Agenda and minutes

The Chair welcomed attendees to the meeting and in particular, the recently appointed Vice-Chair of the Board, Dr Sam Hart and Chief Executive of Oxfordshire County Council, Martin Reeves.

Apologies were received from Kevin Gordon, Kerrin Masterman, Professor Sir Jonathan Montgomery, David Radbourne, Yvonne Rees and Cllr Barry Wood.

Hayley Good attended for Kevin Gordon.

There were no declarations of interest.

Members of the public who wish to speak at this meeting can attend the meeting in person or ‘virtually’ through an online connection.

To facilitate ‘hybrid’ meetings we are asking that requests to speak or present a petition are submitted by no later than 9am four working days before the meeting i.e., 9am on Friday 10 March 2023. Requests to speak should be sent to jonathan.deacon@oxfordshire.gov.uk.

If you are speaking ‘virtually’, you may submit a written statement of your presentation to ensure your views are taken into account. A written copy of your statement can be provided no later than 9am 2 working days before the meeting. Written submissions should be no longer than 1 A4 sheet.

There were none.

To approve the Note of Decisions of the meeting held on Thursday 1 December 2022 and to receive information arising from them.

RESOLVED: That the Board APPROVED the notes of the last meeting and to authorise the Chair to sign them as a correct record.

2.05pm

A verbal update from Oxfordshire County Council’s Director for Public Health, Ansaf Azhar.

Ansaf Azhar, Director of Public Health & Wellbeing, Oxfordshire County Council (OCC) gave a verbal update.

He stated that the position in relation to infectious diseases had improved.  Cases of Covid had significantly stabilised as had excess mortality.  Cases of Strep A and flu had reduced.  There was, however, still significant pressure on the health and care system. The COVID vaccination programme this spring for the extremely vulnerable and the autumn COVID / Flu booster programme remain fundamental to achieving on-going control of these viruses.

He also advised that there was not currently a need for the Health Protection Update briefings to be a standing agenda item, due to the reduction in cases of infectious diseases.  Should any specific health protection issues arise in the future they would be reflected in the agenda.  It was noted that there were indirect impacts from Covid and as there was an emergence from the pandemic, there was a requirement to focus on long term disease management as well as urgent care.

The update was noted.

2.15pm

This report summarises the main outcomes from the Health and Wellbeing Board workshop on 19^th January 2023 undertaken to input into the consultation exercise for the development of the Integrated Care Systems strategy. The ICS strategy has since been finalised and signed off by the Integrated Care Partnership on 1^st March 2023.

The Board are asked to note the output from the workshop on 19^th January 2023 regarding the new Integrated Care System Strategy and that this strategy has now been finalised and published.

The Board was advised by David Munday, Consultant in Public Health, OCC that items 7, 8 and 9 all involved strategy development in relation to the Integrated Care System (ICS) and Oxfordshire.  The ICS Strategy had been developed across the Buckinghamshire, Oxfordshire and Berkshire West (BOB) area. 

The paper set out what had taken place in relation to the Strategy since the previous Board meeting in December including, most notably during the formal consultation period as it was being formed, the themes and priorities considered by Board members at the Workshop held in January.  Some of the key discussions at the Workshop included the wider determinants of health being reflected in the strategic work for the ICS and having true integration of services experienced by residents, moving from the strategy to delivery phases.

It was noted that the Strategy Team had reviewed the feedback from the Workshop, the public consultation and other Health and Wellbeing Boards.  The ICS strategy had now been approved by the Integrated Care Partnership (ICP) and it had subsequently been published.

It was agreed by Board members that the Workshop had achieved a positive impact and that public engagement by the organisations involved needed to be ongoing.

RESOLVED: that the Board NOTED the output from the workshop on 19^th January 2023 regarding the new ICS Strategy and that this strategy has now been finalised and published.

2.30pm

Presentation by Rob Bowen, the Deputy Director of Strategy, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board

The Board received a set of slides in the papers which provided a summary position on the Joint Forward Plan. Rob Bowen, Acting Director of Strategy and Partnerships, ICB, stated that the document set out an ambition for how the NHS will deliver services in partnership with organisations in the BOB system.  It was seeking to articulate how collectively the aims of the ICS and some local NHS commitments would be delivered.

The engagement process with partner organisations was currently taking place.  Mr Bowen outlined the timetable with a draft of the Joint Forward Plan being completed by the end of March.  There was still an opportunity to comment and have input after March.  It was intended to sign off the document by the end of June.  Each of the Health and Wellbeing Boards across the BOB system would have the opportunity to comment on how well the Plan aligned to the joint health and wellbeing strategies.  It was currently intended to run a series of community related focus groups in April and May.

The Board noted that it was expected that the Joint Forward Plan would be formally considered at the next meeting on 29 June.  It was also noted that there would be an ongoing process of public engagement in relation to the document and it would be refreshed on an annual basis.  

RESOLVED: that the Board NOTED the presentation and the timetable for the ICB 5 year Joint Forward Plan.

2.45pm

This report outlines the work happening to develop 3 key components to support effective Place working: the Oxfordshire Joint Strategic Needs Assessment, the development of a new Joint Local Health and Wellbeing Strategy and the formation of the Oxfordshire Place-Based-Partnership.

The Health and Wellbeing Board is RECOMMENDED to;

(a)            Agree the timelines and process for the development of the Oxfordshire Joint Strategic Needs Assessment and the Joint Local Health and Wellbeing Strategy in order to meet the board’s statutory duty to publish these documents

(b)            Agree the oversight for this work to be undertaken by steering group(s) made up of relevant officers and staff from organisations that form the Oxfordshire Health and Wellbeing Board

(c)             Note the development of the Oxfordshire Place-Based-Partnership, its overall aim and the main areas of focus for the partnership.

The report was presented by David Munday and Dan Leveson, Oxfordshire Executive Director of Place, ICB. The Board was advised that the Joint Strategic Needs Assessment (JSNA) continued to be the bedrock of understanding the health needs of residents and informed organisational strategy and plans.  It was proposed to bring the 2023 updated JSNA at the next Board meeting in June incorporating the latest data available, which it was anticipated would include the 2021 Census data.

It was also intended that given the current Joint Local Health and Wellbeing Strategy (JHLWS)had been published in 2018 and ran until 2023, a revised version would be developed over the course of the year with the final version being published by the HWB Board in December.  It would be the principal strategy document for Oxfordshire based work.  Progressing the Strategy would involve a steering group made up from the Board’s representative organisations.  The progress would be reported at future Board meetings.

The Board agreed the proposals.  It was noted that the engagement plan for consultation on the JLHWS was being worked up and input from partner organisations on this was welcome.  It was confirmed that the consultation process would not be online only.

Members discussed local residents’ experiences of accessing primary care services and sufficiency of future provision in light of demographic growth. This issue was noted and agreed that it need further exploration and solution at a system level.

RESOLVED: that the Board:

(a)        Agreed the timelines and process for the development of the Oxfordshire Joint Strategic Needs Assessment and the Joint Local Health and Wellbeing Strategy in order to meet the Board’s statutory duty to publish these documents;

(b)        Agreed the oversight for this work to be undertaken by steering group(s) made up of relevant officers and staff from organisations that form the Oxfordshire Health and Wellbeing Board; and,

(c)         Noted the development of the Oxfordshire Place-Based-Partnership, its overall aim and the main areas of focus for the partnership.

3.15pm

The Health and Wellbeing Board is RECOMMENDED to:

A.    Develop and publish a new All-age Unpaid Carers Strategy for Oxfordshire, based on priorities expressed by carers of all ages

B.    Align workplans across Health, Education and Social Care to the refreshed All-age Unpaid Carers Strategy for Oxfordshire so that all services have procedures in place to identify and support unpaid carers, regularly review procedures, and seek ways to support and include carers

C.    Develop and keep updated a central public repository of information for carers so that carers and those supporting/advising them can easily find support

D.    Support the establishment of the overview arrangements necessary to ensure improvements are achieved across the system.

The report was presented by Councillor Bearder, Cabinet Member for Adult Social Care and Karen Fuller, Corporate Director of Adult and Housing, at OCC.   There had been a Survey of Adult Carers in England 2021/22 which showed that, nationally and in Oxfordshire, unpaid carers’ satisfaction levels against all measures had fallen. In response a new All-age Unpaid Carers Strategy for Oxfordshire across Children’s and Adults’ Services was being developed.

The Board welcomed the ‘Live Well Oxfordshire’ brochure, copies of which had been made available at the meeting.  It was noted that this brochure and a separate Carers’ brochure had been sent to GP practices.  It was recommended that social prescribing teams in Primary Care Networks also received the brochures so that frontline primary care was more aware of the work being taken forward.  It was appreciated that Children’s and Adults’ Services were liaising with the PCNs.

Actions were agreed that OCC councillors received the brochures and that the Board received a digital link to the brochures.

The Board was advised that there would be more consultation with key partners.  The final strategy and consultation outcomes were scheduled to be published in August/September. 

RESOLVED: that the Board:

(a)        Supports the development and publishing of a new All-age Unpaid Carers Strategy for Oxfordshire, based on priorities expressed by carers of all ages;

(b)        Supports the aligning of workplans across Health, Education and Social Care to the refreshed All-age Unpaid Carers Strategy for Oxfordshire so that all services have procedures in place to identify and support unpaid carers, regularly review procedures, and seek ways to support and include carers;

(c)         Supports the development and updating of a central public repository of information for carers so that carers and those supporting/advising them can easily find support; and,

(d)        Supports the establishment of the overview arrangements necessary to ensure improvements are achieved across the system.

3.35pm

It is suggested that three key areas of research work are developed: Oxfordshire County Council research capabilities, creating a community research network, and making better use of data.

The Health and Wellbeing Board is RECOMMENDED to:

DISCUSS and ADVISE on current proposals to develop our approach to community research across Oxfordshire, focused on addressing the wider determinants of health and tackling inequalities.

SUPPORT proposed funding bids to the National Institute for Health Research (NIHR) and to UK Research and Innovation (UKRI)

The report was introduced by Adam Briggs, Deputy Director of Public Health.  He stated that the paper set out the development of a more co-ordinated approach to the community research ambitions across Oxfordshire.  He explained that there were three aspects to this, NIHR Health Determinants Research Collaboration (HDRC), Community Research Networks (CRNs) and data integration.

HDRCs are local government-led partnerships funded for £5m over five years to develop local authorities’ capacity and capabilities to deliver research focused on the wider determinants of health and inequalities.  It was proposed to submit an expression of interest and full application to follow in the event of being shortlisted.  Some funding had been provided by UK Research and Innovation (UKRI) in order to set up a CRN.  Funding recipients were invited to submit applications for full implementation of CRNs (funding up to £600k over three years) from around July 2023.  In relation to data integration, it was proposed to take forward two pieces of work in partnership with people working in data and intelligence across OCC as set out in the report.

It was noted that the funding was competitive on a national level and Dr Briggs was asked what the feedback/lessons learnt had been from not securing the funding to be an HIDR HDRC in 2022 in order to seek to achieve this in 2023.    He advised that these were to make the bid a broader one with research leads across Council directorates, greater collaboration with higher education institutes and also, how the roles of the county and district councils and their partnership working can be best communicated.

The Board welcomed the proposals.  It was agreed that updates would be given at future meetings whether the funding bids were successful or not.

RESOLVED: that the Board supported proposed funding bids to the National Institute for Health Research and to UK Research and Innovation.

3.50pm

To report on views of health care gathered by Healthwatch Oxfordshire.

The Board considered a report by Healthwatch Oxfordshire setting out its activities since its last report to the Board. Sylvia Buckingham, Chair Healthwatch Oxfordshire, presented the report.

Ms Buckingham referred to Ros Pierce having left the post of Executive Director at Healthwatch after 6 years of service.  Dr Veronica Barry was the new Executive Director.  She also drew Board Members’ attention to the mention in the report of the Men’s Health video which had been made by Healthwatch in 2018.  In October 2022 Public Health Oxfordshire commissioned a new and supplementary NHS Health Checks service. They had acknowledged “that [the video] was part of the research that led us to change this contract to offer NHS checks in the community”.

The update was NOTED.

4.00pm

To receive an update on latest performance against agreed Health & Wellbeing Board metrics.

David Munday highlighted a number of performance indicators under the three life course stages “Start Well”, “Live Well” and “Age Well” from the Strategy.  He explained that it would be necessary to update the Performance Report to ensure that what was being tracked tied in with the priorities of the new Health and Wellbeing Strategy for Oxfordshire.

The key points relating to the performance indicators included:

• “Start Well” – there was an improving picture in reducing the level of smoking in pregnancy.  Also, the metric had changed to the reduction target of both overweight and obese children in Year 6.  There would be increased activity system wide to achieve this target as highlighted in the annual report being published shortly.  Finally, there was an improved position in increasing the number of early help assessments.
• “Live Well” – it was known that there had been good engagement with the flu immunisation programme for under 65s, buth that the final 22/23 flu season vaccination data was awaited.  For the children’s programme, there was a higher uptake than had been seen the previous year.  It was welcomed that the number of those quitting smoking had increased.  The four red indicators, including NHS Healthcheck programme and cervical screening, had been impacted by capacity challenges due to Covid.  Recovery programmes were in place to improve performance and uptake. 
• “Age Well” – there was a metric of 93% of people discharged to their normal place of residence.  There was discharge pathway work taking place to improve performance and reach the target.  The target was being exceeded in terms of increasing the percentage of over 65s who were still at home 91 days after discharge from hospital into reablement / rehabilitation services.

It was recognised that the size of the Performance Report spreadsheet needed to be bigger in future to make it easier to read.

The Board NOTED the Performance Report.

4.05pm

To receive updates from Partnership Boards. Reports from –

·       Health Improvement Board; and

·       Children’s Trust.

The Chair thanked Councillor Louise Upton for her contribution as Chair of the Health Improvement Board (HIB) as it was noted that she was stepping down from the role.  She would continue to attend Oxfordshire Health & Wellbeing Board meetings as a representative of the City Council.

HIB

Councillor Upton presented the report of the 23^rd February HIB meeting.  The meeting had specifically focused on the theme of healthy weight and physical activity.  It had reviewed a summary of the Director of Public Health Annual Report which had been presented in Final Draft form before publication later in March.  There had been consideration of the Whole Systems Approach to healthy weight.  There would be a more detailed workshop scheduled in the Spring to look at the role of local authorities in creating environments that are more conducive to healthy weight, including in relation to food and exercise.

Councillor Upton also referred to Active Oxfordshire presenting the new Oxfordshire on the Move physical activity framework that they have developed with the support of a significant number of organisations.  They welcomed the ambitions of Active Oxfordshire and agreed they would receive regular updates from them.

Children’s Trust Board (CTB)

Councillor Liz Brighouse presented the report of the Children’s Trust Board.  Matters she highlighted included the Children’s Services Strapline having now been developed and circulated to all board partners and OSCB, for all to use and reach out more widely with other agencies.  This would involve partners working together to help children, young people and families to thrive.  She also stated that significant training had been put in place for multi-agency staff in the use of Strength & Needs forms and Early Help.   Also, a pilot had been undertaken with health visitors in order to encourage them to engage with Early Help matters / Strengths and Needs Assessments.

The Board NOTED the reports and the presentations at the meeting.