Agenda item

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 and overcome deteriorating mental health and manage debt.  Concerns have been shared with local authority partners regarding rent and mortgage arrears, the end of furlough, and moratorium on eviction to accelerate broader system collaboration.  Without a home, nothing else can fall into place and the development of health begins at home.

 

The aim of the built and natural environment priority is that new developments are designed with health and wellbeing in mind, encouraging active travel and physical activity with sustainability at the core.  There are a number of examples of where this approach has been successfully developed.  Walking, cycling, and running have increased over the pandemic and the new County Council walking and cycling principles presented and considered in Local Transport Plan (LTP) 4 is next on today’s Agenda.  Physical activity in local community and schemes delivered by council and voluntary sector are key.  It is unfortunate that it took a pandemic to make these changes, but lessons learned will continue to be reflected in work following on past the pandemic.

 

In response to questions, Members heard:

 

Homelessness and addiction services are connected but this aspect of health services is often underfunded and underserved.  Consistent working with partners has coproduced specifications with voices of people who have lived with it, for those currently experiencing homelessness on a more outreach type basis.

 

It will be critical to take positive actions happening in parts of the geography to upscale it with wider initiatives consistently for everyone.  Recently formed districts and boroughs community recovery forum includes sharing learning in areas and potentially expanding the impact.  Linking to Council wise equivalent, welfare and recovery forum to have these important conversations is key to upscaling.

 

Willingness for people to operate in partnership across the patch but also feedback on disconnected local authority structure will help the business of joining up and avoid designing in a weakness, in order to have a single voice.  

 

While homes having green spaces and the outside environment are important the internal building specifications of homes are too.  With a shift towards working from home, cooking at home, and being healthy - the space to do so inside is critical with minimum specifications considered by developers.  A significant part of the Healthy Homes Needs Assessment is to bring together partners to improve the built structure of housing.  The Public Health team also contributes to new development consultations and consider improving indoor spaces in building applications.

 

Members noted that NHS health outcomes are key to the success of ICS and homes are an integral determinant of health.  Improving homes to make them warmer and more sustainable will prevent winter deaths due to cold and be in keeping with the County's Climate Emergency. 

 

Future home designs, size and layout and transport plans have a significant impact on health.  While Building for Life standards exist for healthy homes these guidelines should be considered in local building and transport planning to future proof developments.  

 

Members thanked those presenting for a very thought-provoking discussion that highlighted the need for a housing workshop and was exceedingly helpful and useful. The Executive Member for Children and Young People noted that some homes have been too small for families to live in comfortably through the multiple lockdowns.  Safeguarding issues, difficult situations, and the safety and wellbeing of children and young people also needs consideration engaging planners and districts to ensure that when homes are built, they are fit for purpose and for the future.  

 

Members agreed to bring these conversations back to their organizations and encourage districts and boroughs to add these considerations into their planning iterations.  After further discussion, an additional final recommendation was proposed, seconded and agreed by Members to strongly encourage taking these factors into account.

 

 

 

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.

 

·         Note the Healthy Homes project progress and endorse the planned next steps to develop and roll out a joint induction opportunity, and multi-agency training including educational videos. 

 

·         Note the good practice examples of work going on across Hampshire to develop healthier communities, along with the value of partnership working in this area to reduce health inequalities in Hampshire. 

 

·         Support the exploration of a Health Begins at Home Memorandum of Understanding which would allow organisations to make a commitment towards the use of housing to improve the long-term health and wellbeing of communities. 

 

·         Receive a status report on current Disabled Facilities Grant (DFG) practice at a future Health and Wellbeing Board meeting.

 

·         The Hampshire Health and Wellbeing Board request all Planning Authorities to review their Local Plans with particular regards to current and emerging design standards for healthy homes.

 

 

 

b.    Local Transport Plan 4

 

Members received an update from Public Health and Transportation colleagues currently collaborating on the refresh of the Local Transport Plan (LTP).  This has been a valuable opportunity to incorporate the health of Hampshire residents, as transport has a wide-ranging impact on not just access, but on the wider determinants of health. 

 

Members heard that the impact of place and how transport shapes it from spatial aspects of roads, green spaces, cycling and walking infrastructure to connectivity of streets if residents are able to access community feel safe.  Unfortunately, the negative consequences are most felt by disadvantaged groups including noise, air quality and separation with a physical and mental health impact.

 

The transport strategy is currently in the engagement stage for the Local Transport Plan 4.  Following this there will be a consultation stage after which it is planned to adopt a new plan by the end of the year.  This is the time to influence and shape before putting pen to paper.  Engagement is taking place on 2 design principles, the LTP objectives and the drivers of change including: changing climate, environment, changing society, changing economy, and changing technology.   The design principles mark a change in policy direction and are “the engine” of the LTP.

 

Some headline finding of the technical evidence base and research were reviewed, notably around decarbonisation of the transport system, health and transport trends, and the impact of pollution from transport on heath.     

 

In response to questions, Members questions --

 

The rise in homeworking presents an opportunity to reduce the need to travel.  Rail usage and future strategies will need to respond to the longer-term impact of the pandemic.  Rail patronage, of all modes, has seen the biggest drop during the pandemic.  The industry is currently developing strategies to support a strong recovery but in a very uncertain future.   The historic rail system was commercially based on supporting long distance commuting to London.  This is considered likely to change because of the rise in remote working.  Post pandemic, the rail network will need to adapt to offer a much broader market of services and offers including a more local rather than London centric operating model.

 

It was recognised that the car was an important mode of transport that has brought significant freedoms and prosperity.  It is the dominant mode in most rural parts of Hampshire.  The strategy would need to balance the needs of car drivers and other modes carefully.  It will be important to encourage and support people through positive changes and take the people along the journey.

 

The LTP would include a rural topic paper reflecting the complex nature and challenges faced by residents of villages without surgeries, shops, or buses.  Solution like enhanced fibre networks to improve connectivity should have a role to play in such locations.  

 

Members commended the report and focus on implications for health.  Younger generations already have changed behaviours and getting people on board must also make it easier for individuals to make the right choices.  Inequalities will be improved and there is scope to impact even the smaller journeys and increase physical activity there.  

 

The recent ratification of a refresh of the plan for prominence to physical activity and Energise Me’s HIOW physical activity strategy and active transport will further address inequalities via structural determinants that impact physical activity and active transport.  Remote appointments, working from home and opportunities around access and shared learning will be shared.  Continued investment in the green strategy, hospital infrastructure, travel links etc. and the response to the climate emergency will further this journey.

 

 

 

RESOLVED: 

 

That the Health and Wellbeing Board--

 

·         To note the process by which the LTP is being developed and the opportunity for Board members to influence its future direction. 

 

·         For Board members to consider responding to the local transport plan engagement.

 

 

 

The Director of Public Health joined the meeting at this time.

 

A ten-minute comfort break was taken at 11:35am.