Agenda and minutes

To note any apologies for absence

Apologies received prior to the meeting included:

List of apologies (as of 25 July 2023)

Professor Sarah Scott (represented by Siobhan Farmer)

Mark Walkingshaw

Ruth Saunders (represented by Gupti Gosine)

Angela Potter (represented by Des Gorman)  

Andrew Grant

Barbara Piranty

Nicholas Evans

Gemma Artz (represented by Kerry O’Hara)

Olesya Atkinson (represented by Dr Laura Halden)

Darren Knight

Mark Pietroni (represented by Raghuram Ananthakrishnan)

Andrea Holder

Charles Sharp (represented by Katie Tucker)

Matt Leonard

To elect a Chairperson of the Board 2023-24.

Nominations will be invited at the meeting.

Cllr Carole Allaway Martin was elected Chair of the Gloucestershire Health and Wellbeing Board for the period 2023-24. Proposed by Cllr Stephen Davies proposed and seconded by Dame Gill Morgan, the appointment was agreed.

To elect a Vice Chairperson of the Board 2023-24

Nominations will be invited at the meeting.

Dame Gill Morgan was elected Vice Chair of the Gloucestershire Health and Wellbeing Board for the period 2023-24. Proposed by Dr Bob Hodges and seconded by Nicki Richardson, (Healthwatch Gloucestershire), the appointment was agreed.

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

No declarations of interest were made at the meeting.

To confirm the minutes of the Health and Wellbeing Board meeting held on 28 March 2023 (attached).

The minutes of the Health and Wellbeing Board meeting held on 28 March 2023 were confirmed and agreed as a correct record of the meeting.

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 Tuesday 25 July 2023 is 10.00am on Tuesday 18 July 2023.           

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

No public questions.

An update on the Joint Strategic Needs Assessment

Katie Hopgood, (Public Health Team), gave a detailed update on the development and progress of Tier 1 of the Gloucestershire Joint Strategic Needs Assessment (JSNA).

To view the report and power-point presentation relating to this item, please refer to the information published with the agenda on the Gloucestershire County Council website at the link here.

A further update, including performance data, to be provided at a future board meeting.

Comments and questions asked at the meeting, included: -

      i.        Was there locality overlap? It was suggested that, if not, it would be useful to commence analysing/considering comparative data on the variances that existed between the different districts/localities within the county? The comments were noted, including the request to action as soon as possible.

    ii.        To gain a better perspective of the work being undertaken at district level, it was agreed to circulate the Health and Wellbeing Strategies and Performance Dashboards from the relevant authorities as they became available. It was noted that a significant amount of data was produced nationally and that it was not always easy to disseminate the information quickly. Action by – Katie Hopgood

The report was noted.

An update on the Pharmaceutical Needs Assessment (PNA) 2022-25.

At the HWBB meeting on 3 May 2022, the Board was asked to consider the consultation document relating to the Pharmaceutical Needs Assessment (Gloucestershire) 2022-25. The document was published as the formal consultation document on 26 April 2022.

Siobhan Farmer, Director of Public Health, gave a verbal update on the Pharmaceutical Needs Assessment (PNA) 2022-25

From 1 April 2013, every Health and Wellbeing Board (HWB) in England has a statutory responsibility to publish and keep up to date a statement of the needs for community pharmaceutical services of the population in its area, referred to as a pharmaceutical needs assessment (PNA).

The PNA helps identify whether there are any gaps in the provision of pharmaceutical services in the county, which means identifying if any new services, improvements, or better access to existing services, are needed.

The PNA considers the demographics of the Gloucestershire population and the health priorities of the county, and how pharmaceutical services can contribute to improving the health of Gloucestershire's residents now and in the future.

Members recalled that, at the HWBB meeting on 3 May 2022, the Board was asked to consider a consultation document relating to the Pharmaceutical Needs Assessment (Gloucestershire) 2022-25. The document was published as the formal consultation document on 26 April 2022.

Members noted changes to the published document, (current at the time of the meeting). Since the meeting, the following information was published on the Gloucestershire County Council website as a supplementary statement to the PNA published in 2022. The information was published on 14 August 2023

Following publication of the Gloucestershire PNA, the following four pharmacies have closed: -

1.    Lloyds in Sainsbury’s, Gallagher Retail Park, Tewkesbury Road, Cheltenham GL51 9RR

2.    Lloyds in Sainsbury’s, Dudbridge Road, Stroud GL5 3HG

3.    Lloyds in Sainsbury’s, Barnett Way, Barnwood GL4 3RT

4.    Lloyds in Sainsbury’s, St Ann Way, Gloucester Quays GL2 5SA

Since publication of the Gloucestershire PNA, the following 17 pharmacies have been bought by new owners, and remain open: -

1.    The Laurels Pharmacy, Clarks Hay, South Cerney, Cirencester GL7 5UA

2.    All Care Pharmacy, Barton Street, Gloucester GL1 4HR

3.    Matson Pharmacy, Matson Avenue, Gloucester GL4 6LL

4.    Saintbridge Pharmacy, Askwith Road, Gloucester GL4 4SH

5.    Chipping Campden Phrmacy, High Street, Chipping Campden GL55 6HB

6.    Tuffley Pharmacy, Holmleigh Parade, Tuffley, Gloucester GL4 0QU

7.    G Horton, Ashcroft Gardens, Cirencester GL7 1RB

8.    Badham Pharmacy, High Street, Tewkesbury GL20 5JZ

9.    The Forest Pharmacy, Newerne Street, Lydney GL15 5RA

10.Stroud Family Pharmacy, Rowcroft Medical Centre, Stroud GL5 3BE

11.Coleford Pharmacy, Pyart Court, Coleford GL16 8RG

12.Badham Pharmacy, Old Market, Nailsworth GL6 0DU

13.Winchcombe Pharmacy, High Street, Winchcombe, Cheltenham GL54 5LJ

14.Badham Pharmacy, Old Cheltenham Road, Longlevens, Gloucester GL2 0AS

15.Lloyds Pharmacy, Sevenvale, St James, Quedgeley, Gloucester GL2 4WD

16.Lloyds Pharmacy, Abbotswood Road, Brockworth, Tewkesbury GL3 4NY

17.Wotton Family Pharmacy, Long Street, Wotton under Edge, Stroud GL12 7BX

Following publication of the Gloucestershire PNA, the Lloyds Pharmacy located at St Pauls Medical Centre, Swindon Road, Cheltenham GL50 4DP plans to close and has applied for consolidation with the nearby Badham Pharmacy at 118 Swindon Road, Cheltenham GL50 4BJ.

Following publication of the Gloucestershire PNA,  ...  view the full minutes text for item 8.

To discuss progress to date and provide examples of good practice on the Gloucestershire Healthy Lifestyles Priority (Weight).

Sue Weaver, Head of Commissioning: Health Improvement, gave a detailed update on work associated with the Healthy Lifestyles (Weight) Priority, one of the seven priorities identified by the Health and Wellbeing Board for inclusion in the Gloucestershire Joint Health and Wellbeing Strategy. The update included an overview on progress to date and examples of good practice.

To view the report and power-point presentation relating to this item, please refer to the information published with the agenda on the Gloucestershire County Council website at the link here.

Members to note the information published on the NHS Gloucestershire website relating to the Gloucestershire Healthy Lifestyles Weight Management Service introduced in 2022. To view the information, please refer to the link here.

Members to also note the Joint Strategic Needs Assessment (JSNA) webpage on the Gloucestershire County Council website at the link here for more detailed information on children’s health and lifestyle. From the JSNA webpage, members can view data relating to children and young people’s diet and healthy eating at the link here.

Members were informed that, following a cabinet decision in September 2022, and the award of a contract in January 2023 to deliver the Gloucestershire’s Children and Young People’s Healthier Lifestyles Programme from 1 April 2023, work was underway on developing a countywide children’s weight management service for Gloucestershire. The service to work closely with children with obesity, and their families, to support them in making sustainable changes to their eating and physical activity habits and to achieve a healthier weight.

It was confirmed that the NHS England Children’s Community Weight Management Pilot had been extended for a period of one month from 1 to 30 April 2023 to avoid a potential gap in the provision of community weight management support for children and young people in Gloucestershire.

Directed by government policy, it was agreed that one of the biggest challenges to addressing obesity was trying to influence people in what they ate, and why. Members were advised that significant progress was being made to support a range of community prevention initiatives currently in place and in encouraging people to consider the consequences of diet and lifestyle.

Members attention was drawn to one such initiative, the Daily Mile Programme, and efforts to support and improve the physical, social, emotional and mental health and wellbeing of children, (regardless of age, ability or personal circumstances). For more information on the Daily Mile Programme, please refer to the link here. It was understood the programme was having a significant impact on local families.

Acknowledging comments that obesity rates and inequalities continued to rise at both national and local levels, members were guided on ways in which the Health and Wellbeing Board might actively become involved to overcome some of the challenges relating to this growing concern.

Recent evidence indicated that community-led approaches to addressing social, environmental and economic drivers was the most likely area of work to make the biggest gains. Members were advised of a unique opportunity to  ...  view the full minutes text for item 9.

A summary of recent Health and Wellbeing Board Endorsements, including: -

1.    Joint Forward Plan

2.    Annual Report

3.    Better Care Fund

Director of Public Health, Siobhan Farmer, referred to the busy 6 month period that had followed the transition of the NHS Clinical Commissioning Group to the NHS Gloucestershire Integrated Care Board (ICB) and of the impact of the new arrangements on the Gloucestershire Health and Wellbeing Board (HWB), and gave an update on the following areas of work: -

a)    Joint Forward Plan (replacing commissioning plans)

Before the start of each financial year, the ICB, with its partner NHS trusts and NHS foundation trusts, must prepare a 5-year joint forward plan, to be refreshed each year.

ICBs are required to involve the Health and Wellbeing Board in the work to produce the Joint Forward Plan in the following ways: -

                      i.        Joint forward plans for the ICB and its partner NHS trusts and NHS foundation trusts must set out any steps that the ICB proposes to take to implement the Joint Local Health and Wellbeing Strategy (JLHWS).

                    ii.        ICBs and their partner NHS trusts and NHS foundation trusts must involve each relevant HWB in preparing or revising their forward plans, in particular, the HWB must be provided with a draft of the forward plan, and the ICB must consult with the HWB on whether the draft takes proper account of each relevant JLHWS

                   iii.        Following consultation, the HWB has the right to respond to the ICB and may give its opinion to NHS England

                   iv.        The ICB forward plan must include a statement from the HWB as to whether the JLHWS has been taken proper account of within the forward plan

b)    Annual Report – the ICB is required to produce an annual report. Included in the report, the ICB is required to review any steps taken to implement the Joint Local Health and Wellbeing Strategy (JLHWS). In preparing the review, the ICB must consult with the HWB.

c)    Better Care Fund – members received an update on the ambitions, including joint priorities, identified by the BCF for 2023-25. These remained largely unchanged and included: -

                      i.        Supporting improvements in urgent and emergency care; Focusing on reducing waiting times and delivering high quality pathways for planned care, (supported by transformation across planned and cancer care pathways);

                    ii.        Ongoing Covid-19 recovery, including reducing waiting times for appointments, treatments and operations;

                   iii.        Improving mental health services for people with all ages, including supporting people with learning disabilities and autism;

                   iv.        Developing and supporting the existing workforce, while promoting recruitment in health and social care for the county;

                    v.        Making the most of data and technology to support care;

                   vi.        Reducing health inequalities;

                  vii.        Improving population health across the life-course through place-based integrated working; placing a greater a focus on personal responsibility, wellbeing and prevention and self-care and supporting people to help themselves.

Members noted the 5 key metrics under review by the Better Care Fund. These included: -

                      i.        Avoidable admissions

                    ii.        Discharge to usual place of residence

                   iii.        Residential Admissions

                   iv.        Reablement

                    v.        Falls (a new metric for 2023)

A detailed  ...  view the full minutes text for item 10.

To consider next steps in advance of the Health and Wellbeing Board meeting on 28 November 2023.

The Health and Wellbeing Board was asked to suggest items for discussion at the next meeting, including suggestions in preparation for the annual review of the 7 priority areas identified as the focus of work for the HWB by the Gloucestershire Joint Health and Wellbeing Board Strategy 2020-2030.

The priorities include: -

1.    Mental Wellbeing

2.    Best Start/Early Years

3.    Adverse Childhood Experiences (ACE’s)

4.    Social isolation and loneliness (shared priority with Safer Gloucestershire)

5.    Healthy lifestyles (with an initial focus on healthy weight)

6.    Housing

7.    Physical activity

Members are asked to submit any thoughts and suggestions to jo.moore@gloucestershire.gov.uk by 30 September 2023