Agenda and draft minutes

To note that Vicky Murphy has been appointed as the Corporate Director for Adult Social Care and Health (incorporating the role of Director of Adult Social Services) at Nottingham City Council

Resolved to note that Vicky Murphy has been appointed as the Corporate Director for Adult Social Care and Health (incorporating the role of Director of Adult Social Services) at Nottingham City Council

Councillor Saj Ahmad – personal reasons

Councillor Cheryl Barnard – work commitments

Vicky Murphy (sent substitute)

Jules Sebelin (sent substitute)

Geoff Wharton

In the interests of transparency Councillor Pavlos Kotsonis declared that he is part of the Nottingham Financial Resilience Partnership and chairs the Age Friendly Nottingham Steering Group.

Minutes of the meeting held on 25 September 2024, for confirmation

The Board confirmed the minutes of the meeting held on 25 September 2024 as a correct record and they were signed by the Chair.

Report of the Safeguarding Adults Board Independent Chair

Lesley Hutchinson, Safeguarding Adults Board (SAB) Independent Chair, presented the report providing an overview of the activity of the Board over the financial year 2023/2024. This includes 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:

(a)  in November 2023 Nottingham City Council declared it was unlikely to balance its budget and Commissioners have come to help oversee financial management. Significant savings plans and financial management measures have been put in place and the Board has sought assurance that this will not adversely impact on the Council’s ability to keep people safe;

(b)  the SAB acknowledges it has a plan to improve its work with hard to reach communities;

(c)  two Safeguarding Adults Reviews (SARs) have been published, and another is in progress. Two actions were escalated to the National SAB Chairs Network to discuss whether they should be taken forward nationally. One of these has led to working with the DWP to produce a National Joint Working Protocol (JWP) between the National SAB Network and DWP. The document is now complete and signed off, and this locally led JWP has been published and adopted nationally;

(d)  the SAB has done some specific work on Severe Multiple Disadvantage (SMD) this year, and held a conference on the interface between safeguarding and SMD, gaining a range of information from a range of agencies.

The following comments were made during the discussion which followed:

(e)  the 7-minute briefings following SARs are very useful but could be better advertised for use by frontline staff. A website is being launched which will improve the circulation of messaging;

(f)  the universities have around 20,000 students transitioning each year and safeguarding is an important theme for them, so they could offer useful perspectives to the SAB;

(g)  there has recently been a Safeguarding Adults Awareness Week with a raft of events to raise awareness, but the same people from the same organisations tend to attend, so the work of the SAB could be advertised more widely.

Resolved to note the contents of the report.

Report of the Assistant Chief Fire Officer, Nottinghamshire Fire and Rescue Service

The item was postponed to the next meeting.

Report of the Director of Public Health, Nottingham City Council

Hannah Stovin, Senior Public Health Intelligence Manager, presented the report presenting the proposed Joint Strategic Needs Assessment (JSNA) Strategy for Nottingham City, and presenting the revised JSNA Workplan for 2024-2025, highlighting the following:

(a)  the JSNA is a local assessment of current and future health and social care needs. It provides an overview of population health needs, and can be used to monitor trends, identify areas of greatest need, target resources and evaluate impact. Overall responsibility for the development of the JSNA lies with the Health and Wellbeing Board (HWB), with Local Authorities and Integrated Care Boards (ICBs) having the equal and joint duty to prepare the JSNA on behalf of the HWB. The production of the JSNA is a continuous process, and HWB areas can undertake the production of the JSNA in the way that is best suited to local circumstances, using the datasets they identify as appropriate;

(b)  the strategy proposes a shift from a ‘documentary’ based approach to all JSNA products, to an approach offering a range of different options, depending on the purpose, resource available and priority level of the work. The range of options centres around interactive JSNA dashboards, which allow the user to select which data they are most interested in, and tailor the information presented to suit their needs or answer their specific questions;

(c)  additional ‘core products’ include JSNA Profiles and In-depth (Health) Needs Assessments. These will be supplemented by additional products such as supplementary topic information, detailed dashboards or area/community insight profiles;

(d)  benefits to this new approach include functionality, accessibility of data, a sustainable and partnership driven approach which is easier to maintain and keep up to date. JSNA dashboards have been identified as best practice and are being utilised across several other local authorities;

(e)  the strategy proposes that the HWB delegates responsibility to the Director of Public Health for the creation of an annual 12 month workplan, to be formulated with consideration to the Joint Health and Wellbeing Strategy, and in collaboration with system partners. The JSNA workplan for 2024-2025 has been recently revised and agreed by the Director of Public Health.

The following comments were made during the discussion which followed:

(f)  there is still a lack of awareness of the JSNA and the wealth of data that they provide in some areas, so improving the ease of access and usability will be helpful;

(g)  partners have been consulted on what information would be most useful for their needs. The JSNA is hosted on Nottingham Insight and the Council is looking to make this more user friendly;

(h)  it would be useful to share the information with the NCVS Provider Network and Provider Alliance;

(i)  the JSNA Chapter on Severe Multiple Disadvantage is now 5 years old, so it would be good to revisit. Other areas that are priorities for the Board, such as housing and alcohol, would also be good areas for focus.

Resolved to

(1)  receive and acknowledge the proposed JSNA Strategy for Nottingham City;

(2)  approve the JSNA Strategy for Nottingham City;

(3)  note the revised JSNA Workplan 2024-2025 for Nottingham City.

Joint report of the Director of Education Services and the Deputy Director of Public Health, Nottingham City Council

Nick Lee, Director of Education Services, presented the report on a new chapter of the Joint Strategic Needs Assessment (JSNA) which provides an analysis of the needs of children and young people aged 0 to 25 with SEND in Nottingham City. It outlines the current landscape, highlights unmet needs, and identifies priorities for service enhancement. The following information was highlighted:

(a)  children and young people with SEND in Nottingham face a range of challenges, influenced by socioeconomic conditions, health disparities, and service limitations;

(b)  in Nottingham, children with SEND are overrepresented in areas with higher poverty levels, similar to national patterns. For example, 36.7% of children with SEND in Nottingham receive free school meals, higher than the national average of 23.8%, with an even higher proportion (51.4%) among those with an Education, Health, and Care Plan (EHCP);

(c)  currently, Nottingham has gaps in specialised services, such as speech and language therapy, neurodevelopmental pathways, and specialist school placements, compounded by long waiting times that impact timely access to care;

(d)  at Key Stage 4, where only 19.7% of SEND pupils achieve grades 5+ in both English and maths, compared to 27.3% nationally. Additionally, 88% of 16-17-year-olds with EHCPs are engaged in education or training in Nottingham, slightly below the national rate of 91.4%;

(e)  Nottingham faces challenges in data capture and reporting across health, education, and social care services. To address this, Nottingham is enhancing its multi-agency data dashboard to monitor SEND outcomes, support needs, and disparities, better informing future strategic decisions. Additionally, there is a plan to collaborate with the Integrated Care Board (ICB) to explore participation in the ICB’s dashboard, which would grant access to shared data and further improve co-production across services;

(f)  the JSNA makes recommendations to address the identified needs, such as:

·  improving the effective delivery of resources to address the rising demand for specialist SEND services in Nottingham, with a particular focus on speech and language therapy, autism pathways, and additional placements within specialist schools

·  strengthening multi-agency data capture and sharing to provide a holistic view of the SEND landscape, ensuring that outcomes can be effectively monitored, gaps identified, and service effectiveness measured;

·  improving accessibility to health services by reducing barriers, especially in routine health checks, and expanding respite care options to better support families with SEND children;

·  enhancing transition pathways to adulthood, prioritising employment readiness and independent living skills to ensure that SEND young people are prepared for a successful transition to adult life.

The following points were raised during the discussion which followed:

(g)  health checks do not include dental services, but a GP could signpost young people to dental care;

(h)  the number of referrals for SEND has greatly increased and there are significant waiting lists for assessments, however early support is aiming to reduce this;

(i)  the Council works with universities on an Educational Psychology pathway, ensuring that graduates are captured and influencing a more representative workforce.

Resolved to

(1)  endorse the JSNA chapter on Special Educational Needs and Disability (SEND);

(2)  support the work of all partners to ensure implementation of identified recommendations.

Report of the Director for Public Health, Nottingham City Council

David McDonald, Senior Public Health Manager, presented the report presenting the newly developed JSNA Profile for adult mental health and to set out the proposed next steps for drawing on this insight through a shared Better Mental Health Commitment for Nottingham City, highlighting the following:

(a)  the JSNA steering group has collated, analysed and synthesised data and evidence to enable understanding of the needs in the population related to common mental health diagnoses for depression and anxiety and low mental wellbeing;

(b)  in recent years, the number of adults in England experiencing depression or anxiety has risen steadily. In Nottingham, 6.5% of females and 3.5% of males have had a diagnosis of depression or anxiety at the last two years;

(c)  many people in Nottingham access and are effectively supported by a wide range of mental health services delivered by NHS services and by voluntary and community organisations. However, people from some groups are less likely than others to access support;

(d)  recommendations have been developed for this JSNA across 5 themes:

·  reach and equity of access to support;

·  supporting the building blocks of health;

·  supporting the workforce;

·  improving understanding and insight; and

·  improving the shared strategic approach.

The following points were raised during the discussion which followed:

(e)  the Nott Alone website is excellent but needs better promotion and targeting as not everyone is aware of it;

(f)  the mention of students is positive, but there may be some conflation of data sets, and there is no mention of Nottingham Trent University;

(g)  NCVS has led on Green Social Prescribing in Nottingham and has developed some national resources around people of low mental wellbeing accessing greenspaces. It would be good for this to be referenced.

Resolved to

(1)  endorse the JSNA Profile for Adult Mental Health;

(2)  support the implementation of the identified recommendations;

(3)  affirm the proposal to develop a Better Mental Health commitment for Nottingham City

Report of the Director of Public Health, Nottingham City Council

Hannah Stovin, Senior Public Health Manager, presented the report outlining the requirements for the Pharmaceutical Needs Assessment (PNA), formally seeking delegated authority for the sign-off of the draft PNA to the Director of Public Health, and notifying the Board of the intention to bring the final PNA and recommendations back to the Board for ratification in September 2025.

Resolved to

(1)  note the requirements for the Pharmaceutical Needs Assessment;

(2)  formally delegate the sign off of the draft and final PNAs to the Director of Public Health on the recommendation of the Steering Group, with agreement that the report will be presented to the September 2025 HWB meeting for ratification.

Update from the Joint Health Protection Board

Lucy Hubber, Director of Public Health, provided a verbal update and highlighted the following:

(a)  the NHS proposes to delegate responsibility for screening and immunisations to ICBs from April 2026. This work is complex so arrangements are being worked on now. Full national guidance has not yet been produced but this will probably be in a regional model across the East Midlands;

(b)  ICBs have been tasked to respond to M Pox, and to set up vaccinations within 24 hours if necessary. ICB is on track for this, but there has not yet been a reported case across the East Midlands.

Update from the Nottingham City Place-Based Partnership

Rich Brady, Director of Strategy and Partnerships, Nottingham City Place-Based Partnership (PBP), presented the report providing an update on the work of the Nottingham City PBP, highlighting the following:

(a)  following the departure of Mel Barrett as Chief Executive of Nottingham City Council and Lead of the PBP, Tim Guyler, Executive Director of Strategy and Integration at Nottingham University Hospitals (NUH), has been appointed as the new Lead for Nottingham City PBP;

(b)  as part of its approach to supporting the prevention and better management of long-term conditions, the PBP has launched an integrated neighbourhood working programme focused on cardiovascular disease, led by its constituent Primary Care Networks;

(c)  the joint Nottingham City and South Nottinghamshire PBP, Primary and Secondary Care Interface programme, has now generated over 90 projects and is continuing to improve relationships between primary and secondary care clinicians, improving pathways, reducing duplication and improving patient experiences;

(d)  the opportunistic flu vaccination project undertaken between the City and South Nottinghamshire PBPs and Nottingham University Hospitals won the ‘Prevention’ award at the ICS Health and Care Awards. The PBP has also been shortlisted for a Health Service Journal Award for its work on Severe and Multiple Disadvantage with the awards ceremony taking place on 21 November.

Resolved to note the update from the Nottingham City Place-Based Partnership

Updates from Board Members

The written updates were noted.

For noting

The work plan was noted.

Wednesday 26 February 2025

The future meeting dates were noted.