Agenda and minutes

Solihull Health & Wellbeing Board - Tuesday 28th September 2021 2.00 pm

Items
No. Item

136.

Apologies

Minutes:

The following Board Members submitted their apologies:

Yve Buckland – BSOL CCG

Dr Will Taylor – BSOL CCG

Cllr R Holt – Cabinet Member for Children, Education and Skills

Fiona Hughes – Solihull Community Housing

137.

Declarations of Interests

To receive declarations of interest from Members.

Minutes:

There were no declarations of interest

 

138.

Questions and Deputations

To answer any questions, if any, asked by any resident of the Borough pursuant to Standing Orders.

Minutes:

A deputation was received from the Monkspath Patient Participation Group, regarding the Solihull Healthcare Partnership Access Independent Review. Karen Helliwell, Accountable OfficerBSOL CCG, responded to the points raised, emphasising how the CCG took them extremely seriously. It was explained how the issues raised in the deputation were being reviewed in detail and a response would be provided both to the Monkspath Group and the Board. Councillor Grinsell also detailed how a meeting was planned shortly between the CCG, SHP and the Monkspath Group, to consider the points raised.

 

139.

Minutes pdf icon PDF 429 KB

To receive the minutes of the previous meeting held on 15th June 2021.

Minutes:

The minutes of the meeting on 15th June 2021 were presented.

 

  RESOLVED

That the minutes of the meeting held on 15th June 2021 be held as a correct record.

140.

Integrated Care System - update

Board to receive an update on the introduction of the ICS.

Minutes:

David Melbourne, ICS-Programme Director and ICS-Finance Lead, provided an update on the development of the Integrated Care System, detailing how it was an important platform to deliver a number of goals – including the restoration of services across Birmingham and Solihull, ensuring service access, delivering the vaccination programme and reducing inequalities. It was noted how, as part of the Board’s agenda, Members were due to consider a number of critical elements of the ICS – including the ICS Inequalities work programme, as well as the role of Solihull Together in delivering Place-level ICS ambitions in Solihull.

 

  RESOLVED

The Health and Wellbeing Board noted the Integrated Care System update.

 

141.

BSOL ICS Finance Update pdf icon PDF 704 KB

Board to receive an update from David Melbourne, ICS Finance Lead and Paul Athey, BSOL CCG Chief Finance Officer.

 

Minutes:

Paul Athey, BSOL CCG Chief Finance Officer presented the BSOL ICS Finance briefing to the Board, which detailed how a Place-based financial framework and budgets were being scoped and could work within the ICS. He highlighted the following points:

  • How NHS finance would work in the ICS, noting that by 2022-23, it was anticipated ICBs would receive NHS financial allocations for their system populations. These allocations were expected to be broken down into a limited number of ring-fenced areas, as outlined in the report.
  • It was anticipated the ICS allocation would take into account a new weighted capitation formula, which the Government was currently developing. This would be based upon the health needs of individual populations.
  • In regards to where the ICS was starting from, the CCG had a breakeven plan for 2021/22, which was supported by additional funding from the Government to meet Covid-19 and recovery costs.
  • Since BSOL CCG was established in 2018, accounts had not been reported on a Place (Solihull) basis, so developing Place (and locality) budgets for 2022/23 was a new undertaking. For the start of 2022/23, it was anticipated budgets and allocations would be largely based upon current spend, to avoid destabilisation of current service provision. Also, various allocation approaches were currently being reviewed, to enable effective allocation of budgets at place-level going forward.
  • In regards to timescales, it was anticipated that an initial draft budget for 2022/23 would be developed by September/October 2021.
  • A piece of work was also being undertaken with the Adult Care and Support Directorate of Solihull Council, to identify the specific service areas in Solihull they may wish to have an early Place-based focus upon.
  • It was expected that further guidance was going to be published shortly by NHSE, which would include a national place based allocation tool. It was hoped this could be used to assess current spending against benchmarked levels.

 

Members raised the following questions and observations:

  • Councillor Grinsell queried the expected timeline for determining place-level budgets, to enable officers to understand specific allocation levels.
  • Paul Athey explained how place-level budgets needed to be in place by the start of the ICS, in April 2022. There were two key milestones between now and then – a significant piece of work was being undertaken with providers to understand their provider cost-base. It was anticipated this would be completed by January 2022. During this time, they were also expecting to receive an overall financial allocation figure for the whole System, for 2022-23, which was also to be used to determine future budgets.
  • Tim Browne emphasised the importance of ensuring the joint commissioning arrangements across the Council, Children’s Services and the ICS were extremely robust, to ensure the commissioning of the right services, at the right time, in the right way. Ongoing reporting to the Board, on the development of the ICS financial arrangements, was required.
  • Councillor Sexton queried how the new financial arrangements under the ICS were expected to differ from previous approaches.
  • Paul Athey explained how there were  ...  view the full minutes text for item 141.

142.

Covid-19 Outbreak Management - Update

Board to receive a verbal update from the Director of Public Health. Board to also receive a verbal update on the return to schools.

Minutes:

Ruth Tennant, the Director for Public Health, provided an update on current circumstances, highlighting the following points:

  • Rates had increased slightly as a result of the schools returning – as of 28th September, it was 375 per 100,000, with continued high rates within the 11-16 year old group. The 12-15 year old vaccination programme was currently being rolled-out.
  • The Joint Committee on Vaccination and Immunisation had recently announced the introduction of the booster programme, which would be rolled out to the most vulnerable groups.
  • Locally there were good take-up rates of the vaccine – there was particular focus upon areas experiencing lower up-take rates, especially as we move into the winter period, when people would be more likely to socialise indoors.
  • In regards to the impact on the NHS – there had been a reduction in the number of people requiring hospitalisation and intensive care, as a result of the vaccination programme. However, there were still relatively high numbers of people requiring treatment, with around 25 people currently in intensive care.
  • Locally, the multi-agency Local Outbreak Management Board were focusing upon preparing for the winter period – currently, there were quite high levels of a respiratory virus affecting children, whilst cases of flu were rising. There would be significant focus upon ensuring a good take-up of the flu vaccination.
  • The Local Outbreak Management Board was also focusing upon ensuring support for vulnerable groups as we went into winter – this included ensuring good protection around care homes.

 

143.

ICS Inequalities Work Programme - Update pdf icon PDF 414 KB

The purpose of the report is to provide an update for the Health & Wellbeing Board on the work of the Birmingham & Solihull ICS Inequalities Board.

Minutes:

Richard Kirby, Chief Executive, Birmingham Community Healthcare NHS Foundation Trust, presented the report, which provided an update on the work of the Birmingham and Solihull ICS Inequalities Board.

 

It was explained how the ICS Inequalities Board had set three big priorities to drive their work:

  • Ensuring inequalities are at the heart of our ICS (in terms of plans to identify and address them).
  • Ensuring the NHS plays its full part in tackling inequalities.
  • Supporting wider work to tackle the causes of inequality.

 

To deliver these three priorities, going forward, eight main priorities had been identified:

  • Covid-19 Response and Recovery
  • Prevention
  • Infant Mortality and Health Start in Life
  • NHS Anchor Institutions
  • Digital Inclusions
  • Community Development
  • ICS Tackling Inequalities Strategy Development
  • Tackling Inequalities – in the DNA of the ICS

 

Members raised the following queries and observations:

  • Councillor Grinsell welcomed the report and requested for future updates to include further detail on the projects being undertaken in Solihull. Councillor Grinsell noted the role of the NHS as an Anchor Institution and queried the plans in place for further local recruitment, ensuring local people were able to fulfil different roles. She also queried the future plans for community engagement.
  • Richard Kirby explained that, in regards to local recruitment, there was a focus upon ensuring vacancies were accessible to local people who may not have been able to apply for NHS jobs previously. UHB, from their hub at the Queen Elizabeth, had previously undertaken a lot of work on this – it was intended to apply this learning to other providers across the ICS. There a particular focus upon providing opportunities for people to acquire skills, including via apprenticeships.
  • It was explained how community engagement had been considered at a recent ICS Inequalities Board, which local organisations had joined, including Citizens UK. A small group had been established to determine what the best model of community engagement would look like, particularly at a Systems-level.
  • Councillor Grinsell also queried the plans to support Digital Inclusion in Solihull.
  • Richard Kirby detailed how all NHS providers were increasingly using digital forms of service delivery – a review was currently being undertaken to ensure this wasn’t disadvantaging particular groups. The findings of this review could be reported at a future point.
  • Councillor Sexton noted the report made reference to an Outcomes Framework and queried when this may be available for consideration. Richard Kirby detailed how a draft Outcomes Framework had been developed and confirmed this could be circulated to the Board.
  • Councillor Sexton highlighted the Community Engagement and Development, noting how some patients were struggling to access services. She queried how it could be ensured these patients’ views were not being overlooked, as part of any community engagement.
  • Richard Kirby explained how Community Engagement and Development was an on-going area of focus, detailing the work being undertaken to ensure each PCN had access to a good range of contacts and views.
  • James Voller, Community and Voluntary Sector representative, detailed how local organisations were receiving reports that many  ...  view the full minutes text for item 143.

144.

Ofsted Focussed Visit to Solihull on the 23rd - 24th of June 2021 to inspect arrangements for the Protection of Vulnerable Children from Extra-Familial Risk pdf icon PDF 317 KB

This report is to provide information to the Health and Well Being Board about the recent Ofsted Inspection on the 23rd and 24th of June 2021, to look at our arrangements for the protection of children from extra-familial risk.  The visit was conducted in accordance within the ILACS framework (Inspection of Local Authority Children’s Services).  This inspection was delivered primarily on site within the context of national and local guidelines for responding to COVID.

Additional documents:

Minutes:

Tim Browne, Interim Director of Children’s Services, presented the report, which updated the Board on the recent Ofsted Inspection held on 23rd and 24th June 2021, to look at local arrangements for the protection of children from extra-familial risk. He explained how the Ofsted findings were very positive about the services currently being delivered and he emphasised the importance of recognising the volume of work being undertaken by the Social Work teams.

 

The headline findings of the Ofsted Inspection included how local vulnerable children were well protected and cared for from extra-familial risk. Tim Browne also explained how it was recognised that the local approach to exploitation reduced the risk to most vulnerable children and young people. It was also detailed how the Inspection found that the response to children who went missing needed to improve, to ensure timely referrals were made to the ‘Missing Triage’ meeting.

 

Tim Browne explained how areas of focus going forward included ensuring Social Workers did not have excessive case-loads, as well as the pressures on the Multi-Agency Safeguarding Hub and ensuring timeliness of referrals. There would also be emphasis upon ensuring whole system ownership across the children’s partnership.

 

  RESOLVED

That the Health and Wellbeing Board endorsed the very positive findings with the report and supported the continued development of practice to safeguard our children and young people.

 

145.

Solihull Health & Wellbeing Strategy Scorecard pdf icon PDF 4 MB

Board to receive the latest Scorecard indicators.

Minutes:

The Consultant in Public Health Places and Communities took the Board through the Scorecard, highlighting the following points:

  • Priority 1: Maternity, Childhood and Adolescence – overall, there had been a significant drop in performance related to communication and development amongst 2 year olds. It was expected this trend had been experienced amongst 4 year olds as well. In regards to mitigation measures, officers were rapidly scoping out catch-up programmes for children with delayed development, to ensure this did not continue throughout the life course.
  • Priority 2: Adulthood and Work – the Scorecard had been amended here, to ensure it was more in line with reporting to the Employment and Skills Board, to improve accountability. There was significant focus upon how the Council and Partners were engaging people in education, training and employment programmes. Across this Priority, a number of indicators were above target, whilst several were below target and the report identified the mitigation measures in place.
  • Priority 3: Ageing and Later Life – there had been an increase in the number of emergency hospital admissions due to falls, as well as number of hip fractures, in people aged 65 and over. Also, the proportion of the eligible population aged 40-74 who received an NHS health check was below target, due to on-going Covid-19 pressures.
  • Priority 5: All age, Impact of the Covid-19 Pandemic – overall, Covid-19 vaccination rates within Solihull were good; however work was being undertaken to improve take-up rates in specific areas.

 

Members raised the following queries:

  • Councillor Grinsell highlighted the increase in falls amongst people 65 and over and queried where these were happening.
  • The Consultant in Public Health Places and Communities detailed how they were following this up with the indicator owner – the data was currently being reviewed, to determine whether it formed part of the normal year-on-year fluctuations, or whether there were specific trends.
  • Jenny Wood, the Director for Adult Care and Support, explained that, in regards to falls, through the Solihull Ageing Well Board, they had re-instigated the multi-agency Falls group to focus upon improvement work, and would take account of these trends
  • Councillor Grinsell noted how, for some of the indicators, a question mark was recorded against the performance target – she queried when this data could become available.
  • The Consultant in Public Health Places and Communities explained how a number of indicators were new and they required an initial baseline year, in order to help determine the performance target. It was noted that, for some of the targets for Priority 3, the data should be available for the next quarter. Also, various service areas had changed, as a result of Covid-19, and there was on-going work with the Indicator owners to help develop appropriate performance targets.
  • Councillor Sexton highlighted indicators relating to mental health, which were measured annually – she queried whether there was any potential to monitor mental health related indicators upon a quarterly basis.
  • The Consultant in Public Health Places and Communities explained that,  ...  view the full minutes text for item 145.

146.

Solihull Together - Update pdf icon PDF 595 KB

Solihull Health and Wellbeing Board and Solihull Together will be the key forums in the implementation of ‘Place Based Partnerships’ for the Borough as part of Birmingham and Solihull Integrated Care System (BSol ICS). This introductory report provides an update from Solihull Together outlining the progress made and planned next steps in moving forward this important agenda. By way of context, the report will provide a short definition of place based partnerships, re cap on the agreement reached at the Health and Wellbeing development session in June and give an overview of related progress from the BSOL ICS programme.

 

In addition to the development work linked to the ICS, a brief summary of progress of the established workstreams for Solihull Together is also provided. Updates on these delivery elements will feature more heavily in future reports.

 

The Board are asked to note progress and consider the proposal for future reports from Solihull Together. 

 

Minutes:

Anna Hammond, the BSOL Place Development Director, presented the report, which provided an update from Solihull Together, outlining the progress made and planned next steps. The following points were highlighted:

  • The enthusiasm in Solihull, across all agencies, to work differently and improve outcomes for communities was emphasised.
  • National guidance had been issued for the Integrated Care System, including Place guidance. Whilst the guidance encouraged local discretion, it did offer some Place-based structures and options going forward.
  • As part of the Board’s development session, there had been consideration of the Health and Wellbeing Board potentially being the Place-based partnership for Solihull.
  • The governance arrangements for Solihull Place-based working needed to be developed alongside the wider ICS governance arrangements and representatives from Solihull were currently engaged in this. There was focus upon the potential responsibilities that could be delegated to the Health and Wellbeing Board and establishing robust assurance arrangements to ensure delivery.
  • In regards to future reporting, it was proposed it could be around two major areas – the development of Solihull place based partnerships as part of the ICS, as well as updates on agreed delivery priorities.
  • For the next meeting, it was proposed that an initial draft work programme could be shared with the Board. It was also suggested that a focus on a particular delivery priority could be shared, alongside a paper on health inequalities.

 

Board Members raised the following questions and observations:

  • Karen Helliwell, Accountable officer BSOL CCG, emphasised the commitment and strong partnership arrangements around the Health and Wellbeing Board and Solihull Together. She also welcomed the report’s focus upon ensuring effective community engagement.
  • Jenny Wood, the Director for Adult Care and Support, detailed how she supported the proposed future reporting arrangements. She welcomed a progress report that updated on all key areas, alongside thematic reporting on specific areas. In regards to community engagement, there needed to be consideration as to how the Solihull Together partnership overall could support this going forward.
  • Dr Khanna detailed the strong support for Place-based working amongst the Primary Care Networks (PCNs) in Solihull. She detailed how they were actively engaged in this work and re-aligning their structures to complement it. The significant pressures on the system overall were recognised – to improve outcomes for citizens and patients, system-wide working was required, across all sectors. There was a need to ensure balance between governance arrangements and achieving practical outcomes – the governance arrangements may need to be subject to change, as Place-based working developed. Dr Khanna also welcomed the establishment of a Place-based team, to support delivery on the ground.

 

  RESOLVED

The Health and Wellbeing Board noted the progress and endorsed the proposal for future reports from Solihull Together, taking into account the comments from Board Members.

147.

Better Care Fund - Update pdf icon PDF 196 KB

To provide an update to the Health and Wellbeing Board on the arrangements for the Better Care Fund (BCF) in the current financial year, 2021-22.

Minutes:

Jenny Wood, the Director for Adult Care and Support, presented the report, which updated Members on the arrangements for the Better Care Fund (BCF) in the current financial year.

 

The 2021 to 2022 Better Care Fund policy framework had been published and its key themes had been summarised in the report. It was explained how officers were awaiting publication of the planning guidance, to enable the completion of the local BCF plan.

 

  RESOLVED

The Health and Wellbeing Board noted the Better Care Fund policy framework update and confirmed arrangements for the approval of the BCF Plan once planning guidance was published as per the report.

 

148.

For information - Health and Wellbeing Board Work Plan pdf icon PDF 579 KB

Health and Wellbeing Board work plan attached for information.

Minutes:

The Health and Wellbeing Board work plan was noted for information.

 

149.

For information - Health and Adult Social Care Scrutiny Board Work Plan pdf icon PDF 384 KB

Health and Adult Social Care Scrutiny Board attached for information.

Minutes:

The Health and Adult Social Care Scrutiny Board work plan was shared for information.