Agenda and minutes

The Chair, Councillor Dine Romero, Cabinet Member for Children, Young People and Communities welcomed everyone to the meeting.

Members of the Board and officers that were present introduced themselves.

The Chair drew attention to the emergency evacuation procedure.

Apologies had been received from Will Godfrey, Chief Executive, BANES; Cara Charles-Barks, Chief Executive, RUH; Rachel Pearce, NHS England Area Representative; Sara Gallagher, Bath Spa University; Suzanne Westhead, Director of Adult Social Care, BANES; Amritpal Kaur, The Care Forum; Kate Morton, Bath Mind; Susan Hayter, Strategic Co-ordination Officer, BANES; Nicola Hazle, AWP (Mental Health Care); Dr Bryn Bird, BSW CCG; Ronnie Lungu (Avon and Somerset Police) and Councillor Alison Born, Cabinet Member for Adult Services.

Libby Walters, Director of Finance & Deputy Chief Executive attended as substitute Cara Charles-Barks.

Ruth Gawler, Avon & Somerset Police attended as substitute for Ronnie Lungu.

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.

Sue Poole declared an other interest in agenda item 11 (Reprocurement of Local Healthwatch in Bath and North East Somerset) as she is an employee of Healthwatch BANES. She stated that she would leave the room for the duration of the item.

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.

Presentation on the Joint Strategic Needs Assessment (JSNA). 

Joe Prince

Board Members to consider how the JSNA impacts on their work area.

(40 minutes)

Joseph Prince, Team Manager – Insight gave a presentation to the Board regarding this item. A copy of the presentation will be attached as an online appendix to these minutes and a summary is set out below.

Strategic Evidence Base – Update and Key Findings

Themes

Broadly, five themes have emerged.

•  B&NES in summary

In 2020, the population of B&NES was estimated to be 196,953. ?(ONS)

The population has grown steadily over time:

This growth has come from a combination of increasing student numbers at the two Universities and an increasing number of new housing developments.

 ?

The shape of the population is largely driven by the high number of university students.

 ?

This data will be superseded by release of data collected during the 2021 Census in early summer 2022. 

Overall population outcomes remain good.

o  Life Expectancy is 80.8 for men and 84.7 for women, both significantly higher than national average. (OHID).

o  84% of residents satisfied with area as a place to live compared to 75% nationally. (Voicebox & LGIU)

o  84% of residents satisfied with area as a place to live compared to 75% nationally. (Voicebox & LGIU)

•  Inequalities

2019 - As a whole, B&NES remains one of the least deprived local authorities in the country (ONS). However, within some areas, inequality is widening and deprivation remains significant.

Two small areas within the most deprived 10% nationally – Twerton West and Whiteway.

Premature mortality:

Between 2019 and 2021 the average number of B&NES residents that died each year was 1,748. Over this same period, the average number of premature deaths per year was 444. (OHID)

B&NES has a lower premature mortality rate than England, but there are wards within B&NES where the mortality rate for the under 75s is substantially higher.

Education and Lifestyle outcomes:

·  Education outcomes (DFE)

The attainment gap between children eligible for free school meals is significant and has not changed over time. For early years, this is one of the highest gaps in the country. This trend continues in 20/21 Key Stage 4 attainment. 

There remains an attainment gap for children with Special Educational needs and Disability, although this has reduced across all key stages.

Children eligible for free school meals and those of a mixed ethnic background see higher rates of fixed term exclusions than for England and similar authorities

·  Lifestyle 

Smoking - Tobacco remains the greatest risk factor for mortality in B&NES, particularly for those in their 50s and 60s, but also for those aged 70+. (OHID)

In B&NES, 1 in 4 workers in routine and manual occupations smoke. 

Drugs - England level data shows that the most deprived areas have a higher prevalence of opiate and/or crack cocaine use than the least deprived deciles. (OHID)

Alcohol - In the over 40s, men are significantly more likely to be admitted to hospital due to an alcohol related injury or illness than women.? (OHID)

•  Demand and Growth

Requests for adult social care support  ...  view the full minutes text for item 8.

Presentation on housing as a predeterminant of health and wellbeing.

Paul Harris

(40 minutes)

Paul Harris, Executive Director, Curo addressed the Board, a summary of his presentation is set out below.

Housing crisis

Crisis has been ongoing for around 30 years and the recent Government target of building 300,000 new houses a year is not being met.

Investment in safety and zero carbon

This work is of course necessary but has changed the perspective of how we manage our budget.

Levels of mental ill-health and disability

Increase in these numbers is higher for those people who live in affordable homes.

Poverty / Cost of living

This is inevitably affecting those who were already struggling more.

Social housing and other tenures

Social Housing

·  2.4m tenants (1.6m LA)

·  Lonely, anxious, support

·  Smaller homes (66 sqm)

·  13% decent homes failure

·  66% energy efficiency

Private rented

·  4.4m private renters

·  Currently unregulated

·  Smallish homes (74 sqm)

·  21% decent homes failure

·  42% energy efficiency

Owner occupied

·  15.5m owner occupiers

·  Larger homes (109 sqm)

·  16% decent homes failure

·  42% energy efficiency

B&NES (Housing) context

·  High cost of living

·  Huge waiting lists

·  Increasing homelessness, overcrowding

o  Large families living in properties with a low number of rooms

·  Accessibility

o  Properties not equipped or in a good enough state for the people living there

·  Curo estate

o  Former Council homes in the main, built in the 1960’s

·  Lack of development / land prices / planning

o  Small numbers of Affordable Homes

Major factors affecting health

·  Space

·  Neighbourhood

·  Quality of home

·  Damp & Mould

·  Cost/poverty

·  Poor finish/furniture

Damp & Mould - An increasing concern

• 42% Curo properties reported at least once
• 49% residents have someone at home for whom D&M makes their health worse
• 15% residents can heat only one room
• 6.5% have disability, damp & mould and affordability concerns

What is Curo doing to help

• Damp & Mould Plan, remote monitoring, national awareness-raising
• Customer support fund
• Passport 2 Housing, Money Advice Service, Navigators
• Hoarding – help & advice
• Better data – targeted investments (£100m over five years)
• Building new homes (+ HE funding)
• Green spaces plan

What can other partners do to help

• NHS/ICS – understand role housing plays in health and wellbeing; recognise harmful effects of damp and mould, work closely with housing providers
• All – consider joint investments to improve housing quality and save costs elsewhere in the system
• LA – properly fund DFG (Disabled Facilities Grants) process; create adapted housing register; air quality strategy

Rebecca Reynolds said that the presentation showed it was clear that there is a link between housing conditions and the health of residents. She asked who within the Council would be best to talk with regarding the Disabled Facilities Grants.

Paul Harris replied that they would normally discuss this with Graham Sabourn (Head of Housing) and Mike Chedzoy (Housing Options & Homelessness Manager).

Councillor Romero suggested that these officers could be invited to a future meeting of the Board.

Libby Walters asked if a shortlist of top priorities could be identified.

Paul Harris replied that the gaps in housing provision need to be addressed as well as  ...  view the full minutes text for item 9.

Update on Better Care Fund 2022-23. 

Judith Westcott

(20 minutes)

Judith Westcott, Senior Commissioning Manager for Adult Health and Social Care addressed the Board. A copy of her presentation will be attached as an online appendix to these minutes, a summary is set out below.

Key Better Care Fund Developments

Allocations from Integrated Care Boards to BCF plans for 2022-23 have been published. The NHS Revenue finance and contracting guidance (published 12 April) confirmed that the NHS contribution to the BCF would increase by 5.66% in 2022-23.

·  Disabled Facilities Grant Determination: Department for Levelling Up, Housing & Communities have confirmed 2022-23 allocations for the Disabled Facilities Grant. Allocation for 2022-23 will be £1,441,905.

·  Improved Better Care Fund (iBCF) Grant Determination: Publication issued & confirms that the grant determination for the iBCF for 2022-23 will be £4,903,011 (3.02% increase from 2021-22).

·  Better Care Fund Planning and Assurance 2022-23: The national Better Care Fund team are working closely with Government Departments to secure final sign off for this year’s Planning Requirements. The planning timeline looks like it will begin in July and run until September (but is subject to partner sign off).

Better Care Fund End of Year Report – 2021/22

The Better Care Fund reporting requirements and set out in the BCF Planning Requirements document for 2021-22, which supports the aims of the BCF policy framework and the BCF programme. The key purpose of the report is to:

·  To confirm the status of continued compliance against the requirements of the fund (BCF)

·  To confirm actual income and expenditure in BCF plans at the end of the financial year.

·  To provide information from local areas on challenges, achievements, and support needs in progressing the delivering of BCF plans.

·  To enable the use of this information for national partners to inform future direction and for local areas to inform improvements.

Non Recurrent Funding Applications 22-23

Our ambition - Working together to empower people to lead their best life

Benefits to deliver:

·  Keeping people safe by improving the status quo

·  Improving people’s outcomes by testing different system approaches and learning from these

·  Transforming people’s lives through prevention and early intervention

Our journey outcomes:

·  Recovery /relieving system pressure

·  System learning / culture change

·  B&NES System transformation

Organisations across the B&NES health and social care sector were invited to apply for nonrecurrent project funding through submission of a high-level project plan.

30 projects were initially submitted for consideration for 22-23 non-recurrent funding. 3 projects were withdrawn as they were able to secure funding from a different source or felt the application was no longer relevant. 27 projects were presented to the AODG (Alliance and Delivery Operational Group) panel across 3x separate 1-hour sessions. The total value of the 27 projects was £8,984,157.

ADOG members and applicants were invited to rank applications in priority order by submitting a ‘league table’ style vote. Votes have been collated and results can now be shared with the Health and Wellbeing Board, as some of these projects will utilise available iBCF funding.

Available Funding: Project applications totalled £8,984,157,  ...  view the full minutes text for item 10.

Update on Local Healthwatch in Bath and North East Somerset.

Andy Thomas

(10 minutes)

Andy Thomas, Head of Strategy Engagement & Marketing addressed the Board and highlighted the following points from the report.

Healthwatch England provides advice to the Secretary of State for Health and Social Care, NHS England and English local authorities. He added that the Secretary of State is also required to consult Healthwatch England on the NHS mandate, which sets the objectives for the NHS.

Healthwatch England also provides advice and support to Local Healthwatch

organisations. Based in upper-tier and unitary local authority areas in England - and funded and commissioned by them – they gather evidence from the views and experiences of patients, service users and the public about their local health and care services and provide feedback based on that evidence.

Following a procurement process for a local Healthwatch in Bath and North East Somerset, the Care Forum were commissioned for a period running from 1st April 2018 to 31st March 2021, with the option to extend for up to 24 months following this.

The Care Forum was granted two 12-month extensions to the original contract for Local Healthwatch in Bath and North East Somerset, from 1st April 2021 to 31st March 2022. from 1st April 2022 to 31st March 2023.

There is therefore now a requirement to re-procure Local Healthwatch in Bath & North East Somerset from 1st April 2023, and initial work is underway to plan for this procurement process, which will be undertaken by Bath & North East

Somerset Council.

The current indicative timetable identifies a review of the previous specification over the summer in the light of these and other changes, with a view to beginning the procurement process in the autumn.

The Health and Wellbeing Board is therefore invited to nominate a member to assist with this process of reviewing and updating the specification, ahead of the procurement process beginning.

Paul Harris said that he would be happy to be involved.

Mary Kearney-Knowles said that she would also be willing to take part in the process.

The Board RESOLVED to;

i)  Note the position relating to Local Healthwatch procurement in Bath and North East Somerset as set out in the report.

ii)  Agree that Paul Harris and Mary Kearney-Knowles represent the Health and Wellbeing Board and sit on a working group to review the specification for Local Healthwatch in Bath and North East Somerset.