Agenda and minutes

Councillor K Middleton declared a personal and non-prejudicial interest in item HWB75 (Homelessness Strategy Update) and advised that she worked within this area.

To approve the minutes of the meeting 29 September 2022.

RESOLVED – that the minutes of the meeting held on 29 September 2022 be confirmed and signed by the Chair.

No public speaking requests had been received.

To receive an assurance report against Living Well programmes and initiatives.

The Board received the report of the Service Delivery Manager: Health Improvement & Libraries. The report provided an update on the work of the Living Well initiative.

The Board heard from two members of staff, one from the bariatric service and one from the Healthy Lifestyles team, who had worked together to establish a community clinic to run alongside the healthy lifestyles clinic. A strong referral pathway was in place between the two services and patient experience was as one team.

The Board was shown a short video from a service user of the bariatric service explaining the support which had been provided to her.  The Board expressed their thanks to the resident and wished her luck on her journey.

A discussion was held regarding mental health and the impacts this can have on weight.

Members of the Board discussed the importance of preventative health work. The Board welcomed the community based approach and noted that service users preferred not having to go to hospital for these services. A discussion was held regarding the ease of moving the service out into the community.

It was noted that the bariatric service covered the whole of Shropshire, Telford and Wrekin, however, only Telford and Wrekin had the healthy lifestyles service. In areas without the healthy lifestyles service, patients stay with the bariatric service for longer and did not have such good outcomes.

RESOLVED that the updates provided on all programmes of work be noted.

To receive an update on the Pharmaceutical Needs Assessment (PNA).

The Board received the report of the Consultant in Public Health. The report introduced the draft Pharmacy Needs Assessment (PNA) 2022/23-2025/26, which was in its 60 day statutory consultation period. It was noted that the Board had a statutory requirement to complete the PNA and the assessment would return to the Board following the competition of the consultation for final approval.

The Board noted their thanks to community pharmacies. Throughout the pandemic, pharmacies had played a vital role and had been a vital presence throughout the vaccination programme. Members discussed the important preventive work undertaken by community pharmacies.

A discussion took place around the South Telford area, it was noted that there was an inequity of service provision in this area on Saturday evenings and Sundays. The Board noted that the PNA could not compel pharmacies to open in certain areas. The Board would receive the final draft PNA at its meeting in March.

RESOLVED that the assessment of pharmacy service provision in the local context of need, which is explored in the PNA be reviewed and comments be provided to feedback on the assessment and recommendations as part of the consultation period.

To receive an update on the Cost of Living Strategy.

The Director: Communities, Customer and Commercial Services provided the Board with an update on the Cost of Living Strategy. Telford and Wrekin had twice the average number of people classed as ‘low income’ and nearly two thirds of households across the borough had an income of less than £40,000.

The impact of the cost of living crisis was seen locally. A range of services had been made available to residents and businesses to support them during this time. A website had been established which listed all of the support available and webinars had been held for Council staff so that information could be shared with residents.

A discussion took place regarding free school meals and the Board members were encouraged to ask parents to check their eligibility. There was no stigma attached to free school meals and children were not aware of which children received these. The free school meals also opened up other support, such as pupil premium and activities during school holidays.

Members discussed the webinars and noted that these would also be made avaliable for partner agencies and community organisations. Staff members who had attended had also noted that these sessions had contained useful information for their own personal lives.

Members asked about debt surgeries and were advised that the programme had not yet been finalised, however, Citizen’s Advice would soon be restarting surgeries, as well as an outreach programme. The outreach programme would ensure that residents could access support at an early stage.

The Board noted the report.

To receive an update on the Homelessness Strategy.

The Housing, Nuplace Service Delivery Manager presented the report on the Homelessness Strategy Update. The previous strategy on homelessness was due to expire this year and, due to the impact of covid, along with the cost of living concerns, it was an apt time to update the strategy. It was noted that the strategy was a single plan for all agencies across the Borough, and had been co-produced with partners.

The Board noted that numbers of people affected by homelessness had significantly increased in the last few years. Many service users are showing increased levels of complexity.

It was noted that there were four overarching objectives throughout the strategy; prevention through early intervention, accommodation to support and empower, addressing rough sleeping and collaboration.

A homelessness forum was in the process of being established and the Board members were requested to consider membership of the forum.

Board Members welcomed the report and noted that you cannot tackle homelessness without looking at health inequalities. Members discussed the complex needs of service users and the support provided by the dedicated mental health nurse. It was confirmed that funding for the nurse had been extended until March 2024.

In regards to accommodation, the Board discussed the need for one more bed accommodations, particularly self-contained units.

A discussion took place regarding support for people with learning disabilities. It was noted that a number of services were often involved with service users and that work was done to ensure the right services were involved to make sure people did not slip through the net. The partnership approach was key in making sure that the threads were joined up to create a whole picture.

The Board noted the report.

To receive the Integrated Care Board’s report.

The Board received the update report of the ICB Director. The report provided a summary of the development of the Integrated Care System (ICS) since the last meeting of the Board.

The Board noted that the ICS Strategy development timeline. A stakeholder engagement session had recently taken place and feedback from this event was due imminently. It was noted that although the strategy must be published by March 2023, it was an organic document, which would continue to evolve.

Members agreed that the engagement session had been interesting and discussed the phrasing that had been discussed in the session. Some Members noted their concerns regarding the ‘wealthier’ aspect and noted this was not phrasing that the Health and Wellbeing Board had used. Some Members felt ‘enriched’ was more appropriate.

RESOLVED that:

a)    The detail contained within the report be noted;

b)   The statutory requirements for ICBs and LA’s, as core members of the system wide ICP, to develop an Integrated Care Strategy be noted;

c)    This strategy must be informed by the work of the Health and Wellbeing Boards and through engagement with local partners and communities be noted;

d)   The terms of reference of the Shropshire, Telford and Wrekin ICP be noted.

To receive an update on the actions completed to date.

The Board received a presentation from the Divisional Director of Operations and the Deputy Director of Midwifery, Shrewsbury and Telford Hospitals. The presentation summarised the actions taken to implement the recommendations from both Ockenden reports.

The presentation provided an outline of how recommendations were progressed, including a reverse RAG rating and the governance and assurance processes each recommendation went through before being considered as completed.

Members noted that the highest risk actions were being completed first, and that some of these actions were lengthy and complex.

A discussion took place around staff morale. New mechanisms had been installed to ensure that staff felt listened to, such as weekly drop in sessions and moving managers into clinical areas so that they were more visible. It was still important to be respectful to families who had not had a good outcome, however, it was necessary to get the message out that the system was improving.

A Member queried if the number of adverse outcomes was still higher than average. It was confirmed that, sadly there would always be poor outcomes, however, the data showed that the Trust was not an outlier. The Trust wanted to ensure that any incidents were documented, reported and learnt from.

The Board requested a further update in the autumn of 2023.

The Chair of the Community Safety Partnership stated that a piece of work was taking place regarding partnerships and their frameworks.

He also discussed the ‘Most Appropriate Agency’ Policy from West Mercia Police. It was agreed that a full report be bought on this to a future Board meeting.