Agenda and minutes

There were no Declarations of Interest made at the meeting.

There were no questions from members of the public or press.

It was noted that following the meeting, there would be a one hour development session for Board Members in the John Smith Room.

Resolved:- That the minutes of the previous meeting held on 27th September, 2023, be approved as a true record.

Currently scheduled for Wednesday, 27^th March, 2024

It was noted that the meeting scheduled for Wednesday, 27th March 2024, would be moved to 6^th March 2024, due to purdah starting on 13th March, 2024. The meeting would take place at Wentworth Woodhouse.

Resolved:- That the Health and Wellbeing Board:

1)    Agree that the meeting scheduled for Wednesday, 27th March 2024, be moved to 6^th March 2024.

Claire Smith to present

Steph Watt, Deputy Place Director for Rotherham Integrated Care Board (ICB), presented an update on the Rotherham Place Winter Plan with the aid of the following PowerPoint presentation:

Introduction-

•         The plan was developed in collaboration with all Place partners and built on learning from previous years.

•         Approval and assurance through the Urgent Emergency Care (UEC) Board was completed in September and it was taken through the UEC Alliance, Place Leadership Board and to Health and Wellbeing Board.

•         Additional resources were prioritised, allocated and assured through the Better Care Fund which supported integrated working across health and social care.

Summary of Key Learning-

•         Key Themes:

?    Key pressure points were Primary Care, Urgent and Emergency Care Centre (UECC) and Discharge, including access to community services impacting on system flow.

?    Winter came early, pre-Christmas 2022, including acute respiratory infections and/or Covid.

?    The impact of industrial action and cost of living would continue to be a factor.

•         What worked well:

?    A whole system approach.

?    Strong partnership working.

?    Targeted schemes.

?    Additional senior management support at key pressure points.

?    Acute escalation framework and a command centre.

•         Challenges:

?    Short term funding schemes and/or recruitment challenges.

?    Unprecedented pressures were seen in November and December 2022, this included paediatric acute respiratory.

?    Pressure on general and acute beds.

?    Barriers to timely discharge and decision making.

?    Communication challenges in a fast-changing context.

•         Strategy:

?    National funding was for the period of 2023-2025, this enabled longer term planning.

?    Winter schemes would start before Christmas this year.

?    Target key themes would include:

-         Access to primary care.

-         Alternative pathways to UECC.

-         New ways of working and/or investment in the community.

-         Right size of general and acute bed base.

-         A review escalation framework and access to information which would provide a whole system overview.

The year in Primary Care-

•         The Primary Care Hub would be delivered by the GP Federation between the period of December to February, this would support acute respiratory infections and seasonal variations (national forecasts suggested a flu peak between January and February 2024).

•         Additional clinical capacity.

•         Additional reception capacity and hosted (cloud) telephony would be in place in all practices, with a call back functionality which would ensure callers would not loose their place in the queue.

•         Community teams linked to all practices.

•         All CQC registered care homes had an aligned GP practice, with specific responsibilities to provide continuity of care and avoid admission to hospital.

•         Flu and Covid Vaccinations would be delivered as a system using practice footprint, this would include residents and staff in care homes.

This year, alternative pathways to the Emergency Department-

•         Virtual Ward (hospital at home):

?    This would be for people who would otherwise be in an acute bed.

?    Frailty and acute respiratory pathways.

?    Utilising remote technology where appropriate to identify changes in condition.

?    Avoiding unnecessary admissions and facilitating early discharge.

•         Urgent community response (UCR):

?    A two-hour response standard, 70% of the time.

?    Nine clinical conditions.  ...  view the full minutes text for item 49.

Steph Watt to present

Steph Watt, Head of Adult Commissioning at the NHS, presented an update on working with the voluntary and community Sector, Support for Right Care Right Time Right Place with the aid of the following PowerPoint presentation:

Context-

•         Based on Rotherham’s commitment to supporting people to remain independent at home for as long as possible and home first ethos.

•         Built on the strong tradition of partnership working and Voluntary Action Rotherham’s early pioneering of social prescribing.

•         Highlighted three services which supported admission avoidance and discharge, to ensure people would receive the right level of care according to their needs.

Rotherham Urgent and Emergency Care, Social Prescribing Service-

•         The role:

?    To work with health and social care professionals to support patients experiencing social, emotional and/or practical barriers to better health and wellbeing.

?    For admission avoidance and discharge.

?    Would provide holistic, wrap-around support for patients.

?    Would utilise wider voluntary and community sector services.

?    Would help to ensure a safe home environment and build independence, confidence and resilience.

•         The Service:

?    Ran Monday to Friday for age eighteen plus.

?    Received referrals and assessed discharged for patients.

?    Developed a support plan.

?    Onward referrals.

?    Ongoing, short-term support.

?    Follow-up and closure of case.

UEC Social Prescribing in practise, Paul’s case study:

•         About Paul:

?    Admitted with Critical Pneumonia.

?    Unable to walk or mobilise.

?    Poor mental and physical health following 9 months in hospital and a huge life change and lost his job and home.

•         Paul’s experience:

?    Spent nine months in hospital and step-down beds.

?    Referred to befriending and enabling, advocacy and benefits support.

?    Since discharge, Paul had progressed from a bed space to independent living within supported housing.

?    Paul was feeling positive, and the aim was to walk independently and return to work in the future.

•         The impact for Paul:

?    Improved wellbeing (outcomes measures).

?    Improved mental health and physical health.

?    Improved social connections.

?    Maximised finances.

?    Greater independence and resilience.

•         The impact for the system:

?    Bridged a gap from acute back into the community.

?    Linked in with ED high intensity user group.

?    Improved co-ordination of care between health, social care and voluntary sectors

?    Reduced likelihood of readmissions.

YAWR Services Personal Health Budget (PHB)-

•         The Need:

?    Removed barriers to allow early and safe discharge, in order to reduce delayed discharges.

?    Assessment and award of PHB (up to £500, with escalation process for exceptions) used to buy a service or goods for discharge home from the acute or community bed base.

•         YAWR Services Offer:

?    The service visits patients on the ward prior to discharge to discuss and assess their needs to facilitate discharge from hospital.

?    Pre-discharge was included an initial assessment to discuss support needs and action plan.

?    Post discharge was included a visit the patient to address additional needs including benefits support.

•         Barriers to Discharge:

?    Housing, equipment and adaptations, property, and referral pathways.

Personal Health Budgets (PHB) in practise-

•         Marcia’s Story:

?    Patient was aged 59 years and admitted to Rotherham Hospital in June 2022, following a stroke,  ...  view the full minutes text for item 50.

Nicola Curley and Jason Page to present

Board Sponsors Jason Page, Medical Director for Rotherham Place (ICB) and Nicola Curley, Strategic Director of Children’s and Young People’s Services presented an update on the progress of Aim 1, all children get the best start in life and go on to achieve their potential, with the aid of the following PowerPoint presentation:

Alignment of the South Yorkshire Integrated Care Partnership (ICP) priorities with Rotherham’s Health and Wellbeing Strategy-

•         Context for children’s health was very similar in both strategies:

?    Focused of both strategies on health inequalities and the impact of physical, commercial and socio-economic determinants on children’s health.

?    Housing, social networks, education and poverty

?    Impact of the pandemic on children’s mental health.

•         Focus of health areas were very similar:

?    1001 days, parental health, mental health and oral health.

?    Children’s development, development of healthy habits (physical activity and healthy eating).

•         The main difference was the focus on the South Yorkshire strategy on school readiness, which was not a major focus of the Rotherham Health and Wellbeing Strategy. This was also the focus of the ICP Strategy’s Bold Ambition, the area where more could be achieved by working together across South Yorkshire:

?    Focused on development in early years so that every child in South Yorkshire would be school ready.

?    Raising the level of school readiness in South Yorkshire and closing the gap in those achieving a good level of development, between those on free school meals and all children by 25% by 2028 to 2030.

Rotherham’s strategic priorities for children’s health and wellbeing-

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

?    Develop the approach to give every child the best start in life.

?    Support children and young people to develop well.

Context and cross-cutting activities-

•         School age population had increased between 2011 and 2021, the number of children aged 0-4 had decreased from 15,738 in 2011 to 14,645 in 2021 (a 7% reduction).

•         The percentage of children living in poverty in Rotherham was higher than regional and England averages, with an estimated 17,700 children and young people aged 0-15 living in families whose income was less than 60% of the median income (2021).

•         Cross-cutting activities since last year:

?    Development and implementation of ‘Best Start and Beyond’ framework.

?    Mobilisation and launch of the 0-19 Service, with a universal offer to support all children and young people and their families, with an enhanced offer for those that needed it, ensuring that there was equality across the service.

Strategic Priority 1, develop our approach to give every child the best start in life-

•         The first 1001 days (from conception to age 2) was widely recognised as a crucial period. Too many children in Rotherham were not currently getting the best start in life due to differing life chances.

•         Key actions to deliver on this priority:

?    Develop and publish the Start for Life Offer (first 1001 days), through implementation of Best Start and Beyond Framework.

Working towards formal  ...  view the full minutes text for item 51.

Susan Claydon and Alex Hawley to present

Susan Claydon, Head of Locality and Family support and Alex Hawley, Public Health Consultant provided a Progress Update on the Family Hubs programme, and the following overview was provided:

•         The Family Hubs programme was co-launched with the Chair and Cabinet Member.

•         Rotherham was one of the seventy-five local authorities that had received the funding. The funding had been used to add value, to the already imbedded family working that was in place.

•         The key objective of the programme was to improve access to all service delivery. This was being achieved through a range of funding strands, a digital offer, perinatal mental health, publishing the start for life offer and establishing a parent carers panel. There was also an enhanced offer for parenting programmes and evidence-based programmes.

•         There had been a new universal health visit implemented between the period of three to four months, beforehand this had only been completed for families with complexities. Families with more complex needs would continue to be supported through Early Help assessments and plans.

•         From January, parents registered with the job centre would be able attend appointments on site, rather than travelling to the job centre building, this would ensure that services were more accessible.

•         The Satellite hubs was a key element and there would be digital development work completed to link the satellite hubs to the main hubs.

•         Digital Rotherham Inclusion officers were working on site and helping families who have families to accessing the available digital offer. All pregnant women and families had access to the Digital Parenthood programme. There was interactive video guidance which was a short video focused on helping the parent and child relationship.

•         The Liquid Logic Portal had been purchased to improve the process for partners when completing early help assessments.

•         Voluntary Action Rotherham were heavily involved in the delivery of work and were already recruiting volunteer mentors.

•         There had been many recruitments such as three additional nursery nurses, a specialist breastfeeding lead and two home learning officers.

•         It had been agreed that sites would seek UNICEF baby friendly accreditation.

•         In relation to the governance structure, the service was seeking better ways to work and as a result had given the responsibility of overseeing the funded workstreams with family hubs, to the steering group.

•         In relation to school readiness, it was noted that the first 1001 days were the most influential. The best start and beyond framework would assist school readiness. School readiness would be an on-going priority to seek system assurances.

Discussion ensued on the presentation with the following issues raised and/or clarified:

•         A balance was required between the online offer and the in-person experience that the Service provided. The services should be universal to enable people to access more tailored services when required and to ensure that the physical experience would match the online experience.

Resolved: - That the Health and Wellbeing Board:

1)    Noted the progress made in Rotherham’s Family Hubs programme.  ...  view the full minutes text for item 52.

Leonie Wieser to present

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

Board Sponsors/Policy Officer to report

It was advised that this item be deferred until the next meeting.

Resolved: - That this item be deferred until the next meeting.

Lorna Quinn, Public Health intelligence, to present

Lorna Quinn, Public Health Intelligence Manager presented the results of the Rotherham School Lifestyle Survey, with the aid of the following PowerPoint presentation:

Background and Deliverables-

•         Rotherham context.

•         Optional questions and order.

•         Deliverables.

•         Borough wide report (non-identifiable, public facing).

•         School specific reports.

•         Dashboard for targeted work.

Participation and Demographic-

•         15 of 16 schools participated.

•         4,919 students in total: 2,754 Year 7 students and 2,165 Year 10 - 66.6% participation (65% last year).

•         72% White British, 8% Pakistani, 3% ‘Other White Background’.

•         193 children stated they live in a Children’s Residential Home or with Foster Carers (3.9%).

Food and Drink Consumption-

•         588 students (13%) rated their diet as poor (1 or 2 out of 5) and the majority felt that their diet was OK.

•         1,195 students (26.4%) did not have breakfast.

•         This was increasing but remained similar to last year.

•         2,694 students (59.5%) drank at least one high-sugar fizzy drink per day. This remained similar to previous levels.

•         1,797 students (39.7%) drank at least one high energy drink per week (red bull, monster etc), this was a slight increase.

Physical Health-

•         77.5% of respondents rated their physical health as excellent or good, 18.6% as fair, and 3.9% as poor.

?    21% reported a long-term illness, medical condition or disability. This had shown no overall trend since 2017.

?    Asthma and Autism were the two most prevalent self-reported conditions: 4.4% and 3.2% respectively.

?    Young people had a good understanding of where to access support including for sexual health advice; support from school nurses, and family and friends were recognised most frequently.

•         64 respondents smoked on a regular basis and 161 respondents vaped on a regular basis.

?    There was no trend in smoking data: 0.6% and 3.3% of respondents smoked on a regular basis (Y7 and Y10).

?    There had been a positive increase in those who did not think it was ok to smoke.

?    78% of Y7 and 47% of Y10 had never tried an alcoholic drink, this was similar to previous years.

?    87% of respondents had never tried drugs or substances and of those that had consumed in the previous month, data remained similar to previous years.

Mental Health Impacts-

•         Mental health ratings decreased in 2022 and increased this year. However, proportions rating mental health as poor remained higher than in 2019.

•         When asked about the change in their mental health over the last 2 years, 33.4% of respondents reported an improvement in mental health, 35.9% reported their mental health staying the same, and 30.7% reported it being worse or much worse since the pandemic.

•         1.3% of total respondents self-reported diagnosed mental health issues.

•         26.2% of students felt they were not the right size for their age and height and 45.8% felt there was a lot of pressure to have the perfect body image from social media.

•         72.7% of students had been bullied in the last 6 months.

•         16.6% of  ...  view the full minutes text for item 55.

Ben Anderson to present

Ben Anderson, Director of Public Health, provided a report on the proposed extension of the Suicide Prevention and Self-Harm Action Plan and the following was noted:

•         The Suicide Prevention and Self-Harm Action Plan action plan would be in place until the end of this year.

•         There had been a national strategy developed this year and there would be new national planning guidance for suicide prevention, which would be issued at the end of 2024. The current action plan was in line with all new areas relating to the national strategy.

•         It was proposed that the current action plan should be maintained throughout the next year, delaying the full refresh until after the national guidance would be received.

Discussion ensued on the presentation with the following issues raised and/or clarified:

•         Suicide rates within the Borough were high, but the rates of male suicide were now in line with national averages.

Resolved:- That the Health and Wellbeing Board:

1)    Approved the recommendation to update existing actions within in the plan whilst awaiting the issue of the national planning guidance and ONS dataset for suicide rates.

2)    Agreed to receive the updated plan in March 2024.

3)    Would continue to receive regular updates on progress.

4)    Agreed for a full refresh of the action plan, supported by the release of the latest ONS dataset and OHID local planning guidance, towards the end of 2024.

Gilly Brenner and Kelsey Broomhead to report

Gilly Brenner, Public Health Consultant and Kelsey Broomhead, Public Health Practitioner Apprentice, presented an update on the Rotherham Food Network with the aid of the following PowerPoint presentation:

The Aim of the Rotherham Food Network-

•         Over the past 18 months, the network had brought together key stakeholders with an interest in food to work together and share best practice in Rotherham.

•         The network had used the Sustainable Food Places framework as a structure to focus on six key issues.

Food Governance and Strategy-

•         Created the Rotherham Food Network.

•         Included seventeen stakeholder organisations and sixty-eight members.

•         Agreed the Terms of Reference.

•         Gained Sustainable Food Places membership (May 2023).

•         Developed the first action plan (2023 – 2025).

•         Food impact and progress monitoring dashboard was being drafted.

•         The joint strategic needs assessment included a section on food and diet.

Good Food Movement-

•         Adopted a compassionate approach, understanding the context regarding eating and living.

•         Would engage with the Healthy Holiday provision.

•         Synergy bid, would sharing best practice between food partnerships (Sheffield, Rotherham, and Bristol collaboration).

•         Would plan to celebration event to raise awareness of our food movement in Spring 2024.

•         Expanded Rotherhive to include a food section.

Healthy Food for All-

•         Food in Crisis Partnership, focused on a multi-agency approach.

•         Made staff aware of food poverty issues, e.g., Cost of living crisis.

•         Healthy Start voucher, increased the uptake in those eligible (Jan 23 68%, October 23 78%)

•         Breastfeeding Friendly Borough.

•         Participated in campaigns such as Veg Power, through the school catering provision.

Sustainable Food Economy-

•         Takeaway planning within Rotherham, limited takeaways that could be built or licensed within an 800m radius of a school.

•         Rotherham Food Network would attend ‘The Voice’ town centre business meetings to promote and engage on food and the network.

•         Healthy Start Voucher scheme would increase the accessibility to use the vouchers by getting more businesses on board.

Catering and Procurement-

•         Rotherham Council School Catering retain Bronze Food for Life, Riverside Catering was featured as the Soil Association’s caterer of the month in their August newsletter.

•         Catering staff had taken part in additional training such as eating disorders and compassionate approach.

Food for the Planet-

•         The Council had declared a climate emergency.

•         Love Food, Hate Waste Campaign.

•         Joint food waste strategy between Rotherham, Barnsley and Doncaster.

•         WRAP project with Rotherham Minster food bank used labels to reduce food waste.

•         Healthy Foundation Award application included elements of growing and recycling within the award scheme.

Discussion ensued on the presentation with the following issues raised and/or clarified:

•         The action plan did not cover all the current activities, it reflected the actions with momentum at that point in time.

•         There had been work completed to improve the take up on school meals and encouraging children to eat healthier at school.

•         There was an example provided of a recent case,  ...  view the full minutes text for item 57.

There were no items to report.

o    BCF Covering Report and Quarter 2 Template 2023/24

o    Finance and Risk Monitoring Report Q2 2023/24

o    BCF Metrics Report and Scorecard Q2 2023/24

The Better Care Fund papers that were included in the agenda pack were discussed. It was noted that two were for information (The Better Care Fund Quarter 2 Template 2023/2024 and the Better Care Fund Metrics Report Quarter 2 2023/2024) and one was for consideration of board members (The Finance and Risk Monitoring Report 2023/2024).

Better Care Fund (BCF) Quarter 2 Template 2023/2024:

Resolved: - That the Health and Wellbeing Board:

1)    Noted the documentation for submission to NHS England (NHSE) on 31st October 2023.

Finance and Risk Monitoring Report 2023/2024:

Resolved:- That the Health and Wellbeing Board:

1)    Noted the areas of risks, underspends, and explanations.

2)    Accepted the report as the Quarter 2 position.

3)    Agreed to carry over any underspend to 2024/2025 in respect of capital expenditure against the Disabled Facilities Grant.

Better Care Fund (BCF) Metrics Report Quarter Two 2023-2024

Resolved: - That the Health and Wellbeing Board:

1)    Noted the contents of the report and performance for 2023/2024.

Minutes of meetings held on 19^th July and 20^th September, 2023

The minutes of the meeting of the Rotherham Place Board ICB Business held on 19th July and 20^th September 2023, were submitted for information, and noted.

It was advised that Rotherham was now part of the South Yorkshire Integrated Care Partnership (SY ICP), with four of the SY ICP members being from the Health and Wellbeing Board. It was therefore suggested that the South Yorkshire Integrated Care Partnership (SY ICP) minutes should be included in any future Health and Wellbeing Board papers.

Resolved:- That the Heath and Wellbeing Board:

1)    Agreed that the South Yorkshire Integrated Care Partnership (SY ICP) minutes would be included in any future Health and Wellbeing Board papers.

Minutes of meetings held on 19^th July and 20^th September, 2023

The minutes of the Rotherham Place Board held on 19th July and 20^th September 2023, were submitted for information and noted.

Wednesday, 24^th January, 2024, commencing at 9.00 a.m. venue to be agreed

Resolved: - That the next meeting be held on Wednesday 24^th January 2024, commencing at 9.00 a.m. to be held in Rotherham Town Hall.