Agenda and minutes

Apologies for absence were received from Kevin Scarlett, Nicola Allen, Steph Downey and Steve Kirk.

The minutes of the meeting held on the 9^th September 2022 are attached for approval, together with the Action List

 RESOLVED:

(i)               The minutes of the previous meeting held on 9 September 2022 were agreed as a correct record.

(ii)              The Board noted the update from the action list.

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

RESOLVED:

(i)               There were no declarations of interest.

Alice Wiseman advised the Board that £5m of Government funding had been awarded to tackle health inequalities in Gateshead.

Claire Wheatley provided an update on Northumbria Police’s Prevent Strategy which aims to reduce crime and disorder via early intervention. Claire suggested that she would be happy to provide further details at a future meeting.

RESOLVED:

(i)               The Board noted the updates.

(ii)              The Board agreed to receive a further update on Northumbria Police’s Prevent Strategy at a future meeting.

The Board received a presentation from Professor Eileen F. S. Kaner of Newcastle University on the impact of minimum unit pricing (MUP).

From the presentation, Board members were provided with an overview of the public health rationale for MUP and NICE PH24 guidance. An explanation of how modelling informs the NICE guidance was also given.

Attention was drawn to the impact of MUP in the UK; it was also highlighted that legislation to have a minimum price of £0.50 per unit had passed in Scotland in 2012, Wales introduced MUP in March 2020 and MUP in the Republic of Ireland was introduced in January 2022.

It was concluded that:

•        MUP does affect price and alcohol purchases

•        Effects are slightly bigger than UK model estimates

•        Effects are sustained in Scotland (similar size of effect in Wales)

•        There is most effect on households that buy the most alcohol

•        The effect on lower income households is complex

•        There is some concern about accuracy of targeting

•        There may need to be additional measures (particularly focused on younger men who are the heaviest drinkers)

It was questioned whether the introduction of MUP in England would cause a rise in the production and consumption of black-market alcohol. The Board were advised that there is no evidence to suggest this would happen based on the introduction of MUP in other areas of the UK.

The Board noted its thanks to Professor Kaner for her work and presentation.

RESOLVED:

(i)               The Board acknowledged the impact of MUP on communities.

(ii)              The Board noted the contents of the presentation.

The Board received a presentation from Sue Taylor of BALANCE on alcohol harms.

From the presentation the Board were advised that alcohol is linked to 200 medical conditions and can cause at least 7 types of cancer. It was also highlighted that the average age of alcohol related death is 54 with alcohol harm placing massive demands on health services. Attention was also drawn to the fact that alcohol harm is linked with wider health inequalities and mental health problems.

The Board were presented with data illustrating the harms caused by alcohol across the UK; it was stated that the situation is worsening and that the cost to UK society as a result of alcohol harm is between £27-£52billion every year.

It was noted that approximately 88% of adults in the North East drink alcohol with 47% drinking in excess of 14 units per week. It was also explained that 2020 was the worst year on record for alcohol specific deaths in the North East according to ONS data.

From the presentation, the Board were advised that alcohol is too affordable and available. It was also argued that alcohol is heavily promoted and that this has an influence on children. The Board were also provided with examples of campaigns to reduce alcohol harm (similar to those used in tobacco control).

RESOLVED:

(i)               The Board noted the update from the presentation.

RESOLVED:

(i)               The Board agreed to defer this item to a future meeting.

The Board received a report seeking views on current and future plans to support

Health and Social Care to prepare for winter and reduce the harms caused to individuals by delayed discharges and unavailability of social care support to effect timely, safe, discharge.

It was reported that the introduction of Discharge to Assess within Gateshead as a response to the COVID 19 Pandemic allowed patients to be discharged effectively to the most appropriate setting for their care and followed up in the community where longer-term plans could be made.

It was noted that from November 2021 a steady increase in those awaiting a social care package to facilitate their discharge has had a significant impact on all parts of the health and social care system. The Board were advised that this included patient treatment and care. This report outlined the reasons for delayed discharges, the impact on all providers within the system including the ambulance service, the effect on patients and highlighted why partners across Gateshead need to urgently address this.

The Board discussed the issues reported; a comment was made suggesting that social care providers struggle to recruit and retain staff due to the low wages being offered across the industry. It was also noted that initial and ongoing training within social care roles was important for staff and patients (in addition to regular employee supervision). The Board also acknowledged the importance of patient involvement in decision making that affects them.

The Board suggested that ICB resources be used to alleviate the problems reported; the Board were advised that the ICB had invested via the local authority. It was also noted that BCF funding is being used to help reduce pressures, but challenges remain.

RESOLVED:

(i)               The Board noted the ongoing challenges and information from the report.

(ii)              The Board requested a progress report on delayed discharges in 2023.

The Board received a presentation providing an update on the Winter Pressures Plan.

The Board noted that there is currently an increasing demand being place on urgent and emergency care services caused by:

•        Changing needs of an ageing population;

•        Changing expectations as a result of 24/7 culture;

•        Year-round demand, no downtime over summer period

•        Rising demand

•        Impact of Covid; and

•        Increased acuity of patients

It was also reported that demand also includes a high proportion of out of area patients as Gateshead Health NHS FT routinely provides healthcare to new patient groups as a result of service reconfigurations and patients are diverted from other trusts.

The Board were advised that in response to increasing capacity and operational resilience in the UEC there are plans to prepare for variants of Covid-19 and respiratory challenges, including integrated Covid-19 and flu vaccination programmes.

From the presentation, the Board also noted that additional responses would include:

·        Increased capacity outside acute trusts, including the scaling up of additional roles in primary care and releasing annual funding to support mental health through the winter.

·        Increased resilience in NHS 111 and 999 services, through increasing the number of call handlers and enhancing primary care support.

·        Targeted Category 2 response times and ambulance handover delays, including improved utilisation of urgent community response and rapid response services

·        Reduced crowding in A&E departments and target the longest waits in ED, through improving use of the NHS directory of services, and increasing provision of same day emergency care and acute frailty services.

·        Reduced hospital occupancy, through increasing capacity through a mix of new physical beds, virtual wards, and improvements elsewhere in the pathway.

·        Ensuring timely discharge, across acute, mental health, and community settings, by working with social care partners and implementing the 10 best practice interventions through the ‘100 day challenge’.

·        Providing better support for people at home, including the scaling up of virtual wards and additional support for High Intensity Users with complex needs.

A question was asked regarding the availability of flu vaccinations in Gateshead, particularly in the West where it was suggested there is a shortage. The Board were advised that work is ongoing with the regional vaccine team on providing adequate supplies in Gateshead. The Board also acknowledged the impact of the cost of living crisis on health and inequalities.

RESOLVED:

(i)               The Board noted the update.

RESOLVED:

(i)               The Board agreed to receive this update via e-mail due to time.

The Board received a report setting out the Better Care Fund Plan submission requirements for 2022/23, how they have been met and to seek retrospective endorsement to the Gateshead submission to NHS England.

RESOLVED:

(i)               The Board noted the key components of the national BCF planning requirements for 2022/23

(ii)              The Board retrospectively endorsed the 2022/23 BCF submission for Gateshead.

RESOLVED:

(i)               The Board noted the item for information.

https://www.eventbrite.co.uk/e/health-inequalities-summit-primary-care-tickets-427216103867

RESOLVED:

(i)               The Board noted the item for information.

There was no other business.