Agenda and minutes

The Chairman will welcome those present to the meeting.

Cllr Richard Clewer, Chairman of the Board and Leader of the Council, welcomed all attendees to themeeting.

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 Clewer, through a chairman’s announcement, informed Members of a Briefing Note in relation to the Wiltshire Pharmaceutical Needs Assessment, which was attached to the agenda. The Briefing Note provided an overview of the Market Exit Notification from Lloyd’s in Sainsbury Pharmacy as well as an initial impact assessment of the closure by the Public Health Team.

A further point was raised that an additional Lloyd’s in Sainsbury Pharmacy was closing in Melksham, highlighting the need to monitor staffing issues, and that although local efforts were being made to solve this, central support was needed.

As part of the briefing note it was recommended that the Board:

      i.        Acknowledge the closure of the Lloyd’s pharmacy in Sainsbury in Chippenham from 18th April 2023.

    ii.        Review the initial impact assessment for the closure of the Lloyd’s pharmacy in Sainsbury, Chippenham and support the finding that this closure does not create a gap that could be met by an application offering to meet a need for, or secure improvements or better access to, pharmaceutical service.

   iii.        Support the decision that a supplementary statement is not required to be issued as sufficient alternative local providers are available locally.

   iv.        Continue to monitor any future changes in pharmaceutical services within Wiltshire.

After which, it was resolved:

Decision – That the Wiltshire Health and Wellbeing Board accepted the Wiltshire Pharmaceutical Needs Assessment’s recommendations.

To receive any apologies for absence.

Apologies were received from:

• Tony Mears (Salisbury NHS FT)
• Lisa Hodgson (WHC)
• Niall Prosser (RUH)
• Shirley-Ann Carvill (WHC)
• Jo Howes (WCP)
• Jo Madeley (WC)
• Fiona Slevin-Brown (ICB)
• Jen Salter (WC)
• Philip Wilkinson (OPCC)
• Massimo Morelli (ICB)
• Barry Young (ICB)
• Catherine Roper (WP)
• Catrinel Wright (ICB)
• Catherine Symington (WHC)
• James Fortune (CAMHS)

To confirm the minutes of the meeting held on 30 March 2023.

The minutes of the previous meeting of the Board held on 30 March 2023
were presented for consideration. After which, it was:

Decision - The Wiltshire Health and Wellbeing Board approved and signed the minutes of the previousmeeting of the Health and Wellbeing Board held on 30 March 2023 as atrue and 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 Thursday 18 May 2023 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 22 May 2023.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.

No questions were received.

To receive an update on Public Health Nursing Services.

Kate Blackburn, Public Health Consultant, presented an update regarding the Public Health Nursing Contract to the Board. The purpose of this report was to provide Health and Wellbeing Board with an update on the future delivery model for Wiltshire’s Public Health Nursing (PHN) Services beyond April 2024.

During the item, the main points raised included, but were not limited to:

• The contract with HCRG Care Group to deliver the Wiltshire Children’s
  Community Healthcare Service would expire on 31 March 2024.
• The ICB had recently clarified it wasnot able to progress a joint procurement process with Wiltshire Council at this time and the Council was not able to extend the current contract any further under procurement legislation. The options available since June 2022 had therefore evolved to:

a.    Single procurement of Wiltshire PHNS by Wiltshire Council or;

b.    Local Authority in-house PHNS.

• In June 2022, Cabinet was presented with these options for the service beyondApril 2024 and agreed for PHNS to be part of a single procurement of acombined universal and specialist children’s community health service forWiltshire.
• However, there was commitment from both the Local Authority and BSW ICB to continue to work closely together to align Wiltshire’s universal and specialist service specifications, and monitoring processes, to ensure services would continue to be joined up andseamless.
• The full report was included within the Agenda Pack.

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

1. The Board noted the future delivery model for Public Health Nursing Services.

To receive an update on the priorities of Healthwatch Wiltshire.

Alan Mitchell, Chair of Healthwatch Wiltshire, made a presentation of the Healthwatch Wiltshire Priorities to the Board. During the item, the main points raised included, but were not limited to:

• Following a priority setting process, involving volunteers and a short survey open to Wiltshire residents to give their views, the following priority areas were identified for Healthwatch Wiltshire to focus on over this next year:

                                               i.     Hospital Discharge and Care at Home/virtual wards.

                                              ii.     Children and Young People’s Wellbeing.

                                            iii.     Mental Health and Autism.

                                            iv.     Access to GP services – continue follow up work.

• It was also agreed to monitor dentistry and how the BSW ICS manages implementation of any changes now that it is taking on responsibility for dentistry.
• The Board welcomed the focus on access and capacity issues surrounding GP Practices, and support was offered by numerous members in actioning the Survey.
• The full report was included within the Agenda Pack.

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

1. The Board notes Healthwatch Wiltshire’s priorities for the year ahead.

To consider the Better Care Fund End of Year submission and sign off of the Plan for 2023.

Helen Mullinger, (Head of Commissioning Adults), presented the Better Care Fund End of Year Submission to the Board. The report provided the Board with an executive briefing of the end of year submission for BCF Wiltshire. It was noted that the template was required to be submitted to the BCF National Team, as well as that there was a requirement of BCF governance arrangements that the template be formally presented to the Health and Wellbeing Board, to provide accountability for the funding, information, and input into national datasets.

It was highlighted that all national conditions were met, the BCF were successfully enabling integrated working and that both the Department for Health and Social Care and Department for Levelling Up, Housing and Communities had highlighted the BCF as an integral programme for delivering Key Priorities in the NHS Long Term Plan.

The full report can be found in the Agenda Pack.

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

1. The Board noted the end of year BCF submission 2022-23,

2. The Board approved the delegated sign-off of the Better Care Fund Plan to the Chair.

To consider the draft BSW ICS 5 Year Joint Forward Plan and alignment with the Wiltshire Joint Local Health and Wellbeing Strategy.

David Jobbins and Emily Higgins, Interim Deputy Director – Planning & Programmes, presented the Draft BSW ICS Implementation Plan 2023/24 to the Board.

During the item, the main points raised included, but were not limited to:

• Board members were asked to consider the Plan with particular
  reference on whether it took proper account of the Wiltshire JLHWS. It was further highlighted that this was an opportunity to give feedback to allow adaptation.
• The BSW Vision was highlighted as three strategic objectives:

                                               i.     Focus on prevention and early intervention.

                                              ii.     Fairer health and wellbeing outcomes.

                                           iii.     Excellent health and care services.

• The BSW Strategy and this Implementation Plan aimed to bring together the key elements of what is aimed to be delivered and change through the three Strategic Objectives.
• It was suggested that document was currently large, and that work would be done to condense the document.
• The Board echoed the opportunity for engagement and feedback but stated that issues of deprivation were far different in Wiltshire to other areas, therefore it was important that the nuances were to be considered.

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

1. The Board considered the content of the Implementation Plan and provided feedback including responses to the Engagement Process questions made available at the meeting; and

2. The Board contributed to the opinion the HWB would provide on whether the plan took proper account of the Wiltshire JLHWS.

3. The Board delegated provision of the final opinion to the Chair, in consultation with the Corporate Director of People (Wiltshire Council) and the Wiltshire Integrated Care Alliance Director (BSW ICB), given that there was not another Health & Wellbeing Board prior to publication on June 30^th.

To partake in informal break out groups to discuss the implementation of the JLHWS.

The Board partook in informal break out groups to further discuss the implementation of the JLHWS, led by Emma Higgins and David Jobbins.

Three questions were put to the Board to give one-word answers as part of a Q and A using Slido:

What do you like about the Implementation Plan?

Comments included: Localism, Prevention, Ambitious, Inclusive, Comprehensive, Detailed

How useful do you think the plan is and how will it help us?

Comments included: Framework, Unsure, Vague,

What do you think is missing from or needs more focus in the plan?

Comments included: Resources, Timelines, Monitoring, Accountability, Neighbourhoods, SEND, Goals

It was noted that ICB’s were being made to balance their budgets and the challenges that this would bring shouldn’t be underestimated.

The Board appreciated the amount of useful information however, pointed to a need for more information on resources in the implementation plan, and the need to understand where the funding is to understand whether it was realistic.

The military population was highlighted as an anchor institution in Wiltshire, impacting without much notice and the need for cooperation going forward was expressed.

The timescale for incorporating the comments and updating the draft integrated care strategy was noted.

The next meeting is being held on 20 July 2023, starting at 10.00am.

The next meeting is being held on 20 July 2023, starting at 10.00am.

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

There were no urgent items.