Agenda item - Health & Wellbeing Board Review: Proposals for Agreement

Report of the Executive Director, Health and Adult Social Care (copy attached)

         RESOLVED – That the Board agrees to recommend to full Council:

     (1) The revised Terms of Reference for the Health & Wellbeing Board           (Appendix 1);

     (2) The creation of an Adult Social Care and Public Health Sub-Committee of the Health & Wellbeing Board (Appendix 2); and

That the Board agrees

(3) To establish an officer task & finish group (to include NHS and CVS representatives) to report back to the Board with proposals to address the matters that were identified in the public consultation as set out at paragraph 2.18 of the report, in particular to improve public engagement with the Board.

That Full Council:

(4) Agrees the revised Terms of Reference for the Health & Wellbeing Board (Appendix 1);

(5) Agrees the creation of an Adult Social Care and Public Health Sub-Committee of the Health & Wellbeing Board (Appendix 2);

(6) Authorises the Chief Executive and Monitoring Officer to take all steps

necessary or incidental to the implementation of the changes agreed, and that theMonitoring Officer be authorised to amend and re-publish the Council’s

constitutional documents to incorporate the changes; and

(7) That the proposed changes come into force immediately following their approval by Full          Council.

55.1   The Committee considered a report of the Interim Executive Director of Health and Adult Social Care which presented proposals to improve the effectiveness of the Health & Wellbeing Board (HWB)

55.2   Under the Health & Social Care Act (2012) all local authorities with social care responsibilities had been required to establish Health & Wellbeing Boards (HWB). The 2012 Act (and subsequent Regulations) set out a legal framework for HWBs, including a minimum membership and statutory duties. However, local authorities were given considerable freedom to develop locally appropriate HWB models with additional membership and duties. In consequence, a number of different HWB models had evolved and over time it had become apparent that some models were more effective than others. Since 2019 the Brighton & Hove HWB had been working with the Local Government Association (LGA) to better understand good practice with regard to HWBs and it had become clear as a result of that work that there were aspects of the Brighton & Hove HWB model which needed to be changed and updated to reflect recent major developments in health and care in order to make it more effective and to better align it with best practice across England.

55.3.  It was noted that the proposals being put forward for approval had been developed by BHCC officers in partnership with HWB member organisations and stakeholders across the city and that the review process had been supported by the Local Government Association (LGA). The review proposals had also been influenced by an online public consultation which had run during November/December 2020.  It was explained that if approved by the Board, the proposed changes to the HWB membership and Terms of Reference would require amendment of the Council’s Constitution and so would also need to be considered and agreed by Full Council. Insofar as the proposed changes could impact on partner organisations, they might also need to go through those organisations’ governance processes.

55.4   The Assistant Director, Resources, Safeguarding and Performance explained that it was anticipated that further changes to the Membership of the Board and or the Adult Social Care and Public Health Sub-Committee would be required in response to the pending Government White Paper. Notwithstanding that, the proposals being put forward were considered to set the direction of future travel and to be suitably resilient and robust.

55.5   The Chair, Councillor Shanks welcomed the report commending the work of the previous Chair, Councillor Moonan who had supported the process in bringing these proposals to fruition.

55.6   Councillor Moonan welcomed the report and referred to specific points which she considered required to be made explicit or amplified upon going forward. In respect of paragraph 2.15 (bullet point 2), discussions had taken place at the Board Member meeting relating to shared focus work with identified communities, it was also important in her view to make explicit reference to addressing mental health issues. It was recognised that this would constitute a big area of work which would need to be focused on post Covid and would be integral to future wellbeing. In respect of references to those with learning disabilities if responsibilities and overarch for children and adults sat with different directorates it was important that was made clear. One thing which had also been evident was that it was unclear to those outside of the organisations which fed into the Board what its role was where it sat in relation the various Programme Board and how people accessed it. She considered an organogram which indicated the interconnection of these constituent parts and roles would be beneficial. Overall, Councillor Moonan considered that the proposals would affect the improvements identified and was very happy to support the report recommendations.

55.7   The Executive Director, Health and Adult Social Care, Rob Persey, explained which elements of Learning and Disability sat within the Directorate of Children, Families and Learning and which sat within Adult Health and Social Care agreeing that these distinctions would be made explicit he also agreed that the focus on mental health would also be referred to explicitly. Thought could also be given to how the various roles, functions and the overlay between them could be expressed diagrammatically. These matters could certainly be form business for discussion at the first Engagement Board meeting.

55.8   The Senior Partnership and Scrutiny Officer, Giles Rossington, explained that it was recognised that work needed to be done in order raise awareness of the Board its role and the new Sub Committee, if the recommendations were agreed and means by which individuals and organisations could interface with it. This was a work in progress and it was recognised that further work was needed. It was agreed that the HWB and sub-committee Terms of Reference would be amended to reflect Cllr Moonan’s points around mental health and around Learning Disability services; and that the point around being able to explain the local health & care system model in straightforward terms would be taken up by the HWB officer task & finish group as part of its work on improving engagement.”

55.9   David Liley Healthwatch also welcomed the report and sought clarification of the route via which Healthwatch would bring forward reports in future and whether meetings would take place in public. The Chair, Councillor Shanks, stated that meetings of both the Board and the new Sub Committee would take place in public and issues could be brought forward in either forum. Additionally, workshop sessions would take place for Members. The Executive Director, Health and Adult Social Care, Rob Persey confirmed that meetings would follow the council’s governance arrangements and would take place in public and would provide the opportunity for public engagement.

55.10As there was no further discussion the Board moved to the vote and voted unanimously in support of the report recommendations.

55.11RESOLVED – That the Board agrees to recommend to full Council:

     (1) The revised Terms of Reference for the Health & Wellbeing Board (Appendix 1);

     (2) The creation of an Adult Social Care and Public Health Sub-Committee of the Health & Wellbeing Board (Appendix 2); and

That the Board agrees

(3) To establish an officer task & finish group (to include NHS and CVS representatives) to report back to the Board with proposals to address the matters that were identified in the public consultation as set out at paragraph 2.18 of the report, in particular to improve public engagement with the Board.

That Full Council:

(4) Agrees the revised Terms of Reference for the Health & Wellbeing Board (Appendix 1);

(5) Agrees the creation of an Adult Social Care and Public Health Sub-Committee of the Health & Wellbeing Board (Appendix 2);

(6) Authorises the Chief Executive and Monitoring Officer to take all steps

necessary or incidental to the implementation of the changes agreed, and that theMonitoring Officer be authorised to amend and re-publish the Council’s constitutional documents to incorporate the changes; and

(7) That the proposed changes come into force immediately following their approval by Full Council.