Agenda and draft minutes

The Chair welcomed everyone to the meeting, particularly welcoming Cllr Rachel Crouch as West Oxfordshire District Council’s new representative, to the Oxfordshire Health & Wellbeing Board.

Apologies were received by Cllr Liz Leffman, Cllr Tim Bearder, Cllr Nathan Ley, Cllr Helen Pighills and Cllr Rob Pattenden.

Cllr Helen Pighills was substituted by Cllr Lucy Edwards; and Cllr Rob Pattenden was substituted by Cllr Dorothy Walker.

It was noted that several Board members would be present virtually.

There were none.

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 <<DATE>>.  Requests to speak should be sent to simon.wright@oxfordshire.gov.uk

If you are speaking ‘virtually’, you may submit a written statement of your presentation to ensure that 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 26 September 2024   and to receive information arising from them.

The minutes of the meeting held on 26 September 2024 were approved by the Board and signed by the Chair as a correct record.

It was noted that the scheduled JNSA update would come to the Board’s meeting in March, rather than this meeting.

To receive a verbal update from the ICB.

Matthew Tait (BOBICB) provided an update on behalf of the Integrated Care Board and raised the following points:

-       The implementation of the ‘Change’ programme is underway following the end of staff consultation.

-       Several key appointments to positions within the BOBICB were confirmed and it was hoped that the Executive Sponsor for Oxfordshire would be revealed in the near future.

-       The BOBICB’s representation on the Board was discussed moving forward, in terms of both executive and clinical representation.

-       The Board was updated on recent BOBICB board meetings.

-       The vaccination programme was well underway for Winter.

Ansaf Azhar, Director of Public Health and Communities, stressed the importance of having Place/ICB representation and clinical leadership in Health & Wellbeing Board membership.

David Munday, Deputy Director of Public Health, noted that the Forward Plan had been shared with BOBICB colleagues to allow input to ensure items were brought forward in partnership.

The Board to receive a verbal update.

David Munday, Deputy Director of Public Health, provided an update on the Marmot Place and raised the following points:

-       Marmot Place County launch event took place at the end of November and there was good system-wide representation.

-       The plan for future programme-wide projects was shared with the Board.

-       The need to move towards tangible action in future work programmes following the launch event.

Dan Leveson, ICB Place Director for Oxfordshire, referenced the importance of this being a long-term project which requires commitment.  

Ansaf Ahzar thanked everyone who attended the launch event, noted that the themes chosen were based on evidence, and looked forward to working across Oxfordshire on this moving forward. It was also raised that Oxfordshire was unique as a Marmot Place, due to the blend of rural and urban areas.

Cllr John Howson, Cabinet Member for Children, Education and Young People’s Services, noted that the first pillar reflected closely with government announcements around the importance of social mobility earlier on in the education system.

Veronica Barry, Executive Director of Healthwatch Oxfordshire, made reference to the importance of community and voluntary organisations working in partnership to drive County-wide enthusiasm from the bottom, up.

Report of Director of Adult Social Care

This report provides a progress update on the work that has been undertaken in relation to homelessness services in Oxfordshire to improve support following the Safeguarding Adults Review in 2020, specifically “The Alliance”, which is overseen by the Prevention of Homelessness Directors’ Group. The report provides an update on progress made and a summary of current activity.

The Health and Wellbeing Board is RECOMMENDED to note the report

Karen Fuller, Director of Adult Social Care; Andrew Chequers, Deputy Director of Housing and Social Care; and Richard Smith, Head of Housing – Cherwell District Council, provided an update on the Prevention of Homelessness Director’s Group and raised the following points:

-       A good example of the Districts, City and County Councils working well in partnership together.

-       The 3 key pathways within the Alliance are: outreach, prevention and supported accommodation.

-       Noted that there had been supportive statements from the government about not having decreased funding.

-       Homelessness was a national issue, not confined to Oxfordshire.

-       Trying to deal with the causes of homelessness to step up prevention was key, but equally the outcome of homelessness was one that requires significant attention.

-       The important work undertaken in the hospital system with regards to discharges to tackle homelessness.

Caroline Green, Chief Executive of Oxford City Council, noted the increase in demand for accommodation through various pathways for single people and referenced to Housing Summit’s that had taken place to address some of these issues; bringing together all partners to tackle issues in housing. Referring to paragraph 11, it was acknowledged that there were challenges across the County, and in Oxford City, but that additional resources had been put in place to deal with people at risk of homelessness.

Dan Leveson noted the health impacts of homelessness, in terms of life expectancy and other conditions, such as addiction, and also raised that there was expected to be some increase in government funding.

Caroline Green confirmed that there was an additional £233m nationally available for homelessness prevention, but made clear that it was not known how much each District or City Council would receive as part of that funding until the Local Government Finance Settlement.

Cllr Chewe Munkonge, Oxford City Council, asked if there was data available around homeless people without recourse to public funds. Richard Smith confirmed the data was available and would liaise with colleagues at the City Council who could provide greater detail.

Veronica Barry raised the issue of cooking facilities for families in temporary accommodation.

RESOLVED:

The Health and Wellbeing Board noted the report.

Report by Director of Adult Social Care.

The Health and Wellbeing Board approved a new strategy in December 2023, with the priorities split between 4 thematic areas of Start Well, Live Well, Age Well and Building Blocks of Health. Delivery against the ambitions within the strategy is the responsibility of all organisations represented on the Board and is supported by an Outcomes Framework agreed by the Board in March 2024 .  

The Board has agreed to receive a rotating update on delivery of 1 of the 4 strategy themes at its quarterly meetings, meaning that over the course of a 12-month period an update on each theme would be presented once. This report is the first annual report of the thematic domain of Thriving Communities, under The Building Blocks of Health:

·       Priority 10: Thriving communities

o   We will support and enable all diverse and vibrant communities to play their key role delivering better health and wellbeing for people across Oxfordshire.

Vibrant and thriving communities are the cornerstone of a healthy and well Oxfordshire. Communities are crucial to creating good health and wellbeing. There are also opportunities to value and cultivate local communities to help people to support themselves, staying well for longer. This report focuses on the progress of health and wellbeing in communities.

Oxfordshire County Council, along with councils across the country, is working closely with communities to establish effective approaches to building community capacity together with our commissioners in the ICB and Districts in partnership with our residents, enabling us all to achieve better health outcomes and improve our wellbeing. The Oxfordshire Way Prevention Strategy sets out the vision and focus for prevention over the next 4 years. Like all authorities across the country, we need to change, adapt and focus how we can work in collaboration across our communities, with our residents and partners to support long-term health and wellbeing.

The Health and Wellbeing Board is RECOMMENDED to:

(a)           Note the progress on the delivery of priority 10: Thriving Communities within the Health and Wellbeing Strategy

(b)           Comment on the draft Oxfordshire Way Prevention Strategy and endorse the plan to progress to wider consultation.

Karen Fuller, Director of Adult Social Care; John Pearce, Commissioning Manager (Promote, Prevent); and Laura Price, Chief Executive of Oxfordshire Community and Voluntary Action, presented the report and raised the following points:

-       Provided background on the prevention strategy timeline through a presentation of slides.

-       Noted the importance of co-production through the Carers Strategy and with voluntary and community organisations.

-       Stressed the need to work across the community and to be cost-effective and to understand what the community can do itself.

Dan Leveson noted that there was lots of prevention not captured in this strategy, and that it needed to be linked with the social determinants of health. It was noted that the closer this was to communities, the more sustainable and better it would be.

Ansaf Ahzar noted the difficulties of measuring prevention but gave some examples of good measurements such as the physical activity programme.

Professor Sir John Montgomery, Chair of Oxford University Hospitals NHS Foundation Trust, raised points about the governance of the strategy and the importance to avoid duplication of governance streams.

Board Members raised the importance of a long-term approach to this area of work, noting that short-termism, despite financial contexts, is not beneficial.

Michelle Brennan, GP representative, raised the issue of language and not working in silos, in order to ensure that work continued to progress in partnership.

Karen Fuller noted that the use of language was important and what it means to other people. It was also reflected that the strategy was a partnership-wide strategy and governance links between adult social care and public health demonstrated good collaboration with different areas.

The Board further discussed the prevention strategy and thanked officers for their report.

RESOLVED to:

(a)  Note the progress on the delivery of priority 10: Thriving Communities within the Health and Wellbeing Strategy

(b)  Comment on the draft Oxfordshire Way Prevention Strategy and endorse the plan to progress to wider consultation.

Report by Director of Adult Social Care

The report summarises the work of the Oxfordshire Safeguarding Adults Board (OSAB) and its partners over the course of the year 2023-24. It is a requirement set out in the Care Act 2014 and the related statutory guidance that the Local Authority receive a copy of the annual 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 Health & Wellbeing Board is RECOMMENDED to note the content of the annual report which appears at the annex to this report

Jayne Chidgey-Clark, Independent Chair of the Oxfordshire Safeguarding Adults Board, was invited to present the Oxfordshire Safeguarding Adults Annual Report and raised the following points:

-       Neglect and self-neglect remain the main cause of concern, and work is ongoing to see if further interventions can help in this case.

-       There are a number of learning and development needs identified that are not being learned well enough, following reviews and data analysis.

-       Work is underway to co-design solutions to address these needs.

Following discussions with the Leader of the Council, the Independent Chair of the Adults Safeguarding Board stated that there could be an opportunity to present a joint workshop for Councillors sometime in 2025 regarding the work of the Board, the Children’s Board and the Community Safety Partnership to reinforce understanding of the work undertaken around safeguarding.

RESOLVED to:

The Health and Wellbeing Board noted the content of the annual report which appeared at the annex to this report.

Report by Director of Children’s Services

This paper highlights findings from the Board's annual report on the effectiveness of local arrangements to safeguard and promote the welfare of children in Oxfordshire.

The Health and Wellbeing Board is RECOMMENDED to note the annual report of the Oxfordshire Safeguarding Children Board senior safeguarding partners and to consider the key messages.

Ian Sutherland, Independent Chair of the Oxfordshire Safeguarding Children’s Board (OSCB), and Laura Gajdus, Business Manager (OSCB) were invited to present the report and raised the following points:

-       Informed the Board of Oxfordshire’s multi-agency safeguarding arrangements with the County Council, the BOBICB and Thames Valley Police.

-       Multi-disciplinary audits are undertaken in multiple areas to ensure that tests put in place are functioning as they are designed to.

-       3 safeguarding issues identified as priorities and continuing to be reviewed are: neglect of children in the family home, minimising risks to children outside the home and children being safer at school.

-       Updates have been made to information sharing rules.

Michelle Brennan noted that the MASH referrals had decreased slightly and wondered if that was a cause for concern. Ian Sutherland responded that some fluctuation is normal and thus, it wasn’t an area of particular concern.

Michelle Brennan asked if there was any impact of remote consultation on safeguarding issues. Lisa Lyons, Director of Children’s Services, confirmed that from a social care perspective, there have not been remote consultations and has always been face-to-face.

RESOLVED to:

Note the annual report of the Oxfordshire Safeguarding Children Board senior safeguarding partners and to consider the key messages.

Report by Chief Fire Officer and Director of Community Safety

The Safer Oxfordshire Partnership is reporting to the Health & Wellbeing board, and this is the first overview of the work of the partnership in Oxfordshire.

The Health & Wellbeing Board is RECOMMENDED to note the activities and outcomes of the Safer Oxfordshire & Oxfordshire Domestic Abuse Strategic Board, reflected in Annex 1 & 2.

Rob MacDougall, Chief Fire Officer and Director of Community Safety; was invited to present the Safer Oxfordshire Partnership Update and raised the following points:

-       The vision of the Partnership is to reduce crime and make a safer Oxfordshire.

-       It is a statutory function of two-tier County Council’s.

Kate Holburn, Head of Public Health Programmes, was invited to present the report on the Domestic Abuse Strategic Board, and raised the following points:

-       Focuses on priorities that sit within overarching Domestic Abuse Strategy: prevention, provision, pursuing, perpetrator programmes and partnership.

-       Key achievements include the development of the Safer Accommodation Pathway.

Stephen Chandler, Executive Director of People and Transformation, asked what assistance the Health and Wellbeing Board could provide to support the work moving forward. It was explained that constant feedback from the Board would help to support this, and it would become clearer as the reporting process into the Board continued.

RESOLVED:

To note the activities and outcomes of the Safer Oxfordshire & Oxfordshire Domestic Abuse Strategic Board, reflected in Annex 1 & 2.  

Report by Director of Public Health and Communities

The Oxfordshire Domestic Abuse Safe Accommodation Strategy, published in December 2021 (included in Annex 1) outlines how Oxfordshire will implement the statutory duties noted above, to ensure victim survivors and their families have access to safe and supportive housing.

MHCLG require strategies are reviewed every 3 years. We are now approaching this time, with the current strategy having been posted for 3 years at the end of December 2024.

Further to a review of the current strategy it was agreed that many of the actions contained within were still relevant. Therefore, it was agreed by the Oxfordshire Domestic Abuse Strategic Board that the approach of a strategy refresh was more appropriate than implementing a new strategy.

The public engagement and consultation team confirmed the voice of Lived Experience should be fully embed in the refresh process to ensure victim survivor centred approach and that this would fulfil consultation requirements for a strategy refresh.

OCC appointed Solutions in Public Health to undertake the Safe Accommodation Strategy refresh in September 2024, with a view to publishing the refreshed strategy in January 2025.

The Health and Wellbeing Board is RECOMMENDED to note the progress with reviewing the Oxfordshire Domestic Abuse Safe Accommodation Strategy. Statutory duties set out in the Domestic Abuse Act 2021 place a duty on Tier 1 local authorities to assess the need for accommodation-based support and prepare a strategy to provide such support for victims. MHCLG requires strategies to be reviewed every 3 years.

Ansaf Ahzar, Director of Public Health and Communities; and Kate Holburn, Head of Public Health Programmes, were invited to present the report and raised the following points:

-       There is a need to refresh the Safer Accommodation Strategy every 3 years, and this report comes at the end of the last 3-year cycle.

-       Increased the number of refuge spaces available in the last commissioning round.

-       One of the gap areas highlighted is around the lack of provision for marginalised groups and barriers to accessing services.

Dan Leveson noted the connection between this report and issues around homelessness and housing.

RESOLVED:

To note the progress with reviewing the Oxfordshire Domestic Abuse Safe Accommodation Strategy. Statutory duties set out in the Domestic Abuse Act 2021 place a duty on Tier 1 local authorities to assess the need for accommodation-based support and prepare a strategy to provide such support for victims. MHCLG requires strategies to be reviewed every 3 years.

Report by Director of Public Health and Communities

The Combating Drugs Partnership has been formed in response to the national drug strategy “From harm to hope: a 10-year drugs plan to cut crime and save lives 2021.[1]

The plan requires that national and local partners work collaboratively, focusing on three strategic priorities

•       Break drug supply chains

•       Deliver a world-class treatment and recovery system

•       Achieve a generational shift in demand for drugs

The Oxfordshire CDP brings together multi agency partners from across the Oxfordshire system to ensure clear strategic direction and delivery of the aims and objectives set out in the government’s plan. The partnership is chaired by Director of Public Health and Communities.

The CDP provides biannual updates to the Safer Oxfordshire Partnership while also reporting directly to the Health & Wellbeing Board.

This dual reporting structure allows for a comprehensive understanding of substance use issues within the context of broader health and community safety considerations. 

The CDP is required to submit an annual progress report to The Joint Combatting Drugs Unit. This public facing report, which will be published on the Combating Drugs Partnership area of the Oxfordshire County Council website shortly.

HWB members are asked to note the activity of the Combatting Drugs Partnership.

The Health & Wellbeing Board is RECOMMENDED to note the activities and outcomes of the Safer Oxfordshire & Oxfordshire Domestic Abuse Strategic Board, reflected in Annex 1 & 2.

Ansaf Ahzar, Director of Public Health and Communities; and Kate Holburn, Head of Public Health Programmes, were invited to present the report and raised the following points:

-       Statutory obligation following National Drug Strategy – ‘From Harm to Hope’, led by Dame Carol Black.

-       Cannot fix harm from drug misuse by simply focusing on supply of drugs or drug treatment.

-       Three areas of focus are: breaking down supply chains, having good treatment services and achieve a generational shift in the demand for drugs.

-       Defined group of partners that have to be present to help solve issues.

-       Treatment centres perform better than national average.

-       Drug usage in Oxfordshire is lower than national average, as is the unmet need.

-       Drug related deaths overall in Oxfordshire is lower than the England average, but Oxford City is similar to the average across the country.

-       Specific focus on opioid drug use and working in partnership with ambulance service to support this.

Cllr John Howson referenced the level of drug related activities falling in schools and asked if work with young people was making a difference. In reply, it was noted that picking people up early is important in being able to make a difference.

Cllr John Howson also made reference a more general point about other types of addiction for young people, such as gambling. Ansaf Ahzar agreed and noted work was underway nationally on the harms of gambling as an addiction. David Munday noted that a section in the JNSA was around gambling harm precisely because it was an issue of concern.

Caroline Green asked if there was an element of under-reporting of the usage of drugs, and how much of the figures were systemic problems of heavy drug use. Kate Holburn noted that drug use usually is a gradual process that starts from relatively small levels to much higher levels of use.

Board Members engaged in discussion around unmet needs. Ansaf Ahzar noted that reducing levels of stigma around drug use would encourage people to seek help where they needed it.

RESOLVED:

To note the activities and outcomes of the Oxfordshire Combatting Drugs Partnership, reflected in the Annual Progress Report in Annex 1.

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

Veronica Barry, Executive Director of Healthwatch Oxfordshire, introduced the report and raised the following points:

-       Report taken to Health Overview and Scrutiny Committee about people’s experiences leaving hospital using discharge to assess system.

-       Feedback event on food services and why they use it was undertaken; giving useful insights into isolation, for example.

-       A webinar was hosted alongside the Men’s Health Partnership focusing on men’s health and men’s mental health.

To receive updates from Partnership Boards. Reports from –

·       Health Improvement Board; and

·       Children’s Trust (verbal); and

·       Place Base Partnership

Councillor Georgina Heritage, South Oxfordshire District Council, introduced the report from the Health Improvement Board (HIB) and raised the following points:

-       Key items on the agenda of the last meeting were tobacco controls, air quality and the Marmot Place initiative.

-       The HIB was supportive of the government plan to ban vapes, and also distinguished between vapes to reduce tobacco use and vape abuse.

Councillor John Howson and Lisa Lyons provided an update on the work of the Children’s Trust Board, which was that the first meeting had now taken place and that further detailed work would carry on into 2025. It was deemed an introductory meeting, but it was well-received, and partners were on-board for future meetings.

Dan Leveson provided an update on the Place Base Partnership and raised the following points:

-       Capacity to tackle SEN is outstripped by the demand for services; despite increases in assessment clinics, for example.

-       Noted the team was shortlisted for two awards, which was acknowledged, praised and welcomed.

-       It was stated that the leadership for Place Base Partnership was still being discussed following recent changes in ICB.

Members to note the items on the Forward Work Programme.

The Board noted items on the Forward Work Programme.