Agenda and minutes

There were no Declarations of Interest made at the meeting.

The member of the public arrived after this item had been taken on the agenda.  The relevant officers agreed to stay behind after the meeting to discuss the member of the public’s issues.

The minutes of the previous meeting of the Health and Wellbeing Board held on 21^st November, 2018, were considered.

Resolved:-  That the minutes of the previous meeting held on 21^st November, 2018, be approved as a correct record.

Arising from Minute No. 30 (Refreshed Joint Strategic Needs Assessment Consultation), Chris Edwards undertook to contact Miles Crompton to discuss Ward profiles/Health localities.

ACTION:  Chris Edwards

It was noted that the consultation was about to close.  Anyone interested in becoming involved in the steering group should contact Gilly Brenner.

Presentation by Kate Green, Public Health Specialist

Kate Green, Public Health Specialist gave the following powerpoint presentation:-

What we know

-          25.5% of 4-5 year olds and 36.1% of 10-11 year olds are overweight or obese

-          Obesity levels are much higher in our most deprived communities: the three most deprived Wards (Rotherham East, Rotherham West and Valley) have some of the highest rates for obese children at Reception and Year 6

-          Adult obesity levels are significantly higher than the England average with 71.2% of adults aged over 18 either overweight or obese and 6 of the 7 most deprived Wards are above the Rotherham average for obese adults

-          Only 1 in 20 obese children at Reception will have a healthy weight at Year 6

-          These levels of obesity cost the local economy an estimated £23.7M

“There comes a point when you had to stop pulling people out of the river, get upstream and find out why they are falling in” Desmond Tutu

-          Current ‘Weight Management’ Service for age 4+ identified with weight concern

-          Model of delivery only able to work with around 150 children per year

-          There were around 1,000 obese children in Reception and Year 6 alone in 2017/18

-          If only 1 in 20 obese children at Reception have a healthy weight at Year 6, resources need to be directed much more towards early years

-          Obese children are more likely to become obese adults and will generally have poorer health than their non-obese peers – the Health and Wellbeing Board has a strategic aim to ensure “all Rotherham people live well for longer”

-          Need a much stronger focus on prevention

-          Use a whole systems approach to understanding local causes of obesity and what works best to tackle them

A Whole System Approach

Tackling obesity is everyone’s business – there is no single individual, group or organisation that can do this alone

-          6 phases which aim to help local authorities deliver co-ordinated actions involving stakeholders across the whole local system

-          Early phases focus on preparation – securing senior leadership support, developing stakeholder groups, building an understanding of the local obesity picture

-          The next phases are all about collective working: stakeholders from across the system are brought together to create a map of the local causes of obesity in their area and identify and prioritise areas of action – it allows stakeholders to recognise their role in the system and how they can make a difference

-          The latter phases of the process focus on taking actions forward as a group, continuously monitoring and revising them and reflecting on how things can be improved

Local Plans and Strategies

-          Health and Wellbeing Strategy

Aim 1:  All children get the best start in life

Aim 3:  All people live well for longer

Roll of Aim 4 in preventing obesity

-          Children and Young People’s Plan – being refreshed for 2019

-          Rotherham Active Partnership Plan

(contributing to Cultural Strategy and Health and Wellbeing Strategy)  ...  view the full minutes text for item 41.

The Chair to present

The Chair reported that, at the recent agenda setting group, the following issues had arisen which the Board’s views were sought:-

Were Board members happy with the direction of the Board and the way it was going forward?  Some Board members may have been contacted as a key partner to gather their views as to how they felt the Board had progressed in the last year.

Update on the leads and sponsors of the Health and Wellbeing Strategy:-

Aim 1              Jon Stonehouse and Jason Page

Aim 2              Kathryn Singh and Ian Atkinson

Aim 3              Sharon Kemp and Louise Barnett

Aim 4              Steve Chapman and Paul Woodcock

                        Sam Barstow, Ruth Fletcher-Brown, Bronwen Knight,

Polly Hamilton and Sarah Watts

Register of Attendance – would start from April.

Membership – it was not felt that the Board should increase.  Representatives were invited as and when an issue arose. 

Place Board/Health and Wellbeing Board – there were occasions when reports were duplicated between the 2 Boards.  Did it need to be the same report that was submitted to the Place Board? 

Meeting arrangements – venues of meetings were rotated between Voluntary Action Rotherham (The Spectrum), CCG (Oak House) and the Council (Town Hall). 

Frequency of meetings – the Board normally met every 2 months but there may be occasions when additional meetings had to be convened.

Length of meetings – normally the Board meeting lasted 2 hours.

Gambling – there was National Guidance that Health and Wellbeing Boards should take the lead on gambling. Agreement that it should be included within one of the Aims due to its links with mental health and suicide prevention work.

BCF Executive Group – there was a growing trend for the BCF Executive Group to have a wider remit.  It was suggested that, rather than setting up another group, the Executive Group become the Joint Commissioning Team across Social and Health Care for Rotherham and report back to the Health and Wellbeing Board for transparency. 

Resolved:-  (1)  That the Place Board consider the issue of duplication of reports and the format they would wish to receive information.

Action:-  Chris Edwards/Sharon Kemp

(2)  That the offer made by South Yorkshire Police to hold meetings of the Board at the Lifewise Centre be included in the rota of venues.

Action:-  Becky Woolley/Steve Chapman

(3)  That Becky Woolly obtain an electronic version of the LGA guidance on the role of gambling and its effects and circulate to Board members. 

Action:-  Becky Woolley

(4)  That gambling be included within the remit of Aim 2 of the Health and Wellbeing Strategy.

Action:-  Becky Woolley/Kathryn Singh/Ian Atkinson

Kathryn Singh, RDaSH

Aim 2:  All Rotherham people enjoy the best possible mental health and wellbeing and have a good quality of life

Kathryn Singh, RDaSH, presented an update in relation to Aim 2 of the Health and Wellbeing Strategy 2025.

With the aid of a powerpoint presentation, following the principles of Signs of Safety, the Board considered:-

What’s working well

What are we worried about

What needs to happen

Discussion ensued with the following issues raised/clarified:-

-          IAPT (Improving Access to Psychological Therapies) was something that historically Rotherham had done very well, however, now was the challenge of upskill capacity.  The Mental Health workforce was something that took more time than other areas in terms of the system

-          There had been a commitment by partners to look within their organisations as to how Mental Health First Aid training would be rolled out.  A report back was required on how each individual organisation had progressed this

-          Within Aim 2 there were no measures for children and young people’s mental health

-          The NHS Long Term Place set out objectives for mental health.  A stark gap was the mental health provision from birth to 3 years which had never been seen before.  An evidence base was gathering that showed the sooner agencies were involved the better.  There were access targets for children who needed to access mental health services who did not have the opportunity to do so.  It also included trauma informed services; RDaSH was seeing an increasing number of referrals and having to respond to childhood trauma issues.  Work was required around restructuring the workforce to deal with the issue of trauma

Resolved:-  That the report be noted.

Ruth Fletcher-Brown, Public Health Specialist

Ruth Fletcher-Brown, Public Health Specialist, presented an update on suicide prevention and the self-harm action plan.

The latest suicide rata data for Rotherham showed that, after a small decrease between 2013-15, the 3 year combined rate had increased from 13.9 to 15.9 per 100,000 DSR (directly standardised rate) between 2014-16 and 2015-17.  Rotherham was significantly higher than England and ranked as the second highest compared to 15 CIPFA Nearest Neighbour local authorities.  There had been 107 deaths over the 3 years 2015-17 with males accounting for approximately ¾ of suicide deaths.  The female rate had also increased every period since 2010-12 and was now significantly higher than England.  The rate for Rotherham females ranked as the highest amongst CIPFA Nearest Neighbours.

Progress against the 2016-2018 Suicide Prevention and Self Harm action plan had been reported on a monthly basis to the Mental Health and Learning Disability Transformation Board, a sub-group of the Rotherham Place Plan Board.  Annual updates had also been submitted to the Health and Wellbeing Board.

The refreshed draft action plan followed the same national areas for action.  Also local intelligence had been used to inform the priority areas for Rotherham during 2019-21.

South Yorkshire and Bassetlaw Integrated Care System had received funding for 2 years from NHS England for suicide prevention.  The funding could not fund local plans in their entirety but could support work in line with the national priorities i.e.

1.     Reducing suicide and self harm in Mental Health Services

2.     Reducing self harm in Community and Acute Services

3.     Suicide prevention in men and/or work with Primary Care

Discussion ensued with the following issues raised/clarified:-

-          The excellent work of the Suicide Prevention Group

-          From a Police perspective the numbers had recently increased.  Reassurance was required that the appropriate referrals had been made at the right time for early intervention, what happened with the partnership assessment, was the threshold too high.  The Police attended post-event but there was a desire to deploy resources before an event took place

-          There had been a lot of care and attention in Rotherham for a long time and some of the work carried out had been ground breaking.  However, due to the recent increase was there still the critical support and challenge?  If Rotherham was at the forefront of good practice but still finding these issues it was important that work/discussion took place with regional and national players to benefit from their experiences

-          The National Enquiry Team, who was working out of Manchester University, had recently given a presentation to RDaSH.  The information shared had been very thought provoking and driven the organisation to think about where was there clear evidence about what made a difference

-          An event should be held bringing together all the key partners to think differently about what partners were doing as it had not been successful of late and ascertain if there was anything underlying that was not being picked up

Resolved:-  That the draft Rotherham Suicide Prevention  ...  view the full minutes text for item 44.

Becky Woolley, Policy and Partnerships Officer

Becky Woolley, Policy and Partnerships Officer, presented the final draft of the Performance Framework, together with the aid of a powerpoint presentation, to measure the successful delivery of the Health and Wellbeing Strategy.

The draft Framework (Appendix 1 of the report submitted) sought to compliment additional information available to the Board such as the JSNA and the ICP Place Plan quarterly performance reports by providing a high level and outcomes-focused overview of performance through a number of priority indicators.

The priority indicators had been selected to reflect the aims and strategic priorities within the Health and Wellbeing Strategy and aimed to capture some of the key improvements that the Strategy sought to make by 2025 to the health and wellbeing of Rotherham people.

Once approved, a scorecard would be developed including data benchmarking Rotherham’s position to national and regional averages.  It was proposed that the scorecard be included as a standing item on future agendas.

As data publication cycles were not aligned for all of the indicators, it was recommended that updates to the scorecard become a standing item on Board agendas.  This would ensure the Board had continued oversight of performance and could escalate any emerging issues at the earliest possible opportunity.

It was also proposed that partners participated in an annual session dedicated to performance providing an opportunity to evaluate trends and identify any areas that required further attention.

Discussion ensued on the proposed Indicators within each Aim:-

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

-                   Child excess weight in 4-5 year olds rather than 10-11 year olds

-                   Query why Children in Need rate and not Child Protection

-                   Query why Average attainment 8 score rather than NEETS

Aim 2: All Rotherham people enjoy the best possible mental health and wellbeing and have a good quality of life

-                   Include work taking place across South Yorkshire and Bassetlaw and the Sheffield City Region and how supporting people with mental health issues into employment

-                   Probable refresh of the timelines due to the NHS Long Term Plan

-                   3 targets at South Yorkshire level – Dementia Diagnosis, IAPT and early intervention in Psychosis

Aim 3:  All Rotherham people live well for longer

No comments

Aim 4:  All Rotherham people live in healthy, safe and resilient communities

-                   Should rough sleepers be included?

-                   Anti-social behaviour?

Resolved:-  (1)  That the draft Performance Framework be approved in principle.

(2)  That discussions take place with Jon Stonehouse with regard to the queries under Aim 1.

Action:-  Becky Woolley/Jon Stonehouse

(3)  That sub-group be established to look at good practice from other areas and the NHS Long Term Plan with regard to Aim 4.

Action:  Becky Woolley

(4)  That the Board participate in a dedicated annual session on performance.

(5)  That the proposed approach to receive updates on performance be approved.

(6)  That Becky Woolley attend the next meeting of the Place Board to discuss the scorecard.

Action:-  Chris  ...  view the full minutes text for item 45.

The Board noted the design version of the Rotherham Joint Health and Wellbeing Strategy “A healthier Rotherham by 2025”.

Minutes of meeting held on 7^th November, 2018

The minutes of the Rotherham Integrated Care Partnership Place Board held on 7^th November, 2018, were noted.

Resolved:-  That the Kings Fund explainer of the NHS Long Term Plan be included as an agenda item on the next meeting of the Health and Wellbeing Board

Action:  Becky Woolley

Wednesday, 20^th March, 2019, venue to be determined

Resolved:-  That a further meeting be held on Wednesday, 20^th March, 2019, commencing at 9.00 a.m. venue to be determined.