Hampshire County Council Health and Wellbeing Board Meeting

Apologies were received from Alex Whitfield, Penny Emerit, Jason Avery, Donna Jones (Terry Norton attended as the substitute member), Dr Nicola Decker (Dr Rory Honney attended as the substitute member), Gill Kneller and Dr David Chilvers.

Members were mindful that where they believed they had a Disclosable Pecuniary Interest in any matter considered at the meeting they must declare that interest at the time of the relevant debate and, having regard to the circumstances described in Part 3, Paragraph 1.5 of the County Council's Members' Code of Conduct, leave the meeting while the matter was discussed, save for exercising any right to speak in accordance with Paragraph 1.6 of the Code. Furthermore Members were mindful that where they believed they had a Non-Pecuniary interest in a matter being considered at the meeting they considered whether such interest should be declared, and having regard to Part 5, Paragraph 2 of the Code, considered whether it was appropriate to leave the meeting whilst the matter was discussed, save for exercising any right to speak in accordance with the Code.

The minutes of the meeting held on 17 March 2022 were agreed as a correct record and signed by the Chairman.

There were no deputations.

The Chairman shared a video from Park Community School, in partnership with Energise Me, entitled ‘Journey to Health’. Having been awarded Government funding to make use of school facilities outside of school hours, the School had worked with members of the local community to develop their fitness, confidence and overall health and wellbeing.

The Chairman also noted the upcoming changes to the way in which health care was due to be commissioned with the introduction of Integrated Commissioning Boards and the removal of Clinical Commissioning Groups. Members noted that this required a change in membership on the Health and Wellbeing Board as set out within the County Council’s Constitution. The Chairman reported that a report was being prepared for Cabinet and would then go on to Council to agree this Constitutional update.

The Chairman was pleased to announce that a welcome event would shortly be held for Afghan evacuee families, both those permanently resettled and those who remained living in bridging hotels in Hampshire.

It was with regret that the Chairman announced that Dr Barbara Rushton, the Vice Chairman, would be stepping down from the Board. The Chairman noted the outstanding contribution that Dr Rushton had made in her time on the Board and Members echoed her thanks and noted how Dr Rushton would be missed.

The Chairman suggested that the election of a Vice Chairman be deferred to the next meeting of the Board to allow for expected membership changes. The Board agreed to defer this item to the next meeting.

The Board received the report of the Director of Public Health with an update on Hampshire's Joint Strategic Needs Assessment considering the current and future health and wellbeing needs and inequalities within the population.

In particular, the report focused upon inclusion health groups across Hampshire and how these groups are identified and what challenges they may have to accessing healthcare. It was noted that health groups were more likely to experience poor health outcomes.

In response to Members’ questions, it was noted that:

·       The Core20PLUS5 programme (a national NHS England approach to support the reduction of health inequalities) had proven particularly useful in enabling and encouraging conversations within health settings.

·       Building trusted relationships with health groups, specifically within traveller communities, was very important as there remained scepticism and anxiety about accessing health services.

The Director of Public Health encouraged members to share the report within their respective organisations.

RESOLVED:

That the Health and Wellbeing Board note the report and that Members take information and actions within their own organisations and sections that they represent.

The Board received the report of the Board sponsor for the Living Well theme providing an update on the priorities and progress of the Living Well strand of the Health and Wellbeing Strategy.

The report covered topics including post Covid pandemic updates, actions taken to reduce smoking, self-management of health needs and co-production. The report also outlined the importance of digital tools in delivering care and the focus on early intervention and prevention.

Members discussed the topic of self-management in relation to hypertension patients and empowering individuals to monitor their own health needs. It was noted that Frimley CCG (North East Hampshire) had the highest figures nationally for patients with high blood pressure and was working within the community to increase awareness of the available services.

In response to Members’ questions, it was noted that:

·       It was worth being mindful of the opportunity to promote health services in different settings. In particular, it was anticipated that footfall within libraries would increase through the winter period and that could provide an opportunity to reach out to a different part of the population regarding health and wellbeing.

·       The 2025 ‘switch to digital’ would mean that all analogue devices would be unusable. This national rollout would be a significant campaign and that it would be important to consider the impact on residents and the messaging and communication around this.

·       Whilst the Council’s Children’s Services department and HC3S strongly encouraged healthier meal choices and locally sourced produce, the Board heard that schools were autonomously managed and therefore made their own decisions linked to meal choices and the promotion of healthy lifestyles within their settings.

·       The existing community pantries across the County could provide a valuable opportunity for use as health hubs, enabling conversations and providing some services such as blood pressure testing.

·       When considering planning permissions/town planning (in particular linked to permissions for fast food outlets), District and Borough Authorities did have a duty to consider health and wellbeing in developing healthy places. It was noted, however, that there was only so much that could be achieved by Local Authorities alone and that influencing the way that developers create new places was a more challenging factor.

·         In response to a question regarding public play areas and installing fitness equipment, the Board heard that seeking to influence everyday behaviours to incorporate regular exercise was more valuable and sustainable than creating destinations for exercise alone.

RESOLVED:

That the Health and Wellbeing Board:

i)             note the reduction in the numbers smoking at delivery but the need to keep focus on this area.

ii)            note that although two thirds of people set a smoking quit date after 4 weeks there is always more that could be done and more targeted interventions are being employed.

iii)           support and promote the Healthy Weight strategy within their organisations including working collaboratively through a whole system approach.

iv)           ensure their organisations are sighted on and contribute to the Hampshire Physical Activity Strategy implementation.

v)            note the various self-management tools open to clinicians and the public to support them in their conditions.

The Board received the report of the Director of Public Health providing an update on the progress of ongoing work to support the delivery of the Joint Health and Wellbeing Strategy.

The report provided a performance review of each theme of the Strategy and some of the key updates were set out as below.

Starting Well theme

The Board noted the post pandemic pressure on children and young people’s mental health with a significant increase on referrals to CAMHS. Members discussed their collective concern regarding this mental health crisis and noted how this was affecting not only acute services and hospital bed availability but also the range of services provided by Local Authorities. It was agreed that the Board would write to the ICS to strongly set out their concerns and request that this be urgently reviewed as a priority. It was suggested that other local Health and Wellbeing Boards also be contacted to ensure that the ICS received a joint message.

Ageing Well theme

The Board noted the post pandemic relaunch of the falls prevention programme and supporting better continence initiative. Members received an update on technology-enabled care and digital enablement for older people including the cobots programme. It was also noted that the Hampshire Fire and Rescue Service ‘Safe and Well’ visits (free fire safety home visits) had proven valuable opportunities to visually check on the wellbeing of older residents at the same time as conducting the fire check within their homes.

Dying Well theme

The Board heard how workstreams were progressing for both Frimley and Hampshire and Isle of Wight ICS’s on end of life care. In particular, updates were received on community engagement; adopting a multicultural understanding and working with groups with learning disabilities. Members heard how hospice services would be reviewed in response to the pending Health and Care Bill.

Healthier Communities theme

Members heard that the Healthy Homes working group were taking forward their recommendations which had included a successful workforce development programme on healthy homes. Work had been conducted with town and transport planners towards more healthy environments. The Board also noted the ongoing recovery work with District and Borough Authorities post pandemic.

The priorities and progress under the Strategic Leadership and Living Well themes were covered under other business items on the agenda.

RESOLVED:

That the Health and Wellbeing Board:

i)             note the update, progress, and upcoming priorities of the Board’s work.

ii)            actively share the report with constituent members’ boards and committees to ensure further engagement and development of the plan for 2022/23.

iii)           agree for all Board Members to share progress on areas of priority to include in the final report for the Health and Adult Social Care Scrutiny Committee.

The Board received the report of the Hampshire and Isle of Wight and Frimley ICS’s providing an update on their development and implementation.

Members discussed the distinction between the different boundaries and how it would be important to have a whole Hampshire focus despite the geography of the county being split across the two ICS’s. It was noted that North East Hampshire and Frimley had appointed a Director of Healthier Communities with the aim to ‘blur’ the governance boundaries to enable enhanced and improved health outcomes.  

It was noted that having two ICS’s covering one Hampshire area meant a slight risk that the population may be considered differently and there was a need to ensure consistency of care across Hampshire. Members discussed the opportunity for the Board to support the development of both ICS’s and possibly creating a strategic Hampshire assembly whereby messaging can be transferred to both ICS's preventing a duplication of work.

The Board noted the statutory appointments for the ICB’s and ICP’s but that there was no representation from the voluntary sector. There was consensus among Members that further clarity was required as to the membership and also on the issues that would need ICS consideration. Members recognised the important part that the Board would play in supporting the ICS’s as they continued to develop. The JSNA for Hampshire, identifying health and care needs, was also noted as a key document.  

RESOLVED:

That the Health and Wellbeing Board:

i)             receive the report and note the direction of travel and ongoing development work ready for 1 July 2022.

ii)            work with other key partners to ensure the role of the Health & Wellbeing Board is clearly defined in the emerging governance framework.

The Board received the report of the Director of Public Health with an update on the Hampshire Pharmaceutical Needs Assessment - a statement of the needs for pharmaceutical services of the population in the county.

It was reported that, following a public consultation and survey of Hampshire pharmacies, data was currently being analysed with findings will be presented in the final report and emailed to Members for final approval and publication.

Members also noted that further information was required on hearing services to enable individuals to see where they could access services. It was noted that pharmacy, optometry and dentistry services would be transferring to the ICSs from NHS England.

RESOLVED:

That the Health and Wellbeing Board consider the update and support the work programme.

The Board received and noted the Forward Plan outlining the future agenda items for upcoming meetings.