Agenda and minutes

A Member must declare any disclosable pecuniary interest where it relates to any matter being considered at the meeting. A declaration of a disclosable pecuniary interest should indicate the interest and the agenda item to which it relates. A Member is not permitted to participate in this agenda item by law and should immediately leave the meeting before the start of any debate.

If the Member leaves the meeting in respect of a declaration, he or she should ensure that the Chairman is aware of this before he or she leaves to enable their exit from the meeting to be recorded in the minutes in accordance with Standing Order 37.

None.

Minutes of the Health and Wellbeing Board Meeting on 29^th June 2022, to approve as a correct record.

Resolved: that the minutes of the meeting of 29 June 2022 be approved as a correct record

The Director of Public Health presented the report reviewing where the Board was working well and ways in which the Board could become more effective. This included, for the Boards endorsement, a series changes to the Board’s Terms of Reference (ToR) to support more effective delivery and to establish clearer roles and responsibilities. 

There was discussion about possible additional representatives (education and housing) and it was noted that further expansion of the Membership would be considered by the Board in due course.

Resolved:

(1)  that the ten highlighted proposed changes to the Board’s ToR and ways of working (set out in the report) be endorsed; and

(2)  that the proposed revised Health and Wellbeing Board Terms of Reference (ToR) document (appended to the report) be adopted.

Ros Cox (Weston, Worle and Villages Delivery Director, ICB Localities) presented the report outlining plans and the work that the ICB Localities in Weston, Worle and Villages and Woodspring participate in and how this work was being conducted with partners to ensure alignment across North Somerset whilst also identifying the needs of the population win each locality and working closely with lived experience representatives.

Noting that the locality plans would be available soon, The Director added that the next stage would be to develop these into the Integrated Care System (ICS) Strategy.

The following issues were covered when discussing the updates:

• the importance of transport in addressing rural accessibility challenges and the need to maximise opportunities through coordination with community networks and services;
• coordinating winter planning across the partnership; and
• the need to address GDPR data sharing challenges.

Resolved: that the report be noted

The Consultant in Public Health (North Somerset Council) presented the report which summarised the refreshed Health and Wellbeing Action Plan and ongoing progress in implementing the strategy. 

The Board sought and received clarification on the following:

• How was Action Plan tested with localities and who was responsible for delivery?
• How were access issues for Children with complex medical needs and elderly residents in rural areas being addressed? 
• The role of ICSs in respect of green infrastructure (eg retrofitting home insulation) to improve outcomes for people with long term conditions and addressing health inequalities.
• The role of social media in the communications strategy – engagement with community partners and their role in amplifying the message.
• Adapting the plan around the cost-of-living crisis.  Member heard that this was a feature of phase 2 of the plan and would be picked up under equality/inclusion, using cohort learning around where support was most valuable (from Feb 2023 onwards). 

There was further discussion around the length of the Action Plan “agenda” and the suggestion that this needed further prioritisation. Also discussion around Action Plan objectives in the context of evidence illustrating the benefits of a more targeted approach. 

In concluding the item, the Chairman confirmed that Members’ feedback would be taken on board.  Going forward, he also emphasised the importance of partners keeping the Board updated on changing priorities – in order to ensure commitment around shared budgets and ongoing projects and thereby maximising impact. 

Resolved: that the report be noted

The Director of Strategy, Partnerships and Population (BNSSG ICB) gave a presentation setting out the key aims of the Integrated Care system, the work done to date around the rationale for, and identification of, priorities, and how the system might work together differently.

In opening discussion and feedback, the Chairman commented on the tendency towards ‘high-level’ terminology and the risk of it becoming remote from day-to-day reality on the ground; the need for the strategy to demonstrably integrate with locality plans, reflecting localised targeting and ensuring equal partnership.

Further feedback from Members focussed on the following themes:

Workforce –

• A clear ‘vision’ was needed for addressing what was a national workforce challenge in this area?
• Workforce and productivity would always be a challenge with no single panacea; addressing this required building momentum behind a wide range of interventions (prevention, community engagement, housing, education, new ways of working (digital/assistive care), education etc)

• The key challenge was driving shift towards the preventative and community sector agendas.

Public expectation -

• Significant work was needed to be put into this: courageous decisions around priorities were needed to get the best return on investment but in return the public would expect commitment to partnership, the commissioning of class leading service, and clear evidence that this integrated approach was delivering improved outcomes.

System aims -

• The ‘system’ needed to be very clear about the aims (and the values underpinning them) – eg what improving outcomes actually means. Meeting targets did not necessarily translate to improvements in quality of life.
• Tackling inequalities was often expressed in terms of access but there was need to consider the whole picture eg building education into the strategy.  

·      There was reference to the use of Board workshops informing the H&WS Action Plan with the suggestion that these be taken a stage further to focus on how to influence the ICS strategy.

The Director of Strategy, Partnerships and Population appreciated Members’ feedback at this early stage in the development of the Integrated Care System strategy and looked forward to bringing it back to the Board in a more refined form for further consideration in due course.

In concluding discussions, the Chair noted the suggestion about extending the H&WB Action Plan workshops remit, emphasising the importance of common data sets when developing strategies.  He also highlighted comments about the need to rise to the rise to the prevention agenda and community involvement challenges, noting the additional challenge around delivering physical/mental health parity.  These were significant challenges and approaches needed to be evolved and adapted over the longer term, whilst bringing people and communities along on the journey by being honest and clear about what was deliverable.

The Director of Public Health referred to his report under the New Ways of Working for the Board (Item 5 above) and specifically to the proposed Board Operations Group which would develop the forward plan of Board meeting topics and their content.  He would be writing to Members shortly with further suggestions in that regard.  Members were invited to put themselves forward for membership of the Operations Group.