Agenda and minutes

The Chair invited representatives from ABT and TACT to share their lived experiences with Members of the Board.

Members thanked the representatives for sharing their experiences and highlighted the importance of the work of organisations such as ABT and TACT.

The Senior Public Health Commissioner provided the Board with an update on the updated Telford & Wrekin Alcohol and Drugs Strategy 2024-2029 that had been developed by the Telford and Wrekin Alcohol and Drugs Partnership Board during 2023. Members heard that the previous strategy had come to an end in May 2023 and that it had been successful in achieving three of its main aims; increasing the number of people receiving alcohol treatment, improving outcomes for alcohol and drugs treatment, and providing better support for children and young people affected by their parents’ addiction to alcohol and other drugs. However, the Senior Public Health Commission noted that the number of people seeking treatment for alcohol issues had increased by 24%.

The Board were informed that in 2021 the government published the Dame Carol Black Review and a new national strategy, From Harm to Hope, which set out an ambitious 10-year plan to prevent, treat and support recovery from addiction to alcohol and other drugs. The Senior Public Health Commissioner explained that in  2022 the local Alcohol and Drugs Partnership Board was reformed to oversee the production of a new strategy. This Board was chaired by the Director of Public Health. Members heard that the new Alcohol and Drugs Forum was launched in 2023 and brought together partners to work with people with alcohol and other drug problems and to co-produce a new strategy with the Partnership Board. The Senior Public Health Commissioner explained that there were 16 commitments within the strategy, one for each of the four main branches of the strategy. These commitments had been included in an annual action plan that was to be overseen by the Local Partnership Board and the performance indicators included would be reported to the Health and Wellbeing Board on an annual basis. It was noted that this could also be broadened to include drug related crime.

Members of the Board welcomed the strategy and thanked the Senior Public Health Commissioner for their update. The Board recognised the importance of partnership working when tackling an issue that effects so many people and has the potential to impact on other services such as mental health and domestic abuse. Members commended that the number of adults completing treatment in Telford and Wrekin was higher than the national average. 

RESOLVED - that the Telford & Wrekin Alcohol and Drugs Strategy 2024-2029 be approved. 

To receive the Health and Wellbeing Strategy Quarterly Progress Report from the Consultant in Public Health, Telford and Wrekin Council.

The Consultant in Public Health provided Members of the Board with an overview of the progress of the Health & Wellbeing Strategy, detailing the progress updates for each of the relevant inequalities focuses. These focuses included healthy weight, alcohol, drugs & domestic abuse, and mental health & wellbeing.

Members heard that tackling inequalities and closing the gap required comprehensive action across the council’s priority programmes, through a strong targeted, intelligence-led approach. The Consultant in Public Health advised the Board that they had taken away the celebration of case studies that Members had expressed at the last meeting and had provided an overview on outcomes focused on those journeys. Members were advised that a detailed review of the progress on closing the gap was currently being undertaken and a further update was to be presented at the next meeting of the Health and Wellbeing Board in March 2024.

The Board thanked the Consultant in Public Health and commended the way the report had been written with the inclusion of case studies. Members noted that the issues and challenges encountered with the increase in complexity and demand were highlighted by the themes in the report. Members of the Board asked if it would be possible for information be broken down further to be examined at a ward level, to allow for more targeted interventions. The Consultant in Public Health advised that a intelligence led inequalities review was to be brought to a future meeting.

To receive the GP Practice Healthwatch Survey Report from the Chief Executive of Healthwatch Telford and Wrekin.

The Chief Executive of Healthwatch Telford and Wrekin provided the Board with an overview of the initial findings of the GP Practice Healthwatch Survey Report. Members heard that survey has been introduced in response to the feedback that both Healthwatch and the Council had received in relation to patients in Telford and Wrekin accessing GP services. Members were asked to note that this was an independent survey, but that promotion of it had been supported by the Council.

The Chief Executive of Healthwatch Telford and Wrekin noted that both Healthwatch Telford & Wrekin and the Council acknowledged that demand for primary care services had increased and capacity to meet this demand was a struggle, but it was important for the ICB to acknowledge and address patient experience and variation in patient experience between practices. The Board heard that the survey asked people to identify which GP surgery they were registered with. Questions ranged from asking people to rate their overall experience of making their last appointment to their confidence in the health professionals they interacted with.

The Board were informed that at the time of the meeting Healthwatch had received 8312 responses online and 384 separate completed web forms via the Healthwatch website, which was noted to be a statistically significant response. The Chief Executive of Healthwatch Telford and Wrekin explained that strong dissatisfaction with some surgeries had been highlighted by the responses. Members heard that the findings indicated that initial contact with the GP seemed to be the biggest issue, with residents stating that they were happy with the care they received once they were at an appointment. The Board were advised that Healthwatch was working with doctor surgeries to further promote the survey via text and once the survey had closed a full report would be published along with individual practice reports.

The Chair thanked the Chief Executive of Healthwatch Telford and Wrekin and requested that Members of the Board hold any questions or comments on the report until after the Primary Care Access Recovery item had been heard so that they could be discussed collectively. 

To receive the Shropshire, Telford and Wrekin Integrated Care Board Primary Care Access Improvement Plan with a focus on Telford & Wrekin. 

The Director of Delivery & Transformation, Shropshire, Telford and Wrekin Integrated Care System presented that Primary Care Access Recovery Programme. The Board heard that following the publication of the delivery plan for recovering access to primary care in May 2023, Integrated Care Boards (ICBs) were required to develop system-level access improvement plans. The Shropshire, Telford and Wrekin Primary Care Access Improvement Plan set out the ICB’s strategy to improve local access to general practice, maintain and improve patient satisfaction and work to streamline access to care and advice, which the ICB recognise is a key area of concern. 

Members were advised that three million GP appointments were delivered each year and that the number of appointments hadn’t increased materially during that time. The Director of Delivery & Transformation noted that workforce demands did affect patients first point of contact, stating that this could be with a pharmacist or a physio rather than a GP. In July 2023, seven out of ten patients were seen face to face, 55% of patients in Telford and Wrekin were seen the same or the next day. However, the Director of Delivery & Transformation recognised that public perception is that residents struggle to get an appointment, so access remains to be the key issue. To address this, Members heard that there were four national pillars that underpinned the plan; Empowering Patients through self-referral, the NHS app and the use of community pharmacy; Implementing Modern General Practice by introducing online access and digital telephony; Building Capacity by allowing practitioners to work at the top of their licences and directing patients to other forms of first contact; and Cutting Bureaucracy. The Director of Delivery & Transformation informed that Board that by the end of the March 2024, all practices would have a digital system that allowed them to manage calls and demand better. Once this was in place and working the ICB were expected to be in a better position to re-assess the gaps in services.

The Chair thanked the Director of Delivery & Transformation and invited Members of the Board to comment on the GP Practice Healthwatch Survey Report and the Primary Care Access Recovery Plan.

Members noted that the level of service received from GPs varied dependent on where residents were registered but that the results of the survey didn’t indicate that it was the most disadvantaged areas that had the worst service, and questioned what could be improved overall to address the inequalities. The Director of Delivery & Transformation advised that the existing primary care team were carrying out practice visits to look at quality measures including and beyond access. They highlighted that there were limited resources, but targeted support would be deployed based on those assessments.

Board Members highlighted that for many residents access remained to be the most important issue, as indicated by the Healthwatch survey. It was noted that whilst 50% of patients saw a GP on the same or next day that this figure did not include those who couldn’t get through or were turned away.  ...  view the full minutes text for item HWB28

To receive the Local Care Transformation Programme Update with a focus on Telford & Wrekin.

The Director of Partnership and Place, Shropshire, Telford & Wrekin Integrated Care System provided the Board with an update on the Local Care Transformation Programme (LCT). The Board heard that the Local Care Transformation was co-produced and included working with community, voluntary and acute providers. The LCT was a system wide commitment to a range of transformation programmes and initiatives that delivered care in local communities and in people’s homes. The Director of Partnership and Place advised Members that the LCT aimed to deliver more proactive and joined-up care and involved health care professionals working across different settings focused on the person’s individual goals and prevent unnecessary admissions to acute hospitals.

The Board were informed that two cohort of initiatives had been introduced under LCT. The first included alternatives to hospital admission, the integrated discharge team, and virtual wards. The second included Integrated Neighbourhood teams, Sub-acute care and rehabilitation. The Director of Partnership and Place noted that the first of these was now considered ‘business as usual’, and the latter under reconfiguration to ensure the right programmes of work aligned to Local Care and its relationship to place based work. There was also expected to be a review of the governance of the LCT as part of a wider system and ICB review.

Members expressed concerns over continued funding for the LCT and sought assurances that resources would continue to be allocated to the services that needed them. The Director of Partnership and Place advised that the impact of resources was continuously measured and updated within the business case.

Members of the Board recognised the importance of local and place-based delivery to address health inequalities and provide the best level of care. The Director of Partnership and Place agreed, noting that the community approach had allowed the ICS to work with local authorities through the Telford and Wrekin Integrated Place Partnership (TWIPP) to identify and fill gaps in services.

To receive a report on the Most Appropriate Agency from the Chief Executive, PCC.

The Police and Crime Commissioner provided Members of the Board with an overview of the new policy and procedure referred to as ‘Most Appropriate Agency’ which had been rolled out nationally. The Commissioner advised that the policy was introduced as a result of the police acting a safeguard in certain areas that overreach their responsibilities. The policy came into effect in April 2023 and Members heard that it was important to ensure that statutory duties were protected.

The Police and Crime Commissioner invited Members of the Board to consider the questions outlined in section 24 of the report and support the work required to ensure there are no gaps in services.

Members recognised the challenges faced by the police and endorsed partnership and cooperation from both the NHS and the Local Authority. The Board noted that both risk factors and resources would have an impact but welcomed further work that would include partners such as the Safeguarding Board. These discussions were to be led by the Co-Chair of the Health and Wellbeing Board and reported back into the Board at a later meeting.

For information only.

The Chair noted that this item was for information only.

Please see below the relevant Cabinet Reports that have been approved by Cabinet since the last meeting of the Health and Wellbeing Board for information:

·         SEND & Alternative Provision Strategy

·         Telford & Wrekin Council becoming carbon neutral & plastic free update  

·         Local Plan Consultation

The Chair noted that this item was for information only.