Doncaster Metripolitan Council Health and Wellbeing Board Meeting

The Chair welcomed everyone to the meeting and invited all attendees to make introductions.

Apologies for the meeting were received from Dr Rupert Suckling, Anthony Fitzgerald, Lucy Robertshaw, Cath Witherington, Ellie Gillatt and Toby Lewis.

Councillor Sarah Smith and Dr Nabeel Alsindi were welcomed as new Board members.

It was moved and seconded that Anthony Fitzgerald, Executive Place Director (Doncaster) for NHS South Yorkshire ICB, be appointed as Vice Chair of the Health and Well Being Board for the 2023/24 Municipal Year.

RESOLVED that Anthony Fitzgerald be appointed as Vice Chair of the Health and Wellbeing Board for 2023/24.

The Chair, Cllr Rachael Blake, thanked Cllr Andrea Robinson for her past contribution as a Board Member, having stepped down from her Cabinet position on the Council and therefore by default also ceasing to be a member of this Board.

Further to previous discussions by the Board regarding the measures being taken by partners to combat health inequalities, the Chair confirmed that health inequalities training had now been provided which had been well attended by partner organisations.  A further training session was to be organised by Mandy Espey and Vanessa Powell-Hoyland for those who had been unable to attend the first event, and they would also be producing an e-learning package enabling the training to be undertaken remotely.

The Chair stated that she had recently taken up an opportunity to visit the Burns Medical Practice in Doncaster, which she had found to be incredibly insightful in terms of illustrating the current challenges and pressures being faced by surgeries and patients.

Mr Doug Wright addressed the Board and began by referring to the delivery of the five-year NHS Joint Forward Plan and associated funding challenges.  He felt there was a sense of ‘Groundhog Day’ with plans of this nature, as this current document was just the latest in a long line of Plans produced over the last 10 years.  Mr Wright stated that he had concerns over the financing behind the Plan, noting that the ICB had already been hit with a reduction in its finances from £30m to £20m.  He was also concerned that there were no powers within this Board or any other forums to veto any proposals laid down in the NHS Joint Forward Plan and there was seemingly no choice other than to note the contents.

Mr Wright also highlighted that 41% of the Doncaster population were currently living in relative poverty and he felt that this statistic was only going to worsen in the future.

He concluded by stating that he wished to thank this Board for all its work in trying to improve the outcomes for the people of Doncaster.

The Chair thanked Mr Wright for his statement and for his positive remarks about the work of this Board and then invited members of the Board to comment on the points raised. 

With regard to the NHS Joint Forward Plan, Ailsa Leighton explained that while it was labelled as a South Yorkshire plan, there would be a strong focus on the priorities for Doncaster, with consultation and engagement being carried out on a local basis.  This would include identifying the desired outcomes and improvements that were needed for Doncaster’s population over the life of the Plan, with regular updates being brought to this Board for monitoring purposes.

Richard Parker explained that he was on the ICB as an acute trust representative and he gave an assurance that the ICB was absolutely focussed on deprivation.  In relation to plans and strategies, he explained that the aim was to recognise Doncaster as a place in all the various Plans, learning from partners and making sure that our limited resources and finances were used wisely in the delivery of care.  He stressed the importance of having a collective approach by all partners and not just focussing on the needs of each individual organisation.  The NHS was effectively a partnership, and he felt that the five-year NHS Joint Forward Plan would provide a useful collective vision going forward.

Rachael Leslie outlined some of the actions being taken to help alleviate the impact of poverty on Doncaster’s communities.  She added that the Fairness and Wellbeing Commission would be looking at poverty in some detail.

Councillor Nigel Ball stated that his concern was over how we engage with communities to enable them to be co-authors of plans and strategies.  He felt that if the desired aim was to have communities co-designing services and fully engaging with them, then plans needed to be much clearer and less complicated.

Dr Victor Joseph commented on the ways in which partners could address health inequalities, including helping their workforces to better understand the issues involved and changing mindsets to be more conscious of the health inequalities challenges.

The Chair then thanked everyone for their comments and confirmed that the Fairness and Wellbeing Commission’s recommendations would be reported to this Board later in the year for consideration.

There were no declarations of interest made at the meeting.

With regard to minute no. 53 (The Lived British Sign Language User), the Chair reminded members that the Board was due to receive a further report at its next meeting outlining the progress made in implementing the actions identified from the presentation it had received from Pauline Dunn of the Doncaster and District Deaf Society.

RESOLVED that the minutes of the meeting of the Health and Wellbeing Board held on 9^th March, 2023, be approved as a correct record and signed by the Chair.

The Board received a presentation by Mark Johnson and Raymond Humphryes from the Choice for All Doncaster (ChAD) support group and the Learning Disability Partnership Board (LDPB), supported by Cllr Glynis Smith and Annika Leyland-Bolton.  Mark and Raymond outlined their lived experience as individuals with a learning disability and also gave further information on the work of Doncaster’s LDPB.

Board members then asked Mark and Raymond questions about the work of the LDPB and on the actions that partner organisations and this Board could take to assist people with learning disabilities. 

Having discussed at length a wide range of issues arising from the presentation, the Board agreed the following actions:-

• That the partner organisations represented on the Board assist in raising awareness of and publicising the LDPB to help the Board increase the proportion of service users/carers amongst its membership (information to be circulated to Board members for dissemination);
• That all partner organisations consider utilising Mark and Raymond’s expertise in any workforce training events on the subject of Learning Disability and Autism.
• That partners give consideration to ways of encouraging newly qualified nurses with dual registration in learning disability and social work to work in Doncaster.
• Raise at Place Committee to discuss how to ensure that the LDPB is connected to decision making.
• With regard to commissioning and contracting and ensuring social value requirements reflect the aspirations of the LDPB – Rachael Leslie will ask to be invited to a future meeting of the Partnership to discuss.
• The Chair stated that she would like to have a conversation outside the meeting with Mark and Raymond about Due Regard Statements.
• That an update on this issue be brought back to the Board’s meeting in November.

RESOLVED to note the contents of the presentation and agree that the above actions be taken forward by the relevant Board members.

The Board received a presentation by Dr Victor Joseph which summarised the findings set out in the Annual Report on Ethnic Minority Health in Doncaster, produced by the Doncaster Minority Partnership Board, a copy of which was included in the agenda papers.

It was noted that the Annual Report of the work of the Minority Partnership Board supported actions to address health inequalities in Doncaster by addressing challenges identified through national disparity reports as well as from health needs assessment reports and recommendations.

The Report provided updates on achievements, challenges and actions being undertaken in Doncaster to improve health and reduce health inequalities among local minority groups.

During discussion, Members noted that there was a gap in terms of collecting lower-level ethnicity data and the ‘big ask’ of partners was to consider how the data already held could be used in a more efficient way to provide a clearer picture of the needs of minority groups in Doncaster.  There was also scope for strengthening the strategic links between the Minority Partnership Board and partner organisations. 

Arising from this discussion, the Chair proposed that a SMART action plan be produced and circulated to Board members as soon as available to help ensure that the issues raised were addressed.

            RESOLVED to:-

1.         Note the achievements and challenges still being faced in improving and protecting the health of minority groups in Doncaster; and

2.         Support actions to address the challenges for improving health and addressing health inequalities among minority groups in Doncaster.

3.         Request that a SMART action plan be produced and circulated to all Board members as soon as available to help ensure that the issues raised are addressed.

The Board received a presentation by Ailsa Leighton which outlined how the Five-Year NHS Joint Forward Plan (JFP) for South Yorkshire had been developed.

During discussion, Councillor Nigel Ball expressed concern over the low levels of consultation and engagement with the public/stakeholders during the development of the Integrated Care Strategy, and he stated that he also had concerns over whether the strategy and plan could be delivered in the face of current challenges.  In response, Ailsa Leighton acknowledged that there was more to be done in terms of engagement and she stated that it was recognised that this needed to be continued on an ongoing basis with local communities. 

The Board noted that Healthwatch Doncaster had been commissioned to assist in enhancing the consultation and publicity.  Arising from discussion, Fran Joel offered to provide a report produced by Healthwatch for circulation to the Board which would give more detail on the engagement work undertaken in Doncaster to ensure all communities had an opportunity to engage.

Members also discussed the importance of producing an ‘easy read’ version of the JFP and of ensuring that the JFP was co-produced by stakeholders/communities.  The Chair spoke of the need for the JFP to be honest and realistic in terms of its ambition and acknowledging the challenges that the NHS was currently facing and the impacts these were having on service delivery for patients.  She also fully supported the previous comments that the Plan should be co-produced and made available in an ‘easy read’ format.

After Ailsa Leighton had confirmed that she would feed these comments back to the ICB and that a further update would be brought to this Board later in the year, it was

RESOLVEDto:-

1.       Note the engagement work to date, which builds on the approach taken to inform the Integrated Care Strategy; and

2.       Note the work underway to develop the initial Five-Year NHS Joint Forward Plan for South Yorkshire.

The Board received the Second Annual Report of the Doncaster Health and Wellbeing Board (2022-23) for the Board’s comments and endorsement, prior to it being presented to the Full Council in July 2023.

Louise Robson informed Members that this was the second Annual Report for the Health and Wellbeing Board, and it highlighted the work of the Board during the last 12 months since the last report in July 2022. She stressed that this was still a work in progress and that several typographical errors had been identified and would be rectified prior to publication.  The report was only a small snapshot of the ongoing work across some of the partner organisations to improve the health and wellbeing of the Doncaster population. The key going forward would be to build on the foundations of this Report and to address the health inequalities/priorities and to ensure that the work plan for the next year for the Health and Wellbeing Board reflected real needs and addressed those gaps.  In concluding, Louise summarised the next steps and recommendations that were set out at the back of the Annual Report.

In referring to the next steps/recommendations in the Report, Rachael Leslie advised that an additional action would be included in relation to the production of an easy read version of the Health and Wellbeing Strategy.

The Chair suggested that it would be useful if all partner organisations could take the Board’s Annual Report to their respective meetings for formal consideration and discussion, following its sign off in July.

RESOLVED to note and approve the contents of the Annual Report for final sign off by Full Council at its meeting on 13^th July 2023.

The Board received a presentation by Mike McBurney in relation to confirmation of end of year Better Care Fund (BCF) 2022/23 activity reporting and agreeing formal sign off of the BCF end of year template for 2022/23 by the Board as the accountable governance body for BCF locally.

It was noted that, broadly speaking, the BCF’s aim was to make the most efficient use of health and social care resources by breaking down organisational barriers.  In doing so, it assisted people to live independently in their communities for as long as possible and to deliver the right care, in the right place, at the right time.

During discussion, it was noted that the BCF Plan for 2023-25 would be brought to the Board’s next meeting in August for consideration.

With regard to the performance indicator for the proportion of people discharged to usual place of residence (target 92.9%), which was shown as being on track to meet the target (performance 94.36%), Phil Holmes felt that there was scope for reviewing this target and improving performance even further against this indicator.

RESOLVED to note and consider the impact of BCF activity with regards to performance, income and expenditure during 2022/23 and formally agree sign off of the end of year template 2022/23.

The Board received an update from Andy Brown on the process and timeframe for developing the refreshed Health and Wellbeing Strategy.  It was noted that the Board’s views were being sought on the amount of detail to be included in the content of the Strategy and on the timeframe for which the Strategy should cover.

With regard to the proposed time period to be covered by the Strategy, members generally felt that it would be useful if this could be set at five years so that it mirrored that of the five-year NHS Joint Forward Plan.

In relation to content, members were of the view that a strong Health and Wellbeing Strategy was needed in its own right, rather than being light in detail or mainly signposting to other existing plans/strategies.

The Board also felt that the Strategy should be co-produced with a strong focus on lived experience and local issues in Doncaster, such as life expectancy of women.  On this issue, the Chair proposed that a multi-agency supporting group focussing on lived experience be established to assist in the development of the Strategy.

RESOLVED that, subject to the above comments/actions, the update and proposed timeframe for development of the Health and Wellbeing Strategy be noted.

The Board received and noted the minutes of the Health Protection Assurance Group meeting held on 19 April 2023.

The Board received and noted the Report of the Doncaster Safeguarding Children Partnership for the period October 2021 – March 2022.