Agenda and minutes

Apologies for absence were received from S. Brown, C. McEvoy-Carr, R. O’Farrell, and P. Mead, Councillors G. Renner-Thompson and E. Simpson.

Minutes of the meeting of the Health and Wellbeing Board held on Thursday, 14 October 2021 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 14 October 2021, as circulated, be confirmed as a true record and signed by the Chair:

To receive an introduction to the Covid Inequalities Community Impact Assessment; how that will be developed further; and how the council intends to use that to inform recovery plans.  Presentation by Philip Hunter, Senior Service Director.

Members received a detailed report and presentation introducing the Covid Inequalities Community Impact Assessment; how it would be developed further; and how the council intended to use that to inform recovery plans.  Presentation by Philip Hunter, Interim Senior Service Director.

The Assessment was currently in draft form and would be an ongoing area of work to be refreshed and added to as and when new and more up to date information became available.  Members of the Board were encouraged to consider if an inequalities impact assessment of their own area would be helpful to contribute to a richer picture of the issue.  It was intended that the analysis would be used to inform policy and decision making as part of the recovery process.

The detailed presentation highlighted the following areas:-

·            Inequalities Baseline – Pre Covid.  Deprivation was concentrated mainly in the South East of Northumberland but also with pockets elsewhere such as Newbiggin, Berwick upon Tweed and the South West of Northumberland.

·            Covid Response and Inequalities; widening of pre-existing inequalities in mental health, education, income and digital divide.  Increased food insecurity, domestic abuse, social isolation and loneliness, and alcohol use.

·            Vaccine Coverage Inequalities; Despite Northumberland having one of the highest rates of vaccine uptake nationally there was a link between lower take up and more deprived areas.

·            Mental Health particularly of children and young people.

·            Wider Determinants

·            Economic, Jobs and Income – Indicators showed employment increasing slightly and average weekly earnings rising.  However, increases in bills were expected.

·            Poverty – particularly child poverty which remained a challenge.  Food referrals were clustered mainly in the most deprived areas in the South East of Northumberland.  There were clusters elsewhere.  The Citizen’s Advice Bureau was experiencing increased demand for its service.

·            Environment – Journey patterns had returned to pre-covid levels except for journeys to the workplace due to home working.  There was an increase of residents and visitors visiting parks and open spaces.  There was a strong sense of community spirit.

·            Education and Children’s Services

·            Community Safety

The following comments and suggestions were received:-

·            The definitions of poverty, inequality and deprivation should be clarified in the report along with how they linked to a lower uptake of the vaccination.

·            There was a general link to access to and uptake of the vaccine and health care between the more deprived and least deprived areas and there were a number of reasons for that including working conditions making it difficult to take time off and poor health literacy could lead to people not understanding the importance of vaccination or other health care issues.

·            With regard to inequalities, there were systematic differences within the county between geographical areas, communities and age groups in how they accessed services.

·            Recovery – there was little science behind the recovery from the pandemic and it was necessary to look at the recovery experience from events such as flooding, hurricanes etc. to identify the areas to be best focused on.  Community resilience had been identified as a key area to be  ...  view the full minutes text for item 30.

Update on progress on taking a population health management approach and the link to identifying and addressing inequalities.  Presentation by Dr. Robin Hudson, Northumberland CCG.

Members received an update on progress on taking a population health management approach and the link to identifying and addressing inequalities.  Presentation by Dr. Robin Hudson, Northumberland CCG.

Key points from the presentation included:-

·            The System Transformation Board had identified a number of flagship programmes including; Our Children and Young People, Our Workforce, Our Communities, Our Connectivity and Our Culture.  It was important to empower and support local communities to move this agenda forward themselves.

·            There had been an opportunity to engage with the OPTUM programme which gave more understanding of the science and method behind population health management.  The Health Improvement Group chaired by Dr. Hudson, aimed to keep the conversation going between all the stakeholders in the Local Authority, and health care and the voluntary sector.  £1 million had been released to support the population management agenda in 2021/22.

·            Workshops had been held to try and bring together the right stakeholders from the community, public health, general practice and CCG and to identify what work was already taking place.  It was aimed to also look for gaps where there was unmet need.

·            The workforce was essential, and a lot of work had been done with general practice to help them network with their communities.  A primary care network in Wansbeck had already identified child proverty as an issue.   There had been a lot of support from Public Health.

·            The CCG was working closely with the Local Authority and Northumberland Communities Together and had identified ‘Thriving Together’ as a banner.  Communities had come together and there was a lot of energy and creativity.  CAB had been commissioned for a frontline tool called Frontline which any community group could sign into and start referring people to other groups.  There was also a self-referral capacity.  Funding was being made available to the voluntary sector and they would be asked to bid for funds with an emphasis on collaborative working and how they would address health inequalities.

·            An academy or forum was being considered which would bring together the right stakeholders together to agree on what the problem was by looking at the data and then how to solve the problems with interventions.

·            The biggest challenge was culture and how it could be changed to break down those barriers and open lines of communication.

The Chair thanked Dr. Hudson for his presentation.

RESOLVED that the report and presentation be received.

To discuss how the Health and Wellbeing Board may link into the ICS Integrated Care Board and local place based Northumberland System Board.  Presentation by Mark Adams, Accountable Officer, Northumberland/North Tyneside/North Cumbria/Newcastle/Gateshead CCG. 

Members received a presentation and discussed how the Health and Wellbeing Board may link into the ICS Integrated Care Board and local place based Northumberland System Board.  Presentation by Mark Adams, Accountable Officer, Northumberland/North Tyneside/North Cumbria/Newcastle/Gateshead CCG. 

Key points from the presentation included:-

·            A very large Integrated Care System (ICS) was being developed in the area and was expected to come into being in April 2022. It was expected that an Integrated Care Board (ICB) which was a statutory NHS Board would be created along with an Integrated Care Partnership.  The ICS would cover North Cumbria, Northumberland and down to Middlesbrough and the Tees Valley.  Sir Liam Donaldson had been appointed designate Chair of the ICS.  The development of the ICS was now being moved forward quite rapidly.

·            Discussions were taking place with Local Authorities’ Leaders and Executives along with local and regional scrutiny meetings and joint Management Executive Meetings to develop proposals on the ICS governance and operating model.

·            One of the key tasks of the new ICS was to take on board the commissioning functions and responsibilities of the existing CCGs. 

·            The current CCG Commissioning spend across the whole ICS area was approximately £5.33 billion.  Details of how this money was spent was displayed.

·            A lot of consideration was being given to how to structure the ICS’ ways of working.  In general, the ICS would be involved in strategic directions of travel, the strategic priorities and also areas which it was believed would work best across that large footprint.

·            It was planned to devolve down to a place based level including monitoring the quality of local health and care services, continuing primary care commissioning and working with community and local government partners.

·            Participation would continue in Health and Wellbeing Boards and continue to commission local services as close as possible to local communities.  It was planned to continue to build on local strengths to continue to serve the public and patients.

·            Development Timeline – the transition to the ICS was taking place October 2021-April 2022, which would be followed by a period of stabilisation between April 2022-June 2022 and then it would begin to evolve from June 2022 onwards.

·            Details of the core elements of ICB governance arrangements and the proposed membership were shown.

·            The ICB was a unitary Board with responsibility for achieving

·            Improving outcomes in population health and healthcare

·            Tackling inequalities in outcomes, experience and access

·            Enhancing productivity and value for money

·            Supporting boarder social and economic development.

·            Integrated Care Partnership

·            Ethos – to have key role in setting tone and culture of system.  Operating a collective model of accountability, including to local residents

·            Requirements – system partners to determine how the ICP would operate, agree leadership arrangements and functions over and above its statutory responsibilities.  Develop an integrated care strategy for the area.

·            Membership – to include all Local Authorities and representatives to draw on a wide range of partners working to improve health and care in the community and include views of patients  ...  view the full minutes text for item 32.

An update will be provided at the meeting on the epidemiology of COVID 19 in Northumberland, developments with the Council’s COVID 19 Outbreak Prevention and Control Plan, and Vaccination Programme.  Presentation by Liz Morgan, Interim Executive Director for Public Health and Community Services.

Members received updates on the epidemiology of COVID 19 and the Northumberland COVID 19 Outbreak Prevention and Control Plan and COVID Deaths and vaccination programme in Northumberland.  (Presentation filed with the signed minutes).

Gill O’Neill, Interim Deputy Director of Public Health gave a presentation to the Board and key points included:-

·            Seven day rolling rate for England was currently 469 per 100,000 and this was expected to increase as the Omicron variant took over.  Hopefully, measures being put in place would start to slow this increase. 

·            The South East and South West of England were showing the greatest increases and the North East tracking at the lower end at 388 per 100,000.

·            The County Council’s dashboard was showing the latest figures for Northumberland 378 per 100,000.  Rates had been declining but there was now a slight increase.  Within Northumberland’s wards, Prudhoe and Cramlington had the highest rates and Ponteland with the lowest rates.

·            Graph showing seven day average of cases in Northumberland from July 2020 and projected into January 2022.  The graph reflected the changes following removal of restrictions.

·            Graph showing data broken down into age bands - over 75s cases remained low and the highest rates were in the under 25s, mainly in primary school age children.

·            There was a good rate of testing and good offers and opportunities for testing in Northumberland.  Approximately 50% went to testing sites to pick up their PCR kits.

·            For asymptomatic testing there was a national testing programme for care homes and some supported accommodation.  In the community test kits could be collected from pharmacies or ordered online.  A national testing strategy was awaited along with details of funding after the winter period.

·            Northumberland’s Local Tracing Partnership was part of the Local 4 scheme and carried out tracing within the most disadvantaged postcodes within Northumberland.  Details of national strategy and funding after March 2022 were awaited.

·            Omicron (Variant of Concern) - All viruses mutated regularly and were classed as, of concern, if there was evidence of a change that could lead to causing more harm such as an increase in transmissibility or severity of illness.  The Government had announced that Plan B was coming into place and new temporary restrictions.

·            As of 7 December, 2021 there were over 400 confirmed cases of Omicron in England.  UKHSA was managing any confirmed or highly probable cases with a local Incident Management Team.  Confirmed cases were being asked to self-isolate.  Contacts were being asked to also self-isolate irrespective of their age or vaccination status.

·            The Health Protection Board should be maintained, and the Outbreak Management Plan updated. 

·            Key messages to the public remained guidance to be cautious, be considerable and be kind.

Liz Morgan, Executive Director of Public Health and Community Services added the most up to date information:-

·            A large number of changes had been announced yesterday

·            It was becoming very apparent that Omicron was now outcompeting the Delta variant and there was an increase in transmissibility and immune evasion. 

·            There were now 568 confirmed  ...  view the full minutes text for item 33.

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

RESOLVED that the forward plan be noted.

The next meeting will be held on Thursday, 13 January 2022, at 10.00 a.m. at County Hall, Morpeth.

The next meeting will be held on Thursday, 13 January 2022, at 10.00 a.m. in County Hall, Morpeth.