Simon Whitehouse – ICB Chief Executive Officer, NHS Shropshire, Telford & Wrekin (Co-Chair)

Laura Tyler – Assistant Director for Joint Commissioning

Patricia Davies – CE, SCHT

Nigel Lee - Interim Director of Strategy & Partnership SaTH/Director of Strategy, ICB

Superintendent Stuart Bill, LPA Commander, Shropshire, West Mercia Police

Lynn Cawley - Chief Officer, Shropshire Healthwatch

        Carla Bickley substituted for Nigel Lee

        Anna Morris substituted for Zafar Iqbal

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 16 November 2023 (attached).

Contact: Michelle Dulson Tel 01743 257719

RESOLVED:  

That the minutes of the previous meeting held on 16 November 2023 by 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 5pm on Friday 12 January 2024

None received.

Claire Sweeney, Healthy Lives Team Manager, Shropshire Council

The Board received the report of the Healthy Lives Team Manager – copy attached to the signed Minutes – which provided an update on the social prescribing offer and its development in Shropshire.  It described the programme and recent progress on the Adult Social Prescribing programme.  It also provided an update on demand management work focussing on reducing risk of falls, cardiovascular disease and supporting adult social care, new Simple Activation Question to demonstrate the increase in people being able to take action to improve their own wellbeing and in turn reducing healthcare utilisation, and the Winter Support Service which was mobilised across Shropshire to support winter pressures across the system.

The Healthy Lives Team Manager introduced and amplified her report and gave a presentation – copy of slides attached to the signed Minutes.  She gave an overview of the team and the service they delivered and to whom.  She then drew attention to the difference in referral numbers etc for adults and children in 2023 and touched on the outcomes.  She highlighted in particular the Pain Support Group which had been well received and they were looking to see how it could be developed across the county.  In conclusion, the Healthy Lives Team Manager discussed the priorities that they were working on with each PCN.

A brief discussion ensued, and Board Members offered their support.  It was suggested that this be a regular update at ShIPP meetings to monitor its impact and give assurance to the Board about how it was being managed.  Members were reminded that it was a truly integrated service with primary care and a whole range of other partners working very closely together including the voluntary sector which was one of the reasons why this programme worked so well. 

Councillor Hurst-Knight agreed to speak to the Healthy Lives Team manager outside of the meeting in relation to Social Prescribing for Children and Young People and it was confirmed that this would be looked at in a future meeting. 

The Executive Director of People was interested in the impact of Social Prescribing, for example were they seeing less contacts into health and social care six months on following a social prescribing intervention?  In response, the Healthy Lives Team Manager referred to an independent review by Westminster University which showed a 40% reduction in GP contact and other health service usage.  She hoped in future to be able to report on the increase in activation (how well people were able to manage their own health and wellbeing).  The VSCA representative informed the meeting that Citizen’s Advice Shropshire took referrals from social prescribers and had their own tool that measured the difference that their intervention had made which could link into the work being done by the Healthy Lives team. 

In response to a query, it was confirmed that the referrals came from the social care team within the local authority and not local care providers. The Chief Officer explained that Partners in Care represented 260 care  ...  view the full minutes text for item 51.

Amanda Cheeseman, Project Development Officer, 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 presented an update on Shropshire’s JSNA, progress to date, future direction of the JSNA and timescales.

The Project Development Officer for Public Health introduced and amplified her report.  She gave a presentation and reminded the Board that there were 18 place plan areas in Shropshire which highlighted the specific health inequality needs of those residents living in those areas.  Some of the work currently underway in Highley, Ludlow and Whitchurch were then highlighted.

The Board expressed their thanks to the Head of Joint Partnerships, without whom none of this work would have been possible within such a short space of time and just showed what could be achieved when partners pull together.

A brief discussion ensued and a query was raised as to how they could tie in those countywide approaches to the cost-of-living crisis.  It was suggested that the learning from Southwest Shropshire, through Shaping Places, and delivering that local cost of living approach around food insecurity and the fuel poverty work done by Marches Energy, be brought into other areas.  It was agreed that more work could be done around this.

A query was raised as to whether social prescribing was being considered when developing services in these communities.  In response, the Head of Joint Partnerships explained that this would be delivered as part of the community and family hubs that were being developed as part of the Action Plans and she gave an example.

The Executive Director of Health, Wellbeing and Prevention explained that the Prevention Framework would be signed off by the Board and that was where ‘One Shropshire’ fitted in. It was felt that the Board needed to think about how to move this work forward and expand it across all areas including how to ensure the services were sustainable and how to get more people involved and to lead some of the work. It was felt that ShIPP would be a good place to look at these issues.

The Project Development Officer informed the Board that the next Place Plan areas to be launched would be Craven Arms, Church Stretton, Bridgnorth and Cleobury Mortimer.  She confirmed that they were reaching out to the Town and Parish Councils within all of those areas and giving residents the opportunity to tell them what they needed for their health and wellbeing.

Verbal update to be given by Andy Evans, School & Public Transport Team Manager, Shropshire Council

A verbal update and presentation was provided by the School and Public Transport Team Manager and the Public Transport Development Officer – copy of slides attached to the signed Minutes. The School and Public Transport Team Manager gave an overview of what transport was like at the current time and explained that there were two sets of bus services, commercial bus services and subsidised bus services.  The Board were informed that the regulatory body responsible for public transport in Shropshire was the West Midlands Traffic Commissioner although the Council did have certain powers.  He confirmed that no bus services in Shropshire had been cut recently but that at least 60 days’ notice of any planned cuts to bus services would have to be given to the Traffic Commissioner.

Turning to commercial bus operators, the School and Public Transport Team Manager explained that many years ago there used to be about 80% of bus services that were subsidised by the Council and 20% were commercial, whereas now about 97% were subsidised and 3% commercial.  The Council usually step in when there was a gap in the commercial market and would tender the route and award it to the successful operator.  The Council could not however compete with a commercial service but they could step in where there was no commercial benefit to the operator.  He informed the meeting of the different types of contracts depending on where the fare risk sat.  He reported that currently the Council spend approximately £3.5m on the subsidised bus services.  They had received some grant funding from covid from the Government which has been allocated to bus services.

The School and Public Transport Team Manager then discussed Community transport groups of which there were about 9 in Shropshire and who were awarded grants if up to £500,000.  He explained that Shropshire Council had a dedicated passenger transport officer who oversaw the community groups and liaised with them on a regular basis.

The Public Transport Development Officer explained that his role was looking at how to develop public transport going forward.  He gave some background around the difficulties in Shropshire including the lack of investment from operators, rising cost of fuel, declining patronage, large concessionary market etc.  He explained that after the pandemic councils were encouraged to create enhanced partnerships with operators in order to release funding from the DfT.  This had been done in Shropshire and regular meetings were held to discuss the challenges/changes, development and investment of which will be led by Shropshire Council. 

The Public Transport Development Officer drew attention to the Government’s Bus Back Better Campaign which required Local authorities to create a bus service improvement plan which was submitted in October 2021.  It allowed the Council to write a ‘shopping list’ of how it was going to improve public transport in Shropshire.  The first bid of £98m was unsuccessful and so the bid for round two took forward two elements of the original bid being Connect on demand, which was a demand  ...  view the full minutes text for item 53.

Susan Lloyd, 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 overview of the health protection status of the population of Shropshire.  It also provided an overview of the status of communicable, waterborne and foodborne disease.

The Healthy Child Programme Coordinator introduced and amplified the report.  She highlighted the information around measles and what was happening both locally, regionally and nationally about concerns around the rising number of measles cases nationally which began in London.  An increase was also now being seen within the West Midlands leading to an increased risk of potential cases within Shropshire.  She informed the Board of the mitigations being put in place to ensure there was a pathway in place to prevent any measles outbreaks including encouraging take up of two doses of the MMR vaccine. She also informed the Board of the actions that would be taken should an outbreak be seen in Shropshire.

The Portfolio Holder for Children & Education confirmed that information had been issued to all school settings the previous week and would be repeated on a regular basis.

Paula Mawson, Assistant Director for Integration and Healthy Population, Shropshire Council and Gordon Kochane, Consultant for Public Health, Shropshire Council

Please contact Michelle Dulson (01743 257719; michelle.dulson@shropshire.gov.uk) if you would like to receive a copy of Appendix A, Drug & Alcohol Strategic Action Plan spreadsheet by email.

The Board received the report of the Public Health Consultant (Inclusion & Vulnerable People) – copy attached to the signed Minutes – which provided an update on the substance misuse strategic programme for Shropshire.

The Public Health Consultant introduced and amplified his report, and he drew attention to the draft Tackling Drugs and Alcohol Misuse Strategic Action Plan and requested that any feedback be sent directly to himself.  A query was raised as to whether there had been any engagement with the Specialist Care Group at MPFT on the Strategy.  In response, the Public Health Consultant confirmed that part of the ambition in the plan was an integrated approach with mental health services along with another programme of work that they were progressing alongside the Strategic Action Plan for which MPFT was a core partner.

The Executive Director for People explained that it had been discussed previously at the Board the concern around the impact of drugs and alcohol on individuals, both children and adults and she would be interested to see the learning that came out of the drug and alcohol death review panel and where the governance for that would sit.  In response, the Public Health Consultant explained that there had been one meeting so far which had been to test the process where a conversation was had and it was decided that it would sit within the safeguarding adult oversight group.  It was requested that updates be bought to the Board going forward.

RESOLVED:

To note the recommendations contained in the report.

Rachel Robinson, Executive Director of Health, Shropshire Council

The Board received the report of the Director of Public Health – copy attached to the signed Minutes – which provided a summary of her annual report on the health of the population of Shropshire. 

The Director of Public Health introduced and amplified her report.  She drew attention to the recommendations which were around rural proofing, the importance of localities around place-based working and neighbourhood working in rural areas, being intelligence led.  The information was available to inform conversations that were being held both locally and nationally.  She confirmed that the recommendations would be followed up to ensure they were being taken forward.  The final part of the annual report was a reflection back on what was said in her first report back in 2020.

        RESOLVED:

        To note the contents of the annual report and to support the recommendations
        contained therein.

Rachel Robinson, Executive Director of 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 update on the Prevention Framework, for information.

The Chair updated the Board in relation to the following items:

• Winter response and the ‘Think Which Service’ – NHS led campaign

• Health response to flood recovery

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 December 2023 and included actions, for assurance purposes, for information.