Agenda and minutes

Agreed:-  That the minutes be approved as a true record. 

Councillor Ken Wyatt, Cabinet Member for Health and Wellbeing, noted that Brian James, Chief Executive, would be leaving his post at the Rotherham Hospital.  The Health and Wellbeing Board wished to record their thanks to Brian for his support of the work of the Board.

All members present wished Brian all the best for the future. 

·              Rotherham Tobacco Control Alliance Annual Report (Pages 10 - 23)

·              Community Alcohol Partnership s (CAPs) progress as of End October 2012 (Pages 24 – 25)

(1)  Rotherham Tobacco Control Alliance Annual Report: -

The Board noted the annual report for 2011/12 outlining the activity undertaken by the Alliance and its constituent partners highlighting:-

-        Highest ever number of 4-week quitters through NHS Services achieved.  However, smoking prevalence remained at 24%

-        Smoking at delivery rates reduced to under 20% and 194 women had been helped to stop smoking during pregnancy

-        Higher than national average smoking rates for young people (11-15 year olds)

-        Availability of cheap and illicit tobacco remained an issue and undermined other work to reduce tobacco use

-        Performance measures would change in 2013/14 from 4-week quitters to smoking prevalence reduction

-        Almost all tobacco-related funding currently invested in Stop Smoking Services

(2)  Community Alcohol Partnerships (CAPs) – Progress as of October, 2012: -

The Board noted the progress report highlighting the following:-

-        Estimated launch was January, 2013, and initial review in July, 2013, which would inform the next steps for the existing Partnerships.  Two further deprived areas would then be identified for roll out

-        Public Health representatives and CAP regional leadership met with South Yorkshire Police analysts to agree initial benchmarking required and issues to be measured - as anti-social behaviour issues were often seasonal, the analysts had suggested two years’ data to be used as the benchmark

-        They were to also provide ‘hot spot’ areas and crimes in each of the localities – anti-social behaviour highlighting all young and/or alcohol, crime (damage, shoplifting of alcohol, any offences where alcohol was an aggravating factor, alcohol-related violence including domestic and youth related offences) plus NHS A&E admission data, Environmental Health/Warden, litter offences and possibly Designated Public Place Orders, Section 27 Orders and Drink Banning Order data

-        CAP regional lead identified the lead retailer (likely to be Tesco in Dinnington and Co-op in East Herringthorpe)

-        A teaching pack of aids had been created for 11-16 year olds, and consideration would be given to engaging local colleges

-        Stakeholder events would be organised to inform them of the CAP concept

-        Residents of the areas covered by the CAPs would be provided with questionnaires, the answers to these would determine the service offer required.  Whilst both CAPs would use the same key questions, there would also be the potential for them to add localised questions.  The questionnaire outcomes would be incorporated into the benchmarking of the project.

(3)  A National Conference for Childhood Obesity was due to take place on 24th January, 2013.  The Conference would be held in Rotherham’s New York Stadium and would include information relating to the children’s agenda. 

Agreed: -  That the information shared be noted. 

- presentation by Nizz Sabir, Rotherham Council of Mosques

NizzSabir, Vice-Chairman, Rotherham Council of Mosques, was welcomed to the meeting.  Nizz had prepared a presentation in relation to the identified health and wellbeing needs of Rotherham’s Black and Minority Ethnic (BME) communities. 

·        Rotherham MBC estimated that there were 19,000 people from BME communities in 2009, which equated to 7.5% of the local population;

·        The bulk of the BME community lived in the Central Ward according to the Index of Multiple Deprivation (2007).  Key drivers of deprivation related to: - 

o       Employment;

o       Health and Disability;

o       Education and Skills.

The presentation covered a number of underlying detriments to health and wellbeing in the BME community, these were: -

·        The BME community was less likely to be in paid employment (e.g. 20% unemployed in Pakistani community compared to 6% in White British community);

·        Less likely to have a formal educational qualification;

·        Several years ago children and young people from BME communities were shown to be amongst the lowest attaining groups for GCSE results;

·        Employment difficulties;

·        Housing – impact of overcrowding relating to infant mortality, respiratory conditions in children, rates of serious infectious diseases in adults and infections with Helibacter Pylori, which could have implications for growth and diseases of the digestive system;

·        Infant mortality –

o       Babies born to mothers who were born in Pakistan had twice the risk of dying in the first year of their life;

o       South Asian women had more stillbirths than average. This was because of birth defects caused by marriages with close relatives and problems with premature deliveries.

·        Lifestyle and Risk Factors -

o       Smoking – more Bangladeshi and Pakistani men smoke than average;

o       High prevalence of smoking amongst Pakistani and Irish males;

o       The Health Survey England (HSE) 2004, also reported high levels of tobacco chewing in BME groups.

·        Physical Activity -

o       Low rates of physical activity especially in women of Bangladeshi or Pakistani origin;

o       Female only facilities (Rotherham leisure centre, swimming);

o       Lack of independence;

o       Language barrier;

o       Knowledge of services.

·        Diet -

o       Diet typically worse for those born in the UK, compared to first generation migrants;

o       Changing diet with migration;

o       Hard to find familiar foods; 

o       Binge eating, a lack of knowledge about dietary intake and food content was an issue;

o       Increasing popularity of fast food, including cultural pressures and aspirations. 

·        Mental Health:-

o       Research into young Asian women suggested that the factors affecting emotional health were similar across ethnic groups, but access to support was worse for Asian women.  Some barriers were: -

o       Male privilege;

o       Fear of not fitting into a tight-knit community;

o       Fear of offending family honour;

o       Social isolation;

o       Language problems;

o       Fear of racism;

o       Surprisingly little research into mental health needs of Asian men;

o       Caring for family members could create burdens on members of the community. 

·        High risk: -

o       Members of the Pakistani community were six times more likely to have diabetes.  Highest risk was in Pakistani  ...  view the full minutes text for item 46.

- presentation by Nizz Sabir, Rotherham and Barnsley Local Optical Committee

Nizz Sabir, Rotherham and Barnsley Local Optical Committee, gave a presentation on the role of the Rotherham and Barnsley Local Optical Committee and the role of opticians and ophthalmologists in the heath sector.

·        Primary Health Care specialists;

·        Trained to identify defects in vision, signs of injury, ocular disease or abnormality and any problems with general health;

·        Education, training and mandatory continuous professional development;

·        Regulated by membership (with annual renewal process) of the General Optical Council.

Role of opticians in an aging population: -

·        An RNIB report in 2008, ‘Future Sight Loss’, estimated that 1.8 million people lived with sight loss;

·        A projection of needs exercise estimated that there were 102 adults living in Rotherham who required help with their daily activities due to a serious sight impairment;

o       This was predicted to gradually increase over the coming years.

·        Since 2004, the Department for Health had been encouraging the delivery of routine and minor emergency eye care outside hospital in community optical practices. This aimed to free up hospital capacity to cope with increasing demand from both the ageing population and new technologies;

o       Community optical practices were successfully and safely delivering local enhanced services in primary care, with high levels of patient satisfaction reported, as part of local integrated pathways linking into secondary care as appropriate.  A key benefit of these enhanced services was a reduction in referral rates to GPs, A&E and hospital eye departments.

·        Early intervention was being encouraged to increase the effectiveness of the eye care commissioning strategy. 

Primary Eyecare Assessment and Referral Service (Pears): -

·        Support for national and local strategic priorities;

·        Primary rather than secondary care;

·        Evidence based practise;

·        Patient choice;

·        Closer to home. 

Optical issues had many links to other health concerns, many of which were addressed as priorities within the JSNA: -

·        Smoking’s role in increasing the likelihood/severity of: -

o       Aged-related Macular Degeneration;

o       cataract development;

o       Diabetes’ related sight-loss.

·        Obesity’s role in increasing the likelihood/severity of: -

o       Diabetic retinopathy;

o       Age-related Macular Degeneration;

o       Cataracts.

·        Diabetes’ role in changing eye sight: -

o       Diabetic control increased the risk of diabetes sight problems;

o       Dyslipidaemia;

o       Strategies that sought to prevent diabetes and improve the quality of diabetes care would help prevent avoidable diabetes sight loss. 

·        Mental Health: -

o       Higher incidence of mental health in those suffering from sight loss;

o       Higher incidence of falls due to low vision and cataracts. 

·        Social effects: -

o       Independence;

o       Confidence.

Role of Optometric profession: -

·        Work with the local Health and Wellbeing Board and Clinical Commissioning Groups;

·        Work with other health and social care providers;

·        Encourage a multi-disciplinary approach;

·        Early intervention;

·        Quality, innovative, patient-centred, patient satisfaction, patient choice;

·        Improve efficiency and reduce costs;

·        GPS, Ophthalmologists, Orthoptists and social care providers.

The members of the Health and Wellbeing Board thanked Nizz for his informative presentation. 

Resolved: -  That the information be received.  

- presentation by Kate Green, Policy Officer

Tom Cray, Strategic Director for Neighbourhood and Adult Services, gave a presentation outlining a proposed Performance Management Framework, which represented the aims and priorities of the Health and Wellbeing Board.  The proposed Framework sought to track progress against national outcome framework measures without overshadowing locally agreed priorities.

The proposed Performance Management Framework took into account the priorities and strategies of: -

·        Rotherham’s Joint Strategic Needs Assessment’s Priority Measures: -

1) Starting Well;

2) Developing Well;

3) Living and Working Well;

4) Aging Well. 

·        Health and Wellbeing Board’s Priorities: -

o       Smoking;

o       Alcohol;

o       Obesity;          

o       (Dementia).

·        Rotherham Partnership Priorities (as part of the ‘Poverty’ work-steam): - 

o       NEETS;

o       Fuel Poverty.

The suggested reporting mechanisms in the proposed Performance Management Framework were: -

·        Exception reporting based on the Board’s ‘Priority Measures’;

o       Form and frequency needed to be agreed.

·        Not all outcomes from the national Frameworks had to be reported or considered if they were not deemed to be local priorities based on the evidence available (JSNA);

·        Other national measures were managed through other partnership/organisational arrangements.

It was intended that the proposed Partnership Framework would: -

·        Contain SMART targets and action plans;

·        There would be accountable lead managers for all measures;

·        There would be a reporting and communication framework:

·        All measures would be monitored and reported to the right people (across agencies);

·        ‘Exception Reporting’ to the Health and Wellbeing Board; 

·        Enable challenge and problem solving at all levels;

·        Address poor performance quickly and effectively.

Implementation of the Performance Management Framework: -

·        Reports on the progress against all ‘Priority Measures’ would be considered at each Board meeting;

·        One Priority Measure for scrutiny and problem solving would be the focus of each meeting;

·        A quarterly report on national outcome measures, shared outcomes and customer experience would be provided. 

Discussion ensued and the following issues were raised: -

·        Six themes could be taken two per quarterly meeting;

·        Theme Leads to be invited to the meeting to contribute to the discussion;

·        There was support for the addition of dementia as the sixth theme;

·        Children’s issues, and impact on children, to be considered throughout the themes;

·        A thread from conception to end of life should be represented throughout the consideration of each theme;

·        Cultural differences and needs should be reflected.   

The Board confirmed their agreement to the proposed Health and Wellbeing Performance Management Framework with the addition of information in relation to children’s voice and cultural issues. 

Resolved: -  (1) That the proposed Performance Management Framework be agreed with the additions discussed. 

(2)  That each meeting of the Health and Wellbeing Board consider two themes (smoking, alcohol, obesity, dementia, NEETS and fuel poverty), with the theme’s lead officer invited to attend the relevant meeting.

Gary Walsh, Information Governance and Quality Manager, submitted a proposal for the Health and Wellbeing Board to accept ownership of an Information Sharing Protocol.  It was intended that the Protocol would be used by all agencies within the Health and Wellbeing Board. 

The Overarching Information Sharing Protocol (OSIP) was a multi-agency protocol and used by many organisations within Rotherham as evidence and compliance to Information Sharing best practice.  The previous OSIP was owned by the Rotherham Information Governance Group but, following recent organisational changes, no longer met.

The OISP was part of a 3 tier model enabling partner organisations to utilise well established appropriate and transparent information sharing systems (either manual or electronic).  Processes placed the Service user at the centre of how their information was processed in accordance with their rights to privacy and confidentiality.  It was a statement of the principles and assurances that governed information sharing.

The protocol must not be seen as a legal document that allowed all information to be shared between organisations.  All information sharing must be undertaken in accordance with the Data Protection Act, Human Rights Act, common law duty of confidentiality and any other specific statute that authorised or restricted disclosure.

Discussion ensued and the following issues were raised: -

·        Was the proposed protocol compatible with professional information sharing codes for GPs, Social Workers and other professions?  In particular, GPs/Doctors had specific guidelines around sharing of notifiable diseases.

·        Need to ensure that all Partner Boards had the opportunity to comment and agree the Protocol.

Resolved:- (1)  That the report be received and its content noted. 

(2)  That further work be undertaken on the proposed Protocol in relation to ensuring it was compatible with professional guidelines. 

(3)  That Partner Representatives present the revised Protocol to their Boards for comment and agreement. 

(4)  That the revised Protocol be presented to a future meeting of the Health and Wellbeing Board.  

Resolved: - That the report be presented to the next meeting of the Health and Wellbeing Board. 

Resolved:-  That, under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following item of business on the grounds that it involves the likely disclosure of exempt information as defined in Paragraph 4 of Part I of Schedule 12A to the Local Government Act 1972 (information relating to any consultations or negotiations, or contemplated negotiations, in connection with any labour relations matters).

Resolved:-  That, under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following item of business on the grounds that it involves the likely disclosure of exempt information as defined in Paragraph 4 of Part 1 of Schedule 12A to the Local Government Act, 1972 (as amended March, 2006) (information relating to any consultations or negotiations, or contemplated negotiations, in connection with any labour relations matters).

Consideration was given to the report presented by Dr. Ian Turner, GP Specialist in Unscheduled Care, and Ian Atkinson, Senior Commissioner, which outlined the scope of a review that had been planned into unscheduled (urgent) care provision in Rotherham. 

The review planned to look at issues of access, whether clear pathways existed for patients and service users, to remove duplication and waste, and ensure that the highly skilled unscheduled care workforce was deployed in the most effective setting.  The review aimed to ensure that sustainable and high quality access to unscheduled care was available to the people of Rotherham in the longer term.   

It was envisaged that a full public consultation would be entered into between December, 2012, and March, 2013. 

Consideration was given to the scope of the review and provided feedback on the content. 

• Streamlining options available to patients to avoid confusion;
• Travel considerations relating to location of unscheduled care provision(s);
• Cultural norms and whether members of the Black and Minority Ethnic communities used a particular method of unscheduled care.

Whilst Rotherham’s unscheduled care providers would form part of the review, other sources of unscheduled care and information would not be involved in the scope.  These included: -

• NHS Direct help-line and the 111 NHS Service;
• Visit local pharmacists;
• Call 999. 

Resolved: -  (1)  That the information shared be noted. 

(2)  That the Health Select Commission be informed of the scope of the review into Rotherham’s unscheduled care provision. 

- Wednesday, 16^th January, 2013

Agreed:-  That a further meeting of the Health and Wellbeing Board be held on Wednesday, 16^th January, 2013, commencing at 1.00 p.m. in the Rotherham Town Hall.