Agenda and minutes

Gloucestershire Health & Wellbeing Board - Tuesday 3 May 2022 10.00 am

Venue: Committee Room - Shire Hall, Gloucester. View directions

Items
No. Item

1.

Apologies for absence

To note any apologies for absence

Minutes:

Apologies for absence were received from: -

 

Mary Hutton (NHS Gloucestershire Clinical Commissioning Group)

Deborah Lee (Gloucestershire Hospitals NHS Foundation Trust)

Cllr Stephen Davies (Gloucestershire County Council)

Cllr Tim Harman (Gloucestershire County Council)

Peter Tonge (Tewkesbury Borough Council)

Rob Weaver (Cotswold District Council)

Rachel Pearce (NHS England)

 

Mary Hutton was represented at the meeting by Dr Andy Seymour and Ellen Rule (GCCG) and Deborah Lee was represented by Simon Lanceley (Gloucestershire Hospitals Trust).

2.

Declarations of interest

To confirm any declarations of interest on matters being discussed at the meeting.

 

Please refer to note (a) on the agenda cover sheet.

Minutes:

There were no declarations of interest at the meeting.

3.

Minutes of the previous meeting pdf icon PDF 110 KB

To confirm the minutes of the Health and Wellbeing Board meeting held on 22 March 2022.

Minutes:

The minutes of the meeting held on 22 March 2022 were confirmed and agreed as a correct record of that meeting.

4.

Public Questions

To answer any written questions about matters within the powers and duties of the Board. The deadline for the receipt of written questions for the meeting on 3 May 2022 is 10.00am on 26 April 2022.           

 

Please send any questions marked for the attention of the Chief Executive to Jo Moore at email address: jo.moore@gloucestershire.gov.uk 

 

Minutes:

No public questions were asked at the meeting.

5.

Member Questions

To answer any written member questions about matters within the powers and duties of the Board. The deadline for the receipt of written questions for the meeting on 3 May 2022 is 10.00am on 26 April 2022.

 

Please send any questions marked for the attention of the Chief Executive to Jo Moore at email address: jo.moore@gloucestershire.gov.uk 

Minutes:

No member questions were asked at the meeting.

6.

Draft Pharmaceutical Needs Assessment 2022-2025 pdf icon PDF 455 KB

The Board to consider information on the Pharmaceutical Needs Assessment (Gloucestershire) 2022-25.

 

Prior to publication, board members were asked to consider the draft consultation document for the Pharmaceutical Needs Assessment (Gloucestershire) 2022-25. The document was published as the formal consultation document on 26 April 2022. Please refer to the link here for details.

Minutes:

Beth Smout, Specialty Registrar in Public Health Prevention, Wellbeing & Communities at Gloucestershire County Council, gave a detailed presentation on the Gloucestershire Pharmaceutical Needs Assessment 2022-2025 Consultation.

 

It was explained that the Gloucestershire Health and Wellbeing Board (HWBB) was responsible for producing the local PNA. The PNA is a statutory document relating to pharmacy provision in Gloucestershire, including the identification of any gaps in the provision of services. Service developments aimed at securing future improvements and fulfilling future needs form part of the assessment.

 

The PNA is used by commissioners to make decisions regarding the need for additional pharmaceutical premises or services, make improvements, or provide better access to existing services. Such needs can either be current or those likely to arise within the lifetime of the PNA, (2022/23 to 2024/25).

 

The last PNA was published in 2018. The assessment planned in 2021 was delayed due to the COVID-19 pandemic. The new PNA is due to be published by 1 October 2022.

 

The Gloucestershire Draft Pharmaceutical Needs Assessment 2022-2025 was published on 3 May 2022 for public consultation until 3 July 2022. The analysis process would be overseen by a Steering Group, led by the Prevention, Wellbeing and Communities Team at Gloucestershire County Council.

 

Stakeholders, (including representatives from the HWBB, District Councils, Gloucestershire Hospitals NHS Foundation Trust (GHT) and Gloucestershire Health and Care NHS Foundation Trust (GHCFT), would be invited to review and comment on the draft PNA prior to publication of the final document.

 

Members noted key findings taken from recent analysis. It was noted that, overall, there was good access to community pharmacies across Gloucestershire. Whilst community pharmacy access could be limited in some rural areas, this was supplemented by dispensing GP practices. All 108 community pharmacies within Gloucestershire were open after 17.00 on weekdays, with 89% opening on Saturdays and 20% on Sundays.

 

Specific concerns, relating to gaps in pharmaceutical provision in the Podsmead, (Gloucester), and Nailsworth, (Stroud), areas, would be reviewed by the Prevention, Wellbeing and Communities Steering Group, where it was hoped improvements to services would be made.

 

One member referred to the commissioning arrangements for pharmaceutical services in Gloucestershire and how this would change from being commissioned by NHS England to the Integrated Care System (ICS) in the next few months. The change was noted, with reassurances that engagement, (via the Prevention, Wellbeing and Communities Steering Group), would be undertaken during the transition period pending the commencement of the new arrangements.

 

The Executive Director of Adult Social Care and Public Health thanked the Prevention, Wellbeing and Communities Team for their work in producing the draft PNA document.

 

Board members were asked to note the information and encouraged to contribute to the consultation survey at the link here.

7.

Anchors Institute Update pdf icon PDF 125 KB

An update on the work involved in securing Gloucestershire’s Health and Wellbeing using an Anchor Institutions Approach, (large organisations who provide support to their local communities).

Minutes:

Siobhan Farmer, Deputy Director of Public Health, gave an update on the progress being made in developing a county wide approach to the setting up of anchor institutions in Gloucestershire.

 

Members were reminded that anchor institutions are large organisations unlikely to relocate from the county and have a significant stake in their local area. Generally, the organisations have sizeable assets that can be used to support their local community’s health and wellbeing and address health

inequalities.

 

Anchor institutions not only influence the health and wellbeing of communities but can also have an impact on wider factors relating to the health of the population by investing in and working with others locally and from taking a specific responsibility.

 

Recapping on the timeline involved in developing an anchor institutions approach, the Deputy Director of Public Health informed members that, it was just over a year ago that the Gloucestershire Health and Wellbeing Board approved ten principles as directives on how member organisations could act as anchor institutions for the local community.

 

These principles formed a Gloucestershire Anchor Institutions Charter for those organisations who considered themselves eligible to become anchor institutions by pledging their commitment.

 

In November 2021, the Director of Public Health Annual Report, ‘Sources of Strength’ was published, including information on how to secure Gloucestershire’s health and wellbeing using an anchor institution approach.

 

The report outlined five key areas in which anchor institutions might

add value to the local community: -

 

1.    Employment, including recruitment and workforce

2.    Procurement and commissioning

3.    Use of buildings and capital

4.    Environmental sustainability

5.    Partnership working with communities and other anchors

 

The five recommendations outlined ways in which anchor institutions might influence the health of the local population and for organisations to think of any changes they might be able to introduce to ensure the impact of their investments was as positive as it could be.

 

In December 2021, a half day event was held, focussing on how an anchor institution approach could be developed in Gloucestershire and how the recommendations from the Director of Public Health Annual Report could be implemented. The event involved key partners from across the county, brought together to discuss the five areas referred to in the report and to identify any additional opportunities that might exist.

In February 2022, a Gloucestershire Anchor Institutions Task and Finish Group was established, involving representatives from district authorities, Gloucestershire Constabulary, GFirst LEP, NHS organisations and local colleges and universities. The purpose of the task group was to agree how to implement the public sector recommendations set out in the Director of Public Health Annual Report. The task group is committed to meeting monthly for a 6 month period, at the end of which, the group to review progress and set out the next steps in the programme of work.

 

The group is committed to focussing its work on the following three questions:

 

1)    What does ‘good’ practice look like in correlation to the five domains of being a public sector anchor institution?  ...  view the full minutes text for item 7.

8.

Social Isolation and Loneliness Update pdf icon PDF 673 KB

An update on work relating to social isolation and loneliness (one of the priorities included in the Gloucestershire Health and Wellbeing Strategy).

Minutes:

The Board received an update on the progress of activities being taken to address social isolation and loneliness, (one of the seven priorities included in the Gloucestershire Health and Wellbeing Strategy).

 

In October 2019, the Health and Wellbeing Board agreed a Strategic Statement of Intent for Social Isolation and Loneliness for Gloucestershire. The purpose of this document was to help define the County’s strategic approach in tackling social isolation and loneliness and to understand key priorities and responsibilities for delivery.

 

The statement was produced following a ‘deep dive’ into social isolation and loneliness in Gloucestershire, undertaken at the request of the Health and Wellbeing Board. The ‘deep dive’ provided an opportunity to look in detail at the factors affecting individual experiences and service provider perceptions of social isolation and loneliness within the county.

 

The update presented at this meeting was to outline previous findings of initiatives to address social isolation and loneliness and to make further recommendations from which to progress the work relating to this priority.

 

Following publication of the ‘deep dive’ and strategic statement of intent, the COVID-19 pandemic has significantly impacted on social connectedness. It was explained that, at this stage in the analysis, there was not enough detailed understanding on the extent of the consequences from the pandemic. The pandemic resulted in a wealth of community-based work, (both services and groups), to bring people together. Supporting individuals and communities to foster healthy connections was fundamental in the county’s response, (and recovery), from the pandemic. The value of connected communities is widely recognised in relation to health and wellbeing.

 

Building on the priorities and recommendations identified during the deep dive, more recent learning, (taken from observations during the pandemic), suggested adopting a strengths-based, value approach, to look at opportunities from which to create, improve and boost community and individual connectedness.

 

Applying a ‘community-centre’ approach to health and work to strengthen social networks was thought to play an important role in reducing social isolation and loneliness. On this basis, a framework had been developed by the ‘Campaign to End Loneliness’, which proposed using a strategic approach with community assets to understand the needs of those experiencing loneliness. A community base approach was thought to offer better opportunities for the creation and development of meaningful relationships.

 

Based on the good practice already in place, it was suggested the county take a strategic approach to building social connectedness, focussing on individual and community empowerment and asset-building.

 

Recommended next steps included: -

 

1)    Using a strengths-based approach to focus on connecting people and communities.

2)    Strengthening local data and intelligence to inform current understanding.

3)    Understanding current provision, and identifying need around key transition points to understand what can cause people to experience social isolation and loneliness.

4)    Understanding how to best utilise, invest in, and champion what is already in our communities, including connections, groups, infrastructure, and transport.

5)    Better understand how and where statutory organisations contribute to connected, thriving communities, including asset-sharing.

6)    Develop a narrative and communication with  ...  view the full minutes text for item 8.

9.

Gloucestershire Integrated Care System (ICS)

A verbal update on the formation of a statutory Integrated Care System (ICS) for Gloucestershire, subject to the progression of the Health and Care Bill 2021-22.

Minutes:

The Board received the final instalment in updates on the development of the Integrated Care Partnership following the recent announcement that the Health and Care Bill had been granted royal ascent on 28 April 2022. It was confirmed that a Draft Constitution (Governance) document had been produced, and that confirmation of the appointment of ICB members was anticipated later in the month.

 

In setting out the context of the transfer of responsibilities from the Gloucestershire Clinical Commissioning Group to the NHS Integrated Care Board, (NHS Gloucestershire), and the relationship between the Health and Wellbeing Board and the Integrated Care Partnership, (known as the One Gloucestershire Health and Wellbeing Partnership), the following points were noted: -

 

1)    The Integrated Care Partnership will be a statutory committee, established by the ICB and the Local Authority;

 

2)    The core responsibility of the ICP will be to publish an Integrated Care Strategy, setting out how the health and care needs of the Gloucestershire population will be met – this will include the wider health, social care and public health needs of the Integrated Care System for Gloucestershire;

 

3)    The ICB and local authorities to have due regard to this plan when making decisions;

 

4)    Going forward, the ICB will be required to secure the support of the Health and Wellbeing Board for both its long-term and annual plans;

 

5)    The ICB will have a statutory duty with respect to reducing inequalities and regarding public involvement and consultation. Both the ICP and the ICB will have responsibility for health and tackling health inequalities;

 

6)    ICPs will build on existing collaborations and support broad and inclusive place-based partnerships that bring together both statutory and non-statutory partners;

 

Members were informed that a task and finish group had been formed to develop the structures and membership of the partnership. The principles on how the work of the task group are set out below: -

 

1)    Acknowledgement of the overlap between the role and remit of the current Health and Wellbeing Board (HWBB) and the new Integrated Care Partnership (ICP). An aligned model was proposed, whereby the two forums work together in tandem. The HWBB and ICP to meet under joint arrangements, supported by a shared secretariat and a co-ordinated approach to agenda planning;

 

2)    Duties sitting purely within the jurisdiction of either the Health and Wellbeing Board or the ICP to be separated out into bespoke meetings, with all other business conducted in joint session;

 

3)    The proposed integrated approach to planning will enable respective Integrated Care Partnership and Health and Wellbeing strategies and plans to consider common areas of work regarding shared priorities, (to be addressed in partnership).

 

Proposed integrated approach

 

Members were advised of the merits of adopting an aligned model between the Health and Wellbeing Board and the Integrated Care Partnership (ICP). It was explained that the aim of using this model would help avoid the risk of dual reporting and could help in facilitating joint sessions of the ICP and Health and Wellbeing  ...  view the full minutes text for item 9.

10.

Gloucestershire Integrated Care Partnership (ICP)

The Board to receive a verbal update on the work of the Gloucestershire Integrated Care Partnership (ICP).

 

To note the progress of the outcomes and activities agreed at a joint workshop held between the Gloucestershire Health and Wellbeing Board (HWB) and the Integrated Care System (ICS) Board in September 2021, regarding the work of the Integrated Care Board, (NHS Gloucestershire) and Integrated Care Partnership, (One Gloucestershire Health and Wellbeing Partnership).

 

 

Minutes:

Following on from the previous item, the Board received an update on the transition to establishing the Gloucestershire Integrated Care Partnership (ICP) on 1 July 2022.

 

Chairperson, Cllr Carole Allaway Martin, reflected on the volume of work that had been required during the transition period, (from GCCG to the ICB), and commended the good working relationship that existed between the GCCG and the HWBB. Cllr Allaway Martin asked that the Board’s thanks be conveyed to those GCCG employees no longer involved in the delivery of health services for Gloucestershire and remarked on how the GCCG had served the county well.

 

Darren Knight from Cheltenham Borough Council raised concerns about the proposed name for the ICP, (Gloucestershire Health and Wellbeing Partnership), which he felt was very similar to the name of the Gloucestershire Health & Wellbeing Board (HWBB). Proposing that a different name be considered, it was agreed that the current proposal might cause confusion and duplication of work. Darren also enquired about the ICB Governance arrangements with Leadership Gloucestershire and the HWBB, as both organisations were made up of almost identical membership, including representatives from GCC, District Councils and GFirst LEP.

 

The concerns were noted and the following actions agreed. It was agreed that the concerns/comments raised at the meeting should be presented to the ICB, with a request that the proposed name for the ICP, (Gloucestershire Health and Wellbeing Partnership), be reviewed and that lines of communication between ICB/ICP organisations clarified. When available, details of the proposed outline membership for the new HWBB/ICB Partnership to be reported to the HWBB. Action by – ICS Task Group

 

It was agreed that the new arrangements were not without their challenges for Gloucestershire, but important to note that the ICB, through statute and legislation, was obliged to seek agreement from the HWBB endorsement of the county’s strategic plans. It was therefore important to ensure that the new governance arrangements for the HWBB/ICP meet the requirements of delivering the county’s statutory priorities.

 

As Chair, Cllr Carole Allaway Martin, requested that a position statement on the seven HWBB priorities be considered and to form part of the agenda at future meetings. It was also suggested South Gloucestershire Council be invited to participate in discussions at future meetings Action by – GCC Officers  

 

The update was noted.