Agenda and minutes

To note the following membership changes:

·  Dr Husein Mawji, Clinical Director for the Place Based Partnership, has replaced Dr Hugh Porter as a representative of the NHS Nottingham and Nottinghamshire Integrated Care Board.

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

The Board noted the membership changes

Resolved to appoint Dr Husein Mawji as Vice Chair of the Committee for the remainder of the 2023-24 municipal year.

Charlotte Throssel

Superintendent Kathryn Craner (sent substitute)

Kevin Lowry

Catherine Underwood

Jan Sensier

Lesley Hutchinson

Sarah Collis

None.

Minutes of the meeting held on 27 September 2023, for confirmation

The minutes of the meeting held on 27 September 2023 were confirmed as a correct record and signed by the Chair.

Minutes of the meeting held on 27 September 2023, for noting

The minutes of the Commissioning Sub-Committee, held on 27 September 2023 were noted.

Report of the Safeguarding Adults Board Independent Chair

Sara Storey, Director for Adult Health and Social Care, and Emma Coleman, Adult Safeguarding Board (SAB) Manager, presented the report providing an overview of the SAB’s activity over the 2022-23 financial year including progress against the Strategic Priorities set out in the 2022-2025 Strategic Plan, Safeguarding Adults Review activity, annual data provided by Adult Social Care and information from SAB member agencies on their safeguarding activity throughout the year. The following information was highlighted:

(a)  the three strategic priorities of the SAB are Prevention, Assurance and Making Safeguarding Personal. It has three sub-groups focused on Quality Assurance, Safeguarding Adults Reviews and Training, Learning and Improvement;

(b)  there has been a national increase of 9% in the number of safeguarding concerns raised, which is the same annual growth rate as last year. In comparison, Nottingham City’s data shows a 3.65% increase in adult safeguarding referrals when compared to 2021-22 which is less than the national average and goes against the decrease seen the year before. When considering Section 42 enquiries, there is a significant decrease of nearly 10% (9.45%) which goes against the national trend which shows an increase of 7%;

(c)  the most common type of reported abuse was neglect, followed by financial, physical and psychological. Physical and domestic abuse had reduced from the previous 2 years. Discriminatory abuse remains consistently low, something which has been raised nationally as an area for Safeguarding Boards to focus on;

(d)  when compared to 2021-22, there has been a small increase in NHS staff as perpetrator. It is possible this corresponds with the implementation of the SAB PiPoT (People in Positions of Trust) Guidance in Q4, and is something the Board will be seeking to explore in 2023-24;

(e)  the majority of data relates to white British citizens which does not necessarily represent the local population. The Board intends to explore better engagement with other communities and which will need more support;

(f)  all priorities have clear work programmes. Key areas that have been worked on this year include improved datasets, prevention, and implementation of a new quality assurance framework. The SAB will continue to work with all organisations and individuals to understand abuse and how to refer it.

The following points were raised during the discussion which followed:

(g)  the SAB intends to research levels of engagement with different communities in other local authority areas by reaching out through the national networks available;

(h)  the most important way to engage as fully as possible is to make people more empowered to make referrals, and recognise safeguarding concerns and abuse. The SAB is working to raise awareness and also to make the referral process simpler;

(i)  the Fire Service has challenges to engage with communities and is working with Nottingham Trent University. There may be opportunity for collaborative working.

Resolved to

(1)  note the Annual Report and Executive Summary;

(2)  recommend any areas it would like NCSAB to focus on going forward by contacting Emma Coleman or Lesley Hutchinson.

Report of the Director of Public Health

Naomi Robinson and Karla Banfield presented the report, highlighting the following:

(a)  the Better Care Fund (BCF) was announced in June 2013 as part of the Government’s Spending Review. It was described as creating a national £3.8 billion pool of NHS and Local Authority monies to support an increase in the scale and pace of integration and to promote joint planning for the sustainability of local health and care economies;

(b)  Better Care Funding is aligned to Health and Wellbeing Board (HWB) areas. As such in Nottinghamshire there are two joint plans, owned and agreed by the Nottingham City and Nottinghamshire County HWBs and governed by an agreement under section 75 of the NHS Act (2006);

(c)  the BCF in Nottingham City is used under three themes: Early Help and Prevention, Proactive Care, and Discharge to Assess Services;

(d)  following the merger of 6 CCGs and the formation of the Nottingham and Nottinghamshire Integrated Care Board, a decision was made to review the BCF, in order to de-mystify it and allow shared alignment to Integrated Care Strategy strategic plans. The review was planned in three phases: a BCF Planning Template review, a Root and Branch Analysis, and Collaborative Commissioning Reviews;

(e)  the Root and Branch Analysis recommended Joint Commissioning Reviews, Collaborative Oversight of Outcomes, and Collaborative Oversight of Funding. The key recommendation is to progress identified opportunities for integration through a collaborative commissioning review process;

(f)  phase 3 will consist of Stakeholder Workshops with each HWB, Place Based Partnerships and Providers, with sub-groups in place to progress the actions and monitor delivery.

The following points were raised during the discussion which followed:

(g)  the City and County HWBs have different priorities, so following the review sensible decisions will be made on whether to jointly commission services or not, dependent on these priorities;

(h)  the workshops will need to think about what the priorities for the city are and how the BCF programme should be shaped. This is an opportunity to think outside the box and shape priorities.

Resolved to

(1)  note the BCF Root and Branch Review;

(2)  agree to a developmental workshop approach for discussion outside of the H&WBB, in February 2023

Update from the Nottingham City Place-Based Partnership

Rich Brady, Programme Director for the Nottingham City Place Based Partnership, presented the report providing an overview of delivery progress of the four Joint Health and Wellbeing Strategy (JHWS) programmes and an overview of the work undertaken to establish an outcomes framework to allow for assessment of progress and evaluation of the effectiveness of the programmes, highlighting the following:

(a)  the Smoking and Tobacco Control, Eating and Moving for Good Health, and Severe Multiple Disadvantage (SMD) programmes are all progressing in line with delivery plan expectations;

(b)  while pace of progress of the Financial Wellbeing programme continues to be slower regarding collective actions being agreed, there is a plethora of activity being undertaken by individual partners that is contributing to the delivery of the programme. It is the view of the Programme Oversight Group that greater emphasis on collective activity will better enable the successful delivery of this programme;

(c)  in the Smoking and Tobacco Control programme, progress is good against the 4 themes. The success of the Targeted Lung Health Checks programme has enabled a rage of smoking cessation support to people wanting to quit and funding is being sought for the continuation of smoking cessation support in NHS settings;

(d)  the Eating and Moving for Good Health programme is progressing well in line with its delivery plan. A Healthy Schools Team has been established and have begun engaging schools to create a Healthy School Award/Charter, and analysis of national data is being undertaken in order to provide schools with data to support them to better understand the actions that can be taken to support healthy diet and weight management;

(e)  whilst a plan for the Financial Wellbeing programme has been produced, partners are still to agree the delivery of this plan through collective resource and actions that will have the impacts needed to meet the overarching ambition for the programme. To enhance the impact of this programme there is a need for partners to take greater shared ownership of the financial wellbeing programme through greater investment of time and resources to deliver the actions that partners have identified will have maximum impact;

(f)  a gambling related harm awareness campaign has gone live in the city including both digital and out-of-home assets. Advice provided by Financial Advisor Social Prescribing Advice Link Workers embedded in three of the City’s Primary Care Networks are showing significant improvements on people’s wellbeing scores, and an evaluation is underway to understand wider impact and inform a business case for continuation of support;

(g)  the SMD programme is on track to deliver against its delivery plan. The SMD partnership has now been successful in securing ongoing funding through both an extension of national funding and recurrent, local funding through the ICB Health Inequalities and Innovation Fund from 2024/25 onwards. A race equity event was held in September and attended by around 150 people;

(h)  a draft outcomes framework has been developed, which allows for the assessment of progress and evaluation of the effectiveness of each of the programmes in relation to population health outcomes. Work is underway to revise the outcomes for the SMD programme which will be incorporated into the next draft, alongside the outcomes identified as part of the Financial Wellbeing programme plan. The outcome framework will measure Nottingham’s performance in comparison to nearest statistical neighbouring areas;

(i)  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 JHWS.

The Chair raised concerns about people not being able to afford attending their  preventative health checks, and the digital divide and how to link up with those that do not have access to the internet.

The Chair mentioned recently proposed government policy on restricting the smoking age and restriction of vaping, seeking permission to make a response in favour on behalf of the Board.

Resolved to

(1)  note the update provided by the Nottingham City Place-Based Partnership Programme Oversight Group;

(2)  note the challenges identified in progressing the delivery of the Financial Wellbeing programme and consider how greater shared ownership of the programme can be achieved;

(3)  delegate authority on behalf of the Board to the Chair, Vice-Chair and Director of Public Health to provide a view to the government on its recently proposed Tobacco and Vapes bill.

Report of the Director of Public Health

Lucy Hubber, Director of Public Health, introduced her statutory Annual Public Health Report which focuses on 10 years of public health in local government, after the transfer of responsibilities from the NHS in 2013. The report celebrates some of the key public health work undertaken by the team over the past decade.

A presentation highlighting key achievements and challenges was delivered by Ana Oliva and Zara Choudhery, Public Health Registrars.

Resolved to

(1)  note the contents of the Annual Public Health Report (2023) for Nottingham;

(2)  reflect on the lessons learnt as a result of the wide-ranging work undertaken over the past decade, and consider opportunities for building on these to further improve health and wellbeing in Nottingham moving forward

Report of the Director of Public Health

Hannah Stovin, Senior Public Health Intelligence Manager, presented the report informing the Board of an application to consolidate onto the site at 61 Ilkeston Road, Nottingham, NG7 3GR Canning Ltd and Paul Applegate Ltd. The Health and Wellbeing Board has a statutory responsibility to consider pharmaceutical need in the city, and this application has been brought forward because it constitutes a significant change in provision.

The applicant submits that the consolidation request would not create a gap in pharmaceutical services provision because there will be no reduction in the availability of pharmaceutical services during the core hours, all NHS pharmaceutical services that are currently provided will be provided at the consolidated site, premises facilities (e.g. parking, access, translation service) will remain largely unchanged, and there are 12 other pharmacies within a 1 mile radius.

Local ward Councillors have been consulted and no concerns have been raised.

Board members commented that current customers that use the site which is to be closed should be contacted about their options for alternative pharmacies other than the consolidated site, so that they can make a meaningful choice.

Resolved to

(1)  support the proposed consolidation, noting the suitable alternative local access and raising a concern on the reduced accessibility to Site 1, and requesting that customers of the site that is to be closed be written to about their options for alternative pharmacy provision;

(2)  delegate to the Senior Public Health Intelligence Manager to provide representation to the Nottingham & Nottinghamshire ICB.

Update from the Joint Health Protection Board

Lucy Hubber provided a verbal update and highlighted the following:

(a)  a variant of swine flu has been identified in North Yorkshire with mild symptoms, and sources are being identified;

(b)  there has been an increase nationally of measles cases, and there is a push to increase uptake of childhood vaccination. This is a completely preventable illness so all partners should encourage uptake.

Resolved to

(1)  note the updates;

(2)  explore whether it is possible to provide targeted data on eligibility to partners so that they can target their messaging on vaccinations;

(3)  provide leaflets on vaccinations to Councillors so that they can distribute to citizens.

Updates from Board Members

The written updates were noted.

A suggestion was made to include the Race Health and Equalities report at the March meeting. With this addition, the forward plan was noted.

24 January 2024

27 March 2024

The future meeting dates were noted.