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					             DRAFT    AGENDA ITEM 2




           Healthy and Active
           Strategic Coordinating Group
           Meeting

           Date: 26th March 2009           Venue: 3rd Floor Conference Room,          Time: 1:00-4:00
                                                  Lambpit Street

           Attendees         or 
         Name                        /                         /                                /
         Angela Roberts                    Julie Wilkins                   Vicky Jones              
         (Chair)
         Alex Carson                       Karen Allen           Apols      Viv Davies                
         Carol Gardner                     Kathryn Uche          Awaiting
                                                                  new rep
                                                                             Yvonne Harding           
         Dawn Cooper                       Kathy Weigh           Apols
         Donna Dickenson                   Ken Danskin                
         Gillian Cowan                     Margaret Southall     Apols
         Graham Edwards                    Patrick Howells                 NPHS                    TBA
         Graham Minniss                    Pauline Preston                 Police                  TBA
         Jan Jones                         Sarah Hughes           Apols     In Attendance:
         Jeanette Shenton [JSh]            Sue Willis            Papers     Lorna Burdge             
                                                                    only
         Jon Sankey [JSa]                  Vicky Barlow               

           Outcomes
Agenda Item and Details                                                                            Actions/Who
                                                                                                   Responsible
1.  Apologies, Introductions & Pre-Agenda Issues
AR welcomed attendees and apologies were noted.

2.        Minutes and matters arising not on the agenda
          The minutes of meeting on 19 January 2009 were confirmed as an accurate
           representation of the meeting, with the following amendment:
          Page 6; Item LAPA; Action Bullet Point 4: “Joint Revenue Grant” should read
           “Joint Working Special Grant”.
          The Joint Working Special Grant fund posts and projects around integrated projects
           and multi-agency working.

           Matters Arising
          Page 3; ASD TF Group:
          ACTION: JSh to chase regarding what happened to, or is planned tor the                     JSh
           funding.
          PP reported that a survey regarding training has been circulated for the second time.

          Page 4; Item 3.8; Youth Justice Service [YJS]: This item deferred until next             AGENDA
           meeting.                                                                                  ITEM
          Page 5; Item 3.8; Economic Development:
          AR, GC and JSa have not yet met.
          ACTION: JSa to arrange this meeting.                                                        JSa


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              DRAFT    AGENDA ITEM 2


Agenda Item and Details                                                                               Actions/Who
                                                                                                      Responsible

          The PAG have not met since the last meeting of this group.
          ACTION: AR will complete this action, next time PAG meet.                                      AR

          Page 5; Item 3.8; LAPA:
          KD reported that the LAPA group will next meet on 30 April 2009. They are trying to
           gain more representatives from CYP Service, specifically from Education.
          ACTION: KD to contact Andy Hawkins.                                                            KD

          5x60 Scheme: The team are currently looking into piloting a scheme at St.
           Christopher’s School. Children with special needs have fallen outside the remit of
           the 5x60 Scheme, until now. A person has been identified to take on the twelve-
           month post, to oversee this pilot, however they will require specialist support.
           Funding should be ready in time for a September start.
          AR felt that the group would benefit from a short presentation. This to be an agenda
           item for September 2009.
          ACTION: Myra Redman/KD to give a 15-minute presentation to the group in
           the future regarding LAPA and the 5x60 Scheme and how it links into relevant                 MR/KD
           areas such as ACTIV-8, schools, MEND etc.
          CG suggested that KD may want to contact the Play Development Team (Mike
           Barclay) regarding funding for specialist children’s play.

          GC encouraged the group to visit the Health Challenge Wales web page and
           informed that those in-putting their post-code in to England’s alternative Change for
           Life, will receive a letter of apology stating that information will not be sent as they
           live in Wales.


          Page 6; Item 4.2; Multi-Agency Training:
          AR took the report to the CYPFWP Board (25.02.09). AR reported that she thinks
           the report was agreed in principle but that no one had the capacity to lead on it.
          AR reported that Tricia (TAC) is very accommodating with regards to arranging
           training for many different areas/topics but a great deal is carried out on “good will”.
          DD stated that the CYPFWP Board should have an overview of ALL training. This
           mapping exercise was started but so many changes have occurred that this will now
           need to be completely re-done.

3.         Standing items: Group/Board updates
     3.1    EMOTIONAL HEALTH, WELL BEING AND COUNSELLING including EMARS
            Colin Elliot has taken over the chair of this group. Graham Edwards to be vice
             chair.
            ACTION: Colin Elliott to be invited to attend the next meeting of this group.                JS

 3.1.1 Terms of reference
      ACTION: Members asked to look at these and pass any comments to JS by                           ALL/JSh
         the 3rd April 2009.

 3.1.2 E Mars:
    AR informed that funding for the admin post may now have been sorted out.

 3.1.3 Suicide Reduction Group
    Overview document update




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         DRAFT    AGENDA ITEM 2


Agenda Item and Details                                                                        Actions/Who
                                                                                               Responsible
 3.1.4 PMHWE
     Overview document update

 3.1.5 School Counselling Project
     Overview document update
 3.1.6 CAMHS Training Group
     Overview document update

 3.1.7 Autism spectrum disorder Group
     Overview document update

 3.1.8 Autism Spectrum Disorder Group – Terms of Reference (ToR)
     ACTION: Members asked to look at these and pass any comments to JS by                        ALL/JSh
       the 3rd April 2009
 3.2   Integrated Strategic Speech and Language – Task and Finish Group                              AR

      This group have met, further update at the next meeting
      ACTION: AR to feed into next meeting.                                                         AR

 3.3 Childrens Integrated Disability Service (CIDS) – Task and Finish Group                          YH
     Overview document update
 3.3.1 Terms of Reference
    Not available for todays meeting. Will be provided for meeting in June.

      ACTION: Task and finish group to review TOR and present at next meeting.                    YH/JSh

3.4    Young Carers                                                                                  MS

      AR read through the update that MS sent in her absence
      Work from the original ToR have now been complete, with the exception of Carers’
       Assessments.
      A joint approach is being taken to develop both children and adult Carers’
       assessments.
      AR reported that this is a very big achievement as these have always been separate.

 3.4.1 Terms of Reference
    Members asked to look at these and pass any comments to JS by the 3rd April                   ALL/JSh
      2009

 3.5   CYP Substance Misuse (linked via SMAT)                                                        VJ
                                                                                               .
      The last meeting was cancelled. VJ reported that this is not a TF group though; it is
       a linked group and brings the right people around the table at the right time.
      There are two pilot proposals being worked on at the moment; Strengthening
       Families and Stronger Families. The details of which will be worked out following
       WAG’s approval for Wrexham to participate.
      The group are to meet again next month.
      AR asked about work around the “binge-drinking” problem. The main focus of
       In2Change Children and Young People Team is done around alcohol and cannabis
       use. YP have to engage with Substance Misuse workers and cannot be forced to do
       this, therefore engagement is a big part of the team’s work.

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             DRAFT   AGENDA ITEM 2


Agenda Item and Details                                                                              Actions/Who
                                                                                                     Responsible
       VJ informed that they are looking at a pilot (adult services) involving those taken into
        the custody suite and how to engage them in educating them regarding the adverse
        effects of alcohol but discussions are only in the very early stages.
       Much of the work concerned with parents is currently limited to help-lines and ad-hoc
        advice. If the Police pick up YP that are drinking, they do carry out a home visit
        through the harm education scheme and referrals for the YP can be made to
        In2Change.
       VJ stated that there is a project working with children (and whole family) where
        parental Substance Misuse is an issue. SMAT will be contributing funding to this
        project in 2009/10.

       YH will be attending Wakestock in Abersoch, she invited the group to forward their
        top three questions that they would like YP to be asked. In return for completing
        the questionnaire, YP will be given free contraception and sexual health advice. YH
        stated that the answers obtained from this should give a very good “snap-shot”.

       ACTION: JSh and VJ to meet and respond to the DEFS consultation (Ed Balls)                   JSh/VJ
        The group to forward any questions for consideration to YH.
                                                                                                     ALL
   3.5.1 Terms of reference

        ACTION: Members asked to look at these and pass any comments to JS by
         the 3rd April 2009                                                                          ALL

                                                                                                           DD
       3.6    Young People’s Sexual Health Planning and Co-ordination Group
       This group has not met for some time due to a number of issues.
       ACTION: DD and GC to meet next week to discuss re-convening the group.                         DD/GC
        Reports have been back and forth to the LHB. The last time this report went before
        the LHB to gain additional funding for the extended hours/Saturday opening of the
        Info Shop, the group were told to “get on and get started”.
       DD reported that once a nurse who is willing to cover the Saturday morning is found,
        the Info Shop will start opening regularly on a Saturday morning.
       Jonathon Miller is pulling together issues around campaigning and marketing issues.
       ACTION: DD will bring the decision back to this group, once it is known.
                                                                                                           DD
       YH informed of commissioned training on sexual health, arranged through Bangor
        University. This training is more relevant for nurses but it is open to all professionals.

       ACTION: YH to circulate the information once received.
                                                                                                           YH
       The training event taking place in September is the last one and if there is enough
        interest from professionals in this area, it will take place in Wrexham.
       DD stated that it is important that all professionals within the Sexual Health Service,
        deliver the same, one message to Wrexham’s young people. Whatever Bangor
        deliver at these training sessions will be Wrexham’s message as well.
       DD reported that there has been a drop in teenage pregnancies here in Wrexham.
        This is now at a critical point and these numbers need to be driven down further.
        Wrexham is now the eleventh authority in Wales.
       The info outreach scheme scheme will be rolled out to outlying schools such as
        Maelor and Grango, as the YP that attend these find it difficult to get into Wrexham’s
        Town Centre.
       DD thanked AR, YH, VB, JSh and Jerry O’Keefe for their commitment to getting this

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         DRAFT     AGENDA ITEM 2


Agenda Item and Details                                                                          Actions/Who
                                                                                                 Responsible
       project underway.
      AR reported that the North Wales Sexual Health Forum took place this morning.
       This meeting includes GUM (Genito-Urinary Medicine) consultants and others
       delivering a sexual health service. AR informed that this group has been suspended
       until September (at least) until the NHS re-structure has been completed.
      A transition group has been set up to oversee the changes in the mean-time.

      There has been an interesting development within the “Termination Service”.
       Llandudno Hospital will be undertaking first trimester terminations. Before now the
       nearest clinic for those requiring this service, was in Liverpool.
      PP felt that this could be an ideal time to make connections between termination
       services and grief and loss counselling services. PP informed that information on
       these services is on the website.

      ACTION: PP to forward information to group.                                                     PP

      AR informed PP that this information needs to be put on this group’s agenda in order
       to bring it to the group’s focus.
                                                                                                 .
 3.7    Public Health Commissioning Group                                                             GC
  3.7.1 Terms of Reference

      ACTION: Group to read and e-mail any additions/amendments to JSh by the                        ALL
       3rd April 2009.

       3.7.2 Obesity Programme Group
      GC reported that her team are in the process of a mapping exercise.
      ACTION: Any information regarding physical/leisure activities and/or nutrition                 ALL
       should be forwarded to GC as soon as possible.

      GC to circulate information to this group when the information has been                        GC
       compiled.
      The second meeting of this group’s members has taken place and they are
       concentrating on the development of the strategy (requiring the physical activity and
       nutrition information) and looking at gaps in provision. There is so much going on, a
       need to co-ordinate these services has been recognised. The group will also look at
       what is best in terms of commissioning these services.
      SH will be happy to visit any teams to talk through any issues around this topic, or is
       equally happy to talk through any issues over the telephone.
      ACTION: GC to ask SH to arrange another meeting with Mike Barclay, of the                     GC/SH
       Play Development Team.

      AGENDA ITEM: GC to arrange a half-day event, where interested parties can come                AGENDA
       to share their physical/leisure activities and nutrition information to assist in the          ITEM
       development of the strategy and feedback at the next meeting of this group. AR                  GC
       stipulated that if those invited are unable to attend, they must either send a
       briefing, or a representative who can pass the relevant information on.


       3.7.3 Breastfeeding

      GC to meet up with Fiona Lee in May, to decide how to progress. There may be an

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         DRAFT     AGENDA ITEM 2


Agenda Item and Details                                                                           Actions/Who
                                                                                                  Responsible
       issue regarding capacity.
      ACTION: GC report back to this group.                                                          GC
      AR questioned whether the Breastfeeding Group has been re-instated.
      JSh stated that a reporting structure on Breastfeeding is required as it is one of the
       Key Aims in Wrexham’s CYPP.

       3.7.4 Tobacco Reduction
      This is currently being updated and SH will be planning an event around this.
      ACTION: SH to keep this group informed                                                         SH

       3.7.5 Immunisation     [Lorna Burdge – Wrexham LHB]
      Wrexham is well up to reaching WAG’s target of immunising 96% of children.
      There are two new vaccines.
      Some GP practices carry out their own vaccinations and others have a SLA with the
       Trust.
      A two-day immunisation training course is being developed for community nurses,
       school nurses and practice nurses alike and a follow up course.
      Immunisations are very complex injections and must be given with care and up to
       date guidance.
      Travel immunisations have also been looked at with practice nurses.
      Lorna informed that there have been issues around properly recording
       immunisations and reported that while adverse reactions are extremely rare they
       would require immediate treatment.
      Lorna informed that part of her job is to check the weekly vaccination waiting lists. If
       these are getting longer, Lorna contacts the relevant surgery to find out the reasons
       for the wait. Lorna will do clinics for these surgeries if and when required.

      Counselling for parents is required. Vaccinations are a very emotive subject since
       rumours of a link between the MMR jab and Autism were made – although now
       known to be unfounded.
      Repercussions of this link have seen a drop in the number of children being
       vaccinated against Measles, Mumps and Rubella [MMR]. Now, childhood diseases
       that had been all but eliminated are making a return. There has been an outbreak of
       measles in Chirk and another (more recently) was confirmed in Ruabon. Despite
       this, parents are still choosing not to immunise their children.
      An MMR “catch-up” plan has been developed and noted changes are that uptake of
       the second MMR vaccination has increased, while the first MMR vaccination uptake
       has dropped further.
      The group looked at the October-December figures update (handout) Wrexham is
       still around the 90% mark.
      The problem with the HepMenC immunisations is that if the first vaccination is
       missed the two vaccinations cannot be given together, so missing one has a knock
       on effect.
      VB asked about numbers regarding migrant families but was informed that different
       cultures have different systems of vaccinations – very cultural, e.g. France does not
       vaccinate against meningitis and French immigrants will not have this vaccine, while
       the Portuguese have many separate vaccinations.
      YH reported that Wrexham is achieving about a 95% uptake on the HPV vaccine.
      As Immunisation is one of the Key Task Performance Indicators, AR asked the group
       how often Lorna should report back to this group. The group asked how often data is
       made available. Lorna informed that surgeries can take up to six-months to compile
       their data so data can be a good six-eight months behind.
      ACTION: Lorna to request an “exception report” for this group and to inform
       this group of any problems as they arise.                                                      LB

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              DRAFT     AGENDA ITEM 2


Agenda Item and Details                                                                             Actions/Who
                                                                                                    Responsible
           YH reported that all information is also available on the NPHS’ website.

           3.7.6 Children’s Dental Health                                                               GC

           Dr Sandra Sandham will be attending the next Public Health commissioning Group
            meeting in April 2009.
           AR stated that problems are arising in this area as there is no fluoride in the water
            and only WAG can instruct the Water Board to add anything to the water.
           AR reported that in the West Midlands, where Fluoride is added to the water supply,
            children’s dental health is very good.

 3.8        Voluntary Sector Update                                                                     CG

           CG stated that there is nothing to report at this time.
           Groups may struggle to get voluntary sector representation as many are under
            pressure from a number of different issues. Many organisations are struggling in the
            current economic climate and are currently in discussion regarding how best to
            continue.
           CG has spoken to Laura Williams (AVOW) who informed that CYPFWP and SCoGs
            etc. are down by large numbers, with no one coming forward at this time. This will
            undoubtedly affect the Statutory agencies who wish to continue working with the
            Voluntary Sector.
           AVOW may have difficulty finding voluntary sector representatives for groups.
           Action: Update to be brought to the next meeting                                            CG
 3.9        Other Organisations Update                                                                  JW
           JW reported that the OT team are in flux. Glenys has retired and Lesley Cotter starts
            work with the team on 1 April 2009.
           Physiotherapy team are leading the SMART project in main stream primary schools.
            In this project, one ordinary PE lesson is replaced with a physical activity session
            that enables trained individuals to diagnose whether a child has dyspraxia. Many
            children with dyspraxia have been picked up through the SMART project.
           KD reported that when YP have finished their interventions (allowed to do two) they
            are rewarded with a “dash card” which entitles them to 50% reduction on all of
            Wrexham’s Health and Fitness centres.
           Penny Cowleys Update: JW read through Penny’s updates for the benefit of the
            group. Penny had made additions on the circulated Overview report.
           ACTION: AR asked JW to pass on the group’s thanks for the updated
            information but also that Penny be informed that she should feed in to the                  JW
            relevant TF groups, for them to pass to this group’s updates.

4.         Other items tabled
     4.1     H&A SCoG – Terms of Reference (ToR)                                                        AR

             ACTION: The group was asked to read over the ToR for this group and pass                  ALL
             any comments to JSh by Friday 3 April 2009, otherwise the document will be
             considered to be ratified by the group.


      4.2 MEND Update             (verbal)                                                              YH
           YH reported that the “Mind, Exercise, Nutrition and Do-it” (MEND) project is up and
            running in Wrexham and Flintshire.
                                                          7
              DRAFT   AGENDA ITEM 2


Agenda Item and Details                                                                             Actions/Who
                                                                                                    Responsible
         St. Christopher’s will run a group.
         The programme is for children who are obese and consists of two after school
          meetings for a period of ten weeks. No group has more than 15 children and those
          completing the programme are fed through ACTIV-8 as an exit strategy.
         There has been a low uptake for MEND but this has improved for the second
          programme.
         KD stated that positive results are reliant on families taking responsibility.
         CG questioned whether this programme would run for children with disabilities have
          fewer opportunities for play and exercise. AR stated that this situation is better here
          in Wrexham than in other areas.

     4.3 ‘Talk to the Hand’ Update              (verbal)                                                KW
         AGENDA ITEM: This item deferred until the next meeting of this group – 22                  AGENDA
          June 2009.                                                                                  ITEM

     4.4 Community Extravaganza                 (verbal)
         This event will take place on Saturday 6 June 2009 in Queen’s Square and the green
          alongside the Guildhall.

5.       AOB
         JW reported that she is to take part in the “Three Peaks Challenge” on Saturday 27
          June 2009 in order to raise money for charity.
         ACTION: Any one wishing to sponsor JW should contact her directly.                           ALL
         AR informed the group that she would revise the agenda for next month so that the
          meeting will follow a theme.
         AR thanked the group and the meeting closed.

6.       Date and time of next meeting

          DATE: Monday 22 June 2009
          TIME: 1:00 p.m. – 4:00 p.m.
          VENUE: Conference Room 3, Erlas, Wrexham.
Future Meetings
              Monday 21 September 2009, Committee Room 3, Guildhall
               1:00 p.m. – 4:00 p.m.
              Monday 21 December 2009, Committee Room 3, Guildhall.
               1:00 p.m. – 4:00 p.m.




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