Agenda and minutes

District & Borough Council CEO Representative Tim Clegg referred to item 4a for which he is a Board member for Together Active.

An error was highlighted on page 3 second from last paragraph which should read 3 x ICPs rather than 3 x ICS – there is one system and three partnerships. No other errors/omissions identified.

RESOLVED: That the minutes of the meeting held on the 10^th December 2020 be confirmed by the Health & Wellbeing Board (H&WBB) and signed by the Co-Chair.

There were no questions at this meeting.

Dr Richard Harling presented to the Board and gave an update on some of the issues that may face us over the ensuing months and years. The virus has become endemic in our communities and It is unlikely that we will be able to eradicate it completely. This means we will need to maintain a series of Covid defences over the long term. This means that the future is quite uncertain. The Board paper and presentation outlined a number of plausible scenarios which we will need to consider and plan for.

Dr Harling suggested that under any scenario we will need to:

·         Maintain effective testing, contact tracing, isolation and outbreak management. This will mean that we need to make sure have facilities available for testing as many people as possible, as frequently as possible.  Contract tracing will need to be maintained and isolation of cases and contacts is expected to continue.

·         Whilst the uptake of the vaccination is very good there will be pockets where this is sub-optimal, we need to maintain the ability to deal with them. 

·         Covid security will most likely need to continue, and this will include some level of ongoing social distancing.

·         New Covid variants will evolve, which means that the vaccination will need to be updated on an annual basis.

·         In Staffordshire we are supporting the 50,000 clinically extremely vulnerable individuals. We have provided additional support in terms of shopping making sure that they can stay safe at home, underpinned by good communication to make sure that we get the message across.

Dr Harling outlined the 3 scenarios and suggested that at the moment there are some grounds for the more optimistic scenarios, but the risks increase as lockdown is released. 

What this all means is:

·         that we need to protect staff wellbeing and make sure we have sufficient capacity in 21/22. 

·         Continue the digital shift and move our services online

·         Pay close attention to demand for public services, which is unpredictable although we certainly expect high-level demands in NHS and social care to continue for some time, fuelled by prolonged periods of isolation and rising mental health issues. 

·         Keep a grip on our finances and lobby for continued and ongoing Government funding to enable an effective local response to Covid in the future.

·         We need to sustain and build on the improved partnership working of the past year.

·         Businesses that rely on face to face interaction have been and will continue to be affected, we will need to continue to find ways to support our business sector

·         Schools and universities have lost a year of learning and the challenge will be to try to recover and catch up. It is quite possible that universities will become less attractive options for young adults in future. 

·         The pandemic has damaged quality of life; we have early evidence that mental health problems are rising, and that inactivity, diet and obesity have deteriorated over the last year and we have a real challenge ahead of us to turn  ...  view the full minutes text for item 48.

Presentation tabled and led by Tony Bullock, Lead Commissioner.

The Public Health and Prevention team within Staffordshire County Council is currently developing their strategy and the purpose of this item was to share initial ideas with the HWBB, to have a brief debate and to get input into the strategy and ensure linkage to the HWBB Strategy. 

The longer term priorities are:

·         healthy life expectancy;

·         infant mortality;

·         health inequalities

To meet the long term priorities a short term programme will focus on pandemic response and recovery:

·         supportive communities

·         mental wellbeing

·         obesity.

Dr Johnny McMahon (Co-Chair) thanked Tony Bullock for the presentation and fully supported the direction of travel but noted that we need to be vigilant for other issues that haven’t come to light yet.

Garry Jones noted that within the White Paper there is a paragraph which refers to bringing public health commissioning outside of public health regulations in the same way as those available to NHS Commissioners currently. This give us some flexibility in how services are commissioned. 

RESOLVED: Co-Chair reported that the HWBB are very supportive of this approach and asks that colleagues of the HWBB reflect and feedback directly to Tony Bullock. The aim is to bring a more detailed plan back to the June HWBB.

The purpose of the session was to get approval and support from the HWBB to the direction of travel for the obesity strategy and to debate what we can do differently going forward individually and collectively.

Background:

·         Nearly 25% of reception aged children are overweight or obese (2019) (all 8 x districts are above the national average).

·         Nearly 35% of Year 6 children are overweight or obese (2019) (5 x districts above national average).

·         64% of adults (aged 19+) are overweight or obese (2019) (6 x districts above national average).

·         21% of adults (aged 19+) are physically inactive (2019) (5 x districts above national average).

There are a wide range of consequences linked to obesity, both to the individual and to wider society. Whilst obesity has been a priority in many local and national strategies we have not seen a population shift in obesity levels.

Slide 1: Is the current position good enough?

Dr Johnny McMahon (Co-Chair) noted that more folk die now from the effects of overeating than they do of starvation in the World.  We live in an obesogenic society which is why a Whole System place-based approach makes sense. We have got to look at the lives people lead and what we can do to modify behaviour, rather than the individual trying to sort themselves out, which we know doesn’t work.

Dr McMahon also noted that we can rely too much on exercise we need to give more focus to providing people with good healthy nutritious low calorie food as well as providing people with the opportunity to integrate exercise into their day.

Dr Alison Bradley (Co-Chair) agreed that the whole system placed approach is the best approach.

Garry Jones noted the mental health aspects of overeating.

Slide 2: Is taking obesity just an issue for the Public Health teams – or is it genuinely a priority for all?

Tim Clegg noted that the District Councils and SCC, do see this as a priority and welcomed the holistic approach to tackle obesity. To do this we need to make it as easy as possible for people to make healthy choices. There needs to be a culture change in this country and to push back on processed food which manufacturers put in our direction, particularly around fast-food choices which are seen as a treat for families, which doesn’t help in brining children up in making healthy choices. There is a link between health inequalities, poverty and obesity,  more work is needed to understand this more and there must be a concerted effort across the wide range of fronts and we need an honest discussion with partners about what we can do to make a real change.

Dr Alison Bradley (Co-Chair): Challenge of obesity cuts across everything, all our organisations, health and care we all have a part to play in it, it does need to be a priority for all.  

Slide 3: Why have past efforts failed?

Dr Johnny McMahon – In the past we have been judgemental  ...  view the full minutes text for item 50.

Marcus Warnes updated the board about the development of the Integrated Care System, which will be based on the current STP partnership arrangements.

Marcus noted that the ICS application has been submitted and is one of 13 applications yet to be approved.  The expectation is that all ICS bodies will be approved by the 1st April 2021, becoming statutory bodies on the 1st April 2022. The White Paper suggests that there would be an NHS ICS Body and a wider ICS  health and care partnership, with the NHS Body acting as the statutory organisation taking on the roles of the 6  CCG’s and some of those functions which NHS England have had responsibility for.  For Staffordshire and Stoke-on-Trent there will be 3 Integrated Care Partnerships, which already exist in shadow form in the North, South East and South West of Staffordshire.

Health & Wellbeing Boards are statutory sub committees of Local Authorities and we will wait for further guidance that is being submitted in April, but a very close working relationship between ICS’s and the H&WBB is very much envisaged. There was some agreement that further discussion about the role of the HWBB and the ICS Health and Care Partnerships was needed.

Tracey Shewan, Director of Communications and Corporate Services CCG updated the Board in relation to the merger application process, the GPs had voted for merger and supported the ICS application. A questionnaire has gone out to stakeholders to ask for their comments.

Prem Singh is the new Independent Chair to the ICS, there will likely be further changes needed in preparation for the ICS. 

RESOLVED: The updates on the Integrated Care System Plan received and future updates to be provided

John Wood Independent Chair of Staffordshire & Stoke on Trent Safeguarding Adults Board presented a paper focused on safeguarding, health inequalities and learning difficulties.

The HWBB and the Safeguarding Adults Board have a mutual interest in ensuring there is a clear prevention programme to improve health and wellbeing as well as a commitment from all partners to prevention. The report itself raises some significant questions about inequalities and how we can empower our communities to effectively respond to the needs of adults with learning disabilities.

Dr Richard Harling – Confirmed that he absolutely supports the need for due diligence in this area and indicated that we have got some data locally about the equivalent excess deaths among people with learning disabilities during the course of the pandemic. This can be shared. 

RESOLVED: The report was supported. Richard Harling to share the data about excess deaths and learning disabilities.

This item was for information and Helen Riley noted that Stoke on Trent City Council have decided that they needed their own safeguarding board rather than a combined Staffordshire and Stoke on Trent Board. It is anticipated that the two Boards will still work closely in partnership, especially around key issues like child exploitation.  

RESOLVED: The Board accepts the Stoke-on-Trent and Staffordshire Safeguarding Children Boards (SSSCB) Annual Report 2019/2020.

For information – presented by Deputy Chief Executive and Director for Families and Communities, Helen Riley. 

The Staffordshire SEND Strategy was approved by the Council’s Cabinet in February and is currently going through CCG’s approval mechanisms.  It is a strategy that has been produced with a range of partners including the CCG, schools as well as with families and young children and people themselves.  There has been a wide consultation process.

Four priorities emerged out of the consultation and are reflected in the strategy, they were:

·         Improved communication

·         Education health and social care working with and in partnership with families 

·         Early intervention.

·         The right support at the right time

There are 4 delivery plans against the four priorities.

Dr Alison Bradley Co-Chair confirmed that it is going through the CCG Quality and Safety Committee this month for approval.

RESOLVED:  That the HWBB noted the update and endorse the Staffordshire SEND Strategy. 

RESOLVED: That the Board’s Forward Plan for 2021-22 be noted.

Staffordshire Observatory - Your health in Staffordshire

Pharmaceutical Needs Assessment – link in papers – the Board received the update and the key messages summarised are:

·         3 x pharmacies have closed, and no new pharmacies have opened.

·         7 x pharmacies have changed address.

·         14 have changed ownership or name.

None of these are believed to be any concern.

RESOLVED: The HWBB received and accepted the report and the key messages summarised.