Agenda and minutes

Please note: if the alarm sounds during the meeting, everyone should please exit the building via the way they came in, via the main entrance lobby area, and then the front ramp.  Please then assemble on the paved area between the side entrance of the cathedral and the roundabout at the Deanery Road end of the building.

If the front entrance cannot be used, alternative exits are available via staircases 2 and 3 to the left and right of the Council Chamber.  These exit to the rear of the building.  The lifts are not to be used.  Then please make your way to the assembly point at the front of the building.  Please do not return to the building until instructed to do so by the fire warden(s).

Apologies were received from:

Keith Sinclair

Robert Woolley

Julia Clarke > Tony Page substitutes

Eva Dietrich > Stephen Parker substitutes

To note any declarations of interest from the Councillors.  They are asked to indicate the relevant agenda item, the nature of the interest and in particular whether it is a disclosable pecuniary interest.

Any declarations of interest made at the meeting which is not on the register of interests should be notified to the Monitoring Officer for inclusion.

None

Up to 10 minutes is allowed for this item

Any member of the public or Councillor may participate in Public Forum.  The detailed arrangements for so doing are set out in the Public Information Sheet at the back of this agenda.  Public Forum items should be emailed to democratic.services@bristol.gov.uk and please note that the following deadlines will apply in relation to this meeting:-

Questions - Written questions must be received 3 clear working days prior to the meeting.  For this meeting, this means that your question(s) must be received in this office at the latest by 5 pm on 11 July 2019

Petitions and Statements - Petitions and statements must be received on the working day prior to the meeting.  For this meeting this means that your submission must be received in this office at the latest by 12.00 noon on Tuesday 16 July 2019

The following items of Public Forum were received:

1.     Statement on Air Quality and Asthma

2.     Statement on air pollution during major events

3.     Statement on St Paul’s Adventure playground

These statements were noted by the board.

The board discussed the appropriateness of the statements received for the Health and Well Being Board. For example, HWB does not have jurisdiction over licencing for major events or funding for playgrounds. Statements to be reviewed and redirected to the relevant forums for action.

To agree the minutes of the previous meeting as a correct record.

The minutes of the 27 March 2019 Health and Well Being Board were agreed as a correct record.

The action for “CG to create a Bristol Health Scrutiny Forum” should read “CG observed that it would be helpful to have a Bristol Health Scrutiny function, this matter to be raised with the Scrutiny Team”. This action has been completed.

For decision and strategic oversight

Alan Stubbersfield, BCC Director of Education introduced the SEND Strategy paper.

·       BCC are expecting an Ofsted inspection on SEND imminently. In anticipation of this inspection BCC is drawing together self-evaluation data. The proposal is that HWB provide governance for  SEND, as recommended in the SEND Code of Practice. The themes in the Send Strategy are very important.  Early Identification is not based on age checkpoints, it is more flexible to individual needs. Participation is about increasing voice of service users so we can build around them.

·       The strategy recognises robust quality assurance needed, especially in areas that have proven stubbornly difficult to deal with. Ofsted inspection framework indicates a strong preference for joint commissioning and co-production.

·       The Board noted that there has been a large amount of negative feedback from parents on SEND issues. In this region there is increased level of satisfaction but no decrease in dissatisfaction. There is level of dissatisfaction, for both national and local reasons. A lack of funding for reforms mean they did not deliver properly. Lobbying to central government has secured a £350m fund but this is unlikely to be sufficient. Locally, delivery of assessments has been problematic, due to increased demand and legal issues. Decisions have been made to increase capacity for these assessments.

·       Members raised concerns about the strategy being heavily focused on dealing with current issues. While this is important, horizon scanning for future issues is also essential, e.g. the need to increase provision for autistic children was correctly identified 5/10 years ago.  

·       There have been recent cabinet reports to on SEND capital planning and there are 3 new schools are in the pipeline which will require SEND provision. Further Education colleges have been successful with SEND issues. 

·       There was a discussion about the importance of integrating SEND children into their communities. SEND integration in an urban environment presents particular issues.

·       Justine Rawlings on behalf of the CCG requested a minor amendment to the front page of the strategy.

It was resolved that Health and Wellbeing Board approve the recommendations as set out in the report:

1. The Health and Wellbeing Board noted the contents of the Bristol Local Area SEND Self-Evaluation and endorse its publication.

2. The Health and Wellbeing Board adopted the Bristol Strategy for Children and Young People (0-25) with Special Educational Needs and Disabilities 2019-2021, and endorse and promote its publication (subject to minor amendment requested by CCG).

3. The Health and Wellbeing Board agreed the governance arrangements for the oversight of outcomes for special educational needs and disabilities, as outlined in the SEND Strategy.

Board oversight: (Verbal update as agreed at last meeting) Clarity of role and purpose of the board strategic leadership for Health and Wellbeing Board – decision, oversight, statutory duties.

[Alison Bolam / Helen Holland]

A verbal update was given on the role and purpose of the strategic leadership for Health and Wellbeing Board including decision making, oversight and statutory duties.

This included such items as publication of the JSNA, overseeing integration, better care fund, SEND strategy and receiving and responding to health protection issues.

For decision: Approval of the HWBB Plan on a Page

[Christina Gray]

Christina Gray led a discussion on the Health and Well Being Board “Plan on a Page”. This version follows feedback gathered at the recent HWB development session. This plan on a page will be supported by a strategy document that will be produced at a later date.  

·       The overarching aims are “By 2050 everyone in Bristol will have the opportunity to live a life in which they are mentally and physically healthy”, “Mental health will be as important as physical health in Bristol”, “Health inequalities will be reduced” and “Children will grow up free of adverse childhood experiences having had the best start in life and support throughout their life.”

·       The 5 blocks at the top of the page describe the statutory duties of the board. It is important that these are always in sight and maintained.

·       HWB also needs to plan to deliver this year’s ambitions, so there are 6 pillars that represent areas of focus for this year. The first is direct health-related ambitions from the One City Plan. The second is Health in Wider Determinants, representing ambitions in the One City Plan where HWB can add real value. Middle two pillars are for Healthier Together, delivering prevention and integrated care. Final two are about leadership and oversight.

·       Although these have been agreed at the development session, they are a work in progress and all members can input. This is a HWB champion in each block to make sure we have leadership in each area. Champions do not necessarily need to be subject matter experts in their area.

·       There is also a draft performance framework dashboard. RAG rated, with red areas signifying no progress with significant impact. . Alongside this is a work stream reporting framework to collect, monitor and report back data. Each work stream has a lead to deliver, those people will be asked to complete. Public health will support the performance function.

It was resolved that Health and Wellbeing Board approve the recommendations as set out in the report:

1.     The Health and Wellbeing Board approved the Plan on a Page and adopt this as the framework for the new Health and Wellbeing Strategy.

2.     The Health and Wellbeing Board endorsed the named Board member champions for the pillars of the Plan on a Page.

3.     The Health and Wellbeing Board approved the Health and Wellbeing Board Delivery plan against which to measure progress.

For strategic oversight: Thrive Bristol

[Leonie Roberts / Victoria Bleazard]

A presentation on THRIVE was given by Leonie Roberts and Victoria Bleazard.

·       THRIVE would like HWB members to disseminate messages and actions to their contacts in hospitals, schools, etc. to ensure that health organisations are exemplary in terms of mental health.

·       BCC has been making good progress despite limited resources, but needs to make THRIVE city wide. We are seeing culture change being driven by employers, which is very positive. Plan is to have strong online presence for THRIVE to show what is available in Bristol, such as accessing first aid mental health training.

·       Laurence Pitt (BCC) is doing mental health work in schools. It would help to bring these work streams together. Schools are really embracing this.

·       Wellspring community mental health is reaching out into different groups to challenge stigma on mental health. Good timing for THRIVE campaign. In more recent times the drive is coming from the community, e.g. Somali, Bengali, working to create a health network for support.

·       Ward Councillors are very well placed to promote THRIVE and should be champions for their own areas.

·       Briefing pharmacy workers may be helpful due to the public being directed to pharmacies to relieve pressure on GPs. 

·       Very important for THRIVE to get a web portal up and running so members can signpost to it

·       Involve Andrea Dell so she can leverage her contacts in the One City Plan

ACTION JR to find out publication timeline for the mental health strategy to see if THRIVE can be integrated.

ACTION LR/VB to write draft letters for members to amend and disseminate to their organisations and contacts.

Strategic leadership: (Verbal update) HWB contribution to the One City Plan

•          City Gathering

•          Many Neighbourhoods; One City

[Alison Bolam / Sally Hogg]

Alison Bolam and Sally Hogg gave a verbal update on the One City Plan.

·       There was arecent One City gathering attended by approximately 200 people.. This involved the six thematic boards (HWB is one of these). Delegates got allocated to various boards to learn what each of them did. All board chairs have identified sustainability as an issue across all sectors. Some boards have objectives that may not initially seem like a good fit but can add value. For example HWB have taken ambition of a 30% carbon neutral fleet. There was a very diverse group of people in the audience. E.g. Owner of a tyre business explained how tyre design affects air pollution.

·       There was also a One City Event at Kingsweston House. This was about making the OCP accessible to communities, letting them know what they can do and  breaking it down to show how individuals and small groups can make a difference. E.g. taking personal action that can assist with clean air or sustainable food objectives. Different elements will speak to different people. Design your own solutions. This is what the OCP is trying to do, how do you think could be achieved?

ACTION SH to circulate notes of recent One City Plan meetings to HWB members

Strategic leadership: (Verbal update) Joint working across the region: 

•          BNSSG Joint Health and Wellbeing Board Workshop

•          SW Health & Wellbeing Board Network Annual Conference, including the Wigan Deal

•          SW Health & Wellbeing Board Conference feedback

[Helen Holland / Asher Craig]

The Board received a verbal update on Joint Working across the region from Helen Holland and Asher Craig

·       BNSSG Joint Health and Wellbeing Board Workshop: The second of these workshops was held recently. It looked at shared priorities and differences across the region and long term planning in NHS. The challenge is to balance all the different health meetings and avoid duplications. However there was heartening feedback from Julia Ross that suggestions from HWB were being adopted.

·       SW Health and Wellbeing Board Network Annual Conference: Was some interesting topics, including the conflicting jargon and terms in health organisations that inhibit joint working. There is an LGA offer for HWB continuous improvement.

·       The Wigan deal is to improve outcomes with community led interventions. This is about co-production, moving away from grants. Wigan is 7 years in to this programme. It is from ground up and community led. Penny Germon in BCC is doing community development piece at the moment, HWB should support her in that. We need to examine the practicalities of co-working now, e.g. how to integrate GPs.  Communities need a framework that they can apply to any department or organisation. Looking to eliminate the ‘not us’ and turn this into ‘how can we help’.

ACTION TD and JR to update HWB on how PCNs work in communities

Statutory duty (Verbal Update)

•          Feedback from Healthier Together Programme Board

[Helen Holland]

The board received a verbal update on the recent Healthier Together Programme Board meeting. This is a new governance board that HWB chairs sit on. They will be held quarterly. At this meeting, the agenda was agreement of the Terms of Reference, Financial Recovery and a 5 year engagement strategy. It is important for HWB to understand where policy is being developed and decisions made so it can feed in.

ACTION AC to check whether the minutes for the Healthier Together Programme Board can be distributed to Health and Well Being Board members

[Christina Gray]

The HWB forward plan was discussed.

August dev session: Data and intelligence to inform decisions, wider determinants, One City Plan and fuel poverty

Sep formal session: Alive Bristol ,Better Care Fund

October: Dev Session:  Focus on housing for vulnerable people. It is important that the Cabinet Member and Director for Housing are able to attend.

AC asked to provide an update on HIV/AIDS at the August session.

ACTION SUMMARY

• JR to find out publication timeline for the mental health strategy to see if THRIVE can be integrated.
• LR/VB to write draft letters for members to amend and disseminate to their organisations and contacts.
• SH to circulate notes of recent One City Plan meetings to HWB members
• TD and JR to update HWB on how PCNs work in communities
• AC to check whether the minutes for the Healthier Together Programme Board can be distributed to Health and Well Being Board members
• TD and JR to update HWB on how PCNs work in communities