Norfolk Health and Wellbeing Board

October 2016

Welcome to the latest edition of the Health and Wellbeing Board Update which includes:

• Key information from the Health & Wellbeing Board meeting on 21 September 2016

• Asset Based Community Development – a project in South Norfolk

• Healthwatch Norfolk - Update

Agenda papers for the 21 September Health and Wellbeing Board are all available on line - you can access them here - Health & Wellbeing Board agenda papers

Norfolk and Waveney Sustainability & Transformation Plan (STP)Dr Wendy Thomson, MD, NCC, updated the Board on the developing Norfolk and Waveney Sustainability and Transformation Plan (STP) – our place-based, system-wide, plan for health and social care. STPs are being introduced across the country – they are seen as ambitious ‘blueprints’ for accelerating implementation of the Five Year Forward View (5YFV) and the NHS new models of care.

Future Meetings of the Health and Wellbeing Board:2016

• Wednesday 23 November 2016 (Informal meeting)

2017

• Wed 8 February 2017

• Wed 26 April 2017

• Wed 12 July 2017

• Wed 27 Sept 2017

• Wed 6 Dec 2017 – Informal meeting

STPs need to cover how areas will address the three national challenges or ‘gaps’:

• Health and wellbeing gap - inequalities in health

• Care and quality gap - ensuring quality and performance of health and social services

• Finance and efficiency gap - ensuring a financially sustainable health system

NHS England requires STPs to be submitted on 21 October 2016 and they cover the period up to March 2021.

Members recognised that meeting this deadline would be challenging but that considerable progress was being made with the collective commitment by local leaders to tackling the ‘big ticket’ changes that are required to secure a sustainable future for health services. The Board heard how the STP Executive Board had been focusing in getting the right governance, organisational arrangements, infrastructure, mechanisms and overall resources in place, along with the necessary capacity required for the next stages of detailed work. The STP Executive Board had also established a specific Mental Health Work Programme, which was being developed across the breadth of the STP.

Members considered the strategic implications of this whole system transformation and discussed the governance arrangements, including the need for greater clarity around roles and responsibilities.

The Board also considered a presentation outlining the draft Local Digital Roadmap (LDR) for Norfolk and Waveney which would be central to achieving the clinically led digital transformation needed in the Norfolk and Waveney area. The Board heard that all areas were making plans so that patients and the public may have greater control for maintaining their health, and to help ensure that digital technology will support working together across the area so patients only have to tell their story once. Board members noted the content of the LDR plans.

More info

• You can access the STP report on page A2 of the supplementary agenda papers (via this link).

Children and Young People’s Mental Health - Local Transformation Plan for Norfolk & Waveney (2016/17 Refresh)Jonathan Stanley, CAMHS Strategic Commissioner, introduced the report which was sponsored jointly by Antek Lejk (on behalf of the 5 CCGs covering Norfolk and Waveney) and Michael Rosen, Executive Director, Children’s Services.

Members noted that a full refresh of the Local Transformation Plan (LTP) for Norfolk & Waveney had been undertaken and it was proposed that two high level strategic priorities are pursued, with appropriate direction and support provided by the arrangements being put in place to deliver the Norfolk & Waveney STP. The two strategic priorities are as follows:

• To ensure all 8 LTP recurrent service developments are fully implemented and operational as soon as possible

• To undertake an extensive re-design & re-engineering of the entire system for children and young people with mental health needs over the next 2 years to maximise the opportunities for integrated pathways and economies of scale

The HWB welcomed the report and discussed the clear need for collaboration as well as the need for preventative approaches. Members offered their support, as system leaders, in helping break down the barriers, both in delivering the priorities set out in the original LTP and in the future system re-design. It was noted that, due to significant financial pressures on the CCGs, and the lack of additional ring-fenced central funding, that some of the funding coming down to the local system was not making it into the plan. Members endorsed the refreshed Local Transformation Plan, with the caveat around the funding.

More info

• You can access the report on page 7 of the main agenda papers (via this link).

Improving health and wellbeing: developing our future Strategy – discussion paper Dr Louise Smith, Norfolk DPH, introduced the discussion paper which provided Board members with an opportunity for an early discussion to inform the development of the HWB’s future Strategy.

The Joint Strategic Needs Assessment (JSNA) is our shared understanding of the health and wellbeing needs in Norfolk, and contains a wealth of data to inform our planning. Members considered key information on the current health and wellbeing of the Norfolk population, drawn from the JSNA Annual Report Summary 2016, which provides information under the following categories: People, Place, Healthy Start, Healthy Childhood, Adult Health and Older People’s Health.

Members noted some of the key challenges that we continue to face in Norfolk, in relation to our three longer term goals, for example, the support and care needs of an aging population in Norfolk, and the inequalities gap in terms of life expectancies between those living in different parts of Norfolk. The Board discussed issues relating to deprivation, including the indicators used to measure it, and noted the work underway in conjunction with the University of East Anglia to look at some of the ‘pockets’ of multiple deprivation. Related factors such as mental health issues were also discussed, and Members noted the preventative work which had been focusing on building foundations of resilience for later in life, with the mental health of adolescents being a next area of focus.

The impact of housing on health and wellbeing was considered a key issue. It was noted that work was currently underway between the PH team and district councils to ‘drill down’ the data to the local level so that we can, for example, better target housing improvements. It was agreed that, in taking forward the development of our new strategy, it would be important to look at housing and what could be done to make a difference. Members were also keen to better understand and make best use of the wealth of local assets in our communities.

The Board agreed to move forward with the development of the new Strategy based around the framework of our three longer term goals or themes:

• Prevention - providing help and support at an earlier stage before problems become acute

• Reducing health and wellbeing inequalities - narrowing the gap in life expectancy between the most and the least deprived people in Norfolk.

• Integration - partners working together to provide effective, joined up services

More info

• You can access the report on page 12 of the main agenda papers (via this link).

H&WB Information Updates

• Sustainability & Transformation Plan (STP): mental health briefing – you can access the briefing on the mental health workstream at this link

• CCGs Assurance Annual Assessment 2015-16 – you can access the annual assessment of all CCGs by NHS England here

• Strengthening financial performance and accountability in 2016-17 – you can access the report by NHS England and NHS Improvement here.

Other News! 1. ABCD Project in South Norfolk

ABCD means “asset based community development” and it is a way of understanding, supporting, nurturing the resilience, networks and strengths that exist in local communities so that people support each other as friends, family and neighbours. The ABCD team ran a 9 month project in South Norfolk in 2015 to explore and support networks and groups that support good mental health in local communities.

The project was funded by the East of England Strategic Clinical networks and the partners who delivered included NHS South Norfolk Clinical Commissioning Group, Together for mental Wellbeing, Healthwatch Norfolk and Norfolk County Council but it was a real collaborative effort, co-produced with people with lived experience and culminating in a Winter Wellbeing Festival that took place in Attleborough in January 2015 where hundreds of people came to hear talks, take part in activities, visit the market place and enjoy the evening entertainment and soup.

More information

All the information about the project is on the ABCD website www.abcdproject.org.uk so we encourage all to take a look

2. Healthwatch Norfolk update

1. AGM – 22nd September 2016

Our thanks go to all those who attended the AGM at The Forum on 22nd September. The presentations from the AGM are available on our website: www.healthwatchnorfolk.co.uk.

2. Update on our current work programme

We have recently published the following reports:

Access to Mainstream Services for People with a Disability

This project looked at people’s experiences of how good health and care services were at making reasonable adjustments in response to their disability. The recommendations in the report are as follows:

• Conduct a review of the prominence given to information relating to disability/access requirements in referrals between services

• Healthwatch Norfolk to host a summit meeting/event in partnership with disability groups to take forward joint concerns through practical action. eg:

• Greater importance should be placed on physical access issues in inspections of health and care settings

General Practice in Norfolk. Working Relationship with patients and other services

Phase 1 of this project involved engagement with 18 practices, interviews with 73 members of staff and feedback from 338 patients. The recommendations in the report focus on the following issues:

• Booking appointments by telephone and online

• Community transport for patients

• Relationships with community nursing, mental health services and hospitals

• IT systems used in General Practice

Thinking Ahead – Advanced Care Planning and other End of Life issues

This report was prepared on behalf of HWN by the Norfolk and Suffolk Palliative Care Forum. The recommendations in the report to improve local people’s experience of end of life care in Norfolk are as follows:

• Raising awareness about the benefits of Advance Care Planning

• End of life issues to be threaded through all strategies, commissioning contracts and training for health and social care workforce

• Ensure staff who care for people approaching end of life have the knowledge, skills and support they need to identify, to communicate, and be culturally aware in order to provide good end of life care.

• Assure people that their wishes will be respected by ensuring they are recorded and shared with other health and social care professionals.

• Measure and evaluate access to end of life care services and outcomes for all people including from different groups.

This report was also presented at the recent Norfolk Health Overview and Scrutiny Committee on 8th September 2016.

3. Update on remaining projects for 2015-17

We are in the process of completing a number of projects as part of the 2015-17 work programme:

CAMHS Tiers 1 and 2

Equipment Service

Reablement Service

Cardiovascular Disease Prevention

Living Longer, Living Well (Norfolk Older People’s Strategic Partnership)

4. Engagement

During October, events booked to date by the HWN Engagement Team are:

4th October Thetford Community Fayre

5th October Carers Information Day, Shrublands Centre, Gorleston-on-Sea

8th October World Mental Health Day

10th October Aylsham Community Fayre

12th October, Independent Living Event, St Andrews Hall, Norwich

5. More Information

Our Board meetings dates for the remainder of 2016-17 are as follows - all are welcome to attend:

Monday 17 October 2016 10.00 am – 12.00, HWN Offices in WymondhamMonday 16 January 2017 10.00 am – 12.00, HWN Offices in Wymondham

All reports, including Board papers, are published on our website - http://www.healthwatchnorfolk.co.uk/reports-and-papers/

If you have any queries or wish to become part of the newsletter mailing list to keep up-to-date with their work, please contact Healthwatch Norfolk at:enquiries@healthwatchnorfolk.co.uk or telephone 0808 168 9669

® If you need this document in large print, audio, Braille, alternative format or in a different language please contact 0344 800 8020 or 0344 800 8011 (textphone) and we will do our best to help.

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The role of the Health and Wellbeing Board is to:

• Lead the development, in partnership, of the Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy

• Work with commissioners of health and social care, supporting and enabling them to act in line with shared health and health care priorities for Norfolk

• Drive the further integration of health, social care and other public sector services

• Work with NHS England on the annual assessment of Clinical Commissioning Groups