Agenda and minutes

It was noted that apologies for the meeting had been received from the Chair, Cllr Rachael Blake, Cllr Andrea Robinson, Sheila Lloyd and Cath Witherington.

Anthony Fitzgerald (in the Chair) made the following two announcements:-

“Members will recall that in June 2022 we received the first annual report of this Board, which highlighted the work of the Board over the previous 12 months.  This is just to give everyone a heads up that Rupert’s team will be in touch with Board members over the coming weeks asking you to provide updates on the activities and areas of focus that have featured prominently in your respective organisations over the past year.”  Dr Rupert Suckling added that the next Annual Report would be received by the Board at its meeting in June 2023.

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“At the moment, our health and care services are under significant pressure through various perfect storms, such as increased demand and industrial action.  As Executive Place Director for South Yorkshire Integrated Care Board, I wish to place on record my thanks to all members of staff across our organisations who have worked professionally and compassionately across some very difficult weeks and continue to do so.”

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

Mr Tim Brown addressed the Board on his lived experiences of racism.  He expressed concern that it was now 20 years since the Council commissioned a report by Professor Gus John and no action had been taken on the recommendations.  More recently, an OFSTED report had highlighted that the ethnicity details of looked after children were not being recorded, which was an issue that had been articulated 20 years ago.  Mr Brown explained that despite the fact that he and his family worked in the NHS, they were excluded and could not have their say on things such as the OFSTED report or the newly formed Fairness and Wellbeing Commission.  Mr Brown continued by outlining the achievements of his children, despite the barriers they had faced through their lived experiences of racism.

In conclusion, Mr Brown asked how this Board was planning to commemorate the 75^th Anniversary of the Windrush Generation and recognise the contributions made by people who looked like him working in the NHS, and he stated that he would be happy to help with any arrangements.  Mr Brown also pointed out that at a meeting of the South Yorkshire Integrated Care Board (ICB) in October last year, Mr Gavin Boyle (CEO) and Mr Oliver Coppard (Mayor of South Yorkshire) had agreed to apply an anti-racist lense to tackling health inequalities and create a psychological safe space to enable people like himself to have their say.  Mr Brown hoped that this was being taken forward.  He also stated that he was privileged to be reverse mentoring a senior leader within the NHS and he encouraged others to get involved in similar initiatives if they were given the opportunity.

In response, the Chair thanked Mr Brown for his statement and gave an assurance as an NHS employee that there was a commitment within the ICB and wider NHS to continue to adopt an anti-racism stance and he was sure that this was the case in all the partner organisations represented on the Board. 

With regard to the Fairness and Wellbeing Commission, Dr Rupert Suckling explained that this was due to commence in January and membership nominations had been sought from the Minorities Partnership Board.  He added that there would also be opportunities for all people to have an input into the Commission’s work.

Richard Parker reported that the Doncaster and Bassetlaw Teaching Hospitals Trust had operated a reverse mentoring programme for a couple of years and that the vast majority of its Executive Directors had undertaken the programme.  He also advised that the Trust had become the first NHS organisation to qualify to use the RACE (Reporting Action Composition Education) Equality Code Quality Mark, following work undertaken with Dr Karl George.  This Code had been developed to help organisations take action to improve race equality within the workplace.  Furthermore, the Trust was supporting the national Breaking Through Programme, which was being used by the NHS and NHSI as a vehicle to fast track candidates from BAME backgrounds into  ...  view the full minutes text for item 41.

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 10^th November, 2022, be approved as a correct record and signed by the Chair.

The Board received the latest draft of the South Yorkshire Integrated Care Partnership’s (ICP) Integrated Care Strategy.  The Strategy was a legal requirement for the Department of Health and Social Care and had been developed by the SY ICP between September and December 2022.  It covered the years up to 2030 and was seen as the beginning of a journey with the people and communities of South Yorkshire.

Dr Rupert Suckling outlined the background to the establishment of the ICP and summarised the key areas that had been looked at in developing the Strategy.  It was noted that the challenge would be how to translate the 4 shared outcomes through the joint commitments across South Yorkshire.  With regard to next steps, it was reported this Board, together with the Council’s Cabinet, would be asked to endorse the Strategy, once finalised, and then the focus would need to be on delivery and implementation of the Strategy’s goals, outcomes and ambitions.

During subsequent discussion, Board members discussed/commented on various points in the Strategy, including:-

• The very short timescale provided for the development of the Strategy;
• Positives within the Strategy included the prioritisation of children and young people having a good start in life, and the recognition that economic regeneration and skills development were key to improving people’s health and wellbeing, in addition to health factors.
• The Strategy was very well written and well informed, and extremely ambitious, but measurability and demonstrating the impact of the Strategy’s outcomes/ambitions would need future focus.
• The reasons for the timescale of 2028/30 for achieving the aims on page 15 of the Strategy were discussed (which was linked to 3 year data cycles)
• Dave Richmond gave his observations on the references within the Strategy to housing, particularly the need for good quality housing.  While he welcomed the focus in the Strategy on the health impacts of housing, he felt that the Strategy was lacking in ideas as to possible actions/solutions to the issues raised.  He explained that the vast majority of people would be living in ageing housing stock in the future, not new housing stock, so a change in emphasis was needed, as the Strategy tended to focus on the need for good, new housing, which would only represent approximately 1% of the future total housing stock.  Dave also pointed out that with regard to the much publicised issue of damp, mould and condensation in some properties and the impact this was having on people’s health, this was often linked to deprivation, caused by people not feeling able to heat their homes due to energy costs, and was not always due to the poor condition of buildings.  He felt, therefore, that the links between poverty/fuel poverty and health and housing could be clarified and strengthened within the Strategy.

      RESOLVED:

1)    To note the latest draft of the Integrated Care Strategy; and

2)    That the above comments/observations on the draft Strategy be fed back to the ICP by Dr Rupert Suckling.

The Board received the South Yorkshire Child Death Overview Panel (CDOP) Annual Report for 2021-22.  In outlining the background to the Annual Report, Dr Rupert Suckling confirmed that there was a South Yorkshire CDOP group, together with individual Panels for the Barnsley, Doncaster, Rotherham and Sheffield areas.  It was explained that, because child deaths were relatively rare, having a South Yorkshire group allowed the data to be pooled, which enabled improved identification of themes, trends and shared learning than could be achieved at the individual CDOP level.

Dr Suckling reported that during the past year, at a South Yorkshire level, a thematic review had been undertaken into maternal obesity and its impact on child mortality.  On a local level, the Doncaster Panel had focused on two areas, one being suicides, with the suicide contagion protocol being instigated and learning areas identified and shared with relevant agencies, and the other being deaths in children related to unsafe sleeping.  Dr Suckling concluded by summarising the salient points in the data around causes of death at the back of the report, which had seen a rise in deaths caused by chromosomal, genetic or congenital anomalies, and he explained that steps were being taken to quicken the completion times for reviews in Doncaster in the future.

In response to a question regarding the higher number of child deaths in Doncaster compared to Barnsley, Dr Suckling explained that Doncaster was much bigger than Barnsley and he explained that the focus of this report was on the recording of deaths rather than the numbers of deaths.  He also pointed out that infant mortality rates in Doncaster were improving.  Dr Suckling also explained the reasons behind the reported increase in numbers of child deaths in the 0-28 days age group across South Yorkshire.

Richard Parker stated that he had shared the Annual Report with the Local Midwifery Neonatal Services to ensure that there was joined up working.  He explained the importance of recording maternal BMI, as referenced in the Report, as this drove a higher acuity in relation to the needs of the mothers at birth, and in the perinatal, antenatal and postnatal periods and this, in turn, was driving an increased demand for midwifery staff, as the numbers of mothers presenting for delivery at the higher acuity levels 4 and 5 were significantly increasing.  It was therefore noted that the recording of the maternal BMI data was vital not only for improving outcomes for mothers and their babies, but also from a resourcing perspective to assist in anticipating future demand within maternity services.

Riana Nelson stated that she was keen to see the relationship between the CDOP and the Council’s wider children’s services strengthened and would be happy to engage with the Panel in looking at ways of improving reporting processes and timescales.

Arising from discussion, Dr Rupert Suckling undertook to feed back comments to the Doncaster CDOP regarding including in future reports a section on the ‘Voice of the Child, Young Person and Family’, as  ...  view the full minutes text for item 45.

The Board received a presentation by Laura Quinn, Public Health Improvement Co-ordinator, on the importance of breastfeeding as a public health priority, particularly in relation to its positive impact on climate change, the cost of living crisis and food insecurity.

The presentation outlined the reasons why breastfeeding should be promoted and protected, and pointed out that breastfeeding as a positive contributor to climate change and food insecurity was much less publicised.  It was therefore important to not only promote the positive effects of breastfeeding which extended wider than health, but also create an environment where those who chose to breastfeed had the support in place to do this for as long as they wished.  This involved Doncaster businesses/venues signing up to “We support our Mums” (breastfeeding welcome scheme) and City of Doncaster Council and other partner organisations having a breastfeeding policy in place.  The presentation also included an animated video which had been funded by South Yorkshire ICB that highlighted the positive impact of breastfeeding on the environment and climate change.

During subsequent discussion, the Board acknowledged that the positive benefits of breastfeeding in terms of the environment and climate change were often overlooked and welcomed the video as a useful means of getting this message across.  It was recognised, however, that the audience was wider than just Mums – it was also extended families, employers and the wider support networks.  On this point, Laura outlined the extensive range of support that was available to Mums, such as the infant feeding teams at DBTH and within Health Visitors, together with the support provided by the family hubs, and other services such as a breast pump scheme.  However, she acknowledged that more could be done to promote and raise awareness of the support services that were available to help enable Mums to breastfeed their babies.

In response to a question as to the availability of the video and where this would be shown, Laura explained that the video had only just been obtained, but it was intended that it would be available for viewing on a number of different platforms and disseminated widely, including a new infant feeding page on the Council’s website.  She added that it could be made available to any other organisations wishing to use it upon request.

After various Board Members had given a commitment within their respective organisations as employers to consider the introduction of a breastfeeding policy for their employees, where this was not already in place, it was

RESOLVED to:-

1.            Consider and note the information presented.

2.            Continue to support breastfeeding as a public health priority, acknowledging all associated benefits.

3.            Assist in encouraging venues to sign up to We Support Our Mums, noting that any business open to members of the public is able to join the scheme for free.

4.            Request that Doncaster Council, as an employer, implements a breastfeeding policy, demonstrating to employees returning to work that we support them.

The Board received a presentation by Mitchell Salter, Senior Policy and Insight Manager and Emily Adams, Policy and Insight Manager on Doncaster’s Economic Strategy 2030, which had been approved by the Council’s Cabinet on 14 December 2022.

The presentation outlined the key themes, economic missions and mission priorities in the Strategy and, in particular, explained how a new approach had been taken with the aim of placing health and wellbeing at the core of the Strategy.

The Board discussed at length the links between health and economy and how these were mutually supporting.  Members recognised the important contribution that the health and social care sector made to the local economy in terms of its income, being the largest employer in the city, as well as the significant contribution made by its employees as citizens of Doncaster.  This contribution was therefore on two levels, the first being the value of health in respect of maintaining a healthy and resilient workforce, and the second being the contribution the sector made towards the economy as regards employment and income. 

Members also recognised that Doncaster played a significant role in training a third of all health and social care students in South Yorkshire, but because the students were based in Sheffield, this meant that Doncaster was losing an economic advantage to its neighbour.  With this in mind, the Board agreed that it was vital that thought was given to Doncaster’s strategy for developing health and social care over the next decade, including ways of bringing health and social care education into the City.  Riana Nelson pointed out that the possibility of Doncaster becoming a University City was currently being investigated, which would bring with it the potential for developing new educational pathways and local provision in Doncaster and she explained that partner engagement on the proposals would be carried out at the appropriate time.

The Board also discussed the importance of making Doncaster City centre an attractive place for people to live, study and work, if it was to bring businesses and people in.  On this point, it was noted that a significant amount of work was being undertaken by the Council’s Business Doncaster team in relation to attracting inward investment into the City.  Members were also informed that a refresh of the urban centre masterplan for Doncaster was planned, which would consider what was needed to develop the city centre of the future. 

Dr Rupert Suckling commented that this was just one of a whole suite of Team Doncaster strategies which were all inter-related and therefore each strategy also needed to be viewed in the context of other strategies.  As regards the Economic Strategy, Rupert added that he would like to see more focus on the locality way of working included in the Strategy.

Phil Holmes informed the Board that Doncaster’s local account for adult social care was due to be considered by the Cabinet next week.  Included in the local account was the priority to “create and sustain more employment opportunities for  ...  view the full minutes text for item 47.