Agenda and draft minutes

The Chair will welcome everyone to the meeting and give any announcements.

The Chair, Cllr Richard Clewer, welcomed everyone to the meeting and invited members to introduce themselves.

To receive any apologies for absence.

There were no apologies for absence.

To confirm the minutes of the meeting held on 21 March 2024.

The minutes of the previous meeting on 30 November 2023 were presented for consideration.

Resolved

The Wiltshire Health and Wellbeing Board approved and signed the minutes of the previous meeting held on 23 May 2024 as a true and accurate 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 Thursday 16 May 2024 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 Monday 20 May 2024. 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.

A question was received by Mr Chris Caswill in time for a written response, which was published as an agenda supplement.

Mr David Reeves asked the Board the following question:

“The 2022-25 Pharmaceutical Needs Assessment, signed off by this Board, identified that the three pharmacies then operating in Warminster were adequate, even though the ratio of pharmacies to population was already far lower than in other parts of Wiltshire.

Since the closure of the Boots at the Avenue branch on its consolidation into Boots Market Place, the inadequacy of pharmaceutical provision in Warminster has been of major public concern with interventions from the local MP, and the Town Council as well as widespread public dismay expressed online and in the press.

The closure or consolidation of a pharmacy requires a HWB Board to either issue a supplementary statement or to state that there is no requirement to do so. Indeed, the minutes of your own Board records that this process was followed when Lloyd’s pharmacy was closed in Sainsbury Chippenham, a town served by six pharmacies. Sadly, I see no evidence of a similar review carried out for Warminster.

While the Chairman’s statement from March 2024 records that an application for a third application was “welcomed and supported” by the HWB Board, a proper evaluation should have been made at the point of the consolidation.

Noting that supplementary statements only deal with factual changes (number of people served; demographics; and risks to the health and wellbeing of residents and visitors). Whatever the decision made by the Wiltshire HWB at the point of Boots at the Avenue closure, we are now seven months on and pharmacy services in town are under severe strain – and are certainly risking the health of residents and visitors. And, of course, the Western housing expansion is already adding to the existing population placing yet more strain on the infrastructure.

So, I am asking you please to review this situation as a matter of urgency and to issue a supplementary statement that will properly support and allow market entry applications (including the one currently with the Integrated Care Board to be decided in June).”

Mr Reeves also stated that what he was most interested in was pharmaceutical provision and that he was very passionate about residents’ concerns.

In response it was noted that:

• The September Health and Wellbeing Board had considered the closure and shared the initial analysis from the Collaborative Commissioning Hub that the remaining pharmacies will be able to manage demand.
• The November Board meeting had received notice that the closure was confirmed (and that this was not a consolidation). The ICB also shared its plans on addressing workforce gaps (25% vacancy rate) and since then we have also seen the rollout of Pharmacy First
• It is important to note that the PNA does not stipulate a requirement for three pharmacies in the Warminster area, nor their hours or location, and the closure of a pharmacy does not automatically mean that provision is  ...  view the full minutes text for item 17.

To receive a report from Kate Blackburn and Vicki Lofts on the Boater Survey.

Vicki Lofts presented the findings of the survey and the recommendations to improve the health and well-being of the boater community.

Debate

The board was grateful for the report and presentation that helped them to understand the problem boaters face. The board praised the engagement approach and the LGA’s recognition. The board also suggested linking up with West Berkshire and other areas along the canal to share best practice.

It was clarified that one day’s travel could mean 6-7 hours of cruising. It was raised that issues with boater licensing and compliance were rooted in misunderstanding.

It was clarified that one of the main challenges was knowing how boaters can represent themselves and their issues, who the Canal Trust answers to and how do other strategies on smoking, education, vaccines etc apply to boaters.

Resolved

i) To note the results of the survey and;

ii) that board members circulate the report within their networks.

iii) that a 6-monthly update is received

To receive an update from Kate Blackburn and Katie Davies on the Obesity Strategy.

Katie Davies introduced the whole systems approach to obesity and the progress made in different areas of Wiltshire.

The strategy, in its initial stages, was growing into an evidence-based approach based on Government guidance. Consultation with academics at the University of Hull was also highlighted.

Obesity was described as a complex challenge and can be both a cause and effect. The approach is to look at the ability to react to such complexities and achieve coordination and collaboration across organisations in Wiltshire to tackle the problem.

Building a working group to engage stakeholders was voiced as a significant goal.

Debate

The board noted the report and agreed to nominate individuals for the core working group and to circulate the survey results.

It was clarified that government advice and strategy had been issued as a result of and based upon successful areas of the country in tackling obesity.

Resolved

That the board:

i) notes; the whole systems approach to obesity as the strategic

approach in tackling obesity in Wiltshire.

ii) considers who in their teams and organisations should be involved in the systems approach, and to put forward individuals to the Core

Working group

iii) notes; the outcomes of the Whole Systems Approach to obesity will be driven by engagement with key stakeholders and Wiltshire residents.

iv) That a 6-monthly update is received on the strategy

To receive a report on Neighbourhood Service Collaboration from Emma Higgins.

Emma Higgins updated the board on the collaborative work across Wiltshire to improve population health and reduce health inequalities. She highlighted the achievements and learning from the Pathfinder site in Melksham and Bradford on Avon, the Salisbury livestock market project, the Chippenham, Corsham and Box hypertension prevention project, and the engagement with the military community.

Debate

The board noted the report and the regional and national recognition of Wiltshire’s approach.

It was clarified that all projects have a specific measuring plan for data and understanding what can and can’t be measured.

Resolved

To note the update

To receive an update and performance report on the ICA from Emma Higgins

Emma Higgins presented the first report on the monitoring and activity against the joint local health and well-being strategy and the integrated care strategy implementation plan, alongside the activity of the Integrated Care Alliance undertaken in line with this. She said there were some areas where the KPIs were not yet set, or targets met and some challenges around data and reporting which were in the process of being addressed.

Debate

The board noted a strong start and the progress made, however asked for more detail surrounding KPIsin due course.

The point was raised that the ICA do not get a lot of data from the military, and they would be willing to share this and there is also a need to ensure appropriate focus on prevention.

Resolved

To note the update

To receive an update from Fiona Slevin-Brown on the ICBC

Fiona Slevin-Brown gave a brief update on the ICBC programme, which aims to transform community-based care through a procurement exercise. She said the negotiation phase was ongoing and the engagement document was ready to be launched, subject to the pre-election period guidance. 

Debate

It was clarified that the negotiation phase would run until July and would be formalised in September.

The ICBC was confident about having the resources needed to deliver and wanted to focus on having people set in ICBC-only roles.

Resolved

To note the update

To receive an update on developments relating to the implementation of the Better Care Plan.

Helen Mullinger presented the standing update on the better care plan, which showed the performance against the national metrics and the financial summary. It was accepted that there were some areas of underperformance, such as avoidable admissions and residential admissions, and work was being done to address them.

Debate

It was clarified that a £1.8 million “balance” remaining within the report was where final figures and invoices are due and was not an underspend.

Resolved

To note the end of year BCF submission 2023-24,

Approve the delegated sign-off of the Better Care Fund Plan to the Chair

The next meeting will take place on 11 July 2024.

The next meeting will be on 11 July 2024.

To discuss any items the chair agrees to as a matter of urgency.

The committee thanked Col Ricky Bhabutta for his attendance and wished him well in retirement. The need to continue a military presence on the board was stressed given the disadvantage to registered military personal in accessing services and initiatives.

The need to understand the complexities of pharmacies and accessibility for different areas of the community was voiced. Pharmacies being able to provide a range of services is dependent on there being physical pharmacies to attend.