Items
No. |
Item |
1. |
Apologies for Absence
Minutes:
1.1
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Apologies for absence were received from the
Co-Chair, Dr. Tim Moorhead (Chair of
the CCG); Chief Superintendent Stuart Barton (South Yorkshire
Police, representing the South Yorkshire Police and Crime
Commissioner); Dr. Nikki Bates
(Governing Body Member, CCG); Jayne Brown (Sheffield Health and
Social Care Trust); Alison Knowles (Locality Director, NHS
England); Jayne Ludlam (Executive Director, People Services, SCC);
Laraine Manley (Executive Director, Place, SCC); Clare Mappin (The Burton Street Foundation); Dr. Zak McMurray (Clinical Director, CCG); John
Mothersole (Chief Executive, SCC); and Maddy Ruff (Accountable Officer, CCG).
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2. |
Declarations of Interest PDF 88 KB
Members to declare any interests they have in
the business to be considered at the meeting.
Minutes:
2.1
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There were no declarations of interest from
members of the Health and Wellbeing Board.
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3. |
Public Questions
To receive any questions from members of the
public.
Minutes:
3.1
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There were no questions received from members
of the public.
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4. |
Multiple Morbidity PDF 215 KB
Report marked ‘to follow’
Additional documents:
Minutes:
4.1
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The Board considered a report of the Director
of Public Health, Sheffield City Council, providing a background
summary of the challenge of multiple
morbidity (where an individual is living with two or more
long term conditions) and introducing a Board conversation on how
Sheffield should meet that challenge.
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4.2
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Set out in the report were five sets of
questions for the Board in relation to the challenge of
multi-morbidity.
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4.3
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The report was supported by a presentation
given jointly by Eleanor Rutter (Consultant in Public Health, SCC),
John Soady (Public Health Principal,
SCC), Iolanthe Fowler (Clinical Director, Integrated Community Care
and Primary Care Interface Services, Sheffield Teaching Hospitals
NHS Foundation Trust) and Ollie Hart (GP), which (a) provided
details of and commented upon research and statistical data
pertaining to life-course functional decline, prevalence of
cumulative multi-morbidity by age, multi-morbidity prevalence by
age and areas of deprivation, and the impact that delaying the
onset and complexity of multi-morbidity in adults would have in
terms of reducing secondary care costs, and (b) commented on the
need for the approach to dealing with multi-morbidity to shift its
emphasis from medical solutions, and acknowledged that GP training
was now giving greater emphasis to more holistic ways of dealing
with multi-morbidity.
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4.4
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Greg Fell, in supporting the principle that
the development of health and care services should be shaped more
around the needs of the individual and less around the interests of
the services, asked what key changes would secure the step change
required in that regard. In response,
Ollie Hart suggested that there was a need to ensure that adequate
resources were made available to fund the provision of non-medical
services, and Iolanthe Fowler highlighted the importance of the
multi-disciplinary team approach to service delivery.
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4.5
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In reply to Councillor Jim Steinke’s
query about health trends, John Soady
stated that health levels, in general, were improving from
generation to generation, adding that baseline functional capacity
in the early years and early adulthood was hugely important to the
trajectory from that time on. He emphasised that multi-morbidity
and functional decline are interrelated and that it was a whole
life-course issue, not just an issue of older age. He commented, however, that levels of physical
inactivity were increasing and this was a concern which needed to
be addressed.
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4.6
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Nicki Doherty emphasised the need to connect
to work already taking place in this area, and agreed that the
direction of travel should be to move more towards
prevention. However, she queried
whether our approach would be to promote different ways of working
or to advocate budget transfer. In
response, Ollie Hart suggested that addressing the challenge of
multi-morbidity was primarily about different ways of working and
was therefore more a cultural issue, but one which may then result
in budget shift taking place over the medium term.
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4.7
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Judy Robinson, in referring to the proposed
increased focus on community based interventions, highlighted the
significant role played by voluntary and community sector partners
in that regard, ... view
the full minutes text for item 4.
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5. |
Draft Joint Health and Wellbeing Strategy PDF 149 KB
Report of the Director of Public Health.
Additional documents:
Minutes:
5.1
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The Board considered a report of the Director
of Public Health, Sheffield City Council, which commented on and
appended the draft refreshed Joint Health and Wellbeing Strategy to
cover the period 2019-23. The report
also asked the Board to advise on the future development of the
Strategy ahead of its planned agreement at the Board’s March
2019 public meeting, and posed the following questions:-
·
Are the Board content with the specific wording of each ambition
statement?
·
Are the Board content with the development of the substance
underpinning the ambitions?
·
Do the Board feel the Strategy properly addresses mental health and
wellbeing, and healthy communities, and other issues that cut
across the life course?
·
Are the Board content with the proposed approach to implementation
and measurement?
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5.2
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Greg Fell (Director of Public Health)
introduced the report, referring in particular to the proposed
structure of the new Strategy which was to set out, as nine
ambitions for the city, the critical foundations that must be laid
for achieving the previously agreed vision to close the gap in
healthy life expectancy in Sheffield by improving the health and
wellbeing of the poorest and most vulnerable the
fastest. These ambitions were
articulated in the Strategy and structured into the three Life
Course stages of Starting and Developing Well, Living and Working
Well, and Ageing and Dying Well.
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5.3
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He commented that it was not intended that the
Strategy would detail all of the work being undertaken to improve
public health in the city, tobacco control being one such
example. He added that the issue of
loneliness was proving difficult to articulate and incorporate into
the Strategy, and suggested that the content in relation to mental
health and wellbeing, and healthy communities, required further
strengthening. He also highlighted the
proposed approach to delivery of the Strategy including developing
the Board’s future work programme around the Strategy.
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5.4
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Comments from members of the Board
included:-
·
Acknowledge that everyone in the city having a fulfilling
occupation would not necessarily apply to people within the older
age groups.
·
Review how the ambitions are presented in page 7 of the Strategy to
remove the impression of an order of priority.
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Targets/timescales be built into the subsequent metrics and action
plans to be developed in relation to the ambitions.
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Acknowledge relationships to other plans and strategies for the
city, for example, Shaping Sheffield.
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5.5
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RESOLVED: That:-
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(a) the wording of
the proposed ambitions, and the proposed approach to implementation
of the Strategy and measurement of success, be approved;
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(b) the Board
commits to further engagement and development of the Strategy, for
agreement at the Board’s March 2019 public meeting; and
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(c) the Director
of Public Health be requested to undertake further work in relation
to the content on loneliness, mental health and healthy
communities, and members of the Board be requested to forward to
the Director any comments or suggestions they may have in relation
to the content of the Strategy.
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6. |
Health and Wellbeing Board Terms of Reference Review PDF 266 KB
Report of the Director of Public Health.
Additional documents:
Minutes:
6.1
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Further to the consideration given at the
meeting of the Board on 27th September 2018 to future
meeting arrangements, including proposals to conduct reviews of
Accountable Care Partnership governance and Health and Wellbeing
Board membership and terms of reference, the Director of Public
Health, Sheffield City Council, submitted a report (a) providing a
summary of the discussions held during November with a range of
members around the Board’s development, (b) recommending some
minor amendments to the Board’s terms of reference in the
light of those discussions and (c) posing the following
questions:-
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Do the Board wish to make any recommendations for changes to
membership, beyond the formal addition of the Executive Director of
Place and the Cabinet Member for Neighbourhoods & Community
Safety?
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Do the Board wish to discuss the requirements of Board members in
more depth, and make further recommendations for change as a
consequence?
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Do the Board wish to make formal commitments in the Terms of
Reference (or elsewhere) with regard to communication?
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Do the Board agree with the other proposals set out in the
report?
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6.2
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The Board gave consideration to each of the
recommendations and questions, set out in the report, pertaining to
each section of its terms of reference, and the following matters
were agreed/supported:-
Role and Function
·
Paragraph 1.6 be revised to articulate
the requirements relating to the Better Care Fund (Jennie Milner to
supply details to Greg Fell).
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Paragraph 1.8 be revised as
proposed.
Membership
·
To include the Executive Director, Place, Sheffield City Council,
and the Cabinet Member for Neighbourhoods and Community Safety.
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Remove the place for a Housing Association voice.
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To include a 2nd VCF place.
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The academic place be retained but it be
recommended that the appointee be a student representative from one
of the city’s universities.
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To discuss with the Executive Director, People Services, Sheffield
City Council, whether to include a place for an educational expert,
possibly from the Schools Forum.
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To include formalisation of the Accountable Care
Partnership’s representation.
Governance
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Paragraph 3.2 be revised as
proposed.
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Paragraph 3.7 be revised as
proposed.
Meetings, Agendas & Papers
·
Paragraph 4.1 be revised as
proposed.
Role of a Health & Wellbeing Board
Member
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No changes be made to this section,
recognising that the requirement to name one deputy and ensure
deputies are well briefed is incorporated in the proposed revision
to paragraph 3.2 of the terms of reference.
Engagement with the Public & Providers
·
Paragraphs 6.1 and 6.3 be revised as
proposed, whilst acknowledging that there is need to be mindful of
the resource implications for Healthwatch Sheffield.
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Paragraph 6.2 be revised as
proposed.
Review
·
Retain the requirement to review the terms of reference on an
annual basis.
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6.3
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RESOLVED: That the Director of
Public Health be requested to (A) produce revised terms of
reference for the Board, as now agreed, (B) obtain the approval of
the Co-Chairs to the proposed revised terms of reference and then
circulate them to all members of the Board for information, (C)
submit the proposed revised ...
view the full minutes text for item 6.
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7. |
Minutes of the Previous Meeting PDF 150 KB
Minutes:
7.1
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It was RESOLVED: That the
minutes of the meeting of the Board held on 27th September 2018, be
approved as a correct record.
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7.2
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Arising from consideration of the minutes,
Greg Fell (Director of Public Health, Sheffield City Council)
reported that, in relation to paragraph 3.3.1 of the minutes
(Written Question Concerning Blue Badge Policy), a written response
had been provided to Mr. Clegg.
However, Mr. Clegg had deemed the response to be unacceptable,
believing that our statement that almost all applications are dealt
with within the 28 day target, was an
unsupported assertion “as the Council has openly stated it
maintains no records in this area”. Mr. Fell commented that he had received further
information on this matter from the Council’s Customer
Services service (who administer the Blue Badge Scheme), which
indicated that the time taken to process Blue Badge applications is
recorded and can be made available, and that, in terms of the 28
day target, if an applicant has not provided all the information
required and officers have to request it, the clock is stopped and
recommences at the point that the information is
received. Mr. Fell stated that,
accordingly, he would provide a further response to Mr. Clegg.
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8. |
Date and Time of Next Meeting
The next meeting is on Thursday 28 March 2019
at 3pm, at the Town Hall Sheffield.
Minutes:
8.1
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It was noted that the next meeting of the
Health and Wellbeing Board would be held on Thursday 28th March
2019, starting at 3.00pm.
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9. |
Dr. David Throssell
Minutes:
9.1
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It was reported that Dr. David Throssell was
attending his last meeting of the Board prior to his retirement,
and the Board placed on record its thanks and appreciation
to him for his expertise, commitment and
contribution to the work of the Board, and extended to him its best
wishes for the future.
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