Agenda and minutes

Apologies for the meeting were received from Chief Superintendent Melanie Palin, Dr David Crichton, Steve Shore, Riana Nelson (Lee Golze deputised), Kathryn Singh (Christina Harrison deputised), Ellie Hunneyball and Cllr Cynthia Ransome.

The Chair informed those present that the meeting would pause at 11.00 a.m. to join the rest of the Country in observing a 2 minutes silence for Remembrance Day.

The Chair reminded Board members that there would be a formal signing of the Carers Charter and group photograph taking place at the close of today’s meeting.

(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 made at the meeting.

RESOLVED that the minutes of the meeting of the Health and Wellbeing Board held on 2^nd September 2021, be approved as a correct record and signed by the Chair.

Dr Rupert Suckling gave an update to the Health and Well Being Board with regard to the present situation in the Borough regarding Covid-19 and its impact on the borough, health provisions and the local communities and what was being done moving forward.

In particular, the Board was updated on the latest position as regards Covid-19 rates of infection in the borough, hospital admissions, and ITU levels at the present time.

Richard Parker also updated the Board on the current pressures faced by hospitals as a result of Covid-19 and the impact this was having on waiting times for other medical procedures and diagnostics.

            RESOLVED that the update be noted.

The Board received a presentation by Anthony Fitzgerald, Director of Strategy & Delivery, Doncaster CCG outlining the local and national plans for improving access for patients and supporting General Practice.  Anthony was accompanied by Carolyn Ogle, Associate Director Primary Care and Commissioning, and Dr Dean Eggitt, CEO of Doncaster Local Medical Committee.

In particular, the presentation summarised the following key points:-

• Information was provided on the Primary Care structure in Doncaster, including a map showing locations of the General Practices across the Borough.  It was noted that there was variation across Doncaster in terms of people’s access to services.
• The Primary Care response to Covid-19 was outlined, highlighting that Primary Care had been crucial to the rollout of the vaccination programme.
• The headline trends from Capacity and Demand data showed that General Practices remained very busy, with pressures remaining high in relation to Practice call volumes, appointment availability and workforce pressures.
• A National Plan for Improving Primary Care Access had been produced in October, resulting in a £250 million Winter Access Fund being made available (with £1.3 million anticipated for Doncaster).  Doncaster’s Winter Access Fund Plan describing how its share of the Fund would be utilised was included in the agenda pack for this meeting for the Board’s information.  The proposed key actions set out in the Plan were outlined to the Board, according to the main themes which comprised:-

o   Increase and Optimise Capacity;

o   Address Variation and Encourage Good Practice; and

o   Zero Tolerance of Abuse and Public Communiciations

• Dr Dean Eggitt gave a frontline view of the current situation in General Practice.  He explained that the future of General Practice was Primary Care, and that a shift was needed towards viewing Primary Care units operating in a similar way as the former cottage hospital industry, with GPs acting as consultants of Primary Care leading teams of health care professionals to see a whole range of conditions that would not naturally be thought of as being about Primary Care in the past.

During subsequent discussion, Board members asked questions and made comments on a range of issues highlighted by the presentation, including:-

• Jackie Pederson explained that there would be a need to work across the whole sector as a team in future, with all providers and voluntary sector organisations around the table, to ensure there was greater integration in the delivery of services.  The challenge of dealing with the long term (planned care) health conditions of patients while also providing care for the urgent cases was also recognised, and this applied equally to Primary Care and not just in hospitals.
• Councillors Andrea Robinson and Nigel Ball advised that they were aware from their constituents and local communities that people were experiencing difficulties in accessing some general practices, both in person and by telephone and sought assurances that steps were being taken to improve the situation at those practices where there were issues.  It was also suggested that the Plan should include actions/measures via communications to make it easier  ...  view the full minutes text for item 29.

The Board received a presentation by Lee Golze (DMBC) and Andrea Ibbeson (DCCG) on the work being undertaken in preparation for the forthcoming new Children and Young People’s Mental Health and Wellbeing Strategy that would be brought to the Health and Wellbeing Board in the New Year.

The presentation outlined where the partnership was currently in terms of mapping out services and the systems flow, acknowledging that there was still more to do. It also outlined the work done by the Young Advisors in liaising with children and young people about what the future vision and ambitions will be and what the next steps are.

Lee began by outlining the position in relation to current service demand, explaining that there had been increases in demand across a range of services, including:

• Non-urgent and urgent referrals to specialist CAMHS;
• Eating disorder caseloads, which had doubled compared to last year;
• The number of children waiting for an ADHD assessment;
• The percentage of Doncaster school pupils with social, emotional and mental health needs; and
• The number of DCST Forensic Psychology Team consultations, which had doubled in 2021.

It was reported that, pleasingly, the number of children and families accessing early help services was returning to pre-pandemic levels and of those receiving early help, more were staying and moving on to formal pathways.  However, within those figures, there had also been an increase in the prevalence of both Child and Parental mental health issues.

The Board noted that in the pupil lifestyle survey responses, there had been a reduction in the number of pupils stating that they were ‘very happy’ compared to last year, and an increase in children feeling ‘okay’.  Mental Health had almost doubled as a reason for children feeling sad or worried compared to the previous year.  The headline points to take away from this were that there were fewer children reporting high levels of resilience and fewer children saying that they were being listened to.

Lee continued by outlining the current challenges as identified in the risk profile.  The Board noted that many young people did not have diagnosable mental health conditions but had challenges around managing their wellbeing.  The important role that teachers played in supporting pupils in this regard was acknowledged.  In summarising the actions to reduce future risk and next steps, Lee drew particular attention to the work done in relation to developing a support package for schools, with dedicated Mental Health leads in place.

It was reported that the Young Advisors had been asked to develop a Vision and Ambitions for children’s mental health in Doncaster, the details of which were endorsed by the Board, and that they wished to hold partners to account for delivery against these within the Strategy.

Lee concluded by confirming that work on the Strategy would continue with a view to presenting the new Strategy to the Board in the New Year.

Discussion followed, during which Board Members asked questions and made comments/observations on a range of issues including:-

• The possible  ...  view the full minutes text for item 30.

Allan Wiltshire, Head of Policy Performance and Intelligence, DMBC gave a brief presentation to the Board outlining the means by which it was proposed to deliver the Doncaster Delivering Together (DDT) Strategy.

He began by confirming that the ‘Great 8’ priorities agreed by Team Doncaster, along with further information on the DDT Strategy and the Joint Strategic Needs Assessment (JSNA) for 2021 could all be viewed on the Team Doncaster website.  Also on the website were the interactive dashboards that were presented to the Board at its last meeting.  It was intended that the suite of dashboards would be expanded in the future and the Board was reminded that partner organisations had been invited to contribute to the data observatory.

Allan outlined how the priorities would be implemented and their progress monitored, and also explained how delivery of the Strategy would necessitate new ways of working if long term improvements were to be achieved.  With regard to how the Board could help, Allan summarised the following points:

•      Members were invited to attend the Team Doncaster Summit on 25^th November 2021;

•      Use Doncaster Delivering Together to support and guide the work of the Board e.g. Actions listed from Great 8;

•      Help to explore how a well-being commission could work – where could it add the most value?

•      Consider how any future Health and Well-being Strategy compliments and builds on Doncaster Delivering Together.

Allan then referred to the journey as depicted in a flow chart, which showed the progress and next steps from the inception of the DDT Strategy through to the Team Doncaster Summit and then on to delivery of the Strategy over the next 10 years, considering issues such as how partner organisations will align and configure themselves to achieve this.

RESOLVEDto note the contents of the presentation and the proposed way in which the DDT Strategy will be delivered.

Phil Holmes, Director of Adults, Health and Wellbeing (DMBC) gave a presentation to the Board outlining the work being undertaken in developing Local Solutions approaches in Doncaster’s neighbourhoods, together with Locality Plans.  It was noted that Team Doncaster was committed to supporting people, families and communities with local solutions that addressed their needs and built on their strengths in the place where they lived.  Working in a way that was responsive to local issues and assets, and investing funding alongside local communities (rather than “doing to” them) would increase local health and wellbeing by giving people more control over their lives and stronger connections with others.

Phil explained that the Local Solutions model was a way of collaborating on a more geographical basis with Doncaster people that felt more joined up.  He outlined the ways in which this approach might help partners to deliver services for people that were more specifically targeted to the needs of local communities and how this could be done in a more joined up way.  The Board noted some specific examples of how the model might be applied, such is in supporting stronger families and improving access for people to Adult Social Care and Primary Care services.  It could also connect with Town Centre issues where there were cohorts in relation to rough sleeping and homelessness, and some instances of anti-social behaviour by younger people.

The Board noted that it was proposed to use non-recurrent Better Care Fund monies to invest in preventative working and address health inequalities in each of Doncaster’s localities/neighbourhoods via provider collaboratives.

During subsequent discussion, in answer to a question regarding how and when the provider collaboratives would be established, Anthony Fitzgerald explained that this approach was about bringing the various existing provider forums together with other organisations to drive the model forward.  He envisaged that voluntary, community and faith organisations, together with the Primary Care networks and GP Federation would play a significant role in this regard, but he added that the finer detail was still being worked up.

In commenting on the Local Solutions model, Cath Witherington stated that it was important that there was a consistency in approach in order to ensure that residents had equal access to whatever services they needed.

Jackie Pederson explained that there was already a provider collaborative in place, but that this currently mainly comprised the statutory organisations such as DBTH Trust and RDaSH.  There was recognition that this needed broadening to also include voluntary sector organisations and the ambition was that this collaborative would enable all partner organisations from every sector to sit down together to look at the resources available and decide how best to use them, as opposed to all competing against each other for funding.  She stated, therefore, that the necessary infrastructure to take this model forward was already there, and that plans were in place to start having conversations across organisations, including the voluntary sector and primary care, to bring the wider provider collaborative together.

After  ...  view the full minutes text for item 32.

The Board received a presentation by Victoria Ryves, NPO Programme Manager, Heritage Doncaster which gave an update on the History, Health and Happiness programme at Heritage Doncaster. This included the impact on the community to date and the results of ongoing evaluation by Sheffield Hallam University/Arc Research.

Victoria explained that the History, Health and Happiness programme took place in localities across the Borough with the intention of using history and story-telling to spark conversations, improve wellbeing and tackle isolation.  The programme worked with a wide range of people, including vulnerable and isolated adults, families and young people, and the sessions were delivered in collaboration with other third sector organisations and independently.  Victoria gave examples of the types of activities run by the programme and it was noted that a suite of online and offline activities had been delivered during the Covid-19 pandemic to help people who were struggling with loneliness and isolation.

It was noted that the work of the programme had been recognised with a series of awards, namely a Community Impact Award at the Museums and Heritage Awards and Victoria had also been nominated for an award by the Museums Association. 

Having explained that this work was fully evaluated by Sheffield Hallam University and Arc Research, Victoria referred to the findings set out in the Impact Reports from 2019/20 and 2020/21 which demonstrated the wide range of beneficial outcomes being achieved from this work.

Victoria concluded by stating that while the Programme had a strong reputation for best practice and a relatively high profile within the cultural sector, she was keen to increase its visibility and profile within the Council and therefore she welcomed opportunities such as this to spread the word.

Following the presentation, various Board members and attendees expressed an interest in supporting and contributing to this programme and agreed to contact Victoria outside of the meeting for further discussions.

            RESOLVED to:-

1)        Note the progress and achievements of the History, Health and Happiness programme to date;

2)        Consider what role History, Health and Happiness may play in the health and wellbeing of Doncaster’s community, in order to inform future funding applications (submitted in March 2022); and

3)        Consider how the individual organisations represented on the Board may contribute to the work of History, Health and Happiness at Heritage Doncaster until 2023.

The Board considered a report which provided an update on the development of the Doncaster Better Care Fund (BCF) 2021-22.

In presenting the report, Dr Rupert Suckling explained that as the final BCF Plan was not available for the Board to sign off at this meeting, it would be necessary for the Board to agree the arrangements for giving delegated authority to officers to sign off the final BCF Plan in consultation with the Chair of the Board, as in previous years.

RESOLVED:-

1)             To note the draft Doncaster BCF Plan for 2021-22;

2)             That delegated authority be given to the Director of Public Health (DMBC), the Director of Adults, Health and Wellbeing (DMBC) and the Director of Strategy and Delivery (DCCG) to sign off the final plan in consultation with the Chair of the Health and Wellbeing Board, pending feedback from regional assurance on 11 November 2021 for submission by the deadline of 16 November 2021;

3)             To note that a Section 75 Agreement has already been produced for this financial year; relevant annexes will be updated to include details of the new national conditions and metrics; and

4)            To review progress of Doncaster’s BCF plan for 2021-22 and evaluation of schemes at future meetings.