Agenda and minutes

Dr Alison Bolam is chair for this meeting.

The Chair for the meeting, Alison Bolam, welcomed all parties to the meeting and asked everyone to introduce themselves.

The meeting noted the following apologies and substitutions:

Committee Members

Tim Keen attending for Evelyn Barker who sent her apologies

Cathy Caple attending for Robert Woolley who sent his apologies

David Jarrett sent his apologies

Hugh Evans sent his apologies

Officers

Mark Allen sent his apologies

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.

There were no Declarations of Interest.

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

The minutes of the meeting held on Wednesday 28^th October 2020 were agreed as a correct record subject to the following amendments:

Agenda Item 10 -  Minutes of 281020 HWBB Meeting – Rewording First Part of Bullet Point (i) to More Accurately Reflect What Was Said by Tim Keen

Tim Keen advised said there were regulations on charging to be followed and acknowledged that presentation raised some areas where there could be improvements for identifying chargeable patients. In addition, he indicated that he could facilitate a conversation about whether more data sharing  could help improve the system.

Also that the minute is amended to clarify that the second sentence referring to “The need to better identify the status of patients and distinguishing those who are travelling just for free health care” was made by Councillor Asher Craig.

Page 7 281020 Minutes – Paragraph (b)

The reference to University of Bristol Hospital to be amended to read University Hospitals of Bristol and Weston.

Up to 30 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 5pm on Thursday 21^st January 2021.

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 Noon on Tuesday 26^th January 2021.

The statement should be addressed to the Service Director, Legal Services, c/o

The Democratic Services Team, City Hall, 3rd Floor Deanery Wing, College

Green, P O Box 3176, Bristol, BS3 9FS or email - democratic.services@bristol.gov.uk

Anyone who wishes to present their public forum statement, question or

petition at the zoom meeting must register their interest by giving at least two

clear working days’ notice prior to the meeting by 2pm on Monday 25^th January 2021.

PLEASE NOTE THAT IN ACCORDANCE WITH THE NEW STANDING ORDERS

AGREED BY BRISTOL CITY COUNCIL, YOU MUST SUBMIT EITHER A

STATEMENT, PETITION OR QUESTION TO ACCOMPANY YOUR REGISTER TO SPEAK.

There were no Public Forum requests.

To note the draft forward plan.

The meeting discussed the Forward Plan and noted the following:

·       A Stakeholder event would be taking place at 10am to 12pm on Tuesday 2^nd February 2021. 189 people would be attending. One of the issues to be discussed would be the importance of COVID vaccinations. In addition, there would be discussion of Health and Care Integration and Mental Health issues.

·       At the webinar on Tuesday 26^th January 2021, over 500 people had watched from 875 who had signed up to attend and over 400 questions had been asked. There had been a turnout of 47% amongst the BAME community from those who had signed up. A great deal of thanks had been passed on for this event which had helped dispel the most common myths about it. Everybody who signed up would receive a copy of the presentation. It was agreed that all stakeholders would be sent a link to the event.

·       The next development session was scheduled for 2.30pm on Thursday 25^th February 2021 and would discuss City Funds

·       A City Gathering would take place at 10am to 1pm on Friday 12^th March 2021

·       The next full Board meeting was scheduled for Thursday 18^th March 2021 and would include a closed session beforehand at 1.30pm on the Drug and Alcohol Strategy

·       A HWBB Development Session was also scheduled for 22^nd April 2021

·       Christina Gray referred to the short JSNA which was available with framework intelligence. It would be helpful to update this and use it ACTION: Mark Allen to add to Forward Plan

A verbal report will be given on the day as there will be up to date data.

Christina Gray,  Director for Communities and Public Health, gave a verbal report on this issue as follows:

•            The number of cases are starting to level out from the third wave which had been the most difficult period so far. The rate of reduction in rates has been slower than during the second wave.

•            The south west R Number is now moving below 1 but there is still a need to get this much lower.

•            Rates remain high and the pressure on hospitals remains challenging

•            13,000 tests were being carried out a week (15,000 had been carried out at peak)

•            The positivity rate is currently around 10%. In Summer 2020, it had been below 1%

•            The high rates in south Bristol reflect the fact that many people have come forward to take a test even though it may be challenging for people financially.  

•            Christina emphasised the importance of people to come forward for testing as this is how we can see where the virus is and take steps to stop it spreading.

•            The reduction in the infection rate indicates that the interventions of the lockdown are effective.

•            However, there is still a need to keep driving down background rates of infection as these are still incredibly high. For contact tracing to be effective rates need to be much lower.

•            The vaccine is being rolled out to cohorts 1 to 4. These first four groups account for the majority of severe illness and mortality

ACTION: that the priority list of the first four cohorts and analysis of clinical risk is circulated to HWBB Members

•            Cohort 1 – Care Homes and Staff. Almost all of these had now received the vaccine – 100% of residents and all staff would shortly receive it

•            Cohort 2 – Over 80’s. Well above 80% had now received this vaccine via local hospitals and the mass vaccination centre.  All Health and Social Care Staff would also receive it

•            The next to receive it would be based on age and the clinically extremely vulnerable

•            There was sufficient vaccine with a clear clinical plan to deliver it using the best health care system in the world. The local system was very good in delivering it

•            All people needing the vaccine would be invited to attend for an appointment based on a clinical analysis of who is at risk

•            A number of at risk groups, including people with learning difficulties and other extremely vulnerable groups, would be in the next cohort to be vaccinated. Equality and equity would be at the core of the process

It was also noted that GPs and Sirona were already delivering for over 80s patients who were housebound. The local system had already received a letter from Matt Hancock thanking them and congratulating them for having one of the highest vaccination rates in the country of over 80% of care homes.

The following comments were also made:

•            The recent  ...  view the full minutes text for item 140.

The Board received a presentation from Anna Smith, CEO of One 25 and Ann James, Director of Children and Families on the Pause Bristol programme.

Ann James explained that the programme formed part of Bristol City Council’s One City Approach to work with women and help them with their recovery from bad childhood experiences and to help in reducing the need for demand in criminal health, justice and housing demand.

Anna Smith explained that Pause 25 helped women involved in street sex work.

The presentation made the following points:

·       Women who had two or more children permanently taken into care were at the heart of the One25 service which had been operating since 2017. It had been established to address the problems caused by a repeated cycle of children being removed from parents

·       65,000 women were involved in care proceedings with 1 in 5 returning to family court order concerning the child. Many were out of care themselves and their babies were born into care. Many had also experienced neglect and physical and sexual abuse in their past

·       The purpose of Pause was to identify those women who were frequently disengaged from all other services and to intervene to help provide them with goals and to break the cycle of birth and removal

·       The team consisted of 5 people, including 3 practitioners with a caseload of 7 to 8 each that was kept deliberately low to ensure intensive work could be carried out. The other two members of staff consisted of a lead and co-ordinator

·       The first cohort of women in Brsitolbeing supported included 100% who had suffered domestic abuse, 91% with mental health problems and 65% with problems caused by alcohol and drugs addiction

·       Details were provided of different elements of situations faced by women using this service. In Bristol there were particularly complex problems facing women of drugs and homelessness. Many did not realise they were supposed to stop their child support benefit and were getting into debt. They might have low self-esteem, not have a GP and lead very chaotic lives either on the streets or in inappropriate housing. They might also be in a controlling and abusive relationship

·       Details were provided of women who had  completed the programme and obtained more secure housing. Outcomes included an improvement in dealing with issues caused by past loss, trauma and self esteem

·       There had been two cohorts of women completed. Details of the results of Cohort Number One were provided with Cohort Number Two currently being evaluated. A third cohort was about to start

·       As part of the process, women agreed to accept long term contraception.

·       An analysis of Cohort One showed that 91% of women had mental health diagnoses with just under half receiving a further assessment by the NHS, 30 had received statements given to the Police concerning violence or abuse, there was a 50 per cent reduction in A and E visits, 9 had face to face contact with children, 14 had been helped to leave  ...  view the full minutes text for item 141.

The Board received reports from Councillor Brenda Massey (Chair of the Health Scrutiny Committee) and Councillor Claire Hiscott (Chair of the People Scrutiny |Committee).

Councillor Brenda Massey made the following points:

·       There had been cross-party collaboration in this area which attempted to address concerns about the impact of the current pandemic on Planned Health Care

·       The report provided a snapshot of the current situation with lots of different inputs concerning communication, impact on communities and changing ways of working

·       The report had noted that there had been a fear amongst some communities of attending for planned health care in view of the risk of catching COVID-19 and who were therefore reluctant to attend

·       Concerns raised included the gap between treatments, how people are contacted about changes and problems for people with a limited IT ability

·       There were also language and culture difficulties for BAME communities and it was acknowledged that it was important for local communities to help out in this area

·       There was an impact on mental health particularly for older people who were forced to stay at home

·       The difficulties caused by school closures had made a particular impact on single parent families

·       Changes to the way the NHS worked in the current situation resulted in people relying on the role of health providers even more

·       Certain areas have been identified as being very good ie partnerships, social prescribing and advice by chemists

·       Leaflets had been produced in a range of different languages to help provide information to all communities

Board Members made the following comments:

·       It was important for the system to see the problems and be accountable for them and to be as well organised as possible

·       It was also important for systems to be as well organised as possible

·       One City had put together a Digital Exclusion Task Force to address the problems caused by Digital Exclusion. It was important that vulnerable people had access to machines

·       This was a really good report. It could cross reference against work which was already happening in these areas

Councillor Claire Hiscott made the following points:

·       The challenges of child protection in the first lockdown period were analysed in order to capture learning while it was still fresh in people’s memories ie what did you do, what went well and what didn’t go well

·       She expressed her thanks to the wide range of participants who were all extremely helpful. Input was obtained from Avon and Somerset Police, Cirona, the Youth Service and Keeping People Safe. There were comments from experts and academics

·       The Board’s attention was drawn to a diagram on Page 42 of the agenda papers. This helped to understand the risks and harms concerned. It identified how partners identified children at risk including the effects on schooling and attendance for those children who were at risk to begin with as well as those children who were not at risk to begin with but became vulnerable

·       Community support had been looked at including the effect on  ...  view the full minutes text for item 142.

It was noted that Board Members would shortly be receiving a request to complete an Equalities Questionnaire.

The next meeting is scheduled to be held at 2.30pm on Thursday 18^th March 2021 as a remote zoom meeting.

It was noted that the next Health and Well Being Board Meeting was scheduled for 2.30pm on Thursday 18^th March 2021.