Agenda and minutes

It was noted that apologies had been received from Kathryn Singh (RDaSH), Lucy Robertshaw (Health and Social Care Forum) and Steve Shore (Healthwatch Doncaster).

The Chair, Councillor Rachael Blake, informed the Board that she had been made aware that Kathryn Singh was due to retire as Chief Executive of RDaSH at the end of the year.  On behalf of the Board and the communities served by RDaSH, the Chair thanked Kathryn for her contribution and support as a Board Member, both in and outside of meetings, and she wished her a happy retirement and all the best for the future.

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

There were no questions received from the public.

There were no declarations of interest made at the meeting.

RESOLVED that the minutes of the meeting of the Health and Wellbeing Board held on 1^st September, 2022, be approved as a correct record and signed by the Chair.

The Board received a presentation by Ailsa Leighton, Acting Director of Strategy & Delivery, South Yorkshire Integrated Care Board (ICB), which outlined the up-to-date position with regard to progress in the development of the South Yorkshire Integrated Care Strategy.

Ailsa began by outlining the national planning context for 2022/23 and beyond, including the timeframe for developing the Integrated Care Partnership (ICP) Strategy, the ICB 5 year Joint Forward Plan, and the ICB 2 year Operational Plans.  It was noted that there was a very short timescale for drafting the Integrated Care Strategy, which had to be published by the end of December 2022.  Ailsa then summarised the statutory requirements in developing the Integrated Care Strategy, which included the need for broad engagement with local Healthwatch organisations and people who live and work in the area.  The Board noted the work that had been undertaken locally on a South Yorkshire level, and were given details of the emerging vision for the Strategy, together with the shared outcomes and ambitions.  With regard to the next steps, it was noted that there would be further engagement work undertaken in November/December, with the final draft Strategy being considered at the ICP meeting on 20^th December 2022.  Work would also commence on the ICB five year Joint Forward Plan. 

The presentation concluded by asking the Board to consider the following questions:-

• Does the early thinking on the Integrated Care Strategy for South Yorkshire feel right?
• Do the shared outcomes and areas identified to go further, faster feel right?
• How do we ensure our Doncaster residents are actively engaged in this approach?

During general discussion, members recognised the need for a very local approach in engaging with residents on the Strategy, and a clear message explaining how the Strategy would add value to their lives.  It was also acknowledged that this was just the start of the journey in terms of engagement.

In response to a comment by Richard Parker regarding the need to be clear on the short, medium and long term ambitions, Ailsa Leighton stated that the five year joint forward plan would be key in this, as there was an expectation that this would focus on actions to be taken in Year 1 and Year 2 in particular, so she felt it was important to get that right.

The Board discussed various other issues linked to the Strategy, including the need to avoid duplication and improve efficiency in the delivery of services, the extent to which people’s behaviour and lifestyles in relation to their health and wellbeing were a matter of personal choice, and the need for targeted, adequate resourcing to be provided where the need was.

Following subsequent discussion, the Chair highlighted the following points/observations to be fed back to the ICP working group:-

• The need for clear and meaningful engagement with stakeholders, patients and the public, and to ensure that all communities and individuals were reached in the consultation on the Strategy was of key importance;
• A strengthened focus on prevention  ...  view the full minutes text for item 34.

The Board received a presentation by Emma Price, Head of Strategy & Delivery, Children and Maternity, South Yorkshire ICB and Martyn Owen, Head of Service Inclusion, Doncaster Council which provided an update on the Children and Young People’s Mental Health Strategy.  It summarised key points in relation to successes so far, working progress, work still to do, resilience in Doncaster and next steps. 

The Board also noted a report which gave an overview of the continuing impacts upon children and young people following the Covid pandemic.  It also provides an update on the response from key services.

In response to questions from the Board, Emma and Martyn gave further details of the work being undertaken to reduce waiting times on referral to assessment in relation to neurological pathways, and also to raise capacity and capability within mainstream schools.  On the latter point, the Board noted that work was underway to ensure that there was a needs-led process in place so that schools received funding at the right point.  In addition, specialist support services were being reshaped so that conversations were held earlier with schools to ensure that their needs were met, enabling effective resource decisions and guiding the capability of staff so that schools could intervene earlier.  Lee Golze added that Wave 8 Mental Health Trailblazer Programme funding had been awarded by the Government to fund the provision of Mental Health Support Teams in schools, which would help children and young people to get timely support for mild to moderate mental health issues.

The Board noted that a further update would be received at its meeting in March 2023.  Dr Rupert Suckling suggested that it would be useful to hear more detail on the outcomes and also hear from some young advisers as part of the next update.

RESOLVED to note the presentation and update on the CYP Mental Health Strategy, particularly the recommendations for work into year two.

The Board received a presentation by Leanne Hornsby, Assistant Director of Education, Skills, Culture and Heritage, Doncaster Council on the Doncaster Culture Strategy 2030.

The presentation gave an overview of the Strategy, including its purpose, what was covered by the Strategy, the cross cutting themes, who had been consulted in the development stage, the priorities identified in the Strategy, funding opportunities and progress, and next steps.

In response to a question as to how this Board could provide practical support in the delivery of the Strategy from a health and wellbeing perspective, Leanne explained that support was needed from all the organisations represented on the Health and Wellbeing Board in terms of helping to deliver the actions and objectives on the ground.  Arising from discussion on this point, it was agreed that Leanne would circulate to Board members a list of those who were engaged from the partner organisations represented on the Board in the groups to input into the production of the implementation plan and for the Board to identify people where there were gaps.  It was also suggested that a member of this Board be included on the Culture Portfolio Board when established.

After Dr Rupert Suckling had spoken of the need to strengthen the links between the work of this Board which was cross-cutting with arts and culture with the wider work being undertaken across Team Doncaster to promote culture, it was

RESOLVED to note the presentation and the contents of the Strategy, including the ambition and proposed direction of travel. 

The Board received a presentation by Mandy Espey, Health Inequalities Lead Doncaster Place (DBTHFT) and Vanessa Powell-Hoyland, Public Health Lead – Well Doncaster, Doncaster Council, which outlined the measures being taken by partners to combat health inequalities. 

In particular, the presentation was aimed at increasing awareness of the impact of unfair and avoidable health inequalities on the most vulnerable people living in Doncaster.  It also gave details of the national CORE20plus5 programme, outlining the 5 key clinical pathways for focus, alongside access, experience and outcomes of healthcare.

The Board noted the importance of wider provider partnership working and connecting with community leaders and people with lived experience within localities, which highlighted opportunities to work in a more impactful way across Doncaster, focusing on core20 population.

During subsequent discussion, Richard Parker pointed out that, in relation to maternity, the continuity of carer service referenced in the presentation was currently suspended across South Yorkshire as this was dependent on high staffing levels.  It was hoped that this service could be re-introduced in the future, when staffing levels had recovered.

In considering the ask of the Health and Wellbeing Board as outlined at the conclusion of the presentation, Board Members discussed at length the options for redesigning the way partners collectively worked across Doncaster Place in order to connect strategic ambition with resources and delivery.  Members also discussed ways of focussing on prevention to reduce future demand on health and social care.  The Board also recognised the need to shift the mind set to embed addressing health inequalities and focus on core20 communities as part of partners’ business as usual.

In particular, the Board acknowledged the need to identify the method for delivering on the 5 key clinical areas of health inequalities as a next step.  Members also discussed the importance of partner organisations ceasing those processes and activities that did not add value in order to free up capacity to progress this work.  Furthermore, the Board agreed that there was significant scope for reducing the amount of duplication across the various partner organisations and there were other practical changes that could be made to identify ways of doing things differently.  It was noted that discussion on many of these issues could be taken forward at the ICB’s Doncaster Place Committee.

Arising from discussion on health inequalities training and the need for a cohesive training plan across all partner organisations, the Chair suggested that this should be provided for Cabinet Members and other non-Executives first, including the Chairs of the other partner organisations around the table, in order to re-invigorate the process on a top-down basis.

RESOLVED to note the contents of the presentation and receive a further update on progress at the Board’s March 2023 meeting.                               

The Board received and noted the minutes of the Health Protection Assurance Group meetings held on 17 August and 19 October 2022.