Agenda and minutes

The minutes of the meeting held on 23 June 2017 are attached for approval.

RESOLVED -That the minutes of the meeting held on Friday 23 June be agreed as a correct record, subject to it being noted that Sir Paul Ennals was in attendance at the meeting but was not listed.

Matters Arising

The Board were advised that as per the suggestion from the previous meeting that

the Homeless Health Needs Assessment was taken to the Board of the Gateshead

Housing Company.  The Gateshead Housing Company Board were keen to work

with the Health and Wellbeing Board on progressing this work.

It was noted that the report was also taken to the Gateshead Care Partnership and

the Mental Health Programme Board at which it was also well received.

The Action List from the meeting held on 23 June is attached for note.

It was noted that the Substance Misuse Strategy was approved by Council on 20 July.

Concern was expressed about the Deciding Together, Delivering Together work and the expectation of up to date figures on CAMHS Service waiting lists.

It was suggested that Chris Piercy be invited to bring an update to this Board in September / October.

The Chair advised that she would be speaking to NTW and South Tyneside FT regarding their non-attendance at the Board.

RESOLVED - That actions and updates since the last meeting be noted.

Members of the Board to declare an interest in any particular agenda item.

Report attached to be presented by Sally Young.

The Board received a presentation from Sally Young, who had been asked to report on the current contribution of the Voluntary and Community Sector (VCS) in Gateshead.  There is a perception that the VCS is being asked more and more to complement existing services, and this raises some concern about their capacity to provide this support.

The Board were advised that there are likely to be between 700-1000 groups, activities and organisations making up a complex VCS in Gateshead which employ between 3000-4000 people working alongside a number of volunteers.  A further 500 charities are not based in Gateshead, but provide activities within the area.  It is estimated that 34% of Gateshead residents volunteer.  It was noted that the majority of VCS funding does not come from the public sector, for example, one charitable organisation with a turnover of £300,000 received £10,000 from the LA.  It is estimated that 7 out of 10 VCS organisations saw an increase in demand for services in the past year.

The Biggest Challenges highlighted include:

·         The impact of welfare reform

·         Increased poverty in communities

·         Reduction in provision of statutory services

·         Having to pay for things that were once free

·         Lack of jobs / employment opportunities / sanctions

In terms of organisational challenges the following were highlighted:

·         Funding

·         Recruitment and retention of volunteers, especially in terms of volunteers being asked to take on additional work in areas they are not necessarily familiar with

·         Coping with increased costs

·         Maintaining sustainability

The role of the VCS in improving health, wellbeing and

care has developed enormously in the last twenty-five years. It has multiple roles, often dependent on the size and nature of the organisation; these include:

•          As a service provider

•          As a mechanism for bringing patients, users, and carers together e.g. support groups, peer experience

•          As an advocate for individuals, groups and communities who are often excluded

•          Through the use of volunteers to enhance services and experiences

•          As a partner in decision-making

•          As a source of information, knowledge and expertise on particular communities (e.g. contributor to the JSNA)

•          As an improver of the physical environment

•          As a campaigner for environmental and other improvements

However most of these activities require capacity and resources, whether it is goodwill, time, space, volunteers, finance etc. and there is a concern, that VCS organisations will be expected to substitute for paid public sector staff. The shift towards social prescribing is of increasing concern as resources seem to be invested into sign-posters / navigators/ directories indicating where services are, but not into the services themselves.  A clear definition of social prescribing isn’t available and leads to inconsistencies.

There have been some successful examples of asset transfers from the public sector to voluntary organisations, but these take time and a lot of resources. Initially public sector (mainly council) staff were able to invest time in these and provide support and a safety net, however the more recent transfers are not as sustainable.

Experience has demonstrated that  ...  view the full minutes text for item HW150

Report attached to be presented by Gerald Tompkins

he Board were advised that this report was brought to the Board for an update in June and a number of actions were set. It was always the intention to bring a final version to the Board as there was a need to access and analyse further relevant Primary Care data. This has now been completed thanks to data provided by the CCG.

The main issue from the Needs Assessment  is that the prevalence of risk factors in Gateshead appear to be lower than the national figures. It is likely that the main reason for this is the younger age profile in BME populations, but it may also be access to or use of services by them, for instance, the low uptake of Stop Smoking Services. There also appears to be an issue with low recording of ethnicity in some GP practices.  

The Needs Assessment has been restructured, adding an executive summary and in response to the need for a workable action plan, the recommendations have been reviewed to include lead bodies/organisations with responsibility for the recommendation.

The Board is asked to receive and endorse the Needs Assessment with formal updates to be brought to the Board on a three monthly basis.

The following comments were made in relation to the report:

·         Healthwatch Gateshead advised the Board that as they were now working across both Newcastle and Gateshead and they have a joint staff team they may be able to assist in reaching into / engaging further with BME Groups.

·         It was suggested that language and translation may be an issue in terms of accessing services

·         In terms of the BME carers, a prevalence of 1.1% is reported, but there was debate about this as figures from Gateshead Carers Association would suggest this to be higher. It was agreed that this would be acknowledged in the final copy to be available on the JSNA.

·         Also Gateshead Carers have a group from Eretria set up who could easily be accessed for information to feed into future work.

·         The report was commended and it was felt that the recommendations go a long way to helping BME communities access services.

·         It was noted that the CCG have acted on some of the points raised, however it was suggested that it would be useful to know how partners plan to achieve the recommendations.

RESOLVED -             (i)        That the BME Needs Assessment be endorsed.

                                   (ii)       That partner organisations represented on the Board

                                              provide a progress update on implementing the

                                              recommendations in 3 months.

Report attached to be presented by Matthew Liddle

The Board received a presentation which provided feedback on a Health and Lifestyle Survey undertaken by the Council in 2016.  The Council used its online Viewpoint Panel to undertake the survey.  The survey was undertaken between 16 March and 30 April 2016 and 1 November – 18 December 2016.  The reason behind undertaking the survey is that good health is important for happiness and a general feeling of well-being.  A healthy population is in a better position to enjoy life, live longer, to be more productive and to contribute towards economic growth.  The Council is responsible for providing public health services and this survey was designed to explore attitudes to making healthy lifestyle choices, future areas of health promotion and to identify inequalities in health.

In total over the two phases of the survey 881 people responded to the survey.

73% of respondents said they were in good or very good health with a further 20% who said their health was fair.  7% said they were in poor or very poor health.    Although 73% said they were in good health, only 64% thought they were fit.  Respondents who smoke do not get the recommended level of exercise or who have excess weight are significantly less likely to feel fit than on average.  The perception of fitness differs by gender with 41% of women saying they feel unfit, compare with 31% of men.  It also appears, though not definitive that men may feel less fit as they grow older whereas women are the opposite and actually feel fitter they older they get.

Only 9% of respondents said they smoke regularly or occasionally.  This is very low when compare with national smoking prevalence surveys and suggests that the Viewpoint Panel is biased toward non-smoking.  33% said they used to smoke but do not smoke at all now.  Young people are more likely to smoke than older ones, with 12% of those aged under 35 currently smoking, compared to 3% of those aged 65 and over.  There is also a significant ‘social gradient’ for smokers, with a gap of 11 percentage points between those living in the most and least deprived areas.

90% of respondents drink alcohol, but younger people under the age of 35 are significantly less likely to drink weekly or more often at just 32%, compared with 62% of those between the ages of 35 and 64 and 67% of those aged 65 or over.  Men are significantly more likely to drink weekly or more often than women, and this is particularly the case for those aged 65+ with 82% of older men drinking that regularly compare with 47% of older women.  There is a social gradient evident in those who drink weekly or more often with those in the 20% most deprived areas significantly less likely to do so (39%) than those in the 40% least deprived areas (70%).

Fruit and vegetables are a vital source of vitamins and minerals and should make up just over a third of  ...  view the full minutes text for item HW152

Report attached to be presented by Andy Graham and Paul Gray

The Board received a report to seek their views on undertaking a “Year of Action” to highlight the harms arising from tobacco use, and what’s happening in Gateshead to counteract them.

The Annual Report of the Director of Public Health for 2015/16 focused on the harms and inequalities arising from tobacco use in Gateshead and recommended maintaining momentum on action to minimise these harms. In keeping with that recommendation, the Public Health team has outlined a “Year of Action” to highlight the harms arising from tobacco use, and what’s happening in Gateshead to counteract them.

The purpose of this Year of Action is to maintain and raise the profile of the impact of tobacco in Gateshead, and to galvanise action at all levels (i.e. community, organisational, sector-specific) to combat harms.

The proposal is to undertake a series of monthly activities that would be used to generate press/media interest and provide a platform for the communication of key messages.

Key messages would include the impact on health and financial inequalities and harm reduction, encouraging people not to start smoking, protecting others from second-hand smoke, and promoting support for those wanting to stop smoking. The overall message is the desire to achieve a smoking rate in Gateshead of 5% by 2025 – “five by twenty five”.

Activity each month would be promoted through the production of press releases, short videos and other activity that would be made available through Gateshead Council’s social media and the Public Health Team’s “One You Gateshead” social media channels. Suggestions for these are included in Appendix 1.

The impact of the “Year of Action” would be determined by information gathered from social media sources (i.e. unique views, shares, likes, retweets etc), by comments received, and by changes in access to/uptake of stop smoking services.

Some of the following ideas were highlighted from the calendar:

·         Promotion of the Rebranded Stop Smoking Service

·         Celebrating 10 Years of Smoke Free Public Buildings

·         “Burning Injustice” tobacco poverty. Cost to social care and the NHS

It was suggested that there was a need to keep other organisations informed with this and supply resources where available in order for them to also be involved in the initiative.   It was suggested that the fire service, the CCG, and CBC should be included as potential partners.  It was noted that Paul Gray is the contact within Public Health. 

RESOLVED - That it be noted that the Board fully supported the campaign.

Report attached to be presented by Jean Kielty

The Board received an update report on national conditions within the BCF which haven’t yet been fully met and which set out the reasons why this was the case and the planned steps towards progressing these areas of work.

National Condition 4 (ii) – Are you pursuing Open APIs (ie systems that speak to each other)

The long term next steps are in the further development of the Great North Care Record.  This is being developed at a regional level with significant input from health and social care organisations from Newcastle and Gateshead.  It is anticipated that we will soon be able to make use of open APIs from Primary Care clinical systems as part of the national GP Connect Programme.  Health and Social Care Network connectivity is being explored and an initial fact finding meeting has taken place, led by the Council’s ICT services.  This is as a result of the proposed co-location of the 0-19 public health nursing service and the Council’s children’s services.

National Condition 4 (iv) – Have you ensured that people have clarity about how data about them is uses, who may have access and how they can exercise their legal rights.

This is an ongoing piece of work which will need to be a regular feature of communications to the people of Newcastle Gateshead.  We are currently seeking case studies to help us explain messages about data and technology in way which are relevant to our populations and professionals.

The next step is to develop a clearer plan in relation to communications which will happen at a local level to complement communications from the regional Great North Care Record level.

National Condition 6 – Agreement on the consequential impact of the changes on the providers that are predicted to be substantially affected by the plans.

As a Care Home Vanguard Programme, we are currently identifying what developments will be completed and what will be progressed further at the end of the Vanguard period.  In particular, we are focusing on taking the learning from providing enhanced care to older people living with family in care homes to their own homes.  This already involves much of our BCF initiatives and will continue to be improved upon wherever necessary.

National Condition 7 – Agreement to invest in NHS commissioned out-of-hospital services.

As with the frailty developments identified, this will involve many of our BCF initiatve and will continue to be improved upon whenever necessary.  This includes a whole system integrated approach that ensures the voluntary care sector is also appropriately involved.

The quarter 4 BCF return either reported ‘no improvement in performance’ or ‘on track for improved performance, but not to meet full target for the following metrics:

Estimated diagnosis rate for people with dementia

It is understood, however, from a clinical audit completed as part of the Care Home Vanguard Programme that around 7% of care home residents are likely to have dementia but are not yet formally diagnosed.  As a result of  ...  view the full minutes text for item HW154

Newcastle Gateshead CCG

The Board were advised that the assurance ratings for CCGs were to be published, this was going to be done in a very low key way, however, Newcastle Gateshead CCG were to be listed as requiring improvement in their finances.

It was suggested that the Board expressed its concern that the CCG has to return a given percentage back to the centre.  Whilst it is appreciated that this is a national process, it is bound to have an effect on the morale of people working in the services.

Healthwatch Gateshead

The Board were advised that Wendy Hodgson has been appointed as the Operations Manager for Healthwatch Gateshead.