Agenda and minutes

11.1   The Chairman welcomed those attending and thanked them for joining the virtual Health and Wellbeing Board Meeting. In welcoming all to the meeting, the Chairman made the following key points;

·       The Chairman recognised that since the last meeting of the Health and Wellbeing Board in October, the pandemic had continued to bring unprecedented challenges throughout West Sussex and across the nation. The Chairman stated that this period had been one of the greatest challenges that public health, social care, the NHS, and all our communities had ever faced, whilst continuing to stretch and affect daily lives in many ways.

·       The Chairman reassured that there was hope with the arrival of the COVID-19 vaccine, which NHS colleagues were rolling out at great pace, working with Sussex Resilience Forum partners and West Sussex Public Health.

·       Vaccinations were currently being administered in West Sussex to the first two priority groups advised by the Joint Committee on Vaccination and Immunisation (this includes residents and staff in care homes for older adults, all those aged 80 years and over, and health and social care workers) via hospital hubs, GP-led vaccination services, and care homes by a roving service that will also support those who are housebound. This week also saw the largest vaccination centre in Sussex open at the Brighton Centre to provide eligible people across Sussex greater opportunity to receive their vaccine.

• The Chairman highlighted again, the importance of working together and supporting each other, putting a ‘whole systems approach’ at the fore to help everyone through this difficult period, both locally and nationally. Board members, key systems leaders across the health and care system, continued to maximise their collaborative strength, working together tirelessly to make the most effective use of combined resources to protect and support residents and communities during these most challenging times.
• The Chairman recognised that challenges of the pandemic could not be met without the workforces, volunteers and communities. On behalf of the West Sussex Health and Wellbeing Board, the Chairman expressed her sincere thanks to everyone throughout West Sussex, for their determination, stamina, compassion and commitment to supporting residents and communities during this time; the work and support was noted as simply outstanding. 

11.3     In conclusion the Chairman brought Board members attention to the updates that had been circulated that provided the latest information on the COVID-19 Vaccination Programme and West Sussex County Council Communications supporting the COVID-19 response.

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.

12.1   There were no declarations.

The Board is asked to confirm the minutes of the meeting of the Health and Wellbeing Board held on 8 October 2020.

13.1   Resolved – that the minutes of the meeting held on 8 October 2020 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.  Please submit questions, at least three days ahead of the meeting in order to allow a substantive answer to be given. Contact Erica Keegan on Telephone: 0330 222 6050 (a local call) or via email: erica.keegan@westsussex.gov.uk

The meeting will be available to watch live via the Internet at this address:

http://www.westsussex.public-i.tv/core/portal/home

14.1   The Board had invited questions from the public for consideration at this meeting. The Chairman informed the meeting that a question had been received asking;  ‘Bearing in mind that the deadline for vaccinating against Covid-19 adults over the age of 65 in care homes was 24 January, was that objective achieved, please, and did this include the residents of so called extra care homes?’

14.2   The Chairman thanked the questioner for this question and advised that a written response would be provided following the meeting. The Chairman then read out the response, that had been provided by West Sussex NHS Commissioners, as follows:

‘Older people in care homes are one of the top priority groups for the COVID-19 vaccine due to their high risk from coronavirus.

In line with the national target to have vaccinated all care homes by the end of the month, we have been working tirelessly to vaccinate both residents and staff across Sussex, As of Monday, we had vaccinated more than 8,381 residents across a total of 454 care homes for older people (equating to 90 per cent of all of our care homes for older people in Sussex) and progress has continued further this week.

Unfortunately, anyone with COVID-19 is unable to receive the vaccine while they are recovering. Some care homes are currently experiencing positive cases of COVID-19 amongst their residents and in these cases the home or those residents who are unwell have not been able to have their vaccination at this point. The vaccination teams have a clear schedule in place and will be revisiting them 28 days following the positive test.

In Sussex, we have one of the highest numbers of nursing and care homes per capita across the country and so this is a significant undertaking but thanks to the dedication and commitment of our vaccination teams from GP-led services and Sussex Community NHS Foundation Trust we are making excellent progress towards achieving the government target.  For all supported living / Extra Care settings, the residents will be invited in to receive their vaccination during attendance at a local GP-led vaccination service, in line with the national priority groups. We are currently working with groups through 1-4.

Residents who are housebound will have a home visit to receive the vaccine to make sure they can receive this vital protection. Sussex Community NHS Foundation Trust is working with local GP practices to understand which residents need this level of service and will be making arrangements for appointments. Vaccinations have started and people will be contacted as soon as an appointment is available. We are asking people not to contact their GP practice - they will be contacted as soon as possible.’

The inaugural meeting of the Children First Board was held on 8 October 2020. 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.

15.1   The Executive Director of Children, Young People and Learning, Lucy Butler, presented the report updating on the establishment and work of the newly formed Children First Board chaired by Councillor Jacquie Russell (Cabinet Member for Children and Young People).

15.2   It was reported that the Children First Board had met twice with the inaugural meeting held on 8 October 2020 ( notes available on the website appended to this  Agenda). Meetings will be held four times a year.

15.3   It was noted that the Children First Board had agreed three main goals:

·       Improve outcomes for children and young people who live in West Sussex or who are cared for by West Sussex Children’s Services.

·       Ensure that all agencies that provide services for children and young people in West Sussex work together effectively.

·       Listen and respond to the views of children, young people and their families all the time, particularly when discussions are being held about how services are run and funded.

15.4   It was noted that the first meeting of the Children First Board focussed on how the Board could keep the views of children and young people central to its work.

15.5   Board Members were informed that one of the Children First Board’s early priorities was to establish a Children and Young People’s Plan having noted that this was a preference of young people.

15.6   The Chairman of the Children First Board, Jacquie Russell (Cabinet Member for Children and Young People) welcomed the positive feedback from partners in developing the Children and Young People’s Plan. Board Members were informed that Luke Rodgers (The Care Leaders) had provided an informative session on what outstanding participation and engagement could be and the Children First Board were committed to this outcome so that the voice of children and young people was at the heart of the Children First Board.  The Chairman of the Children First Board also explained that the Children and Young People’s Plan would link to the West Sussex Joint Health and Wellbeing Strategy 2019 -2024.

15.7   In receiving this report, Health and Wellbeing Board Members requested a timeline for the Children and Young People’s Plan to be brought to the next meeting and agreed that this plan would be presented to the Health and Wellbeing Board at the appropriate time. 

15.8   The Chairman referred the Board Members to the report’s recommendations and the Board formally; 

Resolved – that the establishment of the Children First Board and contents of the Children First Board report be noted.

15.9   In thanking the presenters for their report, the Chairman congratulated them on the work that had been achieved so far. 

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.

The Health and Wellbeing Board is asked to;

(1)      Acknowledge and provide feedback on the progress of the West Sussex COVID-19 Local Outbreak Engagement Board (LOEB) since its’ inaugural meeting in July 2020; and

(2)      consider how the Board could further increase engagement with communities across West Sussex throughout the COVID-19 pandemic to reduce the spread of infection and save lives. 

16.1   The Interim Director of Public Health provided an update on the progress of the West Sussex Covid19 Local Outbreak Engagement Board (LOEB) since its first meeting in July 2020. It was reminded that the LOEB was established as part of the Government’s requirements for the Covid19 National Test and Trace Programme and as a sub-group, is accountable to the West Sussex Health and Wellbeing Board.

16.2   The LOEB was noted as a key part of the governance structure for the West Sussex Local Outbreak Control Plan published on 30 June 2020 which, following review, was in the final stages of a substantial update. It was reminded that the LOEB’s Chairman was Councillor Amanda Jupp, Cabinet Member for Adults and Health and Chairman of the West Sussex Health and Wellbeing Board. It was reported that the LOEB had met on a monthly basis since July 2019, bringing together key systems leaders across the County Council and the wider health and social care system, applying its collective strength to reduce the spread of infection and save lives.

16.3   The Interim Director of Public Health outlined the purpose of the LOEB was to provide up to date and key information to the public during the pandemic. This includes the latest data, public health prevention messages, any changes to Government Policy  and keep the ‘Keep West Sussex Safe Campaign’ messaging. It was reported that the LOEB had been working with communication teams from West Sussex County Council and partners such as District and Borough Councils and the NHS to coordinate a collective communications approach. The Interim Director of Public Health informed the Board that the LOEB would continue to engage with local communities across West Sussex and welcomed any ideas or suggestions from Health and Wellbeing Board Members on how the LOEB could further increase its engagement with communities in West Sussex.

16.4   It was stated that the LOEB also received operational updates, when needed, on the programme of work around Covid19 including the Local Tracing Partnership, Covid19 Testing and the NHS Covid19 vaccination programme which was noted as the responsibility of the NHS.

16.5   The Interim Director of Public Health updated the meeting on the latest Covid19 data, as of today (28 January 2021), as follows:

·       West Sussex reached a peak of Covid19 cases two weeks ago and now numbers had begun to fall. The Seven day rate remained at 360 Covid19 cases per 100,000 people. Within this figure there was variance between areas of West Sussex such as the Covid19 cases in Crawley being 561 per 100,000 compared to the Covid19 cases in Mid-Sussex of  265 per 100,000.

·       The number of people infected over the age of 60 was reported as 278 per 100,000 people, again with a variance in areas of West Sussex such as 500 per 100,000 people in Crawley and 200 per 100,000 people in Horsham.

·       West Sussex figures were similar to the regional South East figures and National England figures.

·       The measure of testing how many people  ...  view the full minutes text for item 16.

The Board will receive a report that focuses on preventing health inequalities in people with learning disabilities and digital inclusion so that nobody is excluded due to a lack of digital access, confidence or skills.

The Health and Wellbeing Board is asked to;

(1)       endorse the actions of the Learning Disability Partnership Board which works to improve the lives of people with learning disabilities and their families in West Sussex; and

(2)   consider actions each member will take forward in their respective roles and organisations to improve accessibility and health outcomes for those with Learning Disabilities.

17.1   The Board received a report from the Learning Disability and Autism Commissioner on behalf of the Learning Disability Partnership Board (LDPB) asking Members to consider what actions each of them could take forward in their respective roles and organisations to improve accessibility and health outcomes for those with Learning Disabilities.

17.2   It was explained that the LDPB works to improve the lives of people with learning disabilities and their families in West Sussex, including people with learning disabilities as equal partners who often lead the way in working to improve life chances for young people and adults. 

17.3   The Health and Wellbeing Board received an Easy Read report, (appended to the Agenda and available on the Website) which made written information easier to understand and more accessible for people with learning disabilities by using, short, simple sentences and pictures. The report focused on preventing health inequalities in people with a learning disability and digital inclusion so that nobody is excluded due to a lack of digital access, confidence or skills.

17.4   In receiving the report the Board;

·       recognised that life expectancy is considerably lower for people with learning disabilities and the health inequalities needed to be addressed by working together;

·       welcomed the report and agreed that the voluntary sector should be included as it has frontline experience and advice on some of the issues as well as possible solutions;

·       noted that those with learning disability would be supported through the Covid19 vaccination process through the Covid Partnership Group;

·       understood the importance of digital access with provision of equipment and wi-fi;

·       pointed out that Healthwatch were in the process of drafting an Autism and Learning Disability Health Plan;

·       requested that the Board be kept updated on practical ideas for promoting digital inclusion for people with a learning disability;

·       agreed that all respective organisations would develop learning disability inclusion into their plans and share at the next Health and Wellbeing Board meeting on 24 June.

17.5   Resolved – that the Health and Wellbeing Board;

(1) endorsed the actions of the Learning Disability Partnership Board (LDPB) which works to improve the lives of people with learning disabilities and their families in West Sussex; and

(2) considered actions each member would take forward in their respective roles and organisations to improve accessibility and health outcomes for those with Learning Disabilities.

The Board will receive a report on Creating Healthy and Sustainable Places. 

The Health and Wellbeing Board is asked to; Endorse, support and build upon the work on the ‘Creating Healthy and Sustainable Places: A Public Health and Sustainability Framework for West Sussex’.

18.1   The West Sussex County Council Programme Manager, Public Health and Sustainability presented her report on Creating Healthy and Sustainable Places: A Public Health and Sustainability Framework for West Sussex.  The Board was reminded that the council held a responsibility for delivering positive health and wellbeing outcomes for its residents,  addressing the wider determinants of health which includes shaping the built and natural environments.  This Framework provided public health guidance to decision makers on creating healthy and sustainable places in West Sussex in order to help address health and social inequalities and mitigate negative health impacts and consequences.  In presenting the report, the following key points were made;

·       A health in all policies approach was identified as an opportunity to reduce health inequalities and maximise sustainability. The environment was recognised as a major determinant of health and wellbeing with the provision of healthy and sustainable places to live, work and play;

·       The use of the Framework was seen as a support to influencing policy to deliver healthier lives and a consistent, holistic approach to producing good quality places for communities both now and in the future;

·       It was reported that this approach had been endorsed by Public Health England and was noted as innovative and cross cutting with a clear statement on the commitment of the council to healthy and sustainable place making across the County;

·       The Framework had gone out for two round of consultation with internal and external partners. This included the residents of West Sussex, all of the District and Boroughs, NHS Estates, Public Health England, Sport England, two major developers, the Voluntary Sector and Healthwatch.

18.2   In receiving this report Board Members;

·       welcomed the Framework as a good piece of work which supported the Health in all Policies agenda that had been aspired to over 3 or 4 years;

·       stated that the Board would need to consider how policy could be turned into action and embedded;

·       acknowledged the importance of the environmental impact on Health and Wellbeing in helping to deliver positive health outcomes;

·       recognised that the Framework was not a statutory document and therefore there was the challenge of influencing planning policy and decision making as well as the challenge of managing compliance from developers;

·       noted that the Framework supported the Sport England Active Strategy of producing physical and mental wellbeing, individual development, social and community development and economic development;

·       referenced the Marmot Review Ten Years On which examined Health Equity progress and decline since 2010. Board Members were keen that, although ambitious, the Creating Healthy Places Framework be used to influence positive outcomes and tackle unacceptable health gaps;

·       noted the Creating Healthy Places Framework as an important document, despite its non-statutory status, as a resource that can be actively used to help tackle and prevent health inequalities.

18.3   The Interim Director of Public Health thanked the Programme Manager, Public Health and Sustainability for her excellent work.  It was stated that the Framework was a forerunner in the Country and Board Members agreed that the  ...  view the full minutes text for item 18.

This paper provides a summary of the planning requirements, funding sources, and expenditure plan for the West Sussex Better Care Fund in 2020/21, along with the regular monitoring of performance against the 4 national metrics for Quarters 1 and 2, 2020/21.

The Health and Wellbeing Board is asked to;

(1)   Note the national Better Care Fund planning requirements for 2020/21 the associated West Sussex Better Care Fund funding sources, and expenditure plan meeting National Conditions 1, 2, 3 and 4 as described below.

(2)   Note the West Sussex performance against the national Better Care Fund metrics at Q1 and Q2 2020/21, and the degree to which these are impacted by Covid-19.

19.1   The Board received the Better Care Fund (BCF) Monitoring Report Q1 & Q2 2020/21 from the Joint Strategic Director of Commissioning, as part of the mandatory governance requirement that the BCF be reported to the Health and Wellbeing Board. The BCF spanned both the NHS and Local Government, joining up health and care services so that people could manage their own health and well-being and live independently in their communities as long as possible.

19.2   Board Members were notified that National BCF reporting had been suspended as a consequence of the pandemic.  The four national conditions for the West Sussex BCF in 2020-21 had been met as well as being compliant in producing an income and expenditure plan for 2020/21.

19.3   In referring to the Comparative BCF Performance data, it was recognised that operations had been undertaken under the extraordinary pressure of Covid19. However joint working had produced marked improvements in Hospital Discharge figures. The average time for a patient to be discharged from hospital was 15 days and, currently, this had reduced to 4 days.  This meant that the strategic objective of increasing the numbers of people being supported to be at home had been met.

19.4   The BCF programme would continue next year with national guidance expected Mid-March unless delayed as a result of the pandemic.

19.5   In receiving the report, a question was raised on Telecare expenditure of £860,800 as Districts and Borough Councils could offer this service without profit. It was agreed that the Joint Strategic Commissioner would follow up outside of this meeting.

19.6   Resolved – that the Health and Wellbeing Board;

(1)  noted the national Better Care Fund planning requirements for 2020/21, the associated West Sussex Better Care Fund funding sources and expenditure plan meeting national conditions 1 to 4; and

(2)    noted the West Sussex performance against the national Better Care Fund metrics at Quarter 1 and Quarter 2 2020/21 and the degree to which these are impacted by Covid19.

To note the work programme for 21/22 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.

20.1   The Chairman referred Board Members to the Work Programme as attached to the agenda. Members were requested to mention any items which they believed to be of relevance to the business of the Health and Wellbeing Board.

20.2   In receiving the work programme Members;

·       Pointed out there had been a Sussex Wide Covid19 Survey which could be used as part of an item on Covid19 Recovery;

·       Called for close integration on Health and Social Care items, noting that an initial report on ICS (Integrated Care System) would be provided at the next meeting in June.

20.3   In concluding the meeting, the Chairman announced that Alison Challenger would be joining West Sussex County Council on 1 April 2021 as Director of Public Health.  The Chairman passed on her sincere thanks to Dr Tony Hill as Interim Director of Public Health who had worked hard in supporting West Sussex at this difficult time.

The next meeting of the Board will be held at 10.30 am on 24 June 2021 at 10.30am.

21.1   The date of the next meeting of the Health and Wellbeing Board was confirmed as 24 June 2021.

(Meeting closed at 12.35pm)