Agenda and minutes

Apologies for absence were received from Mr M Lobban (Kent County Council) and Councillor G Lymer (Kent County Council).

In accordance with the agreed Terms of Reference, it was noted that Ms C Holden had been appointed as substitute for Mr M Lobban.

To receive any declarations of interest from Members in respect of business to be transacted on the agenda.

There were no declarations of interest made by members of the Board.

To confirm the attached Minutes of the meeting of the Board held on 29 April 2014.

It was agreed that the Minutes of the Board meeting held on 29 April 2014 be approved as a correct record and signed by the Chairman.

There were no matters raising on notice by members of the Board.

To receive a presentation from Ms P Watson, Commissioning Manager & GDP Programme Manager (Kent County Council) and Ms S Rolfe, Commissioning Officer (Kent County Council).

Ms P Watson, Commissioning Manager and GDP Programme Manager (Kent County Council) and Ms S Rolfe, Commissioning Officer (Kent County Council) gave a presentation to the Board on the Dover Day Services Consultation.

The Board was advised that the objective of the consultation, which affected the Dover District, was to deliver a new ‘person centred’ model of service that improved the lives of people with learning disabilities by providing them with activities and opportunities in their local communities as opposed to segregated services. To do this the new service model would invest in community hubs to deliver opportunities within the local community, sustain skilled staff to support people to access services within the local community and move away from large traditional style building based services. This change also reflected the dissatisfaction of younger people with learning disabilities with the existing service model.  

The Board was advised that no savings targets were attached to the new model and any savings resulting from the new model would be reinvested into the service.

In the Dover District, 77 people accessed the current service with approximately 58 of those people attending on a daily basis.

The consultation ran from 29 November 2013 to 14 February 2014 and sought the views of people who currently attended the Walmer Centre, parent/family and carers, those who might want to use the services in the future, staff and union representatives, local councillors and county members and other organisations such as advocacy services.

It was proposed that the new model would be based around two hubs, 1 in Deal and 1 in Dover, although the specific sites had not yet been identified. There was concern that the current site in Walmer was too isolated to be suitable for the new model. However, none of the existing services would be closed until the new hubs were operational.

RESOLVED:   That the presentation be noted.

To receive a presentation from Mr K Fordham, Deputy Managing Director (Your Leisure).

This item was withdrawn.

To receive the verbal update from Ms Z Mirza (South Kent Coast Clinical Commissioning Group).

Ms K Benbow advised that an update would be provided to a future meeting of the Board on the continuing progress of Better Care Fund projects within the Integrated Commissioning Plan.

RESOLVED: That the update be noted. 

To receive a verbal update from Mr M Lobban, Director of Strategic Commissioning (Kent County Council).

Ms C Holden (Kent County Council) provided an update to the Board on the Accommodation Strategy.

The Board was advised that for the South Kent Coast area, there were problems around accessing sufficient high level dementia and challenging behaviour services, with intermediate care beds often occupied by the wrong people.

As part of the strategy, Kent County Council, which funded 40% of placements, was seeking to provide for 140 new extra care units and 110 nursing beds in conjunction with Dover District Council, Shepway District Council and private developers. The strategy would also consider what existing sheltered provision needed to be remodelled as extra care accommodation. Overall, while the number of Intermediate Care beds would remain the same, there needed to be a greater focus on rehabilitation and ensuring that the beds were properly allocated to those who needed intermediate care.

For the South Kent Coast area, the vacancy rate was 2% compared with a national rate of 7%. However, this was a snapshot of data that excluded those vacancies that were unsuitable.

Members of the Board emphasised that Kent County Council was not the only purchaser of accommodation, with many people increasingly buying their own, and that this needed to be factored into the strategy through engaging with the public at an early stage in the consultation process.

The Board was advised that the next steps in the process were:

·         To launch the strategy and publish the supporting evidence

·         To develop Market Position Statements

·         To prioritise and sequence projects

·         To develop options appraisals and business cases

·         To establish consultation routes where appropriate

·         To undertake workshops for all other user groups

RESOLVED:   That the update be noted.

To consider the attached report of Ms K Benbow, Chief Operating Officer (South Kent Coast Clinical Commissioning Group).

Ms K Benbow presented the report on Child and Adolescent Mental Health Services. The report set out the background and current services provided for children and young people with emotional and mental health issues in the South Kent Coast area.

The services were commissioned at four levels:

·         Tier 1 – Support delivered within universal settings

                    (Commissioned by Kent County Council from Young Healthy Minds and accessed currently through the Common Assessment Framework)

·         Tier 2 – Targeted Support

              (Commissioned by NHS West Kent CCG on behalf of East Kent and Medway CCGs from Sussex Partnership Foundation Trust)

·         Tier 3 – Specialist Support

(Commissioned by NHS West Kent CCG on behalf of East Kent and Medway CCGs from Sussex Partnership Foundation Trust)

·         Tier 4 – Specialist Mental Health Services including inpatient provision

(Commissioned by NHS England)

Over the last year, Dover had 146 referrals and Shepway had 120 referrals under Tier 1.

The report acknowledged that there had been workforce issues affecting Tier 3 services in Shepway and Dover but by August 2014 both areas would have a full complement of staff and this would reduce the time it took to assess cases.

RESOLVED: That the report be noted.

To receive a presentation from Mr P Marsh, Project officer (Kent County Council).

Mr P Marsh (Kent County Council) gave a presentation to the Board on Dementia Friendly Communities. A similar presentation had been given to the meeting of the Kent Health and Wellbeing Board held on 16 June 2014.

The Board was advised that people living with dementia wanted:

·         To be able to live the life they had before their diagnosis with dementia;

·         To be able to find their way around and be safe;

·         To be able to access local facilities as they used to be able to;

·         To be able to maintain their social networks so they feel they belong in the community;

·         To pursue hobbies and interests and ‘go out’ more; and

·         To support others in their community by volunteering.

The intention was to use Local Dementia Action Alliances to achieve Dementia Friendly Communities in which these goals could be realised. As part of this, Dover District Council, Shepway District Council and the South Kent Coast Clinical Commissioning Group would be invited to join the Dementia Alliance.

The importance of GP’s correctly diagnosing dementia was raised and Mr Marsh stated that the Alliance wanted to consult with GP’s as part of the development of a ‘Dementia Checklist’.

Ms J Mookherjee indicated that there was also the possibility of collaborative work that could be done with public health on this subject.

RESOLVED:   That the presentation be noted.

To receive a verbal update from Councillor P A Watkins (Dover District Council).

Councillor P A Watkins raised the issue of the role of the Board in respect of the location of GP surgeries in the district given the original intentions of the Department of Health.

The Board was advised that the role of the South Kent Coast Clinical Commissioning Group was in relation to the wider strategic planning of service provision rather than determining the location of individual practices. It was suggested that the strategic planning level might be of relevance to the Board.

RESOLVED: That further discussions be held between Dover District Council, Shepway District Council and the South Kent Coast Clinical Commissioning Group to identify the role of the Health and Wellbeing Board in respect of local GP Surgery provision.

There were no items of urgent business.