Agenda and minutes

Councillor Philip Whitehead, Co-Chair of the Board and Leader of Wiltshire Council 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 confirm their attendance for those watching the live stream of the meeting.

Apologies for absence were received from Nicola Hazle, Dr Gareth Bryant, Tony Fox and Kevin McNamara.

To confirm the minutes of the meeting held on 23 July 2020.

Decision –

The minutes of the meeting held on 23 July 2020 were confirmed as a correct record, subject to minute 21 being amended to read ‘Dr Ed Rendell - (Co-Chair and Wiltshire Locality Clinical Lead BSW CCG) – declared an interest that his wife was employed by Wiltshire Council as an Educational Psychologist’.

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 17 September 2020 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 21 September 2020. 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 was no public participation.

The Health and Wellbeing Board membership contains a number of voting and non-voting members, as set out in Section 6 of Part 3 – Responsibility for Functions of the Council’s Constitution.

A request has been received for a representative of Wiltshire Health and Care is accepted as a non-voting member of the Board. 

The Board are asked to endorse the appointment.

a)      Board Membership

The Chair reported that a request had been received for representation on the Board from Wiltshire Health and Care at Chair/ Managing Director level in common with the other main NHS providers to Wiltshire’s population. The two Co-Chairs felt that this request was appropriate and accordingly, Stephen Ladyman, Chair of Wiltshire Health and Care attended the meeting in an observer capacity until the Board membership is changed at the next annual Council meeting in May 2021.

Comments were received from other Board members suggesting that a representative from Virgin Healthcare could also join the Boards membership as an organisation that has the interests of children at their core, similar to Wiltshire Health and Care having the interests of adults at their core.

Decision

The Chair confirmed that the request from Wiltshire Health and Care to attend Board meetings, initially in an observer capacity, would be accepted and that the overall governance structure and membership of the Board could be considered at a future meeting.

b)      Adult Social Care Reform

The Chair reported that as the Cavendish review on the future of Adult Social Care nears completion, the board may like to be aware of the principles for social care reform agreed and put forward by a wide range of representative organisations including the LGA, ADASS, NHS Providers and Commissioners.

Further information could be found on the Local Government Association website at this link - https://local.gov.uk/adult-social-care-seven-principles-reform

To receive a presentation from Elizabeth Disney – NHS Bath and North East Somerset, Swindon and Wiltshire (CCG) and Emma Legg – Director Access & Reablement, Wiltshire Council.

The Board received a presentation from Elizabeth Disney – NHS Bath and North East Somerset, Swindon and Wiltshire (CCG) and Emma Legg – Director Access & Reablement, Wiltshire Council about the impact of Covid-19, how the NHS in partnership with Wiltshire Council have responded and future plans.

The presentation contained detailed information about the following:

·       Strategic direction (delivery) and development of the Wiltshire Alliance

·       Impact of COVID-19 on the health and care system: service changes and improvements to retain

·       An update on BSW response to NHS Phase 3 Planning (recovery and restart)

·       Winter Planning up-date

·       System challenges

In response to questions about (i) Virtual Frailty Wards; (ii) flu vaccinations for the elderly; and (iii) the health of domiciliary workers and plans in place to cope with sickness levels. Elizabeth Disney and Emma Legg explained that (i) the virtual Frailty Wards were a new concept to encourage better use of collective expertise to manage frail people, so that their needs did not escalate. It was early on in implementing this style of working, which aims to reduce infection risk and footfall into Care Homes. (ii) the impact of Covid-19 on the number of flu cases this year is unknown at this stage, especially with the numbers of elderly people shielding at home for an extended period of time, however, it is anticipated that there will be significant operational pressures on health services, and there may be issues distinguishing between Covid-19 and flu symptoms. (iii) A key element for the health of Domiciliary workers is how demand for services is managed when people leave hospital, if managed well the impact would be reduced and services would be able to cope with these pressures in a more resilient way.

The Chair thanked Elizabeth and Emma for a very interesting presentation which contained a vast amount of very useful information.         

Decision – To note the presentation and comments made.

An update from the NHS, Police and Wiltshire Council - Kier Pritchard/ Tracey Cox/ Claire Edgar

The Board received a presentation from Kier Pritchard – Wiltshire Police Chief Constable, Tracey Cox/ Claire Edgar, and Lucy Baker about the impact and pressures on the Police during the Covid-19 situation and the effects on mental health.

The Police and Crime Commissioner and Chief Constable introduced the presentation and made the following comments:

•       Covid has had a significant impact on communities and services alike. It has led to new and emerging pressures placing increasing demands on services.

•       The report illustrates the impact COVID has had on Mental Health demand as it relates to Wiltshire Police.

•       The report outlines the wider impacts and demand across the system experienced during Covid.

•       It describes the activity in place across the Crisis Care Concordat, led by the CCG, to understand, model and accurately predict future demand from Mental Health and how it will impact across different services.

Further detail was provided from Lucy Baker and Claire Edgar on Mental Health Services, in particular on the following matters:

·       Current position;

·       What could be the new demand – national picture over the next 5 years;

·       Mental Health – future demand;

·       Review of impact on services;

·       Mental Health – impact of Covid on subgroups of need; and

·       What is the system doing proactively together

There was discussion on the data contained in the presentation graphs and how they relate to the population areas under the  influence of the Police and the Local Authority; the need for joined up analysis of trends and impact of Covid-19 on mental health in local areas to be shared at a national level; how plans to support people with suicidal tendencies were in place and being evolved to gain a better understanding of the needs of the community following the recent steep rise in suicides over the Covid-19 lockdown period; the importance of increasing the Board’s awareness of all the significant issues being dealt with by partners due to Covid-19 and how the risk register is helping to focus attention on the most pressing areas/issues; capacity issues at the Bluebell Place of Safety during Covid-19 and plans in place to relieve pressures from facilities in other local authority/police areas. 

The Chair thanked all presenters for a very enlightening presentation and agreed that a presentation at a future meeting on the risk register for the Recovery Coordination Group could be helpful..        

Decision – To note the presentation and comments made.

To receive a report by Dr Michael Allum about the final draft Gypsy, Roma, Traveller and Boater strategy for Wiltshire.

The Board received a report from Dr Michael Allum, Public Health Speciality Registrar, Wiltshire Council presenting the final draft Gypsy, Roma, Traveller and Boater Strategy for Wiltshire.   

It was noted that Travellers experienced significant inequalities throughout all stages of life. Gypsy, Roma, Traveller and Boater people experienced the worst health outcomes of any ethnic group and the average life expectancy was 10-12 years less than the general population. Higher rates of miscarriage, a greater proportion of individuals with long-term health conditions, and higher rates of depression and suicide were just some of the inequalities experienced by these communities. It was most important that all public organisations addressed these health inequalities so that all individuals had the same opportunities to live healthy lives no matter their background.

Dr Allum explained that the new strategy is focussed on reducing the significant inequalities experienced by these communities and will work across the wider socioeconomic determinants of health to address these. In addition, COVID-19 pandemic continues to highlight the significant effect of inequalities on the health and wellbeing of vulnerable communities. The strategy would work within the framework of the Council’s Recovery plans.

Decision –

i)        To acknowledge the Health Needs Assessment

ii)      To approve the GRT&B Strategy for implementation

To receive a report from Alison Enever – Head of Special School Transformation about the SEND Inclusion Strategy 2020-23.

The Board received a report and presentation from Alison Enever, Head of Special School Transformation and Cate Mullen, Head of SEND and Inclusion, Wiltshire Council seeking the Board’s approval of the SEND Inclusion Strategy 2020-2023.   

The Head of Special School Transformation and Head of SEND and Inclusion, introduced the report and presentation and commented on the following matters:

•       The Partnership Strategy

•       Key Principles of the Strategy, including the Vision

•       Underpinning commitments

•       National issues

•       The Wiltshire picture, including challenges and successes

•       Areas that children and young people with SEND felt important to include in the Strategy

•       Priorities developed through the consultation

•       How the Strategy is managed and understanding how it is working

It was noted that the Strategy, approved by Cabinet in March 2020, had been developed with parents/carers, children and young people and the organisations who make up the Wiltshire SEND Local Area Partnership, with a main focus of supporting the development of inclusion for children and young people with SEND.

The Head of Special School Transformation also provided an update on the progress being made at the North Wiltshire School, formally Rowde Special School, following the amalgamation of the three special schools in Trowbridge, Chippenham and Rowde.  It was noted that the merger of the three school was completed successfully on 1^st September 2020 and this was the beginning of a transformational journey. A build partner had been appointed and a period of co-design was commencing with contributions from parents, carers staff and pupils to provide and exciting and future proof facility.

Cllr Mayes, Cabinet member for Children, Education and Skills, thanked all involved in the preparation of the Strategy and she acknowledge the immense amount of progress and achievements made.  Cllr Mayes also thanked all team members involved for their contributions towards the development of the Strategy. 

Decision – To approve the SEND Inclusion Strategy 2020-2023.

To receive a report and presentation from Julie Brown - Acting Manager of Healthwatch Wiltshire updating the Board on the Healthwatch Wiltshire’s recent work and its priorities for the coming year.

The Board received a report and presentation from Julie Brown, Acting Manager of Healthwatch Wiltshire who provided an update of Healthwatch Wiltshire’s recent work and its priorities for the coming year.   

The Acting Manager, Healthwatch Wiltshire introduced the report and presentation and commented on the following matters:

•       Activities undertaken during the year

•       Key projects – evaluating GP improvement access, dementia community services, community cash funds and volunteer led military families project

•       Key findings from the projects

•       Recent work during the Covid-19 pandemic

•       Comments from visitors

•       Healthwatch priorities and workplan

•       Young healthwatch mystery shopping project

The Chair noted the importance of reconsidering the approach to waiting lists for military families that move around a lot and that there would be further legislation enshrining the military covenant into law likely later this year.

The Board also heard from Erin Woodsford and Madeline Cooper about their role in the Young healthwatch mystery shopping project. It was noted that the young people played a key role in designing the project that investigated online mental health resources for young people. The young people reviewed the websites for On Your Mind and Wiltshire CaHMS which provided useful information although there were some areas for improvement. Healthwatch have linked in with commissioners and local providers of the services and will share the project findings with them.

Dr Catrinel Wright, Wiltshire Locality Healthcare Professional, spoke about a blog she had recently written on how young people can be helped to manage anxiety in the current times. The young people supported the suggestion that the use of blogs would be a helpful resource for young people.

The Chair thanked all involved in the presentation, especially the young people for their valuable contributions.

Decision – That the presentations and comments be noted.

Angus MacPherson, Police and Crime Commissioner commented on a recent inspection of Erlestoke prison by the HM Inspectorate of Prisons to assess its success in returning to acceptable conditions following the initial peak of the COVID-19 pandemic and the restricted regime during it.  He reported that the positive element in the published report was the excellence of the prison library service, however a number of issues were highlighted in the report including, the mental health of prisoners, lack of available accommodation for prisoners leaving prison and a number of prisoners not having received an assessment of their social needs. It was agreed that further discussion on the findings would take place.

Decision – To note the comments of the Police and Crime Commissioner.