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Welcome by Chair
The Chair welcomed attendees to the meeting and in particular Councillor Dr Nathan Ley, who was attending his first meeting as Cabinet Member for Public Health, Inequalities and Community Safety.
Apologies for Absence and Temporary Appointments
Apologies were received from Councillor Tim Bearder (Oxfordshire County Council), Councillor Maggie Filipova-Rivers (South Oxfordshire District Council) and Councillor David Rouane was substituting and Councillor Phil Chapman (Cherwell District Council) and Councillor Andrew McHugh was substituting.
Declarations of Interest - see guidance note opposite
There were no declarations of interest received.
Petitions and Public Address
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There were no petitions or requests for public address received.
To approve the Note of Decisions of the meeting held on 5 October 2023 (HBW5) and to receive information arising from them.
Quick verbal update on SEND
It was agreed that the Note of Decisions of the previous meeting held on 5 October 2023 would be approved.
RESOLVED: that the Board APPROVED the notes of the last meeting held on 5 October 2023 and the Chair be authorised to sign them as a correct record.
Update to be presented by Lily O’Connor and Dan Leveson.
The report and tables were introduced by Dan Leveson, Place Director for Oxfordshire, Buckinghamshire Oxfordshire Berkshire West ICB, before he handed over to Lily O’Connor, Programme Director Urgent and Emergency Care for Oxfordshire, to go into the detail. It was reported that the dashboard provided the statistics for the performance overview. Members commented that:
· It was great to see the performance against the targets. It would be good to see them against the national performance. The Committee were informed that the national context would be shown in the next version of the report, there was a comparative but no like for like context.
· It was commented that it was cheaper to have someone at home then in hospital. The current cost of being in hospital was around £2000 and could be a lot more but it was not about the cost, more about the right thing and not just about putting people at home.
· The definition of ‘homes’ was clarified as meaning ‘own bed’ at a residential home, nursing home, care home, hospital or own home.
· It was important to raise that when there was reference to 105 people in inappropriate out of area inpatient beds refers to bed days so that would be maybe four or five people.
· Good progress was being made.
· A request was that urgent care centres be added to the next version of the dashboard. The Officer commented that data had only been received for two of the three urgent care centres, so data was incomplete hence had not been involved. It would be developed further going forward.
· It was highlighted that the situation was improving and reducing year on year if the middle of winter was compared for primary, secondary, and acute care which was an encouraging place to be. The Team was thanked by the Board.
The Corporate Director of Public Health and Community Safety updated the Board infections and vaccinations. There was a current increase in respiratory infections and covid cases. In terms of vaccinations, across Oxfordshire, in all age groups, this was above average and doing well regionally. For the over 65s for flu vaccinations, it was over 80% and we currently were lagging for the under 65 age group. Further outreach work needed to be done with groups such as pregnant women, asylum seekers, people with learning difficulties and the elderly, which had been commissioned by the ICB. Oxfordshire was above average for 2–3-year-olds.
Caroline Green, Chief Executive of Oxford City Council asked if there was variation of uptake in different areas of Oxfordshire and was informed that the under 65’s had dropped and there was a lower uptake in areas of deprivation and within certain communities such as the Pakistani community and the BAME community. It was asked if there was an evaluation on how the vaccine champion schemes were being affective in the areas. It was reported that it was too early to evaluate this, but a significant piece of work was being evaluated on how we ... view the full minutes text for item 49.
Organisations across the Health and Wellbeing Board have developed a new Oxfordshire Health and Wellbeing Strategy for 2024-2030 (Annex 2), which has been informed throughout by the Integrated Care System (ICS) Strategy and the Oxfordshire Joint Strategic Needs Assessment (JSNA). The strategy content has been developed through a process of early engagement with people and communities across Oxfordshire, a workshop with the Health and Wellbeing (HWB) Board, full public consultation and several HWB Board discussions. A cross-organisational Task and Finish group has led the work on behalf of the HWB Board throughout the process.
The Health and Wellbeing Board is RECOMMENDED to
· Note the content of the public consultation report (Annex 1) which contains the consultation methodology, summary of feedback received and how it has informed the strategy.
· Approve the content of the full final strategy (Annex 2) as the final version of the Board’s Health and Wellbeing Strategy for 2024-2030.
· Support plans to publicise the Strategy in January 2024 when it is fully launched.
· Note that Officers plan to bring to the Board meeting in March 2024 a delivery plan and outcomes framework to support strategy implementation.
David Munday, Deputy Director of Public Health, OCC, thanked all Members of the Health and Wellbeing Board (HWB) for there attendance at the workshop and the really helpful engagement and time to steer the task and finish group. The engagement for the Strategy had been really positive.
The Board were reminded that the new Health and Wellbeing Strategy had been structured around four areas. The principles of prevention, tackling inequalities and working in closer collaboration. Secondly, there are priorities across the life course, thirdly, there were the fundamental building blocks of health that everyone needed to have in place to lead healthy and happy lives and finally, the three enablers listed that helped to move from the Strategy to delivery. The Strategy had been heavily influenced by the Joint Strategic Needs Assessment (JSNA), this was the assessment of residents needs in Oxfordshire and also the early engagement and public consultation in this strategy work. This then connected into the Integrated Care System Strategy and the NHS 5-year forward plan and Primary Care Strategy. This was the Primary Place Strategy for Oxfordshire. The two main reflections had been a real desire and willingness to joined up working to have a new Strategy and good collaboration to improve health and wellbeing locally and a real appetite to move this from a Strategy to delivery and making a difference. The Board was introduced to Imogen Coningsby, Health Improvement Practitioner and Tamanna Rahimi, Paediatric Public Health Fellow.
Imogen Coningsby reported on the consultation. From mid-October to mid-November, the draft Health and Wellbeing Strategy went out for consultation, parts of the consultation had been informed by the engagement work carried out by Healthwatch and Public Health with over 1000 residents over summer. The aim of the public consultation was to gather further insights from residents and stakeholders on the final draft version of the Strategy to ensure that the voices of the residents and stakeholders were incorporated into the Strategy. The consultation had been conducted through an online survey that had been conducted through an online survey that had been developed and agreed by the Health and Wellbeing Strategy Task and Finish Group. An easy read survey was also carried out with the sector organisations and community groups. A variety of different channels were used to engage respondents including key networks and partnerships, social media, staff communications, E newsletters, councillors, parish councils and other council teams such as housing social care and children’s services. In order to capture people that could not access the online survey, Healthwatch hosted a webinar that 68 people attended. The online survey received 435 responses, many of which were from organisations that represented many people. There was high support for the priorities and the enablers in the draft, the three principles in the draft received high support at 93%, overall people thought the Strategy was well written, well structured and easy to read.
Tamanna Rahimi added that there were some cross-cutting themes included how the Strategy would be delivered ... view the full minutes text for item 50.
The report summarises the work of the Oxfordshire Safeguarding Adults Board (OSAB) and its partners over the course of the year 2022-23. It is a requirement set out in the Care Act 2014 statutory guidance that the Local Authority receive a copy of the report and that they “will fully consider the contents of the report and how they can improve their contributions to both safeguarding throughout their own organisation and to the joint work of the Board” (Chapter 14, para 161).
The Report is not produced as a document but as a webpage. It is accessible via this link: Safeguarding Adults Board Reports - Oxfordshire Safeguarding Adults Board (osab.co.uk).
The Health & Wellbeing Board is RECOMMENDED to note the contents of the report and its conclusions.
Karen Fuller, Corporate Director of Adult and Housing and Anne Lankester, Head of Adult Safeguarding, presented the report to the Board. The key highlights from the report were presented. Further information was given to the Board on the Multi-Agency Risk management (MARM) process which was designed to support anyone working with an adult where there was a high level of risk and the circumstances sat outside the statutory adult safeguarding framework, but where a MARM process would be helpful.
The Leader process was highlighted to the Board. This was when anyone with a learning difficulty anywhere in the country and in Oxfordshire, a review was carried out to understand what processes could support the individual more.
Councillor McHugh requested that the District Councils continued to be included in the professional relationship’s reviews. And with respect to learning disability health checks with the GP partners, the statistics did not look impressive at 24% when the target was 75%, could something further be done? There were different and better ways of doing this. David Munday informed the Board that there were a number of colleagues looking into this and the figures looked worrying but by the end of the year, the annual check would be much higher.
RESOLVED: that the Board noted the contents of the report and its conclusions.
Laura Gajdus, Business Manager, Oxfordshire Safeguarding Children Board (OSCB). The report in the pack was reporting from April 2022 to March 2023. The Head of Safeguarding and QA for Oxfordshire Childrens Services. The Business Manager shared a couple of slides with the Board explaining the Vision, the aims and the Safeguarding Partners including the Council, the ICB and Thames Valley Police. The three safeguarding issues that the partnership continue to review were the neglect of children in the family home, minimising the risks to children outside the home and that children were often safer in school. The audit of these issues was very important, and this was carried out by system-wide views on safeguarding work, assessments, audits, views from practitioners, families and children and through the data. The Board were informed about the ongoing training and how successful and useful it was.
Councillor Pighills asked how closely the team worked with the Community safety Partnership and was informed that they worked closely, they frequently did learn from the domestic homicide reviews in relation to a child and the impact of the child. There was also a subgroup that looked at exploitation but was always looking for new opportunities to connect. The Serious Incident Notifications were clarified to the Board, and they were carried out.
RESOLVED: that the Board noted the annual report of the Oxfordshire Safeguarding Children Board, senior safeguarding partners and considered the key messages.
Don O’Neal, Chair of Healthwatch Oxfordshire, presented the report to the Board. The main point to highlight was that the Community Research in Oxfordshire report had found that communities were tired of research ‘on them’ and not ‘with them’ and that this needed to change. From the work carried out, four key principles had been identified, these were that nothing about us, without us, commit to action, value the lived experience and time, and to be open, transparent and accountable. All of the Healthwatch Reports could be found on the website.
Veronica Barry, Executive Director of Heathwatch Oxfordshire, informed the Board of the other reports including what people understood by joined up care and patient experience on discharge pathways. Dan Leveson added that the commitment as a system was to invest in the actions that were community driven and built from grassroots communities to make a difference to their health and wellbeing based on the assets from those communities.
Ansaf Anwar added that if any Member of the Board was doing any community research, to engage with him so that the research was not repetitive.
Councillor Upton added they were looking at tapping into the Universities research students that were looking at making people healthier and happier and it was essential to check with Public Health and Healthwatch to ensure that the same questions were not being asked.
The Chair reiterated that people were happy to engage but also wanted feedback.
RESOLVED: that the Board noted the report from Healthwatch Oxfordshire.
To receive an update on latest performance against agreed HWB metrics.
Steven Bow, Consultant in Public Health, presented the performance report to the Board. The main points to highlight included:
· Measures 1.13 and 1.14 were showing modest increases in MMR vaccination coverage but were still short of the 95% target.
· Measures 1.15 and 1.16 showed the updated data was now available for data on reducing the levels of children overweight in reception class and Year 6 as per the National Child Measurement Program.
· Measure 2.17 showed that the number of smoker quitters had decreased and was now amber. This indicator was under review as the smoking prevalence had gone up.
· Measure 2.21 and 2.22, increased in the level of cervical screening had increased and was heading in the right direction but was still short of the target and this was similar for breast screening.
Members raised the following points:
· Councillor Upton asked how the estimated diagnosis rate for people with dementia was obtained and was informed that the national model was used which was linked to GP registrations, it was a national estimate which was subject to caveats.
· Councillor Howson raised a point on the two education indicators for children in care which were green, a current concern was that of unaccompanied young asylum seekers, currently there were 100 under the transfer scheme. Councillor Howson thanked the Interim Corporate Director for Childrens Services, Anne Coyle, who would be leaving at the end of 2023.
· Councillor McHugh commented that there were no targets for CAMHS, there was also no data for a year and yet the notes revealed that there had been a cyber attack in July 2023, Councillor McHugh asked if there was any back up. He was not satisfied that there were no targets and no data for a year, it was not acceptable. The Chair agreed that there was a huge backlog. David Munday commented that this was one of the priorities of the Health and Wellbeing Strategy looking more at early intervention and then the provision. Grant MacDonald, Interim Chief Executive of Oxford Health NHS Foundation Trust, confirmed that there had been a cyber attack and a whole new system had been put in, external reassurance had been taken and this was being done as quickly as possible, the data was available as this was being completed manually and emergency cases were being seen within 24 hours and urgent cases within a week. It was the routine care that took months to be seen for an assessment. There was a solid CAMHS service in place. Councillor Howson was concerned that no data was available and was reassured that trend data could be given. Dan Leveson confirmed that the metrics were being looked at as the regulator and commissioner.
To receive updates from Partnership Boards. Reports from –
· Place-base Partnership – Dan Leveson
· Health Improvement Board - Cllr Pighills
· Children’s Trust Board – Cllr Howson
A) Place Based
Dan Leveson presented his report to the Board and stated that this was a consultative forum where leadership from health and social care come to identify priority populations that can be joined up. The biggest success was actually coming together as a leadership team overseeing the work. Over the next couple of years, it was going to be crucial, with the financial pressures to continue to agree to do the right things. As a system, we were really standing out in some areas.
Councillor Pighills presented the report to the Board and commented that the Board had received a presentation on the new Oxonair webpage and its functionality about the air quality of Oxfordshire. The second part of the meeting was on tobacco control, presented in three parts, smoke-free pathways in NHS provider organisations, tobacco control Alliance action plan update and Stop for life targeted community outreach.
Councillor Howson commented on the recently held workshop that reflected on the impact the Board was having on the outcomes of children and young people and what was working well and what could be improved. There would be revised governance that would be introduced in January 2024.
David Munday commented that going forward with the three standing regular updates and moving to the delivery of the Strategy, it was worth looking at mapping across the different actions and the different priorities and what sat within the different subgroups of the Health and Wellbeing Board. It would be good to see reports from the subgroups and how they were contributing to the Strategy delivery.
Members to note the items on the Forward Work Programme.
RESOLVED: The Board noted the Forward Work Programme.