Agenda and minutes

None.

To approve the minutes of the previous meeting.

RESOLVED – that the minutes of the meeting held on 22 June 2023 be agreed.

None.

To receive the Living Well Update Report.

The Director: Health & Wellbeing provided Members of the Board with an update on the work undertaken across Telford and Wrekin that contributed to the Board’s strategic priority, Living Well. The Board heard that the programmes of work summarised in the report were largely funded from the public health grant and were led by the Council’s Health Improvement team, in collaboration with the Council’s health partners and the community and voluntary sector. As the majority of work was funded on a one-off basis there were concerns about its long-term sustainability. Members heard that in order to address these concerns that work needed to be further embedded within the existing NHS pathways.

It was noted that partnership working had been key to reaching out to less engaged communities, with the Director: Health & Wellbeing highlighting the work of the Healthy Lifestyles Team. Members heard that target communications based upon intelligence lead data from research and development had been working well to achieve this.

Members of the Health and Wellbeing Board noted the report and welcomed the role of partnership working in order to reach out to wider communities to deliver healthier lifestyle outcomes.

To receive the Health & Wellbeing Strategy Progress Report.

The Consultant in Public Health introduced the Health and Wellbeing Strategy Progress Report, stating that this was a standing item introduced following the last Board meeting in June 2023, in order to provide Members with an update on delivery progress of each priority within the strategy over the last quarter.

The Consultant in Public Health highlighted that a wide range of progress had been made against the priorities, including the launch of Family Hubs, the schools health and wellbeing programme and a number of blood pressure testing events that had taken place. Continuing the intelligence-led approach to the strategy, the Consultant in Public Health informed the Board that research into healthy weight, violence against women and girls and alcohol and drug use had been carried out and continued to inform future programmes of work. At a place-based level, Members heard that both a new domestic abuse service and an alcohol and drugs forum had been launched, in addition to continued training across the partnerships.

The Board were informed that there were a number of emerging risks and challenges related to funding, and the sustainability of that funding, staff capacity and partnership engagement when addressing health inequalities. The Consultant in Public Health stated that though the challenges were unlikely to change, closing the inequalities gap remained a central priority.

During the discussion, Members highlighted the importance of aligning the Board's agenda with that of the Integrated Care Board and place boards in order to allow for a targeted discussion around specific inequalities to take place. Members of the Board thanked the Consultant in Public Health for their report and noted the delivery progress of the Health & Wellbeing Strategy 2023- 2028.

To receive the Health & Wellbeing Strategy Outcomes Framework.

The Insight Manager provided the Board with an overview of the new performance framework to monitor the delivery of the Health and Wellbeing Strategy, and the current position of each of the outcome measures identified. It was noted that the report complimented the Health and Wellbeing Strategy Progress Report as it looked directly at the outcomes and indicators outlined in the strategy. The Insight Manager informed the Members that an update on each of measures in the strategy was to be brought to the Board every 6 months, and that there were plans in place for a dashboard to be created for greater ease of access for Members.

During the discussion, Members enquired whether it would be possible for the framework to allow the data to be interpreted at ward level, to allow resources to be targeted at the areas they were most needed. The Insight Manager advised the data from the Joint Strategic Needs Assessment would allow for this so could be explored.

The Board discussed the stalled increase to life expectancy in the borough and noted the importance of identifying and addressing any underlying causes where possible. It was recognised that life expectancy had reduced nationally, however in comparison to areas with similar demographics that we had the narrowest inequalities gap. Members noted that despite this, further place based work was required to reduce the gap further.

RESOLVED – that the Board:

a)    agree the performance framework;

b)   note the current position regarding performance against the strategy priorities;

c)    agree to receive an update on the performance metrics every 6 months.

To receive an update on the Better Care Fund.

The Service Delivery Manager: Adult Social Care provided the Board with an update on the Better Care Fund. Members heard the Better Care Fund was a national programme that was place based to Telford & Wrekin. It was jointly lead by Telford and Wrekin Council and the Shropshire Telford and Wrekin Integrated Care System. The Service Delivery Manager: Adult Social Care informed members that the current two year Better Care Fund Plan had recently been signed off through the Board's delegation arrangements, however challenges still remained.

Members heard that the focus of the plan was to improve systems and to become more efficient, particularly in respect to discharge arrangements. The Service Delivery Manager: Adult Social Care advised that the use of community resources such as the Rapid Response Team had been key to ensuring that.

The Service Delivery Manager: Adult Social Care informed that board that prior to submission the programme must meet the national conditions, which had been revised to include a detailed profile of urgent care demand and capacity and regular reporting on the utilisation of the specific allocated additional Discharge Fund monies. The plan submitted in June 2023 built on the successes of work in previous years, such as the Integrated Discharge Model and Discharge to Assess approach.

RESOLVED – that the Board:

a)    Note the Better Care Fund programme progress to date;

b)    Support the delivery of the Better Care Fund programme for 2023/25;

c)    Receive an update on progress in early 2024.

To receive the Telford & Wrekin Suicide Prevention Strategy.

The Consultant in Public Health provided Members of the Board with an overview of the updated Suicide Prevention Strategy. The strategy had been reframed to consider the council's approach to partnership working in order to reduce and prevent suicides and their impact on residents. The Consultant in Public Health noted that the strategy had been updated in line with the update to the National Suicide Prevention Strategy, which was recently published.

Members heard that the core principles from the previous Strategy had been retained, focusing on: addressing the myths and stigma of suicide, as well as raising awareness of suicide risk across our communities; improving access to timely and appropriate support for anyone affected or bereaved by suicide; ensuring those most likely to connect with higher risk and vulnerable groups of suicide, have the right skills and confidence to appropriately intervene or signpost to early support in a compassionate manner.

The Consultant in Public Health shared that much progress had been made since on this strategy since inception in 2017, citing the launch of the new Shropshire Telford and Wrekin Suicide and Unexpected Death Bereavement Service in January 2021 and the promotion of the Zero Suicide Alliance training. The latter of which had become mandatory for many health and social care staff. The Consultant in Public Health reported to the Board that partnership working and networks created around promoting this strategy were strong, leading to the success of events such as the World Suicide Prevention Day held in Southwater recently.

Members highlighted the importance of suicide prevention being a visible topic of the Health and Wellbeing Board and proposed it be brought to other boards, such as the Children and Adult Safeguarding Boards.

RESOLVED – that the Board approve the refreshed Telford & Wrekin Suicide Prevention Strategy for 2023/24 – 2027/28.

To receive the Children and Young People’s and Vaping Statement.

The Public Health Consultant outlined to Members the position statement on Children and Young people and vaping in Telford & Wrekin. Members heard that there was a growing concern regarding the level of children and young people who were vaping in the borough, and the national Smokefree Youth GB survey 2023 showed a significant increase with 11.6% of 11-17 year olds reporting experimenting with vapes in 2023 nationwide, compared to 7.7% in 2022.

The Telford & Wrekin position statement on vaping in children and young people, had been produced based on the current evidence and best practice.  The Public Health Consultant advised Members that the key aim of the statement was to widely share the evidence and helpful resources with young people, their parents and carers, and professionals to help educate and guide discussions around vaping and the risk it poses. The Public Health Consultant noted that it was important to highlight that vaping has been proven to be an effective tool to aid quitting smoking in those who currently or have previously smoked. Research showed that the vast majority of young people who vape are also current or ex-smokers. However, was a need for a careful balance between the promotion of vaping as a tool to help quitting and promotion of vaping in those who do not smoke. The Public Health Consultant informed the Board that following the meeting the statement would be circulated to headteachers and further work on the issue would be brought to local schools.

Members of the Board expressed support for the report, noting the complexity of the issues and the importance of finding the correct approach.

RESOLVED – that the Board approve the Telford & Wrekin vaping statement for children & young people for dissemination among partners.

To receive a verbal presentation on the Adult Social Care CQC Preparation.

The Service Delivery Manager: Assurance and Transformation provided the Board with an update on the preparation for the Care Quality Commission (CQC) assessment framework of Adult Social Care. Members heard that following the Health and Care Act 2022 there was a duty for the CQC to independently review and assess how local authorities were delivering their Care Act functions. The Service Delivery Manager: Assurance and Transformation informed the Board that there was one singular assessment framework through the Care Act that had been developed with improved outcomes for patients at heart. This framework also applied to Integrated Care Systems.

Members heard that there were nine quality statements outlined across four themes within the framework that the Council would be assessed against. The themes outlined were working with people; providing support; ensuring safety and leadership. The Service Delivery Manager: Assurance and Transformation advised the Board that the CQC were working to tight timescales and would therefore be starting formal local authority assessments from the Autumn. There had been five pilot assessments that had taken place, including one in Birmingham where they assessed children's services. Members were informed that an agreed outcome for each of the pilots would be published.

The Service Delivery Manager: Assurance and Transformation outlined to Members the population statistics of Telford and Wrekin and how our growing aged population impacted the services that the Council provides. As a result of this, members heard that an additional £10 million investment had been made into adult social care this year, accounting for 42% of the Council's budget. The Service Delivery Manager: Assurance and Transformation explained to Members that whilst Telford and Wrekin did face challenges such as market sustainability and financial constraints, that the Council had a lot to be proud of. The Council's workforce and workforce planning was supported through their partners to provide a quality assured approach to services and a strong focus on prevention. The Service Delivery Manager: Assurance and Transformation mentioned the recent OFSTED and CQC recognition of the Council's Shared Lives Services, Children's Safeguarding and SEND services as further achievements.

In preparation for the CQC assessment of Adult Social Care Services the Board heard that a self-assessment and improvement plan where in place, and were reviewed regularly. The Council also took part in 3 weekly CQC forums and sought support from the West Midland Association of Directors of Adult Social Services (WMADASS), a sector lead improvement programme.

Members of the Board thanked the Service Delivery Manager: Assurance and Transformation for their presentation and noted the update.