RESOLVED:

That Councillor Cecelia Motley and Mr Simon Whitehouse be elected as Co-Chairs of the Health and Wellbeing Board.

Ben Hollands – MPFT

Patricia Davies – Chief Executive, SCHT

Sara Ellis – RJ&AH

David Crosby - Chief Officer, Shropshire Partners in Care

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 17 November 2022 (attached).

Contact: Michelle Dulson Tel 01743 257719

The Chair summarised the follow up action and notes of highlight in the Minutes which included the following:

•    Health partners consider who from their service could attend the Healthy Lives steering group. Contact and nominations have been received from three partners. The Health and Wellbeing Strategic Manager thanked partners for this support.

•    Air Quality paper – it was confirmed that a further update would be provided to a future meeting. A paper was being provided at this meeting.

•    The Safeguarding Annual Report which had been deferred, was being provided at this meeting.

•    Leadership for different translation services across the system was a risk to discuss, and the Healthy Lives report submitted for this meeting explained that a full report with recommendations would come to a future HWBB meeting. In the meantime, the Board was asked to note that leadership for this work would be needed and thus remained an ongoing risk for the Board to consider.

•    Information provided from the cost-of-living presentation had been shared with partner organisations.  

RESOLVED:

that the Minutes of the previous meeting held on 17 November 2022 be agreed and signed by the Chair 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 5pm on Friday 13 January 2023.

No public questions had been received by the deadline.

ICS strategy update 

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 - Paper for information

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

ICS Strategy update

The Board received the report of the ICB Director of Strategy and Integration - copy attached to the signed Minutes – which updated the Board in relation to the development of and engagement with the draft Integrated Care Strategy (IC Strategy) for the Shropshire, Telford and Wrekin ICS along with the next steps towards a final version due at the end of March 2023.

The ICB Director of Strategy and Integration introduced and amplified the report.  She explained that the IC Strategy document was part of the ongoing work for the ICB along with starting to think about their Joint Forward Plan and starting to design what the engagement process would look like.

She noted that what had been quite central to developing the Strategy had been the thinking around how to work differently in the future and she explained that some of the content of the document had been shaped in line with that.  She then highlighted some of the key principles that had been adopted along with the four strategic objectives.  She took members through the cycle of development and where they were at now.

The Executive Director of Health, Wellbeing and Prevention stressed that the IC Strategy was interim, and that feedback had been received from various bodies, including the ICB, so there would be another version with more detail around some of the points. She also stressed that the Strategy was very high level, and they would keep coming back to it and holding themselves to it, but that the devil would be in the detail in terms of how it was delivered.

She explained that they had split the priorities of the JSNA and the Health and Wellbeing Strategies along with clinical priorities that had been set and the engagement work that had been done through Healthwatch and other organisations around what the public wanted, had been summarised into three key areas of focus: population health priorities; health inequalities priorities; and Health and Care priorities.

The Head of Joint Partnerships was pleased that the Strategy was person-centred however felt it would be useful for officers working with this document and when programmes were being developed, for this to be explained so that people understood what it meant and how it worked.  She also felt it was important that everyone had the same understanding of what integration meant and a brief discussion ensued in relation to this point. 

The ICB Director of Strategy and Integration explained that conversations had taken place around the need to have people on the same page and ensure they were all talking the same language, had the same understanding and the same buy-in and commitment to them as principles.  There were some key definitions that needed to be flushed out and it was suggested that some focussed sessions be held around what was really meant, in order to be absolutely clear.  It was confirmed that all the feedback from the meeting would be taken away and fed into  ...  view the full minutes text for item 53.

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

The Board received the report of the PPO Professional, Environmental Protection - 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 PPO Professional, Environmental Protection introduced and amplified the report.  He reported that they were currently reviewing the Action Plans that were in place for the Air Quality Management Areas within Shropshire (Bridgnorth Pound Street and Shrewsbury Town Centre) and to that end have commissioned an external specialist consultancy, Bureau Veritas, who had reported their initial baseline assessment of what was happening in each area, what emissions were there, what was causing those emissions and whether the boundary of each Air Quality area were correct.  The areas are where there were residential properties which were receiving higher than the annual current objective levels for nitrogen oxide.

He explained that the Actions Plans that had been put in place set out how the levels of pollutants could be reduced.  The initial findings were still awaited however the model has shown that diesel vehicles are causing a substantial contribution to the pollution in each area.  Also, in Bridgnorth there was evidence that the bus networks were making quite a high contribution to the overall emissions there and likewise In Shrewsbury, the traffic data had indicated that goods vehicles may be causing a substantial contribution to the overall emissions.  This data will be reviewed by the Air Quality Steering Group to which Bureau Veritas have presented their results and would now be going away and reviewing the evidence they had collated and would make recommendations of what measures should be considered in the Action Plans.

He informed the Board that there were a number of work streams happening across the Council to which this work could be aligned and which could help address some of the issues for the betterment of the residents currently being affected. 

A query was raised about whether this work was connected to the social value, commissioning and procurement work within the local authority as it was felt there was an opportunity as big purchasers of services to link this work up.  In response the PPO agreed to explore this further and confirmed that the work was linked to the project place plans in both Shrewsbury and Bridgnorth.

Councillor Hurst-Knight expressed the Boards’ thanks for the huge amount of work being undertaken to address this issue, especially in Bridgnorth. She drew attention to the public realm award received for the work being done on the high street, the local connectivity study, and the car park strategy review that had begun informally with residents that lived around pound street. 

RESOLVED: 

To note the contents of the report and that further reports would be presented to the Board as the project progressed.

Adults, Children and Community Safety Annual Report 2020-21

Lisa Gardner, Development Officer and Sarah Hollinshead-Bland, Statutory Safeguarding Business Partner. Shropshire Safeguarding Community Partnership

The Board received the Annual Report 2020/21 of the Shropshire Safeguarding Community Partnership - copy attached to the signed Minutes.  The Executive Director for People introduced the report and confirmed that producing an annual report was a statutory duty of the Adult and Children’s Partnership.  She apologised for the delay in producing the report and informed the Board that the partnership was currently working on the 2021/22 Annual Report and hoped to present it to the Board by May this year. 

The Statutory Safeguarding Business Partner brought the board up to date with where they were at now.  She explained that they were about to end the third year of their strategic priorities in the partnership and on 3 February were holding a Strategic Planning and Priority setting day which brought all the partners together and would help them to reflect on what had been achieved over the last three financial years and would provide an opportunity to look at the structure and priorities going forward and agree how long the priorities should last for.

RESOLVED:  To note the contents of the report.

Paula Mawson, Assistant Director – Integration & Healthy Population, Shropshire Council, Ian Houghton, Drug and Alcohol Strategic Commissioner, Shropshire Council

The Board received the report of the Assistant Director Integration and Healthy Population and the Drug and Alcohol Strategic Commissioner - copy attached to the signed Minutes – which provided an update on the substance misuse strategic programme for Shropshire and included an update on the Shropshire Substance Misuse Strategy and the Joint Strategic Needs Assessment for substance misuse.

The Assistant Director Integration and Healthy Population introduced and amplified the report.  She highlighted the Government’s national drug strategy ‘From Harm to Hope’ and the work done locally around County Lines to break drug supply chains.  From a public health point of view, a lot of focus had been on delivering a world-class treatment system and what that meant for Shropshire and what more could be done with some of the additional funding received nationally.  It was hoped to move on to ways of achieving a shift in demand for recreational drugs and really build that preventative offer and enhance the work that was already happening in Shropshire.

She drew attention to the Combating Drugs Partnership being established across Shropshire, Telford and Wrekin in line with the national guidance along with the outcomes framework that would be used to drive improvements in delivery.  She explained that although the national strategy mentioned alcohol it was very much focused on drugs, whereas within Shropshire alcohol was the biggest area of need.  She explained that they had to start reporting nationally on performance from April 2024.

She informed the Board that a further report in relation to the Substance Misuse Needs Assessment would be presented to a future meeting as part of the regular JSNA updates.

The Drug and Alcohol Strategic Commissioner updated the Board on the Local Service Delivery and he reported on the successful bid for £1.4m additional grant funding for rough sleepers and those at risk of rough sleeping that had a drug and alcohol issue.  This additional funding had allowed the introduction of a new multi-disciplinary team to work with up to 200 people and to do some intense one-to-one and outreach work.  It was hoped that this project might give some insight into how a new model might be structured to make services more open access and more integrated.

The Portfolio Holder for Children and Education requested sight of the toolkit when it was ready to go out to schools.  The Assistant Director Integration and Healthy Population reported that it was currently going through quality assurance processes but agreed to share it as soon as it was ready.

The Superintendent, West Mercia Police informed the Board of the progress being made with county lines in Shropshire and he welcomed the outreach approach being taken for homeless people.

It was suggested that a report on progress be presented to a future meeting of the Board.  Finally, the Assistant Director Integration and Healthy Population reported that work was beginning to look at the links between people who have got co-occurring substance misuse issues and mental health issues as more could be  ...  view the full minutes text for item 56.

Lynn Cawley, Chief Officer, Healthwatch Shropshire will give a verbal update.

The Board received an update from the Chief Officer Healthwatch.  She reported that just before Christmas they had received some good news when they were told that they had been successful in maintaining their contract for the next three years, which was really great news.  She explained that they were a very small charity of just four full time equivalent members of staff and the current economic situation meant that, like so many other charities and small organisation, were going to struggle over those three years to do what, as a statutory organisation, they were set up to do and so were going to have to look at income generation and looked to their partners to support them to do their work, to hear and bring the voices of the public to these discussions.  As they were not a fundraising organisation, they would really need to look at how they could generate more income over the period of the contract.

She reported that 2023 marked the 10^th Anniversary of Healthwatch being set up nationally and it was hoped there would be some celebration were they get to highlight the work they have been doing over the last 10 years and would feed into their annual event.  The previous years’ annual event was around end of life and bringing together all the work they had done around people’s experiences of end-of-life care and also work with the ICB (was CCG) to promote the end-of-life strategy that had been developed.  She requested that people let her have any thoughts or ideas about how to use the annual event this year.

The Chief Officer informed the Board that she would be bringing a report to a future meeting about the Accessible Information Standard and people’s right to access clear and understandable information.  Although a similar piece of work was undertaken in 2017, it was concerning that there was still a large part of the population who do not know their rights.  She stressed that for organisations it was everyone’s duty to tell people what their rights are, the onus was not on the individual to ask for their rights to be met.

They had also been asking about people’s experiences of calling for an ambulance in an emergency and had hoped to bring a report to this meeting however she was waiting for providers and commissioners across the system to share with her the work they had been doing to try to address this issue in order for the public to see the steps that were being taken.

Finally, she informed the Board about the launch of a Healthwatch England national campaign called ‘Because we all care’ which was trying to encourage more people to share their experiences of health and social care in order to highlight what was working, what could be improved and how things could be working better for people.  They would also be looking at their Forward Plan for 2023/24 and aligning it with the priorities of the  ...  view the full minutes text for item 57.

Rachel Robinson, Director of Public Health, 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 overview of the health protection status of communicable, waterborne and foodborne disease.

RESOLVED:

to note the contents of the report.

Berni Lee/Victoria Standford

The Board received the report of the Assistant Director – Integration and Healthy Population and the Public Health Registrar - copy attached to the signed Minutes – which provided an update on progress with this workstream to date.

The Executive Director for People had previously challenged the suggestion that vaping was ‘safe’ and was concerned about the message this gave out to children in Shropshire.  Schools were reporting that children were vaping more in school and it had become a bigger problem than smoking, also, there was a causal link to exploitation. 

She felt however that this was not clear enough in the report.  She informed the Board that Trading Standards had done a piece of work before Christmas that had focussed on some key establishments where under the counter behaviour was happening which did lead to other concerns for the children and young people of Shropshire. She wondered how best we educate children and young people that smoking or vaping is not good for you, for either your physical or mental health but also financially and what it could possibly lead on to.  The Public Health Registrar noted the concerns and would consider how to manage this risk and would ask the Task and Finish Group to consider this aspect. 

The Assistant Director – Integration and Healthy Population informed the Board that the Consultant in Public Health who had been leading this had now moved on to a different role but that another consultant in Public Health had agreed to take a leadership role around this piece of work, particularly reflective of the level of concern around the number of young people who were vaping and the mixed messages that seemed to be out there.  She felt it was important to make robust assessments of the evidence base around the messaging and to be consistent with that.  She felt the message was quite clear where children and young people were concerned that vaping was not for them and was only to be used as a quit aid for adults.  She hoped they would be able to move this forward.

RESOLVED: 

To note the contents of the report and for further updates to be provided.

The Chair updated the Board as follows – copy attached to the signed Minutes:

·      The Terms of Reference had been updated and agreed by Board Members by email and discussion at the ShIPP/Health & Wellbeing Board workshop in September. Upon being put to the vote the updated Terms of Reference were formally adopted.

·      A response had been provided on behalf of the Board for the Telford & Wrekin Pharmacy Needs Assessment consultation.

·      Two sets of correspondence from NHS England Primary Care Support had been received, as follows:

-    Brown & Francis, 49 Bull Ring, Ludlow, would be increasing their opening hours by 10.30 hours.

-    The pharmacy at 5, Cross Street, Ellesmere, would be operated by Day-Night Ellesmere Limited and the pharmaceutical list for the area of Shropshire Health and Wellbeing Board would be amended with effect from that date.