Agenda and minutes

Paul Harris, Vice-Chair chaired the meeting in the absence of Councillor Dine Romero and welcomed everyone to the meeting.

Members of the Board and officers introduced themselves.

The Democratic Services Officer will draw attention to the emergency evacuation procedure.

The Democratic Services Officer drew attention to the emergency evacuation procedure.

Apologies had been received from:

Sophie Broadfield, Director of Sustainable Communities, Bath and North East Somerset Council

Cara Charles-Barks, Chief Executive, Royal United Hospitals Bath NHS Foundation Trust

Jayne Davis, Principal and Chief Executive, Bath College

Sara Gallagher, Head of Student Wellbeing Services, Bath Spa University

Alice Ludgate, Director of Student Support and Safeguarding, University of Bath

Suzanne Westhead, Director of Adult Social Care, Bath and North East Somerset Council

Rachel Pearce, NHS England Area Representative

Cllr Dine Romero, Cabinet Member for Children, Young People, & Communities

Alison Smith, AWP

Joss Foster, Director of Strategy (RUH) attended as substitute for Cara Charles-Barks

Natalia Lachkou, Assistant Director, Integrated Commissioning, for Suzanne Westhead

David Trethewey, Director of External Affairs, attended as a substitute for Sophie Broadfield

Cllr Eleanor Jackson attended as a substitute for Cllr Robin Moss.

At this point in the meeting declarations of interest are received from Members in any of the agenda items under consideration at the meeting.

(a) The agenda item number in which they have an interest to declare.

(b) The nature of their interest.

(c) Whether their interest is a disclosable pecuniary interest or an other interest (as defined in Part 4.4 Appendix B of the Code of Conduct and Rules for Registration of Interests).

Any Member who needs to clarify any matters relating to the declaration of interests is recommended to seek advice from the Council’s Monitoring Officer or a member of his staff before the meeting to expedite dealing with the item during the meeting.

There were none.

To remind the Board of the Terms of Reference in considering the following agenda items.

The Board was asked to note the Terms of Reference when considering the following agenda items.  Kate Morton raised a question about whether the Terms of Reference needed to be refreshed.

To confirm the minutes of the above meeting as a correct record.

The minutes of the previous meeting were approved as a correct record and signed by the Chair.

Paul Harris updated on the following actions from the minutes:

1.  Public Participation Report – This was included in the agenda for this meeting.

2.  Aligning Mental Health presentations – There would be a joint presentation from Bath MIND/AWP at the June meeting.

3.  Health and Wellbeing Board Final Priorities – the final priorities had been signed off and the final strategy was included on the agenda for approval.

4.  Funding streams – Becky Reynolds would report back on the breakdown of funding streams.

5.  ICP Strategy feedback – Board Members had been circulated a draft copy for comments.

(10 minutes)

To consider options for increasing public participation at Health and Wellbeing Board meetings.

Paul Harris

Paul Harris introduced the report which had been drafted following discussions with Kate Morton and Laura Ambler.  He drew attention to the following points: 

1.  The report suggested different ways of working and the use of different venues to encourage public participation.

2.  There were 6 recommendations relating to purpose; communication; meetings; impact; committee and joining up.

3.  Some of the recommendations would require additional resource.  It was noted that Sarah Heathcote had been appointed to a new Inequalities Manager role starting in April and may be able to assist in this work.

4.  B&NES Council provided free meeting venues in the Guildhall/Keynsham Community Space for Health and Wellbeing Board meetings and so there would be a resource issue of using alternative venues unless any other partners were able to offer venues free of charge.

Board members raised the following comments:

1.  Kate Morton raised the value of the input of 3SG, the third sector group, as a conduit to community organisations and asked for a commitment from the board to recognise the role of 3SG in engagement work.

2.  Sue Poole advised that Healthwatch worked with 3SG and also publicised the work of the Health and Wellbeing Board through its newsletter.

3.  Laura Ambler commented that there were a lot of good mechanisms already in place but there was a need to join this work up while formalising the role of 3SG and recognising their function.  She hoped the new Inequalities Manager role could help with this.

4.  Cllr Alison Born supported the suggestion of using alternative venues but cautioned that this needed to be done in a planned way.  Nicola Hazle concurred with this view and suggested that there should be an appropriate lead in time to allow for planning and publicity.  Val Scrase suggested that a meeting could be held in a school or Bath College to engage younger people.

5.  In terms of improving communication, Laura Ambler suggested that partners take away key messages from HWB meetings and that a few targeted and focused points be identified at the end of each meeting.  Other suggestions included using the 3SG and HWB website and 3SG and Healthwatch newsletters.

6.  Cllr Eleanor Jackson suggested that to engage the public it was necessary to explain what the Health and Wellbeing Board was and what it was trying to achieve.  She suggested that varying the time of meetings may help with engagement for those unable to attend meetings during the working day.

7.  In relation to timings of meetings, Julia Griffith suggested that this should be dependent on the audience, for example, a meeting in a school would need to take place during the school day.  It was agreed that if there was sufficient notice most members could make an evening meeting, but it would be better to schedule evening meetings during the summer.

8.  The option of hybrid meetings/recorded meetings was also discussed.  Some board members thought this may increase participation while others expressed concern that engagement  ...  view the full minutes text for item 62.

(5 minutes)

To ask the Board to agree and champion the final Health and Wellbeing Strategy.

Fedalia Richardson

Fedalia Richardson introduced the report and asked the Board to sign off the final strategy.  She confirmed that there would be some minor editorial changes and that officers would be creating an indicator set to measure progress in delivering the priorities.

In relation to the recommendation for Board Members to champion the strategy, Rebecca Reynolds undertook to produce a summary document to help partners promote the strategy and its priorities.

The Board commended the process and consultation involved in developing the strategy.

The Board RESOLVED to;

1.  Sign off on the Joint Health and Wellbeing Strategy 2023-2030.

2.  Health and Wellbeing Board Members become champions of the Health and Wellbeing Strategy and its priorities.

(30 minutes - 10 minutes presentation/20 minutes discussion)

To receive a presentation on the findings of Healthwatch NHSEI on “Unpaid Carers Experience of Mental Health during the Pandemic”.

The HWB board is asked to respond to the recommendations. 

Sue Poole and Ann-Marie Scott, Healthwatch

Sue Poole and Anne Marie Scott, Healthwatch, gave a presentation on the experience of unpaid carers during the pandemic as follows:

Who are we?

•  Healthwatch champion the views of the public for health and social care.

•  Healthwatch are an independent statutory body, with the power to make sure NHS leaders and other decision-makers listen to feedback and improve standards of care.

•  Healthwatch worked with the NHS England E&I Commitment to Carers Rapid Learning Pandemic Legacy Project to deliver a piece of research to hear the experiences of unpaid carers and their view about mental health during the Covid 19 pandemic.

•  The research was carried out in Swindon and Bath and North East Somerset which are part of the BSW ICS.

What did we do?

•  Project was carried out in March 2022.

•  Used online Surveys in Bath & North East Somerset and Swindon.

•  Attended group meetings/sessions with unpaid carers and families/advocates experiencing mental ill-health.

•  Analysed information/data supplied from carers centres based in each locality and national statistics taken from Carers UK.

•  Incorporated existing sources of feedback/reports so that people don’t have to repeat themselves (data collected by Local Healthwatch).

•  Ran a Twitter poll.

What were the challenges?

•  People do not recognise themselves as carers when caring for loved ones. 

•  Healthwatch were NOT able to go into care provisions to carry out interviews to gather feedback directly from their staff and service users due to COVID restrictions and capacity at the time. 

•  There was limited input from ethnic minority carers, they are less likely to self-identify as carers. 

•  Only able in timescale to talk to a small proportion of carers.

Key Findings

•  Pandemic had a significant impact on carers – isolation, lost support and a lot have not got that support back.

•  Carers feel they are not being listened to and their own mental health is negatively impacted.

•  Care coordinators are overstretched, high turnover, it further impacts on unpaid carers and other service users.

•  Ethnic minorities generally do not self identify as carers.

•  Rural nature of Bath and North East Somerset hinders Carers getting support.

•  One positive was ‘virtual’ get togethers made carers feel less isolated.

What has happened since?

•  Healthwatch has shared the report findings both locally and nationally with organisations that can make a change.

•  Increased Healthwatch engagement with carers across B&NES’s communities and shared their feedback.

•  Continued working with the local Carers Centres to ensure their voice is heard

•  The three Carers Centres in BSW are meeting with AWP in March to look at how they can help AWP staff identify carers during their work & make referrals for tailored support (BSW Older people & mental health sub-group).

•  Working with the local hospital to improve support for carers when the people they care for are inpatients.

Questions for the Health and Wellbeing Board

•  What further steps are B&NES Council  ...  view the full minutes text for item 64.

(10 minutes)

To update the Board on the Adult Social Care Discharge Grant.

Gary Guest

Gary Guest, Commissioning Project and Programme Manager, B&NES updated the Board as follows:

Adult Social Care Discharge Fund - Scheme RAG rating:

1. Big Packages of Home Care £200k – RED: This project was being reviewed.
2. Art+ Investment £100k – GREEN: This project expected to make impact.
3. Social Worker Recruitment £160k – AMBER: There were some agency workers in place.
4. MHSocial Worker Recruitment £40k – RED: funding had now been released to the RUH.
5. Assistive Technology £190k – GREEN: there were a number of ongoing schemes.
6. Care Journey Coordinator Recruitment £139k – AMBER: interviews had been arranged.
7. Community Wellbeing Hub £105k – GREEN: self-serve kiosks went live on the 13 March.

8.  Hospital Discharge Support Payment £62.5k – GREEN: launched in February.

Better Care Fund (BCF) - 2022-23 Closing and 2023-24 Planning

1.  25 individual schemes were funded through the BCF in 2022-23

2.  12 schemes will close at the end of March 2023

3.  13 schemes have existing commitments through to 2023-24

4.  Financial review in-progress to identify available ‘uncommitted’ funding to support new initiatives in 2023-24

5.  Process for applying for 2023-24 funding to be confirmed and communicated.

6.  Outcome of review will be presented to HWB at next board meeting.

2-year plan:

7. The policy framework & planning requirements remain in draft, aiming to publish by end of March.
8. Capacity and demand planning will form a more integral part of BCF planning for 2023-25.
9. Estimates of capacity and demand should influence plans for delivering against both the programme objectives:

10. This will include a section in the narrative plan detailing learning from the capacity and demand exercise and plans to address gaps in capacity and how these will feed into metric ambitions.

Regional update:

11. Dept. Health and Social Care feedback provided on 2022-23 BCF narrative plan.
12. Strengths of submission were highlighted including governance, BSW inequalities strategy and homelessness discharge support.
13. Areas to strengthen: partnership with voluntary sectors, better use of equalities & inequalities impact assessments to drive continuous improvement and more detail on carer services to be included in next submission.

Better Care Fund – Next Steps

1.  Conclude BCF end of year review - review of existing commitments in to 2023-24 to determine available ‘uncommitted’ funding.

2.  Agree & Open Process - determine application process for new initiatives seeking BCF financial investment.

3.  Agree priorities - determine system priorities & follow application process, playing outcomes through correct governance.

Board members raised the following comments:

1.  Will Godfrey questionedwhether the increase in the number of discharges from hospital was due to the money or new capacity.  He stressed the need for a breakdown of how much capacity was already in the system which could be used more effectively and how much was due to extra money.  He confirmed it was important to understand the system as if it was just due to the additional money, it  ...  view the full minutes text for item 65.