1. health and fitness

Subject:
Health and Wellbeing Board
Development 2015/16
Report to: Health and Wellbeing Board
Status:
For Publication
Date:
Tuesday, 31 March 2015
Author:
Wendy Meston
Elizabeth Islam
Tel:
Tel: 01706 927089
Cabinet Member: Councillor Cecile Biant
Report of: Wendy Meston - Director of Public
Health
Author Email:
[email protected]
Comments from Statutory
Officers:
Monitoring Officer: Yes/No
Section 151 Officer: Yes/No
Key Decision:
1
Purpose of the report
1.1
To summarise current regulations as they relate to Health and Wellbeing Boards
(HWBBs) and outline revised local governance and structural arrangements for
2015-16 to ensure these are sufficient to deliver the Board’s key priorities.
2
Recommendations
2.1
That the Board revisits and considers the statutory duties, purpose and functions of
the Health and Wellbeing Board.
2.2
That the Board considers and agrees the proposed revisions to governance and
structure arrangements of Rochdale Borough Health and Wellbeing board (HWBB);
namely:
2.2.1 That the Board reviews and considers membership of the HWBB, particularly in
relation to the voluntary/community sector and providers.
2.2.2 That the Board review and agrees working groups for 2015/16 and reporting
arrangements
2.2.3 That the Board considers the creation of an Integrated Commissioning Board in
2015/16 with formal delegated authority and pooled budgets as agreed. A
separate Board paper is presented to outline this proposal.
2.2.4 That the Board considers the creation of a Premature Mortality sub-group.
2.3
That the Board considers and agrees the proposed workplan arrangements for 2015
16.
2.4
That the Board agrees how it wishes to performance monitor and communicate the
HWBB work plan, priorities and achievements.
2.5
That the Board agrees to a further development day in 2015/16
3
Background
Statutory duties, purpose and functions of HWBBs
3.1
The Health and Social Care Act 2012 established health and wellbeing boards
(HWBB) in every upper tier and unitary local authority with effect from 1st April 2013.
Prior to this date, a HWBB ran in shadow form in Rochdale from April 2011.
3.2
There are a number of underlying principles of HWBBs, including providing shared
leadership and ownership for the health and wellbeing of communities, a
commitment to driving real action and change, openness and transparency, and a
commitment to engaging with patients, service users and the public.
3.3
The Act gives HWBB the following specific functions:
i.
Production of Joint Strategic Needs Assessment (JSNA) and a Joint Health and
Wellbeing Strategy (JHWBS) and a Pharmaceutical Needs Assessment (PNA)
for the local area.
ii.
A duty to encourage integrated working between health and social care
commissioners in connection with the provision of health and social care
services, including providing advice, assistance or other support to encourage
arrangements under section 75 of the National Health Service Act 2006 (i.e.
lead commissioning, pooled budgets and/or integrated provision).
iii.
A power to encourage close working between commissioners of health-related
services and the HWBB itself.
iv.
A power to encourage close working between commissioners of health-related
services (such as housing and many other local government services) and
commissioners of health and social care services.
v.
Any other functions that may be delegated by the council under section 196(2)
of the Health and Social Care Act 2012. For example, public health functions,
functions relating to the joint commissioning of services and the operation of
pooled budgets between the NHS and the council, or wider services which
have an impact on health, wellbeing and health inequalities.
3.4
The statutory membership of the Health and Wellbeing Board comprises –
o
o
o
o
o
o
o
3.5
at least one Councillor of the local authority, to be nominated by the Leader of the
Council
the Director of Adult Social Services for the local authority
the Director of Children's Services for the local authority
the Director of Public Health for the local authority
a representative of the local Healthwatch organisation for the Borough
a representative of each relevant Clinical Commissioning Group, and
such other persons, or representatives of such other persons, as the Board or the
local authority after consulting the Board thinks appropriate
The Health and Social Care Act 2012 also sets out the following principles for
HWBBs:
•
HWBBs cannot ‘veto’ any of board member organisations’ commissioning plans, but
Clinical Commissioning Group (CCG) and local authority commissioning plans will be
expected to be informed by the JSNA and JHWBS.
•
CCGs must consult the HWBB in preparing its annual report which should review the
extent to which the CCG has contributed to the delivery of the Health and Wellbeing
Strategy.
•
It is good practice for local authorities to involve the HWBB in developing their
commissioning plans.
•
All voting members of HWBBs will be governed by the local authority’s code of
conduct.
•
HWBBs meetings are subject to the same openness and transparency rules as other
Council committees. Meetings should be held in public and the public should also be
able to access any additional information that is discussed in a meeting.
•
The Regulations enable HWBBs to establish formal sub-committees to carry out its
functions and make decisions. Formal sub committees are subject to the same
provisions around openness and transparency that the Board is subject to. Less
formal structures, such as sub groups, do not have powers to make Board decisions
but are able to report their recommendations to the HWBB.
3.6
In March 2015, the Association of Greater Manchester Authorities (AGMA) in
association with NHS England and the Greater Manchester Association of Clinical
Commissioning Groups released a ‘Memorandum of Understanding’ for GM Health
and Social Care Devolution. Proposed plans are to be further developed and
implemented from April 2016. Currently proposals include;
•
•
•
A Greater Manchester Strategic Health and Social Care Partnership Board
(GMHSPB) will oversee a GM Strategic Sustainability Plan for Health and Social
Care. A GM Joint Commissioning Board is also under consideration.
Each area will have a Local Area Plan, to be overseen by the Local Health and
Wellbeing Board
Each area will have a local Joint Commissioning Board, with pooled funds and
responsibility for commissioning services in line with the Local Area Plan.
Rochdale Borough Health & Wellbeing Board
3.7
Rochdale Borough Health and Wellbeing Board was formally established in April
2013 and its terms of reference are included within the Council’s constitution (see
appendix 1).
3.8
In July 2014, the Board received a report outlining the findings of a HWBB review.
The key findings were:
1. To agree a programme of development work, including reviewing terms of
reference, governance and membership
2. To create a Board workplan
3. To lead the conversations and be the driving force to produce a refreshed JSNA
and Health and Wellbeing Strategy in 2015
4. To review and agree Board priorities, sub groups, reporting arrangements and
communication plans
5. To develop a tracking and monitoring process in order to demonstrate how the
Board is making a difference and how outcomes are changing
6. To develop a better Board communications process in order to demonstrate the
role of the Board and progress on work programmes and outcomes. This needs to
be both internally and externally.
7. To continue the development process by dedicating ‘time out’ development
sessions in addition to continuing Board business.
3.9
Since the review, initial development work took place in late 2014 which began the
process of creating a new vision statement for the Board. In addition, work has
begun on a refreshed JSNA.
3.10
This report sets out proposals for revised terms of reference, governance and
structures. In addition it proposes plans to take forward previous work on visioning,
ways of working together and communications.
Membership
3.11
Current membership of the Health and Wellbeing Board is as follows:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Councillor Cecile Biant, Cabinet Member for Public Health and Regulation
Councillor Iftikhar Ahmed, Cabinet Member for Adult Social Care
Councillor Ashley Dearnley, Leader of the Conservative Group
Councillor Sameena Zaheer, Assistant to Cabinet Member for Children's Social
Care
Steve Rumbelow, Chief Executive, Rochdale Borough Council
Sheila Downey, Director of Adult Services
Wendy Meston, Interim Director of Public Health
Gail Hopper, Director of Children’s Services
Lesley Mort, Chief Operating Officer, HMR Clinical Commissioning Group (CCG)
Dr Chris Duffy, Clinical Chair, Heywood, Middleton and Rochdale Clinical
Commissioning Group (HMR CCG)
Dr Musharraf Hussain, HMR CCG Clinical Lead
Dr Richard Verity , HMR CCG Clinical Lead
Rob Bellingham, Director of Commissioning, Greater Manchester, NHS England
Dr M Corns, Health Watch
3.12
It was previously agreed that the Board include a member from the
voluntary/community sector but the method of doing so has not yet been agreed and
this requires further work
3.13
It is proposed that the Board review the current method of engaging provider
organisations. The current model is to engage via membership of all current sub
groups, presentations on work to Board meetings and via the Health and Wellbeing
Board Assembly.
Governance, delegated authority and accountability
3.14
A revised governance structure is outlined below for discussion.
3.15
Plans for Greater Manchester devolution describe formal Joint Commissioning Boards
at a local level, responsible for commissioning in line with a Local Area Plan to be
overseen by the local HWBB. It is proposed that the Board consider the creation of an
Integrated Commissioning Board with formal delegated authority and pooled budgets
For health and social care (see section 3.5 on the Council’s ability to delegate
additional functions to the HWBB).
3.16
The structure above outlines a relationship with the following subgroups, accountable
to the HWBB:
•
Premature Mortality (TBA). A new working group is proposed to lead plans to
reduce rates of Premature Mortality in the borough. The HWBB held a
workshop on this issue in June 2014 and agreed it as a Board priority.
Outcomes are not improving at the rate envisaged. This group would focus on
the following:
o Monitor and advise the Board on performance on outcomes
o Creation and agreement of Board and organisational plans to support
the wider HWBB premature mortality plan specifying agency
contributions which can be measured and monitored.
o Review interventions/activity commissioned to support the HWBB
premature mortality plan, particularly the actions identified as most likely
to create early change specified in the action plan
o To consider opportunities for joint interventions and approaches to
reduce intervention decay, ensuring that we achieve maximum benefit
for priority interventions.
o The group will invite providers to describe how their operational work is
aimed at reducing premature mortality.
o
The group will become the hub for premature mortality work stream in
Rochdale and will enable each HWBB partner agency to consider in
detail how to commission and provide effectively for reducing premature
mortality and health inequalities.
•
Children and Young People’s Partnership (CYPP). The CYPP leads on the
priorities relating to children and young people in the Joint Health and
Wellbeing Strategy. It currently should report to the HWBB on the work of the
Partnership and the delivery of its outcomes twice a year.
•
Multi Agency Healthy Lifestyles Strategy Group (MAHLS)
MAHLS is responsible for overseeing and co-ordinating the delivery and review
of the Rochdale Borough Healthy Lifestyles Strategy and ensuring that the
Strategy and Action Plans deliver the priorities set out in the Joint Health and
Wellbeing Strategy. MAHLS reports to the HWBB twice a year on the delivery
of this Strategy which is currently under review.
•
Integrated Commissioning Board
A Joint Commissioning Steering Group was previously established to drive
delivery against the HWBB’s strategic intention for delivering a programme of
joint commissioning in key areas. It is proposed that the Board considers
superseding this group with a formal Integrated Commissioning Board (see
3.12 and separate Board paper)
•
Rochdale Integrated Care Programme Board
The HWBB provides the leadership for the Health & Social Care integration
agenda. Rochdale Integrated Care Programme Board oversees the programme
and projects to deliver an integrated system of health, wellbeing and social care
services across the Rochdale Borough and reports to the HWBB on its work, as
well as to other constituent organisations represented on that Board. A number
of HWBB members are represented on the Integrated Care Programme Board.
3.17
As well as formal sub-groups, the HWBB has established relationships with other
partnerships and formal committees to support delivery of its priorities; these include
Safeguarding Children Board, Safeguarding Adults Board, Public Sector Reform
Board, Safer Communities Partnership and Learning Disabilities Partnership. In terms
of Health Protection assurance and responsibilities the Board receives reports twice a
year updating on Health Protection. In addition, the HWBB holds Health and
Wellbeing Assembly events as part of its annual work plan to engage a wider audience
in our work.
3.18
The Health and Wellbeing Board is subject to scrutiny by the Council Health Overview
and Scrutiny Committee
Vision
3.19
The current HWBB strap line and vision are:
“Co-operating in Rochdale for Better Health & Wellbeing”
•
By 2021, we aim to achieve greater health and wellbeing equality between our
most and least deprived communities, with a focus on tackling our priority health
and wellbeing outcomes.
•
•
3.20
We will work in partnership to maximise the assets and resources that we have in
the Borough to achieve the best possible outcomes for our population.
People and communities will have high aspirations for their own health and
wellbeing outcomes and will feel in control of and able to manage their own
conditions.
In late 2014, a HWBB development day took place during which initial discussions
took place on a new vision statement and ways of working together. It is proposed
that this is further developed in the refresh of our Strategy
Achievements and forward plan
3.21
The 2014 HWBB Review identified many achievements to date. In summary these
were within the following areas:
•
•
•
•
•
3.22
Appendix 2 sets out a proposed workplan for 2015-16 for the HWBB. This has been
timetabled according to scheduled HWBB Board meetings and includes provision for:
•
•
•
•
3.23
Facilitating and leading partnership working e.g. premature mortality, integrated
health and social care, Better care Fund, Healthy Lifestyles, Children and young
people’s partnership working
Commitment of Board members to work together to improve outcomes for
residents and staff.
Good working relationships within the Board and the working groups
Good JSNA and Strategy
Good engagement and action within sub groups and Assembly
Standing items: provider updates, integrated commissioning, premature mortality
Regular update reports from sub-groups and agreed partnership links
Business as usual: JSNA, Health and Wellbeing Strategy
Regular Health and Wellbeing Assemblies
In addition to the proposed workplan, it is anticipated that the Board will receive
presentations and host discussion on emerging priorities from the JSNA and Strategy
refresh.
Performance monitoring
3.24
It is proposed that the Board considers the issue of regular performance monitoring of
the workplan and HWBB priorities in light of the Public Health Outcomes Framework,
NHS Outcomes Framework and Adult Social Care Framework. Appendix 3 outlines
the outcomes of each framework, and the ‘overlaps’ between them. Options for
performance monitoring proposed are:
• Annual updates on Public Health, NHS and Adult Care Outcomes and Public Health
England Local Area Health Profiles.
• Regular updates on outcomes identified as part of the Joint Health and Wellbeing
Strategy Refresh.
• Regular updates on ‘overlapping’ outcomes between public health, NHS and adults
social care.
• To leave performance monitoring as sub-group responsibility, with exception
reporting/recovery plans to the Board as required
Communications
3.25 It is proposed that the Board consider the issue of communications and that this
include the issue of accepting public questions at each Board meeting or Assembly.
Alternatives considered
None
4
4.1
5
5.1
6
6.1
7
7.1
8.
8.1
Financial Implications
Failure to have a successful Board and produce a vision for our Health and Wellbeing
Board may result in negative impact on public health funding to local authority (Local
Authority Circular – Public Health Ring-Fenced Grant Conditions 2014-15, DoH,
December 2014) and could affect Better Care Fund requirements
Legal Implications
Health and Wellbeing Boards have a statutory duty to develop a JSNA and Joint Health
and Wellbeing Strategy – to be refreshed every 3 years. These should be available
publicly (Local Government and Public Involvement in Health Act 2007 as amended by
the Health and Social Care Bill, 1st April 2013).
Personnel Implications
There are no personnel implications arising from this report.
Corporate Priorities
The Health and Wellbeing Board development process meets the Council Blueprint
2014-15 objectives of promoting success and independence through improving health,
wellbeing and prosperity and preventing the need for critical services. It also helps the
CCG and NHS England to meet their duties to improve health and wellbeing and
address inequalities
Risk Assessment Implications
All the issues raised and the recommendation(s) in this report involve risk
considerations as set out below:
i.
Failure to comply with statutory duty of Health and Wellbeing Boards, resulting
in increased scrutiny, negative impact on reputation and public health funding
to local government (Local Authority Circular – Public Health Ring-Fenced
Grant Conditions 2013-14, DoH, December 2013) and would affect our duties
in relation to our Better Care Fund agreement and integrated working going
forward.
9.
9.1
Equalities Impacts
Workforce Equality Impacts Assessment
There are no (significant) workforce equality issues arising from this report.
9.2
Equality/Community Impact Assessments
There are no (significant) equality/community issues arising from this report.
Background Papers
Place of Inspection
Attachment – appendix 1
Appendix 1 Rochdale HWBB Terms of Reference
Document
Appendix 2 Proposed HWBB workplan 2015-16
Appendix 3 Public Health, NHS and Adult Social
Care Outcomes
Attachment – appendix 2
Attachment – appendix 3