Agenda and minutes

Joanna Cooper

Lucy Dadge

Dr Mike Saunders

Michael Sharman

Ciara Stewart

Michelle Tilling

None.

Minutes of the meeting held on 25 January 2023, for confirmation

The minutes of the meeting held on 25 January 2023 were confirmed as a correct record and signed by the Chair.

Minutes of the meeting held on 25 January 2023, for noting

The minutes of the Commissioning Sub-Committee, held on 25 January 2023,  were noted.

Report of the Director of Public Health, Nottingham City Council

Helen Johnston, Public Health Registrar, presented the report and delivered a presentation highlighting the following:

(a)  gambling means to risk loss for a possible gain in an activity of uncertain outcome, and includes casino games, sports bets, scratchcards, lotteries, bingo and more. It can cause harm and significantly affects health and wellbeing. The problems can easily be hidden and generally affect up to 10 others;

(b)  disadvantaged groups and people with poorer health are more likely to develop a gambling problem. There is also a disproportionate impact for minority ethnic groups, relative to participation;

(c)  gambling can have a negative impact on physical and mental health, relationships, finance and employment, and can lead to crime;

(d)  approximately 4,500 Nottingham citizens aged 16 or over have a known gambling problem, and this is affecting more younger people and males. In addition almost 1000 citizens aged under 16 are showing signs of a problem;

(e)  information and support is available and expanding. An NHS Clinic is due to open in Derby soon. However, far fewer people contacted the largest local support provider between April 2021 and March 2022. Nottingham callers reported multiple impacts, most commonly on finance and mental health ;

(f)  gambling premises in Nottingham are clustered in the City Centre, Bulwell and Clifton East. Deprived areas are more likely to contain licensed premises. Residents of Bulwell, Clifton East, Bestwood, Bilborough, Aspley and St Anns are estimated to have a higher risk of developing a gambling problem;

(g)  the report contains a number of actions, which are already being acted upon.

The following points were raised during the discussion which followed:

(h)  financial capability is taught in all schools as part of the national curriculum, and gambling risk could be included in this;

(i)  gambling is often glorified through sponsorship of sports teams, which impacts particularly young people The gambling industry alone cannot be relied upon to address problems;

(j)  alternative diversionary activity such as sports and activities could help young people to avoid gambling.

Resolved to note the report.

Joint report of the Clinical Director, Nottingham City Place-Based Partnership  Chief Executive, Nottingham City Council, and the Director of Public Health, Nottingham City Council

Rich Brady, Programme Director for Nottingham City Place Based Partnership (PBP), introduced the report providing an overview of approach taken by the PBP to deliver the four priorities that make up the Joint Health and Wellbeing Strategy 2022-25, delivery progress to date and expectations in year 2.

Presentations were delivered on each of the four priorities of the Strategy by Jane Bethea, Helen Johnston and David Johns, highlighting the following:

Severe Multiple Disadvantage (SMD)

(a)  the aim is to ensure that people living in Nottingham City who experience SMD receive joined up, flexible, person-centred care from the right services, at the right time and in the right place;

(b)  a key delivery achievement for the programme in year 1 has been the establishment of the Changing Futures programme which includes specialist 1:1 intensive (including minority ethnic and gender specialist) support to people experiencing SMD;

(c)  133 people have benefited from intensive support in the last year, in addition to people that have been supported through the multi-disciplinary team (MDT) and statutory services;

(d)  ensuring the voice of lived experience is key to this work, including in the design and delivery of services, and understanding the needs of women and Nottingham’s diverse communities experiencing SMD, ensuring services meet their needs. There have been difficulties in recruiting people with lived experience from diverse communities in Nottingham City however this has improved.

Financial Wellbeing

(e)  the programme’s 10 year vision is to address lack of financial security by making Nottingham a place where people are able to meet their current need comfortably and have the financial resilience to maintain this in the future;

(f)  Year 1 delivery has included a joint workshop on supporting a coordinated approach to the cost of living, linking up support like financial resilience sessions for NUH staff and informing organisational recruitment policies. partnership arrangements have been developed to strengthen the resource and profile of the Nottingham Financial Resilience Partnership;

(g)  Year 2 priorities have 5 key themes- increased incomes for those on low incomes, ensuring access to money help across the population, improved household finances, reduced food insecurity, and improved financial capability.

Eating and moving for good health

(h)  in Nottingham 1 in 4 children at primary school are overweight, 2 in 5 at secondary school, and 7 of 10 adults. Around a quarter of adults are not active. The programme’s vision is to be a city that makes it easier for adults, families, children and young people to eat and move for good health. This means achieving lasting changes to diet, physical activity and social environment;

(i)  this will require ensuring all early years settings, schools and academies are enabling eating and moving for good health, supporting healthy choices in pregnancy and helping children and adults to achieve and maintain a healthy weight, promoting physically active lives and building active and green environments, creating a local environment that promotes healthy food choices, and promoting sustainable food system that tackles food insecurity;

(j)  the programme is helping schools to further their efforts through additional funding and support. It is also offering adult weight management through Slimming World, Aviva, and partnering with football clubs;

(k)  healthy activity is being supported through active travel bids, mapping of walking routes around the city, and making cycling more accessible.

The following points were raised during discussion:

(l)  some city communities have their own support networks and these need to be connected into this work. Some groups such as LGBTQIA+ people are harder to reach due to poor data;

(m) there will be a new workstream for young people and care leavers, including trauma informed practice;

(n)  there are still people in the city who have not received their energy rebates, are not on the internet, do not have bank accounts or only pay in cash. The financial wellbeing priority work must take this into account;

(o)  people can be overwhelmed by the amount of information provided on financial wellbeing, so messages must be kept simple so that it is taken in. Employers can disseminate messages to the employees on financial wellbeing, including small and medium sized businesses;

(p)  it is important that people are able to walk and cycle around the city more easily and safely. Lowering speed limits and encouraging children and parents to walk to school are important steps in this, as well as making people feel safe to do outdoor physical activity. The national StreetSafe app is available from the police to report feeling unsafe, and community speedwatch is being re-launched to monitor speeding.

Resolved to

(1)  note the progress of programme development and delivery in year 1 of the Joint Health and Wellbeing Strategy;

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

(3)  note the agreed Smoking & Tobacco Control and Severe Multiple Disadvantage programme delivery plans;

(4)  note the Year 1 programme delivery update reports.

Report of the Director of Public Health, Nottingham City Council

David Johns, Consultant in Public Health, presented the report and delivered a presentation on the Smoking and Tobacco Control priority of the Joint Health and Wellbeing Plan, highlighting the following:

(a)  smoking remains the biggest preventable cause of all il-health in Nottingham, with 7% of adults and 13% of pregnant women smoking;

(b)  the vision of this priority is to see smoking amongst adults reduced to 5% or lower by 2035 across Nottinghamshire and Nottingham City, and all born after 2022 to not be smokers;

(c)  Stop Smoking services are helping vulnerable adults to stop smoking, along with a new Stop Smoking app for NHS staff and a new e-cigarette pilot as a quit aid. A new trading standards officer will promote effective regulation of tobacco products for tobacco control, in  partnership with the police;

(d)  To promote prevention and engagement with children and young people. The INTENT programme has been launched, a free smoking prevention programme for secondary schools. Schools have also been provided with information on the risks of vaping.

The following points were made during the discussion which followed:

(e)  schools and early years settings are important to link into families;

(f)  there is very little data available on vaping among young people. This could present a challenge in future and must be kept under observation.

Resolved to endorse and support the long-term ambition and delivery of actions.

Update from the Joint Health Protection Board

As no formal Board meeting had taken place, a written update will be provided at the next meeting.

Report of the Director for Integration, Nottingham and Nottinghamshire Integrated Care Board

Dr Dave Briggs, Medical Director, Nottingham and Nottinghamshire Integrated Care Board, presented the report on the Joint Forward Plan which provides an opportunity to create a longer-term shared sense of endeavour, a realistic and ambitious view of what is achievable and a sense of hope for teams and the public.

NHS partners would like to work with the Board in the development of this plan to ensure that the ambitions of the Integrated Care Strategy are reflected and it is proposed to schedule an item for discussion at the May meeting ahead of the document being finalised by 30^th June.

Resolved to

(1)  schedule an item for discussion at the May meeting of the Nottingham City Health and Wellbeing Board ahead of the document being finalised by 30 June;

(2)  delegate to the Chair and Director of Public Health any engagement with NHS partners to support the early development of the Joint Forward Plan.

Updates from Board Members

The written updates were noted.

The work plan was noted.

To note the proposed meeting dates for the 2023-24 municipal year:

31 May 2023

26 July 2023

27 September 2023

29 November 2023

24 January 2024

27 March 2024

The proposed meeting dates for the 2023-24 municipal year were noted.