Agenda and minutes

To receive any apologies for absence received.

Apologies were noted from the following Members:

Mark Cubbon, Co-opted Deputy for Provider Representative: Acute Health Trusts 

Dr Sarah Schofield, West Hampshire Clinical Commissioning Group 

Michael Lane, Police and Crime Commissioner for Hampshire 

Ron Shields, Provider Representative: Community and Mental Health

David Radbourne, NHS England (Wessex)

Steve Crocker, Director of Children's Services

Councillor Roger Huxstep was present with the agreement of the Chairman.

The Chairman noted that Members Julie Amies and Simon Bryant would join the meeting following the Isle of Wight Health and Wellbeing Board also taking place that morning.

All Members who believe they have a Disclosable Pecuniary Interest in any matter to be considered at the meeting must declare that interest and, having regard to Part 3 Paragraph 1.5 of the County Council's Members’ Code of Conduct, leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code.  Furthermore all Members with a Personal Interest in a matter being considered at the meeting should consider, having regard to Part 5, Paragraph 4 of the Code, whether such interest should be declared, and having regard to Part 5, Paragraph 5 of the Code, consider whether it is appropriate to leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with the Code.

All Members who believe they have a Disclosable Pecuniary Interest in any matter to be considered at the meeting must declare that interest and, having regard to Part 3 Paragraph 1.5 of the County Council's Members’ Code of Conduct, leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code.  Furthermore all Members with a Personal Interest in a matter being considered at the meeting should consider, having regard to Part 5, Paragraph 4 of the Code, whether such interest should be declared, and having regard to Part 5, Paragraph 5 of the Code, consider whether it is appropriate to leave the meeting while the matter is discussed, save for exercising any right to speak in accordance with the Code.

Cllr Anne Crampton declared an interest as an employee of the Branksomewood Surgery in Fleet part of the North East Hampshire and Farnham CCG.

To confirm the minutes of the previous meeting.

The minutes of the 10 December meeting were reviewed agreed.

To receive any deputations notified under Standing Order 12.

There were no deputations received.

To receive any announcements the Chairman may wish to make.

The Chairman made the following announcements:

A survey of all Board Members was completed and many thanks for the time that colleagues took to share their views. COIVD working has further helped develop the strong partnerships which was highlighted in the survey responses.  This feedback will be taken forward with a view to informing and advising Board Sponsors as we continually review the strategy and key metrics and involvement across the Board’s activities. Some key themes include how the Board is run for more effective debate and feedback to others to ensure it is a strong leadership forum. This includes reviewing how the Board links into the system and wider partners who can influence Health and Wellbeing including parish councils and those communities not widely represented.  The majority of suggestions align, and Board Sponsors will be asked to provide an update at the next meeting. Further suggestions include key topics relating to health and wellbeing further broadening out the programme of work as we have been doing to include transport, and wider determinates of health. This will all be taken forward in a strong work plan of both topics and ways of working.

A brief update on the Integrated Care System will follow and views from the ICS Executive considered in due course as to the impact on Board membership.

To receive a brief update on the Hampshire and Isle of Wight Integrated Care System.

The Board received an update from CCG representatives on the Hampshire and Isle of Wight Integrated Care System (ICS) geography and areas withing the Frimley ICS.

Members heard that the white paper reviews legislation and proposals for the health and care bill coming into force April 22, building on previous plans and working together.  It doesn’t address reforms to social care and public health which will be dealt with later this year.  The aim is for joint working and with a duty to collaborate effectively to improve outcomes for residents at the place level with integrations between NHS and other partners.  Provider collaboratives will need specific details to be worked through guided by legislation.  

The NHS body will need to be set up alongside a health and care partnership to meet statutory must dos.  The sub structure beneath the top structure – remains to be implemented along with defining place, maximize existing structures and best way to proceed.  Health and Wellbeing Boards will be key to that and how can they help improve outcomes for the population.  

The HIOW ICS and Frimley ICS will need to ensure coproduction to get it right from all perspectives.  Building on the journey thus far, all coterminous areas of Hampshire’s complicated geography will need to be included in moving forwards.  Representation from both ICSs will be critical when discussed in depth in due course.  Increased clarity with specific detailed guidance will improve collaboration with joined up conversations with both ICSs.  While ICS boundaries are not set down in statute, further discussions will be required across all partners working within both ICSs to ensure boundary issues are considered.

Members noted that working within tribes of NHS and local authorities and committing as a group to explore how we work and be ahead of national guidance and support, with curiosity about each other ways of working ahead of statutory changes.  

The Chairman requested that any questions regarding this item be emailed in ahead of the item to be reviewed in depth at an upcoming meeting.  A further discussion with partners will follow in both the Hampshire and Isle of Wight ICS and the Frimley Health and Care ICS to consider implications and next steps of the White Paper proposals.

RESOLVED: 

That the Health and Wellbeing Board-- 

·         Noted the contents of the Briefing Paper and the direction of travel being taken by the HIOW ICS as it develops.

a.    To receive an on the priorities and progress of the Healthier Communities strand of the Hampshire Health and Wellbeing Strategy.

b.    To engage members of the Board in a dialogue to help inform the development of a new Local Transport Plan (LTP4) for Hampshire. 

a.    Theme Deep Dive

The Board Sponsor for Healthier Communities provided an update noting that the pandemic has brought economic hardship, social isolation, increased loneliness and the need for agencies such as local authorities, NHS and voluntary sector has been highlighted in supporting communities in the recovery phase and beyond.  The Healthy Homes Workshop, workforce training, green spaces, homelessness have been priorities with inspiring outcomes for Hampshire boroughs and districts.

Members heard that there have been three main priorities - family, friends and community resilience, housing, and the built and natural environment.  Local communications have been key to the response.  Strengthened relationships and shared knowledge will continue to take work forwards with some pre-pandemic initiatives but most to address new pandemic needs - food pantries, employment and skills hubs, and community grants.  The pandemic has exposed inequalities within our communities, and work to address health inequalities includes the Healthier Communities Programme in North Hampshire, along with targeted work to raise awareness of key public health messages with the Nepali Community in North East Hampshire. 

There is a broad range of partnerships and programmes working together to keep people safe at home. Following the Healthy Homes Workshop in January 2020, a working group was established in the summer of 2020 to take forward the workshop and needs assessment recommendations. This includes strengthening multiagency working through joint training opportunities.  Survey recommendations are being implemented based on shared determinants of health which includes a joint induction offer across health/care/housing with the aim of more efficient and positive pathways for clients.  The potential “Health Begins at Home” memorandum of understanding will be shared for organisations to commit to long term health outcomes and the support of the Board would be appreciated.  Understanding home adaptation processes and policies will help guide the next steps as outlined in the business plan.

Homelessness prevention work commissioned by the STP and the impact of remarkable effort for people experiencing homelessness who have the worst health outcomes.  While the scale of the effort by health and social care and local authority partners right across the geographical footprint of Hampshire has been significant, it is not a start and finish activity.  The numbers change and for a sense of the scale of the data from March 2020, there were 1700 people homeless with a high percentage underlying physical and mental health conditions and health needs, even when registered with GPs.  

Highlighting outcomes achieved together with a growing multidisciplinary team approach and working groups with transformed access to mental health services for adults and older adults across the community.  Development of primary care services access, acute hospital discharge with people presenting homeless, and housing outreach services for people facing multiple challenges.  

Driven by changing narrative, shared learning, home being the underpinning social determinants of health and a common purpose with sustained appetite for whole system changes.  A large percentage of people facing homelessness need provision of wrap around support and emergency or shared housing to help them lead their best lives  ...  view the full minutes text for item 149.

To receive the Board’s annual report on the progress of ongoing work to support the delivery of the Joint Health and Wellbeing Strategy within the limitations of the Covid-19 impact.

The Director of Adults’ Health and Care introduced the Health and Wellbeing Board’s annual report from the Director of Public Health, with a key focus on inequalities as result of covid but also pre-existing factors.  Each Board Sponsor provided an update on progress, impact of Covid, challenges, key developments and upcoming priorities within their theme.

Strategic Leadership

Members heard that the work of the Board had been taken forward in the last year via virtual meetings with good discussions improved attendance, a survey carried out, and that the Joint Strategic Needs Assessment had been paused but was now being picked up with additional information expected from the current Census.  Inequalities identified through Covid and earlier, are being addressed through various Boards best placed to take action and threaded through all work.  Climate change work has started at the County Council and also further across partnership in relation to health, as well as key areas in planning and local developments to improve health and wellbeing outcomes at the place level.

Starting Well

Members heard that following on from the recent update to the Board, significant investment and activity has taken place in regards to children’s mental health including close working with Clinical Commissioning Groups (CCGs).  The impact of Covid with children not being at school and additional pressures on families with the effects of lockdown expected to be seen for some time with significant work and interventions put in place to support families and young people across agencies.  A joint commissioning strategy with CCGs has been agreed and will delivering targeted work around domestic abuse and parenting pathways as priorities.

Living Well

Members heard that as a result of the pandemic, inequalities have been highlighted across population and though care has been available, not everyone has been able to access care and for the majority it has not been face to face.  There has been good work focused on health and wellbeing around those shielding and homeless.  Encouraging registering and receiving care have demonstrated examples of agencies working together.  There has been a focus on mental health throughout the year.  While there has been Covid related challenges with the anti-smoking program during pregnancy, the work is continuing and new investment to for weight management and obesity prevention.  Increase in self harm, domestic abuse, and poor mental health have escalated as a result of social isolation.  The focus remains on the underserved and on how to offer health and care and support them in taking up the services.  Digital tools have kept the work moving forwards and coproducing solutions alongside voluntary sector.

Aging Well

Members heard paralleled joint working across Hampshire and particularly noting the contribution of the Voluntary Care Sector (VCS) alongside statutory organizations which have been at the forefront supporting residents in collective response.  The one-year anniversary of the first national lockdown will take place on 23 March and be a national day of reflection to consider what has been endured and those lost.  Colleagues are urged to observe  ...  view the full minutes text for item 150.

To review anticipated future business items and progress on actions for the Health and Wellbeing Board.

Members considered anticipated future business items and progress on actions for the Health and Wellbeing Board.

Members noted the following:

·         An update would follow as part of Strategic Leadership and the embedding of a culture of co-production.

·         Embedding positives of Covid learning and united approach for a thumbnail sketch across chapters and supporting each other in addressing inequalities for residents. 

·         Upcoming workshop for development of the next physical activity strategy from all different sectors and request to bring this forward to the Board with appreciation of colleague’s engagement and commitment to physical activity.

·         Joint Strategic Needs Assessment update to follow over the summer.  

·         Signing off the on Pharmaceutical Needs Assessment expected at the next meeting.

·         An update requested on the Joint Hampshire and Isle of Wight children and young people’s mental health and emotional wellbeing Local Transformation Plan following on from December 2019.

·         Following on to the excellent LTP4 presentation request for planning colleagues to attend for similar discussion.

·         Organizational support and how we behave in the new world and request to carve our time to facilitate cultural differences and working together better.

The next formal meeting of the Board will take place on Thursday 1 July.

The meeting concluded at 12:15pm.