Agenda item

The Chair asked if Cllr Birnie had submitted his apologies for the meeting.  RTwiddle confirmed that nothing has been received.

Cllr Timmis, noting that Cllr Birnie is not present, made some observations about the report; , that this Health and Wellbeing Board, does this have anything to do with the Health and Wellbeing building being set up in Hemel Hempstead, although it’s a separate thing, it’s not anything to do with the Health and Wellbeing Board, that’s my first question.  The second thing is looking at this Item 2 on this report, it seems to me extraordinary, and extraordinary mess, if you don’t mind me saying of the fact that the STPs, another acronym which has not been written out, which assume is the Strategic Transformation Programme.

The Chair confirmed that it was, but it now stands for Strategic Transformation Partnership, it’s from a plan to a partnership.

Cllr Timmis commented that this is yet again, another NHS type changing everything, which costs more money, changing headings etc, but this, it says here in Item d, that the establishment of STP, in 2015 has rather complicated the issue but who has responsibility for certain items.  I find it extraordinary because they’re doubling up or overlapping, if you like, it appears and that again will cause more money and more waste of money, I should say, when you’ve got overlapping of the Health and Wellbeing Board and the STPs and it says that Hertfordshire Board has found it difficult to find a role in the STP, because the strategy is largely driven by the NHS and timescales are set nationally.  It’s not together, properly organised thinking.  This, you could roll out into a lot of what’s happening with the Discharge of Care and the fact that you’ve got all sorts of different bodies all working on different levels.  I find this really disheartening.  It says here “the division of responsibility between the elected body and the CCG to fund integrated provision in these straitened times has led to demarcation disputes in Hertfordshire”, which we’re already aware of, which again seems a pity that we’re spending time doing that rather than actually looking at care for patients.  It says here “one very useful function of the Hertfordshire Board has been the gathering of statistics to underpin its planning”.  It then goes on to say a bit further down “The statistics concerned are presumably considered appropriate for each of these life stages but, as a result, are not, unfortunately, always comparable.”  That doesn’t sound very useful.  Another drawback is that at the end of the reporting period some of the statistics will necessarily be out of date.”  So, it seems this is a report, rather than actually saying what’s going to be done about it?  Because it does seem to me that it’s not working.  An Appendix actually came with the second report but I won’t say any more.  I just feel this is a little worrying.

The Chair suggested Cllr Timmis contact Councillor Birnie with her concerns.  The Chair asked Cllr W Wyatt Lowe if he is able to provide some holding information in the meantime, as a Member who has sat on the Health and Wellbeing Board?

Cllr W Wyatt Lowe responded that the Health and Wellbeing Boards, unfortunately, are being eclipsed, as it were by STPs in terms of power structure.  I have feelings that whether or not STPs will succeed in replacing all the other structures that the NHS has tried to impose on us, I’m not sure that it will but the Health and Wellbeing Board is currently fighting back, I understand but I can’t really say any more because their last strategy meeting was this morning and I was not at it.

The Chair confirmed that Cllr Timmis should contact Cllr Birnie direct with any concerns.

EGlasser commented that she feels it is a disastrous reorganisation and the reason it’s happened is because there’s nothing between the CCGs and the government, basically.  We used to have Health Authorities that covered a region and looked at the strategy for a whole region rather than just local places and so that’s how this STP has come about but of course, how on earth they selected their boundaries, because they never do choose boundaries that work together and you wonder how that happens.  I think it’s very sad, too, if the County aren’t more involved because health is about local authorities as well as health authorities.  If you want things to be successful as they have been in Sweden, and Holland now, you’ve got to have everybody working together and if you don’t you can’t just leave it to the health authorities.

The Chair offered some assurance that County is involved with it. 

Cllr W Wyatt Lowe added that the County’s influence is diluted by the fact that it’s (not) the only County Council involved and that is part of the issue here because Essex are also there but Essex haven’t got time to devote to it because they’re split between three different STPs.  It is something of a nonsense, however, what came up at the Dacorum Patients’ Group last night was perhaps very significant to all of us where attention was drawn to the fact that there are at least four different IT systems involved and they don’t talk to each other and some solution absolutely has to be found.

KMinier confirmed but added its not just within the system, and additionally you’ve got the new data confidentiality coming in as well and the fact that you get dropped out if you want your data used for research and everything else and also you’ve got trusts, I can give you an example of that, somebody went into a place here and the GP there couldn’t look at his records because he worked for a different organisation and the senior nurse who could look at the records couldn’t look at the level because she wasn’t senior enough.  So there is a lot more things to work out than just the technology.  On the back of that is that HBrown mentioned the fact that their IT systems are very poor and the quality of audits in this report, say they’re all working at deficit, so it really looks at the moment, unless there is more money released and I won’t say how it’s released, but if there is more money released, we are not going to get out of this.

Cllr Timmis referred to the Appendix, expressing that she found it very confusing.  It says Starting Well, Developing Well, Living and Working Well and Ageing Well as headings and then we have all of it about the negative issues.  Mental health problems, pregnant women smoking, mothers not breast feeding, mental health disorders and suffering from stress, doesn’t sound “well” and it’s also hard to understand what these.

The Chair advised that relates to the County Council’s four priorities for the different stages of life, for pregnant mothers, and under fives; for five to eighteen year old children and young people and for adults of working age and then for sixty-five-plus year olds.  So they’ve got these four priorities for four different age groups.  In Cllr Birnie’s report, he included where we are in Hertfordshire with the extent of people within these different age groups suffering various problems.