council officers on the HWB are not entitled to vote.

RESOLVED THAT:

(i)                  The minutes of the Health & Wellbeing Board held on 17 June 2013 be approved and signed as a correct record of the proceedings.

(ii)                The Board noted that the Council, having consulted the Health & Wellbeing Board (HWB) and having regard to the recommendation of the HWB, directed that the Clinical Commissioning Group representative and the local Healthwatch representative are entitled to vote, but that Council officers on the HWB are not entitled to vote.

Apologies were received from Councillor Helen Binmore and from Dr Peter Brambleby for lateness and from Andrew Christie for leaving early

Any Member of the Board, or any other Member present in the meeting room,

who has a disclosable pecuniary interest in a matter to be considered at the

meeting is reminded to disclose the interest to the meeting and to leave the room

while any discussion or vote on the matter takes place.

Members are also reminded that if they have any other significant interest in a

matter to be considered at the meeting, which they feel should be declared in the

public interest, such interests should be declared to the meeting. In such

circumstances Members should consider whether their continued participation, in

the matter relating to the interest, would be reasonable in the circumstances,

particularly if the interest may give rise to a perception of a conflict of interests,

or whether they should leave the room while any discussion or vote on the matter

takes place.

There were no declarations of interest.

The Board’s proposed work programme for the municipal year is set out as Appendix 1 to this report.

The Board is requested to consider the items within the proposed work programme and suggest any amendments or additional topics to be included in the future.

The Board is requested to consider the oral update on the HWB workshop.

RESOLVED THAT:

(I)                  The work programme be noted.

(II)                The Board noted that a half day workshop, facilitated by the Kings Fund,  would be held on the 8 October 2013, at Hammersmith Town Hall.

(III)               The workshop should review the HWB generally and the CCG’s Clinical Commissioning Intentions and specifically alignment with those of the Council and Public Health.

This report provides the Health & Wellbeing Board (HWB) with:

·         An understanding of the overall development process and the underpinning principles

·         A summary of our key areas of commissioning intent for 2014/15 and their strategic fit

·         A summary of key strategic challenges

·         How these challenges determine our focus for 2014/15

·         A summary of further opportunities for involvement

·         Sight of the proposed content and structure of the commissioning intentions document

·         Some key questions for consideration.

Dr Tim Spicer presented the report on the CCG’s Commissioning Intentions 2014/2015. Whilst the commissioning intentions were published on an annual basis, the process was ongoing, with strategic objectives being developed over a number of years, for example patient involvement in overall care. The commissioning intentions were derived from the Joint Strategic Needs Assessment (JSNA), but there were multiple drivers beyond the JSNA such as the Shaping a Healthier Future (SaHF) re-configuration proposals.

The report set out the basis for developing the commissioning intentions and how these would be developed. Dr Spicer stated that QIPP (Quality, Innovation, Productivity and Prevention) had to be achieved annually, and savings were in the region of 5% per annum. All stakeholders would be involved to a greater extent in developing commissioning intentions over time.  The report set out the engagement with individuals and teams currently.

The report also set out the timeline for developing commissioning intentions and the key milestones. The key strategic challenges includes meeting the needs of the population as identified in the JSNA and ensuring measurable changes in outcomes across the HWB priorities. A table illustrated how the commissioning intentions themes had structured the 2014/2015 service delivery and their fit with the key strategic drivers.

The CCG was currently working with stakeholders to update each of the key areas of the 2013/2014 commissioning intentions. An unscheduled care update had been provided as a draft example.  Dr Spicer stressed the importance of patient empowerment.

Councillor Ginn opened the discussion on alignment of commissioning between the Council, CCG and Public Health and joint commissioning where appropriate. It was suggested that the starting points should be the strategic fit of the CCG commissioning intentions with the  HWB strategic priority areas. There needed to be clarity about how resources could be re-deployed to bring about change and the barriers.  

The key strategic challenge would be to ensure measurable changes in outcomes across the HWB priorities, to be delivered within the context of a recurring QIPP gap and future comprehensive spending round. Joint commissioning of services could also deliver best value for money.

Councillor Ginn referred to Public Health commissioning and procurement and the need to cross reference with the CCG commissioning intentions. The re-procurement timetable was phased over three years and this was being challenged in view of the need to integrate with co-commissioners and to develop a framework against which commissioning outcomes could be measured.

Dr Spicer referred to the October timeline for refining/developing commissioning intentions and ensuring final alignment with the with the JSNA refresh and fit with HWB strategy to achieve required changes. Currently there were block contracts with providers, which were difficult to relate to outcomes and which aspect had brought about change in health status.

Members acknowledged the need to move towards an overarching commissioning plan, and that areas on which to focus could be considered at the HWB workshop.

Councillor Ginn referred to the transfer of public health to the Council and the  issues of  ...  view the full minutes text for item 16.

This report updates on JSNA progress since.

The Board is requested to approve final sign-off on the Employment Support JSNA Deep Dive for further dissemination and to facilitate action on the recommendations

Ms Hrobonova presented the update report, which included the Employment Support JSNA Deep Dive, awaiting sign-off by each of the three HWBs.

The first JSNA Steering Group meeting would take place on 18 September, and would begin to assess the priorities and future direction of the JSNA work programme.

The current deep dive JSNAs were: learning disabilities, physical disabilities and tuberculosis. Future deep dives were: child poverty and alcohol. An application was pending for veterans’ health.

Councillor Ginn queried the mutual relationship between the HBW and Public Health. Dr Brambleby responded that the HWB was responsible for approving the commissioning plan, whilst public health provided quality assurance and a steering group. In addition, the JSNA was in place and supported commissioning.

Dr Brambleby continued that the ways in which the HWB and Public Health monitored each other through included: lines of accountability such as the national annual update of how local authorities were performing in respect of the health of their populations; each borough helping people with disabilities to get back into work; the annual report on the health of the population a requirement of the Director of Public Health. Ms Hrobonova added that the HWB could issue quite specific directives in respect of commissioning intentions to take ensure that the JSNA has been fully taken into account.

Dr Spicer stated that the interface between mental health and physical disability and employment informed commissioning intentions, but remained some way to go to meet different levels of need.

RESOLVED THAT:

(I)                  The report be noted.

(II)                The Employment Support JSNA Deep Dive was approved.

(III)               The update report would include the JSNA needs achieved through the commissioning intention.

Action: Peter Brambleby/Eve Hrobonova

This report sets out the proposals for the use of NHS Funding for Adult Social Care the attached memorandum and schedule.

This item was deferred on the grounds that the report is a draft for the 2013/14 allocations and there is a need for it to proceed through the CCG governance process before it is presented to the Health & Well-being Board.

This report summarises the purpose and terms of the new fund and identifies actions which local health and social care organisations need to take to take advantage of this opportunity, drawing on the recently published Local Government Association/NHS England joint statement[1] and briefing events. 

Mrs Redmond introduced the report in respect of a fund of £3.8 billion nationally to ensure closer integration of health and care services from 2015/2016, referred to as the Integration Transformation Fund (ITF). The ITS was being funded from existing sources of funding, including existing CCG budgets.

Localities where spend would take place would be identified and they would be asked to develop a local plan by March 2014 covering the two years 2014/2015 and 2015/2016. 

RESOLVED THAT:

(1)   The report be noted.

(2)   The Board to be updated on the joint spending plans.  

This report explains the background to the development of a new Partnership Agreement for the Commissioning of Health, Wellbeing and Social Care between the London Borough of Hammersmith and Fulham and NHS Hammersmith and Fulham Clinical Commissioning Group.

This report is for information.

Mrs Redmond introduced the report which explained the background to the development of a new partnership Agreement for the Commissioning of Health, Wellbeing and Social Care between the London Borough of Hammersmith & Fulham and NHS Hammersmith & Fulham CCG.

RESOLVED THAT:

The report be noted.

The Board is asked to note that the dates of the meetings scheduled for the municipal year 2013/2014 are as follows:

 4 November 2013

13 January 2014

24 March 2014

4 November 2013

13 January 2014

24 March 2014