Agenda and minutes

In terms of membership, the Board is asked to note that since its last meeting, Ellen Devine has left her position as the HealthWatch representative on this board (her replacement is Vicki Morris, CEO  of the Care Forum). 

Attendees were welcomed to the meeting.  Apologies were received from Mayor Rees, Linda Prosser and Vicki Morris.

Petitions and written statements (must be about items on the agenda):

Members of the public and members of the Council may submit a petition or

submit a written statement to the Health and Wellbeing Board.  These must be about items on the agenda for this meeting.

The deadline for receipt of petitions and statements for the 12 April Health

and Wellbeing Board is 12.00 noon on Tuesday 11 April.

These should be e-mailed to democratic.services@bristol.gov.uk

Please note: details of all petitions / statements submitted by the deadline will be sent to Board members in advance of the meeting.  Subject to time, anyone who has submitted a petition / statement will be given an opportunity to briefly present their petition / statement at the meeting.

Written questions (must be about items on the agenda):

Written questions may be submitted in advance of the meeting by a member of the public or a member of Council.  These must be about items on the agenda for this meeting.  A maximum of 2 written questions per individual can be submitted. The deadlinefor receipt of questions for the 12 April Health and Wellbeing Board is

5.00 pm on Thursday 6 April. These should be emailed to democratic.services@bristol.gov.uk

Please note: wherever possible (bearing in mind the limited time available in advance of the meeting for the preparation of replies), a written reply will be provided to a question at the meeting, and the questioner will then receive an opportunity to ask one supplementary oral question per question submitted. 

Maximum time allocation for public forum – 30 minutes

The following public forum items were received and noted:

·         Public forum statement from Mike Campbell on CCG/Sustainability and Transformation Plan update.

·         Public forum statement from Karin Smith on CCG/Sustainability and Transformation Plan update.

None.

To agree the minutes of the 15 February 2017 meeting as a correct record.

Resolved:

That the minutes of the meeting held on 15February 2017 be confirmed as a correct record and signed by the Chair.

To be presented by Richard Kelvey (Avon and Somerset Police), Vice-Chair of the Board and Becky Lewis, Bristol Safeguarding Boards Joint Unit Business Manager.

The Board considered the annual report and presentation from Bristol Safeguarding Adults Board.  The Independent Chair, Louise Lawton had extended her apologies and Richard Kelvey presented the report on her behalf.

The Board were asked to note the following from the report:

·         This is the second report from the BSAB since the establishment of the Board as directed by the Care Act 2014.

·         All of the last five SCRs/SARs involved adults with mental health needs living in the community (3 published in 2016, 2 underway).

·         The question - ‘is the current service provision sufficient for meeting the needs of adults with complex needs, including mental health, in the community?’

·         The question of who leads on the issue.

·         Some professionals have limited skills to support the needs of those with poor mental health.  The police have powers of arrest but this is not the  solution when addressing issues arising from the behaviour of a person with poor mental health.  Many police officers working in the field now have access to a specialist advisor to give guidance.  This problem is one encountered by other professions, for instance care workers and housing officers working in the community.

·         The other theme is one of vulnerable adults causing harm to one another, giving rise to the question of how best to assess the complex needs of a vulnerable adult living and sharing accommodation with others. 

·         Emerging theme – is the oversight of risk management arrangements for adults with mental health needs placed in supported accommodation in Bristol by other local authorities sufficient?

·         The challenge for all partners is to consider this question: ‘are we practiced in considering these issues and questioning the requirements of service users?’

·         Also acknowledged is the difficulty in keeping track of vulnerable adults.  Unlike the obligation to know the whereabouts of children in care, adults are able to move from region to region at will.  

·         The challenge amongst health professionals is who takes the lead to support the complex needs in this area.  Working professionals who come into contact with vulnerable adults with poor mental health require training / knowledge to support the needs of this group in society.

·         The learning from the SCRs will be shared between regional authorities and partners.

The following was noted from the discussion:

a.      The reporting of safeguarding concerns arising from care provided in hospitals and care homes appeared to have grown.  It was explained that the mechanism for reporting and recording has improved, therefore allowing for more informed data.  In turn, the data can be used to properly inform learning and training for the workforce.

b.      There continues to be a strong link between the incidents relating to vulnerable adults and poor mental health reflected in the SCRs.  The issue of vulnerable people obtaining access to the right care and receiving advice from professionals working in the community remains a challenge.  The CCG is strategically reviewing the issue of overall integration of services.

c.       Housing officers, when faced with the actions of tenants, for  ...  view the full minutes text for item 61.

To be presented by Martin Jones, CCG Chair.

The Board were asked to note the key developments of Bristol Clinical Commissioning Group (BCCG) and the Sustainability & Transformation Plan (STP) for Bristol, North Somerset and South Gloucestershire (BNSSG).

Dr Martin Jones, Bristol CCG Chair asked the Board to note:

·         The interrelated themes:-

o   Prevention, early intervention and self-care.

o   Integrated primary and community care.

o   Acute care collaboration.

·         The ‘checkpoint’ review by NHS England - the BNSSG STP has started the development of a number of specific proposals.  The programme of work includes:

o   Diabetes

o   MSK

o   Respiratory

o   Making Every Contact Count

·         Appointment of Julia Ross as the BNSSG Accountable Officer in role from the 2^nd May.

The following was noted / arose from the discussion:

a.      With the implementation of the BNSSG STP, the health landscape would change and the question was one of the future role of the Board.  The Board would need to be informed as things progress in order to determine the impact on the population of Bristol.

b.      Clear lines of governance – concerns were raised that the Board should ensure that this happens to avoid duplicating the work of BNSSG STP.  The Board should be engaged in supporting the right conversations taking place in the correct setting to avoid duplication in the regions and different boards.

c.       The Health Committees across the regions have met and intend to continue to work together.

d.      The STP Plan aspires to make better use of available resource; support the seamless sharing of services across partners; doing things better; the Board must continue to support the voice of Bristol. 

To be presented by Becky Pollard, Director of Public Health.

The Board were presented with a report on the Bristol Behaviour Change to Healthier Lifestyles Programme.

Becky Pollard, DPH introduced the report outlining the intention of the draft commissioning strategy.

The Board was asked to note the tight timescale running from May 2017 to completion in April 2018, and to agree the commencement of the 12 week formal consultation on the draft strategy.

Resolved:

-          To agree the consultation on the draft strategy.

To be presented by Katie Porter, Senior Public Health Principal.

The Board received a report updating them on the work underway to embed consideration of health and wellbeing in all relevant strategies and policies by targeting the factors that affect health.

Katie Porter presented the report and highlighted:

·         The 10 year life expectancy gap between residents living in certain wards in Bristol, i.e. depending on where people live.

·         The 16 year healthy life expectancy gap between the least and most deprived areas of Bristol.

·         People in these deprived areas not only die early, but before their death live with poor health for longer than people in the least deprived areas.

·         There are approximately 60 strategies and policies across Bristol that affect people’s health.

·         The strategy to embed HiAP would require:

o   Supporting the use of health impact assessments in new strategies and policies.

o   Working with teams drafting policies and strategies to determine health impacts and optimise the impacts to benefit health outcomes.

o   Set up a template to undertake health equity assessments during a commissioning process.

·         The Public Health team have the skills to carry out health impact assessments and support, train and encourage others to do so.

·         Consult with other DPHs in the West of England region to consider their joint input into devolved authority around HiAP to ensure that the strategic plans for economic development, transport and the spatial plan achieve the best health outcomes possible.

The following points were raised:

a.      It was confirmed that the intention was to share this practice with partners but first to start with Bristol City Council.  The learning from the strategy development would then be shared.

b.      HiAP is established practice in Wales and is a consideration for all Welsh legislation.  This is managed with the use of cross-department key performance indicators.

c.       The strategy would sit well in a task & finish work group to establish an agreed approach amongst partners.

d.      It was agreed that work be undertaken to map out the central theme for the strategy and feed it into a workshop for final outcome.

To be presented by Beth Bennett-Britton, Public Health Registrar and Sally Hogg – Consultant in Public Health.

The Board received a report and presentation from Beth Bennett-Britton, Public Health Registrar and Sally Hogg, Consultant in Public Health, updating members on the progress in developing a Healthy Weight Strategic Plan for Bristol.

The following was noted from the discussion:

a.      The question of how the success of the strategy would be measured and its impact on communities in areas of deprivation.  Measuring outcomes falls within the remit of the terms of reference of the Healthy Weight Group.  The group will oversee the implementation of an action plan that has SMART objectives.

b.      A number of outcomes would be realised over a 3 – 5 year period such as a reduction in childhood obesity and a move to increase individuals’ activity.

c.       The programme requires the endorsement of the Board to allow for this to be reflected in all areas of the strategy.  The strategy objectives support a number of the Health & Wellbeing Board priority areas.

Resolved:

1.      To note the update.

2.      To endorse the strategy.

To be presented by Becky Pollard, Director of Public Health.

Becky Pollard, DPH addressed the Board on the report outlining the Pharmaceutical Needs Assessment.

Main points raised/noted:

a.      The production of the PNA is a statutory requirement transferred to the local authority under the Health and Social Care Act 2012.  There is a statutory requirement for the PNA to be updated every 3 years and it is next due for refresh in March 2018.  The duty includes a requirement to engage in a minimum 60 day consultation period.

b.      The report outlined the uses of the PNA by NHS England and the way it is used as a point of reference.

c.       The PNA must be completed in collaboration with the other regional authorities.

d.      There was general concern about NHS England using the plan to determine the needs of the Bristol region for pharmacists. Pharmacists are engaged with supporting the strategies of Public Health and lesser provision would impact on many programmes.

The Board agreed to note the work to be undertaken.

Author: Michele Farmer – Service Director – Early Intervention & Targeted Services

Carole Watson, Bristol City Council presented the information report and spoke to the presentation.

The report:

·         Provided an overview of the statutory duties of the local area with regard to children, young people with Special Educational Needs and Disability (SEND) and their families as required through the Children and Families Act, known as the SEND reforms.

·         Update on the self-evaluation and progress of the SEND reforms.

·         Sought to raise awareness of the local area inspection framework.

The Board agreed to note the report.

Report author: Guy Fishbourne, Sport & Physical Activity Development Manager.

This report informed the Board on the position with the award of the European City of Sport 2017 and the impact on Bristol.

The Board agreed to note the report.