Agenda and minutes

Apologies for absence were received from the following Board Members: Paul Bentley, Integrated Care Board (ICB) Representative, Jackie Brown, Assistant Director Adult Social Care, Jayne Black, Chief Executive Medway NHS Foundation Trust, Councillor Edwards, Councillor Price and Donna Marriott, Assistant Director Childrens Social Care, Medway Council.

With regards to invited guests, apologies were received from: Jane Howard, Medway Voluntary Action, Kent Local Medical Committee and Adrian Richardson, Director of Partnerships and Transformation, KMPT.

To approve the record of the meetings held on 13 April 2023 and 7 July 2023.

The records of the meetings held on 13 April 2023 and 7 July 2023 were agreed and signed by the Chairperson as correct.

There were none.

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 4.

Disclosable pecuniary interests

There were none.

Other significant interests (OSIs)

There were none.

Other interests

Councillor Van-Dyke declared that she was still officially recorded as being a Governor on Medway NHS Foundation Trust Board despite having resigned.

Councillor Hackwell declared that his wife was a Governor on Medway NHS Foundation Trust Board.

This short report summarises the work that has been on-going since January 2023 to create a new Joint Local Health and Wellbeing Strategy (JLHWS). The JLHWS is the strategy of the Health and Wellbeing Board. Appendix 1 shows the themes that have emerged from engagement exercises and a review of the data and will be used to structure the writing of the full strategy.

Discussion:

The Deputy Director of Public Health introduced the report which summarised the work that had been undertaken to date, and the emerging themes that would form the basis of the final Strategy that would be presented to the Board at its meeting on 23 November 2023.

Members then made the following comments and suggestions:

• There was still a long way to go in terms of equality and it was vital to explore the whole journey in terms of intended outcomes which was why it was valuable to have a local health and wellbeing strategy.

• The extent to which the community was consulted and engaged with must be made evident in the report when the full Strategy was presented to the next meeting of the Board.

• Members recognised that the themes evidenced how broad and complex the areas of work were, and the success of initiatives depended on engagement of partners.It was vital that organisations worked together, and any identified barriers be brought forward to be addressed.

• Officers from Medway NHS Foundation Trust and the Integrated Care Board agreed that the Strategy complemented the work of the NHS Trusts Clinical Strategy and the Integrated Care System Strategy where clear links had been identified. The Public Health Team was thanked for their efforts in maintaining governance.

• It was important to consider the more vulnerable population of Medway and the need for more support at place based level. The focus group work done as part of the Core 20 plus 5 NHS framework, on identification of the plus population, as well as the effort to address the needs of that population was commended.

• In response to comments that the strategy was aspirational, and a clear model of delivery was needed to highlight the direction of travel over a time period, the Deputy Director of Public Health informed the Board that a logical framework matrix was being developed to evidence delivery. The framework would provide the mechanism to demonstrate connections between the aspirations of the Strategy, how it proposed to achieve outcomes, how achievements were measured, and the framework used to measure outcomes. This would ensure that there was clear evidence in place on delivery and outcomes.

• The work being done needed to align with the Councils Climate Change agenda. Whilst the climate crisis was declared in 2019, issues had been in place for a number of years prior to the declaration and current issues greatly adversely affected the health and wellbeing of Medway residents. It was suggested that the Climate Change Team attend a future meeting of the Board to present some of the work that had taken place across Medway to date, to tackle climate issues.

·       A view was expressed that going forward it was important to acknowledge the strong community of Medway, focus and build on the inherent strengths of residents through promotion of a strength based approach instead of a service led approach to improving health and wellbeing.

Officers reminded Board Members that as part of their role,  ...  view the full minutes text for item 241.

The following paper provides an overview of the draft Medway Infant Feeding Strategy. This is a refresh of the 2018 Infant Feeding Strategy, to ensure the strategic ambitions and actions are fit for purpose.

The strategy outlines the steps taken to refresh the strategy, including the detailed data analysis, community and stakeholder engagement and the assessment of best practice. The strategy concludes with the Infant Feeding priorities for Medway, that will need to be delivered by a range of partners over the next five years.

Discussion:

The Head of Health and Wellbeing introduced the report, which was the third iteration of the Infant Feeding Strategy 2018 and outlined the steps taken to refresh the strategy, and the Infant Feeding priorities to be delivered over the next five years.

Medway Community Healthcare had been instrumental in the recruitment and training of peer supporters across Medway. Peer supporters assisted mothers and families with breast feeding. A specialist team was being put in place through Medway NHS Foundation Trust which could include a new Infant Feeding Specialist post at the hospital. A paid peer support model was being explored and this may stimulate recruitment of more supporters and increase the trained workforce in years to come. Increasing peer supporters would reinforce the importance of the service.  There was also alignment with the Start for Life and Family Hubs programme, with a possibility of collaboration with this initiative should resources to fund paid peer supporters not be available in the future.

Members then made the following comments and suggestions:

·     A view was expressed that there was a variation and prevalence in breast feeding for which there were many drivers including social factors. The work to promote breast feeding included promotion of the health benefits for the infant, financial benefit for families, as well as working with local businesses and encouraging them to be more breast feeding friendly.

·     It was acknowledged that the Strategy was clear and pragmatic in ways to overcome barriers to breastfeeding and promoted the role for all in the family unit to ensure that women were supported.

·     Concern was raised at the low uptake of young white women breast feeding and the importance of doing all that was needed to encourage and support this cohort of women was stressed by the Board.

·     Members recognised that there were a number of key factors that contributed to the high numbers of certain demographics that had been identified as not breastfeeding and the importance of understating the barriers faced, which included but was not limited to health, anxiety, physical emotional and cultural factors. The importance of joined up thinking and solutions through other strategies was suggested.

·     With respect to social isolation, it was important to find ways to encourage joining of groups and promoting the idea that support groups were inclusive for all regardless of whether challenges were faced with breastfeeding or not.

·     It was suggested that there was a role for the Council to lead on some of the work by exploring and ensuring that the Return to Work policy reflected the work of the Strategy.

The Integrated Care Board Officer in attendance welcomed offline conversations with different partners of the Board on how to ensure that the work being done aligned with the wider Integrated Care Systems Strategy, providing the best start for children, and reducing health inequalities.

Officers assured the Board that the focus of the Strategy was on collaboration with all partners and sectors, both paid and voluntary, on driving forward aspirations and the priorities  ...  view the full minutes text for item 242.

This report provides an overview of the interventions and progress to reduce childhood obesity within Medway currently being undertaken by the Public Health department. It also sets out the work of the Whole System Obesity programme in relation to collaboration with key partners and stakeholders across Medway.

Discussion:

The Head of Health and Wellbeing introduced the report which was brought before the Board on an annual basis. It detailed the progress and interventions ongoing to prevent and reduce childhood obesity within Medway.

Members made the following comments and suggestions:

• A view was expressed that partners across Medway were working hard to promote and encourage healthy eating and living. It was important to get the balance right through use of language to encourage people to believe that they are able to achieve healthy lifestyles.

• It was suggested that future reports include how climate change feeds into childhood obesity in terms of access to outside spaces for exercise and impact of air pollution.

• Members recognised the difficulties for families to make healthy choices and prepare healthy meals in the current climate when healthy food cost more than processed food which was readily and easily accessible.

• With respect to the Household Support Fund, a refreshed approach to the initiative was being explored. In consideration was the possibility of a Community Shop initiative in Medway. This concept would allow people to shop surplus donated food and household products at heavily discounted prices. This would allow people to not be limited to the use of food banks and be in an environment where they can shop with dignity and have more control and choice over what they need. This successful initiative was currently in place in several areas across the country.

Officers agreed that the response to tackling obesity involved all services working together, looking at the wider contributing issues and tackling a wide range of determinants.

Decision:

The Health and Wellbeing Board noted the report.

The report advises the 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 report and drew Members attention to the two items that had been added to the work programme, Women’s Health and the Major Conditions Strategy.

It was also agreed that the Community Safety Partnership Strategic Assessment and Community Safety Plan would be taken at the 11 April 2024 meeting.

Decision:

The Board agreed the work programme as set out in appendix A to the report.