APB Executive Board Meeting Held On

______

APB Executive Board Meeting held on

24th May 2017, 10:30 am

Apollo meeting room, Willcox House, Grangetown

1 / Introductions
Peter Greenhill (PG)
Fiona Kinghorn (FK)
Nicola Evans
Neil Jones (NJ)
Gareth Hopkins (GH)
Conrad Eydmann (CE)
Benni Lepine (BL)
Ben Davies
Chris Jones (CJ)
Hilary Williams (HW)
Deborah Gibbs
Steph Kendrick Doyle (SS)
Deborah Gibbs (DG)
Eiddwen Thomas
Tina Aelwyn
Luke Midgley (Observer) / National Probation Service (Chair)
Interim Director of Public Health
Welsh Government
Consultant Psychiatrist Cardiff & Vale UHB
SW Police & Crime Commissioner Office
Cardiff & Vale University Health Board
APB Vale Locality Officer
APB Support Team
APB Support Team – Systems Information Officer
APB – Accountant
Vale of Glamorgan – Community Safety Manager
Cardiff Council – Community Safety Manager
Vale of Glamorgan – Community Safety Manager
Cardiff Metropolitan University
Cardiff Metropolitan University
Cardiff University
Apologies
Sue Schelewa
2 / Minutes from the last meeting
Introductions
To amend: FK is interim Director of Public Health
Minutes agreed as accurate.
Matters arising
Domiciliary Care to be added to the risk register.
3 / Presentation Item:
Presentation on the findings of the Pathway Evaluation.
TA and ET outlined the nature of the evaluation that took place on the pathway and presented the board with the main findings.
There are no major issues that the APB need to take urgent action on and on the whole there is some very good practice both within service delivery and in commissioning.
The key recommendations are that:
·  The criteria for referral needs to be looked at. The current EDAS procedure for referral to CAU uses criteria that is different from NICE guidance.
·  The Reengagement service needs to clarify its referral criteria and they are now delivering outside of their commissioned specification by holding onto clients and offering support which is impacting on their capacity.
·  EDAS could use basic triage measures for issues other than alcohol and substance misuse given the general complexity of clients. This would enable services to get an indication of pre-existing precipitative issues that would effect their substance misuse.
·  There is a problem with referral into mental health services. There needs to be clear referral pathways or joint assessment into mental health services.
·  Need to look at the fact that up to 80% of individuals accessing the NEX are not in services and are missing out on testing for BBVs. Work on brief interventions in the Needle Exchange.
·  There are fewer people accessing services in Barry and the Vale of Glamorgan and this should be looked into.
·  Recommendation to identify older people and to develop services appropriate for them and other hard to reach groups.
·  The fact that the TOPs form can’t be accessed between services is an issue as it doesn’t allow services to follow a person’s treatment through seamlessly.
·  The different philosophies within the aftercare consortium create some difficulties especially around data collection and clients who are abstinent being mixed in groups where clients are not abstinent and not at that stage in their recovery. The APB to help Solas have strong leadership within the consortium.
TA and AJ were under the impression that there was a Nalmafene prescribing clinic within Taith. NJ corrected this saying that a Nalmafene prescribing clinic had only happened once. TA and EJ to correct this data.
NJ questioned some of the data, specifically around the Needle exchange. TA and EJ agreed to review service data to check potential discrepancies.
Action: Board to send any comments back to CE by 20th June.
Action: CE to prepare a response to the recommendations
Action: Discussion to be had with mental health colleagues about referral pathways and joint working.
Action: CJ to look at whether or not there is drift from clients from the Vale into Cardiff.
Presentation on the Findings from “Making the Connections” the Substance Misuse and Domestic Abuse development day.
BL delivered a presentation on the findings from the development day held on the 25th April. The main findings were that a training package should be rolled out for:
·  Substance misuse services and domestic abuse services on screening and upskilling in eachother’s disciplines to facilitate joint working.
·  Training across the sector on screening for complex issues and referral pathways.
This will be funded through the workforce development budget and using the training vouchers purchased with slippage at the end of the last financial year.
The second recommendation for the day is that we need to develop a better way of working that involves a more appropriate response with better information sharing for those individuals who present within services with high levels of complex needs. The Area Planning Board invited the proposal that a working group is developed to take this forward.
4 / Work programme update
1)  Follow up to the APB December development session.
Two main recommendations came from the day:
·  Better financial management for unforeseen circumstance i.e. slippage
·  Better communication between meetings.
CE went through the Project Initiation Document for the development changes. Our MOU needs updating and the messages taken from the development day can be woven into the new MOU.
First draft will be out for consideration in October, final consultation document ready for December with a final sign off planned for March 18.
Action: New MOU to be developed in line with timescales.
2)  Feedback from subgroups
The new feedback forms were welcomed by the group. CE explained that each group has updated the forms slightly differently. If the board has a preference in style and amount of information, they should let CE know before the next meeting.
·  Commissioning and Finance
CE went through commissioning and finance update PB is the new chair of the Commissioning and Finance group. A deputy chair is still to be appointed.
Discussions had around managing EDAS effectively on the risk register and future revenue to also be added onto the risk register.
NJ asked about how we manage risks. CE explained the role of mitigating actions but will look at risk the function and processes around risk management within the revised MOU.
·  Feedback from Treatment, Therapies and Clinical Governance
NJ presented the new Audit Work Plan and gave feedback on the Service User questionnaires audit. The board did not have any recommendations on additional items that should be added to service user questionnaires. Concerns and Complaints is the next audit.
Highlighted Fentanyl as an increased issue following the confirmation of a death in Cardiff resulting from Fentanyl toxicity.
·  Feedback from Alcohol Group
BL provided the group with feedback on the alcohol group. The alcohol and older people subgroup has completed its programme of programme.
Board were asked for advice on how the GP Alcohol Clinics should proceed given the low numbers of referrals to the practices in the Vale.
It was suggested that Taith go back to looking at how GPs are identifying the problem? If they haven’t had ABI training then they might be struggling to identify the issues in the first place. It was agreed that Taith should go back to the GPs and get a better understanding of the nature of the resistance from patients who have been identified as needing interventions from the Alcohol Clinics. Recommended that the Alcohol Group work with the Treatment Therapies and Clinical Governance Group to look at a way forward.
·  Feedback from Harm Reduction and Recovery Group
Group asked to send any comments to BD or BL regarding the Harm Reduction and Recovery Group feedback.
3)  Updates on other work programmes
No update provided.
4)  Risk Register
Risk register has been updated.
Risk Management processes and assurance will be reviewed in the revision of the MOU.
5 / Performance Report
Board has moved from Red to Amber on Waiting Times KPI.
Board to send any queries on the attached performance report to CJ.
6 / Finance
1.  Review and approval of the 2017-18 SMAF Capital proposals
The following capital proposals were presented to the board for the 9th June deadline:
·  Living Room Cardiff Lease cost £138,000.00.
The organisation are in a stronger position as a subsidiary of KAIS and we have supported them previously. They sit on the HR&R group Meeting. NJ questioned whether they should also sit in the TT&CG group, it was agreed that they should be invited.
·  Emotional Wellbeing Service building refurbishment £91,500.00
·  Greenroof Project – a ceiling of £75,000.00
The project is still awaiting quotes but if a ceiling is agreed and the quotes are lower they will
·  IT Costs for Aftercare, Open Access and Dyfodyl £20,000
·  Fibroscanner application £325,436.40
·  Holton Road Lease £101,000.00
NE cautioned that work might need to be done to look at how a short lease could be approved under a Capital Scheme.
NE stated that they haven’t yet got a feel for how much the Capital budget will be however they have already approved some larger projects.
Board approved the submission of the Capital Proposals.
7 / Discussion – topics for future meeting presentations:
·  Pathways review
·  Dual Diagnosis
8 / Member agency and Welsh Government updates
9 / AOB
The APB newsletter will be uploaded on the website.
NJ raised that a Welsh Community Information System is being developed to replace PARIS and urged that APB representation is on this group. CJ has been invited to sit on this group.
A business meeting will be set in July to cover the topics that weren’t covered
Dates of meetings for 2017-18
1)  Mid- July 2017; venue, date and time to be advised
2)  September 6th 2017; 09:30-11:30, Armstrong Room, Willcox House
3)  December 6th 2017; 09:30-11:30, Armstrong Room, Willcox House
4)  March 7th 2018; 09:30-11:30, Armstrong Room, Willcox House

4

APB Executive Board Meeting Meeting held on 25/05/17