Agenda and minutes

13.1   In welcoming attendees to the meeting, the Chairman announced that Stephen Lightfoot, Amy Galea and Fouzia Harrington were attending as newly appointed, NHS Integrated Care Board, members of the Health and Wellbeing Board. 

13.2   It was announced that Chris Clark (Assistant Director, Health Integration, and Joint Strategic Director of Commissioning) had left his role and stood down from the West Sussex Health and Wellbeing Board. The Chairman thanked Chris for his valuable service and contribution to the West Sussex Health and Wellbeing Board, over many years.

13.3   The Board received the following updates;

·       Earlier this year, Public Health undertook the ‘Your Health Matters – West Sussex Community Health and Wellbeing Survey 2024’ to help the Council and partners plan services and take action to support the health and wellbeing of residents following the COVID-19 pandemic. The Council’s Public Health and Social Research team were noted as currently carrying out data analyses, with results expected to be published during the summer.

·       West Sussex County Council’s Full Council meeting was announced as taking place on Friday, 19 July where a Notice of Motion from Cllr Wickremaratchi seeking the Council’s support to increase Sepsis awareness would be debated. Alongside this, the Council’s Public Health team would be hosting a stand focused on sepsis awareness and blood pressure.

·       The Chairman reminded that there were two upcoming Health and Wellbeing Board seminars (non-public) in the diary to focus on the development of the new Joint Local Health and Wellbeing Strategy in July and September 2024 for members of the Board as well as members of the West Sussex Health and Care Partnership Board and the West Place Based Community Oversight Group.  The Chairman requested that attendance be prioritised to contribute to the important strategy to improve the health of the local population and reduce inequalities.

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 25 April 2024.

15.1   It was resolved that the minutes of the West Sussex Health and Wellbeing Board Meeting held on 25 April 2024 be approved as a correct record and signed by the Chairman.

The Board is asked to monitor/note the responses to Recommendations and Actions made at the meeting on 25 April 2024.

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 25 April 2024.

16.2   It was requested and agreed that a progress update on the West Sussex Suicide Prevention Strategy and pan-Sussex Suicide Prevention Strategy would be added to the Board’s work programme.

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.

17.1   In receiving the Children First Board (CFB) report from the Assistant Director, Safeguarding Quality and Practice (CYPL), the following key points were noted;

·       The CFB had successfully recruited an Independent Chair and refreshed its membership to be formally noted at the next meeting of the CFB on 23 July.

·       The terms of reference for the CFB had been updated and would be discussed and ratified at the next CFB meeting. It was assured that there had been no significant changes.

·       For effective interaction with children and young people the CFB had amended their meeting style to focus on the need for freedom of expression, conducting formal business during the first part of the meeting.

·       It was noted that the Southern Audit Internal Partnership were conducting an independent audit on the Children and Young People’s Plan. The report would be reviewed at the CFB meeting in July.

·       It was recognised that the CFB, as a sub-group of the Health and Wellbeing Board, would seek feedback on CFB priorities including on the refresh of the Children and Young People’s Plan (CYPP) that runs to 2025. It was agreed that the Health and Wellbeing Board needed to retain an oversight of CFB activity.

17.2   The Health and Wellbeing Board resolved that the content of the Children First Board report be noted.

The West Sussex Safeguarding Adults Board (WSSAB) Annual Report for 2023-24 sets out the work achieved to deliver three statutory duties. It includes reporting on the Board subgroup activities and achievements to meet priorities set for 2023-2024; Safeguarding Adult Reviews (SARs); Safeguarding and Deprivation of Liberty Safeguards data; and priorities for 2024-25.

18.1   The board received the West Sussex Safeguarding Adults Board (WSSAB) Report for 2023 – 24, including reporting on WSSAB subgroup activities and achievements to meet priorities set for 2023-2024, Safeguarding Adults Reviews (SARs); Safeguarding and Deprivation of Liberty Safeguards data and priorities for 2024 – 2025.

18.2   In receiving this report, board members;

·       noted the good progress made on the priorities of embedding learning and assurance and self-neglect and commended the strong multi-agency safeguarding activity;

·       thanked the Independent Chairman, Annie Callanan and supporting officers for their invaluable support and commitment to the activities of the WSSAB;

·       recognised that the report sets out the details of WSSAB work to improve services for vulnerable people by establishing a strategic plan and commissioning Safeguarding Adults Reviews to influence work, thereafter embedding learning and quality assurance.

·       were informed that the Independent Chairman and the Support Team attended several staff forums, meeting with over 258 staff across the partnership;

·       noted the positive feedback on how shared information has improved knowledge across the partnership;

·       acknowledged the commissioned thematic Self-Neglect Adults Review which included a staff self-neglect survey and noted self-neglect would continue to be prioritised for 2024/25;

·       praised the delivery of the annual business plan objectives including the successful bi-annual self-assessment process which focussed on areas of adult protection, led by the Quality and Performance subgroup. The process provided a quality of challenge required for the assurance the WSSAB needs;

·       commended WSSAB learning resources which have been adopted by other Safeguarding Adults Boards across the country;

·       noted that the multi-agency Risk Management Subgroup continues to support and find solutions for high-risk and complex cases;

·       gave thanks to the commitment of members and diligent work of the WSSAB Support Team dealing with high volumes of work;

·       thanked the Independent Chairman for her leadership with NHS representatives present pointing out the positive multi-agency endeavours, noting collaborative, robust partnership whilst pledging NHS commitment as a key partner, particularly in applying any learning to the Integrated Care System; 

·       welcomed the offer from Healthwatch West Sussex in assisting the WSSAB with capturing the voice of carers and families in West Sussex.

18.3   In summing up, the Chairman praised the export of WSSAB’s learning resources to other board’s nationally as something to note and celebrate.

18.4   The Health and Wellbeing Board resolved that;

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

    ii.        feedback be provided on how the Health and Wellbeing Board as a representative of the partner agencies and within the collaborative working agreement will contribute to the WSSAB’s priorities for 2023 -24; and

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

The West Sussex Health and Wellbeing Board (HWB) is responsible for the development of the Joint Strategic Needs Assessment (JSNA) for the county, which assesses the health and wellbeing needs of the population and informs the priorities in the Joint Local Health and Wellbeing Strategy (JLHWS) to improve population health and wellbeing and reduce inequalities, drawing upon the evidence of the JSNA. The Board will receive a report and presentation on the JSNA summary 2024/25.

19.1   Board members received a report and presentation (copy appended to the agenda available on the council’s website) from the West Sussex Public Health and Social Research Unit Manager which outlined the structure and initial findings of the West Sussex Joint Strategic Needs Assessment (JSNA). This data and information is the evidence base that informs and underpins the Joint Local Health and Wellbeing Strategy (JLHWS) and other local plans that seek to improve the health and wellbeing of residents and reduce health inequalities. 

19.2   In presenting this report and slides the following key points were highlighted;

·       The JSNA was noted as the ongoing process through which current and future health trends are identified for future health and wellbeing needs of the population. It was also noted that the Health and Wellbeing Board had a statutory requirement, under the Health and Social Care Act 2012, to jointly develop and approve the Joint Strategic Needs Assessment (JSNA) and ensure it is a key evidence base to inform strategic decisions of the Health and Wellbeing Board and its constituent organisations.

·       The JSNA was described as an ongoing series of analyses and monitoring of population health with a focus on the health and wellbeing outcome. For the purposes of prioritisation four elements provide focus; scale of an issue, direction, comparative significance, and the question, can you do something about it?

·       Population data for West Sussex was viewed with respect to overall trends including an accelerating ageing population (except in Crawley) with pressure on coastal areas, such as Arun and Worthing, highlighting a future projection of increased demand for care as shown against a working population.

·       It was acknowledged that in approaches to tackling health inequalities, it is important to understand groups at higher risk of poor health outcomes such as people with mental illness, children in care and care leavers, homeless people and those responding to life events, such as being at risk of homelessness, bereavement and other crisis.

·       The data also provided an overarching view for a clear understanding of the major cause of ill health, mortality and premature mortality in West Sussex.  It was noted that tackling the health risk factors would have the biggest impact on improving population health. The highest risk factors for poor health were noted as tobacco, obesity and dietary risks such as diabetes and high blood pressure.

·       Healthy life expectancy had fallen in West Sussex (and nationally) whilst life expectancy has continued to rise which had implications for services, the workforce and the wider economy.

·       Wider health determinants were noted as including education, employment, environment and housing. In West Sussex, there were rising trends in temporary accommodation, with Worthing now having the fifth highest rate of households in temporary accommodation in England. It was also noted that the percentage of out of work 16+ year olds in Crawley remains higher than Great Britain having not recovered to pre-pandemic rates.

·       Data presented on health inequalities was taken from samples from the most to least deprived areas in West  ...  view the full minutes text for item 19.

The Director of Public Health will provide a verbal update on current public health matters, including an update on the Director of Public Health Annual Report 2022/23.

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

·       An all-age Public Mental Health needs assessment had been co-produced and would be published shortly;

·       The Director of Public Health’s independent Annual Report 2022/23, which would be published soon, focused on Children and Young People’s (CYP) mental health and wellbeing in a changing world. It was informed that the report highlighted CYP’s mental health as a key priority area and described local need whilst identifying the current support in place to meet this need. The report also focused on the partnership work involved in supporting CYP’s mental health and wellbeing.

20.2 The Chairman thanked the Director of Public Health for this update.

Ian Duke, Chief Executive, Crawley Borough Council, will provide a verbal update.

21.1   In introducing this item, the Chairman declared an interest as a member of Crawley Borough Council.

21.2   The Chief Executive, Crawley Borough Council, provided a verbal update on the project work of the county-wide Strategic Housing Group (SHG) with the following key points;

·       A Care Leavers protocol had been put in place with provision of supportive accommodation for 16 to 25 year olds.

·       Extra Care Housing – 20 sites were being planned over an 18 year period using a model that has worked in Surrey.

·       The SHG had received a presentation on homelessness and rough sleeping which identified some of the key challenges housing colleagues faced. The Local Community Networks were understanding of the wellbeing needs for those experiencing homelessness.

·       The history around the Chagossian arrivals in Crawley was outlined. It was noted that Crawley had become home to the largest community of Chagossians in the UK, approximately 3,500 people, accounting for two-thirds of those resident in the UK. The government had forecast that between 3,500 and 5,000 people currently living in Mauritius will take up the offer of citizenship. Crawley Borough Council had experienced difficulties with large numbers arriving in a concentrated area with a steep upward curve expected to continue. It was reported that on 10 June 2024 fifty two Chagossians had arrived on a single flight. It was stated that this was beyond the capability of a single authority and help would be gratefully received.  NHS Sussex confirmed that they were working together to support whilst referencing the current cost pressures this brings to the NHS Integrated Care system.

21.3     In receiving this update, Health and Wellbeing Board Members agreed that responsibility for the Chargossion people was owned by Central Government and therefore a national response was considered appropriate. 

21.4   The Chairman thanked the Chief Executive of Crawley Borough Council for this update.

Due to NHS pre-election regulations this item will be included in the agenda after the general election as a paper to follow. A report will be received on the NHS Sussex Shared Delivery Plan Year 2 (2024/2025) refresh.

22.1   The NHS Sussex Chief Integration and Primary Care Officer and West Sussex County Council, Director of Adults & Health presented this report, providing an update on the Sussex Shared Delivery Plan (SDP) whilst setting out how the Sussex Integrated Health and Care Strategy, Improving Lives Together, is being delivered.  The report responded to the NHS Operational Planning Guidance for 2024/25, outlining the year 1 achievements, the deliverables planned for year 2, 2024/25 and the changes to programme delivery and governance.

22.2   In receiving this report, the following key points were noted;

·       The Sussex Integrated Care Board (ICB) and partner organisations are required to prepare a joint forward plan before the start of each financial year, setting out how they intend to exercise their functions in the next five years.

·       The Integrated Care Strategy, Improving Lives Together set out the agreed long-term improvement priorities which would be the focus across health and care in Sussex, as well as the immediate and continuous improvement areas that will bring the greatest benefits to local people and workforce.

·       Attention was drawn to the SDP summary of areas of focus, including a focus on support from the Integrated Community Teams, developing a multi-agency approach and designing systems around District and Boroughs

·       In Year Two, Sussex Health and Care ICB had begun development of its plan to outline the anchor role of the integrated care board and the way the NHS can work with partners to deliver improved social and economic wellbeing outcomes.

·       With respect to Intermediate Care Services, it was stated that there was ambition to provide one model of delivery, implementing John Bolton’s (a nationally recognised expert) recommendations made in his detailed report to the NHS Sussex Integrated Care Board (ICB) on opportunities for improvement around intermediate care and discharge.

·       Ambitions were also noted as being centred on three agreed long-term priorities – a new joined-up community approach through Integrated Community Teams; growing and developing the workforce; and improving the use of digital technology and information.

·       It was informed that the Integrated Community Teams would have specific focus on addressing health inequalities, taking preventative and proactive action, and working with local partners that support the wider determinants of health, including housing. Board Members welcomed that the importance of Housing had been recognised such as supporting people with Learning Disabilities and Mental Health issues into appropriate accommodation.

·       Health and Wellbeing Board (HWB) members addressed the need for the robust use of digital innovations including AI technology.

·       Comment was made that Housing should be given a strengthened position within the SDP given its impact on population health and wellbeing. It was thought that partners needed to be more ambitious with their aims around housing.

·       There was discussion on the whole system approach to economics with respect to the total cost of extra care services and how this is managed across areas of need, such as the higher level of need in coastal communities.

·       HWB Members raised that service level data had to be collected across health  ...  view the full minutes text for item 22.

The Board will receive the regular report on the Better Care Fund.  Due to NHS pre-election regulations this report will be included in the agenda after the general election.

23.1   The Board received the regular report on the Better Care Fund providing an update on Better Care Fund (BCF) Planning for 2023-25, including the Year-end Return 2023-24 and Planning Submission 2024-25, and the summary performance against the Better Care Fund national metrics for Quarter 4 2023-24.

23.2   The following key points were noted;

·       The BCF end of year return was submitted on 23 May 2024 pending approval on behalf of the Health and Wellbeing Board (HWB), in line with normal BCF requirements, by the HWB Chairman, Cllr Bob Lanzer, which was given on 27 June 2024. It was confirmed that the BCF national conditions continued to be met throughout the year.

·       In terms of planning, the key priorities remained Hospital Discharge and admission avoidance as well as looking at how demand and capacity modelling could be improved. There would also be a review of community care work practices as this is fundamental to the Integrated Community Teams.

·       All monies in the plan were committed in terms of spend. It was explained that there were regional and national conversations being held on how to provide the best outcomes from a pooled budget to support people in terms of admission avoidance and hospital discharge. Any update on this would be reported to the Health and Wellbeing Board. 

23.3   In receiving this report, Board members gave thanks for the joint working between the Local Authority and NHS, understood that the outcomes needed to be monitored to ensure good progress in all areas.

23.4 The Health and Wellbeing Board resolved that;

1. the update on the West Sussex Better Care Fund Year-end Return 2023-24, be noted;

2. the West Sussex Better Care Fund Planning Submission 2024-25, be approved; and

3. the West Sussex performance against the national BCF metrics at Q4 2023-24, be noted.

To note the work programme for 2024/25 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.

24.1   The Chairman presented the Health and Wellbeing Board Work Programme 2024 – 2025 for consideration. There were no comments.

24.2   The Health and Wellbeing Board resolved that the Work Programme 2024-2025 be noted.

The next meeting of the Board will be held at 10.30am on 7 November 2024.

25.1   The date of the next meeting of the Board was confirmed as 10.30am on 7 November 2024.

The meeting ended at 12.38pm