Agenda and minutes

Mel Barratt

Dr Dave Briggs (sent substitute)

Sarah Collis

Kathryn Craner

Tim Guyler

Annie Jennings

Jan Sensier

Catherine Underwood

To note the following changes to non-voting members of the Board:

·  Candida Brudenell has replaced Damien West as the representative of the Nottinghamshire Fire and Rescue Service.

·  Charlotte Throssel is a new member representing the interests of the 3^rd Sector.

The Board noted that:

·  Candida Brudenell has replaced Damien West as the representative of the Nottinghamshire Fire and Rescue Service.

·  Charlotte Throssel is a new member representing the interests of the 3rd Sector.

·  Councillor Sam Lux has replaced Councillor Eunice Regan as City Councillor representative.

None.

Minutes of the meeting held on 31 May 2023, for confirmation

The minutes of the meeting held on 31 May 2023 were confirmed as a correct record and signed by the Chair.

Karla Capstick presented the report and delivered a presentation on Small Steps, Big Changes (SSBC), one of five partnerships funded by the National Lottery Community Fund with a £45m investment over 10 years. With less than two years until the end of the funding period, the Programme is now focussed on legacy, sustainability and how as a Partnership the SSBC story can be articulated and shared at a local and national level. The following information was highlighted:

(a)  SSBC aims to improve the life chances of babies and very young children by delivering a significant increase in the use of preventative approaches in pregnancy and the first four years of life. Enhanced pathways of support have been put in place based on local need through which all pregnant women, babies and children living in the 4 target wards can benefit;

(b)  the intended outcomes of SSBC are that children will have healthy and positive social and emotional development, that children will have effective and age-appropriate communication and language skills, that children will have good nutrition, and cross partnership system change;

(c)  SSBC is now in its third phase which is continued delivery based on learning, evaluation, legacy and sustainability. Evaluation has been taking place with Nottingham Trent University to ascertain which aspects can continue once the core funding ends;

(d)  4,504 children have worked with 67 family mentors to improve their outcomes through SSBC, and 323,000 books have been delivered through the Dolly Parton Imagination Library;

(e)  local evaluation has found that 100% of families interviewed would recommend Family Mentoring to families with young children. The longer families participated in the programme, the more parents had interactions with their children whilst reading a book, the longer reading sessions they had, and the more they read to their children on a daily basis;

(f)  a pack was produced for new fathers. Both fathers and practitioners described the pack as a useful source of first reference, especially as it is a comprehensive single document from a trusted source. Both fathers and practitioners reported that the information in the pack helped with the participants’ knowledge of the financial help available to them. Participants learned about their rights as a new father and what parental leave and benefits they could access;

(g)  SSBC has not seen locally or nationally large statistically significant data improvements in child development outcomes; but does have rich qualitative data that evidences impact, alongside case studies. Cost benefit analysis, return on investment and cost consequence analysis is challenging to evidence. The universal, early intervention nature of the Programme makes attribution complex;

(h)  not all evidence based interventions have been successful locally. Where SSBC interventions have evidenced impact, the local partnership hasn’t always been able to commit the funding to scale up or implement;

(i)  ownership of the Love Bump and Feed Your Way campaigns is being explored post SSBC, integrating it into the city and county breastfeeding strategy for long-term impact. There is ambition to become a breastfeeding friendly city;

(j)  as part of wider maternity transformation, there are plans to embed and grow the Pregnancy Mentors model. There are also ambitions to become more father inclusive, and to support trauma informed approaches and practice. SSBC’s  intellectual property will require hoisting post funding.

Resolved to

(1)  note the update on the SSBC Programme and current legacy plans;

(2)  note the proposed areas of legacy, system risks and next steps;

(3)  discuss and identify future legacy opportunities a linked to the SSBC Programme’s activity and wider learning and agree to progress with SSBC direct.

Report of the Director of Public Health

Dr Mike Saunders presented the report and delivered a presentation on Nottingham’s first Gambling related harm strategy, which takes a public health approach to preventing and reducing gambling related harm. The strategic vision is that Nottingham City will be a place where people are protected from gambling harm, and can access and receive support. The strategy aims to prevent and reduce gambling related harm in Nottingham City. The following information was highlighted:

(a)  national survey data when applied to Nottingham City, estimates that approximately 4,500 people aged 16 and over and 1,000 in-school 11-16-year-olds show signs of a gambling problem. Each person with a gambling problem has 6 to 10 affected others on average;

(b)  gambling related harm can lead to mental ill health, physical ill health, alcohol and substance use, crime, relationship breakdowns, financial loss, loss of employment and loss of education. Support is available but is under-utilised;

(c)  an alliance of groups, services and organisations has been formed to address gambling related harm in a partnership approach. The group have produced Nottingham’s first Gambling related harm strategy, which takes a public health approach to preventing and reducing gambling related harm;

(d)  the strategy’s vision is that Nottingham City will be a place where people are protected from gambling harm, and can access and receive support, with the aim to prevent and reduce gambling related harm. The three strategic themes cover regulation, knowledge and awareness, and support pathways;

(e)  under the theme of regulation, the strategy seeks to review and update local Council gambling license policy, gain assurances that gambling businesses are responsibly preventing and responding to gambling related harm, and review and update local Council advertising and sponsorship policy;

(f)  under the theme of knowledge and awareness, the strategy seeks to utilise opportunities to collect local data on gambling and gambling related harm, understand the experiences and support needs of people affected by gambling, address priority gaps in evidence through research and evaluation, raise awareness of gambling risks and impacts to people and signpost support services, and provide information on gambling risks and impacts among children and young people and their trusted adults;

(g)  under the theme of support pathways, the strategy seeks to conduct targeted screening to detect gambling related harm and offer referral or signposting to support services, improve pathways to recovery by connecting providers of gambling support with other services that promote ongoing wellbeing and help rebuild lives, promote the visibility of gambling harm support services to make it easier for people to find support, and promote equity of access for people who are affected by gambling;

The following information was provided during the discussion which followed:

(h)  the NHS has recently opened up a gambling addiction clinic which is in Derby. Nottingham City Council has had discussions around accessibility from Nottingham;

(i)  more deprived areas have more gambling venues and they are not always open to preventing gambling related harm from addiction, so this strategy is welcomed to counteract this;

(j)  gambling addictions are often hidden and stigmatised, and can affect children and young people. The public health campaign will have a range of messages and make sure that people are aware of the support available.

Resolved to endorse the Nottingham City Gambling Related Harm Strategy 2023-28

Update from the Nottingham City Place-Based Partnership

Rich Brady presented the report providing an overview of the approach taken by the Place Based Partnership to deliver the four priorities that make up the Joint Health and Wellbeing Strategy 2022-25, delivery progress to date and expectations in year 2. The following information was highlighted:

(a)  robust delivery plans have been agreed and delivery activity is in progress for the Smoking and Tobacco Control, Eating and Moving for Good Health, and Severe Multiple Disadvantage programmes. Each delivery plan demonstrates how population health outcomes will be improved through integrated working, contributing to the delivery of the ambitions set in the Joint Health and Wellbeing Strategy;

(b)  while a delivery plan for the Financial Wellbeing programme is still to be agreed, incremental delivery activity is taking place. A financial wellbeing specific outcomes framework is in development with a delivery plan anticipated to be agreed later in the year;

(c)  while the partnerships that underpin the four programmes are undertaking significant activity as detailed in the delivery updates, it is too early to assess the impact that programme activity is having on the overall delivery of the Joint Health and Wellbeing Strategy.

The following points were made during the discussion which followed:

(d)  there are underlying issues that are constantly evolving such as vaping and landfill and waste issues;

(e)  the mobile dentistry unit could make tangible differences to uptake of dentistry services and it will be interesting to monitor its uptake levels;

(f)  preventative measures are important to factor in so that people will no longer need the services so much in the future;

(g)  there has been recent emphasis on the impact of sleep on children’s education.

Resolved to note the update provided by the Nottingham City Place-Based Partnership Programme Oversight Group

Report of the Director of Integration, Nottingham and Nottinghamshire Integrated Care Board

Lucy Dadge and Joanna Cooper presented the report briefing members of the Board on the development of the Nottingham and Nottinghamshire NHS Joint Forward Plan as required under the Health and Care Act 2022. The Plan is in its final draft version and has already been approved by the Nottinghamshire Health and Wellbeing Board. It will be a live document delivery and oversight arrangements are being drawn up for an annual refresh.

Resolved to

(1)  note the development of the Nottingham and Nottinghamshire NHS Joint Forward Plan as required under the Health and Care Act 2022;

(2)  approve the following statement of support: The Nottingham Health and Wellbeing Board is satisfied that the NHS Joint Forward Plan for Nottingham and Nottinghamshire takes full account and outlines the ICB's contribution to the delivery of the Integrated Care Strategy. We welcome the strong commitment and connectivity to the Joint Local Health and Wellbeing Strategy.

Director of Integration, Nottingham and Nottinghamshire Integrated Care Board.

Following the item at the last Board meeting on the Hewitt Review, Lucy Dadge presented the report briefing members of the Board on the Government's response.

Resolved to note and the Government response to the Hewitt Review 2023.

Update from the Joint Health Protection Board

Lucy Hubber provided an interim update as the Joint Health Protection Board has not met since the last update provided to the Health and Wellbeing Board in May 2023. The following points were raised:

(a)  there has been recent media coverage of an increase in sexually transmitted infections, and Nottingham has a high rate. A much more comprehensive sexual health service is currently being commissioned, and additional online testing capacity has also been commissioned;

(b)  there has been an increase in cases of measles nationally, and there is a strong ambition locally to increase immunity. The Council is working with the ICB to put in additional investment and catch-up capacity, targeted and accessible for communities that have low uptake levels. Learning from the pandemic demonstrated that each community has its own concerns and requires a different response.

Updates from Board Members

The following updates were provided:

·  Nottingham City Council has established four Family Hubs in Bestwood, Broxtowe, Hyson Green and the Meadows, providing families with easier access to universal and early help services delivered by the local authority, health partners, community and voluntary services, both in the Family Hub buildings and in community venues across the city.

·  Ofsted have confirmed a second monitoring visit of Children’s Services will be conducted during July. The purpose of the monitoring visits are to assess the progress and effectiveness of a focused area of the local authority Children’s Services.

·  Nottingham City Council has been selected to take part in the CQC pilot assessment scheme. CQC will be conducting their on-site visit during the week commencing 31st July when they will speak to staff, citizens and partners.

·  A motion has passed at the County Council to improve oral health by making sure that the whole water supply is fluoridated. This should lead to cross boundary work.

The work plan was noted.

27 September 2023

29 November 2023

24 January 2024

27 March 2024

The future meeting dates were noted.