Agenda and minutes

Shafiq Hussain, Voluntary Action Rotherham, declared a pecuniary interest in Minute No. 63 (Better Care Fund – BCF Section 75 Agreement) as VAR was a recipient of the funding.

The Chair thanked Wentworth Woodhouse for their generosity with regard to the hiring of the room for the purpose of the meeting.

There were no members of the public or press in attendance and no questions had been received in advance of the meeting.

The Chair referred to the 2 documents which had been circulated the previous day relating to the South Yorkshire Integrated Care Strategy.

Consideration was given to the minutes of the previous meeting.

Resolved:-  That the minutes of the meeting held on 23^rd November, 2022, be approved as a true record of the proceedings.

Sue Turner and Rebecca Woolley, Public Health Specialists, to present

Sue Turner, Public Health, and Rebecca Woolley, Public Health, gave the following powerpoint presentation:-

Context

-        There was a growing movement and evidence base that supported taking a ‘compassionate approach’ to weight

-        Our working definition of a compassionate approach was: ‘An approach that promotes health gains for all people, without stigma or judgement, and which takes into account the wider context of their lives’

-        This approach involves:

·        Actively tackling weight stigma and body shaming

·        Focussing on healthy habits and sustained behaviour change over time rather than on weight loss as the primary success measure

·        Emphasising the importance of social change over individual ‘lifestyle choices’

·        Taking a person-centred and holistic approach

·        Addressing the wider and commercial determinants

-        We are at the beginning of an evolving process so we want to engage with professional stakeholders and local people to understand how to make this approach ‘real’, consistent and right for Rotherham

Why take a compassionate approach to weight?

-        Weight stigma is a significant public health issue

·        Weight stigma was significantly associated with greater disordered eating, comfort eating, alcohol use and sleep disturbance, after controlling for covariates

·        Weight stigma was likely to drive weight gain and poor health and thus should be eradicated.  This effort could begin by training compassionate and knowledgeable healthcare providers who would deliver better care and ultimately lessen the negative effects of weight stigma

·        Every year the CAMHS Eating Disorder Team will see a number of referrals where the young person had either misinterpreted anti-obesity messages or had been advised to seek help after the NCMP and this had been taken very literally, triggering them to develop an eating disorder

·        Weight stigma may also contribute towards reduced help-seeking and health-seeking behaviour

Should weight loss be the primary success measure

-        BMI was only one indicator of health risk.  For many people becoming healthier would involve losing weight but many people classed as “overweight” were healthy and many classed as “healthy” actually had higher mortality risks than the overweight or even slightly obese

-        Conventional dieting did not work for most people in the long term and estimates suggested that most people would regain weight lost through dieting within 2-5 years

-        A systematic review and meta-analysis of trials exploring the efficacy of 14 popular named diets found that “weight loss diminished at 12 months among all macronutrient patterns and popular named diets while the benefits for cardiovascular risk factors of all interventions, except the Mediterranean diet, essentially disappeared”

-        By focussing solely on weight and weight loss to improve health, measures not only failed to achieve sustainable weight reduction or health benefits but could also be harmful.  Harms may include, but were not limited to, disordered eating, weight cycling, preoccupation with food, distorted body image, poor psychological health, weight stigmatisation and discrimination

Weight was complex and influenced by a wide range of issues

-        There was a 4% increase in fast food outlets in Rotherham between March 2020 and March 2022

-        26.9% of households  ...  view the full minutes text for item 56.

Gilly Brenner, Public Health Specialist, to present

Gilly Brenner, Consultant in Public Health, presented an update on measures being taken locally and proposals to improve tobacco control aided by the following powerpoint presentation:-

Why prioritise tobacco control

-        Smoking was the leading cause of preventable and early deaths in the UK and Rotherham

-        Smoking rates in Rotherham > all England (16.9% vs 13.0%)

-        Smoking was the single largest driver of health inequalities locally and nationally

-        Inequalities in Rotherham were worse than in all England

Why invest in tobacco control

-        Estimated societal cost of smoking in Rotherham = £67.5M per year

-        Major disinvestment in tobacco control locally.  Spend per head of population fell by 49% between 2013 and 2018

-        Every £1 invested in smoking cessation = £10 saved in future health care costs and health gains

-        Major cost to NHS – 5.5% of budget

Background

Nationally

-        Khan review into Government ambition for smokefree (<5% prevalence) UK by 2030

-        Concern over perceived growth in use of e-cigarettes amongst young people

-        No new national tobacco control plan

-        Relaunched NHS Smokefree Pledge and Local Government Declaration on Tobacco Control

Locally

-        Health Needs Assessment and Internal Audit on Tobacco Control in early 2022 – need for better co-ordination locally

-        Re-commissioning of community smoking cessation programme

-        (Re)launch of Health Checks and Lung Checks Programme

Rotherham’s response

-        Tobacco Control Steering Group made up of representatives of the Council, The Rotherham NHS Foundation Trust, Get Healthy Rotherham, South Yorkshire Fire and Rescue Service, NHS South Yorkshire Integrated Care Board and Rotherham Local Pharmaceutical Committee

-        Tobacco Control Action Plan

-        Tobacco Control Monitoring Plan

-        E-cigarette position paper

-        Relaunch of NHS and Local Government declarations

Action Plan (2022- 2025)

Strategy and Co-ordination

-        Smoking prevalence in adults (18+) – current smokers

-        Smoking status at the time of delivery

-        Smoking attributable mortality (35+)

-        Smoking attributable hospital admissions (35+)

-        Create a shared vision, plan, governance structure and set of policies for effective tobacco control across Rotherham

-        Improve the availability and use of local data on tobacco use, exposure and related health outcomes

Quit for Good

-        Provide high quality community-based smoking cessation support

-        Deliver a smokefree NHS

-        Eliminate tobacco dependence in pregnant women

-        Work with local employers to help staff to quit

Strengthening Enforcement

-        Create a hostile environment for tobacco fraud and underage sales through intelligence sharing

-        Tackle illegal activity including sales of counterfeit and illegal nicotine containing products

-        Change perceptions about illegal tobacco sales and the harms of buying and using illegal vape products

Reducing inequalities

-        Deliver targeted and tailored smoking cessation services and communications to reach groups with highest prevalence of smoking

Stopping the start

-        Support schools to minimise uptake of smoking and e-cigarettes

-        Reduce exposure to second hand smoke and de-normalise smoking by expanding and enforcing smokefree place policies

-        Use targeted and mass communication to change attitudes and social norms around smoking and  ...  view the full minutes text for item 57.

Barry Knowles, Voluntary Action Rotherham, to present

Barry Knowles, Voluntary Action Rotherham, gave the following powerpoint presentation:-

Timeline of Social Prescribing in Rotherham

-        2012 - Case management long-term conditions pilot started – Primary Care

-        2015 – Mental Health pilot – secondary Mental Health

-        2020 – supporting Primary Care through the pandemic

-        2021 – Long Covid Assessment Service – Breathing Space

-        2022 – Urgent and Emergency Care pilot – secondary care avoidance/discharge

PCN Link Worker Service and Primary Care Networks

-        Link Worker Service starts – 5 year growth plan – Primary Care (commissioned by NHS England)

-        2021 – Green Prescribing Grants

-        2022 – Children and Young People Social Prescribing pilot

-        2023 – Community Stroke Pathway pilot

Referrals to Rotherham Social Prescribing Service since 2012

-        Over 12,000 patients referred to the Service

-        Over 15,000 referrals received (some patients may have multiple referrals over time)

Impacts of Social Prescribing – findings of independent evaluations

-        Reduced hospital admissions and A&E presentations

-        Cost of in-patient and A&E presentations reduced

-        Reduction in Primary Care use

-        Improved wellbeing outcomes for patients

-        Increase in community groups/capacity of community organisations

-        Increase in resources into the VCSE/enhanced reputation of VCSE

-        Increase in self-care and independence

-        Lifestyle changes leading to improved physical and mental health

-        Increase in financial wellbeing/increase in financial resources spent in Rotherham

-        Increase in people accessing and maintaining social relationships

Positive outcomes reported by Service users

-        Gaining new social connections

-        Improved mental health

-        Improved mobility and physical activity

-        Increased confidence

-        Happier with family life/improved relationships

-        Increase in income – claiming all benefits entitled to

-        Feeling safer at home after help with adaptations and Occupational Therapy support

-        Carer stress reduced

-        Improved digital skills, confidence and knowledge

Importance of funding for the sector – role of RSPS commissioned VCS partners

-        Befriending and Enabling

-        Advocacy and benefits support

-        Carer flexible respite

-        Dementia Enabling

-        Supported physical activity

-        Counselling

-        Digital inclusion/personal development

-        Engagement groups (nature and crafts/complementary therapies)

-        Community hubs

Quote from National Academy for Social Prescribing report

-        ‘Overall, the evaluation of the RSPS suggests that key stakeholders in social prescribing – the NHS, their funders, local infrastructure and small providers themselves – each has a role to play in ensuring social prescribing is sustainable.  Ultimately, the ingredients for a successful and sustainable model of social prescribing lie in a range of local partners working together equitably in the interests of individuals and communities facing multiple forms of disadvantage’

The Social Prescribing Service had won a national award, however, it was a changing world and the challenge was to make sure the Service adapted accordingly.  There was more that voluntary groups could access; Social Prescribing was an element but not the whole of the community sector.

Barry was thanked for his informative presentation.

Councillor Roche, Chair, to present

The Chair referred to the suggested responses that had been circulated to Board members the previous day to the ICP draft Strategy.

The deadline was mid-February for any further points to be added before submission.

Paul Woodcock, Strategic Director, Regeneration and Environment, and Laura Koscikiewicz, South Yorkshire Police, to present

Paul Woodcock, Strategic Director of Regeneration and Environment, and Laura Koscikiewicz, South Yorkshire Police, presented the following powerpoint presentation on Aim 4 of the Health and Wellbeing Strategy:-

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

Priority 1: Deliver a loneliness plan for Rotherham – key areas of progress included:

-        Delivery of dissemination opportunities form OHID Better Mental Health Fund Befriender project

-        Existing resources of loneliness and befriending were regularly promoted this included the VAR film Be a Good Neighbour and Five Ways to Wellbeing

-        The loneliness action plan had been updated

-        Promotion of volunteering opportunities

Priority 2: Promote health and wellbeing through arts and cultural initiatives – key areas of progress included:

-        Rotherham Show had been delivered for 2022 welcoming more than 60,000 residents and visitors back to Clifton Park

-        Complete evaluation of over 55s programme to provide recommendations for future programming for this audience and reduce social isolation

-        Co-design Children’s Capital of Culture with children and young people with focus on improving their mental health and wellbeing

-        Activities were being delivered in libraries for people of all ages to connect, be active and learn new skills and widen the accessibility of Library Services through Pop-up libraries, reading gardens, makerspaces, authors’ visits and performances, fun palaces

-        Meetings were progressing to further utilise libraries as death positive spaces where the public could have conversations around loss, grief, end of life planning and legacy

-        Libraries were being utilised and promoted as spaces for people to share experiences and response to specific health issues including menopause and dementia and improve community resilience

Priority 3:  Ensure Rotherham people are kept safe from harm – key areas of progress included:-

-        Work was ongoing to embed referral pathways with key partners in Rotherham through the Home Safety Partnership Referral Scheme and Safe and Well checks

-        A Combatting Drugs Partnership for Rotherham had been established

-        Delivery of vaccination programme for Covid-19 and flu

Priority 4 – Develop a borough that supports a healthy lifestyle – key areas of progress included:

-        Deliver a range of programmes to welcome women and girls into football focussing on under-represented groups

-        Use football to encourage more women and girls to adopt and maintain a healthier lifestyle

-        Rotherham Food Network to develop an action plan and response based on the framework of the Sustainable Food Places Bronze Award

-        Work was ongoing to enable all partner staff to support neighbourhoods and communities to thrive through exploring options for a partnership offer on training on strength-based approaches

Next Steps

Priority 1: Deliver a loneliness plan for Rotherham

-        Promoting volunteering opportunities:  An Older People’s Campaign was being developed and would run in the new year.  Partners were compiling case studies to use and share

Priority 3:  Ensure Rotherham people are kept safe from harm

-        Work with other partnership boards on crosscutting issues relating to safety and safeguarding: revision of the Safeguarding Protocol  ...  view the full minutes text for item 60.

Leonie Wieser, Policy Officer, to present

Leonie Wieser, Policy Officer, presented an update on the progress of the Health and Wellbeing Strategy action plan.

It was noted that the work on the family hubs model was now complete and had been submitted to Government.  An update would be submitted to the March Board meeting.

Work towards signing up to the OHID prevention concordat for better mental health was slightly delayed due to the gathering of evidence taking slightly longer than anticipated. 

Resolved:-  That the update be noted.

Verbal update by Councillor Roche, Chair, and Leonie Wieser, Policy Officer

The Chair and Leonie Wieser, Policy Officer, had met with all Board sponsors.

It was noted that, whilst the new Chief Executive of RDaSH came into post, Chris Edwards would assume the sponsor role for Aim 2.

It was suggested that all 4 Board sponsors meet with their priority leads and ascertain if there are any changes particularly in light of the ICB/ICP.

Councillor Roche, Chair, to present

Further to Minute No. 43 of the previous meeting, Councillor Roche, Chair, reported that an Addendum to the BCF Policy Framework and Planning Requirements had been published on 18^th November, 2022, setting out conditions, monitoring and reporting arrangements for the Adult Social Care Discharge Funding 2022/23.  The additional funding amounted to a total of £2.773M of funding for Rotherham Place partners for the remainder of the current financial year.

The funding needed to be pooled into local HWB Section 75 Agreements to be used to reduce flow pressures on hospitals, including mental health inpatient settings, by enabling more people to be discharged to an appropriate setting with adequate and timely health and social care support over the winter period.

Resolved:-  That the Section 75 Framework Agreement and Better Care Fund (BCF) Call-Off Partnership/Work Order for 2022/23 be approved.

(Shafiq Hussain, VAR, declared a pecuniary interest as VAR was a recipient of BCF funding)

Sharon Kemp, RMBC Chief Executive and Chris Edwards,

Sharon Kemp, Chief Executive, reported on the Place development session that had taken place recently.  It was expected to receive the draft for the Place Board at the end of March which would be submitted to this Board in due course.

A Health and Inequalities Conference was to be held on Friday, 3^rd February at the New York Statidum.

Karen Smith, Adult Care, Housing and Public Health

The report submitted, for information, set out the schemes that would be funded by the Adult Social Care Hospital Discharge Fund (Minute No. 63 above refers).  

Resolved:-  That the report be noted.

The minutes of the Rotherham Place Board held on 19^th October, 2022, were noted.

The minutes of the meeting of the Rotherham Place Board ICB Business held on 19^th October, 2022 were noted.

Wednesday,  2023

28^th June

                     27^th September

                    22^nd November

                     2024

                     24^th January

                     27^th March

                     26^th June

                     25^th September

                     27^th November

                     2025

                     22^nd January

                     26^th March

commencing at 9.00 a.m. venue to be confirmed

Resolved:-  That meetings of the Health and Wellbeing Board be held during the 2023/24 and 2024/25 financial years as follows:-

Wednesday,  28^th June, 2023

                     27^th September

                     22^nd November

                     24^th January, 2024

                     27^th March

                     26^th June

                     25^th September

                     27^th November

                     22^nd January, 2025

                     26^th March

All commencing at 9.00 a.m. venues to be confirmed.

Wednesday, 29th March, 2023, venue to be agreed

Resolved:-  That a further meeting be held on Wednesday, 29^th March, 2023, commencing at 9.00 a.m. venue to be confirmed.