Claire Parker - Director of Partnerships, NHS Shropshire, Telford & Wrekin

Jackie Jeffrey – VSCA (Substitute: Heather Osborne

Paul Kavanagh-Fields - RJAH

Sara Ellis-Anderson – Deputy Director for Nursing & Quality, SCHT

Claire Horsfield –, SCHT

Nigel Lee – Interim Director of Strategy & Partnership SaTH (Substitute: Carla Bickley)

Stuart Bills – Superintendent, West Mercia Police

Ben Hollands - MPFT

Lisa Middleton – Shropshire Council

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 although some members delivered on the BCF/Winter support service.

To confirm as a correct record the minutes of the meeting held on 15 June 2023 (attached).

Contact: Michelle Dulson Tel 01743 257719

RESOLVED: 

that the Minutes of the previous meeting held on 15 June 2023 be agreed and signed by the Chairman as a correct record.

Following on from the action agreed by the Health and Wellbeing Board to ask providers, on behalf of Healthwatch Shropshire, for their response to their report “Your Care, Your Way” on the Accessible Information Standard requirements, it was requested that an email be sent on behalf of the Board toProvider Partner Board Members (including the Local Authority) asking them to provide the Health & Wellbeing Board with an update on their organisation’s progress on the accessible information standard.

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 8 September 2023.

STRATEGIC ITEMS – REPORTS FOR DISCUSSION

A question was received from Mr Darren Childs in relation to staffing at Ludlow Hospital. 

The full question and the response provided by the Director of Operations & Chief AHP, Co-Chair Shropshire Telford & Wrekin AHP Council / Shropshire Community Health Trust is available from the web page for the meeting:

Agenda for Health and Wellbeing Board on Thursday, 14th September, 2023, 9.30 am — Shropshire Council

Karen Levell, SEND & Inclusion Service Manager, Shropshire Council

Jen Griffin, Designated Clinical Officer for SEND, NHS STW

The Board received the joint report of the Assistant Director Education and Achievement, the SEND and Inclusion Service Manager, the Deputy Director of Partnerships, Shropshire Telford and Wrekin ICS and the Designated Clinical Officer for SEND – copy attached to the signed minutes – which updated the Board on the Ofsted/CQC Area SEND Inspection Revisit in November 2022 and set out the next steps following publication of the inspection report in February 2023.

The SEND and Inclusion Service Manager introduced and amplified the report and highlighted the key areas to note including the progress that had been made and that which was still required.  She drew attention to the Accelerated Progress Plan (APP) which had been published on their local offer website, progress against which would be monitored monthly.  Progress was also monitored by the Department for Education and NHS England both formally and informally.  Following a recent informal visit, no concerns were raised and the formal monitoring was due to take place at the beginning of November and six monthly thereafter.

The SEND and Inclusion Service Manager informed the Board that Shropshire was one of four local areas within the West Midlands to be selected to work on the SEND Change Programme to test and design aspects of that system.  The Change programme was officially being launched on 19 September and would run for two years.

The Designated Clinical Officer for SEND discussed their work around the diagnostic pathway for ADH and ADHD for which the average waiting time nationally was over 9 months with a further 7 months until treatment.  Locally this had been addressed by allowing access to services and support without the requirement of a diagnosis along with work undertaken to clarify and improve access and timeliness of diagnostic pathways.  Although increased funding had been provided to undertake additional diagnostic assessments, demand was still outstripping capacity.

She then highlighted the challenges around waiting times for speech and language therapy services which had very high referral rates and a very variable service offer and how it was commissioned across the Country.  Locally, support was being provided whilst waiting and access to the services in a timely way was being addressed.  Again, demand was still outstripping the capacity of that service and she went on to discuss the next steps.

Turning to EHCP, the SEND and Inclusion Service Manager explained that nationally there were gaps in external provision and training, a lack of coordination between services, weak co-production and a lack of accountability.  Locally, feedback had shown an inconsistency in the quality of the input from Education, Health and Care in relation to the advice and reports that are collected prior to issuing an EHCP, along with a lack of effective quality assurance processes and plans not being updated or issued in a timely manner.  She went on to inform the meeting about the work being undertaken by these workstreams. Timescales for issuing new EHCPs were now more or less in line with the national average.

The Portfolio  ...  view the full minutes text for item 18.

Gordon Kochane, Consultant in Public Health, Shropshire Council

The Board received the report of the Consultant in Public Health, Shropshire Council – copy attached to the signed Minutes – which set out the draft Shropshire Suicide Prevention Strategy which had been refreshed.  The Consultant in Public Health introduced and amplified his report which had been out for stakeholder consultation.  He informed the Board that the Strategy had been co-produced by their multi-agency Suicide Prevention Network which sat across Shropshire, Telford & Wrekin and built upon the work of the first Suicide Prevention Strategy that was launched in 2017.  He drew attention to the outcomes from that Strategy and explained that the vision within the new strategy was to build upon the work that had previously been undertaken with a continued focus on reducing the number of people who take their life.

He went on to highlight the key messages from this Strategy which were very much around promoting greater awareness and conversation about suicide to tackle stigma and to encourage anyone who was struggling or had been impacted by suicide to reach out as early as possible and he reminded the Board of the priorities outlined within the updated Strategy.  He reported that an Action Plan was being created by the Shropshire Suicide Prevention Action Group and sub-groups had been set up to help deliver this.  He went on to explain that buy in and support was required from partners and others who already worked with those high-risk cohorts and who had that insight and understood the challenges in order to really help explore where the shared ambitions could be and what could be done to strengthen outcomes in terms of suicide prevention, reducing inequalities and improving the lives of those individuals.  He requested that anyone who was interested in supporting that work to please contact him direct.

Finally, the Consultant in Public Health explained that the Strategy used to be for Shropshire, Telford and Wrekin, but following stakeholder feedback it was felt that having a dedicated Shropshire local authority area strategy would be beneficial and gave flexibility as Shropshire had quite a different demographic to Telford.  However, he reassured the Board that they still operated as one Shropshire, Telford and Wrekin Suicide Prevention Network and that partnership work was still ongoing. He went on to inform the Board that the local ambitions did align to the national ambitions (the National Strategy having been published that week) however there was still uncertainty around the funding commitment to take this work forward as the current funding was coming to an end in March 2024.

Members welcomed and endorsed the strategy.  A query was raised in relation to objective three, suicide risk aware and Action 5 increasing suicide risk awareness and skills intervention, and what was being done to ensure that the people of Shropshire understood what they could do in terms of contact if they were concerned about someone.  In response, the Consultant in Public Health explained that there were some resources which had been developed and which were available  ...  view the full minutes text for item 19.

Suzy O’Shea, Head of Engagement, Energize STW

Penny Bason, Head of Joint Partnerships, Shropshire Council/STW ICB

The Board received the joint report of the Head of Engagement, Energize Shropshire, Telford & Wrekin and the Head of Joint Partnerships, Shropshire Council/ Shropshire, Telford & Wrekin ICB – copy attached to the signed Minutes – which provided details of the national strategy ‘Get active: A strategy for the future of sport and physical activity’ as well as Shropshire’s activity offer, infrastructure and programmes to support people to take up physical activity and sport.

A presentation was given – copy of slides attached to the signed Minutes.  The Head of Joint Partnerships introduced and expanded on the report.  She explained that within the last few weeks a National Strategy had been produced, which retained the same five outcomes from its previous strategy, and she drew attention to the three priorities of the new strategy (set out on page 43).  The national strategy also highlighted some evidence around reducing the number of inactive children and adults and how it reduces the burden on the NHS and social care and delivered a combined saving of £7.1b to the UK economy which shows how important physical inactivity is.  Locally, we also have a significant number of people who were inactive but the paper highlighted that activity levels could be improved by sustained input and programmes like ‘Beat the Street’ which demonstrated that when you input into support for people to access activity and to do more, people did more, and when you support that a bit more, people continued to do more.

The Head of Joint Partnerships highlighted that as a local authority and a local authority area there were a wealth of things at our fingertips, including outdoor spaces, leisure facilities, and all kinds of things that could help people to get active however, there were still people who had barriers to getting into that activity.

The Head of Engagement at Energize Shropshire, Telford & Wrekin informed the Board that the report set out all of the work and all of the areas that Energize were involved in and she particularly highlighted the work around the Green Social Prescribing project (which was coming to an end in November) which had been a success over the last few years with NHS Charities coming together with Shropshire Council, Telford and Wrekin Council, Sport England’s ‘Tackling Inequalities’ fund, Energize and Shropshire Wildlife Trust.  The next phase of this project was currently being scoped and would be based on all the intelligence that had been gained across the last two years. 

The Head of Operations drew attention to the three ‘Ls’ (local, low-level and low-cost) and how people could be connected to their green spaces and be made more aware of what was available in their communities, how it linked to the social prescribing system in terms of connecting people better but also for the social prescribers themselves to be more connected to green spaces and the local community that they were serving and she gave an example of the ‘Let’s go outside’ brochure and the Bench to  ...  view the full minutes text for item 20.

Lisa Middleton, Place and Personalisation Team Manager, Adult Social Care, Shropshire Council

REPORTS FOR APPROVAL OF RECOMMENDATIONS, WITH DISCUSSION BY EXCEPTION

The Board received the report of the Place and Personalisation Team Manager – copy attached to the signed Minutes – which updated the Board around the work of the Winter Support Service and prevention Commissioning.

The Assistant Director – Joint Commissioning introduced the report of which there were two elements, one was an update on the previous years’ winter support service and how that had informed the way forward.  It had been the third year that a specific winter support service had been commissioned, and each year it was evaluated and reviewed in quite a lot of detail and every year informed what the next year would look like.  The service was provided in collaboration with VCS partners.  She drew attention to the detail within the report around some of the outcomes.  She reported that they had a proposal for some winter funds to support this work, however what they really wanted to do was to provide this type of service all year round.

Turning to the Wellbeing and Independence Advice Service, the Assistant Director – Joint Commissioning explained that this service was funded through the Better Care Fund and was very much focussed on preventative work and was delivered by a consortium for the voluntary sector.  This service was currently being reviewed as part of the Better Care Fund.  She reported that the contract for this was due to expire in March 2024 however there were also other areas where they had to ensure they were reviewing and looking to align it in terms of that concept of that one Shropshire/Front door element looking at a locality based level and ensuring we are delivering across the Shropshire Plan but also the forward plan as part of the ICS and the ICB work that has been done collaboratively.  They were looking to pull together a service specification that was much more fit for purpose, which was a big piece of work to do.

Finally, she drew attention to the recommendations and next steps moving forward in order to meet the needs of individuals as well as the system partner strategies and priorities.  A brief discussion ensued and in response to a query, the Assistant Director – Joint Commissioning explained the plans for making this sustainable and how the capacity would fit in with the capacity and demand modelling for the system. Some of the work going on was with system partners who were supporting looking at the demand and capacity work and it was felt that in turn this would inform what they needed to invest in moving forward.

RESOLVED:

To note the recommendations as set out in the report.

Penny Bason, Head of Joint Partnerships, Shropshire Council/STW ICB

Laura Tyler, Assistant Director, Joint Commissioning, Shropshire Council

Please contact Michelle Dulson (01743 257719; michelle.dulson@shropshire.gov.uk) if you wish to receive a copy of Appendix B; Shropshire 2023-25 Planning Template excel spreadsheet by email.

The Board received the joint report of the Head of Joint Partnerships and the Assistant Director – Joint Commissioning – copy attached to the signed Minutes - which informed the Board that the final Better Care Fund Planning Templates had been submitted on 28 June 2023 and which had been approved nationally.

RESOLVED:

To approve the Better Care Fund along with Appendices A to D.

Report to follow.

Tanya Miles, Executive Director for People, Shropshire Council

Sarah Hollinshead-Bland, Statutory Safeguarding Business Partner, Shropshire Council

The Board received the report of the Executive Director for People – copy attached to the signed Minutes – which set out the Safeguarding Annual Report for 2021/22.

The Executive Director informed the Board that Shropshire was one of only three local authorities in the country to have this type of Board which combined the Safeguarding Adults Board with both the Children’s Safeguarding Partnership and the Community Safeguarding Partnership.

The Executive Director acknowledged that the report has been outstanding for some time due to a capacity issue within the business unit and it was hoped to present the 2022/23 annual report to this Board prior to Christmas.

RESOLVED:

To note the contents of the report and to bring it back to the Board alongside the 2022/23 annual report.

Penny Bason, Head of Joint Partnerships, Shropshire Council/STW ICB

Naomi Roche, Personalised Care Programme Manager, Shropshire Council

The Board received the joint report of the Head of Joint Partnerships and the Personalised Care Programme Manager – copy attached to the signed Minutes – which described the continuing work of the Trauma Informed Steering Group and highlighted the important connectivity to the Shropshire Plan Healthy People and Health and Wellbeing priorities.

RESOLVED:

To note the recommendations contained in the report.

REPORTS FOR INFORMATION – NOT TO BE PRESENTED ON THE DAY

The Chairman had no updates to report.

Jess Edwards, Public Health Intelligence Manager, Shropshire Council

The Board received the report of the Public Health Intelligence Manager – copy attached to the signed Minutes – which presented the Board with an update on Shropshire’s JSNA, progress to date, future direction of the JSNA and timescales, for information.

Claire Parker, Director of Partnerships NHS Shropshire, Telford and Wrekin

The Board received the report of the Director of Partnerships – copy attached to the signed Minutes – which provided an update following the development and publication of the Joint Forward Plan, for information.

The Board received the report of the Consultant in Public Health - copy attached to the signed Minutes – which provided an overview of the health protection status of communicable, waterborne and foodborne disease, for information.

The Executive Director of Health, Wellbeing and Prevention informed that Board that the vaccination programme for flu and covid had been brought forward and the Chairman stressed the importance of getting the message out.

There have been changes to the supplementary opening hours of:

·         Hillside Pharmacy, 18 Sandford Avenue, Church Stretton - effective from 1^st September 2023. 

·         Boots UK LTD, Meole Brace Retail Park, Hereford Rd, Shrewsbury - effective from 23rd July 2023

In addition, there has been a change to the Pharmaceutical List – Lloyds pharmacy in Sainsbury’s, Meole Brace Retail Park, Hereford Road, Shrewsbury has ceased to provide services and has been removed from the pharmaceutical list as of 14.06.23. 

There have been changes to the supplementary opening hours of:

•      Hillside Pharmacy, 18 Sandford Avenue, Church Stretton - effective from 1st September 2023.

•      Boots UK LTD, Meole Brace Retail Park, Hereford Rd, Shrewsbury - effective from 23rd July 2023

In addition, there has been a change to the Pharmaceutical List – Lloyds pharmacy in Sainsbury’s, Meole Brace Retail Park, Hereford Road, Shrewsbury has ceased to provide services and has been removed from the pharmaceutical list as of 14.06.23

AOB

The Chief Officer Shropshire Healthwatch informed the meeting that they would shortly be publishing two reports, one about people’s experiences of making complains across Health and Social Care and the other one about diabetes, which it was hoped would feed into the Diabetes Transformation programme and she requested that they both be presented to the next meeting of the Board.

The Portfolio Holder for Children & Education informed the Board that the Armed Forces Outreach team had been nominated for a national award for the health and wellbeing category of the Veterans UK Awards.