Agenda and minutes

Venue: Brunswick Room - Guildhall, Bath. View directions

Contact: Marie Todd  01225 394414

No. Item


Welcome and Introductions


The Chair (Dr Ian Orpen) welcomed everyone to the meeting.


Emergency Evacuation Procedure


The Senior Democratic Services Officer drew attention to the evacuation procedure as listed on the call to the meeting.


Apologies for Absence


Apologies were received from Councillor Kevin Guy, James Scott (Joss Foster was his substitute) and Kirsty Matthews (Jo Scammell was her substitute).


Declarations of Interest

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 2, A and 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 Announce any Urgent Business Agreed by the Chair


There was no urgent business.


Public Questions/Comments


There were none.


Minutes of Previous Meeting - 29 January 2019 pdf icon PDF 104 KB

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.


Health Inequalities Update

To receive a presentation giving an update on health inequalities as requested by the Board at its meeting on 26 June 2018.


10:35am – 25 minutes - Paul Scott


The Chair invited Paul Scott (Associate Director of Public Health Public Health Department, B&NES) to give a presentation.


Paul Scott gave a presentation (attached as Appendix to these minutes) where he highlighted the following points:


  • What are health inequalities?
  • Health and Wellbeing – the things that affect it
  • Inequalities at the start of life
  • How circumstances, not initial intelligence of children create differences
  • Health comparisons (obesity, smoking, life expectancy) between more deprived and least deprived areas
  • What causes the extra deaths in the most deprived parts of B&NES?
  • National context
  • Income inequality diagram
  • Marmot Review 2010: the current policy basis for reducing health inequalities
  • What are we doing to address health inequalities in B&NES?
  • Do we have a strategic approach?
  • Time needed to deliver outcomes from different interventions
  • Where does an addressing health inequality sit in B&NES?
  • Implementing Chapter 2 of the NHS Long Term Plan
  • A matter of justice – Local Government’s role in tackling health inequalities
  • Inequalities in education and attainment
  • Inequalities and employment
  • Environmental inequalities
  • Inequalities and housing
  • Inequalities and behavioural risks
  • Where next for this work?


The Chair thanked Paul Scott for his presentation by highlighting the importance of the subject, and the role of the Health and Wellbeing Board in reducing health inequalities in B&NES.


Councillor Rob Appleyard asked if there were any information/statistics on a take-up of free school meals from those who were eligible.


Mike Bowden responded that there was no information on a take–up of free school meals.  Free school meals have been promoted to those who were eligible.  Higher use of free school meals would benefit the schools in terms of getting the funding for resources.  The real challenge was in narrowing the gap between those who were eligible for free school meals and those who were not eligible, in terms of their educational attainment. 


Paul Scott added that there was no local indicator on the school meals take-up but that was something that Local Authority could look at.


Jo Scammell expressed her concerns on the gap in terms of the educational attainment in the area and asked if there were any reasons for these anomalies.


Mike Bowden responded that it was a challenge to understand the reasons behind the large gap in terms of the educational attainment.  B&NES was probably in the bottom 5 areas in the country in terms of the educational attainment gap yet at the same time high percentage of the early years settings were marked as Good or Outstanding by Ofsted.  Local Authority would have to work with early years to narrow that gap, although there was no simple solution on that matter.


Paul Scott added that some schools in London area were faced with the same challenge, so this was not unique just for B&NES area.


It was RESOLVED to note the presentation and ask Paul Scott to come back with another update on Health Inequalities in 12 months’ time.

Update on health inequalities for Health and Wellbeing Board - September 2019 pdf icon PDF 866 KB


Better Care Fund Plan 2019/20 pdf icon PDF 83 KB

The Board is asked to consider the Better Care Fund Plan for 2019/20.


11am – 25 minutes - Lesley Hutchinson/Becky Paillin

Additional documents:


The Chair invited Rebecca Paillin (Strategic Business Partner Joint Commissioning) to introduce the report.


Rebecca Paillin took the Board through the report by highlighting that the recommendations have contributed to the Health and Wellbeing Board’s aims including delivery of the Joint Health and Wellbeing Strategy, such as:


  An increased emphasis on prevention, early intervention and empowering individuals to be more independent including the use of adaptions and technology to support independent living;


  A further shift of investment from acute and specialist health services to support investment in community-focused provision; and


  Exploration by commissioners and providers of new approaches to sharing resources, including knowledge and expertise, where there are demonstrable benefits in doing so.


The Chair welcomed the document by saying that it has recognised the opportunity for partner engagement, and that some of those partners were sitting on the Health and Wellbeing Board. 


Nicola Hazle commented that there has been a significant rise in older adult population and that this was an area that the Board should focus more on as one of the issues was a significant impact on carers due to an increase of older adult population.


The Chair agreed with that comment and added that there has been an increase in demand for services for older population, and that demand for those services would be on increase in ten years’ time.


Rebecca Paillin responded that that was something that officers had monitored for the last three years.  One of the initiatives that were set up was Dementia Pathway which was relevant to that particular age group.


Paul Harris commented that one of the things that Curo has been proactive about was for people to live independently in their housing units so they can cut the need of going to care facilities.  Paul Harris asked if the consultation on the Better Care Fund involved external stakeholders.


Rebecca Paillin responded that there had been quite a lot of internal stakeholders’ engagement in the process, although it would be even better communicating external stakeholders and asked Paul Harris if he could make any suggestions.  Paul Harris responded that he would be happy to suggest external stakeholders.


Mike Bowden commented that this was a massive piece of work which was required in order to comply with the relevant legislative act.  The Better Care Fund document has presented in detail a massive list of schemes and initiatives conducted to support and promote the independent living in order to shift a weight of pressure on the system.


Corinne Edwards thanked the officers for the collaborative work in creating the Better Care Fund Plan for 2019-2020 and agreed that one of the main pressures was with the care of older people.


Bruce Laurence also praised the hard work of all involved in the creation of the Better Care Fund Plan and added that one of the major challenges would be around workforce, and asked if there were any schemes addressing the issues of the workforce.


Corinne Edwards agreed with Bruce Laurence  ...  view the full minutes text for item 51.


Baby Friendly Initiative Work and Promotion of Breastfeeding

To receive a presentation regarding the baby friendly initiative and promotion of breastfeeding.


11:25am – 20 minutes - Shiela Willoughby


The Chair invited Shiela Willoughby and Jane Peters (both from Virgin Care) to give a presentation to the Board.


Shiela Willoughby and Jane Peters gave a presentation (attached as Appendix to these minutes) where they highlighted the following points:


  • Team Structure
  • UNICEF Call to Action 2019 video
  • Role of Health Visitor
  • Partnership with Children Services
  • How are we doing in B&NES?
  • Priority area for development
  • How we fit with the Sustainability and Transformation Plan
  • Think Family


The Chair welcomed the presentation and commended Shiela Willoughby and Jane Peters for the great work that they were doing in terms of promoting and supporting breastfeeding in the area.


Alex Francis also welcomed the presentation and asked if there were particular demographic groups outlined in the project, and whether the priority development area was chosen because it was identified as deprived or due to its location.


Shiela Willoughby and Jane Peters replied that Radstock area has been chosen as pilot site, regardless of its socioeconomic and demographic status. Shiela Willoughby and Jane Peters added that, for example, Chew Valley area had more-less the same needs in terms of the low prevalence of breastfeeding.


Councillor Vic Pritchard (Chew Valley Ward) asked what issues were with Chew Valley area in terms of the low prevalence of breastfeeding.


Shiela Willoughby and Jane Peters responded that Health Visitors reported issues with the transport, remoteness of the area and the lack of facilities in that region.


Bruce Laurence said that he was quite impressed with emphasises made on the importance of breastfeeding.  Bruce Laurence also said that local focus and support from the health bodies and community was crucial for this programme.


Shiela Willoughby and Jane Peters added that although the programme was not only set to provide additional support to the community and breastfeeding mothers, but also to support mothers who cannot breastfeed for various reasons.


Joss Foster asked about the project alignment between midwifes and health visitors.


Shiela Willoughby and Jane Peters replied that Baby Friendly Initiative team has been working closely with the RUH midwifes. pregnancy services and other health teams.


Councillor Rob Appleyard asked what would be the reason for young mothers to stop breastfeeding and use the bottle instead.


Shiela Willoughby and Jane Peters responded that sometimes young mothers may feel down due to a number of reasons (post-natal depression, exhaustion, etc.) and they would turn to their family or friends for support.  The advice they may receive could be ‘give them a bottle’ which they could see as an easy option to use and feed the baby.  One way to deal with this would be change of culture.


The Chair commented that there was a need for enhanced collaboration between education, housing, and other relevant organisation in terms of sending the message about benefits of breastfeeding.


Kate Morton commented that mothers who come to Bath Mind due to post-natal depression have had difficulties in breastfeeding their babies. 


It was RESOLVED to note the presentation and to thank Shiela Willoughby and Jane  ...  view the full minutes text for item 52.

Breastfeeding pdf icon PDF 301 KB


Governance Arrangements for Community Safety and Safeguarding in B&NES pdf icon PDF 76 KB

The Board is asked to note the new B&NES Community Safety and Safeguarding Partnership arrangements.


11:45am – 20 minutes - Lesley Hutchinson

Additional documents:


The Chair invited Lesley Hutchinson (Director for Safeguarding and Quality Assurance) to introduce the report.


Lesley Hutchinson took the meeting through the report as per bullet point 1.1 and highlighted the following issues:


  • Launch of the Partnership on 28th September 2019;
  • Legal framework did not specify how the funding would be allocated between the partners;
  • Nobody would be overlooked with the new governance arrangements;
  • There has already been some joint work with the Avon and Somerset Police, especially with children affected by County Lines;
  • New Independent Chair appointment; and
  • Everyone in the new Partnership were ready to start with new Governance Arrangements for Community Safety and Safeguarding in B&NES 


The Chair thanked Lesley Hutchinson for the report and commented that one of the main reasons for setting up new Governance Arrangements for Community Safety and Safeguarding in B&NES was to not lose anyone in the system.


Jo Scammell welcomed the new governance arrangements and added that this would benefit young people who were going through transition from young age to adulthood.  Jo Scammell expressed her concerns on the funding arrangements and also about the training provision for the new body.


Lesley Hutchinson replied that financial contributions have been agreed with the Council, B&NES NHS CCG and Avon and Somerset Constabulary. Contributions from the other two statutory partners – Avon Fire and Rescue and the National Probation Service would be provided through staff resource. There was no requirement in the legislation for Avon Fire and Rescue and the National Probation Service to contribute financially.  In terms of the training arrangements – the new body would not do anything different from what previous bodies did.


Paul Harris welcomed the new arrangements however he expressed his concerns about the attendance, as turnout at previous Boards was not that good.


Lesley Hutchinson inform the Board that arrangements for Independent Scrutiny, which was a statutory requirement to produce as part of the new arrangements, have been put in place. Also, the Health and Wellbeing Board and other equivalent Committees/Bodies would receive regular Annual Reports like they did in the past.


It was RESOLVED to note the report and to receive annual reports from Local Safeguarding Children Board (LSCB) and the Local Safeguarding Adult Board (LSAB) at the next meeting of the Board.


NOTE: The Senior Democratic Services Officer has been informed straight after the meeting that annual reports from Local Safeguarding Children Board (LSCB) and the Local Safeguarding Adult Board (LSAB) have been circulated to all Members of the Health and Wellbeing Board in advance of the meeting for them to read and comment.  As bringing the same reports for the next meeting would be seen as a duplication of agenda item, subject to approval from the Members of the Board at the next meeting, it is suggested that the resolution on this item should read:


It was RESOLVED to note the report and also to note the last annual reports from Local Safeguarding Children Board and the Local Safeguarding Adult  ...  view the full minutes text for item 53.


B&NES Tobacco Control Strategy 2019 - 2024 pdf icon PDF 102 KB

The Board is asked to consider and approve the B&NES Tobacco Control Strategy 2019 – 2024.


12:05pm – 20 minutes - Joanna McLaughlin

Additional documents:


The Chair invited Joanna McLaughlin from B&NES Public Health Team to give a presentation.


Joanna McLaughlin gave a presentation (attached as Appendix to these minutes) where she highlighted the following points:


  • Smoking prevalence in adults in B&NES
  • The Vision – Towards a Smoke Free Generation
  • Key messages from the strategy
  • Attempts and success in quitting
  • Message – ‘Don’t give up giving up’
  • Vaping – is it risky?
  • The NHS Long Term Plan for SmokeFree
  • The Health and Wellbeing Board could provide support for the strategy by adopting some key actions


The Chair thanked Joanna McLaughlin for her presentation and said that this would be interesting opportunity for the Board to engage in which tied-in with Health Inequalities item that was on the agenda for this meeting, although it would be quite a challenging subject overall.


Joanna McLaughlin commented that some of key issues and actions outlined in the strategy have been already in use.  This strategy would follow to build on the progress resulting from the previous 2014-2018 strategy by defining how the Local Authority and its partners would seek to act in evidence and needs based way across the next 5 years.


Kate Morton commented that a number of young people (who to Bath Mind for information, advice and support) were smokers and that those numbers had gone up. 


Joanna McLaughlin commented that results of schools’ surveys, conducted every two years, have suggested that the numbers of young people smoking had gone down.


Jo Scammell acknowledged that vaping was far less dangerous than smoking.  However, she expressed her concerns on the rise in vaping and asked if there were any ways on stopping that trend, in particular with young people.


Bruce Laurence replied that there were many uncertainties on why vaping has risen over the last few years, whether because a number of people stopped smoking or because people enjoy vaping different flavours.  The risk of vaping flavours with higher dosage of nicotine would be in developing an addiction.  Although nicotine was not a significant health hazard for people without heart conditions, it would raise heart rate which could create problems to people with heart conditions. 


Paul Harris commented that he spoke to Curo residents about smoking, and some residents felt that ‘smoking was the only pleasure in life and it made them happy’.  Paul Harris asked the Board how to address such misleading opinions/views as there was a population of 30,000 housing residents in B&NES, with many of them likely to smoke.


Joanna McLaughlin replied that it would be very useful to work with representatives every organisation and body around this table by speaking to and offering support for people to stop smoking.


Councillor Rob Appleyard welcomed the report and thanked the officers for their great work on making B&NES smoke free.  Councillor Appleyard said that some of the recommendations in the report may be difficult to achieve, stopping pension funds to invest in tobacco companies (as they provide high returns).  Nevertheless, Councillor Appleyard  ...  view the full minutes text for item 54.

Tobacco Control Strategy pdf icon PDF 470 KB


Date of Next Meeting

To note that the next meeting will take place on Tuesday 26 November 2019 at 10.30am.


It was confirmed that the date of the next meeting is 26 November 2019 at 10.30am.


Closing Remarks

Dr Ian Orpen will close the meeting.


The Chair thanked everyone who participated at the meeting.