Agenda and minutes

Apologies were received from Colin Hilton (Jacqueline Wilson deputised) and Kathryn Singh (Paul Wilkin deputised).

The Chair welcomed Ian Margerison, Macmillan Involvement Co-ordinator who was observing today’s meeting.

The Chair advised the Board that she had agreed to a request to defer agenda item no. 10 (Doncaster Libraries and Culture Supporting Wellbeing) to the Board’s next meeting.

(A period not exceeding 15 minutes for questions from members of the public.)

There were no questions from the public.

No declarations of interest were made.

RESOLVED that, subject to the addition of Peter Dale’s name to the list of those in attendance, the minutes of the meeting of the Health and Wellbeing Board held on 5th November 2015 be approved as a correct record and signed by the Chair.

(Verbal update)

As requested at a previous meeting, the Board received a presentation on the Obesity priority area and was asked to consider proposals to move away from providing small-scale, local weight management services and initiatives towards a whole systems approach to obesity.

Elaine Thompson, Public Health Improvement Coordinator, outlined in detail the current position in Doncaster with regard to the prevalence of obesity amongst the Borough’s population and the harmful effects that this had, the current services provided and the need to move towards a whole system approach (WSA) to tackling obesity in the future.  It was noted that a WSA would allow for a longer term, more sustainable plan to be put in place and this would have a much wider focus on tackling obesity, rather than continuing to deliver small-scale initiatives that were showing little, if any, improvement.  In particular, the Board noted the following points:-

·         Currently the prevalence of people who were classified as being overweight or obese across Doncaster was considerably higher than the England average.

·         In Doncaster, it was estimated that over 7000 children (aged 2-15) and 71,000 adults (16+) were classified as obese.

·         The proportion of overweight and obese adults was estimated to rise to 74.4% last year, and the 2014/15 data from the National Child Measurement Programme (NCMP) showed that 34% of 10-11 year old children and 22% of 4-5 year olds in Doncaster were overweight and obese.

·         Childhood obesity can be associated with emotional and behavioural problems from a very young age, weight related teasing and bullying and increases in school absenteeism.

·         The harmful effects of obesity on communities included long term health conditions which placed increasing demands on social care services and resulted in lost productivity for employers.

·         With regard to current services, despite what appeared to be a comprehensive pathway of service provision, there was very little change – in fact, the NCMP figures for 2014/15 suggested that children were becoming more obese during their school years.  Although obesity was a Health and Wellbeing priority, current provision was piecemeal and involved the commissioning of small scale services.  Given the reduction in the Public Health Grant, it was no longer possible to work in this small scale manner and there was a need to consider other wider reaching methods of tackling obesity across the lifespan but especially in children.

·         A whole system approach was needed in order to address those factors influencing obesity that were outside an individual’s control and which required society wide action to change.  These included:

o    Creating an environment where it was easy for people to shop healthily, do physical activity, spend time doing positive things with families and friends, travel actively, cook affordable healthy meals and have good mental health and resilience;

o    Ensuring people had enough money and the right skills, knowledge and equipment to feed themselves and their families;

These measures required input society-wide from a range of partners across statutory, voluntary, community and private sectors.  In order to work towards this approach, Public Health  ...  view the full minutes text for item 42.

(Paper attached)

The Board considered the final draft of the Doncaster Health and Wellbeing Strategy 2016-21, together with the Due Regard Statement 2015-21, for endorsement and subsequent referral to Full Council for adoption. 

In presenting the Strategy, Louise Robson summarised the latest changes made to the document.  During subsequent discussion, Members endorsed the Strategy for recommendation to Full Council, subject to making the following observations/comments:

·         The Mission Statement on page 8 should be amended to read “Prevent disease, disability and harm, and sustain health and wellbeing through a world class health and care system.”  It was also suggested that the use of the words ‘world class’ should be reviewed.

·         It was pointed out that the last bullet point on page 7 of the Strategy, which read “Ofsted recognised improvements in services for children in need of safeguarding, looked after children and care leavers, including ‘Good’ services for looked after children”, was inaccurate as the ‘Good’ rating had been given for the adoption service.

·         A view was expressed that the section on Children and Families on page 18 was still quite narrow in its focus, as it only referred to the Stronger Families programme and not to any other services.

After Members had discussed the issue of the alignment of the planning frameworks of the various partnership bodies and the need for a clearer understanding of the wider relationships between each of the thematics, it was

RESOLVED that, subject to the above comments and further minor drafting amendments,  the final draft of the Doncaster Health and Wellbeing Strategy 2016-21, including the Due Regard Statement 2015-21, be approved for recommendation to Full Council for adoption.

(Verbal update)

The Board received a detailed update by Chris Stainforth on the latest position regarding the development of the Better Care Fund (BCF).  In particular, the Board was briefed on the following key issues:

·         The planning guidance from the NHS in respect of the Better Care Fund for 2016/2017;

·         The services currently funded from the BCF;

·         The performance targets that were being looked at nationally; and

·         Changes to the governance arrangements to manage the individual workstreams.

During subsequent discussion on issues relating to the BCF, Board Members commented on/noted the following:-

·         The proposed use of ‘place based plans’ was welcomed;

·         There was a need to ensure that real transformation took place, rather than relying upon the BCF to prop up services;

·         Currently the focus was on 3 main transformation areas:

o   Urgent Care system – this was being redesigned in line with the recommendations from Professor Keith Willett’s Urgent and Emergency Care Review report;

o   Intermediate Care Service – ways of improving services received by dementia patients were being looked at; and

o   Primary Care Strategy/System – there was a need to identify alternative methods of delivering primary care services.  Once this work was done, the findings would be brought to this Board at the appropriate time.

RESOLVED to note the update on the progress and future of the Better Care Fund.

(Verbal Item/Presentation)

This item was deferred until the next meeting.

(Paper attached)

The Board considered a report which outlined a proposal to broaden the content of the Home Safety Checks conducted by the South Yorkshire Fire and Rescue Services (SYFRS) to include Health and Wellbeing messages and the introduction of preventative activities.  The Board also viewed a video which illustrated the wide range of services provided by SYFRS.

In presenting the paper, Steve Helps explained that within Doncaster a steering group comprising representatives from Public Health, CCG commissioning, St Ledger Homes, Age UK and SYFRS was working towards the introduction of Fire and Rescue Service led Safe and Well Visits across the Borough.  The introduction of Safe and Well Checks in Doncaster would enable closer working between key agencies who shared responsibility for supporting vulnerable older people across the Borough.

Taking into account the local priorities identified through the Joint Strategic Needs Assessment and the Health and Wellbeing Board, the Safe and Well Visit would focus on ageing safely, falls prevention, fire safety in the home and crime prevention, with established signposting pathways in place to enable additional support through the most appropriate partners.

It was noted that training of SYFRS staff would be through accredited courses provided by the Royal Society of Public Health with Safe and Well Visits being delivered from 1^st April 2016.

During subsequent discussion, Members gave their full support for this initiative.

In response to a comment, Steve Helps confirmed that the Fire and Health conference to be held on the 16^th Feb 2016 and hosted by SYFRS was aimed at identifying the current and future joint working between Fire and Health service partners.  Invites to this event had been sent out to senior managers who worked across the various health and social care providers.

It was then

RESOLVED to note and support the proposed introduction by SYFRS of Safe and Well Visits within Doncaster.

(Presentation)

The Board received a presentation by Oliver Judges outlining the One Public Estate and the Doncaster Health Partnerships Joint Assets Strategy, which essentially looked at ways of co-locating and working together to reduce costs on buildings whilst supporting improvement to services.

It was noted that the key focus was to reduce the cost of the Health and Public estate by reducing the number of buildings and supporting the protection of front line services.  This also brought an opportunity to reorganise service locations making them more accessible and, working under a single system approach, to improve service levels, experience of the service and efficiencies.

Having outlined the aims and objectives of the One Public Estate, Oliver Judges explained how this work would be taken forward.  It was reported that funding had been awarded to support the delivery of the Programme, and that a cross-public sector Operational Assets Board and One Public Sector Project Delivery Team had been established.

Discussion followed, during which Dr Rupert Suckling pointed out that it was important to remember that there were also other third sector partner assets and non-public estate properties situated across the Borough.  In reply, Oliver Judges confirmed that work was ongoing in relation to mapping the distribution of various property assets in the Borough but he acknowledged that there was scope for collecting more data in respect of third sector assets.

After Members had agreed that it would be useful to receive the Doncaster Health Partnerships Joint Assets Strategy at a future meeting of this Board, it was

RESOLVED to:

1)        note the potential of the One Public estate and agree to work together to deliver projects under this initiative;

2)        note the development of a new Health Partnership Estates Strategy and request that this be submitted to a future meeting of the Board when completed.

(Paper attached)

The Board considered a report which provided an update on the work of the Officer Group to deliver the Board’s work programme and also provided a draft Forward Plan for future Board meetings, as set out in Appendix A to the report. 

Dr Rupert Suckling summarised the salient points in the report, which included updates on:

·                    Use of the Pharmaceutical Needs Assessment;

·                    Public Health Grant Reductions 2016/17;

·                    Draft Recommendations from the Director of Public Health’s Annual Report 2015;

·                    Anti-Poverty issues; and

·                    Forward Plan for the Board.

RESOLVED:

1)            to note the update from the Officer Group; and

2)            to agree the proposed Forward Plan, as detailed in Appendix A to the report.