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					              Adults and Healthier Communities Partnership Board; LAA Block 3
                                       16 June 2006
                                         Minutes




Cllr Graham Newman             Portfolio Holder for ACCS                                                (GN)
Carole Taylor-Brown            Chair, Chief Executive, East Primary Care Trusts                         (CTB)
Linda Hoggarth                 Chair of People with Physical & Sensory Disabilities Partnership Group   (LH)
Hilda Turner                   Co-Chair Learning Disability Partnership Board                           (HT)
Jo Cowley                      Head of Financial Inclusion and Advice Service                           (JC)
Anna McCreadie                 Director of Services & Chief Nurse                                       (AMc)
Rachel Miles                   Assistant Director of Modernisation, Waveney PCT                         (RM)
Jim Bullion                    Head of Strategy and Planning, ACCS                                      (JB)
Jacqui Martin                  Chair Families and Carers Partnership Board                              (JM)
Catherine Sullivan             Supporting People                                                        (CS)
Anthony Dooley                 Co-Chair Mental Health Partnership Board                                 (AD)
Ann Squirrell                  Mid Suffolk action in partnership                                        (AS)
Joy Weaver                     ACE, Supporter for Hilda Turner                                          (JW)
Joe Howarth                    Ipswich Borough Council                                                  (JH)
Alex Hopkins                   Suffolk county council                                                   (AH)
Martin Smith                   Suffolk East PCTs                                                        (MS)
Brian Keeble                   Suffolk East PCT                                                         (BK)
Daren Clark                    Suffolk Mental Health Partnership Trust                                  (DC)

Katrina McGill (Minutes)       Waveney PCT                                                              (KMc)

Apologies:
Andrew Evans, Graham Gatehouse, Daphne Savage, Jill Stewart, Mark Halliday, Lisa Chambers, Laura Hack,
Peter Bradley, Martin Ransom, Judy Rainer, Jon Swift, Tracy Lee, Rachel Thompson, Clair Harvey,
Nicola Swan, Simon Phelan, Mike Stonnard, Jenny Jenkins.


Item:                                                                                            Action:
1.             Welcome and Introduction
               Carole Taylor-Brown welcomed all members to the meeting. All members
               introduced themselves as there were a number of new faces on the board.

2.             Minutes and matters arising – graham
               The minutes of the meeting held on 12 May were discussed and agreed as a
               true reflection of the meeting except for the following:

               Apologies were received from Anna McCreadie.

               Matters Arising

               Item 6 – Board Links to Local Strategic Partnerships
               Work is proceeding well on forging links with supporting partnerships. Terms
               of References are work in progress and JC is talking to the various
               partnerships. The Supporting Housing Strategy Group is getting involved in
               looking at how the needs of marginalised adults are addressed within the LAA.

               Item 7 – Benefits Take Up
               The County Take Up Group passed on its thanks for the ideas generated at
               the last meeting to promote benefits take up. Several of these are currently
               being worked on.

               AD queried what items discussed at meetings actually get on to the minutes.
               After discussion, it was agreed that the minutes should reflect in more detail

AHC Minutes – Meeting of 16 June 2006
                                                                                                                1
Item:                                                                                           Action:
               the contents of any discussions held throughout the meetings


3.             Targets and Trajectories
               LAA Block 3 Board has been in existence for one year. There is a round of
               meetings in progress with Government Office East to sign off the Annual
                                                                   th
               Report. A meeting is being held with GO East on 20 June to discuss
               progress in all four Blocks of the LAA and GO East will give an indication of
               how well they feel that Suffolk is performing.

4.             How the local area agreement is looking one year on                              4.

               A1A. 40% mortality reduction from heart disease, strokes & related
               diseases in people under 75 by 2008.
               Detailed data is not available. However, confident that this is on target.

               On target for heart disease reduction rate of 40% by 2008.
               There are various factors involved with the target progress – people are
               stopping smoking and exercising and GPs are improving in their identification
               of people with heart disease.

               A1B. Reduce mortality rates from cancer in people under 75 by 17.1%
               Death rates have stagnated since the 1990’s, and this target will be proving
               difficult to reach.

               B1A. 2000 people achieving 5% body weight loss upon completion of
               the Slimming World Programme by 2008
               Project Manager confident that the target will be achieved by 2008. The
               programme is based on referrals and is a 12 week course. Success is classed
               when a person reduces their body weight by 5% within the 12 week period.
               The number of referrals to Slimming World will be expanding and the target
               lead is confident that the LAA target will be met.

               A query was raised about areas that do not have a Slimming World near them.
               Does the target only include urban areas?

               B1B. Increase by 3% the proportion of adults taking part in sport and
               recreational physical activity for at leas 30 minutes as least 3 days a
               week
               Base line data is not yet available as audit work is still being completed. JC
               was asked to investigate if this was the case across the whole of Suffolk. A
               breakdown of groups, urban areas, county areas etc., would be beneficial and
               would ensure that Board members received a true figure across Suffolk.

               B2. Increase the number of people who quit smoking
               Total is currently 3,740 which is 83% of target for 2006/07.

               B3A. All public sector organisations to be smoke free by end of 2006
               Work is ongoing to identify which public sector organisations currently do not
               have a ban on smoking to specifically target them. Target deadline is thought
               to be achievable.

               B3B. All enclosed public places and workplaces to be smoke free by
               end of 2007 and B3C. Arrangements for licensed premises to be in
               place for end of 2007

               Environmental health departments have begun work with licensed premises
               about establishing smoke free premises. Deadline is achievable.

               Smoking targets is looking very promising. All smoking targets are being
               monitored by the smoke free alliance.


AHC Minutes – Meeting of 16 June 2006
                                                                                                          2
Item:                                                                                              Action:
               Targets are achievable and on track.

               B4. Increase the number of patients completing treatment for Chlamydia
               infection
               There has been a delay in obtaining Q4 data which will form the baseline data
               for the project. The target is 150 new cases by December 2006. Suffolk LSPs
               have agreed to fund a part time posts with additional resources to run non
               NHS outreach screening sessions. A promotion campaign to enhance the
               national campaign is planned for Autumn 2006.

               Discussions were held about how this target was going to be achieved if data
               is not yet available or if the programme is shortened for any reason. Note –
               this is an LPSA target which means that it is important that the target is met in
               the appropriate time frame.

               B5A. Increase the number of school based health service drop in                     (Jackie)
               centres from 9 - 12
               There are currently 10 drop in centres. Another 2 are required. This has been
               highly successful. No school that has this intervention service has reported a
               known pregnancy since its inception.

               Information received from Target Lead since meeting:
               Schools which have a service are: Stoke (Ipswich), Orwell and Deben
               (Felixstowe), Stowmarket Upper, Great Cornard, East Bergholt, Falingaye
               (Woodbridge), Sir John Leman (Beccles), Bungay. Benjamin Britten and
               Denes (Lowestoft) have just closed, but there are plans to relocate the service
               within Ipswich, potentially Chantry.

               Please find attached to the minutes the email correspondence outlining
               success factors and learning from this project.

               After discussion, it was agreed that this target should be moved to Block 1,
               Children and Young People as the work involved with this target will be carried
               out with Block 1 partners. The Board agreed.

               B5B. Increase the number of community Psychiatric Nurses acting as
               Link Workers in GP surgeries from 0 - 12
               Two link workers are in place. Another 10 are due to be in place by the end of
               2006.
               AMc requested that the Waveney PCT area is included in these target figures.

               Evidence of achievement of this target will be data received from link workers
               on numbers of referrals made during the year.

               AD wanted the Board members to fully understand that this target is not just
               about ‘chucking money at the service’ but that link workers really do improve
               the heal of mentally ill patients. AH suggested that the number of Link
               Workers was not necessarily a reflection of the success or otherwise of the
               project, (although it has the advantage of ease of counting), but greater
               information is needed about outcomes on people’s health.

               DC undertook to provide a brief explanation on how link workers carry out their
               duties and achieve their targets.
               C1A. Increase the number of older people aged 65 and over helped to
               live at home

               Achievement has dipped and is now off target. There are a number of reasons
               for this.

               The target measures the number of people in Suffolk aged 65 or above that
               has been assessed for high health care support services and is in receipt of
               services such as home care. The target was set in a particular demographic

AHC Minutes – Meeting of 16 June 2006
                                                                                                              3
Item:                                                                                             Action:
               area where the proportion of elderly increases dramatically. Part of this dip is
               due to the technical definition. Previously included in this target were people
               assessed as needing a wide range of services such as preventative measures.
               A much tighter definition has now been set. This target should be considered
               in relation to C1C which highlights prevention services activity.

               A discussion was held about the remit of this Board to oversee changes in
               service provision. How does the Board monitor the people who stop getting a
               service – where do they go and do they turn up later within the acute system?

               CTB suggested that an impact analysis is required in a similar format to that
               which Health Scrutiny have asked for on the community service changes
               within health. CTB undertook to work with Graham Gatehouse and suggested
               that they develop a co-joined process which would monitor the impact of
               service changes across the health and social systems on vulnerable adults in
               Suffolk.

               MS asked how we ensure that people are not missing out on services
               available to them. JB advised that people falling out of the above target are
               generally identified by District Nurses, GP referrals and hospital admissions.

               RM asked if any detailed risk analysis has been completed on these targets.
               JC confirmed that the Target Leads Group are working with the County
               Council Performance and Risk Team to develop the Block 3 Risk Register.

               Cllr GN advised that there will be an impact on these targets due to the
               savings that Suffolk County Council has to make in 2006/07.

               It was agreed that communication with people is needed to ensure that
               someone who had been refused help previously did not then believe that they
               could never apply again in the future as circumstances change constantly.

               CTB – people are still intimidated by the thought of completing forms and there
               are people are possibly missing out due to their fear of the forms or the fact
               that someone said no 5 years ago.

               There is now a changed approach to how assessments are completed. JB
               advised that an assessment ‘product’ is being designed and there will be full
               consultation.

               AMc advised that ACS is in the early stages of discussions with BT about how
               the new process will work.
                                                                                                  JB
               The Board agreed that JB would bring evidence and data to the next board for
               members to review and comment.

               C1B. Increase the number of people receiving non-accommodation
               based housing support
               This target is currently on target and the Home Improvement Agencies have
               had a successful year with new expanded services. Work in ongoing with the
               Waveney Local Strategic Partnership and the Suffolk Strategic Partnership to
               expand the service into the Waveney area. The removal of means testing for
               Disabled Facilities Grants for children may impact negatively on the target and
               will be monitored by the HIA co-ordinator.

               C1C. Increase the number of people benefiting from preventative
               services to help them live at home
               Trend is above the trajectory threshold.

               JB will pull together a commissioning strategy for prevention. To return to the    JB
               Board in 6 months time.

               C2. Increase the number of households receiving home care as a % of
AHC Minutes – Meeting of 16 June 2006
                                                                                                            4
Item:                                                                                             Action:
               all adults and older people in residential/nursing care
               Target is on track. However, the number of people receiving residential
               nursing care is increasing. This is manageable at the moment.

               Home First service is a service that has taken existing staff and developed
               their skills to enable them to support people when they are discharged home
               from hospital. This is the first stage of a rehabilitation scheme and appears to
               be working well.

               C3. Reduce the number of days spent in acute hospital beds by people
               aged 75 and over as a result of emergency admissions
               This target is still under development.

               C4A, B,C, D. Benefits take up
               Attendance allowance take up in on target.
               Pension Credit and Disability Living Allowance is suffering a dip. Work is
               ongoing to identify people who would qualify for these benefits.

               Future meetings will receive an exemption report on these targets only. The
               in-depth review at this meeting was for the benefit of new faces and because
               of the Annual LAA review.

5.             Performance Reward Grant

               The funds from the Government have not yet been released. The Suffolk
               Strategic Partnership will decide which bids have been successful and when
               the funds will be distributed. AH advised that a letter is expected shortly
               detailing the successful bids and the funds allocated to them. However, the
               funds are not sufficient to cover all the bids.

6.             Forward work programme – developing the board to achieve our aims

               JB and RM gave a brief update and a presentation on the work that has been
               completed and the future work programme. This included the tasks that might
               arise for the Board from the White Paper.

               It was suggested and agreed that an Away Day would be beneficial. This
               event could be used to formalise the group and set up some structure. The
               away day will set the agenda of how the board will work. This day can have
               facilitated papers and actual work to be completed. The Board agreed this.

               Items to go onto Agenda for Away Day
                    Structure of LAA Board
                    Wider Vision for Board
                    Relationship with other bodies
                    Relationships across the LAA to maximise participation
                    Set LAA Block 3 Board Agenda
                    Set approach to running the meetings, style, how often, how they are
                       used, so that the Board can participate and influence.
                                                                                                  JB
               The away day was set for the Mid September 2006 to replace the meeting
               scheduled for 1st September. JB will consult with Board members when there
               is a draft agenda, and will circulate the date and venue as soon as possible.

               A copy of RMs presentation will be posted on the web site                          JC
               (onesuffolk.co.uk/laa) on the page for this meeting.

7.             Communication – what? How? And making it better

               The Board agreed that communication can form part of the away day.


AHC Minutes – Meeting of 16 June 2006
                                                                                                            5
Item:                                                                                            Action:
               RM advised that a communication strategy was developed for the LAA and this       RM
               could be used as a basis of a new strategy.

8.             Any Other Business
                                                                    th
               A meeting is to be held at Endeavour House on 19 June to promote the
               Suffolk bid to the Big Lottery for the Wellbeing Fund. There is a chance to bid
               for a fund of £1.2 – 1.8M. The meeting will provide a chance to discuss how
               bids are pulled together both locally and regionally. The information will be
               available on the LAA website shortly.

8.             Arrangements for next Meeting
               The next meeting will be held on Wednesday 26 July at Babergh District
               Council Offices, Corks Lane, Hadleigh. Note that the meeting starts at 2.00
               and will finish at 4.30.




AHC Minutes – Meeting of 16 June 2006
                                                                                                           6
Copy of email correspondence around School Based Drop in Centres – referred to in page 3
above. Please read from bottom of next page up!


Hi Jo

More tricky I'm afraid! I have just been able to source data -cluster based for the live birth rate -I will now
receive these quarterly which is great, but any reduction or increase would be an assumption rather than a fact!
Also, ward conception numbers are only up to 2003 at this moment and where numbers are less than 5 they
are supressed for reasons of confidentilaity-so it is more tricky. I also don't think that we should assume that
where there are no drop-ins that young women are getting pregnancy! There are many complex factors
involved with this.

To be clear I think we must go by what the schools that have drop-ins report and compare those with reports
from other schools as to the numbers of pregnancies-that would be a better comparision. This would also be
useful data, but would need to be collated with CYPP/Education colleagues. I will raise with the appropriate
people, but any help you can give on this would be excellent!

Best wishes
Sharon

     -----Original Message-----
    From:           Jo Cowley
    Sent:           28 June 2006 09:16
    To:             Sharon Singleton
    Subject:        RE: School based health drop-in

    Brilliant - thanks Sharon - are you happy if I put this in the minutes. Someone asked about the comparison
    with areas where there were not drop ins, but presumably young women are still getting pregnant in these?
    Do we have a figure or rate?

    Best wiehs
    Jo

          -----Original Message-----
         From:      Sharon Singleton
         Sent:      28 June 2006 09:13
         To:        Jo Cowley
         Subject: RE: School based health drop-in

         Hi Jo
         In response to your questions
         The schools are:

         Stoke in Ipswich
         Orwell & Deben in Felixstowe
         Stowmarket Upper
         Gt Cornard
         East Bergholt
         Farlingaye in Woodbridge
         Sir John Leman in Beccles
         Bungay

         Total: 9

         Benjamin Britten and Denes in Lowestoft have just closed ( May 2006) because of withdrawal of family
         planning nurse.
         Plans in place re establishment of this service and in hot spot areas such as Chantry in Ipswich

         We have been informed by the schools that there have been no known pregnancies since the drop-ins
         began

         As the drop-ins are lunch times once/twice per week in term time and are specifically for young people
         in the school. There will be a link through Youth & Connexions Service to offer similar within the
         community outside school times. There could be opportuntiy via Extended schools to develop this work

AHC Minutes – Meeting of 16 June 2006
                                                                                                               7
         to include local people e.eg family carers, but not as part of the school drop-in. Young people are less
         likely to access a service if adults from within the community would be there-issues of confidentiality
         etc.

         Learning has been around how individual services come together to work as a team and initially we had
         4 separate professions working individually within the same venue. Good leadership and a clear sense
         of the aims of the drop-in were worked on and resulted in excellent multi-agency working that benefit
         young people.

         Very important to involve young people and the whole school community on the design/planning and
         implementation as well as evaluation. Also key is to revisit as new year groups start and what their
         needs are and to revise the drop-in if needed-flexibility and responding to young people's needs is key
         to success. Promotion of the drop-in via the school assemblies and PHSE lessons is also crucial.

         Hope this helps?

         Best wishes
         Sharon
              -----Original Message-----
             From:                Jo Cowley
             Sent:                27 June 2006 10:39
             To: Sharon Singleton
             Subject:             FW: School based health drop-in

             HI Sharon - I am hoping to get the minutes out today or tomorrow. If you have any information that
             would be great.

             thanks
             Jo

              -----Original Message-----
             From:                Jo Cowley
             Sent:                21 June 2006 12:05
             To: Sharon Singleton
             Subject:             School based health drop-in

             Hi Sharon,

             I raised moving this target to Block 1 at the last Adults and Healthier Communities Partnership
             board, and they were in agreement that it made total sense, so I am just sorting this out with
             Maurice Brenner and other colleagues eg performance.

             The Board were very impressed with the results, but wondered if you could supply a bit more info?
             Is this ok? the questions were:

             1. Where are the centres - can we have a list of venues
             2. how do the results compare with other localities where there is no drop-in service?
             3. are there any plans to use the centres more widely eg for people living locally with no children at
             the school (family carers were mentioned)
             4. before we move the target to another block, can we pick up any lessons which might be relevant
             to work within the adults work?

             Any queries about these please do not hesitate to get in touch. I will put your responses in the
             minutes for the meeting.

             I look forward to hearing from you.

             Best wishes
             JO




AHC Minutes – Meeting of 16 June 2006
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