Items
No. |
Item |
1. |
Election of Co-Chairs and Welcome
To formally elect the
Co-Chairs of the Joint Commissioning Committee.
Minutes:
1.1
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RESOLVED: That Councillor
George Lindars-Hammond, Cabinet Member for Health and Social Care,
Sheffield City Council and Dr Tim Moorhead, NHS Sheffield Clinical
Commissioning Group Governing Body Chair, be appointed Co-Chairs of
the Committee.
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2. |
Apologies for Absence
Minutes:
2.1
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There were no apologies for absence.
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3. |
Declarations of Interest PDF 88 KB
Members of the Committee to declare any
interests they have in the business to be declared at the
meeting.
Minutes:
3.1
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Members of the Committee were requested to
declare if they had any interests which may impact on their
participation in decisions at future meetings of the Committee. The
following interests were declared:-
Dr Tim Moorhead – GP and shareholder in
Primary Care Sheffield, a not for profit enterprise.
Councillor Jackie Drayton – Husband was
an employee in the Voluntary Sector.
Mark Gamsu –
Trustee of 3 voluntary organisations in the City, full details
available on the CCG website.
Councillor Olivia Blake – Non-Executive
Director of the Sheffield Health and Social Care Trust and partner
of a Trustee of the Heeley City Forum.
Councillor Lewis Dagnall - Partner of a
Non-Executive Director of the Sheffield Health and Social Care
Trust and Trustee of the Heeley City Forum.
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3.2
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It was noted that declarations of interest
needed to be declared at each meeting of the Committee in
accordance with the Constitution of Sheffield City Council and the
Clinical Commissioning Group.
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4. |
Public Questions
To receive any questions from members of the
public.
Minutes:
4.1
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There were no questions from members of the
public.
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5. |
Minutes of Previous Meeting PDF 97 KB
Minutes of the meeting of the Committee held
on 29th April 2019.
Minutes:
5.1
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RESOLVED: That the minutes of
the meeting of the Committee held on 29th April 2019, be
approved as a correct record.
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6. |
Joint Commissioning for Health and Care - Terms of Reference PDF 336 KB
Joint Report of the
Director of Public Health (SCC) and Executive Director of Delivery,
Care Outside of Hospital (CCG).
Minutes:
6.1
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Jennie Milner, Integration and Better Care
Fund Lead, informed the Committee that the Terms of Reference had
been revised in accordance with the discussion at the Committee
held on 29th April 2019. The
Terms of Reference now set out the enhanced governance arrangements
that would drive forward a truly joint approach to commissioning in
a way that would secure the transformational change that was
required to realise the ambitions of the Joint Commissioning
Committee.
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6.2
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Greg Fell, Director of Public Health,
Sheffield City Council raised the issue of possible wider,
non-voting membership of the Committee e.g. Healthwatch. A
discussion took place regarding the need for wider involvement.
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6.3
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RESOLVED: That:-
(a)
The Terms of Reference be approved, as submitted and;
(b)
Further consideration to wider membership of
the Joint Commissioning Committee take place.
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7. |
Joint Commissioning for Health and Care - Care Outside of Hospital PDF 484 KB
Report of the Director of
Commissioning Inclusion and Learning (SCC) and the Executive
Director of Delivery, Care Outside of
Hospital (CCG)
Minutes:
7.1
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Sarah Burt, Deputy Director of Delivery, Care
Outside of Hospital, Sheffield CCG, and Nicola Shearstone, Head of
Commissioning Early Support, Sheffield City Council, presented the
report which outlined the potential whole system changes required
to support an improvement in the health and wellbeing of people in
Sheffield and reduce health inequalities. Two key elements were outlined – the
prevention of multi morbidity and the development of a robust out
of hospital health and care system.
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7.2
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The CQC Local Area Review Report 2018 had
indicated that many people had a fragmented experience of care and
there had been insufficient focus on prevention. Inequalities and multi morbidity were seen more
frequently in deprived areas and there was a need to invest in
neighbourhoods to achieve fairer healthcare.
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7.3
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Good practice was developing across the city,
but it had not always been effectively evaluated or given
sufficient oversight to develop across the system. There needed to be more focus on prevention and
embedding the person centred approach.
There was a need to develop an outcomes focused approach, working
with key stakeholders, developing ideas and initiatives through
co-production.
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7.4
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A number of aims had been identified which
included:
o
To develop a prevention focused health
and care system.
o
To identify people who are at risk of developing long term
conditions and multi morbidity and maximise independence and
resilience within their own home and community.
o
To provide optimal support to people (and their families) who are
multi morbid/complex or at the end of life.
o
To build on an integrated approach across health and social care to
ensure best use of shared resources.
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7.5
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To achieve the aims, there was a need to shift
to preventative and proactive evidence informed care which was
delivered closer to home and away from hospital. This would require a change in the culture of the
way people’s health and social care needs were managed.
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7.6
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Councillor Olivia Blake, Cabinet Member for
Finance, Resources and Governance suggested that more mention
needed to be made of Mental Health and it was accepted that whilst
Mental Health was implicit within the report, more needed to be
done to ensure that it was explicit.
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7.7
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Councillor Jackie Drayton, Cabinet Member for
Children and Families expressed concern that people were working in
silo’s and the work of the
voluntary, community and faith (VCF) organisations should be
included. It wasn’t always about
doing something new, but ensuring accessibility to what was taking
place and creative commissioning.
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7.8
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A workshop of all the Accountable Care Boards
was being arranged to look at all the different projects etc. that
were taking place. There was a need to
make the most of what was already being done and help people
navigate existing services.
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7.9
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A cultural shift was required and a
systemwide approach did not mean that
one size fits all. Equitable funding
was not always right and there was a need to build in
flexibility. Officers needed to be
empowered and providers were ...
view the full minutes text for item 7.
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8. |
Health Inequalities Presentation
Presentation of the Director of Public Health
(SCC).
Minutes:
8.1
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Greg Fell, Director of Public Health, SCC gave
a presentation which focused on Health Inequalities. The presentation showed that there was currently a
gap in healthy lifespan of 25 years. An
action plan had been published in 2014 which had led to the Health
and Wellbeing Strategy due to be launched in July 2019.
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8.2
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Work on health inequality was constrained by
national policy and there was no single responsible
owner. Air quality, smoking and primary
care all had an impact on healthy lifespans across the
city. The presentation outlined 10
recurring themes which needed to be considered when working on
health inequality, which were:
- Not just about deprivation &
geography – gender, ethnicity, disability, mental
illness, layered disadvantage
- Disproportionate distribution of
resources, services and assets to meet disproportionate
need
- The earlier the better.
Health of the working age population
- economic impact of inequality. GVA vs
social value.
- Community capacity and
approach.
- Shift of hospital to primary
care.
- focused effort on CVD risk
factors.
- Lifestyle “choices”
vs commercial determinants health
- Inequality and poverty are
obviously inextricably linked.
- Participation in education and
generating aspiration is important.
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8.3
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The presentation gave suggestions on how to
reduce health inequalities, which included:
- Health and Well Being Strategy +
discussion – July 19. No single “plan” but
expectations across all areas
- Progress against multiple reviews
& recommendations
- EVERY paper should directly
address a point about positive impact on health inequalities
- Treat with the same gravity as
financial balance?
- Extend the role of EqIA to encompass
inequality?
- PCNs (and beyond) –
differential funding and model of delivery
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8.3
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Councillor George Lindars-Hammond, Cabinet
Member for Health and Social Care, agreed that every report
considered by the Committee should have regard to the 10 recurring
themes and that discussions become actionable with challengeable
proposals.
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8.4
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It was understood that difficult decisions
needed to be taken, but they needed to be backed by evidence and
outcomes should be measured.
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8.5
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There was a relationship between poverty and
health inequality, there was a need to look at welfare rights
provision and to ensure that carers were getting the funding they
were entitled to. Gender specific
conditions also needed to be included.
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8.6
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RESOLVED: That the
presentation be noted.
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9. |
Date of Next Meeting
The next meeting of the Committee will be held
on Monday 19th August 2019 at 12.30pm in the Town
Hall.
Minutes:
9.1
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A discussion took place regarding the timing
of the next scheduled meeting of the Joint Commissioning Committee
on 19th August 2019 and whether it should be
rescheduled.
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9.2
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RESOLVED: That the next
meeting date of Monday 19th August 2019 be discussed at
the next development session of the Joint Commissioning
Committee.
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