Agenda and minutes

Apologies were received from Steve Helps, Richard Parker, Laura Sherburn, Chief Superintendent Shaun Morley (Superintendent Dan Thorpe deputised) and Paul Moffat (Robert Moore deputised).

The Chair, Councillor Rachael Blake, reminded the Board that it had previously supported the Motor Neurone Disease (MND) Charter, and confirmed that both Doncaster Council and RDaSH had subsequently formally signed up to the Charter.  Cllr Blake explained that she was keen to remind partners of their obligations in developing activities in support of the Charter. 

Dr David Crichton reported that the first MND information session for GPs had been held the previous day and that this had been well received.  He stated that the GPs had expressed an interest in receiving copies of the MND Information Packs produced by the MND Association and he would therefore be getting in touch with Mrs Valerie Wood to see if these could be supplied.

The Chair added that she had attended a recent meeting of the South Yorkshire branch of the MND Association held in Doncaster, where they had discussed the Association’s ‘Scrap 6 months’ campaign being run in support of the Access to Welfare (Terminal Illness Definition) Bill, which was currently going through Parliament.  The Bill would remove the current 6-month restriction on the definition of a terminal illness and replace it with a clinical judgement.  This would mean that everyone with MND could access welfare benefits under the Special Rules for Terminal Illness fast-track process.  The Chair advised that she would be tabling a motion at the next Full Council meeting calling for Doncaster Council to support the passing of the Bill.

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

In addressing the Board, Mr Tim Brown expressed concern that his son had been unable to apply for an apprenticeship at Doncaster Council, despite having done well at school and passed his A Levels, as he had been told that he needed to have had previous work experience with the Council.  He felt that there were no opportunities in Doncaster for young people from BAME communities and asked those organisations represented on the Health and Wellbeing Board to provide information as to the diversity of their respective workforces, for both clinical and non-clinical staff.  Mr Brown continued by asking how each organisation took steps to engage with minority groups, who often felt overlooked.  He stated that it appeared that there was often a ‘want to do things for us or to us’ approach from organisations towards BME communities, instead of a ‘wanting to do things with us’ stance.  Mr Brown concluded by welcoming the recent attendance by Councillors Nigel Ball and Rachael Blake at an event at the Little Theatre organised by the Doncaster African Caribbean Support Group, and, with regard to the BAME Advisory Panel meeting held in August 2018, Mr Brown pointed out that he had not seen any resulting action plan produced from that meeting, nor had there been any further meetings held since that time.

Having thanked Mr Brown for his questions, the Chair confirmed that information on the diversity of workforces was publicly available and she therefore undertook to request this from the partner organisations represented on the Board and arrange for this to be forwarded to Mr Brown in due course.

Councillor Nuala Fennelly confirmed that the Council was in the process of putting plans in place which she believed would address the issues that had caused difficulties in the past for young people in obtaining apprenticeships or jobs with the Council due to a lack of work experience.  She explained that, in future, if a young person applied for a job or an apprenticeship at the Council and was unsuccessful, the Council would look to offer them some work experience for a number of weeks so that they would stand a better chance the next time an opportunity arose.  Councillor Fennelly stressed that all young people deserved the same treatment and opportunities, regardless of their background.  She added that businesses in the Borough were also being encouraged to offer work experience placements for young people.

Councillor Nigel Ball stated that he had enjoyed the recent event organised by the Doncaster African Caribbean Support Group.  He spoke of the importance of working with all communities in the Borough on a ‘done with’, not a ‘done to’ basis, and in such a way that people felt empowered and enabled.

No declarations were reported at the meeting.

RESOLVED that the minutes of the meeting held on 6^th September 2018 be approved as a correct record and signed by the Chair.

The Board received an update on the outcomes framework for the Health and Wellbeing Board which allowed the Board to drive delivery and be sighted on the key outcomes and indicators identified as important for the Board and linked into the outcomes identified as part of the plan for the borough – Doncaster Growing Together (DGT).  The report provided a specific view of the new information available since the last Board update in June 2018, and also provided further detail on the Wellbeing and Prevention strands of the outcomes framework.

It was noted that a portal was to be developed on Pentana, a cloud based performance management system, to enhance the outcomes framework, which Board Members would be able to access and use to check progress.  It was reported that a range of indicators had been updated since the last update in June 2018, either with specific updated information for Doncaster or with refreshed national inequalities data, the detail of which was outlined in Appendix B to the report.

During subsequent discussion on the performance indicators in relation to Wellbeing and Prevention, the Board made the following comments/observations:-

• During discussion on the ‘Life Satisfaction Survey’ indicator, Paul Tanney explained that St Leger Homes had conducted a tenants’ satisfaction survey, which had found that tenant satisfaction levels dropped in areas where there were particular problems with anti-social behaviour, substance misuse, and higher rates of crime, so in these cases the dissatisfaction was less about housing and more related to other external conditions and factors, which resulted in having a negative impact on people’s wellbeing.

• It was agreed that it would be useful to have comparative performance information to assist the Board in gauging how Doncaster compared to its peer groups.

• With regard to the indicator for ‘Prevalence of smoking among persons 18 years and over’, Dr Rupert Suckling referred to a recent ‘Tackling Tobacco Dependency in Hospital Settings’ event organised by the South Yorkshire and Bassetlaw ICS which had looked at the proposed adoption of a quit programme which was to be introduced across the region and was aimed at giving hospital patients who were smokers a more focussed intervention.  It was noted that this indicator only related to the use of tobacco products, and did not include the use of vaporisers and electronic cigarettes.

• During discussion on the performance indicator relating to cancer mortality rate (<75), Dr David Crichton offered to provide a future update for members of the Board on the work being done by the Cancer Alliance.  He stated that it was pleasing to note that the cancer mortality rates were flattening, given that statistics showed that one in two people born since the early 1960s would be diagnosed with cancer at some point in their lives.

• Dr Rupert Suckling pointed out, with regard to the indicator on mortality rates for cardiovascular disease, that the work in this area lacked the infrastructure that was in place for other conditions, such as cancer, making it more difficult  ...  view the full minutes text for item 31.

The Board received an update on activity and progress in addressing and reducing health inequalities in Doncaster.  In presenting the paper, Susan Hampshaw confirmed that a successful Health Inequalities conference had been held on 17 September, with international experts speaking at the event.  She stated that this event had provided an opportunity to showcase all the work being undertaken locally, and participants had also made pledges for action.  Susan also summarised the ongoing work to address the health needs of the Borough’s BAME citizens, including the establishment of a BAME advisory group, which was due to meet again in December.  It was also reported that three inclusion health drop-in clinics were now up and running and these were providing a valuable service in enabling vulnerable people to access health care.

Jonathan Briggs then gave details of the HI prototype dashboard that had been developed, as detailed in Appendix 1 to the report.  It was noted that the aim of the dashboard was to both monitor progress on reducing inequality across the Borough and help identify areas for attention as a partnership.  It was suggested that the dashboard could be used alongside the Board’s outcome framework as part of a ‘deep dive’ workshop for the Board in 2019.

General discussion followed, during which Councillor Nuala Fennelly expressed concern that in some schools, children were being given sweets as rewards, instead of healthier alternatives such as fruit.  She felt that this illustrated that there was still room for improvement in terms of schools helping children to lead healthier lifestyles.  In reply, Dr Rupert Suckling explained that the Council encouraged schools to participate in the local Healthy Schools Programme ‘Healthy Learning, Healthy Lives’, which was a voluntary code aimed at promoting, amongst other things, healthy eating.  He added that the success of initiatives such as this also relied upon the support of local Ward Councillors and School Governors.

After the Board had discussed the issue of personal responsibility and the external factors that could influence people’s behaviour in terms of whether they made healthier lifestyle choices or not, it was

RESOLVED to agree that the Board will receive a bi-annual update on health inequalities, commencing with a ‘deep dive’ workshop session in July 2019 to look specifically at using the HI prototype dashboard alongside the Board’s outcome framework.  Going forward, the Board will receive formal updates in the form of a progress report in November and a deep dive discussion in June each year.

The Board received a joint presentation by Jackie Pederson and Damian Allen on the progress made so far on the Doncaster Place Plan and the Your Life Doncaster Programme.

Jackie Pederson began by outlining the context of the Doncaster Place Plan, which fell under the Caring theme area contained within Doncaster’s Borough Strategy, and highlighted that the Plan would need to be delivered in the face of a £139.5 million health and social care funding gap.  The Board noted that work to deliver the Place Plan was underway in a number of key areas, including:

• Joint models of commissioning and delivery as a partnership were being tested across 7 areas of opportunity, comprising:

o   First 1001 days

o   Vulnerable adolescents

o   Learning disability

o   Complex lives

o   Urgent and emergency care

o   Intermediate care

o   Dermatology

• Integrated neighbourhood teams – work was ongoing to build a model based on a single point of access for patients.  This model required new ways of working, focused on services working together, wrapped around the person and delivered in neighbourhoods;

• Strategic enablers and system drivers – this area of work featured the development of a system approach to strategic developments and digital innovation, one example being the integrated digital care record that was currently being tested out.  It would also comprise a single strategic approach to the development, utilisation and disposal of estates, and whole system workforce planning, together with a single front door system, and would also be aimed at fostering community resilience;

• Joint commissioning/provision – this area of work included a Joint Commissioning Plan that would cover the areas which overlapped between the CCG, Public Health and Adults and Children’s Services.  It was also noted that a Provider Alliance group was now in place;

• Governance – it was noted that a structure which comprised 7 different statutory bodies, each with their own statutory duties, brought its own challenges;

Jackie concluded by summarising the positive points and challenges being faced in Doncaster in taking the Doncaster Place Plan forward, and outlined the next phase of the Plan’s implementation.  She added that Doncaster was viewed as being at the forefront of this work nationally, and that she had recently been invited to talk on this subject at an event in Manchester.

Damian Allen then presented an overview of the Your Life Doncaster Transformation Programme, which was a business led initiative to improve the health and wellbeing of Doncaster people.  The programme was focused on embedding a culture that promoted independence wherever possible, and sought to develop community capacity so that support was closer to people who needed it.  It was also aimed at making Council services, practices, processes and partner relationships more efficient and effective.

Having outlined the various projects and initiatives being developed under the Transformation Programme, and achievements to date, Damian concluded by explaining how Your Life Doncaster would eventually be fully aligned with the Place Plan, with the ultimate ambition being to have an integrated customer journey delivered through integrated neighbourhood  ...  view the full minutes text for item 33.

On behalf of John Woodhouse, Independent Chair of the Doncaster Safeguarding Adults Board (DSAB), Angelique Choppin presented the Annual Report of the DSAB for 2017/18, detailing what the DSAB had done during the year to achieve its strategic objectives and how its partners safeguarded adults at risk.  The Annual Report also set out the findings of any Safeguarding Adults Reviews completed during the year and the subsequent learning arising from the reviews.

In summarising the salient points highlighted in the Annual Report, Angelique drew particular attention to the following key areas of work that the DSAB had been involved in during this period:-

• The DSAB had joined forces with the Doncaster Safeguarding Children Board (DSCB) to host a Safeguarding fortnight in Doncaster from 25 September to 6 October 2017;

• The DSAB had held a community-led Keeping Safe event in 2017, raising awareness, sharing information and consulting with service users and members of the public, which had been well attended;

• A policy and procedure to respond to cases of self-neglect and hoarding had been developed by the DSAB/DSCB alongside the Safer Stronger Doncaster Partnership.

In response to a query by Dr Rupert Suckling regarding the 2017/18 figures for the number of Deprivation of Liberty Safeguard (DoLS) authorisation requests received (1357), and the proportion of these that had been subsequently authorised, Angelique Choppin undertook to obtain this information from the DoLS Team and circulate it to the Board.

RESOLVED to note the multi-agency activities undertaken during 2017-18 by the Doncaster Safeguarding Adults Board to safeguard adults at risk and prevent abuse from occurring wherever possible.

The Board received the 2018 Air Quality Annual Status Report for Doncaster.  It was noted that Doncaster Council had a statutory duty to review and assess air quality in the Borough and was required to submit a report each year.  The report contained new information regarding air quality monitoring, developments and updated progress on measures to improve air quality along with any other information that was relevant to air quality in Doncaster.

During subsequent discussion, Members noted that, as part of the Sustainable Development Management Plan, organisations were asked to consider how they contributed towards air pollution with a view to identifying appropriate measures to help alleviate the situation, such as becoming carbon neutral.

After the Board had discussed issues including the methods used by the Council to engage with local residents, businesses and organisations on air quality matters in the Borough, and the potential for encouraging the use of electric vehicles, including buses, in the future, it was

RESOLVED to note the conclusions of the Annual Air Quality Status Report 2018 for Doncaster.

The Board considered a report which provided an update on the work of the HWB Steering 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.

In particular, the report included updates for the Board on:

·             Veterans’ Health;

·             Development of an All Age Carers Charter;

·             ‘Work and Health’;

·             Minutes of the SY&B Shadow Integrated Care System Collaborative Partnership Board meeting held on 14^th September 2018; and

·             Forward Plan for the Board.

Paul Tanney stated that he was pleased to inform the Board that the number of homes provided by St Leger Homes of Doncaster for ex-armed services personnel in Doncaster had been increased from 10 to 15 units as part of the scheme being run in partnership with the ‘Help 4 Homeless Veterans’ charity.

RESOLVED that:

(1)        the update from the HWB Steering Group be received and noted; and

(2)        the proposed Forward Plan, as detailed in Appendix A to the report, be agreed.

As this was the last HWB meeting of 2018, the Chair wished to place on record the Board’s thanks to all staff across the partnerships for their efforts and for all the good work being done.