Agenda and minutes

Health and Wellbeing Board
Wednesday, 27th March, 2019 2.00 pm

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

Contact: Kate Morris  Email:

No. Item


Apologies for absence


Dr Hugh Porter

Catherine Underwood

Tracey Taylor

Hazel Johnson


Declarations of interests




Smoking in Nottingham City pdf icon PDF 281 KB

Additional documents:


Dr Shade Agboola, Consultant in Public Health, introduced the item on Smoking in Nottingham City. She gave a brief summary of the statistics around the impact of smoking on health then went on to highlight the following points:


(a)  19% of adults in Nottingham City are current smokers and although there has been a trend of reducing prevalence in Nottingham the proportion of adults who smoke remains higher than the national average;


(b)  Nationally the number of smokers who are in routine and manual occupations has been higher, but this number has recently seen a reducing trend. This has not been mirrored in the local figures with the number remaining relatively static;


(c)  A new smoking cessation services has been established by the GP Alliance in Nottingham City called Stub-It. There is a targeted Public Health funded element which specifically targets smokers with mental health problems, pregnant smokers and their partners, and smokers living with a long term condition;


(d)  The smoking cessation service can currently be accessed from Upper Parliament Street with an additional location at the Wellbeing Hub starting to deliver from April onwards;


(e)  Battery operated e cigarettes are shown to be 95% less harmful than cigarettes. They aim to provide a similar sensation to inhaling tobacco smoke without the smoke. They are no licensed medicines but are regulated by the Tobacco and Related Products Regulations 2016;


(f)  It is estimated that 2.9 million people in Britain use e-cigarettes and of these it is thought that 1.5 million have stopped smoking tobacco cigarettes;


(g)  Research is showing that E-cigarettes are more effective than nicotine replacement treatment at helping smokers stop using tobacco products;


(h)  There have been a number of concerns raised about the uptake of e-cigarette use amongst young people (11-18 year olds), however a PHE report from February 2019 suggests that regular use of e-cigarettes amongst that age range in Britain is low at 1.7% and that the proportion of young people who have never smoked and use e-cigarettes at least weekly remains very low at 0.2%;


Dr David Johns, Acting Consultant in Public Health and Steve Thorne, Communications & Marketing Manager (Children and Adults) gave a presentation, on smoking in pregnancy outlining the health impacts on the mother and the unborn baby and the work being done towards reducing the number of women smoking at the time of delivery. They highlighted the following points.


(i)  The English average for smoking at time of delivery is 10.8%. the Nottingham average is significantly higher at 17.2%. There has been no significant reduction since 2010/11;


(j)   The LoveBump campaign is running across Nottingham and Mansfield and Ashfield over Local authorities and NHS trusts to encourage expectant mothers to stop smoking;


(k)  All maternity care staff in Nottingham are receiving a toolkit allowing them to pass on support to pregnant smokers, alongside the targeted referral to the Stub-It it campaign;


(l)  There will be continued community engagement throughout the year in two key areas of the city, Bulwell and Aspley, engaging groups such as Neighbourhood development officers, Small Steps Big Changes and Children’s Centres;


(m)The LoveBump campaign is being run alongside other healthy pregnancy messages as part of a more encompassing strategy to encourage a stronger link between the mother and unborn baby;


Kate Smith, Smokefree Nottingham Coordinator introduced the last part of the item, a presentation on extending smoke free outdoor public spaces with the aim to inspire a smoke free generation. She highlighted the following points:


(n)  Creation of smoke free outdoor public spaces reduces children’s exposure to harmful second hand smoke and tobacco use;


(o)  Over 70% of adult smokers started smoking under the age of 18 and children who grow up around smokers are up to three times more likely to become smokers themselves;


(p)  Additional benefits of extending smoke free outdoor public space include:

·  Reduction of tobacco related litter

·  Opportunity to support citizens to make healthier lifestyle choices, including supporting those smokers who would like to quit

·  Reducing expose of children to smoking making it less visible and less “normal”;


(q)  Achievements to date include

·  being the first authority to ensure smoke-free school gates and playgrounds in 2010,

·  Smokefree Summer – summer activity programme aimed at children and families

·  Smokefree sports clubs – support

 clubs to take action to reduce exposure to tobacco use


(r)  Smokefree events have had overwhelming support of citizens with almost 90% who were surveyed supporting them;


The following points were made during discussion:


(s)  Smoking cessation sessions are offered for extended hours to accommodate those who are unable to attend during standard office hours;


(t)  Extending the cessation service into other wards is dependent on funding. Current funding is secured for 2 years;


(u)  A large amount of research shows that smoking levels are higher in lower socioeconomic levels. Budget support is being given to more people who are struggling with benefit freezes and making more of tthe links between stopping smoking and improvement in finances would be hugely beneficial;


(v)  Some of the imagery within the LoveBump campaign material does not reflect the diverse family structures that we see today, and in order not to alienate some families’ consideration should be given to being more inclusive of diversity of family structure;


(w)PHE recommend that e-Cigarettes are made available at hospital shops alongside NRT and that vaping policies support smokers to quit;


(x)  It is essential to understand and then tackle issues that are preventing people from quitting tobacco use and to instil a change of behaviour to prevent relapse.


(y)  Addiction is very complicated to understand, there is no one strategy that will work to reduce smoking in Nottingham City, it will take sustained work from a variety of angles to achieve;


(z)   Every opportunity to reduce visibility of smoking and tobacco use in front of children and young people should be taken;


(aa)  Employers also have an important part to play in reducing smoking. Many employers do not understand their employees use of tobacco and so cannot support them to quit;



(1)  Ask board members to:


Smoking in Pregnancy

  i.  Support the LoveBump Campaign across their organisations

  ii.  Support the achievement of the Council Plan commitment to reduce smoking rates of pregnant women at the time of delivery

  iii.  Ensure the NHS long term plan commitment to provide pregnant women and their partners with a new NHS stop smoking pathway including support, is designed alongside non-NHS funded services


Smoking Cessation

  iv.  To create awareness about smoking cessation service (Stub-it)

  v.  Encourage citizens who smoke to seek support via their GP’s especially if they are in one of the target groups for the service

  vi.  Support referral of patients who are smokers in target groups to the new service


Implementation of the NICE guidance supporting cessation in secondary care (PH48)

  vii.  Support continued implementation of PH48 in NUH

  viii.  Review current policies and ensure that provision is made for staff, patients, and families who wish to vape on site

  ix.  Support staff in the delivery of brief advice through completion of the “very Brief Advice Training Module” by the National Centre for Smoking Cessation Training (NCSCT)


  Vaping and E-cigarettes

  x.  Review current smoking cessation policies in organisations

  xi.  Consider expanding current policy to include recognition that e-cigarettes are 95% less harmful than cigarettes

  xii.  Support staff, patients, and clients who wish to vape by considering the provision of dedicated vaping locations/areas on site



Board Member Updates

Update on issues of relevance to the Health and Wellbeing Board and/or delivery of the Joint Health and Wellbeing Strategy


Third Sector pdf icon PDF 221 KB


Jane Todd informed the Board that a recent paper on VCS in the ICS has prompted a round table discussion within Nottinghamshire.


Healthwatch Nottingham and Nottinghamshire


Sarah Collis informed the Board that Healthwatch Nottingham and Nottinghamshire has recently undergone a strategy refresh with a focus on older people and dementia. She also advised Board members that Healthwatch were looking to increase the breadth and diversity of membership of its Board.


NHS Greater Nottingham Clinical Commissioning Partnership


Hazel Buchanan, informed the Board that the CCG has recently signed off the Significant Seven programme aimed at raising awareness around signs of deterioration in patients. She noted that the other significant update was the introduction of the Primary Care Networks.


Dr Marcus Bicknall gave a brief summary of the Primary Care Networks. The Board agreed that this item should come back in more detail to a future board.


Nottingham City Council Corporate Director for Children and Adults and Director of Adult Social Care pdf icon PDF 233 KB

Additional documents:


Nottingham City Council Director for Public Health pdf icon PDF 270 KB


In addition to the written update circulated with the agenda Alison Challenger informed the Board that there had been a successful bid for Alcohol Capital funding totalling £540,000 to aid reduction of harm as a result of alcohol use.


Minutes pdf icon PDF 308 KB

To confirm the minutes of the meeting held on 30 January 2019


The minutes of the meeting held on 30 January 2019 were confirmed as an accurate record and signed by the Chair.


Forward Plan pdf icon PDF 234 KB


RESOLVED to note the Forward Plan.


Action Log pdf icon PDF 192 KB


The Chair asked partners to ensure that updates were sent through to the Committee Clerk when completed.


A specific register will be distributed to record actions around Reducing Alcohol Harm. Partners were asked to complete the register and return to the Committee Clerk.


RESOLVED to note the Action Log.


Minutes of the Health and Wellbeing Board Commissioning Sub Committee held on 30 January 2019 (DRAFT) pdf icon PDF 116 KB

For information only


RESOLVED to note the draft minutes of the Health and Wellbeing Board Commissioning Sub Committee held on 30 January 2019.


New Joint Strategic Needs Assessment Chapters - Evidence Summary pdf icon PDF 544 KB


RESOLVED to note the new Joint Strategic Needs Assessment Chapter Evidence Summary.


Questions from the public

Opportunity for members of the public to ask questions relating to matters within the Health and Wellbeing Board’s remit.


The maximum amount of time allocated to questions and responses is 30 minutes.