Agenda and minutes

Apologies for absence were received from Councillors P Carr and M Lyons (Shepway District Council), Dr H Armstrong (C4G Clinical Commissioning Group) and the Alternative Service Delivery Manager.

To receive any declarations of interest from Members.

There were no declarations of interest from Members.

To confirm the attached Notes of the meeting of the Shadow Board held on 4 September 2012.

It was agreed that the Notes of the Board meeting held on 4 September 2012 be approved as a correct record and signed by the Chairman.

To receive an update from Hazel Carpenter, Accountable Officer, NHS South Kent Coast CCG and Dr Joe Chaudhuri.

Ms K Benbow informed the Board that Dr Cocker had replaced Dr Chee Mah as the Clinical Chair of the Clinical Commissioning Group.  The CCG would shortly be in a position to make its lay member appointment to its board.

It was expected that the commissioning document for the CCG would be signed off that week with a mock assessment in November 2012 prior to the real assessment in December 2012.

RESOLVED: That the update be noted.

(a)        Review of Work Programme (following third facilitated session) – Councillor Paul Watkins, Leader of Dover District Council (attached)

(b)        Joint Integrated Commissioning Strategy and Plan  – Mark Lobban, Director of Strategic Commissioning, Kent County Council (attached)

(c)        Project brief for Intermediate Care Services – James Lampert, Commissioning Manager, Kent County Council and Karen Benbow, Chief Operating Officer, NHS South Kent Coast CCG (attached)

(d)        South Kent Coast CCG Community Engagement Strategy – Hazel Carpenter, Accountable Officer, NHS South Kent Coast CCG (to follow)

(e)        Public Health Projects Update – Jess Mookherjee, Assistant Director of Public Health at NHS Kent and Medway (verbal update)

(f)         'Patient Knows Best' Update on pilots in South Kent Coast CCG area – Dr Joe Chaudhuri (attached)

(1)          Review of Work Programme

The Leadership Support and Corporate Communications Manager advised that following the third facilitated session two additional items were added to the work programme.  These were:

·                         To maintain awareness and input, if necessary and required, to the Canterbury C4 CCG work programme to ensure 'whole population' links; and

·                         Evidence base for intermediate care beds in Dover (with the potential to lead to a Full Business Case)

In addition, health inequalities would be added to the District/CCG action plan.

It was agreed:

              That the Strategic Business Advisor (Kent County Council) and Leadership Support and Corporate Communications Manager (Dover District Council) would work to ensure that the work streams of for the Kent Health and Wellbeing Board and the Dover and Shepway Health and Wellbeing Board were co-ordinated wherever possible.

(2)          Joint Integrated Commissioning Strategy and Plan

The Director of Strategic Commissioning (Kent County Council) informed the Board that a Virtual Integrated Commissioning Group had been established to develop a strategy, plan and toolkit for undertaking integrated commissioning.  The Group comprised of the South Kent Coast CCG, Dover District Council, Kent County Council and Shepway District Council and had identified four key areas of commissioning activity which supported the delivery of the partners shared objectives.  There were:

(a)          Preventative services;

(b)          Short term care (including a focus on local Intermediate Care and Enablement services);

(c)          Management of Long Term Conditions (including accommodation needs); and

(d)          End of life care

The recent facilitated meeting of the Board had had expressed support for the Commissioning Strategy being developed.  The Board was advised that the plan was still in development and further work had to be undertaken to clarify the governance arrangements as the final commissioning decisions still rested with individual partner organisations, as well as the detail of how resources were to be allocated.  As part of this work was being undertaken to understand how activity, spend and outcome in commissioning were linked.

The process would also be reported in Thanet and the C4G CCG group area so that sufficient information could be compiled to enable meaningful engagement with the acute health sector.

The Director of Strategic Commissioning informed the Board that less than £2 million out of £10 million countywide was being spent in East Kent on mental health services in response to a question from Councillor P A Watkins on the difficulty on finding out information on the level of mental health service expenditure in East Kent.

The problem of patients being charged to mental health services who actually had other issues such as pain management was raised as well as the importance of the strategy including dementia care needs.  The majority of dementia care beds for Dover and Shepway residents were provided in either Thanet or Canterbury.

The need for close co-operation between the county council and district council's was identified in respect of the provision of extra care housing and the support that was needed to make it successful.

It was agreed:

(a)      That  ...  view the full minutes text for item 20.

To consider the Action Points.

The Leadership Support and Corporate Communications Manager advised that majority of the action points identified in the agenda would be dealt with by the governance arrangements for the Board and Integrated Commissioning.

Councillor P A Watkins proposed that awarding the members of the Health and Wellbeing Board observer status at the CCG Boards would assist in building a strong relationship between the work of the two groups.

The nature of the relationship between the Board and the local Children's Trusts and schools was considered in relation to health inequalities. 

It was agreed:

(a)      That the update be noted.

(b)      That the possibility of awarding observer status to Health and Wellbeing Board members on the CCG Board be investigated.

Discussion led by Emma-Jane Allen, Senior Infrastructure and Delivery Officer, Dover District Council.

The Senior Infrastructure and Delivery Officer presented a summary of the draft Dover District Council Parks and Open Spaces Strategy report to the Committee for its consideration.

The Board was advised that the district was well provided for in respect of most types of open space and particularly for natural and semi-natural open space that was accessible to the public.  It was acknowledged that there was only one 'Green Flag' amenity in the district which was lower than that of neighbouring authorities and that with the high growth agenda contained within the Local Plan there would be increased pressure on the district's parks and open spaces.  Dover District Council was in the process of bidding for lottery funding to improve Kearsney Abbey to Green Flag status.  

In order to assess current and future need an audit had been conducted and standards for provision were to be proposed for the following categories:

·                         Accessible green space;

·                         Outdoor sports facilities;

·                         Children's play space; and

·                         Community gardens and allotments.

The audit found that parks and open spaces were Dover District Council's second most accessed service after car parking, with walking/dog walking the most popular reason for using the parks and open spaces and that two-thirds of all visits to parks and open spaces occurred within 2 miles of home.

The Assistant Director of Public Health (NHS Kent and Medway) suggested that a joint bid between the NHS and Dover District Council for funding under the Kent Military Covenant to promote the 'green gym' concept to military leavers would be feasible given the high number in both Dover and Shepway Districts. The Head of Communities (Shepway District Council) advised that a green gym currently operated at the Warren in Folkestone. 

Dr J Chaudhuri suggested that Health Maps could link into the Parks and Open Spaces Strategy and would support the work being undertaken in respect of health inequalities.

It was agreed:

(a)      That the presentation be noted.

(b)      That Mr B Porter be requested to investigate if the Shepway District Council Parks and Open Spaces Strategy could be brought to a future meeting of the Board.

(c)      That the Assistant Director of Public Health (NHS Kent and Medway) be requested to explore the matter as a possible extension to the work programme.

To consider any other business raised by members of the Board.

This item replaces the previous 'any other business' item and will run until the Board moves beyond shadow status and public notice requirements come into effect.

Dr J Chaudhuri informed the Board that he had attended a meeting of a Pensioners Forum in Shepway where he had given a presentation on CCG's.  The meeting was well attended and a 'Question and Answer' session was held afterwards.  A further presentation was to be given to members of the Ghurkha community and the need to take such groups into consideration when developing CCG plans was discussed.

It was proposed by Dr J Chaudhuri, and duly seconded, that the name of the Board be changed to reflect the name of the CCG that it was co-terminus with. 

It was agreed:

              That the Board be renamed the South Kent Coast Health and Wellbeing Board with effect from its next meeting.