Agenda and minutes

Apologies were received from Dr David Crichton, Steve Helps, Paul Tanney, Richard Parker, Peter Dale, Kathryn Singh, Laura Sherburn and Paul Moffat.

It was proposed by Councillor Nigel Ball and seconded by Councillor Cynthia Ransome that Dr David Crichton be appointed as Vice-Chair of the Board for the 2019/20 Municipal Year.

Upon being put to a vote, it was unanimously

            RESOLVED that Dr David Crichton be appointed as Vice-Chair of the         Doncaster Health and Wellbeing Board for the 2019/20 Municipal Year.

Further to her announcement at the Board’s last meeting, the Chair, Councillor Rachael Blake, confirmed that Doncaster Council had recently signed up to the Employers for Carers (Carers UK) scheme to support its own working carers internally, and she stated that she hoped that the other partner organisations represented on the Board would feel encouraged to do the same.  She explained that the Council was now aspiring to gain accreditation – a status that only 6 organisations throughout the country had so far attained.  To this end, the Chair explained that she was seeking partners’ agreement and support to the proposal to start holding conversations across the Borough with a view to adopting a ‘Doncaster Growing Together’ approach in working towards the accreditation, which would be ground-breaking in nature.  If the Board was in agreement, the Chair confirmed that she would speak to the Carers Group with a view to taking things forward.

In response, Board Members gave their full support for this initiative and the proposed course of action.

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

Mr Doug Wright referred to the Health and Social Care Joint Commissioning Management Board (JCMB) and asked why the meetings of this body were not held in public.  He felt that from an accountability perspective, and given the important issues being considered by the Board, such as the challenge of meeting the South Yorkshire and Bassetlaw Integrated Care System efficiency target of £120.9m, that members of the public should be allowed into these meetings to observe the proceedings and ask questions.  Mr Wright acknowledged that the minutes of the JCMB meetings were now being submitted to the Health and Wellbeing Board (HWB) for information, but felt that this did not enable the public to ask timely questions, given that the JCMB minutes could be several months old by the time that they were included on each HWB agenda.

In reply, Dr Rupert Suckling and Damian Allen explained that this issue had been discussed by the JCMB and it had been agreed to continue to hold the meetings in private, but that the minutes would be received by the HWB to provide transparency and give the public an opportunity to ask questions in this forum.  Jackie Pederson added that the JCMB minutes were also submitted to the Doncaster Clinical Commissioning Group’s Governing Body meetings, which provided a further opportunity for questions to be asked on the delivery side. 

Councillor Nigel Ball felt that a valid point had been made with regard to the timeliness of receiving the JCMB minutes and expressed the view that it would be useful if members of the public were permitted to observe the proceedings at the JCMB meetings at some point in the future.  The Chair then thanked Mr Wright for his question and confirmed that the position regarding public access to the JCMB meetings would be reviewed in 6 months’ time.

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Mr Tim Brown addressed the Board as follows:-

“Thank you Chair for giving me the opportunity to speak and express my concerns in front of such a powerful and distinguished audience.

I can confirm that I have read the 3 main reports today:  Joint Strategic Needs Assessment; Tobacco Control; and Doncaster Health and Social Care Commissioning Strategy.

I must say that I am alarmed and distressed by the absence of any narrative regarding health inequalities between ethnic groups and the major differences in health behaviours and outcomes between them.

One example, Chair, is smoking which is a key driver of poor health and premature mortality. 

Smoking by ethnic group and sex in England, 2015 - source: PHE analysis of data from the Annual Population Survey shows considerable inequality: 25% of men in the ‘Mixed’ ethnic group smoke, while only 3% of Asian women smoke.

To strengthen the fantastic Public Health Team Tobacco Control work is there an opportunity to explore whether there is a prevalence of smoking amongst different BME groups in Doncaster and to target some interventions?

Chair, as an ordinary black parent, I am struggling to understand how the Joint Strategic  ...  view the full minutes text for item 4.

There were no declarations of interest made at the meeting.

RESOLVED that the minutes of the meeting held on 14^th March 2019 be approved as a correct record and signed by the Chair.

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:

·         Suicide Prevention and Mental Health Awareness;

·         Get Doncaster Dancing;

·         Anchor Organisations;

·         Recovery City Workshop;

·         Forward Plan for the Board;

·         Minutes of SY&B Shadow Integrated Care System Collaborative Partnership Board held on 8 March 2019; and

·         Minutes of Joint Commissioning Management Board held on 28 March 2019.

In referring to the ‘#Another Way’ suicide prevention campaign, Dr Rupert Suckling stated that he wished to give a big ‘thank you’ to Jayne Desmier for all her hard work on this initiative.  In praising the video that had been made in support of the campaign, Board members hoped that the video would be widely publicised so that it reached as many different audiences as possible.  Dr Suckling confirmed that the video had been shown in cinemas and it also popped up as an advert in certain YouTube videos for viewers located in Doncaster.

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.

The Board considered the 2018/19 Joint Strategic Needs Assessment (JSNA) State of Health Report, together with the JSNA Work Plan for 2019/20, which the Board was asked to agree.

In introducing this item, Jon Gleek summarised the work packages proposed for inclusion in the JSNA Work Plan over the coming year, as detailed in the report.  In answer to a question, the officers outlined the various methods and sources of information that would be used to capture the relevant data for the Older People (Ageing Well) Needs Assessment.

Laurie Mott then outlined the key findings in the State of Health report, explaining that it comprised two elements.  Firstly, the report gave details of some of the key issues affecting the health of Doncaster people.  Secondly, it reported on some of the new insights and findings of the JSNA programmes of the last year.  With regard to health in Doncaster, it was noted that the Borough continued to face significant health challenges.  The information being gathered would help to ensure that partners continued to focus on the right priority areas. 

The Board then noted and discussed the new insights highlighted in the report, in relation to Population Change, Pupil Life Style Survey, Childhood Obesity, Learning Disabilities, Active Travel, Mental Health and Life Expectancy.  It was pointed out that further information on many of these new insights would be available on the new JSNA website.

In referring to the impact of fast-food outlets on childhood obesity, Dr Rupert Suckling confirmed that the Council was taking measures to strengthen the health policies contained within the Local Plan in connection with the prevalence of fast-food premises across the Borough.

During further discussion on various aspects of the report, Damian Allen expressed concern over the findings of the Pupil Life-Style Survey that LGBT children in secondary schools faced mental health challenges and reported higher levels of bullying and lower levels of happiness.  He added that he would be following up these statistics.

After the Board had requested that the State of Health Report also be submitted to the Doncaster Growing Together Portfolio Group for its consideration, it was

RESOLVED that:

(1)   the findings of the Doncaster 2018/19 JSNA State of Health Report be noted;

(2)   the JSNA work programme be agreed and the Director of Public Health be given delegated authority to make modifications to the work as changing circumstances demand; and

(3)   the State of Health Report also be submitted to the Doncaster Growing Together Portfolio Group for consideration.

The Board received and noted two presentations in relation to substance misuse – the first, by Helen Conroy, provided a 2019 strategic update on substance misuse, while the second presentation by Tim Young and Stuart Green gave an outline perspective from the Alcohol & Drug Service and Aspire Drug & Alcohol Services respectively.

Arising from discussion on the support available for people discharged from prison with drug and alcohol addictions, further information was requested by Cllr Nuala Fennelly as to the numbers of prisoners not originally from Doncaster who continued to live in the Borough following their discharge, and the impact this was having on the statistics for substance misuse in Doncaster.  In response, Dr Rupert Suckling undertook to obtain this information for Cllr Fennelly outside of the meeting.

After Members had agreed that it would be helpful if the Alcohol Alliance could feed into this Board in future to assist the Board in keeping a watching brief on this topic , it was

RESOLVED to note the information contained in the Substance Misuse strategic update 2019.

The Board considered a report and received a presentation which gave a summary of the current position with regard to Tobacco Control and outlined the findings from a review carried out into current Tobacco Control activities.  It was noted that the review, which had included the undertaking of a CLeaR Peer Assessment, had resulted in a number of actions and priorities being identified, which all organisations represented on the Board were being asked to consider and sign up to.

In reply to a query as to whether vaping and e-cigarettes could be used as a tool to encourage people to stop smoking cigarettes, Anna Brook confirmed that the NHS Stop Smoking Service did support people in terms of providing advice and guidance on the use of nicotine replacement products and smoking alternatives such as e-cigarettes.  She added that while vaping/e-cigarettes were now commonly used as quitting aids, the longer-term effects of using these as an alternative to smoking were still unknown.

With regard to the earlier question put to the Board by Mr Tim Brown concerning the exploration of smoking prevalence among BME communities, Dr Victor Joseph explained that in April 2017, a Health Equity Audit of the Stop Smoking Service in Doncaster was undertaken by the Public Health team, including examining the uptake of the service by ethnic groups.  This had found that the uptake among the white population was 82%, compared to a 3% uptake among the non-white population of Doncaster.  This information was used as part of the service redesign in order to reach out to those groups where uptake was low.  It was also noted that as part of the BME Health Needs Assessment in 2018, one of the problem areas some of the groups interviewed had identified was smoking.

In discussing the content of the report and appendices, Councillor Nigel Ball felt that the recommended priorities did not go far enough and could benefit from further strengthening.  The Board therefore agreed that the report should be taken back to the Tobacco Alliance to enable further work to be undertaken to strengthen the priorities and discussion on resourcing issues, prior to being re-submitted to this Board’s next meeting in September.

RESOLVEDto refer the report back to the Tobacco Alliance for further work to be carried out on strengthening the priorities, prior to being re-submitted to this Board’s meeting in September 2019.

The Board received an update report on the Quarter Four 2018/19 Statutory Return for the Better Care Fund (BCF), together with a presentation by Anthony Fitzgerald on the Doncaster Joint Commissioning Strategy 2019-21, a copy of which was included in the agenda pack.

It was noted that a key focus of the strategy was to support a managed shift towards health and care that was increasingly preventative and delivered at community level, rather than in acute settings.

RESOLVEDto note the contents of the presentation on the Doncaster Health and Social Care Commissioning Strategy 2019-2021 and, in relation to the Better Care Fund update :-

1.         note progress against the BCF national conditions, performance indicators, the final BCF outturn position for 2018/19 and general positive progress towards the integration of health and social care in Doncaster;

2.         consider the challenges in delivering the BCF plan and actions that could be taken to address these at the strategic level;

3.         note that a BCF plan for 2019-20 and supporting Section 75 Agreement will be finalised as soon as funding allocations and planning guidance are received; and

4.         note the action being taken to prepare for more major changes to the BCF anticipated for 2020/21 onwards.

The Board received a presentation by Jayne Gilmour on the findings of the Autism Self-Assessment (2018) and areas of work required within the new Learning Disability and Autism Strategy (2019 – 2024).

Jayne updated the Board on progress made since the last report to the Board’s meeting in March 2019, in respect of drawing up the Learning Disability/Autism Strategy, and the outcomes from the latest Self-Assessment, completed in December 2018.

In particular, the Board noted that there was more work to be done in respect of Autism Awareness training, such as the fact that there was no multi-agency plan or coordinated approach to collecting data with regard to training provision.

It was reported that work undertaken since December 2018 had included developing a strategy with better population data and putting in place a full engagement process with people who use these services and their families.  Jayne concluded by summarising the priorities identified for the delivery of the strategy, and next steps for taking things forward.

During discussion, Damian Allen stated that an incredible amount of work had been done in relation to the Autism Self-Assessment and to improve areas such as the way in which data was collected and used.  In recognition of this, he stated that he wished to commend Jayne and colleagues across the Partnership for their efforts, and he added that the evaluation of the Assessment had acknowledged the progress made.

RESOLVED:

(1)             to note the findings of the Autism Self- Assessment (2018) and areas of work required within the new Learning Disability and Autism Strategy (2019-2024);

(2)             that the necessary measures are taken to ensure that the needs of people with autism are included in the JSNA; and

(3)             that this Board takes a role in ensuring the priorities within the strategy are delivered.