Agenda and minutes

12.1   In welcoming everyone to the meeting the Chairman outlined the following updates;

·       Board members noted that the way health and care works across Sussex (East Sussex, West Sussex, Brighton & Hove) changed last Friday, 1 July, with organisations including West Sussex County Council, formally becoming part of an Integrated Care System (ICS) for Sussex, having been a partner in the ICS since April 2020.

·       Board Members were informed that with the Health and Care Act 2022 coming into law this April, two new statutory entities are now in place; the Integrated Care Board (ICB), to be known as NHS Sussex, and the Integrated Care Partnership (ICP), to be known as the Sussex Health and Care Assembly. Both would have duties to consider Health and Wellbeing Board plans, and Joint Strategic Needs Assessments and health as well as wellbeing strategies which will set the evidence base and strategic framework to identify priorities for each place within the ICS.

·       The Chairman of the Health and Wellbeing Board confirmed that he is the Council’s representative on the Sussex Health and Care Assembly, and Alison Challenger, Director of Public Health, is the representative on the Integrated Care Board, as a Partner Member, for all three local authority Directors of Public Health.

·     The Chairman also highlighted that the Health and Wellbeing Board had published its draft Pharmaceutical Needs Assessment (PNA) in line with its statutory duty, and was seeking feedback from organisations, community groups, and residents with an interest in local pharmaceutical services. The consultation commenced on Monday, 20 June and would run until Sunday, 28 August.

12.2   The Chairman informed Board Members that as a consequence of  the end of Clinical Commissioning Groups, Board representation had changed and Dr Laura Hill had stood down. The Chairman thanked Dr Laura Hill for her many years of valuable service as a member of the West Sussex Health and Wellbeing Board which has been greatly appreciated.

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.

13.1 There were no Declarations of Interest.

The Board is asked to confirm the minutes of the meeting of the Health and Wellbeing Board held on 28 April 2022.

14.1   In receiving the minutes of the last meeting taken on 28 April 2022, comment was made that the Cost of Living implications had not been  covered in the preparation work for the July meeting as the minutes had recorded under the Work Programme Item; Minute 10.2 ii. An Action Log was suggested to accompany future minutes to ensure items were not overlooked.

14.2   Resolved – that the minutes of the meeting held on 28 April 2022 are approved as a correct record and are signed by the Chairman.

The Board invites questions and comments from the public for consideration at the meeting. Contact Erica Keegan on

telephone: 033 022 26050 (a local call) or via email: erica.keegan@westsussex.gov.uk

15.1   It was noted that the Board had received two questions from members of the public that would be dealt with outside of the meeting as they did not meet with the Board’s jurisdiction. It was confirmed that the questioners would be provided with a written response that also informed when the relevant topics would be addressed at the Health and Adult Social Care Scrutiny Committee (HASC).

The Children First Board, being accountable to the West Sussex Health and Wellbeing Board, as a sub-group of the Board, will provide a formal update at its quarterly public meetings.

16.1   The Board considered a report by the Children First Board.  The following points were covered in discussion:

·       In the period since the last report to the Health and Well-Being Board, the draft Children and Young People’s Plan with an accompanying survey had been put out for consultation. The consultation process started on April 4th, 2022 and would finish on June 26th, 2022. The primary focus of the survey was to find out what those who engage with it think about its proposed content; whether it is easy to understand; whether they feel the focus is on the right things; the format of the final plan and whether, and how they would like to be involved in helping us to evaluate the impact of the Plan on the lives of children and young people and their families.

·       To facilitate the engagement of children and young people with the draft plan and secure their views it was noted that a child and young person friendly version of the plan had been  generated, with the help of some young people, with questions designed specifically for them to answer.

·       Feedback had provided the Children First Board with a wealth of suggestions and ideas regarding what else might be included: either as priorities e.g., the suggestion that SEND (Special Educational Needs and Disability) should be a priority in its own right; or included in plans for implementing the priorities e.g. in relation to partnership working the suggestion that we need to continue to consider how work remains collaborative and engaged with children, young people, families and other stakeholders (building on collective strengths).

·       Board Members were informed plans from July 2022 onwards would include strategies for bringing partners, children and young people, parent carers and families together to workshop how priorities in the plan are delivered and monitor and evaluate the impact of activities.

·       The Chief Executive, Age UK West Sussex asked that the voice of the 2,400 young carers in West Sussex be included in the survey and plans.

·       The Chief Executive, Adur and Worthing Councils raised concerns with respect to youth violence and how plans could be adapted to address these concerns. It was confirmed that the plan would be flexible and interactive.

·       Following a request from the Cabinet Member for Adults Services, it was agreed that when results of the survey had been collated and reviewed that this would be presented to the Health and Wellbeing Board.

16.2   Resolved – that

                   i.        the report be acknowledged and feedback provided on the progress of the Children First Board since its last quarterly update in April 2022, in particular, the development of the draft Children and Young People’s Plan (CYPP), which has gone out to consultation with an accompanying survey; and

                  ii.        support be continued by the Health and Wellbeing Board, as key systems leaders across the county’s health and social care system, for the Children First Board to maximise its collective strength and helping to achieve its goals.

The Local Outbreak Engagement Board, being accountable to the West Sussex Health and Wellbeing Board, as a sub-group of the Board, will provide a formal update.

17.1   The Board received the regular quarterly update on the

West Sussex COVID-19 Local Outbreak Engagement Board (LOEB) from the Director of Public Health.

17.2   It was noted that the LOEB had met once (22 April 2022) since the last formal update to the West Sussex Health and Wellbeing Board in April 2022 and was due to meet again in September 2022. Meetings had moved to 3 monthly following lower infection rates.

17.3   In receiving this report the Board;

·       were informed that planning was in progress for Covid-19 booster vaccinations in the Autumn but the priority groups were not yet known. The Director of Public Health would make the position clear as soon as the detail was known.

·       asked about Winter Planning and noted that a flu vaccine programme was also being developed using learning from the Covid-19 vaccination programme on how to extend community reach.

·       understood that the NHS was reverting back to the wearing of masks in health care settings and there may be a need for Public Health to reassess the council’s own risk assessments.

·       agreed the term ‘post pandemic’ was misleading and the chairman reminded that Covid-19 vaccinations were still available for the unvaccinated.

17.3   Resolved that –

                   i.        feedback be provided on the progress of the West Sussex COVID-19 Local Outbreak Engagement Board (LOEB) since the last quarterly report to the Health and Wellbeing Board in April 2022; and

                  ii.        consideration be given to how the LOEB can continue to engage with residents and communities across West Sussex, maximising its collaborative strength as we continue progressing through the ‘Living with COVID-19’ phase of the pandemic.

The Director of Public Health will provide a verbal update on current public health matters.

18.1   The Director of Public Health provided the Board with a verbal update on Public Health matters. Key points raised were:

·       The pandemic had reached the ‘Living with Covid-19’ Stage with Omicron variants BA4 and BA5 being responsible for most of the Covid-19 infections in Sussex at present. These variants were noted as more transmissible which was impacting on work force availability and hospital admissions.  Most positive cases had been reported in the 50 – 69 year old age group.

·       With organisations including West Sussex County Council, formally becoming part of an Integrated Care System (ICS) for Sussex, the Director of Public Health had attended the first meeting of the Integrated Care Board held on 6^th July 2022. The Integrated Care Strategy would be informed by the Health and Wellbeing Board Strategy and Joint Strategic Needs Assessments which will set the evidence base and strategic framework to identify priorities for each place within the ICS.

·       Smoking cessation was highlighted as a primary focus for Public Health as smoking remained a key contributor to mortality rates. This was reflected in the recent Notice of Motion presented to and agreed at Full Council on 27^th May which supported Cancer Research UK’s calls for a Smokefree Fund (a fixed annual charge on the tobacco industry), making them pay for the damage their products cause without having any influence on how the funds are spent) to fund local tobacco control work as part of its efforts to tackle health disparities.

·       Public Health had been successful in receiving funding from the Department of Health to help improve the lives of those affected by alcohol including children. Public Health had received additional funding from the NHS to provide early support and expand the existing service.

18.2   In discussing this update Board Members;

·       agreed that ICS arrangements would be a Standing Item on the Health and Wellbeing Board’s agenda

·       requested that vaccine information (Seasonal Flu and Covid-19), including news on priority groups, be updated on the council’s website as soon as possible.

Focused on the West Sussex Joint Health and Wellbeing Strategy 2019-2024, this item will further contribute to identifying priorities for the Board’s workplan for 2022/23 to tackle issues locally, to improve the health of the population and reduce health inequalities across West Sussex.

19.1   The Board received a presentation (copy tabled at the meeting and  appended to the agenda available on the website) on the Board’s Joint Health and Wellbeing Strategy 2019-2024, including the impact of Covid-19 and health inequalities, the role of the Health and Wellbeing Board, and the development and implementation of the Integrated Care System (ICS) for Sussex and how it will interface with Health and Wellbeing Board’s to identify priorities for each place within the ICS.

19.2   In discussing the presentation the Public Health Priorities 2022/23 (West Sussex Joint Health and Wellbeing Strategy 2019-2024) were considered and the Board;  

·       requested data on progress with health matters, taking the pandemic into consideration, such as access to clinics for pregnant women and social isolation, to provide the Joint Strategic Needs Assessment (JSNA) with a clearer overview.  It was agreed that Performance Indicators could feed into  qualitative work on outcomes.  Evidence was starting to emerge that there was a sharp increase in childhood obesity last year, late diagnosis of Cancer and increased levels of mental health needs.

·       noted that Public Health performance data on measures such as healthy weight and vaccination rates were regularly reported to the Health and Adult Social Care Scrutiny Committee.

·       pointed out that the Health and Wellbeing Board Strategy required an update with respect to the Cost of Living crisis so that support work is able to progress. It was agreed that as the Strategy was written 3 years ago it was right to consider new relevancies.

·     agreed integrated working is necessary to reflect the priorities in the community according to their demographic and tackle health inequalities. This place based work was being carried out but it was noted that West Sussex had unique structures, different workstreams and multiple layers of communication. The Director of Public Health assured that Public Health were working with District and Boroughs and NHS colleagues to tackle health inequalities. Five clinical areas were under review, looking at the health outcomes for  the most deprived areas in West Sussex and the associated vulnerable population groups including diagnosis of Cancer, mental health, health outcomes for ethnic minorities and carers.  

·     assured that Public Health, together with partners, had a good reach into communities with well established Primary Care and Local Community Networks.

·     highlighted the need for monitoring outcomes on life expectancy as a clear indicator of health disparities. It was agreed that quality of life as well as its longevity was the priority.

·     reflected on the ‘Cost of Living’ crisis and noted that the demand for the Household Support Fund grant from Central Government was still there. Preventative action and developing strategy to get ahead of the crisis was seen as a key priority. It was recognised that all partners were already undertaking huge amounts of work in an effort to tackle and support those experiencing hardship.

·     agreed a Health and Wellbeing Board Seminar in September would be useful to review the Health and Wellbeing Board Strategy in terms of Homelessness and Cost of Living.

19.3  ...  view the full minutes text for item 19.

The Assistant Director (Safeguarding planning performance) will present the report on the West Sussex Safeguarding Adults Board that outlines the work progressed by the Board in the past year. 

20.1   The Board received the West Sussex Safeguarding Adults Board (WSSAB) Annual Report 2021/22. This report provided information about the Board and:

·     a Safeguarding Adults Review (SAR) Case Study

·     the activity and achievements of the Board’s subgroups to meet the 2021-212 Board priorities

·     Safeguarding Adult Reviews (SARs)

·     Safeguarding and Deprivation of Liberty Safeguards data

·     Compliments and complaints

·     Priorities for 2022-23

20.2   The following key points were highlighted;

·     It was noted that following the unprecedented challenges as a result of COVID-19 in 2020/21, the last year had been a continued challenge for both the Board and its partner agencies. In the past year the WSSAB had continued to adapt to new challenges. With the commitment of Statutory Partners, Board Members, and the diligent work of the Board Support Team, these challenges had not prevented the Board in progressing planned work.

·     Safeguarding referrals remained steady in 2020/2021. It was noted that the Deprivation of Liberty Safeguards (DoLS) is part of the Mental Capacity Act and is a legal measure to protect people who lack capacity to make decisions about their care and treatment. In 2021/22 there were a total number of 6,928 DoLS referrals being progressed.

·     The WSSAB undertook a professional survey to seek awareness and understanding of the WSSAB, learning briefings, and podcasts; feedback from this would be taken forward in 2022/23.

·     The WSSAB created and published learning briefings and podcasts for the six Reviews published this year. This learning would be taken forward into 2022/23.

20.3   In discussing this report Board Members;

·     highlighted the need for care around transitions so that there was a smooth process for handover from 17 to 18. It was noted that the audit for safeguarding cases for people age 17½ to 25 helped the WSSAB to understand key themes and areas for development including making safeguarding personal; case recording; decision-making; professional curiosity; multi-agency working and managing ongoing risk. The majority of actions from the audit recommendations to improve practice in these areas had been achieved.

·     the impact on safeguarding that the Cost of Living Crisis could cause was discussed. One focus had been on Scam awareness where work had been undertaken with partners such as Sussex Police but other vulnerabilities such as the need for use of Food Banks were identified. It was confirmed that issues that related to the possibility of an increased Safeguarding risk would be considered by the Multi Agency Risk Management Subgroup and the WSSAB.

·     recognised that the WSSAB works well with strong partnership having been developed across Sussex.

20.4   Resolved – that

                         i.         the Health and Wellbeing Board actively supports the WSSAB’s Strategic Plan, to improve prevention services and the experience of adults in West Sussex County Council who are at risk of abuse and/or neglect;

                       ii.         feedback be provided on how the Health and Wellbeing Board, as representative of the partner agencies, and within the Collaborative Working Agreement, will contribute to the WSSAB’s priorities for 2022-23; and

                      iii.         learning and improvement which interfaces with Adult Safeguarding be shared.

The Assistant Director (Safeguarding planning performance) will present the report from the West Sussex Safeguarding Adults Board that outlines the plans in place to progress new objectives over the coming years.

21.1   The Board received the West Sussex Safeguarding Adults Board (WSSAB) three year Strategy 2022/25. It was noted that it is a statutory duty for the WSSAB to have a 3-year Strategy. The WSSAB Strategy for 2022-25 followed the previous Strategy for 2019-22.

21.2   It was noted that the Strategy was based on the six principles of Safegaurding;

·       Empowerment

·       Prevention

·       Proportionality

·       Protection

·       Partnership

·       Accountability

and the three key strategic objectives were noted as;

·       Accountability and Leadership

·       Quality Assurance, Learning and Shaping Practice

·       Promotion and Engagement

21.3   Board Members were informed that the Safeguarding Adults Annual Business Plan is based on the three Board Priorities for 2022/23. These were considered and decided upon during a bespoke Board meeting in March 2022, where data, learning from Safeguarding Adult Reviews, learning from audits, and work undertaken in 2021/22 was considered.

The three priorities decided upon were noted as:

1. Safeguarding those with complex needs

2. Safeguarding older people

3. Communications and promotions for community engagement

21.3   There were no questions/comments from Board Members.

21.4   Resolved that –

                   i.        the WSSAB’s Strategic Plan, to improve prevention services and the experience of adults in West Sussex County Council who are at risk of abuse and/or neglect, be actively supported;

                  ii.        feedback be provided on how the Health and Wellbeing Board, as representative of the partner agencies, and within the Collaborative Working Agreement, will contribute to the WSSAB’s priorities for 2022-23; and

                 iii.        learning and improvement which interfaces with Adult Safeguarding be shared.

This paper summarises performance against the Better Care Fund national metrics for Quarter 4 2021/22 and provides a brief overview of Better Care Fund (BCF) planning expectations for 2022/23 and beyond, pending publication of guidance.

22.1   The Board considered a report by the Assistant Director (Health Integration) which summarised performance against the Better Care Fund national metrics for Quarter 4 2021/22 and provided a brief overview of Better Care Fund (BCF) planning expectations for 2022/23 and beyond, pending publication of delayed guidance. The following key points were made;

·       trends showed that more people were receiving care in their homes rather than using residential care which aligned with the council’s objective and patient’s preference to be able to stay in their own homes for as long as possible. The implementation of the council’s Home First model had been supporting the aim to keep patients out of residential care.

·       trends also showed a growth in emergency admissions to hospital with length of stay averaging longer.

·       trends were being monitored in terms of future planning for primary and social care so that community health needs are met.

·       joint working continued to be refined to align with health priorities and the Better Care Fund continued to contribute to the reduction of health inequality.

·       capacity in the social care market was noted as a real problem with recruitment being difficult in the sector, particularly in domiciliary care.  The Council would be working with West Sussex Partners in Care on a plan to address workforce issues.

·       funding uplifts were confirmed as follows: CCG Minimum Contribution increased by 5.66%, Improved Better Care Fund (IBCF) increased by 3.0%.

·       planning and assurance were expected to be broadly similar to previous years but with minor changes necessitated by the replacement of Clinical Commissioning Groups to Integrated Care Boards.  It was expected that there would be limited changes to the BCF national metrics for 2022/23.

22.2   Resolved – that the West Sussex performance against the national Better Care Fund metrics at Q4 2021/22 and the Better Care Fund planning expectations for 2022/23 be noted.

To note the work programme for 22/23 as attached. Members of the Board are requested to mention any items which they believe to be of relevance to the business of the Health and Wellbeing Board. If any member puts forward an item the Board is asked to assess briefly whether to refer the matter to the Chairman to consider in detail for future inclusion.

23.1   The Board considered its work programme and the following suggestions were made: -

·       the Chairman reminded that as there was a gap between this meeting and the next scheduled meeting on 3 November 2022, Board Members were invited to correspond on any pertinent matters including the Health and Wellbeing Board Strategy.

·       a thematic view be adopted for the next meeting with a Cost of Living focus supported by a set of  integrated actions. The Chief Executive of Adur and Worthing Councils and the Assistant Director (Communities) offered to support this item by collating a system wide set of actions for consideration by the Board.

·       in noting that the Board used to regularly receive an annual Children’s Safeguarding report it was requested that a report from the West Sussex Safegaurding Children Partnership     be obtained.

·       a request to reintroduce the Health and Wellbeing Board Newsletter was put forward.

23.2   Resolved – that

                       i.    A Cost of Living item be added to the Work Programme for the 3 November meeting;

                      ii.    an annual report from the West Sussex Safeguarding Children Partnership be requested and the Independent Chairman be invited to fill the vacant seat on the Board; and

                     iii.    an action be noted to request reinstatement of the Health and Wellbeing Board Newsletter.

The next meeting of the Board will be held at 10.30am on 3 November 2022.

24.1   The date of the next meeting of the Health and Wellbeing Board was confirmed as 3 November 2022.

The meeting ended at 12.47pm