The following apologies were reported to the meeting by the Chair:

Mark Brandreth, CEO, Robert Jones & Agnes Hunt Orthopedic Hospital NHS Foundation Trust

Andy Begley, Chief Executive, Shropshire Council

Dr Julie Davies, Director of Performance and Delivery, Shropshire CCG

Megan Nurse, Non-Executive Director MPFT
David Stout, Chief Executive, Shropshire Community Health Trust

Louise Barnett, Chief Executive, SaTH. 

The following substitutions were also notified:

Chris Preston substituted for Louise Barnett, Chief Executive, SaTH
Ros Preen substituted for David Stout, Chief Executive, SCHT

Zafar Iqbal substituted for Megan Nurse, Non-Executive Director MPFT

Members are reminded that they must not participate in the discussion or voting on any matter in which they have a Disclosable Pecuniary Interest and should leave the room prior to the commencement of the debate.

Members were reminded that they must not participate in the discussion or voting on any matter in which they had a Disclosable Pecuniary Interest and should leave the room prior to the commencement of the debate.

Jackie Jeffrey Chief Officer, Citizens Advice Shropshire, representing VCSA declared a pecuniary interest, as she held a contract under the Better Care Fund.

To confirm as a correct record the minutes of the meeting held on 12 November 2020, to follow.

Contact: Michelle Dulson Tel 01743 257719

The Chairman reported that the minutes of the previous meeting were unavailable and would be presented to the next meeting for approval.   

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 9.30am on Tuesday 12 January 2021.

Questions submitted by Ms Sue Stewart, in relation to the Making it Real Committee for Shrewsbury, had been circulated to Members. 

A copy of the questions and responses provided are attached to the signed Minutes and available on this Committee’s pages on the Council’s web site.

Regular update reports to the Health and Wellbeing Board are attached:

STP Update

Report to follow.
Contact: Jill Robinson, Shropshire, Telford & Wrekin Clinical Commissioning Group

Care Closer to Home

Report attached.

Contact: Dr Deborah Shepherd, Shropshire Clinical Commissioning Group

Better Care Fund

Report to follow.

Contact: Penny Bason, STP Programme Manager/ COVID Community Response Lead
Tanya Miles, Director of Adult Services, Housing & Public Health, Shropshire Council

Healthy Lives

Report attached.

Contact: Val Cross, Health & Wellbeing Officer, Shropshire Council

STP Update

David Evans, Accountable Officer, Shropshire CCG presented an update from the Sustainability and Transformation Partnership. It covered ICS development; Winter Planning, including Covid 19, NHS 111 First and Flu and Workforce response to Covid 19, drawing out the key points of the report that had been circulated. The Accountable Officer reported that a huge amount of work had been undertaken across the STP and provided an update on an application to become an integrated care system. Shropshire, Telford & Wrekin STP was currently undergoing NHSEI assurance and was on track to become an ICS in shadow form in April 2021 as planned. The process required a further submission to NHSEI by 11^th January 2021. This submission was a point in time and should be seen as a development plan for the next year. It would be subject to change over the next few months and while they  had continued to engage throughout the process of developing the plan with all partners, they would seek to engage more fully throughout 2021/22. In developing the submission, the Accountable Officer reported that there was a recognition how they remained a challenged system and there was a commitment to key pledges divided into service transformation and change enablers. Being an ICS would allow them to draw together the strengths of all of their ICS partners across the NHS and local authorities into a combined force that would deliver their transformation ambitions, their pledges, and created a financially balanced and clinically sustainable system.

The paper also included an update on COVID-19, Flu and winter planning.

In response to a question regarding any potential financial risks associated with either of the two options for the future form of Integrated Care Systems, detailed in the report.  The Accountable Officer confirmed that he did not think there were financial risks associated with either option. 

RESOLVED: That the STP Update be noted.

Care Closer to Home

The Chairman reported that a report had been provided with the papers but that there would be no formal presentation.   The paper highlighted the change for the Care Closer to Home Board and the agreement that it would be relaunched as Shropshire Integrated Place Partnership.  This would continue to report to the Health and Wellbeing Board and would be a forum for commissioners and providers to discuss and determine the delivery of system priorities at place (Shropshire) level. Draft Terms of Reference were to be drawn up with the aim for agreement at the next meeting in January.  Membership of the Programme Board would include clinical and managerial representation from: ICS/CCG; adult social care; children’s social care; Shropshire PCNs; public health; Housing; public and patient representative; Healthwatch; VCSA (representing community services both as consumers but also as providers); SCHT; MPFT; SaTH. The Board would focus on objectives and outcomes and there would be shared ownership and leadership across all partner and provider organisations represented on the Board. Whilst the system would continue to set the priorities, the Board would use  ...  view the full minutes text for item 107.

Report attached.
Contact: Rachel Robinson, Director of Public Health, Shropshire Council

Rachel Robinson, the Director of Public Health introduced and amplified her report – copy attached to the signed Minutes – which provided an update on Shropshire’s JSNA, progress to date, future direction and revised timescales following a pause in progress due to Covid-19.  This also included aligning the JSNA with key work programmes including Population Health Management and the Community and Rural Strategy.  The revised programme would focus on local communities and considering health and wellbeing in its widest sense including the wider determinants of health.  The revised JSNA would take account of the impact of COVID and inequalities, understanding local needs, assets to support addressing these needs and further action required to improve health and wellbeing outcomes.

In response to a question regarding the mental health transformation and whether there would be a data analysis and equity audit and whether that would be stand alone or linked to the JSNA programme, the Director of Public Health commented that a date refresh would be undertaken and that mental health, as a very important theme would be embedded across all of the needs assessments. 

Lynn Cawley, Chief Officer Healthwatch Shropshire added that she would welcome a conversation with Public Health colleagues about how Healthwatch could use its engagement function to support the development of the JSNA in specific areas.  It was added that although the engagement function was limited during the pandemic it would be really good to help planning in order to support engagement as much as possible.

The Director of Public Health proposed to bring updates routinely to the Board to update on progress and establish a Strategic Group reporting into the Health and Wellbeing Board to take this work forward.  This would be a multidisciplinary group made up of key partners to ensure joint ownership.

RESOLVED:

1.           That the current JSNA work programme, proposed JSNA refresh and move to a place based JSNA be endorsed as attached at appendix 1.

2.           That the Note the current priorities attached as appendix 2 be noted.

3.           That the proposed work programme and resourcing be noted.

Report attached.

Contact: Karen Bradshaw, Executive Director of Children’s Services, Shropshire Council

Karen Bradshaw, the Director of Children’s Services for Shropshire and Julia Dean, Service Manager for SEND introduced themselves.  The Director of Children’s Services introduced the report – copy attached to the signed Minutes – which provided an update on the local area SEND inspection and the written statement of action.   A joint SEND CQC and Ofsted Inspection had taken place in Shropshire across education, health and social care between 27 January and 31 January 2020. The final letter, published on 6 May 2020, identified many strengths but also highlighted those areas that required further development as well as some areas of significant concern.  As a result of the findings of this inspection and in accordance with the Local Area Inspection Framework the Chief Inspector determined that a Written Statement of Action (WSoA) was required because significant areas of concern were identified.

The Chairman thanked the team and their partners for the considerable work involved, particularly in relation to getting the written statement of action agreed and signed off.

Councillor Ed Potter, Lead Member for Children’s Services for Shropshire Council, commented that there was a real positive change and progress for young people within the County and he was pleased to see the progress being made and thanked all those involved for their hard work so far.

RESOLVED:

1.           That Health & Wellbeing Board endorse the actions contained within the Written Statement of Action and the priorities contained within the SEND Strategy

2.           That the Health and Wellbeing Board agree to review progress against the actions, and to receive periodic updates including holding organisations to account as necessary.

3.           That the Health & Wellbeing Board acknowledge and endorses the priority that this work needs to be afforded across the system in order to make the necessary improvements.

Report attached.

Contact: Jackie Jeffrey, VCSA on behalf of Lesley Perks, IASS Manager

Jackie Jeffrey, Chief Officer of Citizens Advice Shropshire, presented the report – copy attached to signed minutes, which provided an update on the remit of Information Advice and Support Service (IASS).  The report highlighted that as part of the Children and Families Act 2014 it was a legal requirement that all local authorities ensure children and young people with Special Educational Needs and/or Disabilities (SEND) and their parents have access to an impartial Information, Advice and Support Service. Shropshire Information, Advice and Support Service (IASS), part of Citizens Advice Shropshire, provided information, advice and support to children and young people and their parents, around education, health and social care, by telephone, email and online e.g. Teams. The support included preparing for meetings such as Annual Reviews, appealing decisions and support to develop good communication between clients and services and organisations. Cases varied from simple enquiries for information to complex cases.  Last year the service averaged nearly 50 new referrals / enquiries a month, but this drastically reduced during the first lockdown in March 2020. Feedback about the service was very positive.

The Chairman thanked Jackie Jeffrey for the update and noted how important it was that there was open access to the Service and that children, young people and their families could ask for advice without a specific diagnosis, if they had concerns.   It was added that it would be helpful to know to what extent the referral pathways had changed following SEND inspection and following the opportunity to present the paper here at the Health and Wellbeing Board.  It was suggested that it would be useful to benchmark those referrals.  

RESOLVED:

That the report be noted.

Report attached.

Contact: Penny Bason, STP Programme Manager/ COVID Community Response Lead and Katy Warren, Social Prescribing Project Lead

Penny Bason, Head of Service Joint Partnerships, introduced the report – copy attached to the signed minutes – which  provided an update on the Social Prescribing offer and development in Shropshire. It described the programme and recent progress, as well as progress in developing the Children and Young People’s Social Prescribing Programme.

Board members all thanked the Head of Service Joint Partnerships for the presentation and to the team for the delivery of this important programme with significant outbcomes.  It was agreed that Social Prescribing was an important programme in our system and was a foundation for the work of the Board in improving and supporting people to take control of their health and wellbeing and improving their chances of preventing ill health.

RESOLVED:

That the Board note and endorse the update.

Report attached.

Contact: Rachel Robinson, Director of Public Health, Shropshire Council

Rachel Robinson, the Director of Public Health for Shropshire provided an update on flu immunisations reporting that the uptake within Shropshire was very pleasing and had increased, particularly in high risk groups, including children and pregnant women.  Flu was still in circulation, but the uptake of the vaccine and social distancing measures had impacted on the rates.

The Director of Public Health for Shropshire provided an update on Covid-19 within Shropshire.  It was reported that Shropshire was in a difficult position, along with the West Midlands and nationally, the second wave had impacted rural areas.  The County was now also seeing the impact of the new variant and of households mixing during the Christmas period.   The rates within elderly populations was also increasing.  In terms of the impact on hospitals in the area, there had been an increase in both admissions and deaths. The public were working hard to bring rates down and people were being asked to follow advice and step up those efforts again.  Testing provision was also increasing, for those with symptoms but also for those with mild or less common symptoms.  A variety of local testing sites were operating and for those who were asymptomatic, they were being encouraged to come and get tested at one of the nationally run asymptomatic testing sites.  In response to a question, the locations of the asymptomatic test centres were detailed. It was noted that the situation was changing very rapidly.

In terms of protecting those most vulnerable a huge amount of support was available for all sorts of needs. 

David Evans, Accountable Officer for Shropshire and Telford and Wrekin CCG, provided an update on the roll out of the Covid-19 vaccination.  The Programme had started before Christmas and was being expanded to bring more sites on board.  Every vaccine that came into the County was being administered and as quickly as possible.  There was no stock pile, there were some supply chain issues as production increased. The progress of the roll out of the vaccination programme was outlined. 

The Chairman thanked Rachel Robinson and David Evans for their update and Board Members for their useful contributions. 

RESOLVED:  To note the report and updates given.

The Chairman updated the Board in relation to the following pharmacy update:

Notification of changes to supplementary opening hours for Rowlands Pharmacy branches in Shrewsbury, Wem, Broseley and Bayston Hill, with effect from 1 February 2021.

The Chairman thanked all of Shropshire’s health and care partners including the VCS, businesses, schools and colleges, and the people of Shropshire for their hard work and playing their part during a challenging situation and a third lockdown.