Agenda and minutes

West Sussex Health and Wellbeing Board
Thursday, 10th October, 2019 10.00 am

Venue: Horsham District Council, Goodwood Room, County Hall North, Parkside, Chart Way, Horsham, RH12 1XH

Contact: Erica Keegan on 033 022 26050  Email:  erica.keegan@westsussex.gov.uk

Items
No. Item

24.

Chairman's Welcome

Minutes:

24.1   In welcoming Board Members, Officers, Members of the public and the Press to the meeting, the Chairman made the following announcements:

 

24.2   Committee Membership – The Board noted that Dominic wright, NHS Coastal West Sussex Clinical Commissioning Group, was leaving his role on 30 September and would, therefore, step down from the Board. The Chairman and Board Members passed on their thanks for his service, over many years and wished him success in his future endeavours.

 

Philippa Thompson, Sussex Oakleaf, was also reported as stepping down as Board Member. The Board thanked Philippa for her continued support representing the voluntary sector and wished her well for the future.

 

Frances Russell and Katrina Broadhill, Healthwatch, were stepping down as Healthwatch’s representatives.  The Chairman and the Board thanked them both for their contribution to the Health and Wellbeing Board particularly recognising their support in partnership working. It was announced that as of the next meeting of the Health and Wellbeing Board, Sally Dartnell, HealthWatch West Sussex, Chief Officer would join the Board.

 

The Board noted and welcomed newly appointed representatives from the Voluntary Sector, Helen Rice (Age UK) and Nik Demetriades (4Sight) who had sat on the board as a substitute member in the past. Pennie Ford, Sussex Health & Care Partnership, was also welcomed as a new Member of the Board representing West Sussex CCGs and Chris Clark was welcomed as a Board Member due to his new role as West Sussex County Council’s Joint Strategic Director of Commissioning.

 

24.3   The Chairman announced that following the Health and Wellbeing Board’s Seminar held on 29 July the Voluntary Community Sector Consortium (VCS) and the Voluntary & Community Sector Infrastructure Services (VCSI) Alliance members would shortly receive a letter from Catherine Galvin, Head of Commissioning at West Sussex County Council, outlining proposals on a co-production approach to commissioning with the Voluntary Sector. This would initially focus on a ‘learning by doing’ basis with preventative social support.

 

24.4   The Chairman was pleased to highlight the successes of capital and revenue bids to Public Health England over the last four years to support substance misuse service priorities in West Sussex. In total and from 2015, this had secured just over £1.5m capital monies and £425k revenue.

 

24.5 In completing her welcome the Chairman took the opportunity to remind Board members that the Collaborative Working Agreement Conference would take place on Thursday, 24 October, in Horsham. This would be the official launch of the CWA between the four boards (West Sussex Health and Wellbeing Board, West Sussex Safeguarding Children Partnership, West Sussex Safeguarding Adults Board and Safer West Sussex Partnership). The Chairman encouraged all Board Members to attend.

 

 

 

 

25.

Declaration of Interests

Members and officers must declare any pecuniary or personal interest in any business on the agenda.  They should also make declarations at any stage such an interest becomes apparent during the meeting.  Consideration should be given to leaving the meeting if the nature of the interest warrants it; if in doubt contact Democratic Services before the meeting.

Minutes:

25.1 There were no Declarations of Interest.

26.

Urgent Matters

Items not on the agenda that the Chairman of the Board is of the opinion should be considered as a matter of urgency by reason of special circumstances.

Minutes:

26.1 There were no Urgent Matters to consider.

27.

Minutes pdf icon PDF 166 KB

The Board is asked to confirm the minutes of the meeting of the Health and Wellbeing Board held on 20 June 2019.

Minutes:

27.1 Resolved that the minutes of the Health and Wellbeing Board held on 20 June 2019 were agreed and signed as a correct record by the Chairman.

 

28.

Public Forum

The Board invites questions and comments from the public observers present at the meeting.  Those with more complex issues are asked to submit their question before the meeting (ideally several days) in order to allow a substantive answer to be given.  Contact Erica Keegan on 0330 222 6050 (a local call) or via email:  erica.keegan@westsussex.gov.uk

Minutes:

28.1 There were no questions.

29.

Health and Wellbeing in Horsham pdf icon PDF 6 MB

A presentation will be given by Horsham District Council on the work this Council has been doing with respect to health issues relevant to Horsham District Council’s residents.

 

The Board is asked to:

 

1)   Note the report/presentation (to be sent under separate cover);

2)   Comment and ask questions on the information received; and

3)   Provide feedback on how the Board and Local Health and Wellbeing Partnerships could support the Health Priorities in Horsham.

 

Minutes:

29.1 A presentation on Health and Wellbeing in Horsham was given by Horsham District Council’s Health & Wellbeing, Community Safety Manager and Head of Housing and Community Services.  This provided an overview of the health and well-being issues and key priorities that were relevant to residents in Horsham. (Presentation tabled at the meeting and available on the website).

 

29.2 Board Members were informed that as part of Horsham District Council’s Corporate Plan 2019-2023 a Strong, Safe and Healthy Community was cited as a key priority. The district’s key demographic facts were provided and these included:

 

·       there was a population of 141,100K (2017)

·       the area had an ageing population 22% of residents are over 65 years of age, higher than the England and West Sussex average

·       Life expectancy was noted as 84.6 (Women) and 82.1 years (Men)

·       The area had one of the lowest teenage conception rates in England.

·       There was a workforce of 67,300k (economically active)

·       An entrepreneurial district – the second highest business start-up rate in the County with 72% of businesses rurally based.

·       The prevalence of underweight, healthy weight and overweight and obese children in Horsham was noted as better than the rates in West Sussex, which was better than in England.

·       Horsham District was noted as having the highest rate of unpaid carers who provided 50 hours or more care in West Sussex.

·       In terms of family the district had one of the lowest rates of children living in relative poverty at 9.1%. The number of lone parents in the region was joint lowest in West Sussex at 4.6% of families against a West Sussex figure of 5.4%.

·       The District had the lowest rate of mental health admissions for 0-16 year olds in West Sussex, in the last recorded year.

·       It was pointed out that the majority of Horsham District had the least deprived area of England (10%) when looking at crime and deprivation, health deprivation and disability but the number of households accepted as homeless and in priority need was above the national average.

 

29.3   It was recognised that although Horsham District was a great place to live and work it also had key health challenges. These included; health inequalities; an Ageing population; loneliness and isolation and a high number of carers; alcohol related hospital admission remained a concern as did the numbers of smokers and 62% of adults were noted as obese or overweight. 7.6% of homes were classed as fuel poor.

 

29.4   A key health challenge highlighted was the amount of emergency hospital admissions for hip fractures amongst those aged 80 plus.  In 2016/17 West Sussex had 946 emergency hospital admissions for hip fractures amongst those aged 80 plus. Horsham District Council had linked to the West Sussex Falls and Fracture Prevention Service which were noted as having a team based in Horsham.

 

29.5   In order to tackle some of the challenges and plan for the future, Board Members heard that Horsham District Council was expanding theirfalls prevention programmes, helping to deliver NHS Health  ...  view the full minutes text for item 29.

30.

Children First Strategy Development pdf icon PDF 270 KB

This report provides an update on the process of co-production and consultation to date and that programmed ahead of the scheduled November 2019 approval by the Cabinet Member.

 

The Health and Wellbeing Board is asked to: -

 

1)   agree the strategic leads from each organisation to be involved in a monthly partner steering group between October and April at Appendix 1; and

2)   consider and respond to the questions for discussion in 2.6

 

Minutes:

30.1 In the absence of the Director of Children’s Services the Assistant Director, Early Help, Children’s Services presented the report on the Children First Strategy Development.  The Children First Strategy was noted as a multi-agency Strategy sponsored by the Director of Public Health, the Director of Education and the Director of Children’s Services. The report provided an update on the process of co-production and consultation to date.

 

30.2 Board Members were referred to Section 2.6 of the report and asked to provide a response to the questions listed as follows:

 

  What would be different if Children and Families came first in West Sussex across our organisations? Do you think they already come first?

  Where are the opportunities to work better together for children and families and their carers?

  What are the barriers and how can we overcome them?

  Why do you think previous strategies haven’t worked in the ways we hoped?

  What can you/your organisation bring to this agenda? What can you commit?

 

30.3 In discussing the questions raised the Board recognised the importance of hearing the voice of children in order to provide a considered and appropriate strategic response to provide services that meet need. It was agreed that the Voices of Children had to be the central focus moving forward. The Board responded as follows:

 

·       Joint ownership to put children first was agreed as the aspiration and intent.

·       Healthwatch had been listening to the voice of the children and would be supplying a report that would be made available within the next two weeks. The Board agreed that the partner organisations had to get better at listening to children.

·       Good placed based prevention activity was cited as key and Board Members were keen to use the local knowledge and influence of the District and Boroughs. Localised plans with the focus on actions and implementation were preferred to avoid a ‘one size fits all’ approach.

·       Members were keen not to look at barriers but focus on an asset based approach, defining what ‘good’ should look like.

·       It was recognised that all partners needed to change and adapt behaviours so Children First is seen as one piece of work across the County whilst still being place based. This was seen as both a financial (pooling resources) and strategic issue (ceasing duplication of work).  It was agreed that younger people needed to be involved in the process and suggestions were made on who the Partnership Steering Group could engage with. It was suggested that contact was made with the young/youth leaders such as Youth Mayor, Voice of Looked after Children Council, Youth Cabinet, Scout Association, Guiding Association Leaders.

·       Members agreed that Housing, Environment and Education was vital to a child’s security and development.

·       It was recognised that in West Sussex it was easy to be drawn into needs around an Ageing Population but the Health and Wellbeing Board’s Strategy also championed the Start Well agenda.

30.4 In summing up, the Board agreed that children needed to  ...  view the full minutes text for item 30.

31.

Re-invigorating a strategic approach to healthy weight for children in West Sussex pdf icon PDF 920 KB

This paper sets out proposals for the Health and Wellbeing Board to take an active role in supporting a new strategic, whole systems approach to tackling childhood overweight and obesity in West Sussex.

 

The Health and Wellbeing Board is asked to: -

 

1)   Acknowledge the importance of this topic in West Sussex and endorse the new strategic, whole systems approach being outlined; and

2)   Provide feedback on ways in which the Health and Wellbeing Board will support this agenda.

Minutes:

31.1 The Chairman introduced the West Sussex County Council Start Well Public Health Consultant who presented the report on, ‘Reinvigorating a strategic approach to healthy weight for children in West Sussex’, that set out proposals for the Health and Wellbeing Board to take an active role in supporting a new strategic, whole systems approach to tackling childhood overweight and obesity in West Sussex.

 

31.2 The Board was informed that the Public Health Board had recently endorsed a paper outlining a new, strategic approach to children’s healthy weight in West Sussex, beginning with the launch of a Healthy Weight Steering Group in January 2020. Districts and boroughs were being asked to do the same through the Chief Executives’ Group. The Health and Wellbeing Board, as a wider strategic grouping of the key partners involved in influencing this agenda, was noted as a key to the success of this new approach and was now being asked to do the same.

 

31.3 It was explained that West Sussex compares favourably with national averages for childhood obesity although there were notable variations within the County. It was noted that crucially, weight was closely linked to emotional health and wellbeing, a key priority of the ‘Starting Well’ section of the West Sussex Joint Health and Wellbeing Strategy 2019-24.

 

31.4 The Board noted the report and provided feedback on ways in which the Health and Wellbeing Board could support. In discussion the Board:

 

·       noted that West Sussex had average statistics for childhood obesity but acknowledged the importance of tackling childhood obesity and the need to support the whole systems approach;

·       stated that the whole systems approach should start with hearing the voice of the children;

·       pointed out that it was important to involve Housing as deprivation/temporary accommodation could mean no access to cooking facilities for fresh food;

·       suggested that public health teams build on their work with influencing organisations such as takeaways, supermarkets, hospitals, children & family centres and schools to make healthier options more accessible so that individuals were given opportunities to make healthier choices;

·       welcomed the ‘quick wins’ with the use of existing schemes such as Park Run and the Daily Mile in schools to promote exercise;

·       agreed that Community Based projects such as the Community Fridge Project (supplying fresh food to those in need) and Community Kitchen (teaching cookery skills) were good initiatives that could be utilised and expanded upon as an asset;

·       pointed out that consideration should be given to pre-teens and teenagers as a group when tackling child obesity; 

·       felt that there was a need to expand upon the Family Wellbeing Programme so that it was offered across the County and not just in two areas;

·       emphasised the need for systems leaders to challenge within their own organisations, for example healthy lunch options served during County Council meetings;

·       focus on the benefits of a healthy weight and do not ‘fat shame’.

 

31.5 In summing up, Board Members agreed that this topic should be revisited by the Health and Wellbeing Board to monitor  ...  view the full minutes text for item 31.

32.

Children and Young People's Emotional Wellbeing and Mental Health pdf icon PDF 200 KB

This Report provides an overview of the West Sussex Local Transformation Plan for Children and Young Peoples Emotional Wellbeing and Mental Health Services Refresh and the Sussex wide Review of Emotional Health and Wellbeing Support for Children and Young People

 

The Health and Wellbeing Board is asked to: -

 

1)   agree the recommendation to progress the Local Transformation Plan (LTP); and

2)   note the information provided about the review.

Additional documents:

Minutes:

32.1 The Board received a report and presentation on Children and Young People’s Emotional Wellbeing and Mental Health (CAMHS) presented by the Principal Manager, Children and Families. The report provided an overview of the West Sussex Local Transformation Plan (LTP) for Children and Young People’s Emotional Wellbeing and Mental Health Services Refresh and the Sussex Wide Review of Emotional Health and Wellbeing Support for Children and Young People (CYP).

 

32.2 The following key points were outlined:

 

·       Children and young people’s emotional wellbeing and mental health was recognised as a key local and national priority. Data indicated that there are greater numbers of children and young people seeking support with their emotional wellbeing and mental health and there are many and varied drivers for this increase.

·       The West Sussex LTP outlines an integrated, multi-agency system-wide approach which builds resilience, improves access to services and supports Children and Young People along pathways of care whatever their needs.

·       Much had been achieved since 2015 – as described in the current LTP and Making Progress, Making a Difference (September 2019). It was noted that the refresh would focus on progress of the plan, and next steps with the deadline of 31 October 2019.

·       Particular groups of children were identified as a risk for poor emotional wellbeing and mental health. Examples included children that lived in areas of deprivation/poverty, were in care or had parents who had alcohol or substance misuse problems.

·       Board Members were informed that going forward, by 2023/24 an additional 345,000k children and young people 0-25 would access mental health support; The LTP would aim to; continue to achieve the access targets for eating disorder services; ensure children experiencing a mental health crisis receive the response they need through mental health liaison teams in acute hospitals and a 24/7 response via NHS 111 with a robust community follow up support; embedding mental health support in schools through the roll out of Trailblazers; adopting an integrated approach across health and care, education and the voluntary sector to develop a model of care for 0-25 year olds; and improve the response to Learning Disability and autism.

 

32.3 Board Members noted the information provided about the review. In commenting on the presentation, the Board:

 

·       reported that although children may be seen quickly initially there was significant delay between the first appointment and access to care;

·       stated that support in schools needed to be robust, enhancing provision whilst avoiding duplication of service;

·       emphasised the need to have more support in Junior Schools to aim provision at an earlier life stage;

·       agreed it was important to use a whole systems approach and avoid silo working and look at how services interact to ensure effective access to relevant support.

 

32.4 The Health and Wellbeing Board Resolved that the Local Transformation Plan Refresh as of October 2019, be agreed.

 

 

 

 

 

33.

West Sussex Age Healthy Communications Campaign pdf icon PDF 160 KB

At the launch of the West Sussex Health and Wellbeing Board’s Joint Health and Wellbeing Board Strategy 2019-2024: Start Well, Live Well, Age Well, delivery of a healthy ageing campaign was agreed as one of the priority actions for 2019/20.

 

The Health and Wellbeing Board is asked to: -

 

1)   note the delivery of a 6 month Age Healthy campaign commencing on 1st October 2019; and

2)   support the delivery of the campaign via the Health and Wellbeing Board member organisations

Minutes:

33.1 The West Sussex Acting Consultant in Public Health (Ageing Well) presented the report on the West Sussex Age Healthy Communications Campaign.  Ageing Well was noted as one of the three components of the West Sussex Joint Health and Wellbeing Strategy 2019-24. It was stated that overall, older people in the county were relatively healthy, contributing to the life of their communities and find West Sussex a great place to live. However, with age there was an increased likelihood of living with one or more long term health conditions and / or sensory impairment. It was reported that older people have increased risk of dementia, and large numbers of older people suffer from depression. It was also noted that older people had an increased risk of falls and were vulnerable to social isolation and/or loneliness. All of these could result in a reduced quality of life and increased use of health and care services.

 

33.3 It was reported that at the launch of the West Sussex Joint Health and Wellbeing Strategy 2019-24, delivery of a healthy ageing campaign was agreed as a priority action for 2019/20. Board Members were informed that the West Sussex Public Health team, working with partners, had led on developing a six month campaign which was launched on 1 October 2019. The campaign adopted a different theme each month: October – introduction; November – the home and neighbourhood environment; December – social connections; January – finance; February – mental health; March – physical health. Campaign activity included a survey on older people’s views on ageing in West Sussex, a dedicated campaign page, monthly newsletter, and social marketing campaign.

 

33.4 Board Members were shown the dedicated West Sussex County Council webpage that focused on the Age Healthy Campaign providing signposting, resources, prevention support and case studies. In viewing this page, the Chairman requested that photo content accurately reflect positive ageing with images detailing activities such as dancing and climbing. Board Members agreed that the language used also needed to be positive and not use words such as ‘frail’.

 

33.5 Key partnership working opportunities were identified and it was noted that the Ageing Well theme was included in the NHS Long Term Plan. It was noted that Age UK could support this work with their FALLS hazard free toolkit, loneliness research and corporate sponsorship opportunities. This campaign could also align with the work of 4Sight.

 

33.6 The Health and Wellbeing Board resolved that;

 

1) the delivery of a 6 month Healthy Age campaign commencing on 1st October 2019 be noted;

2) the delivery of the campaign via the Health and Wellbeing Board member organisations be supported.

 

 

 

34.

West Sussex Health Protection Annual Report 2018/2019 pdf icon PDF 162 KB

The West Sussex Health Protection Annual Report 2018/2019 details the West Sussex data, and activities carried out by the Council and partner organisations during the period 1st April 2018 to 31st March 2019. The Health and Wellbeing Board is invited to consider this report 2018-2019 and the recommendations made, providing any comment to the Director of Public Health (DPH) prior to publication.

 

 

Additional documents:

Minutes:

 

34.1 The Health and Wellbeing Board was invited to consider the West Sussex Health Protection Annual Report 2018-2019 and the subsequent recommendations made, providing any comment to the Director of Public Health (DPH) prior to its publication.

 

34.2 It was outlined that West Sussex County Council holds key statutory health protection responsibilities. To ensure robust delivery of these statutory responsibilities, the Director of Public Health chaired a multi-agency West Sussex Health Protection Committee bringing together organisations across the county that contribute to protecting the health of the West Sussex population. The group produces an Annual Report to provide assurance that all parts of the system are working together effectively towards various targets and outcomes.

 

34.3 It was reported that the West Sussex Health Protection Annual Report 2018/2019, detailed the West Sussex data, and activities carried out by the Council and partner organisations during the period 1 April 2018 to 31 March 2019.

 

34.4 In receiving the report the Board noted the key priorities and challenges.  Challenges included flu prevention, TB, immunisations including MMR, national rise in Scarlet Fever. It was suggested that flu vaccination should be taken into Care Homes and residential settings to increase immunisation rates.

 

34.5 The Health and Wellbeing Board Resolved that the West Sussex Health Protection Annual Report 2018-2019 be agreed.

 

 

 

 

35.

Healthwatch West Sussex Annual Report 2018-19 and Work Plan for 2019-20 pdf icon PDF 134 KB

This report is the local Healthwatch Annual Report 2018/19 and the Work Plan going forward 2019/20, based on this year’s agreed priorities.

 

The Board is asked to note these documents and have awareness of the focus Healthwatch West Sussex will have over the remainder of this financial year.

Additional documents:

Minutes:

35.1 The Healthwatch Service Manager presented the local Healthwatch Annual Report 2018/19 and the Work Plan going forward 2019/20, based on this year’s agreed priorities, to the Board. The Board was asked to note these documents and have awareness of the focus that Healthwatch West Sussex would have over the remainder of this financial year.

 

35.2 It was explained that the insight given by local people to Healthwatch West Sussex, should be viewed as complementary to other evidence. The Board and other stakeholders could consider the insight as indicators of how and where things might be done differently. The insight provided through the Work Plan offered a positive opportunity to hear, understand and respond to the public voice.

 

35.3 In receiving the Annual Report and Work Plan the Board commended Healthwatch’s valued and constructive challenge and looked forward to continuing partnership work with Healthwatch West Sussex.

 

36.

ICS/STP Place Based Plan pdf icon PDF 138 KB

The Board will receive an update on the Place Based Plan.

Additional documents:

Minutes:

36.1 The Board received the West Sussex Response to the NHS Long-Term Plan, delivering the Joint Health and Wellbeing Vision for the County’s Population. In receiving this report the Board noted that Sustainability and Transformation Partnerships (STPs)/Integrated Care Systems (ICSs) were required to create their five-year strategic plans by November 2019 covering the period 2019/20 to 2023/24. In West Sussex, partners had agreed to co-produce a joint response plan between West Sussex County Council and Coastal West Sussex, Horsham and mid-

Sussex and Crawley CCGs.

 

36.2 It was reported that the West Sussex plan is being developed following an extensive period of public and stakeholder engagement and would be the agreed delivery plan to achieve the Joint 2019-2030 Health

and Wellbeing Vision for the County, as well as delivering a local response to the STP clinical priorities and the objectives of the NHS Long-Term Plan. In particular, the West Sussex plan would seek to address the health inequalities identified within the local population.

 

36.3 Attention was drawn to the joint approach across West Sussex with work in progress. It was recognised that more work would be required. Medical Directors, Public Health Directors and Clinical leads were ensuring local plans were being co-designed and co-supported.

 

36.4 It was agreed that the Health and Wellbeing Board would have an important role in overseeing this plan and its implementation. As such the Chairman announced that a Health and Wellbeing Board Seminar would be held on the subject during November 2019.

 

36.5 The Board Resolved that the importance of this plan for West Sussex be acknowledged and endorsed the new strategic whole systems approach.

 

37.

Winter Planning to support the health and care system pdf icon PDF 224 KB

This report provides an update regarding the plans across West Sussex to manage demand in health and social care over the winter period.

 

The Health and Wellbeing Board is asked to note the plans in place for the health and social care systems across West Sussex.

 

Additional documents:

Minutes:

37.1 The Board was provided with an update regarding the plans across West Sussex to manage demand in health and social care over the winter period.

 

37.2 It was reported that each year the health and social care systems across West Sussex undertake reviews of winter to understand lessons learnt to enhance future planning. These lessons had been incorporated into the plans for winter 2019/20 as follows:

 

·       Support from other local health and social care systems in response to pressure in the local system.

·       Maintenance of patient safety in A&E during periods of sustained demand pressure.

·       Ability of system partners to rapidly support additional capacity in response to system pressure.

·       Single winter communications plan across West Sussex and East Surrey aligned to the national NHS campaign.

·       Development of discharge to assess pathways across health and social care to ensure people do not wait in acute hospitals when they can be supported at home.

·       More live feeds are required into the real time data system Single Health Resilience Warning Database (SHREWD) including mental health and 136 capacity. The database provides up to date information about demand allowing the system to react in a timelier manner to surges in demand.

·       Renewed focus on stranded/ super stranded patients to manage patient flow.

·       There are high levels of minors attending A&E. System wide collaboration was noted as underway to deliver Integrated Urgent Care model (IUC) including Urgent Treatment Centres (UTC) roll out from December 2019.

·       West Sussex wide system capacity and demand planning for this winter has built further upon the successful planning model that use for last winter ensuring that mitigation actions are in place for forecast surges in demand over winter.

 

37.3 The Health and Wellbeing Board Resolved that the plans in place for the health and social care systems across West Sussex, be noted.

 

38.

Date of next Meeting

The next meeting of the Board will be held at 10.00am on 30 January 2020 in Adur & Worthing Borough.

Minutes:

38.1 The next meeting of the Board will be held on 30 January 2020 in Adur & Worthing Borough.