To receive any apologies for absence, including notifications of any changes to the membership of the Committee.

Apologies for absence were received from Alison Brewer, Paul Johnson, Matt Johnson who was represented by Mark Cottrell, Ann Wagner who was represented by Shelley Machin, Alison Botham and Caroline Dimond who was represented by Bruce Bell.

To confirm as a correct record the Minutes of the Health and Wellbeing Board held on 6 September 2018.

The Minutes of the Board held on 6 September 2018 were confirmed as a correct record and signed by the Chairwoman.

Caroline Taylor, Director of Adult Services and Housing provided an update on Minute 72 regarding the Mental Health Strategy and informed the Board that the strategy had not yet been approved following feedback and was being amended to take account of the comments made by the Board.

The Chairwoman requested all Board Members consider the priorities contained within the Health and Wellbeing Strategy, their role and their organisations strengths and feedback to her where partners can work together going forward.

To note the progress of the Devon wide ‘Commitment to Carers’.

The Board noted that carers services across the Sustainability and Transformation Partnership footprint have worked together to develop a Devon-wide commitment to carers.  It has been agreed in principle by Torbay Council and South Devon NHS Foundation Trust and will be formally agreed by the STP’s Programme Delivery Executive Group.  The aim is to have six organisations with action plans in place by March 2019, public facing services can also adopt tools to aid early identification of carers in order to assist the person to recognise themselves as carers.

Resolved:

That the Health and Wellbeing Board supported the Devon-wide commitment to carers.

The Board received a presentation on the development of a strategy to tackle the challenges faced by people with multiple complex needs.  Jude Pinder, Advanced Pubic Health Practitioner informed Members that she was posed the challenge to quantify the number of adults with multiple complex needs in Torbay, due to different definitions a definitive number proved very difficult.  What became apparent was by commissioning services, providers were being made to compete against each other and despite everybody trying their hardest all the needs of clients were still not being met.  As commissioners a significant amount of data and evidence of outcomes is required resulting in the providers having to reduce the level of interaction with clients resulting in questions about whether outcomes based commissioning actually works.

Jude challenged whether consideration should be given to a new approach which embraces complexity and accepting complex systems cannot be controlled.  Moving to an alliance contract model would formalise co-operative working and culture change, contracts would be built on joint risk and responsibility, joint planning of services and budget and joint staff days to develop vision and plan the journey.  Partners were asked to consider and identify their organisations contact with clients with complex needs and question whether there are services that partners commission or provide that would be able to work more effectively and more creatively in an alliance contract.

The Board supported the approach of alliance commissioning and welcomed a model that placed the person at the centre and recognised the need for partners to engage to ensure the alliance is successful.

To consider the attached report.

Members noted a report that provided a review of the Prevention, Self-Care and Wellbeing Board.  The Board was informed that the programme of work was now at a stage where those actions that can help people stay healthy are defined and developed.  Subsequently the focus had shifted to the implementation of the enabling products and processes to ensure they became embedded in practice.  The agenda for the Prevention Board had also evolved from an assurance function that holds the system to account for work on prevention to becoming a group that acts as a forum to facilitate learning from prevention initiatives that are being implemented across Torbay and South Devon.

The Board requested Bruce Bell make direct contact with Healthwatch, Police, Fire and Torbay and South Devon NHS Foundation Trust colleagues to ensure enabling products are fully embedded and celebrate the work being undertaken.

To note the report.

The Board received an update on the Healthy Torbay Framework.  Members were advised that the framework had been split into three parts:

·         Business as usual – includes current, ongoing delivery against a number of topics that impact upon the wider determinants of health;

·         Development and delivery of healthy towns approach, the purpose of which is to unlock potential to improve health and wellbeing, develop communication channels in order to better target information and gather insights about residents, capture community identified town concepts of health and wellbeing and complement other local initiatives such NMoC and social prescribing.

·         Steering Group and Development Workshop.

The Board noted the achievements of the last six months and the priorities for the future and challenged the sustainability of progress given the reliance on external funding bids.  The Board requested the Director of Public Health invite Duncan Selbie to visit and discuss the approach of the Healthy Torbay Framework.

To receive a presentation on the impact of First Response Services.

This item was deferred until the next meeting.