RESOLVED:

That Councillor Dean Carroll be elected as Chair of the Health and Wellbeing Board for the ensuing year.

The following apologies were noted:

Councillor Cecilia Motley, Shropshire Council, Portfolio Holder for Communities, Place, Tourism and Transport

Karen Bradshaw, Director of Children’s Services, Shropshire Council

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

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

Denise Porter, Interim Chief Officer, Shropshire Partners in Care

Chris Preston, Director of Strategy and Planning, Shrewsbury and Telford Hospital Trust

Megan Nurse, Non-Executive Director MPFT

       The following substitutions were also noted:

       Ben Hollands, substituted for Megan Nurse.
Nicola Daniels, substituted for Jackie Jeffrey, VCSA

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 meeting prior to the commencement of the debate.

None were declared.

To confirm as a correct record the minutes of the meeting held on 4 March 2021 (attached).

Contact: Michelle Dulson Tel 01743 257719

RESOLVED

That the Minutes of the meeting held on 4 March 2021 be approved 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 9.30am on Tuesday 6 July 2021.

Questions were submitted from the following members of the public:

Sue Gerrard, Sue Stewart and Marilyn Jones – regarding future support for the Making it Real Board and steps being taken to ensure it is fit for purpose to support the people of Shropshire.

The Chair stated that a full response would be sent to the questioners and attached to the webpage for the meeting:

http://shropshire.gov.uk/committee-services/ieListDocuments.aspx?CId=217&MId=4296&Ver=4  

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

Shropshire Integrated Place Partnership (SHIPP)

Report attached.

Contact: Tanya Miles, Executive Director of Adult Services, Housing & Public Health, Shropshire Council or Penny Bason, Head of Service, Joint Partnerships, Shropshire Council, Shropshire, Telford & Wrekin CCG

Better Care Fund (BCF) update

Report to follow.

Contact: Penny Bason, Head of Service, Joint Partnerships, Shropshire Council, Shropshire, Telford & Wrekin CCG

Integrated Care Systems (ICS) Update

Report attached.
Contact: Nicky O’Connor, Shropshire, Telford & Wrekin CCG

Shropshire Integrated Place Partnership (SHIPP)

The Director of Adult Services, Housing and Public Health introduced this report (copy attached to signed Minutes) and highlighted that the purpose of SHIPP was to act as a Partnership Board of commissioners, providers of health and social care and involvement leads in Shropshire to ensure that the system level outcomes and parameters agreed by the ICS Programme were implemented at place level in Shropshire.  The Board would focus on objectives and outcomes not on organisations.  It was a partnership of equals with shared collaborative leadership and responsibility, enabled by the Shadow ICS governance and decision-making processes. 

She went on to inform the Board that clinical care and primary care leadership was central to the partnership to ensure that services provided the best quality evidence-based care and support for the people of Shropshire, improving outcomes and reducing health inequalities.  She then referred to the draft priorities set out in the report and the key areas of delivery, which included children and young people, case management, rapid response and hospital at home, end of life care, personalisation (which would include prevention and social prescribing), community service review, support in our primary care and the Joint Strategic Needs Assessment.

The Director of Adult Services, Housing and Public Health explained that the governance for the ICS was still developing and that the governance described in the Terms of Reference attached to the report would be updated as the Board evolved.  She confirmed that SHIPP would report to the Health and Wellbeing Board (HWBB) as well as through the ICS reporting structure.  Integrated Place Boards would hold significance in how the ICS deliver their place in the future.

In conclusion, the Director of Adult Services, Housing and Public Health felt that the SHIPP had great potential through working with the HWBB and ICS Boards and programmes to really drive forward integrated working.  It had the potential to ensure that local people were at the heart of decision making through the HWBB by providing that really important public accountability.  Like all programmes and Boards, SHIPP must now have a key focus on inequalities to ensure that the impacts of Covid-19 were reduced and outcomes for local people were improved.

The Board were pleased that the Terms of Reference included a Memorandum of understanding with the voluntary and community sector who were keen to be real partners in this process however resources were required to allow them to properly participate in the development of the ICS.  The Director of Adult Services, Housing and Public Health confirmed that the VCS were represented on the Integrated Place Partnership as well and that there were ongoing system conversations around the infrastructure within Shropshire as joint Chair she would ensure that the VCS were not just a guest at the table but a valued partner at the table.

The Director of Adult Services, Housing and Public Health responded to a number of questions from the Board.  In response to a query about the governance structure  ...  view the full minutes text for item 129.

Report attached.

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

The Board considered a report summarising the Health and Wellbeing Board workshop held on June 2021. The purpose of the workshop was to bring the new Board together, to provide an overview of the Health & Wellbeing Board and to discuss whether the priorities agreed in January 2020 were still appropriate.

The Board members agreed Key focus priorities of Workforce, Weight and Physical Activity and Adverse Childhood Experiences (expanded to include ‘Children and Young People’) and Mental Health.

Strategic priorities were agreed as: Joined up working; Improving population health; Working with and building strong and vibrant communities; and Reduce inequalities.

The Board noted that the next steps would be to draft the 2021-2026 Health and Wellbeing Strategy based on the agreed priorities, engage stakeholders and the public with the draft with the strategy launch date in January 2022. However, it was agreed that the launch date should be revised to the 2022 financial year in order to allow greater flexibility.

RESOLVED:

i)             That the content of the report be agreed as an account of the workshop;

ii)            That the Board members be active participants in the work going forward to develop and implement the Strategy.

Page update attached for Information.

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

The Director of Public Health presented an update report on Shropshire’s Joint Strategic Needs Assessment (JSNA), the progress made to date, the future direction of the JSNA and revised timescales.

The following points were noted:

·         The pharmaceutical needs assessment was being progressed

·         18 needs assessments would cover the 18 community place plan areas

·         Place Plans were very helpful as needs differed widely across different areas in the county

·         3 Place Plan areas had been identified as priority – Whitchurch, Highley and Oswestry

·         The 3 areas identified would highlight a wide range of Shropshire experiences

·         More beneficial to undertake the task properly by recognising the different communities in the county and their varying needs

RESOLVED:

i)             That the Health and Wellbeing Board reviews the preliminary data and information list for the Place Based JSNA and considers any additions to Appendix 1

ii)            That the Health and Wellbeing Board notes the proposed work programme and resourcing

iii)           That the Health and Wellbeing Board considers and approves the proposed wave 1 place based JSNA areas.

Report attached.

Contact: Rachel Robinson, Director of Public Health, Shropshire Council or Berni Lee, Consultant in Public Health, Shropshire Council

The Director of Public Health stressed the purpose of Health and Wellbeing Boards to oversee and set the strategic direction regarding the health and wellbeing of a population. This would entail narrowing health inequalities in their area by facilitating informed and collaborative decision making between the local authority, NHS partners, the Voluntary and Community Sector and local people.

She then drew attention to the highlight report describing a combination of strategic imperatives and local activity on inequalities. The report highlighted the role of the JSNA and the meaning of a ‘whole system approach’ to tackling inequalities.  The report also described the NHS imperative in more detail, work on mental health, complex need, lifestyles, and the wider determinants of health and the Board’s role in influencing this work and for ongoing input as a Board.

The main points made during consideration of the report:

·         Essential that everyone gets what they need whilst recognising that people have different needs

·         Development of social prescribing is very important in supporting how inequalities are addressed

·         Need to work together and to understand what the services are and what is available

·         Importance of the voluntary and community sector is recognised

·         Infrastructure funding is vital

·         Development of a personalised approach is essential

·         Value of the Health Foundation report, ‘Unequal Pandemic, Fairer Recovery’

·         Mental health underpins many areas

·         More face to face interaction in future helpful in particular to those suffering with mental health issues

·         All partners have a responsibility to take steps to reduce inequalities and the Health and Wellbeing Board has a key role to play in promoting this work

·         Need to recognise the diversity and inequalities throughout the county

·         Care needed to ensure that digital exclusion is avoided, for example, health care appointments

RESOLVED:

i)             That the Health and Wellbeing Board notes the content of the report and receives regular updates at each meeting on each area presented;

ii)            That the Health and Wellbeing Board discuss the Board’s role in promoting the system work on population health and inequalities.

A verbal update will be given.

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

Rachel Robinson, the Director of Public Health for Shropshire provided an update on Covid 19 within the county and made the following observations:

·         Rates of infection were rising, as expected, but this was not reflected in the numbers of hospital admissions or deaths

·         There was a need to understand the effects of long Covid and the impact of this on the healthcare system

·         Testing rates were high in the county and people needed to continue to be encouraged to keep testing even when they had received both innoculations

·         There was a need to encourage as many as people as possible to receive their two innoculations; this was an essential tool in mitigating the impact of Covid 19

Responding to a question, she stated that a decision had not yet been made regarding the roll out of a double vaccination programme later in the year for flu and Covid.  Trials were ongoing and a good uptake of any such initiative would be needed.

Report attached.
Contact: Lynn Cawley, Chief Officer, Healthwatch

Lynn Cawley, Shropshire Healthwatch, gave a presentation to illustrate the key findings and recommendations from the Healthwatch survey on telephone, video and online appointments during the Covid 19 pandemic.  The survey had attracted 568 responses and highlighted the positive and negative findings of managing triage during this period and made recommendations to be taken forward by health and social care services in future.

The Board acknowledged the importance of the content of the report and made the following comments in response:

·         The survey feedback was a vital tool in planning for future delivery of triage

·         A rapid response had been required in response to the Pandemic, the aim being to maintain the service and to reduce the number of deaths

·         Safer consultation methods had had to be quickly implemented

·         Some groups may have difficulty in accessing via technology; one size did not fit all!

·         Consideration would need to be given to how to achieve the best benefit in future without causing inequalities in access

·         Clear messaging would be essential to signpost the public how to access services

·         Different offers would suit different people

RESOLVED:

i)             That the feedback from the Healthwatch report on its survey on telephone, video and online appointments during the Covid 19 pandemic be raised at the ICS Board; and

ii)            That system partners be requested to provide a written update on the recommendations within the above report to a future meeting of the Health and Wellbeing Board.

The Chair reported an update from the West Midlands Pharmacy Team available on Shropshire Council’s website and added that the St Martins pharmacy in Shrewsbury would no longer be opening on Saturdays from 17 May 2021.