Agenda and draft minutes

Apologies for absence were received from Tim Benfield, Healthwatch Medway, Jackie Brown, Assistant Director Adult Social Care, Councillor Lawrence, Martin Riley Joint Senior Responsible Officer, Medway and Swale Integrated Care Partnership and Dr David Whiting, Director of Public Health.

Apologies for absence were received from the following invited guests:

Sarah Atkinson, Kent and Medway Mental Health NHS Trust, Celia Buxton, Assistant Director Education and SEND, and Adrian Richardson, Kent and Medway Mental Health NHS Trust.

To approve the record of the meeting held on 17 June 2026.

The record of the meeting held on 17 June 2026 was agreed and signed by the Chairperson as correct.

The Chairperson 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. 

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

There were none.

At the 21 November 2024 Health and Wellbeing Board, it was agreed to theme future board meetings in line with the strategic priorities set out in Medway’s Joint Local Health and Wellbeing Strategy 2024-2028 (JLHWS).

Discussion:

The Board was presented with the key strategic the indicators used to monitor the performance, progress and success of the Joint Local Health and Wellbeing Strategy.

Several comments and questions were raised which included:

It was encouraging that there had been noticeable improvements to hospital admissions relating to some indicators for under 19s. However, particular attention was needed on the wider impact of hospital admissions due to the effect on other aspects of a child’s life such as education and school attendance.

It was commented that following recent attendance at a webinar on early deaths of care leavers, concerns were highlighted regarding social isolation of care leavers and their management of long term health conditions as contributing factors. The Public Health team agreed to have further discussions with Children’s Social Care on the drivers and characteristic of this issue. It was also commented that there was a need to establish closer links between Primary Care and the care leavers agenda. Partners from the NHS commented that there were issues with lack of engagement during transition from child to adult services and this was an area of concern to be addressed.

Comments were made that the distinction around the indicator for Gross Value Added per filled workforce job was unclear. The officer agreed to provide a summary of the drivers but commented that it was important to note that these were published data sets from three years ago and that the timeline would be considered again against the current stage of the world.

A request was made for future indicators to be more explicit on the impact of climate change.

Decision:

The Board noted the report.

This report provides an update for the Health and Wellbeing Board on the development of a neighbourhood health plan. A framework has been published recently that clarifies what is expected of Health and Wellbeing Boards in 2026/27 and how the Integrated Care Board (ICB), local authorities and other partners should work together to develop neighbourhood health plans.

Discussion:

The Board considered the update report which directed Members to identify two or three key priorities for Medway.

Several comments were made which included:

·        Breaking down the cost of delivery of Neighbourhood Health may be challenging.

·        There were many approaches from different parts of the system, and it was important to ensure that priorities in other strategies aligned with Neighbourhood Health (NH) Plans. It was crucial not to produce a plan from the Health and Wellbeing Board that did not accord with actions elsewhere in the system.

·        Consideration needed to be given to the configuration of the Kent and Medway boundaries .

·        Alongside the NH Plan, there must be clear communication to the  public on what to expect from NH Plans.

Officers assured the Board that the NH Programme Board met regularly to discuss key priorities. Medway would have its own priorities, however, plans needed to support other services that were already being commissioned and aligned with priorities of the Joint Strategic Needs Assessment. Development of the NH Plan must take these factors into consideration.

Discussions took place regarding the ambitions of NH and how to ensure compliance by all GP Practices to deliver multidisciplinary services. The issues in Medway with inconsistencies in practice were evident but there was support and commitment from GP Practices on the NH model and it would be the responsibility of the Integrated Care Board to address any issues or inconsistencies with adherence to expectations.

Decision:

The Board noted the update report and suggested that the three areas  of priority that should be considered should include:

a)     Children and Young People’s Health.

b)     Specialist services for women’s health.

c)     Rare Diseases.

Medway declared its ambition to become a Marmot Place in April 2025. This report provides a summary of the progress to date and a set of recommendations from the Institute of Health Equity who have been commissioned to support Medway to achieve its ambitions to reduce health inequalities.

The Medway Marmot Place is not just a Medway Council initiative. In order to achieve the ambition of halving health inequalities over the next ten years, action will need to be taken by all public, private, voluntary, and academic sector partners.

Discussion:

The Board received the summary of the progress made to date and the recommendations from the Institute of Health Equity (IHE) who had been commissioned to support Medway to achieve its ambitions to reduce health inequalities.

The ambition set was a ten year target to halve health inequality in Medway against the England average, progress continued to be made, and the aspiration was to utilise Marmot as a guide for all partners to encourage them to take action through the various initiatives and plans adopted by the Council. As a result of this review, partners would be provided with the recommendations that relate to their organisation.

Resident engagement would continue to take place throughout to reach groups not heard from and to identify their priorities. An evaluation framework was being co-produced with work to be undertaken on diversity assessment and development of a Marmot champions model.

Members were asked to provide comments and responded with the following:

Considerable progress had been made, with support and commitment on Marmot principles from various organizations who had articulated the challenges and difficulties faced.

It was encouraging that steady progress was being made against the 10 year target to halve health inequality in Medway.

The list of recommendations from the IHE was extensive and it was crucial that each Portfolio Holder took responsibility for the recommendations under their portfolio.

Voluntary, Community, and Social Enterprise - progress was being made with engagement, and it was commented that Medway clearly valued and worked with the Voluntary Community and Social Enterprise sector. There was good representation on governance. It was, however, key to ensure robust neighborhood level engagement as may organisations were doing good work,  and it was vital to reach out to those smaller organisations.

Older people and mental health - it was commended that children were a priority on the IHE recommendations, however, it was suggested that there was a lack of focus on the older population which made up 25% of residents of Medway. The Board was informed that this was a 10 year approach and all the different factors that made up the demographics of Medway would be focused on at a point throughout the journey. The work being undertaken was  being completed in a universal way which meant  priority would be directed where needed first.

Impact of LGR – it was asked what the impact would be and the officer responded that that the aspiration was for the new authority to adopt Marmot, once system changes had embedded.

Decision:

a)     The Board agreed to note the report.

b)     The Board suggested that officers arrange a briefing for cross boundary partners on how this will impact  and what it will involve for LGR areas.

c)     The Board suggested that care leavers be a focus for the Marmot Board.

d)     The Board suggested that there be a focus on neighbourhood health engagement, including the impact to the VCSE.

The report sets out Medway's Local Special Educational Needs and Disabilities (SEND) Reform Plan, approved jointly by Medway Council, NHS Kent and Medway Integrated Care Board and the wider Local Area Partnership. The Plan sets out the next stages of whole-system reform creating a sustainable, inclusive, and outcomes-focused 0-25 SEND system.

Discussion:

The Board received the report which had been jointly produced with partners across the systems and sets out the vision for a high quality inclusive SEND system that represented a whole system approach.

Several challenges continue to be experienced across the system including  high support needs, costs and increase in request for statutory assessments  which had doubled in the last year. The growth of which threatened sustainability as a result, the partnership agreed four main goals, with six priorities identified to achieve goals.

It was commented that extensive work had been undertaken by partners jointly working together. Utilisation of the family hubs was key to achieving goals as it was essential that families be able to access expert support in one place. The work being undertaken by mainstream schools was encouraging and it was crucial to continue to ensure that provision was in place to support staff working with SEND children.

The work undertaken by the Therapeutic Alliance continued to provide vital support for families, the results of which would start to emerge and was being monitored closely.

Decision:

a)     The Board agreed to endorsed the partnership vision for a high-quality, inclusive and financially sustainable 0-25 SEND system.

b)     The Board agreed to support the delivery of the six strategic reform priorities.

c)     The Board noted the governance, performance and reporting arrangements that will monitor delivery of the reform programme.

This report presents Medway Council’s Adult Social Care Workforce Strategy 2025 – 2028.

The strategy sets out how Adult Social Care will attract, retain, develop and support a skilled, stable, inclusive and future-ready workforce capable of delivering safe, effective and person-centred services for Medway residents. It establishes a clear framework for workforce improvement through six strategic priorities focused on workforce capability, ethical practice, inclusion, recruitment and retention, leadership, and workforce intelligence. The strategy also provides a three-year delivery roadmap and framework for measuring impact and assuring progress.

Discussion:

The Board received the report which detailed the strategy to expand on and develop a ‘future ready’ workforce. As part of the Strategy, various workforce challenges were identified and responded to which aligned with learning from the January 2025 Care Quality Commission inspection and the improvement plan developed as a result of that inspection. The Strategy reinforced the Councils intentions and aspirations to existing staff, and senior management continued to work extensively to promote development opportunities to staff and encouraged staff to remain working in medway.

Improvements had been made to the workforce which resulted in improved strategic decision making for the people cared for. There was also a willingness by new staff to share ideas and expressed that they felt valued and listened to by senior management.

It was commented that this Strategy would facilitate a much needed transition between adult social care and the NHS by integrating health and social care services in line with legislative requirements.

Discussions took place regarding staff access to flexible working and reliance on an out of hours service to which the Board was informed that the service was committed to ensuring there were opportunities for staff to work flexibly whilst maintaining the needs of the service. Particular mention was made on encouraging providers to explore the actions being taken in this Strategy and how it could be applied to their own workforce strategies. The officer  explained that there was also another workstream currently in progress on development of a care sector plan which took learning from this plan and  would be made available to providers to support them with their own workforce plans.

It was commented that this Strategy was similar to that of the Children’s Social Care Workforce Strategy and the regular meetings held to monitor progress had been instrumental in driving  forward change. This had enabled  improvement to be made to the recruitment and retention of staff.

There were strong links between the University and Medway, students sought placements across children and adults services and were encouraged and supported through the process. If a social worker expressed a desire to develop their skills in another areas, opportunities to take up posts across both children and adults were encouraged and supported.

The Strategy was commended by partners across the Board, in particular colleagues who were keen to refer to this strategy as the reviewed their own policies.

Decision:

a)     The Board agreed to note the proposed monitoring, reporting and governance arrangements set out within the report.

b)     The Board suggested that officers consider exploring how to share their aspirations  with other parts of the Council such as the  Employment and Skills Board.

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 Board discussed items for the upcoming meeting on 19 November 2026 and remainder of cycle of meeting for 2026/27.

Decision:

The Board agreed:

a)     To note the work programme at appendix 1 to the report.

b)     That a report of Foetal Alcohol Spectrum Disorder be taken at the 19 November meeting.

c)     That a report on the GP Satisfaction Survey be taken at the 11 February 2027 meeting.