Tanya Miles – Executive Director for People

          Patricia Davies- Chief Executive, SCHT
          Paul Kavanagh-Fields – RJAH

          Stuart Bills – Superintendent, West Mercia Police
          Dan Quinn - Assistant Chief Fire Officer, Shropshire Fire & Rescue Service
          David Crosby - SPIC

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 14 September 2023 (attached).

Contact: Michelle Dulson Tel 01743 257719

RESOLVED: 

that the Minutes of the previous meeting held on 14 September 2023 be agreed and signed by the Chairman as a correct record.

The Chairman reminded Provider Partner Board Members to provide 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 10 November 2023.

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

The full question and the response provided by Shropshire Council is available on the web page for the meeting:

Agenda for Health and Wellbeing Board on Thursday, 16th November, 2023, 9.30 am — Shropshire Council

Lynn Cawley, Chief Officer, Healthwatch

The Board received the report of the Chief Officer Healthwatch Shropshire – copy attached to the signed Minutes – which set out people’s experiences and views of complaints handling across health and social care services in the last two years.

The Chief Officer gave a presentation which set out what they had done and why and drew attention to the recommendations.  She explained that Healthwatch Shropshire had been providing the Independent Health Complaints Advocacy Service (IHCAS) since 2016 (but interestingly, there was no requirement to provide such a service for those who wished to make a complaint about social care).  She reported that they had given 884 people information about how to make a formal complaint, including social care complaints along with providing 119 people with advocacy support and only a handful of people had reported that they were satisfied with the outcome of their complaint.

The Chief Officer discussed their reflections as providers of IHCAS which included poor communication, psychological distress, meetings to discuss complaints held in inappropriate/triggering areas etc.  Finally, more work was needed to show the public the difference their complaint/feedback had made on the experiences of others. She felt that this piece of work fed into a lot of different workstreams happening across the system including the accessible information standard, advanced care planning, trauma informed workforce and personalisation.

She drew attention to the NHS Complaint Standards which had been published in December 2022 and which set out a single vision for what should happen when a member of the public makes a complaint about NHS services and explained that same areas of the country had now got one complaints procedure across the entire Integrated Care System (ICS).  She explained that the purpose of this work was to highlight how the system was doing against the standards and she implored organisations to embrace the standards.  It was an opportunity to demonstrate to the public all the work that was happening to try and improve people’s experiences of complaining.

A brief discussion ensued.  It was felt that the idea of using a person-centred approach had not previously been considered in relation to complaints but that it may help the public in the way they view, use and consider health services.  It was felt that the complaints process was not always the right thing for the public whereas more investment in bereavement and psychological support would also assist including making TRIM available to the public.

The Chairman confirmed that himself and his chief nurse saw every single complaint and that he signed off all responses before they were sent back, and he also stated that his chief nurse took any  learning through their quality committee, quality conversations and patient experience team to get their views on trends, where the delays were, what the challenges were etc, however, he recognised that this did not always resolve the issue for the person complaining.

CI Tracey Ryan informed the Board of the way in which complaints were dealt with by the Police  ...  view the full minutes text for item 34.

Laura Fisher, Head of Housing, Resettlement and Independent Living, SC

Paula Mawson, Assistant Director for Integration and Healthy Population, SC

The Board received the report of the Head of Housing, Resettlement and Independent Living – copy attached to the signed Minutes – which highlighted the importance of housing in supporting and improving the health of the population. It updated the Board on key areas of recent and current activity undertaken by the Council’s strategic housing function as well as some of the frontline work ongoing at present to improve people’s health and wellbeing. The report also asked how the system could better integrate housing within its decision making, strategic commissioning and delivery programmes.

The Head of Housing, Resettlement and Independent Living introduced and amplified her report. She stated that housing was the foundation of good health and if you did not have a stable, suitable and secure home you could not look after your health and wellbeing, and she highlighted the reasons why housing was an important determinant of health.  Whilst recognising that there was a lot of work already taking place, there was however more that could be done and in order to explore those opportunities, a workshop for system colleagues was being suggested in order to develop closer working relationships and processes.  An update report would be presented to the Board in six months times demonstrating the positive changes taking place.

A brief discussion ensued and partners drew attention to the work being undertaken by their organisations. The Assistant Director Integration and Healthy People agreed to pick this up later in the day at the Place Partnership Board meeting which she was chairing.  She felt that a workshop would be valuable in terms of the whole pathway and the link between housing and the early intervention prevention framework. She felt there was some practical things that could be done if everyone started to think about housing and have housing at the forefront of their minds.  The Chief Executive of Citizen's Advice Shropshire requested that the VSCA be involved in the workshop.

RESOLVED:

To note the recommendations contained in the report.

Jackie Jeffrey, Chief Officer, Citizens Advice Shropshire

The Board received the report of the CEO Citizen’s Advice Shropshire (CAS) – copy attached to the signed Minutes- which explored the learning from their research into the local support system in Shropshire during the cost-of-living crisis along with recommendations for how partner organisations could work together to best support residents facing financial crises.

The CEO Citizen’s Advice Shropshire gave a presentation – copy of slides attached to the signed Minutes.  She explained that when they were talking about the ‘safety net’, they were referring to systems of government programmes designed to support those facing financial hardship and that the voluntary sector was playing an increasing role in catching people when that ‘safety net’ failed.  She reported that the number of people accessing CAS in crisis had increased and that the demographic of those in crises had changed.

She went through what they had learned including that the safety net system was difficult to navigate, there was a lot of stigma around those who struggle financially and not having access to enough support had far reaching implications.  There was a lot of work to do around raising awareness of the support that was available.  She informed the meeting that the cost-of-living crisis was hitting Shropshire hard because of its rurality.  She briefly discussed the strain currently being put on food banks.

Finally, she drew attention to the four recommendations around partnership working, support system design, recognition of the value of the local voluntary sector and advocating for ‘big picture’ change.

A brief discussion ensued, and Councillor Hurst-Knight agreed to discuss free school meals with the CEO outside of the meeting and suggested that a link be included in the digital newsletter that went to all schools in relation to food poverty in order to raise awareness.  It was also agreed to raise this issue with the social task force.  The Executive Director of Health, Wellbeing and Prevention felt that the report was a difficult read but could be used as a platform for all partner organisations and frontline support workers to tell the public about the support that was available.

Councillor Motley explained that the ‘warm welcome’ initiative that had been promoted the previous year had really been welcomed, especially in rural areas and wondered whether it could be promoted again this year. 

The Chairman felt that the challenge for the Board, as leaders, was to take the message back into their own organisations/networks.  He endorsed the recommendations and welcomed the commitment of the Board to the actions that followed as a result.

RESOLVED:

To note the recommendations contained in the report.

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

The Board received the report of the Director of Partnerships, NHS Shropshire, Telford and Wrekin – copy attached to the signed Minutes.  She drew attention to the GP Access Recovery Plans which were being returned to the ICB for overview and she felt it would be good to bring this back to the next HWBB meeting to show what these plans looked like etc.  She also drew attention to page 12 of the report which discussed Child and Infant Mortality in Shropshire, Telford and Wrekin which had been discussed at the last ICB meeting. 

The Executive Director of Health, Wellbeing and Prevention explained that there had been a discussion at the development session were all of the data had been looked at in detail and it was felt that the system response needed to be looked at in order to develop a collective system-wide action plan that considered all of the evidence together.  To that end, a workshop would be held with partners in December to bring those key stakeholders together and a report including an Action Plan would be taken back to a future ICB and the HWBB.

RESOLVED:  To note the contents of the update.

Gordon Kochane, Consultant in Public Health, SC

The Board received the report of the Consultant in Public Health – copy attached to the signed Minutes – which provided an overview of the national policy paper ‘Stopping the start: our new plan to create a smokefree generation’, along with an update on local activity.

The Consultant in Public Health drew attention to the consultation on the proposals set out in the policy paper which closed on 6 December and the Underage Vaping Task and Finish Group were collating a response on behalf of the Council.  The Chairman felt that the HWBB should also respond to this consultation.

The Consultant in Public Health then drew attention to the work that was being undertaken locally, including a new web page resource on the Healthy Shropshire website called ‘Stopping Smoking’ which included a whole range of resources, tools and advice around how Shropshire residents can get support for quitting smoking, along with advice for adults on using vapes as part of their journey to quit smoking and a dedicated page on youth vaping.  The web page also included a toolkit of resources for anyone supporting a young person who was vaping.  A parent/carer leaflet was also being developed.

RESOLVED:

To note the recommendations contained in the report.

Berni Lee, Public Health Consultant, SC

Cathy Levy, Public Health Development Officer, SC

The Board received the report of the Public Health Consultant and the Public Health Development Officer – copy attached to the signed Minutes – which sought the Board’s endorsement of the Shropshire Healthier Weight Strategy 2023-28 and for Board Members to present the Strategy for approval to their respective governing bodies.

The Public Health Consultant informed the Board that the Strategy now incorporated a high-level Action Plan which included the rationale for the actions and the indicators that would be used to monitor progress.  She highlighted the crossover with earlier conversations that had taken place in the meeting.

The Health and Wellbeing Strategy Implementation Manager, MPFT updated the meeting on the work being doing in relation to the NHS National Standards for healthcare and food.  He reported that MPFT had progressed this work and had a nutrition policy for the Trust and had just appointed a nutritionist to provide oversight/direction for improving food provision within their hospitals.  He agreed to provide a contact for this work.

RESOLVED:

To note the recommendations contained in the report.

It was agreed to take Agenda Item 13 – Chair’s report next.

Simon Whitehouse, ICB CEO

The Chair updated the Board in relation to the following items (copy attached to the signed Minutes):

·         Pharmacy Update

·         Department for Health and Social Care visit

·         Celebrating 10 years of Healthwatch Shropshire

·         VCSE Event

·         Child Mortality

Councillor Cecilia Motley took the Chair.

Rachel Robinson, Exec. Director of Health, SC

The Board received the report of the Executive Director of Health, Wellbeing and Prevention – copy attached to the signed Minutes.

The Executive Director of Health, Wellbeing and Prevention thanked the Public Health team in particularly Jessie Dixon the Public Health High Potential Scheme (HSP) placement for all their work in pulling this together and she explained that the Action Plan was a living document and would be developed as actions were developed through the HWBB, through ShIPP, through the healthy lives groups and these would be monitored.  She drew attention to the considerable engagement that had been undertaken culminating in a stakeholder event where partners came together to develop some of the work.  She explained that the framework would be signed off before the next HWBB meeting and the finalised Action Plan would be brought to the next meeting.

Jessie Dixon reported that two separate events had been arranged to allow primary care colleagues to attend.  The two key areas that were highlighted as needing to be strengthened were sustainability and deprivation.  A second event was scheduled for the following week, feedback from which would be included in the Action Plan.

RESOLVED:

To note the recommendation contained in the report.

Laura Tyler, Assistant Dir. of Joint Commissioning, Adult Services, SC

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

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

The Board received the report of the Assistant Director of Joint Commissioning and the Head of Joint Partnerships – copy attached to the signed Minutes – which detailed the recent submission of the quarterly BCF return which was the first quarterly return since prior to the pandemic and also provided an update on the work the system was doing in preparation for winter pressures. 

The Assistant Director of Joint Commissioning informed the meeting that further work was being done as part of the BCF to see where the focus needed to be in terms of pathways and the resources that they currently had and were working through that with system partners and some of the things that came out of that work would need to be actioned.  She reported that they were on track to meet most of the targets but were currently below the emergency admissions due to falls in people age 65 and over but it was hoped that the anticipated falls response that went live earlier that week would have an impact so they could get back on target for the next quarterly return.

The Assistant Director of Joint Commissioning highlighted the work being done around the winter response within the BCF.  She informed the Board that a report would be presented to a future meeting around the virtual care support model that was currently being piloted but was hoped to be expanded.

RESOLVED:

To note the recommendation contained in the report.

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

The Board received the report of the Head of Joint Partnerships, Shropshire Council/STW ICB – copy attached to the signed Minutes – which provided an overview of the ShIPP Board meeting held in October 2023 and included actions, for assurance purposes, for information.

The Head of Joint Partnerships requested that the Neighbourhood working part of local be presented to a future Board meeting for discussion.

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 provided an update on Shropshire’s JSNA, progress to date, future direction and timescales, for information.

Susan Lloyd, Consultant in Public Health, Shropshire Council

The Board received the report of the Consultant in Public Heath – 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 reminded everyone about the importance of getting their flu/covid jabs, especially for the workforce.

Toby Pierce, PPO Professional, Regulatory Services, SC

The Board received the report of the Public Protection Officer, 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, for information.