Agenda and minutes

Apologies for absence were received from Suzanne Lamb, Victoria McFarlane-Reid, Rob Murfin, Claire Wheatley and Councillors W. Pattison, H.G.H. Sanderson, L. Simpson and J. Watson.

Minutes of the meeting of the Health and Wellbeing Board held on Thursday, 12 January 2023 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 12 January 2023, as circulated, be confirmed as a true record and signed by the Chair.

To receive the independent Director of Public Health Annual Report for 2021/22 which is focused on healthy weight in children and highlights the importance of creating the conditions to enable all children to be a healthy weight.  The report will be presented by Gill O’Neill, Executive Director of Public Health, Inequalities and Stronger Communities, and Kaat Marynissen.

Members received the independent Director of Public Health Annual Report for 2021/22 which focused on healthy weight in children and highlighted the importance of creating the conditions to enable all children to be a healthy weight.  The report was introduced by Gill O’Neill, Executive Director of Public Health, Inequalities and Stronger Communities, and a presentation made by Kaat Marynissen, Public Health Trainee.  A copy of the presentation is filed with the signed minutes.

Gill O’Neill reported that this was Liz Morgan’s final report and a good legacy for her on this important issue.  Many Board Members had contributed to the report, and it was added that all of the case studies were Northumberland based.  Kaat Marynissen highlighted the key points of the Annual Report:

•       Healthy weight was incredibly important for physical and mental health being associated with lower rates of anxiety and depression.  Children were more likely to do well at school.  Economically, there were huge benefits as obesity was the second highest burden on the NHS after smoking.

•       In Northumberland in 2020/21, 26.7% of children aged 4-5 years were overweight or had obese and 40% by the age of 10-11 years.  2021/22 figures were very similar.  Covid did have an effect with a national trend of increased obesity and there was still an increase on pre-pandemic figures.

•       Obesity was more likely to affect boys, particularly relating to severe obesity.  The Northumberland trend was following the national trend.  Poorer households were disproportionately affected by obesity

•       It was now believed that obesity was not just individual responsibility and ‘willpower’ but also caused by environmental factors.  Within the home, barriers to healthy weight included increased portion sizes, healthy food was less affordable than calorie dense alternatives particularly for poorer households.  Poorer households had to spend almost half of their disposable income to eat healthily, whereas it was only 11% for the wealthiest fifth of households.  The cost of living crisis was creating increased use of food banks.  Breastfeeding rates were increasing in Northumberland over the last three years but was still below the national average.

•       Reliance on takeaway food had increased during the pandemic and this trend was continuing.  Advertising also tended to be for more unhealthy food (HFSS – high in fat, salt and sugar).  Barriers to physical activity included access to equipment, confidence and skills (such as cycling).  Northumberland was a car dependent culture due to its rurality.

•       Schools were trying to add physical activity in the daily routine and provide healthy and nutritious food.  There was an issue for some families which were not eligible for free school meals but could not afford to provide a healthy packed lunch and may resort to unhealthier options.  Physical activity was known to reduce with age especially in girls. 

•       There was still a lack of recognition of weight issues amongst parents and healthcare professionals and a lot of stigma surrounding weight.  This made it difficult to breakdown some of the barriers.  A lot of  ...  view the full minutes text for item 134.

To receive an update report describing progress to date and giving assurance that the team delivers a high quality, responsive and effective service to the children, young people and families of Northumberland.  The report will be presented by Ashley Iceton, Harrogate & District NHS Foundation Trust.

Members received an update report describing progress to date and giving assurance that the team delivers a high quality, responsive and effective service to the children, young people and families of Northumberland.  A detailed presentation was provided by Ashley Iceton and Samantha Anderson, Harrogate & District NHS Foundation Trust and is filed with the signed minutes.

The following key areas were raised:-

•       The 0-19 Service Model aimed to meet the key priorities of the partnership arrangements and support integration and collaboration with local authority partners, Family Hub model and key stakeholders. 

•       Restructuring changes were influenced by experience and best practice and the model would evolve and developing to respond to local and national changes and need. Key contacts and structure was displayed for information.

•       Three areas had been agreed; the North, Central South East and Central West.  Some managers were in post and recruitment for other posts was ongoing.

•       Three pillars had been introduced to deliver the 5-19 service – Safeguarding, Emotional Health and Resilience, and Public Health with each pillar having a lead.

•       Key Performance Indicators were displayed covering antenatal to 2.5 years.

•       Infant Feeding Pillar – this was led by a specialist nurse and an action plan was in place to lead the service going forward.  Support would be available throughout the county in line with UNICEF standards

•       Public Health Pillar – referral criteria were listed. 

•       School profiles would be offered to all schools in Northumberland and schools would be asked to identify three priorities and these would include digital delivery, targeted delivery into schools or signposting within the system.  NCMP screening would be offered throughout the year. 

•       There had been a surge in referrals for children with low mood and low level anxiety.  A waiting list was in operation and parents/carers received a list of other potential resources which they could access.

•       Emotional Health and Resilience Pillar – partnership working to develop a service criteria to support early intervention and level 1 support.  Sensory pathway was being developed with partners to enable support for children and young people with possible neurodiversity.   There was a long term plan to appoint four Children’s Psychological Wellbeing Practitioners.

•       Safeguarding Pillar – Safeguarding clinical lead posts had been appointed and their role would be to include face to face support for complex case management

•       Innovative Roles – new roles included Community Anchor, Community Triage Nurse and The Project Support Officer

•       Estates Strategy – a sustainable estates strategy had been designed to meet the needs of the service and residents.  A first move had been made in the west of the county.  Work to develop and strengthen relationships with GP practices would be ongoing.  Clinical staff would be able to go out to carry out their work but still have a single point of contact manned by administrative staff.

•       Key achievements and quality improvements 2021-23 were listed.

•       Key challenges and areas for development were listed.

The following comments were  ...  view the full minutes text for item 135.

To receive a brief overview of the programmes approved by the ICB Executive and highlights how this will benefits residents in Northumberland.  The report will be presented by Gill O’Neill, Executive Director of Public Health, Inequalities and Stronger Communities.

Members received a brief overview of the programmes approved by the ICB Executive and highlights how this will benefits residents in Northumberland.  The report was presented by Gill O’Neill, Executive Director of Public Health, Inequalities and Stronger Communities.

RESOLVED that the report be received.

To receive a presentation from Pamela Phelps, Senior Head of Commissioning Primary Care (NENC ICB), and Hilary Snowdon, Local Medical Committee.

Members received a presentation from Pamela Phelps, Senior Head of Commissioning Primary Care (NENC ICB), and Hilary Snowdon, Local Medical Committee.  A copy of the presentation is filed with the signed minutes.

The following key points were raised:

•       There were 36 practices which was down 10 since 2013/14 but with an increase in the number of patients of 12,000.  The ‘weighted’ element of that population registered with a practice had increased by 30,000.  This was leading to more complexity with patients when converted into workload, and complexities and more time and capacity was needed to support families.

•       An overview of the workforce was shown and also the age profile with the population of Northumberland seeking support from Primary Care and General Practice. There had been an increase of 130 in staff employed by practices across Northumberland but a small decrease in the number of GPs.  The increase in staff reflected a shift in patients’ reliance on just seeing a GP and realising that support was also aware at pharmacies, physiotherapists etc.

•       An overview of the Primary Care estate, main sites and surgeries had been carried out.  A number of surgeries needed to expand due to the number of patients needing to be seen.  The required capacity for appointments and in the estate were being looked at and also to align with other services such as the 0-19 service and mental health.

•       There was a marked increase in the number of appointments even from before Covid.  Details were given of the number of appointments available in Northumberland and the numbers of face to face appointments and home visits.  82% of patients got an appointment within two weeks.  The demographics and demand varied between practices and was reflective of the populations registered and the workforce skill mix in each.  It was stressed that the data set did not include all appointments.  Unfortunately, there was an increasing trend in missed appointments when the patient did not attend.

•       In order to improve patient experience, it was important to understand patient experience.  A five year Delivery Plan was being produced across the ICB and focusing on primary care, so including dentistry, optometry and pharmacy.  There would be an emphasis on patients being cared for by the Primary Healthcare Team within a practice and not just their GP.

•       It was important that the Health & Wellbeing Board had the opportunity to inform this agenda.

The following comments were made:-

•       It was noted that work to make healthcare services more accessible to fishermen at Amble had been very well received and it was suggested that a similar arrangement be considered for hill farmers.

•       The public did feel that there was an access problem locally and nationally.  There was a need to move away from the term General Practice and more towards Primary Care Teams.  There was a view by some that if you did not see your GP, then you were not receiving the best care, however, the most appropriate  ...  view the full minutes text for item 137.

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

Members noted details of forthcoming agenda items at future meetings; the latest version is enclosed.

The next meeting will be held on Thursday, 13 April 2023, at 10.00 a.m. at County Hall, Morpeth.

The next meeting will be held on Thursday, 13 April 2023, at 10.00 am in County Hall, Morpeth.