Agenda and minutes

To elect a Vice-Chairman of the Health and Wellbeing Board for the forthcoming year.

Councillor Howard Doe was elected as Vice-Chairman for the forthcoming year.

Apologies for absence were received from Board Members, Councillors Gary Etheridge and Vince Maple, Eunice Lyons-Backhouse (Healthwatch Medway Representative) and Dr Farnaaz Sharief, MBE (Primary Care Network, Medway and Swale Representative).

Apologies for absence were also received from invited attendees, James Devine (Chief Executive, Medway NHS Foundation Trust), and Helen Greatorex (Chief Executive, Kent and Medway NHS and Social Care Partnership Trust (KMPT)).

To approve the record of the meeting held on 1 September 2020.

The record of the meeting held on 1 September 2020 was agreed and signed by the Chairman as correct.

The Chairman will announce any late items which do not appear on the main agenda but which he/she has agreed should be considered by reason of special circumstances to be specified in the report. 

The Chairman agreed that agenda items 8 (Joint Health and Wellbeing Strategy and Joint Strategic Needs Assessment Monitoring Report) and 9 (Joint Health and Wellbeing Strategy Theme 3 Review) be considered by the Board as urgent items by reason of special circumstances, to enable the Board to consider these matters at the earliest opportunity and to avoid adding to the volume of business programmed for the next meeting of the Board. These reports were not available in time for despatch with the main agenda due to other COVID-19 related response activity in the Public Health team which had to take priority.

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct. Guidance on this is set out in agenda item 5.

Disclosable pecuniary interests

There were none.

Other significant interests (OSIs)

There were none.

Other interests

Councillor Adrian Gulvin disclosed that he was the Chairman of the Community Safety Partnership which was referenced in agenda item 7 (Medway Safeguarding Children Partnership (MSCP) Update Report).

The Chairman referred to the recent announcement that Jackie Brown would be taking up the role of Assistant Director, Adults’ Social Care. Jackie had worked for the Council since its formation, working in and with a range of services within the Children and Adults Directorate. Jackie had led on a range of projects including the Three Conversations Model in Adult Social Care and the work on the Kent and Medway Care Record as part of the wider Sustainability and Transformation Plan. Jackie attended the meeting as an observer before she formally took up her role.

On behalf of the Board, the Chairman congratulated Jackie on her appointment and also thanked Suzanne Westhead, Interim Assistant Director, for her work in the interim period and her support and advice to this Board.

This report provides an update on the Local Outbreak Control Plan (LOCP) including the outcomes of and plans for stress testing the LOCP.

Discussion:

Acknowledging that this report was prepared before the recent announcement about the national lockdown, the Director of Public Health provided an update on COVID-19 prevalence in Medway compared with the national picture. He referred to recent stress testing, set out in detail at paragraph 2.2 of the report and confirmed that the Domiciliary Care Stress Test had been completed. Whilst he recognised that there had been challenges in relation to access to testing, linked to national capacity issues, he considered that Medway was prepared to manage local outbreaks. A bid would imminently be submitted to access rapid testing kits.

Members raised several points and questions including:

·       BAME System Plan – it was considered important that health inequalities were reduced, and a request was made that the Board receive a further report on the issue. In response, it was explained that a programme of work, called turning the tide, was underway in Kent and Medway which looked systematically across the whole system to understand population vulnerabilities and provide targeted interventions. It was confirmed that the Board would consider a report on Theme 5 of the Joint Health and Wellbeing Strategy: Reducing health inequalities at the next meeting (16 February 2020). In addition, the theme of this year’s Director of Public Health’s Annual Report was around health inequalities.

·       Track and Trace – asked how well the Track and Trace system was working locally and whether there was more the Board could do to help, referring to the most recent data, it was explained that Medway’s completion rate was 81%. Advice from Sage suggested that a figure over 80% was good and the level required to control the virus. Working in conjunction with Public Health England, the local Track and Trace system would commence next week, with training already completed.

·       Education settings – The Public Health team were thanked for their continuing work in education settings, particularly with school headteachers. This had helped teachers, parents and children feel confident retuning to schools after the initial lockdown period. Medway had exceeded the national expectations around attendance. As the locality moved into another lockdown period, it was anticipated that there would be a particular need for ongoing support and guidance from the Public Health team.

·       Care homes – recognising that individuals residing within care homes were a particularly vulnerable cohort of the community, the importance of the recent targeted engagement with care homes was recognised and commended. It was noted that through collaborative working, the funding for infection prevention and control was well utilised to improve access to PPE for providers and meet training needs in relation to infection prevention and control.

Throughout the discussion, it was generally acknowledged that whilst the prevalence of COVID-19 in Medway had been comparatively low and the response by the Council officers and its partners including the Kent and Medway CCG had been excellent, individuals ought not to be complacent and continued vigilance was needed. The Director of Public Health encouraged people to act accordingly if contacted by  ...  view the full minutes text for item 376.

The purpose of the report is to update the Health and Wellbeing Board on the work of the Medway Safeguarding Children Partnership (MSCP) during 2019-20 and to provide members with an update on the MSCP Strategic Plan and Business Plan 2020-22.

The report has been written in accordance with the joint protocol between strategic partnerships in Medway. The Joint Working Protocol has recently been updated and members are asked to approve the updated protocol. The MSCP Annual Report 2019-20 will follow later in the year.

The update report was considered by the Children and Young People Overview and Scrutiny Committee on 23 July 2020. The comments of this Committee are set out at section 5 of the report.

Discussion:

The Director of People – Children and Adults Services introduced the report, highlighting to the Board the MSCP’s five priority areas. He also outlined the impact of COVID-19 on the work of the Partnership.

He then introduced the Independent Scrutineer, who explained his role in relation to the Partnership and his initial assessment of the partnership’s impact.

Members raised several points and questions including:

·       Business Plan Red, Amber, Green (RAG) rating – in response to a query about unrated actions, it was clarified that actions which were yet to commence did not have a RAG rating. The Director of People undertook to discuss future presentation with the MSCP Executive.

·       Revised Protocol setting out the relationship between strategic partnerships – the roles of the CSP and CPB in relation to the MSCP were outlined. A comment was made that the CSP strived to put young people at the centre of all the work it does, and it was confirmed that the Lead Member for Children’s Services had agreed to become a member of the CSP.

The Director of People added that bilateral meetings were held between himself, the Assistant Director for Children’s Social Care, and the Police (policy leads as well as senior operational staff). Working alongside Medway Task Force this had afforded an opportunity to understand in detail the initiatives and interventions put in place to tackle difficult issues such as gang culture, child exploitation and missing children.

·       Voluntary and Community Sector (VCS) – the importance of hearing the voice of the VCS was recognised. In answering a question about working with the VCS, it was considered that, generally, this sector was very good at engagement and were the ‘eyes and ears’ of the community, often working with the most vulnerable groups. It was important that the MSCP were aware of the issues communicated by the VCS and that the partnership worked effectively with them to address the challenges. It was for the Partnership to determine how to best involve the VCS. This could include engagement through the sub-groups or leadership events.

·       Headteacher representation on the executive – inclusion of education leaders on the MSCP Executive was considered to be an important step forward and key to supporting vulnerable children. It was explained that collaborative action over the course of the pandemic was part of the catalyst for this.

·       Constructive criticism - the constructive criticism received which had helped to shape services, particularly those relating to early help was welcomed. It was considered that significant progress in Children Services had been made and cooperation and synergies across agencies had developed.

Decision:

The Health and Wellbeing Board:

a)    noted the Medway Safeguarding Children Partnership (MSCP) update report, Strategic Plan (Appendix One) and Business Plan (Appendix Two).

b)    agreed to add the full MSCP Annual Report 2019-20 to its work programme for 16 February 2021.

c)    noted the protocol set out at Appendix Three to the report and agreed that the Chairman sign to evidence acceptance.

This report will provide an update on key Joint Health and Wellbeing Strategy (JHWS) indicators.

This item has been circulated separately to the main agenda. The Chairman of the Board is of the opinion that it should be considered at this meeting as a matter of urgency as permitted under section 100B of the Local Government Act 1972 to enable the Board to consider the matter at the earliest opportunity and to avoid adding to the volume of business programmed for the next meeting of the Board. The report was not available in time for despatch with the main agenda due to other COVID-19 related response activity in the Public Health team which had to take priority.

Discussion:

This report provided an update on key Joint Health and Wellbeing Strategy (JHWS) indicators across all five themes of the Strategy. For the benefit of the Board, the Consultant in Public Health outlined the main successes and the ongoing challenges in Medway in relation to the indicators.

Members raised several points and questions including:

·       Impact of COVID-19 – with particular reference to mental health, asked to what extent the assessment of population need will change because of COVID-19 and therefore the priorities within the JHWS, it was explained that the JHWS was a live document which could be shaped by the Board and would evolve going forward. It was generally recognised that the health and social care system had transformed and there would be a future focus on population health management. This would involve a systematic approach to using data to understand what was happening in the population at a granular level and ensure that the health system and partners targeted the issues identified. This might highlight hidden harms present in the local population which have manifested owing to the consequences of COVID-19. One of the key issues, which could be considered a positive impact of the pandemic, was the emerging sense that addressing health inequalities was critical.

Referring to the comments on mental wellbeing, it was explained that there had been a very clear focus on this throughout the pandemic. A briefing note had recently been circulated to Board Members setting out local services for children and young people. Answering a question about the closure of leisure facilities during the second lockdown, it was explained that under the new rules unlimited exercise could be undertaken outside. The Council’s website provided further guidance in ways to remain active and information on Medway’s open spaces. A comment was made that individuals should be supported to manage their mental health. It was said that older people could have a role within the community to support this, which could also benefit them with respect to reducing social isolation.

·       Access to services during the pandemic – referring to examples of difficulties accessing child health services and support networks, a question was asked about how this would be addressed going forward. In response, it was explained that there were challenges around providing COVID secure services, but services could be provided online. Some support services could continue during the second lockdown and it was expected that government guidance would be published in due course.

·       Use of technology in primary care – acknowledging that, in some cases, use of technology may be beneficial, concerns were expressed in relation to and increased use of virtual GP appointments. A return to face to face appointments was welcomed. It was recognised that most clinicians would likely agree that there was an imbalance at the present time, it was reiterated that the challenge was ensuring COVID secure services for patients and professionals. With respect to the how GP services might be designed and delivered in the future, it was accepted  ...  view the full minutes text for item 378.

This report asks the members of the Health and Wellbeing Board to identify how they and the organisations that they represent can encourage the system to improve health and wellbeing with respect to the future state describe for theme 3 of the Joint Health and Wellbeing Strategy: Prevent early death and increase years of healthy life.

This item has been circulated separately to the main agenda. The Chairman of the Board is of the opinion that it should be considered at this meeting as a matter of urgency as permitted under section 100B of the Local Government Act 1972 to enable the Board to consider the matter at the earliest opportunity and to avoid adding to the volume of business programmed for the next meeting of the Board. The report was not available in time for despatch with the main agenda due to other COVID-19 related response activity in the Public Health team which had to take priority.

Discussion:

The Health and Wellbeing Board considered a report which focused on the third theme of the Joint Health and Wellbeing Strategy (JHWS), ‘Prevent early death and increase years of healthy life.’ Board Members were asked to consider how they and the organisations that they represent could encourage the system to improve health and wellbeing with respect to the future state described for this theme, as set out as set out at Appendix A to the report.

Members raised several points including:

·       it was commented that with respect to this theme, reducing social isolation was an important issue. It was considered that initiatives put in place during the pandemic, such as food parcel deliveries, helped to reach people who might otherwise not have been contacted.

·       The importance of connecting health with wider Council strategies was recognised for example linking to Transport Strategy to promote active travel.

·       Mental health was considered to be an emerging issue of importance. It was noted that work was ongoing with partners on programmes such as suicide prevention. However, it was important that this was prominent in thinking going forward.

·       The importance of all partners emphasising prevention and early intervention was highlighted. Recognising current financial challenges, a comment was made around whether funding could be diverted to deliver and sustain these types of initiatives.

·       The value of the systematic population health management approach in targeting interventions to where they were most needed based on evidence, was reiterated. Referring to the Marmot indices, it was noted that a related aspiration for the emerging Integrated Care System was to manage unwarranted variation.

Decision:

The Health and Wellbeing Board noted comments made by Board Members in relation to how they and the organisations they represent could encourage the system to make changes that will improve health and wellbeing with respect to theme 3 of the Joint Health and Wellbeing Strategy.

The report advises the Health and Wellbeing Board of the forward work programme for discussion in the light of latest priorities, issues and circumstances. It gives the Board an opportunity to shape and direct the Board’s activities.

Discussion:

The Democratic Services Officer introduced the work programme report and explained that the work programme had been revised following the pre-agenda meeting held on 7 October 2020, details of which are set out in paragraphs 2.2 to 2.4 of the report. The report also provided an update on the Joint Board meeting held on 17 September 2020.

Decision:

The Health and Wellbeing Board agreed the work programme attached at Appendix 1 to the report and agreed to receive the following reports as briefing notes:

·       Evaluation of the Suicide Prevention Programme

·       Update on the Social Isolation Task Group.