Agenda and minutes

The Committee are asked to approve the minutes of the last meeting held on 6 March 2018 (copy attached).

The minutes of the last meeting held on 6 March 2018 were approved as a correct record.

The Committee also received a verbal update on Blaydon GP Practice. The procurement process has been halted due to an agreement being reached with NHS Property Services regarding the level of service charges. The existing contract will end in September 2018 and a new procurement round will take place. This development will be communicated to the patients and stakeholders and the Committee wished to place on record their thanks to the officers for their hard work undertaken so far.

Report of Strategic Director, Care, Wellbeing and Learning.

The Committee received a progress update on the work of the Gateshead Health and Wellbeing Board for the six month period October 2017 to March 2018.

The Committee were advised on Needs Assessments, the Director of Public Health’s Annual Report 2017, Strategic and Operational Plans, Reviews undertaken on Gateshead Shared Care Substance Misuse and Review of Carers Services.

The Board considered the work to progress the implementation of Gateshead Newcastle Deciding Together, Delivering Together regarding the design of inpatient and community adult mental health services.

The Board considered the issue of excess winter mortality in Gateshead and the Performance Management Framework along with The Local Safeguarding Children’s Board Annual Report 2016/17 and Business Plan 2017/18 and the Safeguarding Adults Annual Report 2016/17 and updated Strategic Plan 2016-19.

Other issue the Board considered were Fit for Future and the Remit of the Health and Wellbeing Board.

RESOLVED - that the information be noted.

Representatives of NTW NHS FT will provide the OSC with a verbal update.

Colleagues from NTW NHS FT attended the meeting and provided a verbal update to Committee, outlining the proposals for progressing the move from the Tranwell Unit to the Hadrian Clinic (and St Nicholas Hospital as required) in Newcastle ahead of the full development of the St Nicholas site.

The presentation outlined the rationale for the proposals (given that the temporary  measure of relocating to the Hadrian Clinic was not part of the original proposals for Deciding Together and the previous commitment that the Tranwell would not close until Community Services were in place) and the proposed timeline.

The Committee were advised that the key issues facing NTW NHS FT are:-

·         NTW NHS FT are facing big financial issues – in relation to the availability of wider NHS capital funding.

·         The redesign of community mental health services has been a time consuming process but it is essential that the model and arrangements that emerge are fit for purpose and prevent admissions to in patient care going forwards otherwise the system as a whole will struggle to meet needs.

·         NTW has now clarified its future direction.

·         NTW has submitted a £50 million bid to redevelop its secure services on a single site – this would include the development of adult acute services for Newcastle and Gateshead on the St Nicholas Site in Newcastle. There is a funding pot of £220 million capital available and bids to the value of £700 million have been submitted but NTW bid has been shortlisted.

·         NTW has indicated that it is critical to their strategy for their secure services that the redevelopment plans go ahead so if they are unsuccessful in their bid they will be exploring financing via new private/public partnership.

·         NTW confirmed that this is not about privatisation of NHS care.

·         Timeline for proposals is 2021 in terms of development of St Nicholas Site

·         In meantime there is a recognition that the facilities at the Tranwell site are not fit for purpose and from a quality of care and staffing perspective things are becoming increasingly difficult.

·         As a result it is proposed that, on an interim basis, Gateshead and Newcastle mental health wards are consolidated at the Newcastle General Hospital Site and facilities are refurbished at that site. £1 million has been set aside for this refurbishment to improve the in-patient facilities.

·         Centralising the improved facilities on the Newcastle General Hospital Site will make a significant difference in terms of managing in-patients safely and will provide better outcomes for Gateshead service users and carers.

·         Currently acute in patient provision for Gateshead residents at the Tranwell Unit consists of 20 beds in the Fellside ward and 18 Beds in the Lamesley Ward (this does not equate to the numbers of Gateshead service users overall as there are some Gateshead service users in other wards, and there may be people who are not Gateshead residents on the wards at Tranwell)

·         In terms of meeting Newcastle/Gateshead’s acute in-patient needs – the longer term strategy is to  ...  view the full minutes text for item CHW90

Report of Strategic Director, Communities and Environment.

The OSC received a report outlining the work carried out by Development, Transport and Public Protections, Environmental Health team during the last year.

During 2017/18 the Environmental Health Team within Development, Transport and Public Protection have responded to over 800 accidents, food poisoning and service requests and undertook over 1500 interventions in a wide range of premises to build stronger, healthier, prosperous and sustainable businesses.

The number of food premises on the team’s database at the start of 2017/18 was 1600 and health and safety premises was 3000.

Under food safety legislation it is a requirement to visit all new food businesses within 28 days of opening. Within 2017 there was 120 new businesses register with the team. New businesses receive an enhanced questionnaire, so that the team can prioritise inspections so that the highest risk businesses are inspected quicker than lower risk premises.

At the start of 2017/18 it was estimated that there was a deficit in officer days and this was compounded by the fact that the Technical Officer post was vacant for much of the year because of ill health.

In 2017/18 the team was required to undertake 1101 food hygiene interventions, 1018 food standards interventions and 1433 health and safety interventions. The team achieved 100% of interventions to high and medium risk food hygiene premises. The low risk premises that didn’t receive an intervention will be prioritised for an intervention during the coming financial year. The team also carried out 43 accident investigations and responded to 218 service requests.

The team has introduced complaint selection criteria which highlights complaints of public health significance. All complaints are recorded against the relevant premises and where multiple complaints are received close together a visit will be undertaken, even if the complaint does not fall within those we would normally investigate. During the year 2 prosecutions were undertaken and 3 simple cautions issued. We were also involved in a major investigation into the sale of DNP. DNP is a chemical which typically has industrial applications including fertiliser. It is used by some bodybuilders to strip remaining body fat prior to completion. DNP causes the cells within the body to heat up and there have been a number of deaths associated with its use due to multiple organ failure. The investigation involved co-ordinating 3 local authorities’ actions and liaising with the National Food Crime Unit, The Medicines and Healthcare Products Regulatory Agency (MHRA) and local Police forces. The investigation also involved agencies in the USA. The investigation was equivalent to a major prosecution in terms of resources.

The team have recently introduced a charge for Food Hygiene Rating Score

re-ratings and although there have only been 5 requests, these do take a significant amount of time as it equates to a new inspection. These have subsequently generated £800 in income.

The team have generated approximately £6500 from registering skin piercing activities throughout the year. 6 export certificates have been provided at a cost of £75 each, for a total of £450.  ...  view the full minutes text for item CHW91

Report of Director of Public Health.

The OSC agree that the focus of nits review in 2017/18 will be work to address the harms caused by tobacco. The review has been carried out over a six month period and a draft interim report has been prepared on behalf of the Committee setting out key findings and suggested recommendations.

The scope of the review was to provide an overview of current activity to reduce harms caused by tobacco in Gateshead compared to best national and/or international practice, where such practice exists.

It was agreed that the above would be considered in the context of:

·         Higher than average levels of smoking in Gateshead

·         The fact that smoking remains the single cause of most preventable illness and death in Gateshead

·         Significant inequalities in the prevalence of smoking persist between different groups and areas

·         A reduction on demand for stop smoking services

·         Particularly low levels of take up of stop smoking services amongst some groups i.e. people from black, Asian and minority ethnic groups.

·         Pressure on public Health budgets now and in the future, and opportunities for future savings to primary and secondary care costs from prevention activity.

The OSC were informed that the review identified the following issues/challenges:

·         Austerity and Public Sector budget cuts

·         Complex systems and historical siloed approaches

·         The role of the tobacco industry

·         The perception that the job is done leading to a shift of focus

·         The perceived difficulty of ‘doing’ tobacco control

·         The threat to the comprehensive regional tobacco control approach posed by financial pressures across the region

·         NHS focuses on treatment not prevention – smokers not universally encouraged to quit and given support and medication to do so

·         Funding cuts to public health and local authority budgets

·         Reducing demand for the current Stop Smoking Service offer

·         Persistent inequalities in smoking prevalence between different communities

·         Mass media campaigns cut to the bone

·         Enforcement cuts

The OSC were informed that the draft recommendations arising from the review were:-

1)  Tobacco remains the greatest contributor to health inequalities and action to denormalise smoking and reduce prevalence lifts families out of poverty. The human, social and financial cost of tobacco to Gateshead means that it is vital to retain the Council’s strong commitment to comprehensive tobacco control, and in fact, increase our efforts.

2)  Refresh and reaffirm the Council’s commitment to the 2025 vision of 5% adult smoking prevalence.

3)  Invest to save principles would suggest the continuation of appropriate resourcing for this priority area.

4)  The Smoke-free Gateshead Alliance should be supported to develop a strategic Tobacco Plan for Gateshead and to drive this forward. This will clearly set out actions across the public and voluntary and community sectors to address the harms caused by tobacco.

5)  Continued support and commitment for the regional Fresh Tobacco Control Office is important to continue development of hard hitting mass media campaigns which have a strong evidence base in triggering quit attempts, encouraging quitters to stay quit, and reducing uptake among children.

6)  Action to be taken to address inequalities  ...  view the full minutes text for item CHW92

Report of Director of Public Health.

The OSC received a report providing a progress update on the 2016/17 review of the role of housing in improving health and wellbeing.

The aim of the review was to recommend key housing actions that would have the greatest impact on improving health and wellbeing.

A summary update on progress against the recommendations to date was outlined as well as a more detailed update from the Gateshead Housing Company appended to the main report.

The progress against the recommendations as at April 2018 are outlined as follows:-

Recommendation 1 – review the actions set out in the Housing Intervention Work Plan, and where appropriate, provide Public Health support to assist in maximising the benefits to health arising from delivering elements of the Plan. The evidence presented in the review identified priority candidate elements with the greatest potential to improve health and wellbeing.

Update – progress on delivery of the Housing Intervention Work Plan (HIWP) is being reviewed by DT&PP in consultation with CW&L, and Public Health contribution to this is in place.

The interventions contained within the HIWP are to be integrated within the Gateshead Housing Strategy 2018-2030, currently in draft stage.

Recommendation 2 – ensure that improving health and wellbeing is reflected in the production of local development plan documents i.e. Making Spaces for Growing Places (MSGP).

Update – consultation on the draft MSGP concluded at the end of August, Public Health was a consultee. The draft MSGP is programmed to be reported to Cabinet in October 2018.

Recommendation 3 – review how health and wellbeing is reflected in Council Letting Policies and TGHC support services (i.e. health criteria, preventative interventions)

Update – a review of the Council’s Strategic Transport Tenancy Policy will be carried out as part of the Housing Strategy Review (The Gateshead Housing Strategy 2018 – 2030), is currently in draft stage; due for completion in 2018), and existing Allocations and Letting Policies under review, by the Council and The Gateshead Housing Company). The review will reflect the Council’s agenda to make Gateshead a place where everyone thrives, as well as respond to Government policy and legislative changes, including the Homelessness Reduction Act 2017, and ongoing Welfare reform, including roll out of Universal Credit).

Recommendation 4 - assess the current range of Council private sector housing interventions to maximise their contribution to health and wellbeing (including energy efficient programmes, private landlord accreditation, Selective Landlord Licensing, financial assistance programmes, falls prevention, Making Every Contact Count)

Update – this forms work streams of the Housing Intervention Work Plan (HIWP), and will be integrated within the Gateshead Housing Strategy 2018-2030, currently in draft stage. This work will also be influenced by the Council’s agenda to make Gateshead a place where everyone thrives.

Recommendation 5 – undertake actions to ensure that the greatest proportion of Council housing is maintained to a standard that secures the health and wellbeing of residents within the context of changes to revenue and capital funding.

Update – Responsive Repairs Budgets have been protected  ...  view the full minutes text for item CHW93

Report of Chief Executive and Strategic Director, Corporate Services and Governance.

The OSC received a report outlining how the OSC has influenced/shaped development of policy/decision making during 2017-18 and the development of the work programme for OSCs and the provisional work programme for the Care, Health and Wellbeing OSC for the municipal year 2018-19.

On 18 July 2017 Cabinet agreed to pilot a number of changes to OSC in Gateshead aimed at ensuring that OSC in Gateshead:-

·         is first and foremost member led

·         enhances the leadership role of OSC Chairs and Vice Chairs in driving forward, directing and shaping individual OSC work

·         enhances engagement and involvement with OSC members in shaping the focus of the work of specific OSCs

·         creates stronger relationships/linkages with the Executive

·         enables Overview and Scrutiny to understand and track how it is influencing Cabinet Policy/Decision making going forwards.

The pilot changes to OSC commenced in September 2017 and this is the first review of the work programme following these changes.

During 2017-18 the OSC has sought to influence and shape policy development and decision making via a number of routes.

During this period the OSC’s recommendation relating to the OSC’s Review of the Role of Housing in Improving Health have been approved by Cabinet and implemented. The OSC has monitored progress on the implementation of these recommendations at its meeting on 12 September 2018. At that stage the recommendations had helped shape the content of the Housing Intervention Work Plan (HIWP), the production of the local development plan documents approved by Cabinet i.e. Making Spaces for Growing Places (MSGP). The OSC indicated at that time that it was satisfied with the level of progress made, and a further report was considered at this Committee meeting.

The OSC has also carried out a Review of work to address the harms caused by Tobacco and agreed its findings and recommendations at the meeting today. These recommendations will be presented to a future Cabinet meeting for approval and, subject to these recommendations being agreed, the OSC will then monitor implementation of these recommendations during its 2018-19 work programme.

As part of its Review to work to address the harms caused by tobacco the OSC has also sought to influence NHS partners and requested that a letter to be sent to the Chief Executive of Gateshead Health NHS Trust highlighting the OSC’s Review and seeking the Trust’s support in prioritising work on Tobacco Control, specifically the identifications and management of nicotine dependence among the Trust’s patients.

An interim response was received in January 2018 indicating that the Trust’s Executive Team was exploring the issues raised and would respond further in due course. Subsequently, the Trust has advised that it has pledged to go Smoke Free and has committed to improving the identification and management of nicotine dependence in patients.

The OSC has monitored Council performance generally, in those areas falling within its remit, at its meetings on 20 June 2017 and 5 December 2017 and Cabinet has had regard to the OSCs views when considering the Council’s performance overall.

The OSC  ...  view the full minutes text for item CHW94