Agenda and minutes

Apologies had been received from Simon Adams, Vic Allison, Sarah Raistrick, Andy Roberts, Tina Russell, Jonathan Sutton and Simon Trickett.

Carole Cumino attended for Jonathan Sutton, Jo Ringshall attended for Simon Adams.

Ian Hardiman was welcomed to his first meeting as the new District Council representative for Wyre Forest.

Carole Cumino declared that although she was attending the meeting as the VCSE representative, she would be presenting the Carers Strategy on behalf of the Worcestershire Carers Partnership; and with regard to the items on Mental Health and CAMHS she declared that she had recently become a Associate Non-Executive Director of Herefordshire and Worcestershire Health and Care NHS Trust.

Sarah Dugan also declared an interest in the items on mental health as Chief Executive of Herefordshire and Worcestershire NHS Trust.

Members of the public wishing to take part should notify Legal and Democratic Services in writing or by e-mail indicating the nature and content of their proposed participation on items relevant to the agenda, no later than 9.00am on the day before the meeting (in this case 9.00am on 23 May 2023). Further details are available on the Council’s website. Enquiries can be made through the telephone number/e-mail address listed in this agenda and on the website.

None

The minutes of the last meeting held on 14 February 2023, were agreed to be an accurate record of the meeting and were signed by the Chairman.

This item was moved up the agenda and was introduced by Fran Kelsey with support from Rachel Barrett, Sam Sinderberry and Sandra Rohan-Kickham.

The Learning Disability Strategy had been co-produced by Worcestershire’s Learning Disability Partnership Board, which was Chaired by an Expert by Experience with a learning disability. People had worked together on an equal basis by holding a wide range of meetings and discussions with those with learning disabilities. The Strategy was about making Worcestershire a great place to live for those with a learning disability and had been produced to be accessible as possible with quotes and photos included.  Real life examples of what success would look and feel like were included. The Strategy was intended to be the go-to guide to allow people to work together to make positive changes to the lives of those living with a learning disability. A key target area was to improve the disparity of health and life expectancy compared to the general population. Good mental health should also be on an equal basis.

Rachel Barrett explained that she was pleased that people with learning disabilities had been involved with developing the strategy and had their voices heard from the beginning. She felt that it was important being healthy in body as well as mind, and that everyone with a Learning Disability should get a good quality annual health check. Reducing health inequalities and ensuring that everyone gains a better understanding of learning disabilities were important aims.

Sam Sinderberry said that enabling people to lead good lives and including everyone were key themes of the strategy.  People with learning disabilities wanted to do things which were important to them such as having a job, volunteering, taking part in different activities or developing friendships or relationships but they needed the right support to be able to carry out these activities and to feel safe. Organisations and communities needed to include people with learning disabilities and the right housing was important along with available transport.

Sandra Rohan-Kickham was a carer for her 42-year-old son who had profound disabilities and complex health needs. She had witnessed the production of many strategies over time, but this one was different and reflected the changes and challenges that had happened following COVID. The Strategy stated that COVID should not be used as an excuse by organisations for services not being offered or people not being supported on equal terms. During that time physiotherapy, occupational health, dentistry and mental health services had all been reduced.  The recruitment of care staff had been equally problematic.

She explained that from the outset this strategy had been aspirational, bold and ambitious and believed that it was important that all voices were heard. Each section asked what success should look and feel like. She said success would be for the strategy to be visible, accessible and used, so that people reading the strategy could make a difference to the lives of people with Learning Disabilities. She stated that for carers to have a  ...  view the full minutes text for item 702.

The main thrust of the strategy, which had been endorsed by the Health and Wellbeing Board in February 2022, was that carers felt recognised and valued, that they had a life of their own, that their physical as well as mental wellbeing was important and that they felt safe.

Carole Cumino explained that that there were more than 55,000 carers in Worcestershire, and in general they had worse health and wellbeing than the rest of the population. It was often difficult to persuade people that they were actually carers, especially if it was part of their culture to look after family members.

The Strategy was important as it was important to address inequalities for carers and financially it was sensible to support carers to reduce demand on formal health and care services. Following the approval of the Strategy the tender for the provision of support had gone to Worcestershire Association of Carers. One of the biggest priorities was sorting out issues with Parent Carers, which involved sorting out two sets of legislation, but it was important to ensure carers were not forgotten.

The Carers Partnership had been created, following the successful model of the Learning Disability Partnership which had been in place since 2015, and consisted of representatives from different groups. It was noted that the next a carers strategy would copy the example of the new Learning Disability Strategy and be more accessible.

It was important to recognise carers and Primary Care were doing a good job of identifying them. In particular Black, Asian and Minority Ethnic groups often did not identify themselves as being a carer and young carers were also a group who were not easily identified.

The most recent census had shown that there appeared to be a reduction in the number of carers in Worcestershire, with numbers providing 19 hours or less of care a week falling but those providing 50 hours or more increasing. However, carers groups believed that numbers were likely to have increased, so work was underway to identify why numbers seemed to be under-represented.

A Board Member felt that the demands put on carers of those with dementia was underestimated as it could be very intensive and suggested that the strategy did not bring out the full mental and physical health impacts on carers of their caring role.

It was noted that Worcestershire Association of Carers were pleased that the County Council maintained its investment in carers and had signed up to the commitment to carers. The work being done by Worcestershire County Council in identifying members of staff who were carers was important.

In future it was suggested that health services could be realigned so that in general pharmacies and primary care provided more services rather than hospitals but there was concern that this would add to the burden and responsibilities on carers. It was pointed out that it would be important that Equality Impact Assessments were carried out to capture the effect of any changes on carers  ...  view the full minutes text for item 703.

This report was introduced by Tanya Richardson – Consultant in Public Health, ICB Clinical Lead for Social Change Chair of Suicide Prevention Partnership

Lucy Chick – Senior Public Health Practitioner Chair of Suicide Audit Group

Louise McAvoy – Advanced Public Health Practitioner. Lead on the Suicide Prevention work

The purpose of the report was to inform and assure the Board of the work which was ongoing in Worcestershire. All organisations represented on the Board were involved in the work showing true partnership working. Death by suicide is devastating but the stigma involved means that people often don’t ask for help. In Worcestershire the rate is similar to the national average with the rate higher among males than females. Suicide is the result of a complex and interrelated set of factors meaning that suicide prevention work is required across a range of settings. Improving mental wellbeing across the population is important and an enhanced Herefordshire and Worcestershire Suicide Prevention programme of wellbeing support has been in place in Worcestershire since November 2020 funded by NHS England.

The Programmes objectives were to contribute to a reduction in the number of suicides across the two counties, particularly focussed on men aged 30-65.The programme was working to reduce stigma, improving identification of those at risk and creating opportunities to intervene before crisis.

The new National Suicide Prevention Plan was expected in July 2023, and the Worcestershire strategy would be assessed and updated as necessary. There would be continued engagement between the Suicide Prevention Partnership and the Health and Wellbeing Board to implement the Action Plan.

National Suicide mortality data was taken from death registrations following inquests so could take up to a year to be recorded. A Police led Real Time Suspected Suicide Surveillance (RTSSS) system had been in place since September 2022 in Worcestershire with the Suicide Audit Group set up to look at data to identify patterns and opportunities to intervene.The Bereavement Suicide Service had been in place since 2021.

Suicide was not just about mental health so it was important that communities thought about early prevention. A range of activities were taking place such as the Orange Button scheme which enabled people who had received 3 hours of suicide prevention training to wear an orange button to let people know that they were confident to speak about suicide and signpost people to support. Some funding had been made available to develop the orange button scheme further.

Webinars had been developed, as well as face to face sessions which focussed on small business which did not have support from large HR departments.

The Campaign Acting Together to Prevent Suicide was important to raise awareness and to get people to engage with the follow-on work. The Campaign was fronted by Delicious Orie, Work was ongoing with the communications team on developing campaigns for specific groups such as farmers, Gypsy Roma Traveller community and the construction industry.

Board Members made a number of comments:

·         GPs in Worcestershire were keen to  ...  view the full minutes text for item 704.

The Chair explained that the Scrutiny Task Group had been put on hold during COVID but had subsequently been completed with the resulting report being received at Cabinet on 30 March 2023 and it had been suggested that the report go to the Health and Wellbeing Board.

RESOLVED that the Health and Wellbeing Board:

a)    Received the Scrutiny Report about Child and Adolescent Mental Health Services; and

b)   Agreed that the Children and Young People’s Strategic Partnership, as a sub-group of the Health and Wellbeing Board, consider the report and responses of the Cabinet Members with Responsibility and Herefordshire and Worcestershire Integrated Care Board to ensure a system wide collaborative approach be taken.

The Board noted the discussion which had taken place at the previous Development meeting on 15 May. The final Joint Forward Plan would be further discussed at the Development meeting on 20 June.

RESOLVED that the Health and Wellbeing Board

a.    Noted that the Integrated Care Strategy for Herefordshire and Worcestershire was approved by the Integrated Care Partnership on 26 April 2023, and has now been published; and

b.    Noted that the approach outlined in this report for involving Health and Wellbeing Board Members in the development of the Joint Forward Plan.

Health and Wellbeing Board Members would be emailed the 2023-2025 submission in June after it had been to the Integrated Commissioning Executive Officers Group, and prior to the submission to NHS England on 23 June. The full submission would be ratified at the Health and Wellbeing Board meeting in September.

RESOLVED that the Health and Wellbeing Board

a.    Noted the timescales and progress of the 2023-25 Better Care Fund Plan, 2023/24 budget and the BCF 2022/23 annual return, which included the year end outturn; and

b.    Agreed to receive and approve the relevant documents virtually due to the relevant national timelines.

Health and Wellbeing Board Members noted the Worcestershire Safeguarding Adults Board Annual Report, which was also being considered at Cabinet on 25 May, where the Chair of the Board, Professor Brown would be able to reassure Worcestershire County Council that safeguarding of adults was in a good position with regard to partnership work.

A Board Member commended the report and noted that homelessness and rough sleeping were key strands in the report. It was clarified that the Chair of the Safeguarding Adults Board was independent and was offering reassurance to the Health and Wellbeing Board about the work of the Board.

RESOLVED that the Health and Wellbeing Board:

a.    Received assurance that the Worcestershire Safeguarding Adults Board was meeting the requirements of the Care Act; and

b.    Considered any cross-cutting themes and to refer issues either directly to the WSAB or through the next joint Cross Cutting Issues meeting to be held between the Chairs of the four Boards.

The Board noted the Children’s Safeguarding Partnership Annual Report and were informed that any questions could be put in writing to the Director of Children’s Services Tina Russell.

RESOLVED that the Health and Wellbeing Board considered the report and highlighted any opportunities for collaboration and support between the Board and the Partnership on shared priorities and future work.

Public meetings (All Tuesday at 2pm)

• 26 September 2023
• 14 November 2023

Private Development meetings (All Tuesday at 2pm)

• 20 June 2023
• 17 October 2023

The next meeting would be a private development meeting which would take place on 20 June.

The next public meetings of the Board would take place on 26 September 2023 and then 14 November.