Agenda and minutes

To note that Michelle Simpson is no longer the Department for Work and Pensions representative on the Health and Wellbeing Board and a replacement is being sought.

RESOLVED to note that:

(1)  Michelle Simpson is no longer the Department for Work and Pensions representative;

(2)  a replacement member is being sought.

Councillor Steve Battlemuch – personal

Councillor Nick McDonald – personal

Councillor Marcia Watson – work commitments

Lyn Bacon (Phyllis Brackenbury substituting)

Alison Michalska (Helen Jones substituting)

Gill Moy

Samantha Travis

Leslie McDonald, Executive Director at Nottingham Counselling Service, representing interests of the third sector, declared an interest in agenda item 8: A Health Needs Assessment of Black and Minority Ethnic Groups in Nottingham, as his organisation provides mental health services for members of the BME community. Leslie remained in the room during discussion of this item, as this was not considered to be a pecuniary interest.

To confirm the minutes of the meeting held on 26 July 2017

Dawn Smith asked that minute item 13(a) from the previous meeting be amended from: Dawn Smith from NHS Nottingham City Clinical Commissioning Group informed members that the 4 regional clinical commissioning groups are coming together under a joint committee arrangements. They do not currently plan on merging until 2019 at the earliest. There will be a single management team and a single accountable officer.

To: Dawn Smith from NHS Nottingham City Clinical Commissioning Group informed members that the 4 local clinical commissioning groups are coming together under a joint committee arrangement. They do not currently plan on merging until 2019 at the earliest. There will be a single management team and a single accountable officer.

Maria Ward asked that minute item 10(n) from the previous meeting be amended from: Voluntary sector organisations are overwhelmingly supportive of the work being done, however concerns have been raised around the intention and idea that they will be able to deliver services to the community as a whole. More clarity is needed about what is expected of the voluntary sector and how it will be funded.

To: Voluntary sector organisations are overwhelmingly supportive of the work being done, however concerns have been raised around the intention and idea that they will be able to deliver services to the community without additional resources. More clarity is needed about what is expected of the voluntary sector and how it will be funded

Subject to these changes being made, the minutes were agreed as a correct record and signed by the Chair.

RESOLVED to:

(1)  note the progress against existing actions on the action log;

(2)  add actions relating to an update on STP (Sustainability and Transformation Plan) progress, and on the STP communications and engagement approach;

(3)  ask Peter Homa to feedback concerns raised by the Board regarding the STP.

(NB: approximately 40 minutes)

Helen Jones, Director of Adult Social Care, introduced an interim report on the Health and Wellbeing Strategy 2016-2020, Outcome 1: Healthy Lifestyles. Shade Agboola, Consultant Director of Public Health, gave a presentation on the report (circulated with the minutes). The Board offered questions and comments relating to the report and presentation:

(a)  an extension of “smokefree” areas may be considered. A Health Promotion Specialist works closely with students at the hospital, and the Nottingham University Hospital Trust campus is now entirely smoke free;

(b)  whilst behaviours have a significant impact for the health economy, discussing behaviours can lead to negative reactions. Discussing behaviours can feel like professionals are “nagging” citizens, whereas incorporating physical activity into those activities citizens already enjoy has proved far more effective and positive. Prevention is a large part of the Sustainability and Transformation Plan;

(c)  access to facilities can present a barrier to engagement. It is vital to ensure that facilities can be made accessible to those who cannot afford paid activities, and that community facilities are widely advertised and readily available to optimise use. The Healthy Lifestyles Delivery Group will respond to these suggestions;

(d)  work is ongoing with the DWP (Department for Work and Pensions) and Leisure Services, to ensure that sport is accessible for those with disabilities;

(e)  the draft Nottingham City Physical Activity, Obesity and Diet Declaration is with the Board for comment, and members are asked to feedback any comments by 1 November 2017. It will be added as an agenda item to the November 2017 meeting of the Health and Wellbeing Board, for noting rather than for discussion.

RESOLVED to:

(1)  review the draft Nottingham City Physical Activity, Obesity and Diet Declaration and feedback any comments to David Johns, Public Health Specialty Registrar, by 1 November 2017;

(2)  ensure that all Board member organisations sign the Tobacco Control Declaration and then develop action plans which demonstrate their contribution to the achievement of the City’s tobacco control priority objectives;

(3)  review the workplace smoking / smokefree policies of Board membership organisations and consider emerging evidence on the use of e-cigarettes and the distinction between smoking and vaping;

(4)  ensure the staff of Board membership organisations are trained in very brief advice and referral to healthy lifestyles services by engaging with the rollout of making every contact count and promoting independence tools and training across all Sustainability and Transformation Partnership partners including the voluntary sector;

(5)  join Adult Social Care in promoting physical activity to citizens and colleagues in order to maximise the benefits for all.

(NB: approximately 15 minutes)

Shade Agboola, Consultant Director of Public Health, provided an update on the Joint Strategic Needs Assessment Annual Report. The Annual Report contains 25 chapters in total, including 6 for last year’s update, 17 on next year, and 2 new chapters. The work plan should be complete before the end of the financial year.

RESOLVED to:

(1)  note the 2017/18 Work Plan contained in appendix 1 of the report;

(2)  note the progress and development of the Joint Strategic Needs Assessment.

(NB: approximately 20 minutes)

Alison Challenger, Director of Public Health at Nottingham City Council, and Jennifer Burton, Insight Specialist in Public Health at Nottingham City Council, presented a report on the Health Needs Assessment of Black and Minority Ethnic (BME) Groups in Nottingham, as contained within the presentation circulated with the minutes.

(a)  the assessment of BME health needs, whilst largely requested by Nottingham City Council and the Nottingham Clinical Commissioning Group, will help to inform the services of all Board member organisations;

(b)  between the 2001 census and the 2011 census, overall there has been a significant increase in Eastern European communities, and Asian and Pakistani communities, whilst the Nottingham School Survey shows over 80% of schoolchildren in Nottingham in 2016 were BME, with a large increase since 2008 in mixed ethnicity groups;

(c)  a comprehensive literature review has also taken place, with large amounts of data collected at a local level;

(d)  the key findings of the review are that the BME community and their health needs are not homogenous. Access was raised consistently, as was mental health – people often do not know how to access appropriate mental health services available;

(e)  feedback of the findings now to those communities surveyed is very important, and consideration must be given as to how best to do this.

There followed questions and comments from the Board:

(f)  the Board felt that the assessment was an outstanding piece of work, and the Board must reflect on the fact that Nottingham is now at its most culturally diverse, and likely to become more so going forward given the Nottingham School Survey data;

(g)  Citycare and Sexual Health Services are both excellent examples of recording of ethnicity and other data. Whilst the census happens nationally, local ethnicity recording can be influenced and consistency across organisations would be ideal;

(h)  whilst the summary states “The City of Nottingham is the 8th most deprived local authority area in England” it is important to note that this may be even worse for Nottingham’s Children and Young People. There is currently a significant issue regarding families with no recourse to public funds whilst awaiting a decision on their status from the Home Office. This also limits their access to other support and services, which adds to their deprivation. Work has been conducted with the Refugee Forum in compiling the assessment, particularly seeking opinions from refugee parents on the health of their children;

(i)  the report is primarily a tool for future commissioning, and can be used to design and improve on services, by setting up a Community of Interest Group to best use the information moving forward. Board member organisations can self-assess as to how they can use this information to best serve these communities. A progress report will be prepared on the establishment of a Community of Interest Group, and will come back to the Board in six months’ time.

RESOLVED to:

(1)  consider the recommendations contained within the Black and Minority Ethnic Health Needs Assessment;

(2)  work to identify opportunities to work collaboratively to improve the health and wellbeing of Black and Minority Ethnic citizens in Nottingham;

(3)  request an update report on the formation of a Communities of Interest Group, arising from the findings of the Health Needs Assessment, to be reported back to the Health and Wellbeing Board at the March 2018 meeting.

RESOLVED to note the Health and Wellbeing Board Forward Plan.

Updates on issues of relevance to the Health and Wellbeing Board and/or delivery of the Joint Health and Wellbeing Strategy

In addition to the written updates circulated as part of the agenda pack, a written update was circulated at the meeting from Healthwatch Nottingham (circulated with the minutes) and further information was provided by Members:

(a)  Nottingham City Healthwatch is progressing with a merger with Nottinghamshire County Healthwatch, and a Chair position will be advertised soon;

(b)  NHS Nottingham City Clinical Commissioning Group has aligned with three other Commissioning Groups in Greater Notts, and a Single Chief Officer has now been appointed.

RESOLVED to note the Board Member Updates.

For information only

RESOLVED to note the minutes from the Health and Wellbeing Board Commissioning Sub Committee meeting held on 26 July 2017.

For information only

RESOLVED to note the draft minutes from the Health and Wellbeing Board Commissioning Sub Committee meeting held on 13 September 2017.

For information only

RESOLVED to note the new Joint Strategic Needs Assessment Chapter – Safeguarding Children.

For information only

RESOLVED to note the new Joint Strategic Needs Assessment Chapter – Female Genital Mutilation.

To note that a new Health and Wellbeing Board website has been developed (to be shown at the meeting)

RESOLVED to note the new Health and Wellbeing Board website: /www.HealthyNottingham.co.uk