Agenda and minutes

Apologies for absence were received from Graham Harris, Dr Elizabeth Lunt, and Ann Tidmarsh.

The Chairman reported that since the last meeting Stuart Collins and Cecilia Yardley had left the Board.  Mr Collins had received promotion within KCC and his place was to be taken by Mr Nick Moor.   The Chairman welcomed Mr Moor to his first Board meeting. 

The Chairman also informed the Board that Cecilia Yardley was unable to continue as a Board member due to work commitments, and that he had written to Ms Yardley thanking her for her service on the Board, her valued contributions, and wishing her well for the future.

The Chairman finally explained that he was due to attend the funeral of a colleague and that he would have to leave the meeting at 2.30pm.  He asked Councillor Ann Allen to take the Chair at that point.

There were no Declarations of Interest received.

The Minutes of the meeting of the Dartford Gravesham and Swanley Health and Wellbeing Board held on 8 June 2016 are attached for confirmation.

Issues arising from the Minutes not addressed elsewhere on the Agenda can be raised at this item.

The minutes of the Dartford Gravesham and Swanley Health and Wellbeing Board, held on 8 June 2016 were confirmed as a correct record of that meeting.

The Chairman may wish to report on any issues of relevance to this Board arising from the meeting held on 20 July 2016

The Agenda for the meeting is attached as an aide memoire.

The Chairman reviewed the meeting of the Kent Health and Wellbeing board held on 20 July 2016, and updated the Board on

The Kent Environment Strategy.   It was noted that this topic was to considered by local HWBs

Kent and Medway Crisis Concordat

Review of Outcome 2: Prevention of Ill – Health The Board noted that an item on this topic was contained in the Agenda for the current meeting.

The Chairman will report on any urgent item and determine its position on the Agenda.

There were no urgent items for the Board to consider but the following issues arising from the morning Member training session were mentioned.

·         Agenda Balance – ensuring that the Board has a more proactive role than merely monitoring progress.

·         Considering ways to action decisions and proposals made by the Board

·         Publicity for the HWB

·         Engagement of schools and young people in health initiatives

·         Preventative approaches to Healthcare.

Arising from this it was noted that the Chairman and Sarah Kilkie were to draw together the points raised at the training session in order to formulate an alternative approach to decision making and task setting.

Andrew Scott – Clark presented a report which acknowledged the priority issues which had been identified by the Board in previous meetings, identified strategic health inequalities across Kent and informed the Board of a revised focus adopted by the Kent Health and Wellbeing Board which concentrated on the 88 areas within the County which have the highest “all age” “all cause” mortality rates.

It was noted that 13 of these areas lie within the DGS Board area and that the Kent Board has asked that the Board re - focusses its attentions on these 13 areas.

Members commented that it would wish to target the most deprived communities, which were at present being mapped and were informed that this would be completed by December this year.

The Board accordingly agreed that it would

a)    review priorities once discrete community area had been identified;

b)    try to clarify he role of the Board in addressing health inequalities; and,

c)    involve local GP practices in promoting schemes to reduce obesity.

Lesley Bowles and Hannah Gooden to present to the Board on this matter.

Members were reminded that they had received initial details of plans for the redevelopment and regeneration of Swanley town centre and Hextable.

Arising from this the Board received a presentation from Lesley Bowles and Hannah Gooden of Sevenoaks District Council, which set out a number of broad actions which would be necessary for the regeneration of Swanley which included

•      Ensuring delivery of improved rail services and connectivity;

•      Creating a new small business quarter in Swanley;

•      Reinforcing the town centre offer;

•      Widening the residential offer of the town; and,

•      Marketing Swanley as a business and residential destination.

The presentation also considered a number of development proposals in some detail, including transport and leisure improvements and set out details of public consultation undertaken to test the needs and wants of local residents.

It was noted that arising from the consultation a 20 year Master vision for the area had been developed, to include housing developments, town centre redevelopment, transport improvements and plans to improve the quality of parks and green spaces within Swanley and Hextable.

The Master Vision also contained provision for health provision improvements and aimed to offer healthy living options for local residents. 

The Board was informed that Sevenoaks Council had been working closely with the local CCG to ensure the realisation of the development and that health was a major plank in the whole process.

The Board agreed to note the presentation and the plans for regeneration and future health provision in Swanley and Hextable.

The Board received a report which updated Members on the work undertaken in Dartford Gravesend and Swanley to reduce the number of falls amongst elderly and infirm people and presented data on a number of falls related issues.

The report explained ongoing and new work streams being undertaken in the following areas

·                Community Falls

·                Launch of Acute frailty pathways, ambulatory care unit and ageing health clinics

·                Creation of Falls ‘Hub’ Kent Public Health

·                Postural stability classes

·                Kent wide Falls group

·                Integrated falls pilot with Kent Fire & Rescue Service

·                Polypharmacy reduction

·                Care home provider forum

·                New review of Frailty pathways and services within DGS

·                New improved links with District Council Housing –

Members expressed some concern that falls outcomes did not seem to have improved to levels expected by the Board, and that linkages and co - ordination between services were not as well developed as was felt necessary.

Accordingly it was agreed that a report be presented to the Board as soon as possible considering outcomes and the co – ordination of work strands, and possible initiatives to improve the current situation.

Reports from Debbie Stock and Carol Patrick.

The Board received reports from the Clinical Commissioning Group and from Kent County Council on the ongoing review of the NHS estate holdings within the Board area (the Strategic Estate Plan)and the One Public Estate initiative in Kent.

Debbie Stock reported that the objectives of the Strategic Estate Plan (SEP) were to review the NHS estate within the CCG area and align this with commissioning service requirements to identify estate changes in terms of investment required and rationalisation opportunities which will deliver both clinical and financial benefits.

The SEP also aimed to allow the identification of key priorities for estate development in primary care as part of the Estates and Technology Transformation Fund (ETTF) programme.

It was noted that key to the determination of estate priorities and solutions was the development of a primary and community care clinical model which when agreed would be used to inform the services required, the locations and facilities to enable delivery of this model.

It was also noted that the development of the Strategy was an ongoing and iterative process, that the SEP has been updated and that it was currently in its third version.

Carol Patrick of Kent County Council informed the Board of the work of the One Public Estate Initiative (OPE).

Mrs Patrick informed the Board that the OPE programme is designed to facilitate and enable public sector organisations to work collaboratively on property and land matters, to encourage Public sector partners OPE principles and reap strategic benefits including the development of joint accommodation plans.

She further reported on bids submitted for the possible provision of a new health facility in Dartford Town centre which would enable the rationalisation of health care in the area and attract users external to the immediate area to relocate.

The Board welcomed both reports and thanked Mrs Stock and Mrs Patrick for presenting the information.

The Board received its regular update on the work of the three district health inequalities sub groups, and progress made against the delivery of each district’s Inequality action plan.

It was reported that difficulties were being experienced in delivering Objective 3 relating to Healthy Workplaces and that this may need to be amended to “Working Toward” status due to the unwillingness of local employers to commit to the programme.

The Board agreed to note the progress made.

The Board received and noted a report on issues outstanding from previous meetings.

There was no information for dissemination to the Board Members.

The Board considered a report on its updated programme of work for the forthcoming year.  It was noted that during the Board training session earlier in the day questions were raised regarding the format of Board meetings and the structure of the Board Agenda.  It was further explained that a need for more “workshop” style meetings had been expressed.

Accordingly it was agreed that Councillor Mrs Allen consult with the Chairman and that a review of the Board’s current processes and practice be undertaken with a view to formulating reforms for the future.