Agenda and minutes

The Chair welcomed everyone to the meeting.

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

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

Apologies for absence were received from:

Sophie Broadfield (David Trethewey substitute)

Cara Charles-Barks (Joss Foster substitute)

Will Godfrey

Alice Ludgate

Suzanne Westhead (Natalia Lachkou substitute)

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.

Cllr Paul May reported that he was a non-executive Director of Sirona Health and Care which operated in Bristol, South Gloucestershire and North Somerset and if a conflict of interest arose at any future meeting, he would declare and withdraw from discussions.

David Trethewey declared an interest in item 14 “Better Care Fund update” and withdrew from the meeting during discussion of the item.

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. 

The Chair confirmed that the Terms of Reference would be reviewed at the December meeting.

Ms Shiva Page read a statement on the subject matter of inclusion which expressed concerns about the treatment of disabled people by the Council and other public bodies including the lack of accessible information and lack of awareness of non-physical disabilities.

Laura Ambler undertook to co-ordinate a response to Ms Page on behalf of the Board in liaison with the appropriate Council officers.

(1)  To confirm the minutes of the meeting of 20 June 2023 as a correct record.

(2)  To consider outstanding actions.

RESOLVED that the minutes of the meeting of 20 June 2023 were approved as a correct record and signed by the Chair.

20 minutes

To agree the process for the implementation of the Joint Health and Wellbeing Strategy.

Sarah Heathcote (Health Inequalities Manager) and Paul Scott (Associate Director and Consultant in Public Health) to present the report.

Sarah Heathcote and Paul Scott gave a presentation on monitoring progress of the Joint Health and Wellbeing Strategy Implementation Plan as follows:

1.  Proposed process for monitoring progress:

·  Reporting on progress would be through the usual route of bringing papers to the HWB meeting.

·  Template for papers coming to board to include reference to contribution to JHWS implementation plan.

·  HWB agenda setting meeting to consider requests for papers linking to specific actions in the implementation plan.

·  All actions in the implementation plan are owned by a key partnership team or sub group of the HWB.

2.  Exception reporting on actions in the implementation plan: 

·  Reporting lead and sponsor have been identified for each of the 4 themes.

·  Priority theme leads complete exception reporting proforma prior to HWB meeting twice a year indicating if actions are on track.

3.  Monitoring impact through the set of priority indicators:

·  Priority indicator set will be accessible.

·  Priority theme reporting leads will report annually on the priority indicators.

4.  Development sessions with the HWB:

·  Propose a rolling programme with 3 sessions planned in advance to be confirmed by HWB.

·  Suggest minimum of 3 sessions per year are focused on priority theme areas allowing flexibility to respond to emergent issues.

·  Leads will be identified to plan and deliver the development session with other colleagues and partners as appropriate in advance.

The Chair confirmed that the session held immediately prior to the Board meeting had agreed that terms of reference would be drafted for development sessions and that 4 sessions per year would be focused on priority theme areas.

The following comments were raised by Board Members:

1.  In relation to exception reporting, where priorities had been identified as not being on track there needed to be an action plan in place with different options and suggestions on what needed to be done collectively. 

2.  In terms of indicators to measure impact over a long period, there needed to be updates on how these were progressing on an annual basis whilst recognising that there were different cycles for collecting data and some targets were cumulative.

3.  The suggestion that exception reporting should also include where progress was better than anticipated was welcomed.

4.  Reports, as with all HWB issues needed to be more concise.  There could be hyperlinks to longer background documents.

The Board RESOLVED to:

(1)  agree taking forward the proposed approach for monitoring implementation of the JHWS.

(2)  Agree to trial the approach for a period of 12 months and review in September 2024.

20 minutes

At the Bath and North East Somerset Council meeting on 26 July, Cllr Ruth Malloy made a statement about single use vapes (attached), asking the Council to back the Local Government Association in calling for a ban on the sale and manufacture of single use vapes, for both health and environmental reasons.  As a result of the subsequent discussion, Cllr Paul May undertook to include this as an item for discussion at a Health and Wellbeing Board meeting.

Cathy McMahon (Public Health Development and Commissioning Manager) and Ruth Simpson (Health Improvement Officer) to lead a discussion.

Cathy McMahon and Ruth Sampson led a discussion on Single Use vaping following the motion at Bath and North East Somerset Council requesting support for the Local Government Association in calling for a ban on the sale and manufacture of single use vapes, for both health and environmental reasons.

There was a presentation as summarised below:

Why is this debate happening?

·  Growing concerns over youth vaping rates.

·  The environmental impacts caused by disposable vapes being difficult to recycle/limited recycling options for users / poor governance across retailers.

What do we need to consider? The pros and cons of a ban of disposable vapes – and how the decision will impact the following:

·  Information communicated to smokers – balance the message in line with Swap to Stop

·  Recycling behaviour – environmental impacts of other products, specifically cigarettes

·  Regulation / legislation across industry / impacts of illegal vape and capacity of Trading Standards

·  Associated costs

·  Impact on youth vaping rates / smoking rates

Four main themes:

1.  Disposable vapes – what they are and who is using them?

·  A vaping device that is fully charged and filled with e-liquid by the manufacturer.

·  Disposable vapes contain batteries and are made from plastic.

·  The majority of vape users are adult smokers.

·  Most 11-17 year olds have never vaped.

·  Vaping is much more common among children who also smoke or have smoked.

2.  Background information

·  Disposable vape use among current vapers up since 2021

·  At least 1.3 million disposable vapes are thrown away every week.

·  Few consumers are disposing of products responsibly.

·  Recycling behaviour is challenging to change.

·  There is also the environmental impact of other products (i.e., cigarettes) to consider.

3.  Options available – pros & cons

·  Option 1: Ban Disposable Vapes

·  Option 2: Regulation and Taxation

4.  What about cigarettes? - If we ban disposable vapes, should we also ban cigarettes?

The following questions/comments were raised by Board Members:

1.  It was confirmed that nicotine patches were still available to assist smokers give up cigarettes, but many smokers found vaping more effective as it mimicked the action of smoking.  There were benefits in people using vapes to give up smoking cigarettes, but their long-term use was not encouraged.

2.  Cllr Alison Born stated that the long-term health implications of vaping were unknown, and the environmental impact of disposable vapes were substantial and for those reasons she would be supportive of a ban.

3.  Val Scrase stated that it was a complex issue and there was no simple solution, but it was better to dissuade people from using disposable vapes alongside stricter regulation rather than a ban which would result in illegal use that couldn’t be regulated.  It was confirmed that there had not been a high level of success in countries where a ban was in place as it was difficult to enforce due to a lack of resources.

4.  Board Members agreed there was value in a targeted campaign to dissuade young people from using disposable vapes for environmental reasons.

In considering the  ...  view the full minutes text for item 26.

15 minutes

To approve the Children and Young People’s Plan (CYPP) progress report on the priorities identified in the plan for 2022-2023 and to review the proposed draft CYPP 2024-2030 and the eight objectives that will deliver against the priorities for children and young people identified in the Health and Wellbeing Strategy.

Mary Kearney-Knowles (Director of Children’s Services and Education) to present the report.

Mary Kearney-Knowles introduced the Children and Young People Sub-Committee report progress report for 2022-2023 and the proposed draft CYPP 2024-2030 and drew attention to the following:

1.  The report gave an overview on how well multi agency partners were delivering on the priorities.

2.  There was an ongoing challenge of the need to support the emotional wellbeing of children and young people.

3.  The Group was working towards the detail of the CYPP 2024-2030 and how objectives would meet the priorities of the H&WBB Strategy.

The Board RESOLVED to:

(1)  Note and approve the CYPP Year 2 Review progress report on the priorities identified in the plan for 2022-2023.

(2)  Note and approve the revised TORs for the CYP subcommittee.

(3)  Note the proposed draft CYPP 2024 - 2030 and the eight objectives that will deliver against the H&WBB priorities for children and young people identified in the H&WBB Strategy.

(4)  Note how the Participation Standards were embedded across most of the commissioned services.

30 minutes

To note the annual report of the BCSSP and recommend any areas that the BCSSP should consider in 2023-24.

Fiona Field, Independent Chair of BCSSP, to present the report.

Fiona Field, Independent Chair of the BCSSP, gave a presentation on the BCSSP Annual Report 2022-23 on the following:

1.  Partnership Structure

2.  Key Priorities and how they were delivered:

1.  Develop a ‘Think Family, Think Community’ approach.

2.  Learning from experience to improve how we work.

3.  Recognising the importance of prevention and early intervention.

4.  Providing executive leadership for an effective partnership.

3.  The number of referrals to Children’s Social Care compared with other authorities and comparison of how referrals were made.

4.  Factors Identified across Assessments

5.  The number of children subject to a Child Protection Plan in B&NES compared with other areas.

6.  The number of looked after children in B&NES compared with other areas.

7.  Adult Safeguarding Summary

8.  Avon and Somerset Constabulary Data

In response to questions from Board Members, it was confirmed:

1.  There had not been a decrease in referrals from schools as a result of schools joining multi academy trusts.

2.  Although the number of referrals from health providers was low when compared with other agencies, reassurance was given that health providers did take safeguarding seriously and participated in case reviews and so this wasn’t considered to be an area of concern.

The following comments were raised by Board Members:

1.  It was noted that due to the absence of a BCSSP trainer, the advanced safeguarding training of staff was below target and this was an area for concern.

2.  Transitional safeguarding needed to be prioritised to support adolescents as they moved into adulthood.

3.  There was a lot of work undertaken by agencies that didn’t meet the threshold of a safeguarding issue but did constitute preventative work as it avoided issues being escalated.

4.  More work was required to break down categories, for example, the “other” category for reporting adult safeguarding incidents.

The Board RESOLVED to note the Annual Report and Executive Summary for the BCSSP.

15 minutes

To note the Health Protection Board Annual Report for 2022-23 and support the recommended priorities for 2023-24.

Anna Brett (Health Protection Manager) and Amy McCullough (Consultant in Public Health) to present the report.

Anna Brett (Health Protection Manager) and Amy McCullough (Consultant in Public Health) gave a presentation on the Health Protection Board Report 2022-23 as follows:

1.  What is Health Protection? - Protecting the health of the population by improving the prevention and control of communicable diseases and other environmental threats.

2.  Which specialist areas does the Health Protection Board cover?

·  Healthcare Associated Infection

·  Communicable Disease Control & Environmental Hazards

·  Health Emergency Planning

·  Sexual Health

·  Substance Misuse

·  Screening & Immunisation

3.  2022-23 - 5 priorities RAG rated green, and 3 priorities rated amber.

4.  6 priorities set for 2023-24.

5.  Questions for the Board:

·  Is the Health & Wellbeing Board assured that the Health Protection Board has delivered on the priorities from last year?

·  Does the Health & Wellbeing Board support the priorities that have been recommended for next year and are there further opportunities to join up with partners to achieve them?

In response to questions from Board Members, it was noted:

1.  In terms of governance, there was an informal arrangement that the Health Protection Board would report back to the Health and Wellbeing Board.

2.  The importance of communication was acknowledged and there were different strategies in place for reaching vulnerable people e.g., specific projects, roving vaccine backpack and visiting community settings.

The Board RESOLVED to note the annual report and the following recommended priorities for the Health Protection Board in 2023-24:

1.  Assurance: continue to monitor the performance of specialist areas, identify risks, ensure mitigation is in place and escalate as necessary.

2.  Continue to actively participate in the prevention, preparedness and management of outbreaks and incidents with partner agencies to slow down and prevent the spread of communicable disease and manage environmental hazards.

3.  Continue to ensure that the public and partner organisations are informed about emerging threats to health.

4.  Embed the BSW Local Health Resilience Partnership Communicable Disease Plan to reduce vaccine preventable diseases and reduce transmission of winter illnesses. Use the Sector Led Improvement Plan and Gap Analysis Action Plan to inform this work.

5.  Contribute to the BSW system wide quality improvement projects, which aims to reduce the incidence of E-coli blood stream infections and Clostridium Difficile infections.

6.  Help improve immunisation uptake and reduce inequalities in uptake through the following: the BSW Maximising Immunisation Uptake Group, a refreshed B&NES Vaccination Implementation Plan, and through contributing to the development of a new Integrated Vaccine Strategy for BSW.

5 minutes

To receive an update on the Better Care Fund.

Judith Westcott (Senior Commissioning Manager, Community Health Care Services) and Lucy Lang (Commissioning Programme and Project Manager)  to update the Board.

Lucy Lang Commissioning Programme and Project Manager gave an update on the Better Care Fund as follows:

Funding 2023-2024:

·  Better Care Fund (including Improved Better Care Fund and DFG) £72,957,229

·  2023-24 Adult Social Care Discharge Fund (LA Allocation) £687,394

·  ICB Request for B&NES Funding (including the 2023-24 Adult Social Care Discharge Fund - ICB Allocation) £5,600,000

·  Market Sustainability Fund (not managed under BCF but included for reference) £1,700,000.

Changes since last report to HWB:

·  2023/2025 narrative plan as signed off by HWB approved by DHSC, pending formal notification.

·  Additional DFG funding of £102m nationally (split £50m/£52m over 23-25 announced).

·  £125,820 for B&NES in 23/24 although this will likely be offset by increasing cost of living pressures.

2023-2024 schemes & financial update

·  The BCF is supporting 15 schemes in 2023-24 (measured) and other non-measured commitments.

·  Total commitment = £75,074,272

·  YTD spend = £30,990,959

·  Spending to date is to plan.

Priorities:

·  Admissionavoidance and neighbourhood development focusing on the role of the community wellbeing hub and carer support and engagement.

·  Young people with learning disabilities, autism &/or mental health transitioning into adult care.

·  Provision of resource to support technology development in care linked to the neighbourhood teams strategy.

·  Contingency supporting transformation and re-contracting of community health and social care provision.

The Board RESOLVED to note the update.

KEY MESSAGES FROM THE MEETING

1.  There are a number of ways for residents to have their say about issues which concern them, or they are passionate about – this includes Area Forums, Your Health/Your Choice and numerous other public events and meetings are held each month – more information is available on the BANES website.

2.  The HWB considered the problem of disposable vapes and their environmental impact – the Board was keen that stricter regulation is put in place, but further discussion is needed about the potential for an outright ban; a broader campaign has been suggested highlighting the environmental dimension, and this is being considered by the team.

3.  Annual reports for Children and Younger People’s Services and Community Safety and Safeguarding were reviewed and approved – these are available to the public via the BANES website and demonstrate a huge number of successful activities and programmes, alongside some areas for further focus.

4.  Representatives from the Health Protection Board provided an update on performance last year and priorities for the year ahead – this report is also available on the BANES website.