Agenda for Nottingham City Health and Wellbeing Board on Wednesday, 27th May, 2015, 1.30 pm

Agenda and minutes

Venue: Ground Floor Committee Room - Loxley House, Station Street, Nottingham, NG2 3NG. View directions

Contact: Phil Wye  Governance Officer

Items
No. Item

1.

APPOINTMENT OF VICE CHAIR

Minutes:

The Board agreed to appoint Dr Ian Trimble as Vice-Chair for the 2014-15 municipal year.

2.

APOLOGIES FOR ABSENCE

Minutes:

Lyn Bacon (Nottingham Citycare Partnership)

Peter Homa (Nottingham University Hospitals NHS Trust)

3.

DECLARATIONS OF INTEREST

Minutes:

Leslie McDonald declared interests in agenda items 6 and 7 as representative of the Health and Wellbeing 3rd Sector Forum, but this interest did not prevent him from speaking or voting on the items.

4.

MINUTES pdf icon PDF 217 KB

To confirm the minutes of the last meeting held on 25 February 2015

Minutes:

The minutes of the meeting held on 25 February 2015 were confirmed by the Board, with the exception of the following:

 

a)  in item 50 (Apologies for absence), Councillor Alex Norris’ name was recorded incorrectly;

b)  the list of voting and non-voting members was incorrect.

 

The minutes, including changes as above, were signed by the Chair.

5.

NOTTINGHAM SUSTAINABLE HEALTH AND CARE LOCAL IMPLEMENTATION PLAN pdf icon PDF 979 KB

Report of the Interim Director of Public Health, Nottingham City Council

Minutes:

Helen Ross, Insight Specialist, Public Health Sustainable Development lead, presented her report on the outcomes of the Health and Wellbeing Board Development Session on Sustainable Development. This session demonstrated how health can be improved and how health inequalities can be reduced through the further development of a local Sustainable Health and Care Local Implementation Plan. Helen gave the following updates:

 

a)  the Nottingham Clinical Commissioning Group (CCG) has recently won a Green Award for its work on carbon reduction. The Nottingham CCG is the first in the UK to reduce carbon from data transmission, setting a benchmark;

b)  Carillion, who caters for the Nottingham University Hospital NHS Trust, has achieved gold status for its food;

c)  Helen recently spoke at a national event in Bristol about sustainable food work in Nottingham and other delegates were impressed with Nottingham’s achievements. Nottingham is on its way to becoming a sustainable food city;

d)  a bid has been submitted to the European Regional Development Fund for £1m to support private care homes in Nottingham to carry out sustainability activities and initiatives;

e)  a second focussed workshop would be required to develop an action plan in the priority areas identified in the session. A provisional date of 24 August 2015 has been set for this workshop.

 

Helen gave the following answers in response to questions from members of the Board:

 

f)  Helen is able to attend the next meeting of the Health and Wellbeing 3rd Sector Forum to engage smaller organisations, and Leslie McDonald is invited to attend the workshop in August as a representative of the 3rd sector;

 

g)  work on sustainable development could be promoted by ward councillors. They are welcome to attend the workshops but it is difficult to accommodate a date which would suit all of them;

 

h)  Helen will meet with the CCG to discuss co-ordinating tying these initiatives with their Vanguard Status work. Dawn Smith can help with any issues arising;

 

i)  sustainability should be encouraged in all health and wellbeing work in Nottingham, under a strategic plan.

 

RESOLVED to

 

1)  note the outcomes of the Sustainable Development Health and Wellbeing Board workshop;

2)  draft a Nottingham Sustainable Health and Care Local Implementation Plan and develop action plans in the priority areas mentioned in the report, through a second focussed workshop that utilises the Sustainable Development Unit Local Implementation Toolkit and an Action Learning approach, in consultation with representatives from other partnerships such as the Nottingham Green Theme Partnership, to ensure that value is added to others’ work and potential duplication is avoided;

3)  agree finance for room booking, meeting expenses and participation from partner organisations through existing budgets.

6.

HOUSING'S CONTRIBUTION TO THE HEALTH AND WELLBEING AGENDA pdf icon PDF 229 KB

Report of the Director of Housing, Nottingham City Homes

Minutes:

Gill Moy, Director of Housing and Lorraine Raynor, Chief Environmental Health & Safer Housing Officer, Nottingham City Homes (NCH) presented their report, identifying the contribution housing services make to improving the mental and physical health outcomes for Nottingham citizens. The following points were highlighted:

 

a)  poor housing has an impact on citizens’ physical and mental wellbeing. The 2004 Housing Act made it the duty of local authorities to ensure that all homes are safe and healthy, but this is a huge challenge in Nottingham due to the size and variety of the housing stock;

b)  housing problems cause huge cost to the NHS. Nationally, £1.4bn would be saved annually if 3.3m poor homes were brought up to a decent standard. The local figures for Nottingham are unknown as homes have not been surveyed since 2006. NCH is intending to commission the Building Research Establishment (BRE) to survey homes in Nottingham;

c)  over 1300 complaints have been made by residents about housing in Nottingham, mainly amongst the private rental sector. 435 homes have been improved by enforced legal action, along with a significant number which have been improved without having to resort to legal action;

d)  all social housing in Nottingham (around 30% of the housing stock) meets the ‘Decent Homes Standard’, but it is a challenge to keep the housing at this high standard. The Nottingham Trent University Decent Homes Impact Study found that the work carried out by NCH:

i)  avoids 2 excess winter deaths a year from excess cold;

ii)  reduces respiratory illness in over 1000 children;

iii)  avoids 178 accidents at home, including 12 falls;

iv)  improves mental health and wellbeing;

v)  saves the NHS £700,000 a year (from a sample of health benefits);

 

e)  the success of NCH’s work on housing improvement has been promoted as a leading example by Lilian Greenwood, MP for Nottingham South,  in the House of Commons;

f)  the city council has recently been successful in obtaining funding for home improvements in Clifton, Bulwell and Sneinton, for example refurbishment of tower blocks in Sneinton;

g)  Nottingham On Call has received 11,000 calls, and made 1,007 emergency call-outs in 2014/15, saving £302,100 by avoiding 999 call-outs. Only 1500 of these calls were from private rentals, so there is considerable scope to increase the number of people benefiting from the service;

h)  Around 1000 housing adaptations are made each year by NCH, along with the provision of hundreds of specialist houses. Other schemes such as Homelink, Independent Living Schemes and the Hospital to Home Project have also been successful;

i)  poor quality housing has an impact on mental health, including social isolation. Recent and future welfare reform may also create significant future challenges as residents receive fewer benefits. An example of a scheme which helps reduce social isolation is Fit in the Community, which helps to increase physical activity as well as improving mental health;

j)  the Joint Memorandum of Understanding has been signed by a wide range of health, social care and housing organisations including the Department of Health and the Department for Communities and Local Government. It sets out:


i)  shared commitment to joint action across government, health, social care and  housing sectors;

ii)  principles for joint-working to deliver positive outcomes;

iii)   a framework for partnerships, to design and deliver healthy homes, communities and neighbourhoods as well as integrated and effective services that meet individuals’, their carers’ and their family’s needs.

 

Gill and Lorraine provided the following answers in response to questions from the Board:

k)  a business manager has recently been recruited to help widen the scope of Nottingham On Call;

l)  the number of homes which require improvement to bring them up to decent standard is not known as the last survey was carried out in 2006;

m)  licensing in the private rental sector is currently discretionary, however licensing could be introduced for the whole sector. This would give the council additional tools and powers to intervene, but intervention and the closure of housing is expensive. Other enforcement options include the Nottingham Standard accreditation scheme, and a requirement for pre-checks prior to rental of a house;

n)  there is a problem with the under-reporting of poor quality housing stock. The council is working with the police to create a single point of contact receive complains about landlords. Health and care partners could also report cases they are aware of;

o)  a French model where students live with older tenants to improve their mental wellbeing is being investigated;

p)  the 30% figure of  for social housing in Nottingham includes all housing associations, not only NCH. Social Landlord Forum members are welcome to attend Health and Housing Partnership Board meetings;

q)  the Health and Housing Referral Service helps to pick up housing problems in the private sector in the council. The council also provides funding to Age UK to support older people living in their own homes;

r)  the Health and Housing Partnership Board is trying to get as many partners as possible around the table and would welcome new members from social care and the CCG.

RESOLVED to

 

1)  note the contribution that housing providers, and housing interventions, make to the health and wellbeing of Nottingham Citizens, particularly in reducing demand for primary and secondary health and social care services, and to consider the contribution that housing services can make when commissioning health services;

2)  note the Memorandum of Understanding (MOU) to ‘support joint action on improving health through the home’ and to agree that the Health and Housing Partnership Board should own such actions locally and make future recommendations to the Commissioning Executive Group (CEG);

3)  note the outcomes from the Health and Housing event on 28th November 2014 organised by the Strategic Housing Network and the Nottingham Health and Housing Partnership Board.

7.

CHANGE TO THE HEALTH AND WELLBEING BOARD TERMS OF REFERENCE AND ESTABLISHMENT OF A SUB-COMMITTEE pdf icon PDF 246 KB

Report of the Acting Corporate Director of Resources

Minutes:

Councillor Alex Norris introduced the report of the Acting Corporate Director of Resources proposing a sub-committee of the Health and Wellbeing Board with responsibilities including:

 

a)  performance management and amendment of the Health and Wellbeing Commissioning Plan;

b)  making funding decisions relating to the spend of the Better Care Fund and Domestic Violence Commissioning pooled budgets.

 

 

RESOLVED to

 

1)  note the changes to the Terms of Reference for the Health and Wellbeing Board;

2)  establish a sub-committee of the Health and Wellbeing Board called the Health and Wellbeing Board Commissioning Sub-Committee, and agree the terms of reference subject to the following changes:

i  that the Terms of Reference allow for additional meetings as and when required, should a decision be needed urgently, and;

ii  that the Terms of Reference include reference to the Section 75 agreement signed by the CCG;

2)  note that Full Council approved the membership and voting arrangements for the Health and Wellbeing Board Commissioning Sub-Committee, subject to the establishment of the sub-committee by this Board.

8.

FORWARD PLAN pdf icon PDF 148 KB

Minutes:

RESOLVED to note the forward plan, subject to the addition of a report on Child Sexual Exploitation as agreed at the meeting on 25 February 2015.

9.

UPDATES

9a

Corporate Director for Children and Families pdf icon PDF 148 KB

Minutes:

Alison Michalska, Corporate Director for Children and Adults, gave the following updates:

 

a)  Changes to the Adult Social Care structure
Linda Sellars is now Director for Quality and Change and remains Chief Social Worker for Adults;
Julie Sanderson is now in the new post of Head of Adult Safeguarding;
Gemma Poulter is the Head of Integration;
Wendy Griffiths will take on a broader portfolio; her job title is now Head of Commercial Services and Change;
Oliver Bolam and Paul Haigh retain their roles as Head of Specialist Services and Head of Social Care Provision respectively;

b)  Fostering and Adoption
the number of adoptions completed has increased greatly from 43 in 2013/14 to 70 in 2014/15. There has also been an increase in the numbers of foster carers following a successful advertising campaign;

c)  Education Improvement Board
the Board has a new chair, Professor David Greenaway, Vice Chancellor of the University of Nottingham. School attendance has improved and Nottingham City is now 109 in the ranking of Local Authorities. This is the second most improved school attendance in the country;

d)  Early Help, Safeguarding and Family Support Delivery Plan
a new Delivery Plan has been produced to help make clear where responsibilities lie for Children’s Social Care and Vulnerable Children and Families, which will be rolled out and embedded across teams in the next few months;

e)  Project Evolution
tendering and procurement is now complete on a new case management system to replace CareFirst, which should improve connectivity with partner agencies;

f)  Independent Chair – Safeguarding Boards
the current independent chair of the Adults’ and Children’s Safeguarding Boards, Paul Burnett, is leaving in September. Two new chairs (separate Adults’ and Children’s) are currently being recruited;

g)  Dolly Parton’s Imagination Library
The Imagination Library, which currently operates in the four most deprived areas of Nottingham (Aspley, Arboretum, Bulwell and St Anns), is being expanded across the city as part of the ‘Small Steps Big Changes’ programme. Funding is being generated by donations from the City Council workforce through a workplace giving scheme.

9b

Director of Public Health

Minutes:

Alison Challenger, Interim Director of Public Health, gave the following updates:

 

a)  the Joint Strategic Needs Assessment (JSNA) is currently being refreshed;

b)  as part of the smoke-free agenda, the Nottingham University Hospitals NHS Trust is making its grounds completely smoke-free. This is a huge challenges but should be in place by October.

9c

Healthwatch Nottingham

Minutes:

No update

9d

Clinical Commissioning Group pdf icon PDF 336 KB

Additional documents:

Minutes:

Dawn Smith, Chief Officer, Nottingham City Clinical Commissioning Group (CCG) gave the following update:

 

a)  NHS 111 re-procurement
the CCGs in Nottingham City and Nottinghamshire County (excluding Bassetlaw) are beginning a re-procurement process for the NHS 111 service, with the service needing to commence in March 2016. 20 CCGs are involved and there is national interest. The service aims to help smaller services who struggle to manage their communications;

b)  The selection of Quality Premium Indicators for 2015/16
targets have been selected by the Nottingham CCG as its Quality Premium Indicators for 2015/16. These will be assessed and used to reward any improvement;

c)  360° Stakeholder Survey
NHS England has conducted a further survey this year which allowed stakeholders to provide feedback on working relationships with CCGs. There are a number of areas where the CCG has performed higher than the national average;

d)  Diabetes Care in Nottingham City
the CCG is currently seeking the views of patients and carers living with diabetes in the city to help them shape and improve local NHS services;

e)  Improving Patient Flow through Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust is holding two ‘Breaking the Cycle’ sessions at Queens Medical Centre and City Hospital, working with partner organisations to help ward teams chase and resolve patient delays. The former took place from 29 April and was successful, and the initiative met its target of 95% every day over 20 consecutive days.

9e

The Care Act

Minutes:

Helen Jones, Director of Adult Social Care, Nottingham City Council, provided an update on the implementation of the Care Act in Nottingham City:

 

a)  Nottingham City Council has delivered against all legal requirements in the implementation of the care act to date;

b)  Nottingham City Council has volunteered to undertake a piece of work on the funding impacts of new reforms, as there has been national lobbying for additional guidance prior to consultation taking place.

10.

HEALTH AND WELLBEING BOARD MEETING DATES 2015-16

To consider meeting on the following Wednesdays at 1.30pm:

2014: 29 July, 30 September, 25 November

2015: 27 January, 30 March 2015

Minutes:

RESOLVED to meet on the following Wednesdays at 1.30pm:

 

2015:  29 July, 30 September, 25 November

2016:  27 January, 30 March