Agenda and minutes

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RESOLVED – That the minutes of the meeting held on 4 March 2021 be confirmed and signed by the Chairman.

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The Board considered an oral report of the Director of Health and Care updating them on progress of the Covid-19 pandemic in Staffordshire.

Confirmed cases of the virus had declined by approximately 80% since the meeting in March 2021 and the case rate was substantially below the national and regional average. Excellent progress was being made in the vaccination programme with approximately 95% of vulnerable adults (aged 50 years and above) having received their first dose and 80% their second dose. Residents aged 30 years and above were now being called for vaccination and the response from this group, so far, was good. Cases of the more transmissible Delta variant were beginning to emerge in the County. And whilst the majority of cases were currently confined to younger people, the number of hospitalisations were low. However, strenuous efforts continued to be made in order to control local outbreaks. The speed of roll-out of the vaccination programme and infection control measures were seen as key in preventing a third wave over the next few months.

RESOLVED – (a) That the report be received and noted.

(b) That the Board be updated on developments with regard to the Covid-19 Pandemic, as necessary.     

The Board considered a report of the County Council’s Director of Health and Care (Schedule 1 to the signed minutes of the meeting) informing them of (i) plans to refresh their Joint Strategic Needs Assessment to take account of the Covid-19 pandemic, latest data, emerging trends and issues of concern etc and; (ii) the draft Annual Report of the Director of Public Health.

The report was presented by the County Council’s Senior Commissioning Manager (Jonathan Topham) and accompanying PowerPoint Slides (Appendix A to the signed minutes) by the Senior Commissioning Manager and County Council’s Research and Development Manager (Wendy Tompson).

The JSNA sought to assess current and future health, care and wellbeing needs of the local community to inform local decision making by Partners. At their meetings in December 2020 and March 2021 the Board agreed to (i) define and focus on various key post pandemic issues; (ii) consider the role of wider determinants of health and; identify opportunities for greater collaboration between Partners with a view to tackling health inequalities. The new JSNA was to describe local needs and assets in the wake of the pandemic and make recommendations for priorities for inclusion in a new Joint Health and Wellbeing Board Strategy. 

The Annual report of the Director of Public Health was a statutory document prepared under the Health and Social Care Act 2012 in his role as an independent advocate for the health of residents of Staffordshire. Annual reports demonstrated the state of public health within communities in the County.     

During their presentation the Research and Development Manager highlighted:- (i) the JSNA 2021; (ii) Existing Health and Care Issues; (iii) Key Headlines (Wider Determinants; Aging Well; Staying Well Mentally; Healthy Lifestyles; Alcohol and Drugs; Maternal and Infant Health); (iv) Supportive Communities Response to Covid-19 (First Lockdown); (v) Supportive Communities Delivery During 2020/21; (vi) Staffordshire Connects and; (vii) Next Steps.

In the full and wide-ranging discussion which ensued Members welcomed the proposed approach for the new JSNA in its focus on post Covid-19 issues and assets-based methodology. However, they sort further details as to how evidence was be gathered having regard to the current uncertainty surrounding the longer-term effects/outcomes of the pandemic. Nevertheless, they undertook to share relevant information from their respective organisations to help ensure the refreshed Assessment was appropriate for all communities across the County.

In response to a question from the representative of Staffordshire Police, the Director of Health and Care undertook to ensure that reference to ‘Maternal and Infant Health’ (as identified as a Headline in the presentation) was amended to ‘Parental and Infant Health’ to acknowledge the importance of fathers in the rearing and development of children.

RESOLVED – (a) That the report be received and noted.

(b) That the plan for a new post Covid-19 Pandemic Joint Strategic Needs Assessment as set out in the report agreed.

(c) That the proposed scope of the 2021/22 Annual Report of the Director of Public Health be endorsed.

(d) That  ...  view the full minutes text for item 62.

The Board considered a report of the County Council’s Director of Health and Care (Schedule 2 to the signed minutes) updating them on current prevention activities aimed at tackling mental health issues together with proposals for the development of a new Mental Health Strategy for Staffordshire.

The report was presented by the County Council’s Senior Commissioning Manager, Care Commissioning (Jan Cartman-Frost) and Commissioning Manager, Public Health and Prevention (Chris Stanley) (presentation slides attached at Appendix B to the signed minutes).

In presenting the report the representatives highlighted:- (i) the impact of the Covid-19 pandemic on mental health and wellbeing; (ii) the Staffordshire and Stoke-on-Trent Suicide Prevention Programme; (iii) mental health campaigns; (iv) other initiatives aimed at supporting  people’s mental health following the pandemic and; (v) Staffordshire County Council’s and Clinical Commissioning Groups’ new joint Mental Health Strategy including the proposed approach, engagement and timelines.

During the full and wide-ranging discussion which ensued the Chief Executive of North Staffordshire Combined Healthcare NHS Trust emphasised the importance of co-ordination and collaboration between partners particularly in respect of the prevention agenda. In response, the Director of Health and Care acknowledged the Chief Executive’s concerns and undertook to liaise with him further to ensure the County Council’s work on promoting good Mental Health was fully aligned with that of all Partners.

RESOLVED – (a) That the report be received and noted.

(b)  Support proposals to engage across the whole health and care system in the development of a new joint Mental Health Strategy for 2022-2027.

(c) Note the timelines for production of the Strategy referred to in (b) above, as set out in the report.       

The Board considered an oral a report of Staffordshire Healthwatch’s Chief Executive (slides attached at Appendix C to the signed minutes) informing them of their work programme priorities which had been identified following consultation with the public.

During his presentation the Chief Executive highlighted:- returning to normal following the eighteen month period of the Pandemic which had had serious consequences for individuals, communities and Health and Care system); (ii) the role of Healthwatch in supporting the public and providing collaborative working/constructive critique with strategic partners and; (iii) intelligence on how the public felt about returning to normal which had been obtained thorough circulation of a ten question survey between July and October 2020.

During the discussion which ensued, the Chairman commented on the results the Question on Home Testing which indicated that only 40.16% of people who responded said they were testing whilst 17.93% said they did not intend to test. He went on to request that the full results of the survey be shared with the County Council so that their future media campaigns/messaging could be informed by some of the issues which had been highlighted with a view to controlling of the spread of the infection. In reply, the Director of Health and Care agreed and undertook to liaise with Healthwatch in this respect. Continuing the Chairman referred to the negative impact of social media in spreading misinformation about virus during the pandemic particularly amongst younger age groups.

The Chairman then thanked the Chief Executive for a comprehensive, interesting and informative presentation.

RESOLVED – That the oral report be received and noted.

The Board considered a report of the County Council’s Director of Health and Care (Schedule 3 to the signed minutes) updating them on the operation of the NHS’s Better Care Fund (BCF) which aimed to support the integration of local health and care systems in a way that supported:- (i) person-centred care; (ii) sustainability and; (iii) better outcomes for people and carers.

The report was presented by the County Council’s Senior Commissioning Manager (Rosanne Cororan).

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Members were informed that In December 2020, NHS England (NHSE) had confirmed that BCF Plans were not required for 2020/21. However, systems were still expected to meet the following national conditions:- (i) Plans covering all mandatory funding contributions to be agreed by Health and Wellbeing Boards with minimum funding contributions included in a Section 75 Agreement under the NHS Act 2006; (ii) contribution to social care from Clinical Commissioning Groups (CCGs) are agreed and meet or exceed minimum expectation; (iii) expenditure on CCGs commissioned out of hospital services meets or exceeds the minimum expectation; (iv) local authorities and CCGs confirm compliance with the above conditions to their Health and Wellbeing Boards. They noted that all of the conditions had been met in Staffordshire and a Section 75 Agreement covering 2020/21 completed by the County Council and CCGs.

In addition, NHSE required an end of year report to be submitted which gave information on BCF expenditure normally included in the above-mentioned Plans. Members also noted that this report was currently being collated.

With regard to 2021/22, whilst the national Policy Framework and associated Planning Requirements had not yet been published by NHSE, the County Council’s and CCGs joint BCF Steering Group were to commence their initial planning in the expectation that existing schemes/projects would be extended with an appropriate adjustment made for inflation.

In the discussion which ensued the Chairman highlighted the County Council’s new Cabinet structure under which he was now Cabinet Support Member for Public Health and Integrated Care. This position did not carry with it executive authority on behalf of the Council. The Director of Health and Care commented that the BCF regulations required Plans to be approved by Health and Wellbeing Boards rather than Members or Officers of the County Council or CCGs. Therefore, the decision on the 2021/22 Plan could either be delegated to the Joint Chairmen or dealt with via correspondence with the wider Board Membership, as they considered appropriate. In reply the Chairman indicated that his preference would be the latter of these two options.

RESOLVED – (a) That the report be received and noted.

(b) That the completion of the Section 75 Agreement under the NHS Act 2006 by Staffordshire County Council and Staffordshire and Stoke-on-Trent Clinical Commissioning Groups relating to the 2020/21 Better Care Fund, be noted.

(c) That planning for the 2021/22 Better Care Fund be undertaken by the Better Care Fund Steering Group in advance of receipt of the 2021/22 national Policy Framework, be supported.

(d) That the likelihood of the 2021/22 Better Care Fund  ...  view the full minutes text for item 65.

The Board considered reports by the Integrated Care System (ICS) Director and Chairman of the North Staffordshire Clinical Commissioning Group (Schedules 4 and 5 to the signed minutes) updating them on the development of the Staffordshire and Stoke-on-Trent ICS and recent publication of the Integrated Care Partnership (ICP) Visioning Document, respectively.

The Chief Executive, North Staffordshire Combined Healthcare NHS Trust/Chief Executive Lead – ICP Development (Peter Axon) and Staffordshire and Stoke-on-Trent Clinical Commissioning Groups’ Director of Communications and Corporate Services (Tracey Shewan) also spoke to the reports.    

Members noted that significant progress had been made since their previous meeting in the development of the ICS. Formal designation had been confirmed by the Department of Health in March 2021 following submission of the ICS Development Plan in December 2020. An interim governance structure had been established with Board meetings being held in public from February 2021.

ICS Delivery Plan Actions had recently been reviewed to determine progress made since submission with outstanding actions being identified together with next steps and timeframes for completion.

During the full and wide-ranging discussion ensued the County Council’s Director of Health and Care commented on the potential impact of Central Government’s White Paper published in February 2021 entitled “Integration and Innovation: Working Together to Improve Health and Social Care for All”, on the work of the Board. The creation of an ICS Health and Care Partnership Board with similar functions to that of the Health and Wellbeing Board would necessitate a discussion on the operation/co-ordination of the two bodies going forward. Therefore, close attention would need to be given to the contents of the forthcoming Parliamentary Bill expected to be published in the summer 2021. With regard to the ICPs, the County Council looked forward to closer working with the NHS as an opportunity to improve the health and wellbeing of residents of the County. However, further details were required before the Authority could fully endorse the proposals particularly in respect of locations and responsibilities for ‘local Authority provision’. In addition, the proposed governance arrangements appeared to be cumbersome at this stage.

Although the Chairman spoke in support of greater integration in Staffordshire’s health and care system, he agreed with the Director’s views on the proposed governance arrangements, in particular, the Clinical Senate.

RESOLVED – (a) That the reports be received and noted.

(b) That the potential route map/timeline for progressing the development of an integrated Care System in Staffordshire, as set out in the report, be supported.

(c) That the contents of the Integrated Care System Visioning Document be supported in principle and that further discussion between Stakeholders on the detail be undertaken at the appropriate time, as necessary.                 

RESOLVED – (a) That their Forward Plan for 2021/21 (Schedule 6 to the signed minutes) be received and noted.

(b) That items for inclusion on the Agenda at their next meeting be identified by the Joint Chairmen in consultation with the County Council’s Senior Commissioning Manager and Health and Wellbeing Board Lead, at the appropriate time. 

RESOLVED – That the date, time and venue of the next meeting of the Board (Thursday 2 September 2021 at 3.00 pm, County Buildings, Stafford), be noted.