Agenda and draft minutes

To note that Superintendent Chris Pearson, City Commander, has replaced Superintendent Kathryn Craner as the representative for Nottinghamshire Police.

Resolved to

(1)  note that Superintendent Chris Pearson, City Commander, has replaced Superintendent Kathryn Craner as the representative for Nottinghamshire Police;

(2)  note that Roz Howie has replaced Sara Storey on an interim basis as the Director for Adult Social Care for Nottingham City Council.

Lou Bainbridge

Mel Barratt

Sarah Collis

Tim Guyler

Councillor Sam Lux

Michelle Tilling

Catherine Underwood

None.

Minutes of the meeting held on 24 January 2024, for confirmation

The minutes of the meeting held on 24 January 2024 were confirmed as a correct record and signed by the Chair

Minutes of the meeting held on 24 January 2024, for noting

The minutes of the Commissioning Sub-Committee, held on 24 January 2024 were noted.

Update from the Nottingham City Place-Based Partnership

Rich Brady, Programme Director, Nottingham City Place Based Partnership, introduced the report on delivery of the Joint Health and Wellbeing Strategy as it moved into its final year. Whilst Year 1 of the Strategy focused on development partnerships and development of delivery plans, Year 2 has focused more on delivery and maturing of partnership working.

A presentation was delivered on delivery of the four overarching priorities by Helen Johnston, Ruth Bell, Swathi Krishnan and Bobby Lowen, highlighting the following:

Improving Financial Wellbeing

(a)  there has been a lot of activity on this priority and a broad range of approaches such as the Gambling Harm Awareness campaign, working with schools linking with financial harm programmes, and a well-attended conference with frontline mental health services;

(b)  this work is underpinned by the Strategic Coordination Group which meets monthly to coordinate delivery, and a programme plan and logic model setting out a coherent programme theory for how change is being impacted;

(c)  the context for this priority is difficult, with the need in Nottingham remaining very high due to the cost of living crisis, financial pressures, impact on household finances, low economic activity, and financial constraints on the public sector;

(d)  a pilot has been established for financial awareness training for health and social care, although this is difficult to resource.

Eating and Moving for Good Health

(e)  a governance structure is being built up to provide a unified direction so that a wide range of partners can contribute towards positive outcomes. The first phase is pulling together a strategic alliance group, and pulling together some operational level groups, and a plan to build citizen voice into the structure;

(f)  a Healthy Schools Team has been established and held initial events. A school pupil health and wellbeing survey was rolled out and over 2,000 pupils took part;

(g)  a new, free, health and wellbeing service has been commissioned called Thriving Nottingham and this will be the provider of all weight management services;

(h)  the Healthy Start Vitamins scheme for pregnant women has been expanded and evaluated with positive feedback;

(i)  Nottingham Trent University has completed research into food sustainability and food insecurity, and this data will be provided to schools to aid identification of those eligible for free school meals. Funding has been secured for a workshop to explore a Nottingham City Good Food Plan.

Smoking and Tobacco Control

(j)  there has been an increased uptake of Stop Smoking services, and the number of smokers achieving a 4-week quit has risen. A partnership between the GP Alliance and Lung Health Check will deliver additional support;

(k)  in 2023, the Trading Standards team seized more than 4,000 cigarettes and over 4,930 vapes. They also conducted 17 test purchases of illegal tobacco and vapes since April 2023 to test for underage sales. A new suite of resources is now available for professionals who may encounter illegal tobacco or vapes;

(l)  the newly established Healthy Schools Team’s work has included supporting school vaping policies. Smoking cessation services have been expanded to support those aged 12 years and older.

Severe Multiple Disadvantage (SMD)

(m)recurrent, local funding has been secured from 2024-25 onwards via Nottingham and Nottinghamshire’s ICB Health Inequalities and Innovation Fund, as well as additional transition funding in 2024-25 via the national Changing Futures programme. Sustainability going forward will depend on partners’ commitments to maintain embedded SMD Practitionerroles within key statutory services;

(n)  there has been an increase in participation from a more representative population, including those from minority ethnic backgrounds;

(o)  an SMD programme has now been established in Nottinghamshire County. The programme was showcased at NHS ConfedExpo 2023 & presented to the NHS England Chief Delivery Officer, influencing development of cross-departmental government planning on SMD.

The following comments were made during discussion:

(p)  following the withdrawal of funding for Advice Nottingham, Disability Support is the only service that can offer a full and comprehensive Welfare Rights Service, including everything from entitlement checks through to representation at appeals and tribunals. Nottingham Financial Resilience Partnership has looked at the landscape of what advice is available, and Public Health have agreed to fund some advice but not as much as before;

(q)  individual organisations often only see parts of the problem, and solutions cannot be found individually It is to be commended that partnership is continuing under difficult financial constraints. Learning from this delivery needs to be embedded into business as usual practice;

(r)  the involvement of Health and Wellbeing Board member organisations and the ownership of key strategic priorities within their organisations is essential in progressing all programmes and delivering on ambitions of the Joint Health and Wellbeing Strategy;

(s)  the extent to which population health outcomes can be measured in the short-medium term is limited. Board Members should be cautious around expectations on the impact on population health outcomes in the life of this Strategy.

Resolved to

(1)  note the Year 2 programme delivery progress in the update reports;

(2)  note the outcomes framework;

(3)  note the key messages for the Health and Wellbeing Board;

(4)  discuss how the Health and Wellbeing board can best support the delivery of the Joint Health and Wellbeing Strategy programmes in year 3.

Report of the Director for Public Health, Nottingham City Council

Joanna Cooper, Assistant Director of Strategy, NHS Nottingham and Nottinghamshire ICB, presented the report with changes to the Integrated Care Strategy following a light touch review at the end of its first year. The changes include strengthened wording around the 14 priorities articulated in the Strategy and increased emphasis on children and young people, and frail elderly.

Resolved to endorse the Integrated Care Strategy

Report of the Director of Public Health

Joanna Cooper, Assistant Director of Strategy, NHS Nottingham and Nottinghamshire Integrated Care Board, presented the report regarding the annual refresh to the Joint Forward Plan, in line with national guidance. The final version will now be agreed at the ICB Board Meeting in May 2024, so comments can still be submitted.

Resolved to

(1)  note the progress in developing the NHS Joint Forward Plan and the publication date;

(2)  agree the statement of support on the NHS Joint Forward Plan which will be appended to the plan presented for approval at the ICB Board on 9th May 2024.

Report of the Chief Executive, NCVS

Donna Sherratt and Clive Foster, Co- Chairs of the Race Health and Inequalities Group, delivered a presentation highlighting the following information on the work of the group which was established in July 2020:

(a)  the launch of the programme coincided with significant global issues. Even in the early stages of the Covid-19 pandemic there was a compelling evidence base to show the disproportionate impact that the virus was having on minority ethnic communities. At the time, the murder of George Floyd and the Black Lives Matter campaign also gave greater exposure and amplification to the systemic and institutional racism that exists in society;

(b)  with the objective of challenging the deep-rooted structural racism that exists within parts of the health and care system, the primary focus of the programme has been on the development and roll out of the Race Health Inequalities Maturity Matrix. Co-produced between health and care partners and community leaders in Nottingham, the matrix is now supporting over 30 organisations in Nottingham and Nottinghamshire to address structures and process that contribute to the exacerbation of health inequalities experienced in minority ethnic communities;

(c)  communities of practice have been established to support organisations to embed the matrix into organisational processes, such as commissioning cycles. The Matrix has received national recognition and its development is being supported by the NHS Race Health Observatory. In November 2023 the matrix was shortlisted finalist at the Health Service Journal Awards 2023 in the NHS Race Health Equality category;

(d)  following the rollout of the Maturity Matrix the RHI Steering Group have been working to identify new areas of focus for the programme. In May 2023, Nottingham’s first-ever Race Health Inequalities Summit was held at the Indian Community Centre. This event brought together over 200 people across the partnership alongside community representatives in Nottingham to discuss health inequalities that disproportionately impact minority communities in Nottingham.

Resolved to

(1)  note the work of the Race Health Inequalities Programme;

(2)  champion the Race Health Inequalities agenda in decision-making despite austerity;

(3)  undertake the Maturity Matrix in the next year;

(4)  as organisations, commit their most senior leaders and EDI leaders to attend a round table event which explores the opportunities for system change.

Update from the Joint Health Protection Board

Lucy Hubber, Director of Public Health, provided the following general updates:

(a)  a big focus at the moment remains the uptake of childhood vaccinations and vaccinations at all ages. The measles outbreak is beginning to ease, and there have not been notable numbers of cases in Nottinghamshire, but we are now beginning to see an increase in whooping cough which is entirely vaccine preventable;

(b)  lots of work is done to support vaccination programmes by engaging with community leaders and faith leaders, and  primary care have endeavoured to organise sessions that are culturally appropriate. Dedicated nurses have been employed dedicated in Citycare offering conversations and direct vaccinations in order to avoid barriers;

(c)  both universities have been working with public health to look at promoting vaccinations for MMR, HPV and meningitis, and this is well embedded into the programme for incoming students. Vaccination records for international students are not always clear, but current uptake is high. Messages will go out for September prior to the start of the next academic year, to make sure students are up to date with their vaccinations.

Updates from Board Members

The Board noted the written updated from Catherine Underwood, Corporate Director for People, and noted Catherine’s intention to step down from this role before the next meeting.

For noting

An item for a future meeting was suggested on the impact of weather, including cold homes, hot homes and workspaces. An item on Green Social prescribing was also suggested for a future meeting.

The rest of the forward plan was noted.