Agenda and draft minutes

Russell Hardy South Warwickshire Foundation Trust and George Eliot Hospital Trust and Julie Grant NHS England and Improvement. Councillor Parsons advised that he would need to leave the meeting early.

None.

Draft minutes of the previous meeting are attached for approval.

The Minutes of the Health and Wellbeing Board held on 6 January 2021 were approved.

The Chair welcomed everyone to this additional meeting of the Board, outlining the key items to be considered.

It was reported that this was the last meeting of the Board before the County Council elections. The Chair, Councillor Les Caborn was retiring from office and tributes for his service were led by Councillor Izzi Seccombe, Leader of the County Council. She spoke of the way the board and partnership working had been developed under his leadership, including the alignment with Coventry. There were many contributions from Board members paying tribute to Councillor Caborn for his service to the area, both verbally and through the meeting’s chat dialogue. Nigel Minns advised that his service spanned over thirty years, with numerous roles undertaken for children’s services, health scrutiny, the place forum, its underpinning concordat and the year of wellbeing. More recently his role as portfolio holder during the Covid-19 pandemic and leadership of a member engagement board. His leadership of meetings, ensuring all parties were heard, and numerous examples were given of the initiatives he had championed. Tributes were paid by Sir Chris Ham on behalf of the Health and Care Partnership and by Chris Bain for Healthwatch Warwickshire, who considered Councillor Caborn a consistent champion for partnership working and patient voice. Councillor Judy Falp spoke of his work at Warwick District Council and the engagement with all councils. Further contributions from Councillor Dave Parsons and Dame Stella Manzie who spoke on behalf of the NHS partners. The Chair responded thanking everyone for their kind comments and the support received from partners.

Dr Shade Agboola, Director of Public Health will provide a presentation on her statutory annual report.

It was reported that the Director of Public Health (DPH) had a statutory requirement to write an annual report on the health and wellbeing of the population, and the local authority was required to publish it. The theme of this year’s report was the impact of Covid-19 on health inequalities in Warwickshire.

The covering report provided key headlines with an update on the health and wellbeing of the Warwickshire population, the impact of Covid-19 on health inequalities and progress on the 2019 recommendations. It was supplemented by a presentation from Dr Shade Agboola, Warwickshire DPH. The presentation covered the following areas:

• Overview – it was confirmed that this was a draft report at this stage
• Progress on 2019 recommendations
• Picture of health and wellbeing in Warwickshire
• Healthy life expectancy
• Deprivation
• Warwickshire continued to face several public health challenges
• Covid-19 in Warwickshire
• Covid-19 and impact on health inequalities
• Experience of testing positive with Covid-19 in Warwickshire
• Living through lockdown in Warwickshire
• Amidst all the challenges, there had been some positives
• Challenges of lockdown
• Homelessness
• Loneliness and social isolation in older adults
• Young people with mental health needs
• Family poverty
• Adults with learning disabilities
• The Director of Public Health’s recommendations for 2021
  • ‘Health in all’ policies
  • Health inequalities
  • Community engagement
  • Prevention
  • Communication
• Next steps – the final report would be published in the week commencing 22 March

Further sections set out the proposals for dissemination of the report and an audit process, including a peer review by external public health colleagues.

The Chair thanked Dr Shade Agboola for the excellent report and paid tribute to her for the response to the Covid-19 Pandemic, during her first year as DPH. Questions and comments were invited, with responses provided as indicated:

• It was agreed that the presentation slides and the final DPH report would be circulated.
• The focus on health inequalities was commended.
• In responding to the pandemic, reference had been made to the joined up working of the public sector. There was also recognition of the private sector contribution, an example being the food supply chain services. These comments were noted.
• It was questioned if the impact on peoples’ health could be quantified for other medical conditions such as cancer and heart disease, due to delayed diagnosis resulting from Covid-19. The annual report did reference wider issues such as cancelled elective procedures and reduced access to dentistry services. Other issues were beyond the scope of the annual report but were important and needed to be considered.
• It would be useful to draw out the learning from the pandemic to inform the response to future pandemics. This point would be raised with the project board, to see how it could be incorporated.

Resolved

That the Health and Wellbeing Board:

1. Notes and supports the draft Director of Public Health Annual Report 2020/21.

Agrees to endorse the recommendations stated in the report.

The Health and Wellbeing Strategy is submitted for the Board’s approval – Nigel Minns / Gemma McKinnon

The Board gave consideration to the final draft of its Health and Wellbeing Strategy (HWBS). It had been drafted using findings from the most recent Joint Strategic Needs Assessment (JSNA), a Covid-19 recovery survey and a health impact assessment (HIA).

A survey was undertaken to consult with Warwickshire residents on the draft HWBS, with details provided of the mechanisms used and Appendix 1 to the report detailed the outcomes from the survey. The executive summary pulled out key data from the consultation. Specifically, responses were sought to the following ambitions:

• People will lead a healthy and independent life
• People will be part of a strong community.
• People will have access to effective and sustainable services

The feedback against each ambition was reported, together with some concerns around partnership and ensuring that the voluntary and community sector was involved fully. The executive summary and appendix provided more detail on this. Working collaboratively with a wide range of diverse communities was recognised as a key to success. Consultee feedback was provided on the proposed focuses for the Board.

The draft strategy was reviewed in light of the consultation findings and examples were provided of the changes made, strengthening partnership aspects, inclusion of the voluntary and community sector and in relation to implementation and monitoring. The draft HWBS had been updated to reflect the ambition to work with communities, to ensure cultural competence and to develop accessible, responsive, and high-quality services designed in a way to reduce inequalities in health.

Next steps were reported in terms of sharing feedback and subject to approval, the development of delivery and local implementation plans and an outcomes framework.

The report was accompanied by a presentation from Nigel Minns on the consultation findings and the final draft of the HWBS, which covered the following areas:

• Consultation – process and responses; there were 562 responses to the surveys.
• Headline findings, with the majority of respondents supporting the three ambitions and priorities for the next two years.
• Key findings and response. This outlined feedback on partnership and collaboration aspects, implementation/monitoring and the review of priorities after two years, together with the reviews made to the draft strategy.
• A plan on a page showing Warwickshire’s population health framework.
• Next steps in response to the consultation and in delivering the strategy.

The Chair commended the document as a step change, providing a positive way forward. It had also been endorsed by the leaders of all district and borough councils in Warwickshire. Discussion took place on the following areas:

• A key aspect would be linking both the Warwickshire and Coventry HWBSs to the Integrated Care System / Health and Care Partnership work. There were complex structures in place. To achieve desired outcomes, a need to trace lines of action and their impacts in the short and longer term, to show the outcomes to the public and the anticipated timescales. It was agreed this was important, with reference to the implementation plan which should be a combination of the three implementation plans at  ...  view the full minutes text for item 3.

The Homelessness Strategy is submitted for the Board’s consideration and approval – Emily Fernandez

It was reported that in 2019, the Board approved formation of a Homelessness Strategic Group which commenced work on a countywide strategy on tackling and reducing homelessness.

An update was provided, which included a presentation from Lisa Barker Head of Housing at Warwick District Council and Emily Fernandez from WCC Public Health. The presentation covered the following areas:

• Countywide homelessness conference
• The approvals given previously by the Board
• Partners involved
• Engagement and collaboration
• Chapter themes
• Homeless strategy strategic vision and priorities
• Homelessness and health – what the evidence tells us
• Health recommendations
• Challenges for delivery
• Next steps

The Warwickshire Homeless Strategic Group had been working collaboratively across a wide range of partners, writing a countywide strategy on preventing homelessness. Development of the strategy had been delayed for several months due to Covid-19. A concerted effort had been made to bring it to fruition. The completed strategy had been taken through district and borough council governance processes, ahead of this report being submitted.

A section of the report focussed on the development of the strategy, including the strategic priorities of health, financial inclusion, young people, domestic abuse and offending. Countywide strategy engagement was undertaken. The recommendations and content had been refined following this engagement, to ensure relevant comments were reflected within the strategy. An appendix to the report provided a detailed analysis of the feedback. The covering report highlighted this feedback and the support for proposed priorities / recommendations either in total, or to some extent. Qualitative feedback from the engagement had resulted in further changes to the strategy.

In terms of next steps, the homelessness strategic group would continue to work collaboratively and to develop an action plan to underpin the strategic recommendations. This would result in the development of workstreams, to achieve the strategic vision and periodic updates would be provided.

The Chair thanked the officers for the presentation. Questions and comments were invited, with responses provided as indicated:

• Councillor Falp welcomed the strategy and particularly the section on tackling domestic abuse. A question on the arrangements for refuge provision and how the strategy would align if those placements were out of County. Reference also to the Government Bill on domestic abuse and the duty of care for authorities to assist people from any area balanced against the limits on available accommodation.
• Emily Fernandez spoke of the plans for a working group on safe accommodation. This would look at the issues referenced, such as cross border arrangements. The Bill provided a good opportunity to look at the challenges from domestic abuse and homelessness across partnerships and organisational boundaries.
• Lisa Barker added that the vast majority of abuse was against women and at times relocation out of county, even temporarily, may be appropriate, especially if cases involved stalking. Not all people needed refuge accommodation, but it was crucial to provide help and support. It was correct that people could approach any council to receive support to escape domestic abuse.
• Becky Hale updated on the recommissioning of domestic abuse support services,  ...  view the full minutes text for item 4.

To receive the minutes of the Health and Wellbeing Board Sub-Committee meeting.

It was reported that, at its meeting on 6 January 2021, the Board received an update on the Better Care Fund (BCF) Plan. It delegated authority to a sub-committee to give final consideration to the BCF Plan for 2020/21.

The sub-committee met for this purpose on 29 January 2021. A copy of the meeting documents were publicised to all members of the Board. The Minutes of the meeting were submitted.

Resolved

That the Board notes the decisions taken by the Health and Wellbeing Board Sub-Committee at its meeting on 29 January 2021.