Apologies for absence were received from Claire Wheatley, Andrew Beeby, Steph Downey, Alice Wiseman, Councillor Jane McCoid, Steve Kirk, Councillor Brenda Oliphant, Steve Thomas.

The minutes of the meeting held on the 21^st October 2022 are attached for approval, together with the Action List

RESOLVED:

(i)               That the minutes of the meeting hled on 21 October 2022 be approved.

(ii)              That the action list update be noted.

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

RESOLVED:

(i)               That there were no declarations of interest.

The Board were advised that Adult Social Care have recently had their Peer Inspection in preparation for the CQC Inspection.  A number of recommendations have been made and are currently being formulated into an action plan.

A new Persistent Physical Symptoms Service is being set up, this is a really good innovative piece of work, it is going to be shared with the Council’s Overview and Scrutiny Committee.

It was noted that the Council is currently engaged in a public consultation in terms of its leisure services review.   The public consultation is taking place until 20 December.   A report will be taken back to Cabinet in the new year.

It was noted that this is a position none of us wants to be in however, so much of the budget is meeting statutory obligations.

A submission is being prepared in relation to a newly announced Adult Social Care Hospital Discharge Fund.  This will be linked with the existing Better Care Fund. The submission needs to be made by the 16^th December and a copy will also be brought to the next meeting of the Board in January.

RESOLVED:

(i)               That the Board noted the updates.

The Board noted that Alice Wiseman provided a paper on Alcohol Related Harm at its last meeting and that it also received presentations from Professor Eileen Kaner of Newcastle University on the impact on Minimum Unit Pricing (MUP) in Scotland and from Sue Taylor, Balance.  The evidence was that there had been some decline in alcohol consumption as a result of MUP.

It was noted that alcohol-related hospital admissions can be due to regular alcohol use that is above low risk levels and are most likely to involve increasing risk drinkers, higher risk drinkers, dependent drinkers and binge drinkers.

In terms of admissions for alcohol-specific conditions, numbers locally are 972 per 100,000 of the population, the England figure is 644.

It is felt that there is also a degree of unmet need within the population and if all those who needed support were to present to services that it would be difficult to meet their needs.

Treatment for adults is successful and is on par with the national figure. 

There is support available, work is targeted at schools, and a number of campaigns raise the awareness of the health harms.

With regards to young people, we have a specialised young person service and a separate Adult Substance Misuse Service.  There are different interventions depending on the level of needs.

There are some opportunities with some supplementary funding which is available to build capacity in the workforce and get more people into treatment.  Currently though there is no residential detox provision in the North East.

Regional Work is being undertaken as part of the recommendations from the Regional Alcohol Needs Assessment.  SSMTR funding is available and there is a need to look at inpatient funding.  We need to look at partnership working to better meet the needs of vulnerable dependent drinkers.  Work also needs to be undertaken to embed an ‘alcohol free childhood’. 

There is a recovery community who are working to take away the stigma and give a message of hope.  It was noted that for every person who has an issue, at least 3 more people are affected. 

There are some challenges to be faced, including the prevalence of alcohol within peoples lives, the visibility of alcohol is across the board.  We have a licensing system which is difficult to challenge and influence from a public health point of view.  There is an issue around the visibility of alcohol to children, for example a Temporary Event Notice may be for a community event in a park but there could be alcohol available.  We have an opportunity on Council land to have family focussed events.  There is also the whole issue of normalisation of alcohol within our society, we need to think about how we can change the mindset. It has taken a long time to do so with tobacco and it will also take a long time to do something similar with alcohol.  The data is challenging and it is difficult to make in-roads where there are  ...  view the full minutes text for item HW376

The Board received a presentation from Peter Rooney with regards to the Draft Integrated Care Strategy.

Peter advised that the ICP is a statutory committee, established by the NHS and local government as equal partners, and involving partner organisations and stakeholders. It forms part of the arrangements for the Integrated Care System (ICS).

•        Each Integrated Care Partnership is required to develop an integrated care strategy covering the whole ICP population by December 2022

•        ICBs and local authorities must ‘have regard to’ the strategy when making decisions, and commissioning or delivering services

•        The strategy must use the best evidence, building from local assessments of needs (JSNAs), and enable integration and innovation.

It was noted that the ICP should set an overarching strategic direction, the following was noted in relation to our Assets and Case for Change.

•         We have strong communities, an amazing Voluntary, Community and Social Enterprise sector, World Class natural assets and vibrant industries

•         We have a strong foundation of partnership working, an outstanding health and care workforce, and some of the best research and development programmes of any system

•         Our health outcomes are some of the worst in England, with deep and protracted inequalities, which correlate with socio-economic deprivation

•         Life expectancy at birth is 81 (women) and 76.9 (men), compared to 82.6 and 78.7 for England

•         Healthy life expectancy is 60.2 (women) and 59.4 (men), compared to 63.9 and 63.1 for England.

There is a key commitment to reduce the gap by 2030.

The following comments were fed back to Peter and it was noted that a response on behalf of the Gateshead health and care system had also been sent in response to the consultation:

•     It was noted that the strategy was high level and provides an overall strategic vision.

•     The focus of the strategy on prevention and preventative measures could be enhanced.

•     There needs to be a number of different plans to find solutions to key health challenges - sometimes we have tended to look at a complex problem to see what might be a simple solution which in turn can create perverse incentives.

•     Noted that in Cuba there have a significant focus on prevention. The country has 9 doctors and 9 nurses per 1,000 of population, whereas the UK has 3.1 doctors per 1,000 which raises the question of how do we increase the focus on prevention.

•     Increase the focus on Children and Young People – not very strong within the strategy currently.

•     Would like an assurance that children will very much be at the forefront of the strategy – a focus on children will provide much more ‘bang for your buck’.

•     Reference was made to the detailed response from the Directors of Children’s Services about the lack of reference to Children and Young People and the need to make key commitments in terms of Children’s Mental Health.

•     The strategy should incorporate a more asset-based approach around connected communities.

•  ...  view the full minutes text for item HW377

The Board received a presentation from Gateshead Health NHS Foundation Trust on their Corporate Strategy.

There are three strategic areas that the strategy is structured around, People, Patients and Partners.

These are underpinned by 7 Strategic Enablers: Digital and Data, Innovation and Improvement, Estates, Finance, People and OD, Communication and Engagement and Planning and Information.

There are five strategic aims:

·       We will continuously improve the quality and safety of our services for our patients

·       We will be a great organisation with a highly engaged workforce

·       We will enhance our productivity and efficiency to make the best use of our resources

·       We will be an effective partner and be ambitious in our commitment to improving health outcomes

o   Objectives:

§  Tackle our health inequalities

§  Work collaboratively as part of Gateshead Cares system to improve health and care outcomes to the Gateshead population

·        We will develop and expand our services within and beyond Gateshead

Engagement work has been done with staff and patients and the following Vision 2025 has been developed:

·        People will live more years in Good Health

·        The Gap in Healthy life expectancy between people living in the most and least disadvantaged communities in Gateshead will be reduced

·        People’s experience of using services will be better. Our staff will be working in a way that embraces our organisations core values and beliefs

·        Ensure our planned care reflects what is affordable and sustainable to meet the health needs for the community of Gateshead

There are four key components to addressing health inequalities:

Starting Well

Living Well

Ageing Well

Better Care

The Trust is also looking at Digital Exclusion and how it can be built into everything it does.

The Plan which has been developed for the next 5 years is looking at 3 main areas:

·        Remove barriers to access

·        Focussing on experience of care

·        Improving outcome for everyone

One area of success is the Tobacco Service, the QUIT Team is a joint venture. Everyone admitted who is a smoker has a visit from one of the team. In terms of the maternity ward, smoking at delivery is down from 17% to 7.8%.  An incentive scheme was started and was offered to everyone in the person’s household, it is recognised it is not just about the patients.

For staff we have a listening space and we have been working with Gateshead College to offer manicures, pedicures and massages.

With regards to the screening programmes, we have very good links with the Jewish community to make sure we are reaching harder to reach groups.

The Discharge from Hospital project is linking in with feeding families so that those who have no-one at home or no means to get food for going home are getting a box delivered with soup, cheese and crackers etc. in order that they can get home.

It was also noted that the Trust has an alcohol liaison nurse if a person comes through A and E.  It may need to start looking at a similar model for alcohol  ...  view the full minutes text for item HW378

The Board were presented with a report to seek its views on the next steps in taking forward place-based governance and working arrangements for the Gateshead Health & Care System (Gateshead Cares).

It was noted that a Joint Committee arrangement has been suggested for Gateshead going forward.

A Joint Committee would be helpful for making joint decisions within its scope of authority between relevant partner organisations.  The statutory bodies can agree to delegate defined decision-making functions (and resources) to the joint committee in accordance with their respective schemes of delegation. It was noted that there will need to be further discussions on roles, membership, structure and accountabilities.  It is suggested that this is done across the partnership in a phased way.

It was noted that the Gateshead Cares System Board supports the proposed direction of travel and process outlined in the paper. CBC commented that they agreed with the approach set out within the report. 

It was also noted that Gateshead Council had discussed the report at its Corporate Management Team and that further discussions will take place in the New Year.

RESOLVED:

(i)               That the comments of the Board be noted.

This item was circulated to the Board for information after the meeting.

No additional business was raised.