To approve as a correct record the minutes of the meeting held on 29 August 2018.

Decision

To agree the minutes of the meeting of the Health and Wellbeing Board held on 29 August 2018.

The report of the Director of the Single Hospital Service Programme, Manchester University NHS Foundation Trust is enclosed.

A video clip will also be played.

The Board received a report from the Director of Single Hospital Service (SHS) Programme which provided an update on the progress of the SHS. The report referred to delivery of the integration plans and Year Two post-merger plans following the creation of Manchester University NHS Foundation Trust (MFT) and the current position regarding the proposal for MFT to acquire North Manchester General Hospital (NMGH). The Board also viewed the MFT “Together Care Matters – Our Values” video to demonstrate the ongoing work to engage staff and develop positive culture, values and leadership across the organisation.   

The Chair invited questions.

Members commented that the positive benefits provided by a single trust were noticeable and included the positivity and moral of staff to continue to develop and improve care and an increase in efficiency through dealing with a single citywide organisation rather than of a number of trusts.

A member referred to the involvement of Healthwatch and questioned why the number of Quality Impact Assessments (QIA) had increased from a single QIA, as previously reported, to four hundred QIAs.

It was reported that a review of the Single Hospital Service had revealed a large number of QIAs across the Trust. The Trust is committed to equality and diversity and the Integration Steering Group had received a report on the issue which would be shared with Healthwatch.

In welcoming the report, the Chair referred to the partnership of the MFT, Manchester Primary Care Partnership (MPCP) and Manchester Local Care Organisation (MLCO) and the work to move towards a preventative care approach away from hospital and closer to patient’s homes and asked would this be addressed in the next report.

The Board was informed that the report submitted had focussed primarily on the first year of the MFT, however during this period the MFT has provided a lot of support to the work of the MLCO. It was reported that a partnership of MFT, MLCO, the Council and MPCP is working to move the provision of care out of hospital and into patient’s homes. An example of this joint work included the recent discharge of 57 patients over a period of seven weeks who’s stay within hospital had gone over 100 days.

In noting the good progress made with MFT and the improvements in care provision in Wythenshawe and Central Manchester the Chair commented that the progress of the transformation journey had been delayed and it was necessary to accelerate the work in the development of a different approach to care. The point was also made that patient care at NMGH had suffered as a result of the uncertainty around the acquisition and transformation process of NMGH and it was now vital to finalise and agree a strategic case in order to move forward.

The meeting was informed that MFT is working closely with SRFT to accelerate two strategic cases. Further discussions with National Health Service Improvement (NHSI) had been necessary to resolve questions raised on national funding and NHSI options appraisal. This  ...  view the full minutes text for item 29.

The report of the Independent Chair of the Manchester Safeguarding Boards is enclosed.

The Board received a report from the Chair of the Manchester Safeguarding Boards, the Strategic Director of Children’s Services and the Executive Director of Adult Social Care. The report provided the Annual reports of the Manchester Safe Guarding Adults Board and the Manchester Safeguarding Children’s Board for the period April 2017 to March 2018. A copy of the “Trust Your Instinct” booklet was circulated to members.

The report set out the business priorities for 2017/18 that would be shared across the two boards. These included:

·         Engagement and Involvement – listening and learning; hearing the voice of children and adults and Making Safeguarding Personal.

·         Complex Safeguarding – Domestic Violence and Abuse; Female Genital Mutilation; Sexual Exploitation; Radicalisation; Missing from Care, Home and Education; Organised Crime; Trafficking & Modern Slavery; So-called Honour Based Violence.

·         Transitions – Moving from child to adulthood in a safe and positive way.

·         Neglect – Ensuring the basic needs of every child are met.

·         Neglect - Safeguarding and supporting adults at risk of wilful neglect, acts of omission and self-neglect.

The Board welcomed the report and commented on the help the reports provide to GPs and other frontline roles and the work with communities in helping to identify and report on areas of concern.

Decisions

1.    To note the Children and Adults Safeguarding Annual Reports 2017/2018.

2.    To request that Health and Wellbeing Board members to consider how the Children and Adults Safeguarding Annual Reports are disseminated and hold to account their organisation with regard to delivering the priorities of both Safeguarding Boards.

The report of the Director of Population Health and Wellbeing is to follow.

The Board received a report from the Director of Population Health and Wellbeing which provided an overview of some of the initiatives and programmes currently underway in Manchester related to housing and health for the purpose of contributing to better outcomes for residents. The Board also received a presentation.

The report provided the basis for a thematic discussion on the challenges and opportunities for a stronger collaborative approach between the organisations represented on the Health and Wellbeing Board registered providers and other key stakeholders.

The Chair invited comments and questions from Board members.

A member welcomed the report and referred to the work being done on age friendly initiatives within the city. Reference was also made to the good work being done within the social housing sector however, it was commented that more focus was needed on work with private rental sector landlords. The Board was informed that a growing number of residents in private rented accommodation were contacting local councillors regarding the condition of their homes and the related health conditions suffered as a consequence of this. The private sector provided accommodation for many of the most vulnerable people in the city and this would usually be low quality accommodation. It was requested that private rental sector accommodation be included within the work programme of the Board.

A member commented on the positive work of health providers to provide mini hubs to support heath care for homeless people in view of the significant impact homelessness has on the health of the individual. It was noted that the average life expectancy of a person sleeping rough over time reduces significantly due to resulting ill health (female 43 years and male 47 years). The Board was informed that another area of concern is the number of homeless people living within temporary dispersed accommodation across Manchester, which currently stands at 1900. The poor living conditions of short term private sector accommodation being used in these situations was having a negative impact on the health of those people concerned. The Board was requested to include the impact of homelessness on health within the work programme.

It was reported that the work of Wythenshawe Integrated Neighbourhood Service (WINS) had been successful in the way issues such as health and adult and children’s safeguarding had been identified and addressed. Also, training materials had been developed for health workers and twelve homeless health champions were available to provide help and support at the Urban Village Medical Practice. It was noted that the service could be further improved through upskilling by primary care staff within their existing skillsets.

In noting the importance of focussing on the health of homeless people, a member highlighted the need to consider work taking place on an inclusion based primary health care model that included support for before and after periods of homelessness. Reference was made to clusters of poor quality temporary private rented accommodation that is used to home a significant number of vulnerable people and the need to recognise the  ...  view the full minutes text for item 31.

The report of the Director of Population and Wellbeing is enclosed.

The Board received a report from the Director of Population Health and Wellbeing which highlighted the success of adopting a public health approach to tackling violent crime. The Board was informed that work in this area, undertaken in Glasgow over the last decade, had achieved positive outcomes based on a significant reduction in the number of homicides involving a knife.

The report stated that partners in Manchester are keen to explore a similar approach for the city and for the work be taken forward through a Working Group under the guidance of the Health and Wellbeing Board and Manchester Community Safety Partnership, using existing resources. To ensure the work involves the appropriate people with the expertise the input of the following groups and organisations would be required:

·                    MHCC Population Health and Wellbeing Team

·                    NHS Hospital Trust Emergency Department Consultants and Senior Nurses

·                    Greater Manchester Mental Health Trust Leads

·                    GP Neighbourhood Leads

·                    Community Safety Partnership Team

·                    Greater Manchester Police

·                    Youth Justice Lead

·                    Probation Service

·                    MCC Education and Social Work Leads

·                    CSE Organisations

Decisions

1. To support the development of proposals to adopt a public health approach to violent crime.

2.    To request officers to ensure that key personnel from the organisations represented on the Board input to the proposals.

The report of the City Treasurer (Manchester City Council) and Chief Finance Officer (Manchester Health and Care Commissioning) is enclosed.

The Board received a report from the City Treasurer (Manchester City Council) and the Chief Finance Officer (Manchester Health and Care Commissioning) which provided the Board with an overview of the plan submitted for Better Care Fund 2018/2019 and an update on changes from the guidance released in July 2018.

The Better Care Fund was established by the Government to provide funds to local areas to support the integration of health and social care. Section 75 of the National Health Service 2006 Act gives powers to local authorities and health bodies to establish and maintain pooled funds. Payment from the funds may be made towards expenditure incurred in the exercise of prescribed local authority functions and prescribed National Health Service (NHS) functions.

Decisions

1.    To note the changes to the Delayed Transfers of Care monitoring.

2.    To confirm the expenditure plan for 2018/19, as agreed previously at the meeting of the Health and Wellbeing Board held on 30 August 2017.