Agenda and draft minutes

13.1   The Chairman welcomed attendees to the meeting with particular mention of the Board’s new Members; Ian Duke, Chief Executive Officer, Crawley Borough Council, Dan Charlton, Chief Communications Officer Sussex Partnership NHS Foundation Trust and Roxanne Smith, Chief Strategy Officer, University Hospitals Sussex NHS Foundation Trust. The third voluntary sector representative for this meeting was announced as Kirstie Thomas, Chief Executive Officer 4Sight Vision Support.

13.2   In his welcome, the Chairman highlighted the following key points:

• Following the Notice of Motion regarding defibrillators moved and backed by West Sussex County Councillors at the County Council meeting on Friday 26 May 2023, the Chairman was pleased to update that several actions had taken place since to increase county-wide coverage and accessibility of the devices, including; issuing a press release , writing to town and parish councils highlighting the opening of the grant application process for the Department of Health and Social Care’s (DHSC's) £1 million Community Automated External Defibrillators (AEDs) Fund, writing to West Sussex schools encouraging the registration of devices on The Circuit, and moving defibrillators maintained by the Council’s Facilities Management team to external locations (where possible), enabling 24 hour community access, and delivered internal staff communications to raise awareness.

• Building on communications messages over the last year, the Chairman informed that the council’s Public Health and Communications teams had continued to develop the County Council’s all-age mental health communications campaign which would run until March 2024, aiming to raise community awareness of mental health, signpost to sources of information and support, and to challenge the persistent stigma of mental illness. As part of this approach, a dedicated campaign page ‘Your mental health – West Sussex’ on the Council’s website had been developed to enable residents to find the information they need to help their emotional wellbeing and mental health. Additionally, there would be regular social media messaging and residents’ e-newsletter articles, ongoing promotion of Your Mind Matters, ‘Don’t brush it under the carpet’ and the ‘Warning Signs’ initiative.

• The Chairman announced that the new countywide West Sussex housing support service for those recovering from substance misuse was officially launched last Friday, 19 January. Keynote speakers Professor Dame Carol Black and Professor Michael Preston-Shoot, headlined the event, which was hosted by the County Council and Alcohol Change UK.

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.

14.1   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 20 July 2023.

15.1   It was resolved that the minutes of the West Sussex Health and Wellbeing Board Meeting held on 29 July 2023 be approved as a correct record and be signed by the Chairman.

The Board is asked to monitor/note the responses to Recommendations and Actions made at the meeting on 20 July 2023.

16.1   The Board considered the Actions and Recommendations Tracker (copy appended to the agenda available on the council’s website) which had been updated from the last meeting on 20 July 2023. All items were noted as completed or in progress with no outstanding actions or recommendations.

The West Sussex Safeguarding Children’s Partnership (WSSCP) is required to produce an annual report providing an overview of its key achievements against its business plan priorities. The Health and Wellbeing Board does not have a role in approving or endorsing this annual report as it is a partnership document. It will be presented to the board, for information, as a key partner and as WSSCP activities aligns with the Joint Health and Wellbeing Strategy outcomes.

17.1   Chris Robson, Independent Chairman of the West Sussex Safeguarding Children Partnership (WSSCP) presented the West Sussex Safeguarding Children Partnership’s (WSSCP) annual report, April 2022 to March 2023 to the Board for noting. The following key points were made;

·         Recognition and thanks were given to the strategic leaders and practitioners who work hard to deliver good outcomes for families and children in West Sussex.

·         The annual report highlighted achievements as well as improvements and was aligned to the Joint Health and Wellbeing Strategy priority areas of improved mother and baby wellbeing, children growing in a safe and healthy home environment with supporting and nurturing parents and carers, good mental health for all children and children and young people leaving care are healthy and independent.

·         The annual report preceded new legislation under Working Together to Safeguard Children 2023. The revised statutory guidance meant that the WSSCP would be required to report to the Department of Education by 30 September for the business year April 2023 to March 2024).

·         The WSSCP continued to focus on neglect, exploitation, significant learning on suicide prevention, improving transitions from child to adult services as well as improving multi agency working.

·         It was noted that lay membership was crucial to the success of the WSSCP and members of the community were currently being recruited as lay members on the partnership.

17.2   Councillor Jacquie Russell as Cabinet Member for Children, Young People and Learning thanked the WSSCP Independent Chairman for his report and echoed the sentiment of thanks to social workers, leaders and partners for all their hard work in going above and beyond for children and families in West Sussex. Whilst understanding that a continued striving for excellence was necessary, Councillor Russell emphasised that the council and its partners recognised the importance of capturing the voice of the child and had been working to put this at the centre of all processes. The Early Help Service had been redesigned and was now delivering better outcomes.  This improvement had been reflected in the latest OFSTED report.

17.3   In receiving this report the Board;

·         praised the multi-agency triage approach for children deemed to be at risk of self-harm/suicide as an exemplary piece of partnership work, acknowledging the award received from the HSJ Patient Safety Awards of ‘Mental Health Initiative of the Year’.

·         noted the WSSCP key achievements including the ‘Dad Pad’/Co-Parent Pad aimed at first time parents to provide valuable advice and support. The WSSCP had been widely advertising this service and would be assessing impact but present feedback had been positive.

·         recognised the challenge of needing to hear the voice of the child with the WSSCP relying heavily on the local authority and the voluntary sector. National learning reviews were also seen as important to continuous improvements.

·         acknowledged Safeguarding in West Sussex is not perfect but it is a very important cultural aspect of West Sussex County Council that has the commitment and drive to strive for excellence.

17.4   The Health and Wellbeing Board resolved that;

                i.          the  ...  view the full minutes text for item 17.

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

18.1   The Director of Public Health provided verbal updates on current public health matters as follows;

·         The West Sussex Health and Wellbeing Board had accepted an offer of support, to all Health and Wellbeing Boards, from the Local Government Association (LGA) to develop the board in the context of the emerging NHS Integrated Care System. It was noted that all Health and Wellbeing Board Members had an individual feedback session with LGA associates to help inform the Board’s private development workshop on 11 March 2024.  Board members were thanked for their valued engagement and helpful conversations. This had enabled the LGA to scope the support that the project needed to help the board embark on this work.

·         It had been recognised that coastal health inequalities were producing serious health challenges with the risk of further poor health outcomes in coastal areas. It had been decided to assess coastal communities health needs separately using intelligence work and evidence. A draft framework had been formed to look at analysis and best practice and this would be published on the  West Sussex Joint Strategic Needs Assessment (JSNA) Website. Any feedback on this matter would be required by 16 February 2024.

·         On 19 January, the UK Health Security Agency (UKHSA) declared a national measles incident in England due to increases cases of Measles and a drop in vaccine uptake.  All areas across the country have been placed on alert and are reminding residents to take up the offer of the MMR vaccine (if unvaccinated).  The Director of Public Health confirmed that there had been no outbreak in West Sussex but the council was encouraging residents to receive two doses of MMR vaccine that will provide maximum cover.

18.2   The Chairman thanked the Director of Public Health for the updates.

Following the progress update presented to the Health and Wellbeing Board on 27 April 2023, this report presents the final West Sussex Suicide Prevention Framework and Action Plan 2023 – 2027 (including Year 1 action plan to April 2024), and the Sussex Suicide Prevention Strategy and Action Plan 2024 - 2027.

19.1   The Board received the final West Sussex Suicide Prevention Framework and Action Plan 2023 – 2027 (including Year 1 action plan to April 2024), and the Sussex Suicide Prevention Strategy and Action Plan 2024 – 2027, following the progress update presented to the Health and Wellbeing Board on 27 April 2023.

19.2 In presenting this report, the Director of Public Health and WSCC Consultant in Public Health provided an update on the actions being taken to reduce and prevent the risk of death by suicide across West Sussex. The following key points were highlighted;

·         The Sussex Suicide Prevention Strategy and Action Plan 2024-2027 builds on local learning and aligns with the national strategy as a multi-agency partnership strategy. It was noted that all organisations represented on the West Sussex Health and Wellbeing Board had been involved in the strategy’s development as a large piece of collaborative work.

·         It was acknowledged that suicide is a serious public health problem. The strategy, informed by data and evidence, aimed to reduce the suicide rate over the next 5 years – with initial reductions observed within half this time or sooner, improve the support for people who have self-harmed, improve the support for people bereaved by suicide.

·         It was noted that a more detailed action plan underpinned the public facing action plan with the aim of supporting early action across a range of settings to prevent people reaching crisis point. Board Members were informed that the Sussex Suicide Prevention Steering Group, a multi-agency partnership group, will oversee the delivery of the strategy and action plan.  

19.3 In receiving this report, Board Members commented on both the West Sussex Suicide Prevention Framework and Action Plan 2023-2027. Board Members;

·         welcomed this comprehensive strategy and action plan,

·         stated the importance of the role of the GP and timely referrals at place level,

·         emphasised the need for all partners to develop the skills, knowledge and confidence to provide necessary support and intervention,

·         recognised the need for targeted prevention to vulnerable groups, especially those at higher risk such as children and young people, middle-aged men, people who have self-harmed, people with mental illness and the homeless, amongst others, 

·         suggested that employers are made aware of suicide prevention matters and how they can support their work force,

·         acknowledged that targeted communications assisted outreach to vulnerable groups such as men and the homeless,

·         noted the strategy and action plan’s ethos that suicide is everybody’s business with joint responsibility and accountability for delivery of action at a local level,

·         commented that the governance surrounding the strategy and action plan should be robust to enable activity to take place in the right spaces such as food banks. The Health and Wellbeing Board would form part of the required governance looking at accountability and progress,

·         discussed how the Integrated Care System (ICS) could build this thinking into the network of community teams, recognising the scope for involving a wider spread of partners such as local businesses, using district and borough connections, utilising communication  ...  view the full minutes text for item 19.

This report and presentation will set out the intention and need to develop a strategic approach to food and nutrition for all ages across West Sussex.

20.1   The Board received a report and presentation (copy appended to the agenda available on the council’s website) that set out the intention and need to develop a strategic approach to food and nutrition across West Sussex.

20.2   In presenting the report the following key points were made ;

·       It was proposed that a West Sussex Food and Nutrition Strategic Framework for system wide action, be developed across all partners with an interim action plan to tackle the food environment and impact on population food consumption in the county.

·       To assess population need a West Sussex Food and Nutrition Needs Assessment would be undertaken.  

·       The NHS Eatwell Guide was presented which detailed how to achieve a balanced diet as well as maintaining hydration. 

·       It was noted that the food people eat is an important aspect of health and wellbeing with diet being the leading cause of avoidable harm to health.  In 2019, there had been 60,000k deaths in England attributed to poor diet. Malnutrition included those with undernutrition as well as overnutrition. 

·       low fruit and vegetable consumption had been found more likely in those living in the most deprived areas It was also informed that the UK population eats more highly processed foods than any other European country and UK children aged 11-18 consumed more than double the recommended limit of free (added) sugars in 2016-19.

20.3   In receiving this report and presentation Board Members;

·       recognised the impact of cost of living pressures as well as the critical issue in ensuring all residents have access to healthy food especially where deprivation exists. The importance of the quality of available food was referenced, for example, items provided in food banks,

·       agreed that reducing health inequalities would be at the heart of this strategic approach to food and nutrition,

·       referenced the environment and the need to rethink food waste,

·       noted the link between malnutrition and FALLS in the older population (as a possible contributory factor) and how healthy food would support FALLS prevention work,

·       acknowledged that those partners providing food were under pressure to supply healthy meals despite the cost of living impact on food prices,

·       suggested that a strategic approach could be used to influence the food landscape and behaviour for better outcomes; such as healthy eating to prevent loss of muscle mass,

·       discussed the need to provide healthy messaging to Early Years environments where young parents/carers could be supported with how to cook healthy meals on a low budget and ensure children start with a healthy diet,

·       advocated engaging with Farm Shops and other suppliers to make access to healthy, locally produced, food easier,

·       acknowledged the complexity of support for parents/carers in their provision of freshly cooked meals when they may physically have low energy or be concerned about meeting the energy costs to pay for meal preparation,

·       reminded of the quality standards that caterers and West Sussex County Council are required to meet in the provision of school catering,

·       advised of the opportunities to engage with residents through community  ...  view the full minutes text for item 20.

This paper provides an update on Better Care Fund (BCF) Planning for 2023-25, presents the Better Care Fund Q3 Quarterly Report for approval and the Q2 Quarterly Report for information, and summarises performance against the Better Care Fund national metrics for Quarter 2 2023-24.

21.1   Chris Clark,WSCC Assistant Director (Health Integration), and Joint Strategic Director of Commissioning (West Sussex) NHS Sussex Integrated Care Board presented the Better Care Fund report to the Board. The paper provided an update on Better Care Fund (BCF) Planning for 2023-25, the Q2 Quarterly Report for information, and summarised performance against the Better Care Fund national metrics for Quarter 2 2023-24.  It was noted that the Quarter 3 Quarterly Report was not ready and would be presented with the papers at the next meeting on 25 April 2024.

21.2   In receiving this report, members were informed that in reviewing the second year there had been no substantial changes to the schemes that the BCF funds from the first year.

21.3   It was noted that National Planning Guidance had not yet been received. The report confirmed that West Sussex continued to meet national conditions as follows:

·       Jointly agreed plan

·       Implementing BCF Objective 1: Enabling people to stay well, safe and independent at home for longer

·       Implementing BCF Objective 2: Providing the right care in the right place at the right time

·       Maintaining NHS’s contribution to adult social care and investment in NHS commissioned out of hospital services

It was also confirmed that the BCF Section 75 agreement had been approved by the council.

21.4   In turning to BCF performance Quarter 2 2023-24  the board were supplied with the 5 national metrics:

·       Metric 1: Long term support needs of older people (aged 65 and over) met by admission to residential and nursing care homes, per 100,000 population.

·       Metric 2: Proportion of older people (65 and over) who were still at home 91 days after discharge from hospital into reablement/ rehabilitation services.

·       Metric 3: Unplanned hospitalisation for chronic ambulatory care sensitive conditions.

·       Metric 4: Discharge to usual place of residence.

·       Metric 5: Emergency hospital admission due to falls (aged 65 and over)

21.5   It was advised that metrics 1, 3 and 4 had been achieved but 2 and 5 had not been achieved. It was pointed out that it was difficult to collect accurate data for metric 2 as this data related to residents not directly cared for by WSCC. Board members were informed that discussion was taking place with other system users to see how this could be overcome.

21.6   The Board was asked to stay sighted on emergency hospital admissions due to falls. It was reminded that preventing falls was a multi-agency challenge and an important issue for the Health and Wellbeing Board to remain sighted on. 

21.7   Board members discussed the issue of falls and welcomed coordination across partners. It was acknowledged that Age UK had a five year falls strategy and was in a position to collect data to help provide an evidence base for targeted work. This was welcomed by Chris Clark, the WSCCAssistant Director (Health Integration), and Joint Strategic Director of Commissioning (West Sussex) NHS Sussex. It was asked if falls data could be split between those falling inside  ...  view the full minutes text for item 21.

Pennie Ford, Executive Managing Director NHS Sussex and Chris Clark, WSCC Assistant Director (Health Integration) and Joint Strategic Director of Commissioning (West Sussex) NHS Sussex Integrated Care Board will provide a brief verbal update.  

22.1   Pennie Ford, Executive Managing Director West Sussex NHS Sussex, verbally updated the board on the Integrated Care System, for information.

22.2   Board members were reminded that last year following the establishment of the Sussex Integrated Care System (ICS), partners agreed the Sussex Health and Care Strategy ‘Improving Lives Together’ and the Shared Delivery Plan (SDP).  Further to that NHS Sussex Integrated Care Board (ICB) has developed a “target operating model” and established an organisational change programme in order to redesign the structure around delivery of the SDP. It was informed that in addition there is a national requirement  to reduce the administrative running costs of the ICB by 30%. As a result, a process of change was underway to deliver the Strategy whilst reducing running costs.  

22.3   It was noted that organisational change had commenced with the Executive Team in December 2023 and had currently moved to the Senior Leadership Team. The number of senior leads would be significantly reduced. The restructure would be completed with a staffing review of the rest of the organisation from February to April 2024.

22.4   It was informed that, as part of overall change, the programme would focus on positive health outcomes, making decisions based on data and intelligence and this would shape how the NHS continued to work with system partners.

22.5   Board members were advised that NHS England had not yet issued planning guidance for 2024-25 although a letter had been sent to Integrated Care Boards setting out expectations. A work programme was in place, driven by the Improving Lives Together Strategy, which would target population health needs especially in areas with health inequalities.

22.6   It was recognised that there were a number of areas that required improvement and prioritisation would be set around the areas where performance targets were not being met. This could mean difficult choices would need to be made to provide the best population health outcomes within the resources available.

22.7   The Sussex Health and Care Assembly, a statutory joint committee  between the NHS and local government, made up of three councils (West Sussex County Council, East Sussex County Council and Brighton and Hove Council) had met five times since its establishment in 2022. As initially requested by the committee, a review of the Assembly’s effectiveness, at the end of its first year, was being undertaken. As a member of the Sussex Health and Care Assembly the Chairman of the Health and Wellbeing Board, Cllr Bob Lanzer, stated that the assembly membership would be slightly reduced and once the new structure had been finalised Health and Wellbeing Board members would be informed.

22.8   In discussing this verbal update, it was recognised that partners, represented at the Health and Wellbeing Board, were working in a constrained financial environment and needed to have open conversations to coordinate financial planning and collectively make the right decisions to avoid unintentional impacts on partners. It was suggested that the Health and Adults Social Care Scrutiny Committee may wish to take  ...  view the full minutes text for item 22.

To note the work programme for 2023/24 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 Chairman presented the Health and Wellbeing Board Work Programme 2023 -2024 which was noted as in draft.

23.2   The item proposed, during this meeting, to update on the progress of developing the strategic approach to Food and Nutrition across West Sussex at the next meeting on 25 April 2024 was added to the work programme.

23.3   Resolved – that the Health and Wellbeing Board draft Work Programme 2023-2024 be noted.

The next meeting of the Board will be held at 10.30am on 25 April 2024.

24.1   The date of the next meeting of the Board was confirmed as 10.30am on 25 April 2024.

The meeting ended at 12.32pm.