Agenda item

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

Members of the public and members of the Council may present a petition or submit a statement to the Health and Wellbeing Board.  One statement per member of the public and one statement per member of Council is permitted. A maximum of one minute shall be allowed to present each petition and statement.  The deadline for receipt of petitions and statements for the 22 June Health and Wellbeing Board is 12.00 noon on Tuesday 21 June.  These should be emailed to democratic.services@bristol.gov.uk or sent to Democratic Services, City Hall, P.O. Box 3176, Bristol, BS3 9FS by the above deadline.

Questions (must be about matters on the agenda):

Questions may be asked by a member of the public or a member of Council.A maximum of 2 written questions per person can be asked.  At the meeting, a maximum of 2 supplementary questions may be asked.  A supplementary question must arise directly out of the original question or reply.  Replies to questions will be given verbally at the meeting. If a reply cannot be given at the meeting (including due to lack of time) or if written confirmation of the verbal reply is requested by the questioner, a written reply will be provided within 10 working days of the meeting. The deadline for receipt of questions for the 22 June Health and Wellbeing Board is 5.00 pm on Thursday 16 June.    These should be emailed to democratic.services@bristol.gov.uk or sent to Democratic Services, City Hall, P.O. Box 3176, Bristol, BS3 9FS by the above deadline.

It was noted that two public forum questions had been received.  The questions, together with the response given by the Mayor are set out below:

Question 1 – from Andy Birkitt re: Agenda item 9 – Health and Wellbeing board – next steps 2016 and beyond

“These HWB Boards are statutory bodies under the Health & Social Care Act 2012 formed by upper-tier local authorities.

Their aim legally is to improve integration between practitioners in local health care, social care, public health and related public services so that patients and other service-users experience more "joined up" care, particularly in transitions between health care and social care. The boards are also responsible for leading locally on reducing health inequalities – quoted from the Act & the DH guidelines.

Each board produces the joint strategic needs assessment (JSNA) for its local authority area that profiles the health and wellbeing needs of the local population. They also produce a joint health and wellbeing strategy.

Whilst not responsible for commissioning, they are involved in its strategic development and oversee the CCG.

In particular HWBs shape the local public health landscape, and help CCGs to commission services in an effective and targeted manner.

It was perceived by many members of the Bristol public that the previous administration:

- Downgraded the role of the Director of Public Health from a Tier 1 officer;

- Was ineffective in overseeing the CCG – indeed most health service professionals saw the CCG as overseeing the HWB;

- Did not concentrate on ensuring there was a public health input into every department and policy statement;

- Did not assist in building effective mental health policies.

So will the HWB today confirm that:

- The post of Director of Public Health will be restored as a Tier 1 post;

- The Mayoral Team will build its own in-house expertise and not just that of the CCG through groups from the universities, the Foundation Hospital Trusts, the BMA, the unions and groups such as PONHS, KONP, Kings Fund, SHA, Mental Health Trusts etc to widen the health expertise in the area;

- Every policy and department be examined to ensure ALL THEIR WORK goes towards reducing health inequalities?”

Reply from the Mayor:

“As Mayor, increasing the reach of public health in the city is one of my key priorities, as demonstrated by the creation of a Cabinet portfolio to oversee this work led by Councillor Fi Hance.  In addition, I am determined to ensure the Director of Public Health has the resources to tackle health inequalities throughout the city.

I want the new City Office to pull together all of Bristol’s health expertise, including the Director of Public Health, so that we as a city can tackle health inequalities by co-ordinating our resources and skills.

As part of this approach, I will work with Fi Hance and all of the Cabinet members to ensure that all parts of the Council have a stake in our public health agenda.

It is vital that we reduce health inequalities in Bristol – but the Council will not be able to do this alone.

The co-operation of, and co-ordination with our partners is essential.  The Strategic Director for Neighbourhoods and the Director of Public Health are key to ensuring this happens and that the City Office becomes an effective vehicle in which all institutions in Bristol can work together to reduce health inequalities in our city.”

In discussion, the Director of Public Health confirmed that one of her key aims was to ensure the strongest efforts to reduce health inequalities across the city.  Through the Health and Wellbeing Board, and working with the Mayor and City Office, every effort would be made to ensure effective leadership and focus on this priority.

Question 2 – from Andy Birkitt re: Agenda item 7 – Sustainability and Transformation Plan – Bristol, North Somerset and South Gloucestershire

“As the STP Plan has now been described in most areas of the country as not a way to improve services but to reduce costs (or as stupid people like me say – cause cuts) – will the HWB refuse to be directly involved with the approval of such a STP plan nor give its approval to it, until the effect of the change of monies through QUIP and STP implementation etc have been fully costed, assessed and published?

Will this same procedure be used in ANY transfer of medical or care services to a regional Metro Mayor including amendments to the STP plan?”

Reply from the Mayor:

“As you point out in your question, all health and social care communities in England are working to develop a Sustainability and Transformation Plan.  You will notice that a report on the local STP is on the agenda for this meeting.  In Bristol, the development of the plan is being led by Robert Woolley, Chief Executive of University Hospitals Bristol.  The STPs are designed to support the 5 year forward plan for the NHS and make no secret of the fact that demand for health and social care is rising rapidly and planners are facing increasing financial pressure.  I think it is vital that the Health and Wellbeing Board is fully sighted on the STP.  I have sought assurance that the plan and its governance are not seen in isolation from other local schemes and plans, like for instance the Better Care programme, and that they complement each other as we work to build better support for people in Bristol and our neighbouring areas.”