Agenda and minutes

To note any apologies for absence

The following apologies for absence and non-attendance was noted at the meeting: -

Cllr Carole Allaway-Martin (Chair)

Professor Sarah Scott

Siobhan Farmer

Angela Potter

Keith Gerrard

Ruth Saunders

Alistair Cunningham

Nigel Brinn

Rachel Pearce (NHS England)

Nick Evans (Deputy Police and Crime Commissioner)

Dame Gill Morgan

Professor Mark Pietroni (NHS Gloucestershire)

Olesya Atkinson

Gail Pasquall

Chris Witham

Helen Edwards

Chris Brown

Tracy Clark

Chief Sup Jane Probert

Sarah Danson

In the absence of the Chair and the Vice Chair, it was agreed and accepted that Mary Hutton would Chair the meeting on this occasion.

Members to advise of any declarations of interest relating to items on the agenda for this meeting.

No declarations of interest were declared at the meeting.

To confirm and agree the minutes of the meeting held on 26 September 2023 (attached) and to review any outstanding actions.

The minutes of the meeting held on 26 September 2023 were confirmed and agreed as a true record of that meeting.

To consider any written questions from members of the public about matters within the powers and duties of the Partnership.

Written questions to be marked for the attention of the Chair of the Gloucestershire Health and Wellbeing Partnership and submitted by 10.00am four clear working days before the date of the meeting. The deadline for submitting questions for consideration at the meeting on 28 November 2023 is 10.00am on 21 November 2023

Please submit any written questions to: jo.moore@gloucestershire.gov.uk

No public questions were asked at the meeting.

An opportunity to focus on achieving equity as one of the four strands within Pillar 2 of the Integrated Care Strategy.

An overview of work relating to Pillar 2 of the Gloucestershire Integrated Care Strategy, ‘Transforming What We Do – Achieving Equity’.

Within the Gloucestershire Integrated Care Strategy, ‘health equity’ is referred to as ‘where every individual has a fair opportunity to achieve their full health potential. Differences in health status, access to care, treatment, and outcomes between individuals and across populations that are systemic, avoidable, predictable, and unjust are often referred to as health inequalities (or disparities). These differences occur between people or groups due to social, geographical, biological, or other factors. The differences result in people who are worst off missing out on life chances, experiencing poorer health and having shorter lives’.

During the discussion, members were asked to consider the following questions: -

1.    What is Health Equity?

2.    Why is it important?

3.    What could Health and Wellbeing Partnership members do to recognise and take action to address health inequalities?

4.    How is health equity addressed within organisations/work areas?

5.    What opportunities might the Partnership add value to from achieving health equity?

6.    How can we systematically understand where we are not achieving health equity and what can be done about it?

A detailed presentation document from Dr Charlie Sharp, Dr Mala Uhbi and Dr Graham Mennie, can be viewed on the Gloucestershire County Council website at the link here.

Throughout the discussion, emphasis was placed on the importance of partnership working to try to better understand health inequality and its causes. It was agreed the issue was complex and constituted a huge area of work.

It was suggested that health inequality is linked to a wide range of issues and not merely a result of deprivation. Areas of focus to consider included: who is affected and who is at most need of the services available to them. Another key area of understanding was why some of the services being offered were not being accessed. It was agreed ‘prevention’ was pivotal to the work.

Proposals made at the meeting included: -

1.    Activity: Arranging a development session in 2024 to consider the issue in more depth. For those organisations yet to establish a work place plan, it was suggested that this might be an opportunity for partners to work together to establish firm ideas and to make a definite start.

2.    Activity: An agreed Charter, based on common principles, to be produced at the development session. The Charter to encourage and inspire individual organisations to take action and to make a commitment. It was agreed that it was important to motivate as many teams as possible to recognise the value of working together to overcome health inequalities in the County.

3.    Action: Best practice and work already underway to be shared across the Partnership.

4.    Action: The context of the development session to be scoped out and scheduled to follow on from the next planned Health and Wellbeing Partnership meeting on 30 January 2024. Action by - Health and Wellbeing Secretariat  ...  view the full minutes text for item 5.

An update on the employment exemplar theme, following on from the recent employment and health inequalities summit.

Pete Carr, Head of Employment and Skills at Gloucestershire County Council, gave an overview of work and activities relating to the Integrated Care Strategy exemplar theme relating to employment.

To view the presentation for this item, please refer to the document published on the Gloucestershire County Council website at the link here.

The concept of exemplar themes was first introduced in 2023 to allow the Health and Wellbeing Partnership (HWP) to focus on shared ambitions and to add value and create greater impact by collectively working together. The three themes identified as the focus of work for the HWP in 2023 included: blood pressure, smoking and employment. The themes were highlighted by the Gloucestershire Integrated Care Strategy as topics for the HWP to work as a collective unit using combined resources. 

Included in the presentation was an update on the Gloucestershire Employment, Health, Wellbeing and Inequalities Summit held on 13 November 2023, providing details of progress to date, actions and next steps.

The purpose of the event was to bring together, (as a network of organisations), representatives from groups who provide support to people, who have become, or at risk of becoming, unemployed or economically inactive. The event was hosted by the Gloucestershire Employment and Skills Hub, Gloucestershire Health and Wellbeing Partnership and Department for Work and Pensions.

The aim of the summit was to share evidence on the links between employment and health; provide support locally for individuals; consider the needs of Gloucestershire residents; examine common barriers that prevent people from working or staying in work and identify gaps in what is known or what is needed to be known, to provide the necessary support to people affected by redundancy and unemployment. The summit sought to encourage the organisations to work collaboratively to provide more joined-up support, to lobby with a ‘collective voice’ and to secure further resources for the unmet needs of residents.

Over 70 people attended the event, including commissioners, strategists, providers of employment services, and other organisations connected with wellbeing and other activities to help people engage or progress within their employment journey.

More information on the summit can be found at the link here. Members were encouraged to listen to the presentations from the event.

Five key messages identified at the event included: -

1.    The value of working as a network – develop a pilot for closer joint working with a priority cohort in a specific area. Share accountability as a network.

2.    Collaborative commissioning - use the mapping of overall provision to inform commissioning and shine a light on unhelpful competition between providers.

3.    Information sharing - Share information to support clear pathways. Develop an app populated with current information and contacts, including details of 1:1 support.

4.    Focus on employers - speak with one voice to local employers and businesses and create a “product” to highlight social value from linking work and health.

5.    Earlier intervention - shift support further upstream from seeking more opportunities to engage with schools and  ...  view the full minutes text for item 6.

Reflections of progress and highlights to date with next steps outlined.

Mark Walkingshaw, Director of Operational Planning & Performance, (NHS Gloucestershire), and Dr Emily Moseley, Public Health Registrar, at Gloucestershire County Council, gave a detailed overview of the work of the Health and Wellbeing Partnership in progressing the Gloucestershire Integrated Care Strategy.

To view the full presentation published on the Gloucestershire County Council website, please refer to the link here.

It was explained that to implement and maintain momentum of the comprehensive Interim Integrated Care Strategy for Gloucestershire, it was important to encompass the work already underway across the system.

Work to implement the strategy in 2023, included: -

·       Continuing work on building and growing the partnership

·       Seeking to generate actions from partnership discussions

·       Progressing the three exemplar themes identified by the Gloucestershire Health and Care Integrated Strategy, with a strong focus on Pillar Two

·       Transforming work already underway and exploring the sub-pillars within this

·       Adopting a community and locality focussed approach

·       Creating a One Workforce for One Gloucestershire Strategy (developed jointly between health and local authority partners with a focus on apprenticeships and youth engagement)

·       Improving quality and outcomes across the whole person journey

It was suggested that more time was needed to allow the Interim Integrated Care Strategy to develop and to act as roadmap for action across the partnership, and this was agreed. Reflecting on the choice of themes identified as the focus of work for the Partnership, it was felt that the themes of blood pressure, smoking and employment were appropriate and provided a good balance.

Members supported the recommendation that partners continue to focus on implementation of the strategy, with endorsement of the proposal that a review and light refresh of the strategy should be undertaken in 2024 to explore areas of strength and to consider any gaps or challenges that might need to be addressed. The outcomes of the review to be included in a revised/updated version of the strategy. It was agreed that a full review of the strategy was not essential at this time and that more understanding and evaluation of the initial stages of work would be beneficial.

Reflecting on the recent survey, seeking feedback from across the partnership on the progress of the ICS, it was announced that the deadline for the survey had been extended to 5 December 2023. Members were encouraged to complete the online questionnaire and to share their thoughts. Feedback from the survey to be considered at the HWP meeting on 30 January 2024. Action by – All

To compete the survey, please visit the online Health and Wellbeing Partnership Annual Review questionnaire at the link here. 

An overview of the national consultation and proposals.

As representatives of the ‘Gloucestershire Health and Wellbeing Partnership’, members were encouraged to share their views and to offer support to the government proposals to create a smokefree generation. Members were advised that the online consultation ended on 6 December 2023 at 11:59pm.

To respond to the consultation, members were asked to visit the online survey published on the government website here. For more information on the proposals, please visit Creating a smokefree generation and tackling youth vaping: your views - GOV.UK (www.gov.uk)

Health and Wellbeing Partnership Meeting – 30 Jan 2024

Health and Wellbeing Board/Partnership Meetings – 19 Mar 2024

Health and Wellbeing Partnership Meeting – 07 May 2024 

Health and Wellbeing Board/Partnership Meetings – 30 July 2024

Health and Wellbeing Partnership Meetings – 24 Sept 2024

Health and Wellbeing Board/Partnership Meetings – 26 Nov 2024

Meetings commence at 1.30pm, (with a short break between meetings on the dates when the two committees meet).

Health and Wellbeing Partnership Meeting – 30 Jan 2024

Health and Wellbeing Board/Partnership Meetings – 19 Mar 2024

Health and Wellbeing Partnership Meeting – 07 May 2024 

Health and Wellbeing Board/Partnership Meetings – 30 July 2024

Health and Wellbeing Partnership Meetings – 24 Sept 2024

Health and Wellbeing Board/Partnership Meetings – 26 Nov 2024

Meetings to commence at 1.30pm, (with a short break in between meetings on the dates when the two committees meet).