Agenda and minutes

There were no declarations of interest on this occasion.

Resolved – That the minutes of the meeting held on 7 September 2023 be agreed and signed by the Chair.

None received.

The Board received a report on the Good Mental Health priority from the Staffordshire Health and Wellbeing Strategy, along with a progress update.

The Board were reminded of the Good Mental Health in Staffordshire Strategy which was approved by the Board in December 2022, and the six main outcomes of this.

An action plan had been developed to achieve the outcomes set out in the strategy. This was co-produced by the County Council and ICB working with people affected by mental health conditions as well as frontline professionals.

The primary focus of the Strategy was adults in Staffordshire, however it was recognised that there were opportunities in people’s early lives to positively influence their future mental health and wellbeing. The strategy also referenced children and young people. It was noted that other work was ongoing as part of the Staffordshire and Stoke-on-Trent Integrated Care System Children and Young People’s Mental Health Local Transformation Plan, which would be considered as part of the Health in Early Life Priority for discussion in September 2024.

Progress to achieve the strategy would be measured using a set of metrics as well as tracking completion of the actions set out in the action plan.

Councillor Jessel stressed the importance of timeliness with regards to people getting that support and access to services and questioned whether these metrics were collected and if they could be included in the monitoring of the action plan. In response, it was confirmed that the metrics are collected but the focus was on NHSE mandated actions. A number of data collections, including waiting times, were taking place however were not yet published due to them being classed as experimental, but it was hoped that this could be shared at a later date.

It was noted that the Good Mental Health action plan would feed into the Health and Wellbeing Board Strategy, acting as the bedrock of the work of the overall Strategy. The metrics for the action plan would need rationalising against the metrics of the Board Strategy to ensure progress was being made. Alongside this, it was confirmed that the item would return in 12 months time to the Board for a progress update. It was requested that the future progress update include the revised metrics.

The Board also queried mental health support teams in schools, and whether the trailblazers originally set up in certain parts of the County would be implemented across the County overall. The ICB had been pursuing this and were pleased to confirm that there was over 40% coverage across the County. And two further teams had been secured for the next financial year, starting in January 2025. These would be targeted based on need. The ICB would continue to work with local authorities to best plan where these teams could be placed, and for areas that did not have this support, the Action for Children service could reach into those schools and provide additional support where required.

Councillor Jessel sought clarification on the additional  ...  view the full minutes text for item 21.

Note by Clerk: This item was considered earlier in the agenda than originally scheduled.

The Board received a presentation from Lisa Cope, Strategic Lead for Right Care, Right Person from Staffordshire Police.

The Board noted the four phases of the Right Care Right Person model, which set out to ensure that better protection could be given to vulnerable members of our communities and provide them with specialist help they need.

-      Phase 1 – would be launched in February 2024 and focusses on reports relating to concerns for welfare and walk-outs of health care facilities

-      Phase 2 – would be launched in May 2024 and focusses on AWOL and walk out of mental health facilities

-      Phase 3 – would launch in August 2024 and focusses on transportation

-      Phase 4 – would launch in November 2024 and focusses on S.136 / management of mental health incidents.

Underpinning the above phases, it was noted that the Police would continue to respond to all incidents where there was an immediate, real and substantial threat to life or risk of significant harm. All incidents would be reviewed on a case by case basis to assess risk, threat and harm and determine if it was right for the RCRP principles to be applied.

Staffordshire Police launched the implementation of RCRP in July 2023 through a number of multi-stakeholder events, noting the phased approach to implementation. They would continue to attend numerous partnership meetings.

A multi-agency partnership group with representatives from across local authorities, health, social care, VCSE and more was established to work through the implications of implementing RCRP and share learning. A single point of contact for stakeholders was also established.

The National Partnership Agreement, published in July 2023 set out the following actions for RCRP and Mental Health:

-      Agreement of a joint multi-agency governance structure for developing, implementing and monitoring the RCRP approach locally.

-      Reaching a shared understanding of the aims of implementing RCRP locally and the roles and responsibilities of each agency in responding to people with mental health needs.

-      Enabling universal access to 24/7 advice, assessment and treatment from mental health professionals for the public (via the NHS111 mental health option).

-      Putting in place arrangements to work towards ending police involvements in situations where the RCRP threshold was note met.

-      Embedding multi-agency ways of working that could support decision making about which service or services were most appropriate to respond to an incident reported to the emergency services.

-      Ensuring arrangements are in place to minimise delays to handovers of care between the police and mental health services.

-      Developing an approach for police and health systems to work together to quickly and efficiently identify the best place to take a person detained under Section 136.

-      Developing local escalation protocols for situations

-      Establishing effective mechanisms to support data collection and sharing across agencies.

-      Developing multi agency training to support decision making and understanding of roles and responsibilities in relation to  ...  view the full minutes text for item 22.

Note by Clerk: This item was considered later in the agenda than originally scheduled.

The Board received the Staffordshire and Stoke-on-Trent Adult Safeguarding Partnership Board (SSASPB) Annual Report for 2022/23 for consideration and feedback.

This annual report covered the period 1^st April 2022 to 31^st March 2023. During this time, Mr John Wood was the independent chair of the Board. The report provided an overview of the work of the Board and its sub-groups and illustrated with case studies as to how the focus on making safeguarding person was making a positive difference to ensuring that adults with care and support needs were supported to make choices in how they would live their lives in a place where they felt safe, secure and free from abuse.

The Board were provided with adult safeguarding data and the Staffordshire headlines for the same reporting period, along with the SSASPB strategic priorities during the reporting period.

A new priority arose from a revision of the SSASPB strategic plan and in response to five themes of significant importance and recurring concern arising from a combination of learning events, this was around ensuring effective practice. Pages 18 – 32 of the annual report provided a comprehensive overview of activities of safeguarding partners in evidencing the changes in practice in response to learning experiences.

The Board thanked John for the comprehensive report and asked what had gone well over the past year, and also if there were any trends or issues providing concern. It was noted that following the revision of the strategic plan, the Safeguarding Partnership had matured and that partners were working to a common and coherent plan with good engagement. John further noted the area for future work around evidencing progress made against lessons learned and strengthening practitioner engagement. Colleagues further discussed the need to identify and recognise self-neglect earlier and more proactively.

Councillor Sutton queried whether self-neglect was linked to those who lose capacity, through dementia or Alzheimer’s in particular. It was clarified that lack of capacity would not be classed as self-neglect but would be dealt with under adult social care through the mental capacity act. Self-neglect would be better defined by people who have more complex needs, drug and alcohol abuse, bereavement etc.

Health colleagues commented on the consistency between Stoke-on-Trent and Staffordshire on the types and location of abuse but queried the correlation between this and national trends. It was noted that the trends were broadly similar from a national and regional perspective, but some anomalies were present in organisational abuse, however this could be attributed to reporting mechanisms. Safeguarding data nationally offered two schools of thought, and it was hoped that the recently started CQC enhanced assurance process would regularise this recording.

Assurance was provided that changes had been made to the management of incoming concerns and how resources were utilised to be more effective. Work streams had been reduced to ensure that response times were improved and most cases were now being dealt with in  ...  view the full minutes text for item 23.

The Board received a report from Jon Topham on the recent audit report undertaken by the Staffordshire County Council Internal Audit team, which sought to provide assurance that the Health and Wellbeing Board was operating in accordance with clearly defined Terms of Reference which aligned with the requirements of the Health and Care Act 2022.

The audit report made several recommendations which focused on updating the Terms of Reference and making minor changes to the Board administration.

A summary of audit findings was presented to the Board based on recommendations made, along with key changes to the Terms of Reference. Quoracy arrangements were clarified along with attendance at meetings. Points around publication of agendas were clarified.

The Board noted the discussion points within the report and were asked whether they were happy with the revised terms of reference presented and the questions raised in the report.

The Board supported the revised terms of reference and arrangements subject to some amendments. The membership of district and borough colleagues was raised, both from an Elected Member and Officer level, and whether this needed broadening to better highlight functions of the districts and boroughs.

Colleagues from the ICB raised a specific query around the job titles referred to in the revised Terms of Reference, and that these would need amending to acknowledge the representatives on the Board.

It was agreed to review the make up of the Board but agree the revised Terms of Reference.

Resolved – That the Board (a) note the findings from the audit report;

(b) discuss and agree the revised Terms of Reference for the Board; and

(c) consider the discussion points in the report.

The Board received an update from Chris Bird on the ICB Joint Forward Plan (JFP), with a note that the Board were ratifying the decision made at the meeting at June 2023, which was invalid due to non-quoracy of the meeting.

Background to the Joint Forward Plan was shown to the Board, referring to the presentation on the 8^th June 2023 and subsequent publication on the 30^th June 2023.

Specific suggested areas for the annual refresh of the JFP were noted by the Board as follows:

-      Reflecting any changes to local authority priorities

-      Long term finance strategy and recovery

-      Impact of ICS wide strategies published since June 2023

-      Wider strategic system development to reflect any new areas of focus.

Next Steps were detailed as the following:

-      First system task and finish group on the 23^rd November 2023

-      Work commenced across portfolios to support refresh;

-      Guidance expected shortly;

-      Updates and refresh of the JFP requested to be presented to the Board on the 7^th March 2024.

Resolved – that the Board (a) note that the JFP was published on the 30^th June 2023 following on from the draft JFP being presented at the Staffordshire Health and Wellbeing Board on the 8^th June 2023;

(b) Formally approve the decision to delegate to the Chair the sign off of the JFP for the Staffordshire Health and Wellbeing Board;

(c) Receive the final Joint Forward Plan published on the 30^th June 2023;

(d) Note that the JFP would require refreshing in line with any new guidance and feedback from ongoing engagement work;

(e) Endorse the approach for the refresh;

(f) Agree to the refresh JFP being presented to the Board on the 7^th March 2024.

The Chair notified the Board that this item would be deferred to the next meeting.

Cllr Jessel queried if the existing Staffordshire Observatory would be superseded by the new publishing of the JSNA. It was clarified that the JSNA would continue to be published on the Observatory, but that the Board’s webpages would be updated in line with the new format.

The Board received the Forward Plan for 2023/24 and noted the following items scheduled for discussion at the 7 March 2024 meeting:

-      Healthy Ageing Priority Progress Update

-      Carers Strategy

-      Staffordshire Better Care Fund

-      Children’s Safeguarding Board Annual Report

-      ICB JFP / Annual Report Sign-off

-      Joint Strategic Needs Assessment update (deferred from the December 2023 meeting)