To approve as a correct record the minutes of the meeting held on 28 August 2019.

The minutes of the meeting held of 28 August 2019 were submitted for approval.

Decision

The approve the minutes of 28 August 2018 as a correct record.

Report of the Chief Executive and Director of Operations, Greater Manchester Mental Health NHS Foundation Trust is enclosed.

The Board considered the report and accompanying presentation of the Chief Executive, Greater Manchester Mental Health NHS Foundation Trust that provided a progress report on developments in Manchester mental health services following the acquisition of Manchester Mental Health and Social Care Trust on 1^st January 2017.

The Chief Executive, Greater Manchester Mental Health NHS Foundation Trust referred to the main points and themes within the presentation which included information and updates on the following areas of activity: -

•      Improving Access to Psychological Therapies (IAPT);

•      Reducing Out of Area Placements for Adult Acute Patients;

•      Developing an Enhanced Community Mental Health Model;

•      Mental Health Liaison in Acute Hospitals;

•      Provision of a dedicated Section 136 Suite;

•      Rehabilitation Pathway and Housing and Mental Health Strategy;

•      Community Engagement and Manchester Wellbeing Fund;

•      Improving our environments;

•      Integrating with Manchester Local Care Organisation;

•      Greater Manchester Transformation Programme; and

•      Update on CQC Well Led Inspection of GMMH – July 2019.

The Chief Executive, Greater Manchester Mental Health NHS Foundation Trust reported that the Trust employed the highest number of apprentices in the UK and the Trust was recognised as Living Wage Foundation Employer. He stated that this was important to assist in the recruitment and retention of the best workforce to deliver services for the benefit of Manchester citizens. He further commented that the Trust had recently commissioned a dedicated student mental health service; was delivering mental health services for a Housing First project, delivered by a local housing provider to support 400 homeless people; delivering a mental health and criminal justice service and that the substance misuse service had been extended across the city. 

The Board welcomed the reported improvements and noted that both areas of challenge and improvement had been identified. In particular, the Board welcomed the work undertaken to address the number of out of area placements for patients requiring care. 

In response to a question from a Member the Director of Operation, GMMH stated that individuals could self-refer for treatment, however the waiting time for face to face advice was approximately 6 weeks for an IAPTS appointment.

The Chief Executive, Greater Manchester Mental Health NHS Foundation Trust acknowledged a comment from a Board Member by advising that work was underway at a Greater Manchester level to improve the transition from CAMHS (Child and adolescent mental health services) to Adult Services. The Director of Operation, GMMH also commented that opportunities did exist to work with families and deliver targeted preventative work.

The Chief Executive, Greater Manchester Mental Health NHS Foundation Trust welcomed the suggestion to work closely with Partners to continue to address out of area placements and delayed transfer of care cases. He further acknowledged a comment regarding sustainability of community projects and commented that opportunities to use the Manchester Wellbeing Fund to achieve this were being explored, and he provided an example of where this Fund had been used to then attract alternative sources of funding to support projects long term.  ...  view the full minutes text for item 32.

Report of the Chair, Manchester Health and Care Commissioning (MHCC) is enclosed.

The Board considered the report and accompanying presentation of the Chair, Manchester Health and Care Commissioning that provided an update on the North Manchester Strategy with particular reference to the two major capital announcements that had been made by Government to invest in facilities at the North Manchester General Hospital (NMGH) site.

The Executive Director, Strategy, MHCC referred to the main points and themes within the presentation which included information and updates on the following areas of activity: -

•      Providing a context for the site in terms of area and population;

•      The case for change and a summary of the proposition to deliver a modern health and care offer;

•      The opportunity for health to deliver wider economic benefits to the area;

•      A description of the financial investment required; and

•      The approach to partnership working.

Professor Matt Makin, Medical Director, North Manchester General Hospital commented that there was a genuine positive culture amongst all staff working at NMGH and staff were engaged in the delivery of an improved offer for the area. This was recognised by members of the Panel who commented that they had witnessed this also.

Peter Blythin, Manchester University NHS Foundation Trust (MFT) reiterated the commitment to bringing NMGH into the Single Hospital Service model.  

The Chair, on behalf of the Board thanked all of the staff working at the site for their continued dedication to the residents of North Manchester. He further commented that the proposals represented a unique opportunity to transform the provision of health and care services in North Manchester and provide a stimulus for economic regeneration. A Board Member further commented that people have an emotional attachment to the hospital site and it was valued by the local population. 

In response to a question regarding public transport and access to the site the Executive Director, Strategy, MHCC said this would be considered as part of the wider strategy considerations. He further responded that the Board would have oversight of the delivery of the strategy and reiterated the importance of community engagement with this project, noting the comment regarding local pride in the site.

Decision

To note the report.

Report of Executive Director of Strategy, Manchester Health and Care Commissioning and Director of Strategy, Manchester Health and Care Commissioning is enclosed.

The Board considered the report of the Executive Director of Strategy, Manchester Health and Care Commissioning that described how the Manchester system was approaching the development of its 3^rd Locality Plan Refresh and the proposed content.

The Chair noted that this was the third Locality Plan and consideration needed to be given to devising a longer term plan. The Executive Director of Strategy, Manchester Health and Care Commissioning acknowledged this comment.

Decision

To note the report.

Report of GP Board Member, MHCC and Director of Population Health, MHCC is enclosed.

The Board considered the joint report that provided an update on the following areas of activity, Zero Carbon Framework (2020-38); Air Quality and Respiratory Disease. The report also provided an update on the recommendations of the Manchester Public Health Annual Report 2018 on Air Quality.

The Board welcomed Jonny Sadler, Programme Director, Manchester Climate Change Agency who described that in November 2018, Manchester City Council had adopted new climate change targets for the city, based on work by Manchester Climate Change Agency and the Tyndall Centre for Climate Change Research at the University of Manchester. The targets commit Manchester to limit its CO₂ emissions to 15 million tonnes during the period 2018-2100, our ‘carbon budget’ (recognising that the city currently emits 2 million tonnes per year); rapidly reduce CO₂ emissions, by an average of at least 13% year-on-year and; and become a zero carbon city by 2038 at the latest.

Mr Sadler said that he recognised and welcomed the stated commitments and ambitions of all Partners to achieve these challenging targets, however challenged them to do more. He said the NHS needed to consider their direct emissions from buildings and the ‘hidden’ emissions generated and provided examples of these.

The Board then heard from Claire Igoe at MFT, Martina McLaughlin from MHCC and

Naomi Makin from the Greater Manchester Mental Health NHS Foundation Trust who

described the actions and initiates delivered and planned for their respective sites to

engage with staff around the issue of climate change.

Dr Murugesan Raja described that emissions aswell as contributing to global climate change, carbon-based activities in Manchester also exacerbate the city’s air quality and associated respiratory problems. He stated that action was needed to address the risks to Manchester residents from the changing climate, such as extreme heat; heavy rainfall and potential flooding and other local risks due to climate change.

Dr Murugesan Raja informed the Board that MHCC continued to focus on respiratory disease as one of the key long term conditions to address poor health outcomes in Manchester.      He advised that it was recognised that in order to address respiratory inequalities a system wide approach to change was required. He said that MHCC were therefore working in partnership with primary care, community care, secondary care, patient engagement and RightCare to address this.

Dr Murugesan Raja informed the Board that MHCC had developed a set of Manchester wide standards, based on the Greater Manchester Standards for primary care that would focus on Chronic Obstructive Pulmonary Disease (COPD) patient reviews; review of COPD patients following an exacerbation; asthma reviews in adults; asthma reviews in children; COPD Virtual Clinic for 2019/20 and pharmacotherapy for smoking cessation 2019/20.

The Director of Population Health informed the Board of the updates to the recommendations of the Manchester Public Health Annual Report 2018 on Air Quality as detailed within the report.

The Board discussed the challenge presented to becoming a zero carbon city by 2038 at the latest. Members of the Board discussed the need  ...  view the full minutes text for item 35.

Report of Strategic Director of Children and Education Services and Executive Director of Adult Social Services is enclosed.

The Board considered the report of the Former Independent Chair of the Manchester Safeguarding Boards, Strategic Director of Children and Education, Executive Director of Adult Services that provided the annual reports of the Manchester Safeguarding Adults Board and the Manchester Safeguarding Children's Board covering the period from April 2018 to March 2019.

The Chair on behalf of the Board thanked the Former Independent Chair for her commitment and dedication on behalf of the residents of the city.

Decision

To note the report.

Report of Executive Director of Strategy, MHCC is enclosed.

The Board considered the report of the Executive Director of Strategy, Manchester Health and Care Commissioning that provided an outline of the Manchester Better Care Fund Plan 2019/20, the linkages to support performance with regards to Delayed Transfer of Care (DTOC) and associated key performance metrics.

The Chair commented that more needed to be done to employ staff on permanent contracts that would reduce the cost incurred by agency staff. The Executive Director of Strategy, Manchester Health and Care Commissioning acknowledged this comment.

Decision

To note the report.