Agenda and minutes

None.

To approve the minutes of the meeting held on 14 December 2023.

RESOLVED – that the minutes of the meeting held on 14 December 2023 be agreed.

The Chair invited a representative from the Young People’s Forum to speak to their lived experience and the importance of young people’s mental health and wellbeing services.

Members of the Board thanked the Young People’s Forum representative for sharing their experiences and expressed that value should be placed on listening to the voices of young people when designing services.

To receive the Annual Public Health Report: The Emotional Wellbeing of Our Children and Young People Matters.

The Director: Health & Wellbeing presented the 2024 Annual Report of the Statutory Director of Public Health, which focused on the emotional health and wellbeing of children and young people. The Board heard that providing the best start in life was key to tackling health inequalities, as had been highlighted within the 'Marmot Review 10 years on'. It was noted that whilst the wellbeing of children and young people had been a concern prior to the pandemic, it had been exasperated by lockdowns causing isolation in children, as well as other factors such as the cost of living crisis that have had an impact.

Members were informed that young person participation had been key, and that the report included insights on the thoughts and feelings shared by local young people. The Director: Health & Wellbeing explained that there had been a series of focus groups held at a range of young people's groups and forums, and also an online survey for secondary school pupils. Based on these insights, the Board heard that a series of recommendations had been included, that were aimed at enhancing support to ensure all children felt valued, visible, included and emotionally well.

The annual report also updated Telford & Wrekin's local position across the Public Health Outcomes Framework, providing a picture of population health indicators across the life course. Members heard that the public health outcomes considered under the themes in the report has worsened for both men and women, with both lower than the national average.

The report also highlighted a focus on children's mental health. The Director: Health & Wellbeing informed Members that mental health support was now provided in many local schools, and that they were working with Bee-U and local schools to develop a whole school approach. It was also noted that of young people accessing Bee-U services had seen an improvement in wellbeing, but there were still concerns over wait times. 

The Board commended the report and endorsed the recommendations. Members emphasised the importance of involving young people in consultations, particularly within Bee-U commissioned services and urged future collaboration and consideration of in-person services over online alternatives in some cases. Members highlighted that in person groups can be more effective at combating isolation and stressed the importance of securing the future of family hubs. It was requested that a further update be provided at a future meeting and asked that additional consideration be given to transitional services.

The Chief Executive Officer: Shropshire Telford & Wrekin Integrated Care System acknowledged Members comments and assured that alternative services would include both online and in-person options. The Chief Executive officer committed to meeting with the youth forum to co-produce services and advised that clarity would be sought on the closure of BEAM. It was proposed that the recommendations outlined in the report form the baseline for future report to the Board.

RESOLVED - that the Health & Wellbeing Board endorse and support the recommendations of the Director of Public Health’s Annual Report 2024, which are aimed at improving the emotional  ...  view the full minutes text for item HWB36

To receive the Helath & Wellbeing Board Strategy Quarerly Progress Reprort.

Members heard that the Health & Wellbeing Board Strategy highlights that tackling inequalities and closing the gap required comprehensive action across the priority programmes, through a strong targeted, intelligence-led approach. An update on the inequalities programme was received in September 2022, and a detailed review of activity and progress on closing the gap ambitions was underway, with an update to be presented to the HWB in September 2024. The Deputy Statutory Director of Public Health advised the board that the strategy leads had provided progress updates for their programs within the report, including references to the relevant inequalities focus. The Board were advised that future updates will summarise key progress over the quarter, include case studies and outcomes, and highlight future challenges.

During the discussion, Members acknowledged the contribution of Mind in addressing social isolation, and suggested inviting them to attend a future meeting to discuss their work.

The Board noted that the report detailed an increase in alcohol dependency in the borough, but were reassured to see the report also showed that the increase in the number of people accessing treatment. The Director: Health and Wellbeing advised members that this increase following the pandemic had been expected and had been accommodated for in the work plan.

Members stressed the need for faster action to be included in the integrated neighbourhood health and care plan to address issues in the acute sector. Members of the Board discussed potential opportunities for commissioning and deploying work sensibly, whilst maintaining the importance of pace in the work being done. The Board were assured that there would be continued collaboration with the six ICBs and Shropshire to focus on the financial side aspect. It was  suggested the focus of future work was expanded beyond the cost of living crisis to include wider determinants.

Members of the Board thanked the Deputy Statutory Director of Public Health for their report and noted that it helped them identify areas for deeper investigation.

To approve the Healthy Weight Strategy.

The Senior Public Health Practitioner and the Service Delivery Manager Health Improvement provided the board with an overview of the Healthy Weight Strategy, which considered the issue of obesity across the borough, highlighting an evidence-led approach that examines physical activity levels and fast food density. Members heard that engagement with the public and health professionals about barriers to healthy weight was conducted in August-September through 28 focus groups, ensuring inclusion of underrepresented priority groups such as males, individuals with learning disabilities, BAME communities, and those over 55.

The Service Delivery Manager Health Improvement advised the Board that Schools played a key role in maintaining a healthy weight in children. The Council were working with local schools to ensure that they can signpost parents to where they can find advice and help. This work included promoting healthier food environments in schools and workplaces, for example not using unhealthy food options as rewards. The Senior Public Health Practitioner explained that often lack of motivation or funds acted as barriers to achieving a healthy weight so they had focused on ensuring the strategy was accessible to all. It was noted that the strategy was underpinned by a whole system approach and that tackling obesity was everyone's business, not just the council's responsibility.  Members were advised that an action plan and the associated performance indicators were being developed and would be included in the strategy document.

Members of the Board expressed concern about the prevalence of obesity, particularly 1 in 4 children in reception being overweight, and welcomed the need for a whole system approach.

RESOLVED - that the Telford and Wrekin Healthy Weight Strategy 2024-2029 be approved.

To receive the Starting Well Update Report.

The Deputy Statutory Director of Public Health provided the Board with an update on the starting well strategy priority. Members heard that ensuring that all children and young people in Telford & Wrekin achieve the best start in life had been a Health & Wellbeing Board priority since September 2021. It was noted that whilst it was important that every one of our children has the best start in life, poverty and disadvantage created significant challenges and inequalities for many families.

Members of the Board heard that the Telford & Wrekin Best Start in Life Early Help (BSIL) Board was established in July 2022 to steer the agenda, providing governance and oversight that ensured effective partnership planning and improved outcomes and narrowed inequalities. The BSIL Board had three key priority work streams, agreed through partnership engagement, JSNA intelligence and evidence of local demand and pressures on services. These were the start for life and family hubs programme, healthy weight and social emotional and mental health. The Deputy Statutory Director for Public Health advised Members that as two of the priorities had been discussed earlier in the meeting, the focus of the update would be family hubs.

The Family Hubs transformation had progressed across Telford & Wrekin with the opening of the Oak Family Hub in January in Oakengates, alongside the Silver Birch Hub in Sutton Hill and Walnut Hub in Woodside, which opened in August. The Deputy Statutory Director of Public Heath informed Members that Phase two of implementation continued with Hadley Children Centre based at HLC, and Dawley Children Centre based at Dawley Town Hall, which would become the fourth and fifth Hubs. Phase three of the transformation would focus on hubs in Wellington, Donnington and Newport. The Board heard that the next steps involved developing a website that would link the family hub offer with Live Well Telford, the SEND offer and the youth community offer provided by the council.

Members of the Board thanked the Deputy Statutory Director for Public Health and commended the officers involved on the progress of the family hubs transformation.

RESOLVED - that the Board note:

a)     the programme updates on the starting well priority in terms of: Family Hubs implementation, the Healthy Child Programme and the development of the partnership’s Early Help Strategy

b)     the collaborative work being undertaken across the Integrated Care System to reduce child mortality.

To receive the Telford & Wrekin Intregated Place Partnership Update Report.

The Chief Executive Officer: Shropshire, Telford & Wrekin Integrated Care System provided the Board with an update on the Integrated Care Board's Governance. Members of the Board were advised that a place based approach was best placed to underpin delivery, and the Chief Executive Officer stated that they wished to thank and recognise the work to develop the Telford & Wrekin Integrated Place Partnership (TWIPP).

Members heard that there was a national mandate from the government that had resulted in a 22% decrease in budget. Consequently, there was a need to review the operating model and delivery agenda. The Chief Executive Officer informed the Board that the revised governance structure would be presented to the Integrated Care Board (ICB) in April 2024 and would formalise TWIPP and SHIPP as sub-committees of the ICB, balancing innovation with bureaucracy. They stressed the importance of oversight and centralised reporting to the ICB, and called for support from partners to ensure effective implementation.

The Board welcomed the proposal to devolve TWIPP and SHIPP and expressed the need to closely examine governance and reporting mechanisms to avoid excessive bureaucracy. Members suggested  holding a workshop on key priorities within the communities and emphasized the desire to provide wrap-around services, including social prescribers.

Members noted the update. 

To receive an update on the Better Care Fund.

The Service Delivery Manager: Hospital and Enablement informed Members that the quarterly determinants of the Better Care Fund (BCF) plan had to be reported to the Health & Wellbeing Board. These requirements focused on national conditions and reporting metrics, particularly on hospital discharges into long-term care, support at home and longevity of interventions, with the aim to prevent premature entry into long term care. Members heard that the BCF considered each locality's metrics but maintained a system-wide approach. The Service Delivery Manager: Hospital and Enablement advised that the metrics for quarter two and three outlined in the presentation highlighted the need to understand and manage pressures and resources effectively.

Members heard that the targets that had been submitted in the plan were high, and that the expectation was that they would be met or nearly met. There had been an increasing demand for complex discharges which had meant a focus on preventative intervention and the urgent care pathway. The Service Delivery Manager: Hospital and Enablement informed the Board that the aim of the second year of the plan was to work with partners to promote a home-first approach, rather than long or short-term care, building extra capacity.

During the discussion the Board noted the increased pressures across the system both in terms of demand and resources. Members emphasised the need for collaborative work with partners across the local authority, NHS and the voluntary sector.

The Chair of the Board informed Members that the BCF has already been approved under delegated authority.

To receive a verbal update on the All Age Carers Strategy Consultation.

The Director: Adult Social Care provided Members with an update on the All Age Carers Strategy consultation. The consultation would be subject to scrutiny before the formal consultation was to expected to begin from May 2024.

The Director: Adult Social Care notified the Board that the pending Care Quality Commission (CQC) assurance framework. The framework included four categories and Members heard that the council had begun sharing evidence with the CQC as part of this submission. Members heard that the council were also required to submit a self-assessment which would include information relating to the working relationship with the HWB, the ICB and the voluntary sector.

Members noted the update.

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:

·       Telford Town Park Strategic Framework

·       Housing Investment Programme Update

·       Building Safer, Stronger & Healthier Communities through better Air Quality

The Chair noted that this item was for information only.