Tanya Miles – Executive Director for People

Zafar Iqbal - Non-Executive Director, Midlands Partnership NHS Foundation Trust

Patricia Davies - Chief Executive, Shropshire Community Health Trust

Jackie Jeffrey - VCSA

Stuart Bills - Superintendent, West Mercia Police

David Crosby - Chief Officer, Shropshire Partners in Care
Nigel Lee - Interim Director of Strategy and Partnerships, Shrewsbury & Telford Hospital Trust

Substitutes:

Ben Hollands substituted for Zafar Iqbal (virtual)
Nina Grix substituted for David Crosby (virtual)

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 8 September 2022 (attached).

Contact: Michelle Dulson Tel 01743 257719

The Chairman summarised the follow up action noted in the minutes which included the following:

•  A request for an update on the ICP draft strategy – this was being presented to todays’ meeting

•  A cost-of-living update had been requested and was being provided by Emily Fay at todays’ meeting

•  With regard to the Severe Mental Illness (SMI) and Complex Need paper, the Chairman said he felt there was a role here for the NHS around integration and how to bring physical health services and mental health services together in a more equitable way, along with a role for the NHS and its broader partners e.g. social care, local authorities, voluntary/community sector in order to get a better outcome for the population that was served.

•  Concern was expressed about how vaping was being made to look attractive to children, and that more work was therefore needed around this messaging. The Chairman confirmed that this was happening, and that a task and finish group had met to take this forward. Updates on action would be reported back to the Board.

RESOLVED:

that the Minutes of the previous meeting held on 8 September 2022 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 11 November 2022.

A public question was received from Mike Richardson, Shrewsbury Friends of the Earth in relation to the Air Quality update.

The full question and the response provided by the Chairman is available from the web page for the meeting: Agenda for Health and Wellbeing Board on Thursday, 17th November, 2022, 9.30 am — Shropshire Council

ICS updates  

Nicola Dymond, ICB Director of Strategy and Integration 

Shropshire Integrated Place Partnership (ShIPP) update  

Penny Bason, Head of Joint Partnerships, Shropshire Council and NHS Shropshire, Telford and Wrekin

Joint Commissioning Board/Better Care Fund (BCF)  

Laura Tyler, Assistant Director, Joint Commissioning, Shropshire Council and NHS Shropshire, Telford & Wrekin

Penny Bason, Head of Joint Partnerships, Shropshire Council and NHS Shropshire, Telford and Wrekin

Healthy Lives Update

Val Cross, Health and Wellbeing Strategic Manager, Shropshire Council? 

ICS Updates

The Board received the report of the Director of Strategy and Integration, NHS STW – copy attached to the signed Minutes - which provided an update on the Integrated Care System (ICS) development programme, the Integrated Care Partnership (ICP) and the development of the Integrated Care Strategy (IC Strategy).

The Director of Partnerships, NHS STW introduced and amplified the report.  She informed the Board that the first statutory meeting of the ICP had taken place on 5 October and that a strategy workshop had been held on 16 November which had been very well attended with discussions taking place around inequalities, how to shape the mission and vision and the values of the system and what delivery would look like. 

The Executive Director of Health, Wellbeing and Prevention explained that a subgroup had been set up to ensure that the first draft of the IC Strategy was developed by the deadline of 5 December 2022.  She drew attention to the purpose of the strategy, which was to set out the vision for everyone in Shropshire, Telford and Wrekin to have improved quality of life, health and wellbeing.  She explained that the workshop was only the start of the conversation as the Strategy continued to be developed and that wider engagement would continue.  She confirmed that the final draft strategy would be shared with the Board.

A brief discussion ensued in relation to the workshop and the commitment across the Board to work together in partnership, to pool resources and to use resources more wisely.  There had been a general agreement to take this work forward and a willingness to engage from all partners.  It was hoped that the strategy would be able to articulate a sustainable health and care system and what that means for the local population.

RESOLVED:

1.    to note the detail contained in the report;

2.    to note the statutory requirements for ICBs and Local Authorities (LA), as core members of the system wide ICP, to develop an Integrated Care Strategy;

3.    to note that this strategy must be informed by the work of the HWBBs and through engagement with local partners and communities; and  

4.    to note approval of the Terms of Reference of the Shropshire, Telford, and Wrekin ICP.

Shropshire Integrated Place Partnership (ShIPP) update

The Board received the report of the Head of Service, Joint Partnerships – copy attached to the signed Minutes – which gave an overview of the ShIPP Board meetings held in September and October together with the actions identified.

The Head of Service, Joint Partnerships assured the Board that work was under way to deliver both elements of the HWBB Strategies as well as that of the ICS and priorities within the system.  She highlighted the priorities for ShIPP and explained that the report highlighted the key areas of focus over the last few months including some risks to the system, one of which was around the falls response.  She reported that a specific piece of work was  ...  view the full minutes text for item 41.

Berni Lee, Consultant in Public Health, Shropshire Council

The Board received the report of the Consultant in Public Health – copy attached to the signed Minutes – which provided an update on work around the Inequalities Plan.  The Consultant in Public Health gave a presentation – copy of slides attached to the signed Minutes - which covered the following areas:

•          Plan content

•          The overlapping dimensions of health inequalities

•          Evidence for intervention

•          Indicators of Inequalities across Shropshire

•          Barriers to housing and services

•          Underpinning principles

•          Understanding and addressing inequalities

•          Shropshire Plan

•          NHS Healthcare Inequalities – core 20

•          Over-riding priorities

•          Key areas of focus

•          Recommendations and Next steps

The Executive Director of Health, Wellbeing and Prevention thanked the Consultant for this significant piece of work that put the Shropshire Health and Wellbeing plan at its heart, and she informed the Board that there was systemwide commitment to tackle inequalities, not just health inequalities.  It was a very comprehensive plan and the HWBB would hold everyone to account.  It was felt that the thread through all of that morning’s conversations had been around not creating further inequalities when designing delivery of services.

The piece of work around rural health inequalities was welcomed, and it was recommended that they keep in touch with the Rural Services Network.  In response, the Consultant in Public Heath informed the Board that she was in dialogue with the Rural Services Network on a potential proposal.  A brief discussion ensued, and it was recognised that access to health care was one type of health inequality, and it was confirmed that each Trust Board should have an Inequalities Lead.

RESOLVED:

1.    to note the contents of the report and the details included in the Inequalities Plan, including the recommendations made in section 17 (Appendix 1);

2.    to endorse the Inequalities Plan;

3.    to recognise that the success of the plan in reducing inequalities was a joint system responsibility that all partners were committed to delivering; and

4.    to advise on timescales for reporting progress in reducing inequalities and health inequalities across Shropshire.

Emily Fay, Programme Manager (Shaping Places for Healthier Lives: Food Insecurity), Shropshire Council

The Board received the report of the Programme Manager, Public Health – copy attached to the signed Minutes – which provided a brief overview of the current situation in regard to the cost-of-living crisis, and a description of key areas of work to date.  The Executive Director of Health, Wellbeing and Prevention introduced this item and took Members through the presentation – copy of slides attached to the signed Minutes - which covered the following areas:

·         Cost of Living increases – inflation, food inflation and interest rates

·         Government support – with cost of living and energy price ‘cap’

·         Comparing increases in the cost of living for low-income families between 2021/22 and 2022/23 with Government policy support

·         The direct and indirect health effects of winter weather

·         An economic crisis with public health implications

·         Cost of living vulnerability Index

·         Key groups likely to be impacted

·         A note on stigma

·         Social Taskforce

·         Key messages

·         Available support

The Executive Director of Health, Wellbeing and Prevention highlighted the fantastic work being done by the Programme Manager and all members of the taskforce around cost-of-living help across Shropshire for Shropshire residents.

It was commented that there had been discussion at a meeting the previous day around the issue of stigma that had been very helpful.  The meeting had been recorded and was available to view on YouTube.  The key messages from that meeting were that people were not alone, there were some simple steps that could be taken to reduce costs and maximise income, and not waiting to get help as support was available.

In response to a query, it was confirmed that the information around available support was for single people with no children, as well as for families and households.

In response to concerns around the issue of stigma and how to tackle those conversations, the Executive Director of Health, Wellbeing and Prevention confirmed that there was a training resource that all partners could access, and she would ensure they were all sent the link.

RESOLVED:

1.    to note the work underway to mitigate the impact of the cost-of-living crisis on our residents and to make any comments as appropriate.

2.    to take this information on the cost-of-living back to partner organisations and consider how the cost-of-living crisis was impacting both their own workforces and the residents they support. 

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 the signed Minutes – which provided an update on Shropshire’s JSNA including progress to date, future direction and timescales. 

The Executive Director of Health, Wellbeing and Prevention reported that the Pharmaceuticals Needs Assessment had been published and she thanked the team for pulling this together.  She informed the Board that both the Drug and Alcohol JSNA and Children and Young People JSNA would come back to a future meeting.

Turning to the Place-Based Needs Assessment, the Head of Service, Joint Partnerships and the Community Wellbeing Team Manager gave a summary of the work that had been undertaken on the high-level profile for Highley (set out in Appendix A of the report) and which had been used to gather the views of the public about the issues facing the area and would be used to create an Action Plan to address the main areas of focus.  The Community Wellbeing Team Manager expanded on the engagement exercise that had taken place in Highley which included online and in person surveys along with interviews.

A brief discussion ensued in relation to GP Services in Highley following the medical practice giving 3 months’ notice to cancel its GMS contract.  This was felt to be a great opportunity to inform the JSNA and to design the services provided in a different way to meet the needs of the community.

The Public Health Intelligence Manager then updated Members on the Web-Based Needs Assessment, the beta version of which had gone live and Members were able to explore it for themselves.  He reported that further content and additional sections had been added so the information was available on-line, broken down by theme showing the latest available data.

RESOLVED:

to note the contents of the report.

Rachel Robinson, Director of Public Health, Shropshire Council

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

The Consultant in Public Health drew attention to the immunisation cover for Shropshire for various vaccinations along with the uptake for both Antenatal and newborn and Breast screening before moving on to updates for communicable, waterborne and foodborne diseases.

She reported that the draft of the Shropshire, Telford and Wrekin Health Protection Strategy 2022-2025 had been updated with the final draft going to the Health Protection Assurance Board for agreement later in November following which it would be shared with the Board along with the Action Plan.

In response to a query, the Consultant in Public Health confirmed that once the backlog had been resolved, the breast screening service would return to normal.  She agreed to check the situation with NHS partners and would let Board Members know when this was likely to be.

RESOLVED:

to note the contents of the report.

Toby Pierce, PPO – Professional, Environmental Protection, Shropshire Council

The Board received the report of the Public Protection Officer – copy attached to the signed Minutes – which was for information only and it was confirmed that a further update would be provided to a future meeting.

The Chairman updated the Board as follows:

·           Correspondence had been received from NHS England Primary Care Support about change of ownership for pharmacies in Church Stretton and Ellesmere. The correspondence would be attached to the minutes of this meeting.

·           The Shropshire Pharmacy Needs Assessment was published following the last meeting.

·           Telford & Wrekin Pharmacy Needs Assessment was out for consultation. The Health and Wellbeing Strategic Manager would circulate the document to Board members after this meeting, asking for any comments to be received by 7^th Dec.

In the meantime, a response would be drafted and shared with the Board with any additional comments from members added, with a response date of the 14 Dec requested for the final submission. This would enable a response to be emailed back to Telford by the deadline of 21^st December.

·           The Safeguarding Annual Report had been deferred to the January meeting.