Agenda and minutes

There were no Declarations of Interest made at the meeting.

There were no members of the public and press present at the meeting.

Resolved:-  That an update be provided to the next meeting on the recent meeting of the Integrated Care Partnership.

Resolved:-  That the minutes of the previous meeting held on 6^th March, 2024, be approved as a true record.

Arising from Minute No. 86 (Pharmaceutical Needs Assessment), it was noted that, when compared with other areas in South Yorkshire, Rotherham had a similar situation in terms of opening hours compared to its neighbours and there had not been a significant reduction in the opening hours.

It was clarified that there was no other area in South Yorkshire that opened beyond 9.00 p.m.  Rotherham was in line with the rest of its South Yorkshire neighbours. 

Arising from Minute No. 88 (Physical Activity/Moving Rotherham Board), the Chair requested further information regarding the Sport England Place Expansion Programme.

Ben Anderson, Director of Public Health, undertook to forward further information.  He explained that a number of places had received funding over the last 4-5 years to fund physical activity.  The Expansion Fund was Sport England taking that model out to a number of areas of which Rotherham was one.  A bid was currently being worked up.

The Chair felt that the list of activities submitted to the last meeting was not as full and comprehensive as it could be and requested that it be added to when submitted again.

Presented by Lorna Quinn – Public Health Intelligence Principal

Lorna Quinn, Public Health, gave the following presentation summarising the key findings of the Joint Strategic Needs Assessment (JSNA):-

People

-        The population of Rotherham was 268,400 (2022 mid-year 30^th June) estimate of population) with an age structure that was slightly older than the national average

-        The Rotherham population had increased steadily by approximately 1,000 per year from an estimated 259,400 in 2013 to 268,400 in 2022 (+3.5%)

-        Rotherham ranked as the 35th most deprived upper tier local authority in England on the Index of Multiple Deprivation 2019 out of a total of 151 authorities

-        59 Rotherham neighbourhoods (Lower Super Output Areas or LSOAs) ranked among the 20% most deprived in England and 36 LSOAs were in the top 10% most deprived

Life Expectancy

-        Life expectancy at birth for males in Rotherham 2020-22 was 77.1 years; significantly lower than the England value of 78.9 years

-        Life expectancy at birth for women in Rotherham 2020-22 was 80.2 years; significantly lower than the England rate of 82.8 years

Healthy Life Expectancy

-        The healthy life expectancy at birth 2018-2020 in Rotherham was 58.7 years for a male, significantly lower than the England average of 63.1

-        The healthy life expectancy at birth 2018-2020 in Rotherham was 56.5 years for a female, significantly lower than the England average of 63.9

Health Behaviours

-        The Rotherham Drug and Alcohol Service has been supporting more people with substance and alcohol use; the number of new presentations to treatment for adults increased from 784 in 2021/22 to 959 in 2022/23; the number of new presentations to treatment for children aged under 18 increased from 27 in 2021/22 to 36 in 2022/23

-        There had been a significant increase in the percentage of physically active adults in Rotherham from 54.9% in 2018 to 64.4% in 2021.  Despite this, health conditions which were associated with having a lower risk in physically active adults (such as CHD, Stroke and Hypertension) all had significantly higher rates in Rotherham than Yorkshire and the Humber and England

-        Smoking prevalence in Rotherham resumed its steady decline in 2022 after a spike in 2021 and was currently at 14% of adults smoking compared with 12.7% across England.  Quit rates in Rotherham had nearly doubled from 1,580 in 2018 to 3,155 in 2022

-        Prevalence of depression in Rotherham had increased between 2013 and 2022 from 9.85% to 17.3% with the gap between England and Rotherham growing to 4 percentage points

-        Both the Gonorrhoea and Syphilis diagnostic rates in Rotherham rose significantly between 2020 and 2022.  The Gonorrhoea diagnostic rate remained better (lower) than the England average (94 compared to 146 per 100,000 population) whilst the Syphilis diagnostic rate was worse (higher) than the England average (16.5 compared to 15.4 per 100,000 population)

-        Around 1 in 4 (24.4%) children aged 4-5 years were categorised as overweight or obese for the 2021/22 to 2022/23 period, however, this was 2 in 5 (40.2%) for children aged 10-11 years  ...  view the full minutes text for item 5.

Presented by Denise Littlewood

Denise Littlewood, Public Health, gave the following presentation on Health Protection Assurance:-

The report considered the following key domains of Health Protection

-        Communicable disease control and environmental hazards

-        Immunisation and screening

-        Health care associated infections and antimicrobial resistance

-        Emergency planning and response

Specialist Local Response

-        Local response to national Measles outbreak

-        An outbreak of Legionella in a social housing complex

-        Increase in cases of Syphilis and Gonorrhea in South Yorkshire

-        Increase in complex cases of TB cases including a South Yorkshire cluster

-        Increase in cases of Whopping Cough (Pertussis) locally and nationally

-        Large numbers of gastro-intestinal outbreaks in early years, schools and residential care settings

Screening

-        Priorities within the breast, bowel and cervical cancer screening programmes included increasing uptake and collaborative work with programme providers and partners to improve uptake of screening for patients with a learning disability

-        Cervical screening figures below target due to poor uptake in 25-49 year olds.  Work ongoing to understand barriers particularly in individuals who had never accessed screening

-        Breast screening figures below target.  Change in appointment model and uptake was now increasing

Immunisation

-        Seasonal Flu.  Rotherham had seen a slight decrease amongst all the eligible cohorts.  The reasons for the decline were not yet clear but the downward trend was reflected regionally and nationally.  Work would be undertaken to try and understand the reasons behind the decline and inform planning for 2024/25

-        The adult vaccination programme had seen a significant change within the Shingles programme (those turning 65 from 1^st September 2023 becoming eligible), change of vaccine and schedule (from one dose to 2 doses) and extension to all patients over 50 years of age who were immunosuppressed.  The priority for Rotherham had been to ensure all providers were aware of the change and the programme was fully and safely implemented

-        For maternal Pertussis, the priority had been to implement the offer and delivery of the vaccine by the maternity provider (along with Flu and Covid vaccines)

-        For adolescent (school-aged) immunisations, the priorities had been the procurement and mobilisation of a new contract (commenced 1^st September 2023), work to restore uptake to pre-pandemic levels, implement the new HPV schedule (reduced to one dose) and reduce the gap between schools within the highest and lowest uptake.  Although showing recovery, all adolescent vaccination programmes remained below the pre-pandemic levels, a trend which was reflected nationally

-        Childhood Immunisations.  A key focus had been and continued to be on MMR dose one by 2 years of age, achieving and maintaining coverage of above 90% (minimum threshold) with the aim of achieving 95% (optimal threshold)

Health Protection Focus

Preparedness was the key

-        Refresh Outbreak Plan

-        Refresh Mass Treatment Plan

-        Adverse Weather Plans

-        All involved work with Emergency Planning and Environmental Health

Upcoming Priorities

-        Ensure preparation for future Health Protection events was key

-        Ensuring Health Protection roles and responsibilities across Rotherham Place were understood  ...  view the full minutes text for item 6.

Presented by Ben Anderson, Director of Public Health

Ben Anderson, Director of Public Health, presented the Health and Wellbeing Board’s annual report with the aid of the following presentation:-

Context

-        Life expectancy at birth for both men and women in Rotherham continued to be significantly lower than the England average (77.1 years vs 78.9 years for men and 80.2 years vs 82.8 years for women)

-        The difference in healthy life expectancy at birth was particularly stark with a 7.4 year gap for Rotherham women compared with the national average (2018-2020) (56.5 years vs 63.9 years) and a 4.4 year gap for men (58.7 years vs 63.1 years)

-        On the Index of Multiple Deprivation 2019 Rotherham ranked as the 35^th most deprived upper tier local authority in England out of a total of 151 authorities

-        The key drivers of deprivation in Rotherham remained Health and Disability, Education and Skills and Employment (as were in 2015)

-        Of 45,800 residents (aged 16-64) who were economically inactive, 35.2% were due to long term sickness compared to 27.2% nationally

Achieving the conditions for a healthy life continues to be a concern

-        The estimated number of alcohol dependent in Rotherham was higher than the national average.  In 2021/22 there were 619 per 100,000 admission episodes for alcohol-related conditions (narrow definition) significantly worse than the national average of 494 per 100,000

-        Approximately 14% of Rotherham adults (around 29,600 people) were smokers in 2022 compared to 12.7 nationally

-        In 2021/22 71.9% of adults in Rotherham were classified overweight or obese compared to 66.5% regionally and 63.8% nationally.  Child obesity rates were also higher than national average – in 2022/23 22.2% of reception age children were overweight or obese compared to 21.3% nationally and 41.1% of Year 6 children were overweight or obese compared to 36.6% nationally

Mental Health and Welling were also a concern

-        In Primary Care in Rotherham 2022/23 the recorded prevalence of depression (aged 18+) was 17.3% a total of 36,892 persons.  This was higher than the England value of 13.2% and had been increasing in Rotherham since 2013/14

-        Data from 2018/19 showed 12% of Rotherham residents reported a long term mental health problem which was significantly higher than the England value of 9.9%

Environmental Factors impacting Health in Rotherham included

-        Particulate pollution – in 2022 the percentage of mortality attributable to particular pollution for Rotherham was 5.2% (England 5.8%)

-        Lower than average use of the natural environment – 69% of residents in Rotherham indicated they used the natural environment for health and exercise purposes compared to 82% for England (2017)

Delivery the Strategy

Aim 1:  All children get the best start in life and go on to achieve their full potential

-        An independent travel training (ITT) offer had been created to support children with Special Educational Needs or Disabilities

-        A new post-14 specialist campus opened in September 2023 providing 50 school places.  This meant more children and young people could access high quality educational provision in the local  ...  view the full minutes text for item 7.

Presentation by Board Sponsors

Jo Brown, Assistant Chief Executive, gave an update on Aim 3 of the Health and Wellbeing Strategy with the aid of the following powerpoint presentation:-

Aim 3:  All Rotherham people live well for longer

-        Aim 3 has 3 priority areas

-        Ensure support was in place for carers

-        Support local people to lead healthy lifestyles including reducing the health burden from tobacco, obesity and drugs and alcohol

Priority 1:  Ensure support is in place for carers

-        Increase the flexible support options available for unpaid carers to sustain them in their caring role

•     Needs assessment completed via co-production exercise in 2023.  This identified a need for a flexible break option for carers

•     It also identified a gap in tailored information and support for young adult carers in particular

•     The outcomes from the Unpaid Carers’ Health and Wellbeing Small Grants Programme were currently being collated and would further contribute to the needs and gap analysis

•     Development of the unpaid carers’ offer was underway which would inform the options appraisal and any future commissioning requirements

•     Research/benchmarking other local authority unpaid carers offer taking place

•     ADASS Carers Leads Network and national carers bodies were utilised to identify good practice

-        Develop and streamline the advice and information available for unpaid carers in line with the Care Act 2014, Care and Support statutory guidance and for NHS Standard for Creating Health Content

•       Co-production work had been undertaken with carers leads from the South Yorkshire region to complete an expression of interest for funding (as a consortium) from the DHSC’s Accelerated Reform Fund (ARF) to develop an app for unpaid carers

•       Funding of circa £500,000 received which would fund development of the app and a resource for each local authority to aid further co-production and progress the project

•       Rotherham Council to lead the commissioning of a developer on behalf of the consortium

•       An outline project plan was in place which would be fully developed over the new few weeks by the consortium members

Priority 2:  Support local people to lead healthy lifestyles

-        Develop the healthy lifestyles prevention offer/pathway

•       Communications and engagement prevention campaign ‘Say Yes’ and its 6 themes of alcohol, cancer, diabetes, loneliness, breastfeeding and self-care during Winter – work to date had predominantly focussed on promoting the resource DrinkCoach and pages on RotherHive focussed on smoking, eating well and moving more

•       The promotion of DrinkCoach had included partnership work with Rotherham United to promote the app at match days and collaborations with GP practices to promote the app via direct text messages

•       The work to promote RotherHive had led to over 45,000 page visits with engagement rising during key engagement weeks/months such as Stoptober and Mental Health Awareness Week

•       Building from focus groups with both professionals and communities, work had also started to develop a loneliness campaign in support of delivery of the local Loneliness Action Plan

•       Action to review the current Service specification for  ...  view the full minutes text for item 8.

Presented by the Chair.

The Chair presented the Board’s terms of reference for its annual report.

The report detailed:

• The role of the Health and Wellbeing Board
• Responsibilities
• Expectations of the Health and Wellbeing Board Member
• Membership
• Governance
• Quorum
• Meeting arrangements
• Engaging with the public and providers

It was noted that the next formal review was due in May 2025.

Further details were provided of the governance arrangements and the Memorandum of Understanding between the Rotherham Health and Wellbeing Board and Board Sponsors for Health and Wellbeing Strategy Aims.

The MoU detailed the role of sponsors as follows:

·        To have strategic oversight and ownership of their respective aim, this includes:

o  Monitoring progress against aims and removing blockages

o  Providing strategic steer and identifying opportunities to develop their aim, including action to reduce health inequalities and actions that support integration of delivery

·        To be champions for their aim within the Board and Board activities

·        To be champions for health and wellbeing priorities in their organisations

Reference was also made to the 5 members of the Board who sat on the ICB Partnership one of whom was former Councillor Roche.  It was proposed that Councillor Baker-Rogers take up that vacancy and the membership be reaffirmed.

Resolved: (1)  That the refreshed Terms of Reference be approved.

(2)  That the next formal review takes place in May 2025.

(3)  That the Health and Wellbeing Board representatives to the ICB Partnership be affirmed as Councillor Baker-Rogers, Ian Spicer, Jason Page, K. Davis and Richard Jenkins.

Presented by Presented by The Chair and Sunday Alonge, Policy Officer and Ben Anderson, Director of Public Health

Ben Anderson, Director of Public Health, presented the update on the Health and Wellbeing Board Strategy Action Plan as at June, 2024.

The current Health and Wellbeing Strategy would end in 2025.  All projects were on track with the majority of the action plan “green”.  Work would now move to development of the new Strategy.

Resolved: That the update be noted.

Jason Page reported on the possible collective action by GPs.

The BMA were currently balloting GPs with regard to potential collective action as from 1^st August, 2024.  They were being asked if they were prepared to undertake one or more examples of collective action which included 16 measures doctors may wish to implement including seeing a maximum of 25 patients a day (GPs often saw 70), pull out of data sharing agreements or offer  face-to-face appointments.

Collective action was not the same as strike action but it could see GPs prioritising their patients’ and practices’ needs over local NHS system wants.

27 out of Rotherham’s 28 practices were part of the partnership model and would each vote individually.

Resolved:-  That the Chair be kept informed of the outcome of the ballot.

(a)  The Board received for information the BCF Year End Template report that had been submitted to NHS England with regard to the performance of Rotherham’s Better Care Fund, Improved Better Care Fund, Disabled Facilities Grant and Discharge Fund in 2023/24.

The overall delivery of the Better Care Fund continued to have a positive impact and improved joint working between health and social care in Rotherham.

The information contained within the BCF submission included:-

-        Section 75 Agreement

-        Confirmation of National Conditions

-        BCF Metrics

-        Income and Expenditure

-        Year End Feedback

It was noted that the documentation had been approved by the Better Care Fund Executive Group on 20^th May, 2024 (approved on behalf of the Health and Wellbeing Board) and had been submitted to NHS England on 23^rd May, 2024.

(b)  The Board received for information the BCF Planning Template including capacity and demand for intermediate care for 2024-25.  The planning template was in line with the Addendum to the 2023-25 Better Care Fund Policy Framework and Planning Requirements.

It set out the 2 core objectives of the BCF over the 2 years:-

-        To enable people to stay well, safe and independent at home for longer

-        To provide the right care in the right place at the right time

It was noted that the documentation had been approved by the Better Care Fund Executive Group on 20^th May, 2024 (approved on behalf of the Health and Wellbeing Board) and submitted to NHS England on 10^th June, 2024.

Minutes of meetings held on  21st February and 17^th April, 2024

The minutes of the Rotherham Place Board held on 21^st February and 17^th April, 2024, were submitted for information and noted.

Minutes of meetings held on 21^st February and 17^th April, 2024

The minutes of the meeting of the Rotherham Place Board ICB Business held on 21^st February and 17^th April, 2024, were submitted for information and noted.

Resolved:-  That a further meeting be held on Wednesday, 25^th September, 2024, commencing at 9.00 a.m.