Minutes and Matters Arising Not on the Agenda

Date: / 29 October 2007 / Venue: / Erlas Centre / Time: / 1.00 – 4.00

Attendees or X

Name / /X / /X / /X
Sue Willis (Chair) /



/ Donna Dickenson / Apols / Viv Davies / Apols
Angela Roberts /  / Susan Evans /  / Alex Carson / X
Yvonne Harding /  / Graham Edwards / Apols / Kathryn Uche / 
Patrick Howells / Apols / Vicky Barlow /  / Janet Williams / X
Dawn Cooper / Apols / Pauline Preston /  / Ken Danskin / 
Jonathan Miller / Apols / Margaret Southall /  / Gillian Cowan / Apols
Karen Allen /  / Police - TBA / X / Jerry O’Keeffe / 
Jan Jones /  / Economic Devel - TBA / X / Vicky Jones / Apols

Outcomes

Agenda Item and Details / Actions/Who
Responsible?

Apologies

See table above

Minutes and matters arising not on the agenda

Item 7 from meeting of 01 June 07: Slide 23 of JO’K’s presentation

Addressing Alcohol Misuse – What Works? - now deferred as a group is likely to be set up by Health Alliance to look at risky behaviour.
Pg. 1 Representationfrom Trust Programme Groups via CR – YH can cover Well Child and Disability. Dawn can cover Maternity. PH covers emotional Health and Wellbeing. The Trust child protection committee feeds information to LSCB and Safe from Harm
Item 3.2: CAMHS Strategy: JHJto check that last set of minutes and strategy are on website.

Big Lottery - Mental Health (KU): the deadline was met. Must wait to hear (takes about 3 months).

JOK to keep SCoG informed of progress

JHJ to action

KU to keep SCoG informed of progress

Standing items: Group/Board updates

3.1 Integrated Children’s Disability Service (ICDS) (YH)

Project brief taken to the point where the consultant needs to take it forward. TF Group completed its Part 1 work – consultant needs to step in now. The TF Group will, therefore, disband in its current form. The next phase of work will be set up once consultant reports.
The consultant will network with the TF Group which will support her/him. Phased implementation of ICDS expected. Project brief has gone to potential consultants. (Without any indication of funding). They also had copy of the Prince 2 plan forwarded.

There are two ‘applicants’ for the consultancy post – interviews in November.

Grading of the full time post from March 08 – JD now drafted. There is sufficient funding available to pay the higher salary which it is felt would be merited by the responsibility implicit in the post, but it will have to go back to Flexibilities as a business case once it is known for certain that there will be Flexibilities funding in 80/09. Business case to be put together by AR/YH/MS. If there is no Flexibilities funding the post will have to go forward as part of the requests for funding generally from RSG.

AR/YH/MSto note and action.

3.2 Emotional Health, Well-being and Counselling (AR)

At last EHWBC meeting, PH informed that all but one post for Tier 2 had been filled – final one going for re-advert. Business proposal was shared with Estyn as part of inspection evidence. LC also interviewed. Work on CAMHS well received by Estyn – JHJ confirmed this and stated that Estyn are considering highlighting Wrexham’s partnership working on CAMHS in a good practice box (a rare honour!
Two PMHW (education) appointed – not yet certain which schools they will be deployed in.
NE Wales has been allocated £50k plus for training of T2/3 staff.
Solutions Caia now have agreed funding. Working with Julie Gillbanks of NCH to integrate them into supervision processes.
CAMHS is a key priority across all partnerships and organisations in Wrexham. The LSB has asked for information on what it can do to help to progress/realise the Strategy. A workshop session has been arranged for 09 November for CAMHS Strategy Group members to look at this. A paper will produced for CYPFWP Board in November this will be circulated to HA SCoG. Paper to go to the LSB for 12 December (not January as previously stated).
HIW/Wales Audit Office Review of CAMHS: A team of reviewers is undertaking fieldwork involving staff from WAO and HIW, and peer and lay reviewers. Work with education and social services will be undertaken either by WAO staff with relevant backgrounds, and/or Estyn and CSSIW staff.
Theyare planning to visit each region and undertake all detailed fieldwork during the course of a single week during November and early December. Regional feedback will be provided.
The target is to produce a draft all-Wales report by the end of February 2008. This will then be subject to internal discussion and external consultation prior to publication, which is likely to be at the end of April 2008. Wrexham LHB has been notified that they wish to interview the Chief Exec, Angela, Patrick plus others including a Focus Group of doctors andpractice nurses on 13 December and possibly 14th also. Letter received by JHJ today re this.

3.3 CYP Substance Misuse (linked via SMAT)

VJ not present at today’s meeting. Updated SMAT diagram of relationships was sent out by VJ soon after last meeting. JHJ will try to get dates of all TF Group meetings for SCoG information.

JHJ to action.

3.4 Sexual Health (linked via Health Alliance)

No real change from minutes of last meeting.
Business plan for extending Darland Outreach project (JOK) needs to wait until pilot ends in December. Also more work to be done on smoking cessation. SW - outcomes of evaluation would need to go to the three Boards. Funding issue re pharmacy costs.
Conwy/Denbighshire provision: a meeting has been set up by AR on12 November with Liz Morgan etc. to look into the specifics of the service which is provided for Wrexham, and any proposed changes to this service. Does the service comply with NICE Guidance? This will be Wrexham’s opportunity to articulate what it wants from a Sexual Health Service for YP in Wrexham.
YH has seen some paperwork on proposed changes but currently such plans are not to be disclosed. It is clear, however, that they involve a significantly streamlined service. There appears not to have been any consultation on changes as yet; commissioners have not been made aware that of any intention to change the services previously purchased. Phase 2 being mooted as opportunity to include C&YP services.
Our position is strongly rooted in the principle that funding should follow the service user – including young people.
YH has sent a paper through to CR this morning on this issue and would hope to be able to share with the SCoG in due course.
Following the meeting on 12 November, J O’Keefe to be asked to develop a paper stating what we need and what the gaps are.

JO’K to keep SCoG informed.

AR to report back to SCoG.

YH to action.

AR to actionwith J’OK .

3.5 Young Carers (MS)

MS – will take this TF Group forward for the SCoG. Key priorities need to be established. There was a meeting earlier this month following on from Young Carers presentation to CYP Scrutiny Committee re. education issues and support in schools. SW: Carers was a priority in previous HSCWB Strategy and a group was set up in relation to carers in general - Carers Programme Group. The earlier group did not function effectively in respect of YP. JHJ will send MS all information we have. NB NSF key actions in respect of this.
JHJ: Young Carers has not been identified by CYPFWP Board as a priority; SW in agreement with this. It should not appear in HSCWB Strategy as a CYP priority.
Questions were raised about funding previously allocated to Young Carers - NCH funding – andhow used.The LHB has also given money in the past to support young carers through NCH.
AR – there was also funding for mental health project workers re carers, with a point 5 post for Young Carers caring for parents/siblings with mental health problems. AR will send documentation re this to JHJ/MS. There are some issues around funding for posts which used to go across adults and children’s social care now that children’s social care is part of CYP Service. JHJ/MS to pursue with the help of BMcL.
SE had spoken to NCH last week and they said they have someone coming into post shortly. JOK has been working with Kate Meredith looking at issues in relation to adults – transport, leisure access, etc?

JHJ to action.

Gillian Cowan to note.

AR to action.

JHJ/MS to action.

3.6 Speech and Language (K/A)

KA provided an A4 overview of activities thus far. Membership listed. AR summarised.
A Visioning Day is planned for 19 November (date may change).
KA has had copy of eMail from WAG saying that they are bringing in their consultants much earlier than expected in November 07 to gather feedback (project is funded until March and so this can only be interim feedback). JHJ wondered if WAG come to the Visioning Day rather than scheduling a separate visit. Steering Group needs to consider.
WAG very keen to hear more about service user consultation, which went very well (36% response rate).
AR currently chairing this group and will liaise with Sarah Morris and with WAG. AR not originally chair of group – may need to take a view on this as F’Shire was originally chairing and this has been disrupted.

KA to contact Hywyn about this.

Steering Group to consider.

3.7 Health Alliance (general update) (JO’K)

Health Alliance Performance Information (tabled).
Active 8-2-16: funded from Cymorth and has 18 months to go. Evaluation went to sub-group looking at Exercise on Referral (report on this also provided). Has an impact on mental health. JOK producing paper on referral routes for exercise. NPHS has provided evidence-base for this. There has been consideration of extending Active 8 to obese children but there is no capacity.
Obesity being looked at strategically at the moment by Health Alliance. Junior Gym in Queensway – largely referrals-in for obesity and struggling to support its operational costs – might have to ask Head Teachers topay for it though HW/CF providing some funding.
Wrexham Leisure Card – acts as an entitlement card – when swiped tells people on reception what people are they’re entitled to. Flexibility to tag-on whatever we want without stigmatising – just need it to be evidence-based. In future will also provide a reward scheme. Can target discounts and concessions against need (PURE card and DASH Card 50% reduction) Currently looking at discounts for students and at identifying quiet times for them to access at £1 per session. NB. LAC and Young Carers.
Stay Safe – releases whole package of safety equipment for the home (eg. fireguards).
Management of injury data – data-capture database about to be set up. Will enable us to explore background to injuries so that these can be reduced.
Breastfeeding Co-ordinator: funding from Cymorth. Need to look at protecting funding for post if Cymorth goes into RSG
Appetite for Life agenda – AR: no point in having healthy eating approaches while children are allowed out of school and can go into the nearest chip shop. VB – has been discussed at WASH – not just from eating point of view but also ethos also. JOK – need to look at whole service side of healthy eating.
Allotments policy – involving primary schools – YOS funding to make allotments in primary schools. VB – very good scheme and improves children’s language levels and enthusiasm also.
Sexual Health – last year 4 sessons were delivered – high demand. Yale college to deliver at OCN Level 2. Also meeting with Sarah Jowett at NEWI re. enhanced provision. VB: policy development in Wrexham recognised as good practice by all-Wales PSE Conference. Need to explore stronger links with NEWI and Yale – significant possibilities here. Some kind of strategic understanding needed especially re. student projects and dissertations. They have taken on SAP and think highly of it. AR – any chance of working with Nursing Students at Yale in respect of sexual health – could contribute to capacity issues at Info Shop. YH – work at KelstertonCollege demonstrating how productive this can be. 14-19 – Learning Core: Partnership Working around PSE.

3.8 NSF (AR)

Looking at these as part of the TF Groups and Service Management Plans (SMPs). Draft NSF plan on website – no comments received.
CYPFWP Board have agreed to extend MW’s contract (1-day per week) until the end of March 2008.
NSF Co-ordinators’ meeting eMail received.

3.9 EMARS (AR)

NE Wales has been allocated £8k for EMARS; there is meeting re. this on 15 November to determine referral logic. Virtual integration of the service could be developed from this project.

3.10 Issues from Trust Programme Groups

YH: Disability Trust Focus Group – purely health-focused for professionals to look at professional issues. There won’t be a need for this group once ICDS goes ahead – just a need to ensure that there is appropriate representation.
Well Child – looking with WAG at universal minimum standard for all YP – frustration at the slowness with which things are agreed and they are then locally interpreted, which can destroy the universality which was aimed for. Getting there slowly - NSF underpinning document for this.
Well Child has a particular focus on childhood obesity – there is poor data to support this. It is a multi-faceted issue and there is a need for accurate baseline data.
Y7 pupils to have height, weight and body mass index recorded; already measure on entry at age 4. Waist measurements will NOT be taken – ethical issues re. this - could be mass opt out if varied from agreed normal screening across Wrexham and Flintshire. Debate ensued re. the effectiveness of this indicator vs. BMI; clearly so for adults – is it also true for children?) –
Information will go onto national child health database. Is postcoded and can be geo-coded. Data also goes to WAG.
LW of NPHS will provide data to us provided we are very clear on what we want and why we want it.
Other two big issues – Y8 girls inoculation and catch-up campaign re cervical cancer rates.
Immunisation is a standing item on Well Child. Either GPs or NHS Trust can do it – money goes to whoever carries out the work. Rates for some age groups have increased but pre-school has decreased. There will be a need to ask both delivery groups to explain what they are going to do about increasing rates.
School nurse capacity – a discussion took place re. a letter which had been sent to schools. Secondments of experienced School Nurses have led to posts being backfilled leading to a need for new school nurses to be inducted. Short term capacity issue; NO suggestion that this service will be reduced. Wrexham is one of the few areas in Wales which meets the expected ratios – we’re the best in Wales. WAG is committed to having a Family Health Nurse in every school – AR – this is based on the Scottish model which was abandoned there because it didn’t work!
School Nurse Teams in Wrexham have been developed to support schools, to provide specialisms and create a career structure – so not just one person but a range of people is involved. For example, they provided cover throughout the school holidays. JHJ – schools not fully aware of what’s being done and what’s on offer – need to keep them constantly informed. VB: Can YH attend a future PSEQC to share information?
Summary sheet goes to schools on a CD. NW NHS Trust website – provide link to this on schools intranet and Framework webpage (JHJ). MW working on this. AR: Include data in NSF SAAT. Also invite YH to attend WASH and Primary Headteachers’ Federation.
F’Shire and Wrexham going to move towardsIntegrated Primary Healthcare teams for chronic illness and for preventative work. Wrexham to be split into three areas for this purpose - same as police boundaries. Has to fit around the estates.
Conwy/D’shire in consultation re. maybe progressing proposed amalgamation.
Needs to be remembered that Trust Children’s Service is accountable to both the Trust, Board and CYPFWP.

VB to invite YH to PSEQC.

JHJ to action and speak to MW re. website and JD/JOR.

3.11 FWP Board/YPP/CP/HSCWB Partnership/Community Safety Partnership/LSB/Other SCoGs/Other

Estyn Inspection of YSS: self-evaluation report (SAR) distributed. Apologies that timescales and pressures created by October inspection of LEA meant that there was no time to share for comments before sending to Estyn.
Pro forma was created and sent to potential contributors – 75 returns – very pleasing (though quality variable). Self-evaluation based on these returns and so reflective of contributions. Health colleagues had stated that they did not feel that their services to young people were suited to the Estyn seven Key Questions in the inspection Framework.
Clear when writing the SAR that there is a lot of excellent work (outstanding?) going on in Wrexham. However, we have graded ourselves as 3 rather than two in recognition that we are not yet joined up enough at the strategic and SCoG level (next phase to be addressed).
Thanks to those who got involved in October inspection. (If you are asked to be interviewed againthe angle should be different)
NB: Next FWP Board meeting scheduled for 21 Nov. 07.

Other items arising/tabled

4.1 A Strategy to Reduce the Prevalence of Smoking in Wrexham (JO’K – tabled at previous meeting)

Being delivered in 4 secondary schools.
Smoke bug – 30 primary schools engaged.
JOK will get an update from JM on these schemes.
Chris McMahon currently analysing outcome data – not sure that the schemes are being effective.

NPHS would be very helpful in relation to this and identify data streams and evidence-based approaches.

JOK/JM to action.

4.2 Exercise Referral Schemes in Wrexham (JOK report attached with agenda)

JOK will bring an evaluation report to next meeting.

JOK to action.

4.3SCoG Representation

Request for Therapy Services Representative on SCoG – agreed. Gareth Evans, Head of Therapy Services and CommunityHospitals for the Trust to identify someone from this Directorate
AVOW – request for CG of Dynamic to be second representative from Third Sector (instead of Janet Williams). Absolutely no problem with this - job description provided by AVOW re. representation of sector rather than own organisation. Invite to next meeting.
NPHS representative would strengthen the SCoG. PS to identify representative please.

JHJ to action.

JHJ to action.

JHJ to contact PS.

4.4Discuss posts that may be required for CYPs Integration agendas when the Joint Working Special Grant becomes RSG

BMcL had asked AR to raise this. CYP representation needed on Flexibilities Group – TDG asked to identify someone to do so – not sure re. progress on this. YH thought that there had been discussions re. joint working in respect of Occupational Health? Each to accept the other’s referrals?
Criteria to be sent to JHJ by AR for circulation with these minutes for consideration. Need to address these closely. TF Group Chairs to prepare suggestions for Flexibility-funded posts and projects with a tightly argued business case which pays close attention to the criteria – This is a common TF Group Task which all TF Groups must address in next meeting please – info to come to next SCoG for consideration/support.

TDG to provide information please.

AR to send criteria to JHJ.

TF Group Chairs to note and to action please.

4.5 Draft National Targets 2008/2009 for inclusion in the NHS consultation exercise

SAAF 2008/09 targets are out for consultation now – the only CYP-specific target relates to CAMHS. Teenage pregnancy/Sexual health are there – lots of targets touch on CYP but are not specific to this group. Closing date is soon. Acute work takes precedence and adult chronic disease management takes priority too.

SW/AR to send to JHJ for publication on HA SCoG webpage, for information/

4.6 Children and Young People’s Plan (CYPP)

Memo and overview paper which has gone to Council staff distributed. JHJ talked the group through the main points. Agreed that SW will share with Board after JHJ adds some of the timescale information from previous papers.

JHJ to amend and send to SW for sharing with Board.

5. AOB
5.1 Review of TF Group Action Plans and outcome measures

Common TF Group task for next meeting: review ToR (using template already prepared and shared) and Work Programme Action Plan with outcome measures. These to be agreedby next SCoG in future. Intention is to move away from descriptive updates towards progress reporting and raising actions which require SCoG support/advice re. next steps.

TF Group Chairs to note and to action please.

5.2 Sexual Health Consultation (tabled) (JOK)

Closing date 31 October. This was in fact tabled by JHJ at the September CYPFWP Board meeting. A response has been received from DD. LHB response being drafted - very medically focused but hasn’t gone to their Board yet – coming at it from a different angle. This is perfectly acceptable and the two responses do not clash. Key concerns – original framework tabled in 2000 but they appear to be making same mistakes again. Also YP consultations – there do not appear to have been any. AR has passed on corrections to JOK and he will send this off on behalf of Council and Health Alliance. SW/AR will deal with LHB response. Both to be placed on webpage when finalised, for information.

JOK/SW to action. Send final versions to JHJ for posting.

5.3 Health Alliance Performance (tabled) (JOK)

Dealt with mainly in 3.7, above.
The Sexual Health Group wants to change its name to Teenage Pregnancy (the name used in England). SCoG very firmly NOT in favour. JOK will make sure that DD and the group is aware of this and takes this on board.

JOK/DD to pass this strong message through.

5.4 Additional After Meeting

Big Way of Life Lottery Bid – report from Janet Williams, AVOW – this was sent to JHJ on 18 October but she missed it amongst eMail tsunami – apologies. SW/AR to be asked to consider report on behalf of SCoG and to confirm support or otherwise for bid to JW/GC and update SCoG members at next meeting please.

SW/AR to consider and respond to JW/GC.

6. Date and time of next meeting(nb. next PAG meeting: 12 February 08 and CYPFWP Board meeting 27 Feb 08).

Mon 28 Jan 08: 11am – 4pm: JHJ book lunch

Venue Erlas Centre unless otherwise notified.

JHJ to action.