Agenda item

6.1

The Board received presentations concerning the five work programmes which support the Health and Wellbeing Strategy, as follows:

6.2

A Good Start in life

Sue Greig, Consultant in Public Health, Sheffield City Council presented the ambitions, what it is intended will happen next and  governance arrangements relating to the Good Start in Life Workstream, which was overseen by the Sheffield Children’s Health and Wellbeing Partnership Board.

The Partnership Board’s Future Shape Children’s Health Programme comprised 4 areas: 

·         Children with Complex Health Needs

·         Emotional Wellbeing and Mental Health

·         Supporting the delivery of the Healthy Child Programme including Best Start Sheffield – Early Years

·         Communications, Participation and Engagement

Ambitions included reducing health inequalities, establishing care pathways that are effective in a multi-agency environment, improving transition for young people and families, from children’s to adult services and improving Children & Young People’s emotional wellbeing.

Achievements comprised improved and enhanced partnership working, alignment with the Children’s Joint Commissioning, focus on parenting and attachment/attunement in Early Years, improvements in health indicators such as a reduction in childhood obesity and teenage pregnancy rates, a successful stage 2 Lottery Bid Submission – Best Start Sheffield and ‘Inde’ Travel Transport for young people – promoting independence.

Sue Greig also outlined key future priorities and governance arrangements. The outcome of the Lottery Bid relating to early years would be known in May 2014.

6.3

Building Mental Wellbeing and Emotional Resilience

Dr Jeremy Wight, Director of Public Health, presented the ambitions, what it is intended will happen next and  governance arrangements of the Building Mental Wellbeing and Emotional Resilience workstream.

He acknowledged that not as much progress has been made with this workstream as with the others, or as we all would have wished.  This had been due primarily to lack of officer capacity working on this agenda, as well as lack of clarity about the governance of this workstream.

A wide range of ambitions were identified, including: work programme development (leadership/workforce capacity); to promote understanding of five ways to wellbeing, build upon community based assets, making every contact count; and that understanding mental wellbeing can lead us to do things differently.

Three social cafés had been commissioned, provided from community bases, the mental health information and advice service had been reviewed and there had been a wellbeing assessment of care homes. Events had been held, such as the Wellbeing Festival and Older People’s Day. A Mental Health First Aid training programme had been developed and a City Council Members’ task and finish group was established.

Plans included: promoting 5 ways to wellbeing, beginning with the Council workforce (April 2014); that the integration agenda is explicitly physical and mental health; working to bring £6 million of lottery funding for loneliness and isolation amongst older people; to implement Mental Wellbeing NICE (National Institute for Health and Care Excellence) guidance for older people in residential care and creating better links across programmes to build social capital and connect people.

A refresh was required of governance relating to mental health and wellbeing and the aim was to engage with academic and clinical expertise, the public and service users, and providers to guide future strategy and commissioning.

6.4

Food and Physical Activity

Dr Jeremy Wight outlined the ambitions, plans and governance arrangements for the Food and Physical Activity workstream. Food and physical activity, independently and together, were major determinants of health and Sheffield’s Food Strategy vision was that the local community are food literate, and have a good understanding of how important food is for their health; Everyone can access food that is safe, nutritious and that benefits their health and wellbeing; food plays a key role in strengthening our local economy; and our local food system is sustainable.  The City’s Move More vision was to create a culture of physical activity resulting in Sheffield becoming the most active city in the UK by 2020.

Achievements included:stopping the rise in children overweight and obesity; the establishment of the Food and Physical Activity Board; the development of two new strategies for the City; and dedicated investment from the Public Health Grant.

The Board was requested to ratify the Sheffield Food Strategy and the Move More Strategy. The priorities of the Food Strategy were:

·         Tackle food poverty in Sheffield.

·         Improve the takeaway food offer in Sheffield.

·         Support local communities in their efforts to eat well.

·         Encourage more people to learn about and get involved in growing their own food.

·         Boost the role food plays in the local economy.

·         Establish an Independent Sheffield Food Trust.

A detailed implementation plan and evaluation framework was in development.

The outcomes of the Move More Strategy were: empowered communities; active environments; active people and families; physical activity as medicine; active schools and active pupils; active workplaces and an active workforce. Dr Wight also set out the principles of the Move More plan.

The Food and Physical Activity Board had oversight of the plans and the workstream, three executive groups had been established and more work was to be done on monitoring outcomes and progress for both food and physical activity.

6.5

Health, Disability and Employment

Chris Shaw, Head of Health Improvement, Sheffield City Council presented the ambitions, achievements, plans and governance arrangements relating to the Health, Disability and Employment workstream.

There were a number of ambitions which recognised that there were things that could be done to bring about interventions or reduce gaps in relation to health and employment, including employment as a realisable ambition for more young people with a disability.

Among the achievements relating to health, disability and employment were the development of a referral pathway from primary care to employment and a pilot with Macmillan Cancer Support to enable employment for those with or recovering from cancer.

Next steps were to create a GP referral pathway; to deliver Fit Note development between Primary Care and Employers; deliver the ESA (Employment and Support Allowance) employment pilot with Job Centre Plus; deliver the Employment Award; review existing ‘Employment Support’; deliver Core Cities agreement; and hold the first Employment Disability and Health Summit.

Chris Shaw also outlined areas in which this Board might assist or accelerate change as regards the development of a referral pathway, supporting the Job Centre Plus pilot and the Good Employer’ award – such as through a joint endorsement with the Chamber of Commerce or Local Enterprise Partnership; to steer LEP investment regarding support funding (through the European Social Fund) for employment of those with health conditions or disabilities to recognise and therefore support funding of health/disability oriented interventions and to engage in how this should be delivered.

6.6

Supporting People Closer to Home

Joe Fowler, Director of Commissioning, Sheffield City Council, outlined the ambitions, achievements, plans and governance arrangements relating to the Supporting People Closer to Home work programme.

Ambitions were to ensure more care is provided at or closer to home; enable service users to take control of their care and treatment; reduce dependency on hospital and long term care; and to help people to live independently for longer.

The work programme was part of the Health and Wellbeing Board’s work on integrating health and social care, which had a clearly defined vision, supported by the Board’s engagement events. At this meeting of the Board, approval was attained for plans relating to the Better Care Fund, which had a focus on supporting people closer to home.

The work programme would be delivered through the Health and Wellbeing Board’s work on integrated commissioning and it would initially focus on services to help people stay well and at home, on intermediate care, community equipment and on long-term care.

6.7

Members of the Board made general comments on the work programmes/streams as follows:

The work streams would progress, all at a different pace and would have specific governance arrangements. In terms of this Board’s relationship to those governance arrangements, there needed to be understanding of the strategy in the various workstreams, which may need to be seen in greater detail, to inform the Board and to avoid not only duplication but also the occurrence of gaps. There were some cross-cutting themes and greater emphasis could also be given to health inequalities issues.  

Where there were links between workstreams, these should be identified. Consideration should be given as to how actions to reduce inequalities could be measured, so we know what was making a difference. Thanks were given to people involved in the various workstreams, including volunteers, such as those on the Food and Physical Activity Board.

There was a lot of work in other workstreams which would contribute to the Building Mental Wellbeing and Emotional Resilience workstream. In relation to community resilience, there were significant assets in communities which could be drawn upon. 

The most valuable contribution of Dr Margaret Ainger to the development of the Children’s Health and Wellbeing Partnership Board was noted.

Thought would need to be given as to how this work was communicated. There was a significant amount of work involving co-production, redesign and integration. There should also be a method of sharing information between the various workstreams.

The degree of change within the workstreams required the right amount of support and resources to enable its delivery and evaluation of the extent to which change had been successful. Some form of communication of how people have been involved in that change was necessary and consideration would be given to the resources required.

In relation to health inequalities, it was right that there was challenge as to whether it was explicit as to how far inequalities featured within work programmes. A distinction was necessary between programmes that would impact upon health inequalities (for example those concerning employment) and other programmes, where a programme might prove successful but have little impact on health inequalities. Such an example might be in relation to the Move More Strategy, where there may be different outcomes in the East and the South West of the City and these might be seen to perpetuate or exacerbate existing inequalities in relation to physical activity.

Therefore, work which would improve health overall but not necessarily reduce health inequalities needed to be specifically targeted, and the impact on health inequalities monitored. There was a role for both commissioning organisations and providers in making the necessary interventions to address health inequalities.

6.8

RESOLVED that the Board:

(1)          Notes the presentations and the information received relating to ambitions, achievements, plans and governance arrangements for the following five work streams:

(a)  A Good Start in Life

(b)  Building Mental Wellbeing and Emotional Resilience

(c)  Food and Physical Activity

(d)  Health, Disability and Employment

(e)  Supporting People at or Closer to Home; and

(2)          Ratifies the Sheffield Food Strategy and the Move More Strategy, which are integral to the Food and Physical Activity work stream.