Agenda and minutes

Apologies for absence were received from J. Daniel, P. Mead, L. Morgan, H. Snowden, C. Wardlaw, C. Wheatley, and Councillor G. Renner-Thompson.

Minutes of the meeting of the Health and Wellbeing Board held on Thursday, 13 October 2022 as circulated, to be confirmed as a true record and signed by the Chair.

RESOLVED that the minutes of the meeting of the Health and Wellbeing Board held on 13 October 2022, as circulated, be confirmed as a true record and signed by the Chair.

To receive a presentation from Graeme Binning, Deputy Chief Fire Officer, Northumberland Fire & Rescue Service.

Graeme Binning, Deputy Chief Fire Officer, provided a presentation outlining the Northumberland Fire & Rescue Service’s collaborative approach to safety and wellbeing.  He raised the following key issues:-

•        Statutory duties for Fire & Rescue Services in Fire and Rescue Framework for England 2018, including

•        targeting those individuals or households who are at greatest risk for fire in the home; those most likely to engage in arson or deliberate fire setting……

•        identify individuals’ wider vulnerabilities and exposure to ‘risks beyond fire’.

•        A duty to collaborate and keeping collaboration opportunities under review and not precluding wider collaboration with other local partners, such as local authorities…..’

•        Northumberland Fire & Rescue Service contributed to many elements of the Health and Wellbeing Strategy.

•        General Approach to Intelligence Led.  The Safe & Wellbeing Policy had been launched in July 2022.  Efforts were being made to identify citizens most at risk of injury or harm.  The policy had been produced in conjunction with a number of external partners.  The focus was ‘making every contact count’.

•        A whole systems contribution.  Home fire safety was still a priority along with a wider scope to look at slips, trips and falls, dementia, alcohol and smoking.  An all-risk questionnaire was in place along with referral partner pathways.

•        When we don’t collaborate - an example was described detailing the effects of a fire death and the wider impact of that event on the local community.  This may not have occurred had a number of organisations collaborated

•        When we collaborate - an example was described of a case where organisations had collaborated providing an improved outcome for the person involved.

•        The Fire & Rescue Service welcomed the opportunity to become a member of the Health & Wellbeing Board and to work with other organisations to give the best outcome for the residents of Northumberland.

The following responses were made to comments from Members-

•        The Fire & Rescue Service had committed to its Corporate Parenting Promise which was its committed to Looked After Children and how they would fit into its priorities.

•        An opportunity to work with the Harrogate NHS Trust on its Environmental Assessment Tool was welcomed.

•        The collaboration with Northumberland Communities Together was much appreciated and further work going forward would be welcomed.  Some officers had been identified to work on asset based community training.

•        Future collaboration with CNTW was welcomed and would be discussed outside the meeting.

•        It was acknowledged that there was a need to understand the needs of people who may be deaf or visually impaired.  Some work had already begun in this area.

RESOLVED that the presentation and comments be noted.

To receive verbal updates from each thematic group on what its plans are likely to be going forward and what the governance and membership may be.

Members received verbal updates from the thematic groups as follows:-

Empowering Communities

Gill O’Neill, Deputy Director of Public Health reported as follows:-

The three priorities for this thematic group contained in the Strategy were:

•        Ensure that partners, providers, practitioners and the systems they work in promote and encompass a 'more than medicine' approach.

•        Provide people and communities with access to networks and activities which will support good health and resilience.

•        Support people to gain knowledge, skills and confidence they need to be active partners in managing and understanding their own health and health care.

There had been significant organisational and system change since the priorities were agreed and there had still been a lot of progress on this work since the strategy was written and now there were:

•        NCT and its Strategic Board

•        Thriving Together and the 13 thematic networks

o        Tackling inequalities task force (operational)

•        VCSE Liaison Group

•        Inequalities Plan and the HWBB Steering Group

•        ICS level -scoping the social prescribing offer 

•        Health Watch board

It had been discussed if this was about strategically creating a collaborative approach to asset based community development and doing that through our wider workforce inclusive of social prescribers, health trainers, link workers, locality coordinators etc. 

It was proposed that the first steps would be:

•        Chairs of the groups listed above to talk to their groups about coming together in a system workshop to scope out a gap analysis of what and how we were already working towards the priorities in the strategy and where we might wish to focus our collective attention.

•        Workshop December/January to discuss and agree how to work collaboratively across existing groups and if one group could be morphed to become the Empowering People and Communities Thematic Board or if individual groups were retained but to agree to come together a few times a year to ensure cohesive practice and delivery.

•        To report back to Health & Wellbeing Board in January/February pending agreement of the workshop date.

Best Start in Life

Graham Reiter, Service Director - Children's Social Care and Interim DCS, provided the following update:-

•        Best quality education

•        Children feeling safe and supported in all areas of life

•        Support children, young people and their families to make positive lifestyle and social choices.

The Department was already looking at the range of governance arrangements in place regarding partnership work around safeguarding children and young people strategic plan, healthy families.  These could be streamlined to sit under this thematic area.  There were a number of activities ongoing including:-

•        Wholesale review of education provision

•        Continue to invest in the capital programmes to create an environment which promoted learning.

•        Work with schools via school improvements to target children with free school meals who need additional support to reach their potential.

•        Maximise the use of the pupil premium.

•        Ensure that children and young people get the right support at the right time.  First point of  ...  view the full minutes text for item 106.

To verbally receive progress updates from representatives of partner organisations about their sign up to and commitment to the plan.

Graham Syers reported that all member organisations had been requested to take away the essence of the Inequalities Plan and ensure that their organisations had an understanding of it and were signed up to it.  Members were requested to update the Board on what stage their organisation was at.  It was suggested that organisations be requested to formally sign up at the December meeting of the Health & Wellbeing Board.

From a Primary Care perspective, it had been discussed with PCN Groups and there was a part of the Primary Care Commissioned Service which was about asking practices as part of their primary care groupings to commit to a piece of work.  It had already been agreed that the primary care networks would sign up to the Compact.

Within CNTW, the Inequalities Plan fitted perfectly with what the organisation was already pulling together in its Annual Plan.  It was confirmed that the Northumbria Trust was ‘walking the walk’ and there were already a number of inequalities conversations going on between clinicians.

RESOLVED that partner organisations be requested to formally sign up to the Inequalities Plan at the Health & Wellbeing Board meeting on 8 December 2022.

To receive a verbal update by Liz Morgan, Interim Executive Director for Public Health and Community Services.

Members received a verbal update from Gill O’Neill and an update on the Covid and flu vaccination programme from Rachel Mitcheson, NENC ICB Northumberland.

Gill O’Neill raised the following key points:-

•        ONS Survey data at 4 November 2022 was showing a decline in Covid cases across England with an estimated 1:35 people testing positive. 

•        In Northumberland, estimated cases identified from lateral flow and PCR tests was also declining with 46.63 per 100,000 testing positive.

•        The ‘Hands, Face, Space’ message remained the same and it was important to remain vigilant and to prioritise vaccination.  In crowded spaces, masks remained an option.  Now that we were moving into winter, with both Covid and flu circulating it was important to keep the airflow moving and if feeling unwell to stay at home, if possible. 

Rachel Mitcheson, NENC ICB, and Alistair Blair, Northumbria Healthcare Trust updated Members on the current Covid and flu vaccination programmes and hospital situation and raised the following key points:-

•        111,000 booster jabs had been delivered in Northumberland and the uptake across all eligible cohorts was 57.3% which was above the England and North East and Cumbria averages.

•        It was vital to maintain momentum, particularly with regard to the 50-64 year age group as this group appeared to be less keen to come forward.  A new national campaign had been launched.

•        Vaccinations were still being carried out in care homes where there had previously been outbreaks preventing the vaccination teams from entering.

•        Over the last few months, the number of hospital cases with Covid had not been admitted because of Covid had decreased. 

•        It was important not to look at Covid in isolation but to also look at flu.  Data from Australia had indicated that a high number of flu cases should be expected earlier in the season than normal, but this had not happened to date.

•        It was expected that Covid cases would continue to plateau off over the next month but there was some epidemiological evidence that they may pick up again in January 2023.

•        Covid was not the cause of operational pressures at the moment.

RESOLVED that the updates be received.

To note/discuss details of forthcoming agenda items at future meetings; the latest version is enclosed.

Members discussed a number of items for inclusion in or removal from the Forward Plan.  It was suggested that ‘Living with Covid’ be removed from the Forward Plan on the understanding that it could return should Covid become a concern again in the future.

RESOLVED that the Forward Plan be noted with the following additions.

•        Northumbria Police Presentation

•        Inequalities Plan – Compact Sign Up

•        0-19 Service Structure and Model

•        Northumberland Communities Together Update to include cost of living crisis and warm hubs.

•        Better Care Fund Plan

•        System Pressures to include GP services and Accident & Emergency service.

•        Core20Plus5

It was possible that some items may be more appropriately dealt with in informal Development Sessions in the future.

To consider such other business as, in the opinion of the Chair, should, by reason of special circumstances, be considered as a matter of urgency.

The Chair reported that he had been made aware of the following and agreed that they be raised as items of urgent business.

The Chair reported that he was attending the next Joint OSC for the North East and North Cumbria ICS and North & Central ICPS.  He was happy to raise any issues at the meeting which Members may give to him.

The next meeting will be held on Thursday, 1 December 2022, at 10.00 a.m. at County Hall, Morpeth. 

The next meeting will be held on Thursday, 8 December 2022, at 10.00 a.m. in County Hall, Morpeth.

To receive a presentation from Peter Rooney, Director of Strategy and Planning.  The draft Strategy and a document explaining the development of the Strategy are attached for information.

Members received a presentation from Peter Rooney, Director of Strategy and Planning NENC ICB Northumberland.  A copy of the presentation is filed with the signed minutes.

Mr. Rooney made the following key points:-

•        The Integrated Care Strategy (ICP) was a statutory committee involving partner organisations and stakeholders and formed part of the arrangements for the Integrated Care System (ICS).  It was required to develop an Integrated Care Strategy by December 2022.  ICBs and local authorities were required to have regard to the strategy when making decisions and commissioning or delivering services.  The strategy must use the best evidence.

•        The structure, and overarching visions, goals and enables were outlined.  The vision was to create better health and wellbeing for all through longer healthier life expectancy, excellent health care services and fairer health outcomes.  This could be achieved through the workforce, working together to strengthen communities, using improved technology, equipment and facilities, and making best use of resources and protecting the environment

•        Assets and Case for Change – health outcomes were some of the worst in England with inequalities correlating with socio-economic deprivation.  Life expectancy and healthy life expectancy for both women and men were lower than the England average.

•        Draft Key Commitments were:-

•        Reduce the gap in healthy life expectancy

•        Reduce smoking prevalence from 13% of over 18s in 2020 to 5% of below in 2030.

•        Reduce inequality in life expectancy between the most deprived and least deprived deciles within ICP by 25% by 2030.

•        Reduce suicide rate to below England average in 2019/21 by 2030.

•        The Core20plus5 approach was designed to support ICS to drive targeted action in healthcare inequalities improvement.  Aimed at the most deprived 20% and at the following five key clinical areas; maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis, hypertension case finding

•        It was aimed to achieve a ‘Good’ or ‘Outstanding’ CQC rating and improve sustainability of the most challenged parts of the system.  To enable personalised care and improve support to unpaid carers.  The development of provider collaboration would be supported.  To ensure parity of esteem between mental health, learning disability, autism services and physical health.  Integration to be improved and services valued equally across sectors.

•        A lot of engagement work was taking place and any feedback on the draft strategy was welcomed.

•        It was hoped that the local areas would continue with the fantastic work they were already doing. 

•        The draft would be considered again by the ICP on 15 December 2022.

The following comments and responses were made:-

•        It was possible that when targets were set for such a large geographical area such as Northumberland, some measures may disadvantage some other areas and it was important to avoid this.  Improvements in all metrics, everywhere was desirable but obviously, the biggest improvement should be where it was most needed.  Some difficult decisions would need to be made.  Some measures had a minimum baseline which should not be reduced  ...  view the full minutes text for item 112.