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Shirehall
Abbey Foregate
Shrewsbury
Shropshire
SY2 6ND

Agenda and minutes

Health and Wellbeing Board
Thursday, 17th January, 2019 9.30 am

Venue: Shrewsbury Room, Shirehall, Abbey Foregate, Shrewsbury, Shropshire, SY2 6ND

Contact: Michelle Dulson  Committee Officer

Items
No. Item

50.

Apologies for Absence and Substitutions

To receive apologies for absence and any substitutions notified to the clerk before the meeting.

Minutes:

The following apologies were reported to the meeting by the Chair

 

Dr Simon Freemen     Accountable Officer, Shropshire CCG

Jackie Jeffrey              VCSA
Neil Carr                       Chief Executive, South Staffordshire and Shropshire Foundation Trust

Paul Bennett               Business Board Chair

Peter Loose                 Chairman, Shropshire Partners in Care

Neil Nisbet                   Finance Director & Deputy CE SaTH NHS Trust

Lisa Wickes                 Head of Out of Hospital Commissioning and Redesign

Jan Ditheridge            Chief Executive, Shropshire Community Health Trust

 

          The following substitutions were also notified:

 

Heather Osborne substitute for Jackie Jeffrey, VCSA

 

Barrie Reis-Seymour substitute for Lisa Wickes, Out of Hospital Commissioning and Redesign

 

Ros Preen substituted for Jan Ditheridge, Shropshire Community Health Trust

Cathy Riley substituted for Neil Carr, Shropshire Community Health Trust

 

51.

Disclosable Pecuniary Interests

Members are reminded that they must not participate in the discussion or voting on any matter in which they have a Disclosable Pecuniary Interest and should leave the room prior to the commencement of the debate.

 

Minutes:

Members were reminded that they must not participate in the discussion or voting on any matter in which they had a Disclosable Pecuniary Interest and should leave the room prior to the commencement of the debate.

 

52.

Minutes pdf icon PDF 151 KB

To confirm as a correct record the minutes of the meeting held on 1 November 2018.

 

Contact: Michelle Dulson Tel 01743 257719.

 

Minutes:

It was noted that Tony Marriott was not in attendance at the meeting and that Dr Julian Povey was the Chairman of Shropshire CCG and not the Vice-Chairman as stated in Minute Number 39.

 

RESOLVED:

 

That the Minutes of the meeting held on 1 November 2018, be approved and signed by the Chairman as a correct record, subject to the above.

 

53.

Public Question Time

To receive any questions, statements or petitions from the public, notice of which has been given in accordance with Procedure Rule 14.

 

Minutes:

No public questions had been received.

 

54.

System Update pdf icon PDF 152 KB

Regular update reports to the Health and Wellbeing Board are attached:

 

i.               Shropshire Care Closer to Home

             A report is attached.

 

                   Contact: Lisa Wickes, Head of Out of Hospital Commissioning and Redesign,
                   Shropshire CCG

 

ii.              The Sustainability and Transformation Plan for Shropshire, Telford & Wrekin

             Report to follow.

 

iii.             Future Fit

             Report to follow.

 

             Contact: Phil Evans, STP Director, Telford and Wrekin CCG

 

       iv.        Better Care Fund, Performance

                   A report is attached.

 

                   Contact: Penny Bason, Shropshire Council / Shropshire STP

 

v.              Healthy Lives

A report is attached.

 

Contact: Val Cross

 

Additional documents:

Minutes:

i.        Shropshire Care Closer to Home

Barrie Reis-Seymour Programme Lead introduced and amplified the Shropshire Care Closer to Home update (copy attached to the signed Minutes).  He confirmed that the Phase II Model for case management had been agreed by the Governing Body in August.  It had been agreed to go ahead with the pilot demonstrator site despite lack of progress on the Alliance Agreement and expressions of interest had been requested by 25 January 2019. 

The Programme Lead confirmed that a Communications and Engagement Working Group had been established and that each provider had a Lead Communications Officer who sat on this Group.  He also confirmed that STP Digital support was now being received.  The IT Task and Finish Group continued to look at data and IT infrastructure requirements including data sharing, information governance requirements and the development of a shared care plan. 

The Programme Lead reported that the Phase III concept models had been designed and shared with the Programme Working Group for feedback by the end of January before engagement with wider stakeholders through a number of workshops.  Feedback would be collated in April when the final proposed models would be appraised by the CCG.

The Chairman suggested that it would be helpful for elected Members to know when the workshops would be taking place in their areas and in response to a query, the Programme Lead confirmed that the Council’s Communications Lead Officer did attend meetings of the Communications and Engagement Working Group.

The Programme Lead informed the Board that the JSNA software tool shared by Professor Rod Thomson had provided a wealth of information about the population which could be incorporated into the design allowing checks to be made in 5/10/15 years to ensure it was sustainable, fit for purpose and met the needs of the population.  It was felt that the current care closer to home design was spot on with current needs.  However, it was vital to develop the fifth stage of step up community beds, which required further work to identify changes required to ensure the service remained fit for purpose and was sustainable.

ii.       The Sustainability and Transformation Plan for Shropshire, Telford & Wrekin

Phil Evans, STP Director introduced and amplified the STP Programme update (copy attached to the signed Minutes) which highlighted the NHS 10 Year Plan. The STP Director gave a short presentation (copy of slides attached to the signed Minutes) which covered the following areas:

·           The NHS Long Term plan - what the future looks like;

·           Timeline – what outputs were expected and by when;

·           System approach;

·           Quantitative diagnostic;

·           Population Health Management Flatpack;

·           Next steps for Shropshire, Telford and Wrekin STP;

·           Performance and Transformation reporting requirements;

·           Governance Structure.

In response to a query, the SPT Director reported that the STP was a complete refresh as the previous plan had no buy in.  The engagement would be very broad with each organisation involved in writing their own part.  Although the Long-Term Plan was a nice aspiration and backed  ...  view the full minutes text for item 54.

55.

Shropshire Food Poverty Action Plan pdf icon PDF 455 KB

Report attached.

 

Contact: Emily Fay, Food Poverty Alliance

Minutes:

Emily Fay, the Food Poverty Alliance Co-ordinator, and Katie Anderson, Project Manager for Shrewsbury Food Hub introduced and amplified their report (copy attached to the signed Minutes) which set out the Shropshire Food Poverty Action Plan.  It was explained that food poverty was a growing problem in Shropshire with an estimated 27,000 households being affected by changes in the benefits system.  Research has shown that Shropshire Residents would lose approximately £102m per year which was an average of £550 per working age adult.

The Shropshire Food Poverty Alliance was formed in 2018 to tackle this issue and membership included Shropshire Council, the NHS, Foodbanks, Age UK, and Citizen’s Advice Shropshire.  The Alliance have developed a 12-point Action Plan in order to enhance support for people in crisis, to prevent food poverty and to increase awareness.  The Alliance was seeking resources to continue co-ordination of this vital piece of work.

Attention was drawn to the research carried out in 2018 across the county to map current provision, identify gaps and potential solutions.  The research involved a lot of participatory work, including workshops, online surveys, and interviews to find personal experiences.  The key findings highlighted that food banks were consistently seeing more people come through their doors which had real implications for health across the County. The cost of food had risen by 28% whilst average wages rose by only 5%.  It was highlighted that some schools really struggled with this issue with pupils attending school not having had breakfast, nor having sufficient food for lunch, parents not being able to afford to buy fruit and vegetables etc.

The Alliance was seeking support for the Action Plan and for the Board to consider the resources that may be available to support it.  The Clinical Chair, Shropshire CCG informed the Board that the impact on Health and Wellbeing could not be played down and he confirmed that the CCG would be happy to work with the Food Poverty Alliance.  The Director of Performance and Delivery would put them in touch with the relevant programme leads.

A brief discussion ensued in relation to volunteers and how they could be used flexibly eg the working population could be requested to provide evening and weekend cover.  Assistance was offered by a number of officers/organisations who agreed to make contact outside of the meeting.

In response to a query about how engaged the supermarkets were, it was confirmed that food was collected from about 15 supermarkets in Shrewsbury and were distributed between about 50 community groups.  However, it was restrictive in getting the community organised to deliver food and that although surplus food was useful it was also random and only a small part of the solution.

In conclusion, the Chairman felt that the Alliance approach was to be applauded and particularly welcomed the initiative to improve cooking and nutrition skills especially in schools.  The Chairman requested an update on how things were progressing in a few months’ time.

 

56.

Shropshire All-Age Carers Strategy Update pdf icon PDF 437 KB

Report attached.

 

Contact: Val Cross

Minutes:

Val Cross, the Healthy Lives Coordinator introduced and amplified her report (copy attached to the signed Minutes) which provided the Board with an update on current progress of the Shropshire All-Age Carers Strategy and Action Plan.  She confirmed that work continued on the five key priority areas as set out in paragraph 3 of the report.

The Healthy Lives Coordinator drew attention to the Young Carers Day taking place on 31 January 2019. 

In conclusion, the Healthy Lives Coordinator reported that although there was a lot of really good work happening, there was also a lot more work to do. 

RESOLVED:

That the contents of the update be noted.

 

57.

STP All-Age Mental Health Strategy update

A presentation will be given.

 

Contact: Steve Trenchard

 

Minutes:

Steve Trenchard the Programme Director for Mental Health gave a presentation and updated the Board in relation to the STP All-Age Mental Health Strategy. He informed the Board that in order to ensure the best value from the service, he was asking colleagues and patient groups etc to set out what their ambitions were for access to mental health support.  He therefore wished to ask the Board what its ambitions were and in getting to this ideal future he wished to find out the things that Members would most like to do to help them and their colleagues to achieve this goal.

Responses included the following:

·           Good communications and an understanding of what needs were and the services already being delivered;

·           To ensure professionals were well trained and informed;

·           A shared ambition to understand roles and responsibilities, where gaps were and how to bridge those gaps;

·           To work in an integrated way;

·           The reduction of stigma;

·           To ensure adequate resources applied to the greatest effect;

·           To ensure a preventative approach was taken across all ages of life;

·           To help people to understand the reality of mental wellbeing;

·           To use techniques to prevent/mitigate dementia;

·           For individuals with some form of mental health to be supported in the community;

·           Timely access to the level of service required when required and that crisis intervention be available when needed;

·           The right service at the right time and in the right place; 

·           A children’s graduated model with a wide range of different interventions, not one suits all;

·           Support to combat loneliness;

·           Resources and support for the voluntary sector to tap into to ensure services were safe and could be supported for longer;

·           A more holistic approach to prevention.

 

The Board welcomed the approach in terms of engagement and encouraged all organisations to engage in this.  The Director of Adult Services championed this important area of work and he set an ambition for joint commissioning opportunities and an opportunity to do something in the short to medium term. 

 

 

58.

Healthwatch Shropshire update pdf icon PDF 283 KB

Report attached.

 

Contact: Lynn Cawley

Minutes:

Lynn Cawley, Chief Officer of Shropshire Healthwatch introduced and amplified her report (copy attached to the signed Minutes) which provided the Board with an update on the progress made to date on the Healthwatch Shropshire Forward Work Programme for 2018-19.

The Chief Officer drew attention to the key points and in particular the significant changes in officers and volunteer numbers.  As well as their on-going activities, Healthwatch Shropshire had been asked to support Healthwatch England with two pieces of work being conducted across the country, the STP Long Term Plan and Maternity Mental Health Services.

Turning to the Forward Plan, the Chief Officer requested the views of the Health and Wellbeing Board on what the Forward Plan Programme for 2019-20 should look like.  In response, the Director of Public Health felt a key area was to link in with the work being done around Care Closer to Home.  The Clinical Chair, Shropshire CCG would welcome the work of Healthwatch Shropshire especially around the development of a primary care network.

Councillor Calder, Chairman of the Health Overview and Scrutiny Committee informed the Chief Officer that the future work programme of the Joint Health Overview and Scrutiny Committee included looking at Mental Health and she would be pleased to look at the intelligence gathered to inform where the focus should be.

The Chairman thanked the Chief Officer for her very clear report.

 

59.

Housing pdf icon PDF 321 KB

i         Winter arrangements for rough sleepers

 

ii        Update on new Homeless Families Learning Resource and Toolkit.

 

Reports attached.

 

Contact: Laura Fisher

Additional documents:

Minutes:

i.        Winter Provision for Rough Sleepers in Shropshire

Laura Fisher, the Housing Services Manager introduced and amplified the report (copy attached to the signed Minutes) which provided information on Cold Weather Provision for rough sleepers in Shropshire. 

It was confirmed that the annual rough sleeper count undertaken on 20 November 2018 identified 21 verified rough sleepers.  The Cold Weather Provision, which offered accommodation to all current known rough sleepers and any that present during the winter, had been activated on 14 December 2018 and would be on-going until March 2019.  The Housing Services Manager reported that half had taken up the offer. 

For those that had refused, the offer would continue to be made along with an offer of Severe Weather Emergency Provision which was offered in conjunction with accommodation in The Ark.  Three nights of Severe Weather Emergency Provision had been offered so far this winter.  The Housing Service Manager confirmed that the Outreach service continued throughout the winter attending any reports of rough sleepers and she drew attention to Appendix A which set out how to report a rough sleeper.

In response to a query, the Housing Service Manager confirmed that the number of verified rough sleepers had increased from 13 last year to 21 this year.

RESOLVED:

That the contents of the report be noted.

ii        Reducing Health Inequalities of Homeless Families

The Housing Services Manager then introduced and amplified a report (copy attached to the signed Minutes) which provided information on the Homeless Families learning resource and toolkit.  It was confirmed that across the country the number of homeless families with dependent children was increasing leading to an increase in the use of temporary accommodation including B&Bs. 

It was explained that the self-study tool had been produced to enable the health sector to support homeless families and homeless young people to reduce their health inequalities and improve their wellbeing, using public health interventions. The toolkit also included more practical guidance about what other professionals could do to support homeless people.

The Housing Services Manager wished to raise awareness of the toolkit with the Health and Wellbeing Board and felt that it could be used to great effect in Shropshire.  The toolkit was endorsed by the Board however concern was raised around the overall ability of Public Health to deliver all aspects of it due to significant pressures on the budget.  The Director of Public Health informed the Board that public health were seeing a continued loss of funding with another cut having taken place just before Christmas.

RESOLVED:

That the contents of the guidance be noted and that it be determined whether it could be used in Shropshire to promote and improve better health outcomes for those individuals and families at risk of suffering from homelessness.

 

60.

Any Other Business

Minutes:

In relation to the application to open a new pharmacy in Baschurch, discussed at the Health and Wellbeing Board meetings on 5 July 2018 and 1 November 2018, it was reported that the pharmaceutical company had submitted a further application stating unforeseen benefits.  Councillor Bardsley informed the Board that the final consultation deadline was the end of January 2019.

The Chairman proposed that the Board write reaffirming its previous view that Baschurch remain a controlled locality which was supported.

In response to a query Councillor Bardsley reported that the unforeseen benefits included an extension of hours and that a number of premises had been identified.  It was felt to be totally unrealistic and a very weak case. 

 

 

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