Laura Tyler – Assistant Director for Joint Commissioning
Jackie Jeffrey – VSCA

Stuart Bills- Superintendent Stuart Bills

Patricia Davies – Chief Executive, Shropshire Community Health Trust

David Crosby – Shropshire Partners in Care

Sara Ellis - RJAH

Members are reminded that they must declare their disclosable pecuniary interests and other registrable or non-registrable interests in any matter being considered at the meeting as set out in Appendix B of the Members’ Code of Conduct and consider if they should leave the room prior to the item being considered. Further advice can be sought from the Monitoring Officer in advance of the meeting.”

None received.

To confirm as a correct record the minutes of the meeting held on 3 March 2022 (attached).

Contact: Michelle Dulson Tel 01743 257719

RESOLVED: that the Minutes of the previous meeting be agreed and signed by the Chairman as a correct record.

To receive any questions, statements or petitions from the public, notice of which has been given in accordance with Procedure Rule 14.  The deadline for this meeting is 5.00pm on Friday 13 March 2022.

No public questions were received.

Refreshed Urgent and Emergency Care Improvement Plan

Sam Tilley, Director of Urgent Care and Planning, NHS Shropshire, Telford & Wrekin Clinical Commissioning Group (STWCCG)

Shropshire Integrated Place Partnership (ShIPP) update

Penny Bason, Head of Joint Partnerships, Shropshire Council and Shropshire, Telford & Wrekin Clinical Commissioning Group (STWCCG)

Joint Commissioning Board/Better Care Fund (BCF)

Report to follow

Laura Tyler, Assistant Director, Joint Commissioning, Shropshire Council and STW CC / Penny Bason, Head of Joint Partnerships, Shropshire Council and Shropshire, Telford & Wrekin Clinical Commissioning Group (STWCCG)

Healthy Lives Update – paper for information

Val Cross, Health and Wellbeing Strategic Manager, Shropshire Council

Shropshire, Telford & Wrekin Urgent & Emergency Care (UEC) Improvement Plan

The report of the Director of Urgent Care & Planning, Shropshire, Telford & Wrekin CCG had been received by the Board (copy attached to the signed Minutes) which set out the context of the Urgent & Emergency Care Improvement Plan for the current financial year.  She gave a summary of the plan and took the Board through the headlines of the Plan.  She explained that following development of an initial improvement plan for UEC the previous year this plan built on that and set out a set of objectives and aims and deliverables for the coming financial year.

The Director of Urgent Care & Planning drew attention to the UEC Improvement Plan Review development process that had been utilised in the development of the plan and the development of its three priorities, as follows: Pre-Hospital; Hospital improvement and flow; and Discharge.  She explained that they had tried to be very clear about the set of parameters they wished to focus on in order to ensure they were going to be deliverable.  The crafting of the plan was very much aligned to tackling some of the most prominent issues that they had been challenged with and making some real improvements within the next financial year.

The Director of Urgent Care & Planning took the Board through the three priorities in more detail along with the range of linked programmes across the system that were being delivered that did not fall directly within the remit of UEC but were inevitably important in enabling them to deliver what was required.  She explained that there was a whole programme of work looking at the whole pathway but being very distinct about the things to be focused on and the things it was felt would provide the most benefit in the next 12 months.  This was a distinct part of a much longer-term journey that really focussed in on what could be achieved within that time frame.

The Director of Urgent Care & Planning explained that there was a process of this going through approvals, the Urgent and Emergency Care Board had approved it in principle as a set of priorities and a good discussion was had at the Urgent Care Delivery Group the previous day to work up the next level of detail around these plans and that would then go through the Urgent and Emergency Care Board at the end of May.  This would then be monitored throughout the year and supported with data flow and communications to ensure the best results were achieved.

The Executive Director of Health, Wellbeing and Prevention commented that the Board would be particularly interested in understanding the detail of the whole plan and requested that more detail be brought back to a future meeting. In response, the Director of Urgent Care & Planning agreed to bring back the next set of detail which would make it easier to see how this tracked through in terms of some of the improvement areas and how that was  ...  view the full minutes text for item 5.

Barrie Reis-Seymour, Programme Lead, STW CCG / Claire Roberts, STW CCG

The Programme Lead and the Clinical Lead for Eye Care Transformation gave a presentation (copy of slides attached to the signed Minutes) which covered the following areas:

·         Background

·         Long Term Plan

·         Local Requirements

·         Case for change

·         What the programme covers

·         Completed engagement activity

·         Next steps

The Programme Lead reported that the programme had started in February 2022 and would run over a couple of years.  The first phase was engagement about patients’ experiences of eye care in the county and their thoughts around how it could be improved.  The first round of engagement had just been completed but further engagement would take place later in the year.

The Director of Public Health thanked the officers for their presentation which was helpful in understanding the process, which sounded very rigorous and she requested that an update come back to the Board in the Autumn once the proposals had been worked up.  It was agreed to come back to the Board in 6 months-time with a bit more detail around the proposed future eye care model.

In response to a query, an update was given in relation to paediatric ophthalmology which was included as part of this programme, the design work for which had just begun so it was unclear what this would look like.  Concern was raised about SATH’s provision of paediatric eye care and the fact that they were no longer accepting any referrals as they no longer had a specialist consultant.  In response, the Interim Director of Strategy and Partnerships informed the Board that SATH were looking at arrangements going forward, and in the meantime had a locum consultant.  Going forward they were looking to join forces with neighbouring services.

Keiron Smith, Environmental Protection Team Manager, Shropshire Council / Toby Pierce – Public Protection Officer (Professional), Environmental Protection, Shropshire Council

The Board received the report of the Public Protection Officer (copy attached to the signed Minutes) which provided a brief update on progress with the statutory Air Quality work and improvements in air quality in Shropshire.  The Public Protection Officer gave a presentation on Local Air Quality Management (LAQM) in Shropshire (copy of slides attached to the signed Minutes) which covered the following areas:

·         Air Quality

·         LAQM

·         Monitoring

·         Current levels and limits

·         Air Quality Management Areas (AQMA) in Shropshire

·         Current work

·         Potential Interventions

The Public Protection Officer highlighted the three aspects of air quality work being undertaken in Shropshire (strategic, Local Air Quality Management and responsive). 

He reported that there were two Air Quality Management Areas in Shropshire (Shrewsbury Town Centre and Bridgnorth) which were areas where the levels of pollutants exceeded those in the UK guidelines.  He went on to discuss the current work being undertaken in the Air Quality Management Areas.  Each AQMA was required to have an Air Quality Action Plan setting out specific measures and how it was proposed to reduce levels.  The Action Plans for Shropshire had last been updated in 2008 so were currently being updated.  He reported that the air quality in Shropshire’s AQMAs had only come down to the national average during lockdown. 

The Public Protection Officer informed the Board that a further report would be presented to the September meeting when it was hoped to have completed the work.

In response to a suggestion, it was confirmed that a green wall would be considered alongside other measures.

Lynn Cawley, Chief Officer, Healthwatch Shropshire

The Board received the report of the Chief Officer, Shropshire Healthwatch (copy attached to the signed Minutes) which reported on Mental Health Crisis Services for Children and Young People in Shropshire, Telford and Wrekin.  The Chief Officer gave a presentation (copy of slides attached to the signed Minutes).  She firstly thanked the Board for the opportunity to present the report and she thanked the young people, parents and professionals who had shared their opinions. 

She explained that all age mental health had long been a priority of Healthwatch since it was established in 2013 but that this was one of the hardest to reach groups of the population and it highlighted how much reliance was placed upon partners across the system in particular providers when doing pieces of work like this to help promote it so that as many views as possible were captured.

This piece of work was undertaken as a result of the CQC Inspection at SATH and the report in February 2021, when Healthwatch Shropshire was asked by The Director of Nursing to do a piece of work that captured the voices of the children and young people themselves. The Chief Officer gave more context on why this piece of work was undertaken.

As part of the approach and because they particularly wanted to hear from the children and young people themselves, both SATH and MPFT were asked to forward the information to the young people experiencing crisis mental health services.  This was unfortunately not possible and impacted upon the number of children and young people they heard from.  Instead, the usual methods of press release, poster and social media campaign were used to reach out to children and young people, their families and professionals, some of which may not have used crises mental health services referred to in the report.

MPFT felt that there was some confusion amongst the population about which services they were actually usingwhich highlighted the need for better information for children and their families about the services they were using and how they all worked together.

The Chief Officer then drew attention to therange and complexity of the issues and their impact on children’s mental health, along with the range of services available.

One of the young people that they heard from highlighted the issue of waiting times to be seen and described the impact on their mental health but also the impact on them of seeing the psychologist and how much it helped them and enabled them to go back into school and get a place at college.

The Chief Officer explained that they were keen to understand what people felt could make a difference particularly when experiencing a long wait for that specialist provision.  For a lot of young people, it was important that they could see the same person as they did not really want to have to talk about how they were feeling and what they were thinking to lots of different people.  Another comment was  ...  view the full minutes text for item 8.

Rachel Robinson, Director of Public Health, Shropshire Council / Alex McLellan, Public Health Intelligence Manager, Shropshire Council

The Board received the report of the Executive Director of Health, Wellbeing and Prevention (copy attached to signed Minutes) which provided an update on Shropshire’s JSNA including progress to date, future direction of the JSNA and timescales.

The Executive Director of Health, Wellbeing and Prevention reported that the JSNA was a statutory requirement of the HWBB and regular reports came to the Board but as an update had not been received for some time, this was just a brief update on the work that had been happening.  One of the programmes of work had been to develop a SEND Needs Assessment which she was pleased to report had been delivered.  The second piece of work was around a Pharmacy Needs Assessment across Shropshire, Telford & Wrekin (although two separate Needs Assessments are required) and she assured the Board that work was progressing to deliver that and an update would be provided in the Autumn. 

The other aspect was a Place-Based Needs Assessment with a web-based tool, the first stage of which was complete and gave an overview of key data, including the wider determinants of health, for Shropshire.  The other piece of work was being developed in three waves, the first being a profile for Highley.  The next profile to be developed would be for Oswestry.

The Executive Director of Health, Wellbeing and Prevention drew attention to other needs assessments that were being developed.  In response to a query it was confirmed that it was hoped to demonstrate the interactive facility of the web-based tool at the next meeting.

Rachel Robinson, Director of Public Health, Shropshire Council / Dr Sue Lloyd, Consultant in Public Health, Shropshire Council

The Board received the report of the Consultant in Public Health for noting (copy attached to the signed Minutes) which provided an overview of the health protection status of the population of Shropshire.  It addressed immunisation and screening and provided an overview of the status of communicable, waterborne and foodborne diseases.

The Consultant in Public Health introduced and amplified her report.  She informed the Board that a Shropshire Health Protection Strategy was being written jointly with Telford and Wrekin.  The first draft would be written by 31 July with a final draft in September 2022.

In relation to the currently reported cases of Monkeypox, it was explained that this was a virus related to chicken pox but was not easily transmissible and that sufferers generally recovered quite well.  It was reported that there were no cases in the West Midlands.

The Chairman updated the Board in relation to notifications of change of ownership and opening times for C G Murray & Son Limited (now PCT Healthcare Limited) and changes to the supplementary opening hours of Asda Stores Limited, Old Potts Way, Shrewsbury.  These would be attached to the webpage for the meeting.

The Chairman made the following statement:

‘This is the first board since the Ockenden Review was published (30^th March 2022).  I know all of our thoughts are with the families who have suffered so much distress and shared their experiences.

It is reassuring that many measures and recommendations in the report are already in place to improve services at the Trust, and it is making itself accountable to the parents and families affected, to restore public confidence and transform its culture.  Our Scrutiny processes have an important role to play in monitoring outcomes, particularly in this case our Joint Health Overview and Scrutiny Committee across Shropshire, Telford & Wrekin which has responsibilities for scrutinising health services within their areas.  In addition, as partners and in chairing this Statutory Health and Wellbeing Board, the Board acts to ensure that key leaders from the health and care system work together to improve the health and wellbeing of Shropshire.  As Chair of the Board we make the commitment to continue to work together in this way’.