Agenda and minutes

The Chairman will welcome those present to the meeting. In addition, the following announcements will be made:

·       Health and Wellbeing Board Membership

·       BSW Inequalities

Cllr Richard Clewer, Chair of the Board welcomed everybody to the meeting.

Before the meeting began each Member of the Board, other Councillors and officers who would be contributing to the meeting were given the opportunity to introduce themselves.

Cllr Richard Clewer provided the following Chairman’s Announcements:

·   Health and Wellbeing Board Membership

The Chairman drew attention to the Health and Wellbeing Board composition paper within the agenda, as well as a proposed revision which would aim to ensure ongoing parity between council and NHS representatives by reducing the numbers of voting representatives required. It was also stated that the proposed revision would take account of the need to include a representative from the Voluntary and Community Sector, reflecting discussions at the Health and Wellbeing Board earlier this year, as well as the development of the VCS forum in the county.

The Board stated that they would support the changes and the Chairman informed that further discussion would be required at the Council’s Constitution Focus Group as well as ratification of the changes at a subsequent meeting of

full council.

·   BSW Inequalities

The Chairman drew attention to the BSW Inequalities Strategy, with it noted that in March 2022, the Health and Wellbeing Board noted the development of the BSW Inequalities Strategy 2021-202 and its development in consultation with health and social care partners across the Wiltshire Alliance. The strategy had now been finalised and published, alongside its implementation plan.

To receive any apologies for absence.

Apologies for absence were received from Alison Ryan, Cara Charles-Barks, Philip Wilkinson, Cllr Nick Holder, Clare O’Farrell, Louise Greenwood, Laura Edwards, Julie Thornley, Dawn Chalcraft, Will Howard, Lisa Taylor, Lisa Harding, Marc House, Michelle Lombardi, Clare Edgar, Amber Skyring, Kate Blackburn, Helen Jones, Stacey Hunter, Dr Sam Dominey, Stephanie Elsy, Dr Andrew Girdher, Laura Nicholas, Margaret Firth, Dr Catrinel Wright and Sue Harriman.

It was noted that Philip Wilkinson (Police and Crime Commissioner for Wiltshire and Swindon) had arranged for Rob Llewellyn  (Director of Ops) to attend in his place. In addition, Cllr Gordon King joined the meeting in a Hybrid capacity via Microsoft Teams.

To confirm the minutes of the meeting held on 31 March 2022.

The minutes of the meeting held on 31 March 2022 were presented for consideration.

Decision - The minutes of the meeting held on 31 March 2022 were agreed as a correct record.

To declare any personal or prejudicial interests or dispensations granted by the Standards Committee.

There were no declarations of interest.

The Council welcomes contributions from members of the public.

Statements

If you would like to make a statement at this meeting on any item on this agenda, please register to do so at least 10 minutes prior to the meeting. Up to 3 speakers are permitted to speak for up to 3 minutes each on any agenda item. Please contact the officer named on the front of the agenda for any further clarification.

Questions

To receive any questions from members of the public or members of the Council received in accordance with the constitution.

Those wishing to ask questions are required to give notice of any such questions in writing to the officer named on the front of this agenda no later than 5pm on 1 September 2022 in order to be guaranteed of a written response. In order to receive a verbal response, questions must be submitted no later than 5pm on 5 September 2022. Please contact the officer named on the front of this agenda for further advice. Questions may be asked without notice if the Chairman decides that the matter is urgent.

Details of any questions received will be circulated to Committee members prior to the meeting and made available at the meeting and on the Council’s website.

There were no questions raised by members of the Public to be answered at this meeting.

To receive an update on the development of the Joint Strategic Needs Assessment and a refresh on JHWS.

The Board received a presentation from Rachel Kent (Public Health Consultant, Wiltshire Council) .The item covered the following matters:

·       An update was provided that the 8^th edition of the JSNA is currently being written, with the aim of publication in October.

·       Due to the timing, it was requested that sign off for the JSNA to be delegated to the Chair in order to enable findings to be fed into the development of the Integrated Care Strategy and local health planning as soon as possible.

·       Attention was drawn to the slides which had been circulated in order to provide context.

·       It was suggested that there could be a future workshop based around the JSNA.

Comments were received in relation to the importance of the strategy being organic in order for it to adapt to changes in circumstances. The impact of the JSNA from a Council perspective was cited, with it noted that the strategy allows Area Boards to understand specific issues in tightly defined areas and then be able to shift resources to act.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals:

i)                The Wiltshire Health and Wellbeing Board noted the timeframe to produce the Wiltshire Health and Wellbeing JSNA.

ii)              The Wiltshire Health and Wellbeing Board agreed to delegate sign off for the Wiltshire Health and Wellbeing JSNA to the chair, in consultation with the Director of Public Health and partners within the NHS.

iii)             The Wiltshire Health and Wellbeing Board noted that the Wiltshire Health and Wellbeing JSNA will be a key document in guiding the Board’s work and supporting the development and delivery of the Wiltshire Joint Health and Wellbeing strategy in tandem with a new Integrated Care Strategy for BSW.

iv)             The Wiltshire Health and Wellbeing Board agreed that its next meeting on 1 December would focus on the findings of the JSNA and developing the JHWS and Integrated Care Strategy.

To receive an update on the Pharmaceutical Needs Assessment.

The Board received a presentation from Sammer Tang (Public Health Speciality Registrar, Wiltshire Council). The item covered the following matters:

• The statutory consultation for the PNA took place after the Health and Wellbeing Board endorsed the draft in March 2022. All statutory consultees agreed upon the recommendations and conclusion of the draft PNA.
• It was stated that the Commissioner of Community Pharmacy Services would be visiting the Integrated Care Board in the new year and would therefore be a big opportunity to include pharmacies.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals:

i)  The Wiltshire Health and Wellbeing Board noted the summary of findings from the statutory consultation process.

ii)              Wiltshire Health and Wellbeing Board agreed to approve and publish the most up-to-date version of the Wiltshire Pharmaceutical Needs Assessment.

iii)             Wiltshire Health and Wellbeing Board agreed to continue to monitor the future changes of the pharmaceutical needs of Wiltshire population and publish additional statement and/or commission a new Pharmaceutical Needs Assessment as required.

To receive information regarding the Health Protection Strategy 2022-2026.

The Board received a presentation from Michael Allum (Acting Public Health Consultant, Wiltshire Council). The item covered the following matters:

• It was outlined that a Health Protection Assurance Group had been set up to take strategic lead for Health Protection, with the purpose of the strategy to build upon previous work conducted by the group.
• Key topics of work that had bene agreed for 2022-2026 were outlined to the Health and Wellbeing Board as well as further objectives based upon local data and requirements.
• The strategy has the aim of ensuring that relationships formed within the pandemic continue to grow as well as providing assurance of the different processes involved.

Comments were received in relation to why Abdominal Aortic Screening had been identified as being a medium-term priority, to which it was clarified that Cancer programmes would be the first initial term focus. In addition, it was recognised that there is room to improve regarding uptake and that there are ways in which communication can be used to connect with communities to improve this. A further comment was made in regard to how a number of the screening elements would be reliant on NHS capacity and ability to deal with pressures. It was stated that though this would be outside of the Health Protection Assurance Group, there would be reporting pathways to potentially address this and that work is being done to raise Cancer Screening rates to back to where they were pre-Covid by targeting the most appropriate people.

In regard to the environmental element of the report, it was stated that the Health Protection Assurance Group and Public Protection team have processes in place with a range of stake holders to raise issues regarding water and air quality. It was stressed that it would be important to gain assurance that the correct monitoring is take place, especially within the planning system.

It was queried why mental health trusts were not listed within the report, to which it was clarified that the author would be happy to add more partners to the work. A further point for discussion was made in regard to infection disease control and anti-vaccination stickers which had been placed on signposts within the Wiltshire locality and whether this was still an underlying problem. It was clarified that there has been an increased discourse online including the positive outcome of the Covid vaccines and that the NHS and partners would hopefully have the correct tools and relationships to address such concerns.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals:

i)                The Wiltshire Health and Wellbeing Board noted and acknowledged the Wiltshire Health Protection Strategy2022- 2026 document (see appendix 1) and would support the priorities setout in the document.

To receive an update on the Integrated Care Alliance work programme.

The Board received an update from Emma Higgins (Associate Director, NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board (ICB)).The item covered the following matters:

• It was stated that the paper attached to the agenda set out the journey of the alliance programme and the shared work programme over the past 18 months.
• Despite issues, progress has been made on the work programme, which started in April 2022, with work continuing on mandated development and the way which the ICA wants to work with population health and connection with communities.
• A neighbourhood collaboratives programme is ready to be launched, which will support neighbourhoods to come together and consider their population gaps.
• It was stated that the ICA ambition for the 2023 work programme is to be led by population health and wellbeing inequality gaps.
• Dated milestones were provided for the 2023-2024 work programme.

Positive feedback was received in regard to the programme having a neighbourhood focus, with it stated that there has been emphasis from Wiltshire Council to have a focus on inequality within neighbourhoods; including work with partners in Studley Green and Bemerton Heath. The importance of mapping community assets and assets were discussed along with how communities are understood and defined, with each neighbourhood potentially formulating themselves differently.

It was questioned how the work would link with theFuller stocktake report and that initial conversations had taken place with PCNs, with outline agreements with two PCNs in Salisbury as well as one each in Devizes and Trowbridge, with these different areas picked for a reason. These areas would be initially piloted and tested in order to recognise that each neighbourhood is different and to understand what does and does not work. Furthermore, a development day took place in March to identify key areas that each neighbourhood wants to consider as well as ensuring there are the right foundations for collaboration. Though it was stated that resource would potentially be a challenge, it was stated that the work could potentially be something for Board partners to get involved in.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals:

i)  The Wiltshire Health and Wellbeing Board noted the content of the paper.

To receive the Better Care Fund annual submission and end of year template.

The Board received a presentation from Melanie Nicolau (Head of Resources Commissioning, Wiltshire Council). The item covered the following matters:

• It was stated that attached to the agenda was a paper to formally bring the end of year submission of the Better Care Fund to the Health and Wellbeing Board as part of government arrangements.
• The Better Care Fund Plan for 2022-2023 is still in development and would need to be submitted in September. This would act as an enabler for work from the alliance and would be a main vehicle for prevention, admission, hospital discharge and rapid response services.
• A lot of consultation had taken place with communities and stakeholders, with the results tied together within the report.

Comments were received in relation to page 177 of the agenda pack, which stated that the number of external providers for homecare went down. In response it was suggested that this was due to there not being people available to provide homecare, in addition to a number of variables such as Covid increasing complexity with hospital discharge and a reduction in beds at the point of discharge. In addition, it was question that on page 161, the income was stated as being £57.5million, however the spend was just under £50million. This was clarified as being down to using the hospital discharge fund which was received from central government and that the £7.5million that was not spent would not need to be given back.

Further comments included, but were not limited to, that through scrutiny the council had been looking at the disabilities grant and how homes should be more adaptable. Additionally, the need to ensure that in planning policy housing standards involve new homes being capable of being adaptable.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals

i)                The Wiltshire Health and Wellbeing Board noted the end of year BCF submission 21/22.

ii)              The Wiltshire Health and Wellbeing Board approved the delegated sign-off of the Better Care Fund Plan to the Chair.

To receive an update on the development of the Wiltshire Autism Strategy.

The Board received a presentation from Robert Holman (Commissioning Manager, Wiltshire Council). The item covered the following matters:

• It was stated that the Wiltshire Autism Strategy would be the first all age strategy and would emphasise a whole-life approach, whilst echoing the four areas of the Health and Wellbeing and SEND strategies.
• The strategy is a product of significant co-production and engagement, including the voices of autistic people, their families and the local mental health and autism group.
• The six priorities of the strategy were outlined within the attached report.
• It was stated that for the first six months the Wiltshire Locality Mental Health and Autism Group would be responsible for implementation before handing over to the Wiltshire Autism Partnership in the new year.

Comments were received in relation to how the strategy was positive from a Councillor perspective, having seen gaps within case work. Additionally, it was voiced that members were pleased that the strategy was whole life. It was also clarified that in regard to co-production, the Wiltshire Parent Council had been consulted. Further clarification was provided that there would be a timeline for the implementation plan, with a lot of work happening already. Additionally, a plea was made to the authors to capture what elements of co-production worked well as this would allow others to learn going forward.

It was stated that transitions are a key area within services and that this would be an area that would be considered within the initial proposal, however there would be a lot of people who would not be known to social care, due to there being a wide spectrum. Praise was also received for the strategy from a mental health perspective, in the way that it linked in with inpatient units as well as referring to the community mental health framework.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals

i)                The Wiltshire Health and Wellbeing Board approved and signed off the Wiltshire joint all-age autism strategy 2022-27.

ii)              The Wiltshire Health and Wellbeing Board noted the governance arrangements for its implementation.

iii)             A report would be brought back to the Wiltshire Health and Wellbeing Board in 12-months’ time.

To receive the Healthwatch Wiltshire Annual Report.

The Board received a presentation from Catharine Symington (Interim Manager, Healthwatch Wiltshire).The item covered the following matters:

• It was stated that Healthwatch Wiltshire had published 12 reports about the changes people would like made to health and social care services as well as 78 recommendations for improvement.
• Over the past year Healthwatch had supported 4,426 people to share their experiences of health and social care services as well as having had 7,141 people come to them for clear advice.
• Projects that took place included making changes to the service offered at the Emergency Department and inpatient wards at the Great Western Hospital, Swindon; helping to develop mental health services; improving information about the new Devizes Health Centre as well as community projects.
• Healthwatch Wiltshire’s priorities for 2022-2023 were identified within the attached report.

Comments were received in relation to how it was positive to see the voice of young people referenced a lot more, interwoven and included as part of Healthwatch. Additionally, multiple Health and Wellbeing Board members praised and showed gratitude for the work of Healthwatch, in particular the work towards the Great Western Hospital and for community mental health.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals:

i)                The Wiltshire Health and Wellbeing Board noted the key messages?from the report.?

ii)              The Wiltshire Health and Wellbeing Board confirmed its commitment to listening to the voice of local people to influence commissioning and service provision.?

The next meeting is being held on 1 December 2022, starting at 9.30am.

It was agreed that the next meeting of the Health and Wellbeing Board would be on 1 December 2022, starting at 09.30am.

Any other items of business which the Chairman agrees to consider as a matter of urgency.

There were no urgent items.