Agenda and minutes

Apologies were received from Councillors Crompton, E M Giles, Simms, and Shackleton; and Dr Priyanand Hallan (CCG), Richard Beeken (SWBNHS Trust), Marsha Foster (Black Country Partnerships NHS Foundation Trust),

Members to declare any interests in matters to be discussed at the meeting.

There were no declarations of interest made.

To confirm the minutes of the meeting held on 22 September 2021 as a correct record.

The minutes of the meeting held on 22 September 2021 were confirmed as a correct record.

The Director of Public Health reported on the latest covid-19 data for Sandwell. 

Case were rising in line with regional and national trends and currently there were 379 new cases (per 100,000 people) a week.  Regional cases were around 452/100,000 and national case were around 520/100,000.  Cases had remained lower than national since April/May, however, caution remained.

The new Omicron variant incorporated a high number of mutations and was significantly more transmissible than previous variants, and fast becoming the dominant variant.  Data from South Africa showed that the variant escaped both immunity from the vaccine and prior infection, so people were encouraged to get a third vaccine dose.  The case severity was still unclear, however, even if the variant was as mild as suggested, the high case numbers could still cause pressure on health services. 

Sandwell’s vaccination campaign success continued and more than 2,700 boosters had been administered on 14 December 2021, breaking previous records.

Those people who had not had a first vaccine dose were encouraged to come forward, with no judgment.

Retrospective approval was sought for the Better Care Fund (BCF) Plan 2021-22.

The Plan had been developed in collaboration with partners from Sandwell Council, Black Country and West Birmingham CCG, Sandwell and West Birmingham Hospitals Trust and Sandwell Council for Voluntary Organisations. 

The BCF Pooled Budget quantum for 2021/22 had been  confirmed as £57 million.

The Board noted the success of the BCF programme to date:-

·      Sandwell had been the leading authority for performance on Delayed Transfers of Care (DToC) at the time reporting was suspended in March 2020.

·      Establishment of an integrated commissioning team across the CCG and Adult Social Care, which meant that adult social care teams were now working in a more co-ordinated way.

·      Establishment of an Integrated Discharge Hub to improve the effectiveness of out of hospital care pathways and support better patient flow between local hospitals and the community.

·      Making the approved Dementia Strategy a reality by implementing the commissioning plan.

·      Building the new Integrated Social Care and Health Centre on the Knowle site in Rowley Regis, which was due to open in July 2022.

·      Establishing the Shared Care Record to enable health and social care professionals to access appropriate information to improve the care of local citizens.

The key priorities for 2021/22 included:-

·      Supporting the implementation of the Discharging to Assess (D2A) operating model.

·      Supporting the wider health care system through Winter 2021.

·      Transforming and aligning community health and care services to need.

The Director of Adult Social Care had provisionally approved the Plan, which had now been submitted to the NHS’ Better Care Fund Team.

Resolved that the Sandwell Better Care Fund Plan 2021-22 is approved.

The Board noted an update on the delivery of the Sandwell Dementia Commissioning Strategy 2019-2025.

As part of the Council and Sandwell and West Birmingham Clinical Commissioning Group’s commitment to improve support for those living with the effects of dementia a refreshed “Better Lives” strategy had been coproduced and launched in November 2019.  Dedicated financial resources was available through the Better Care Fund [BCF] to deliver the strategy.  The actions within the strategy had now been categorised into four themes for ease of resource allocation:-

·      Training and awareness raising

·      Improved information advice and sign-posting

·      Pre and post diagnostic support

·      Dementia Friendly Communities

A draft training strategy and skills matrix had been developed during 2020, based on the Department of Health and Social Care social care skills matrix [2019].   By providing training and awareness raising opportunities for local communities, schools, health and social care professionals and local businesses people would be supported to stay healthier for longer. 

A Sandwell dementia road map had been developed in 2020 which provided advice on living well and brought together all support services available within Sandwell’s six towns.  A “Sandwell My Future Care Handbook” was currently being produced and would be made available to all those living with the effects of dementia, including carers. 

A Sandwell community dementia support service [pre and post diagnostic support] had been commissioned for two years with the possibility to extend for a further year. The new service had launched on 16th November 2021 and provided:-

·      Information, advice and sign posting.

·      Support - Memory screening, safe and well checks, support planning, emergency planning, benefits advice and support, co-ordinating support function.

·      Training for people living with the effects of dementia, professionals, communities and businesses.

·      Support for each of the six towns to become a Dementia Friendly Sandwell.

The new service was based on a six towns model and was being delivered through a provider calibration of eight local third sector organizations and one national organization.  The service was integrated with primary care, secondary care, acute and community services.  NHS England had recognised the model as best practice. 

To deliver the required improvements to peoples experience in receiving a dementia diagnosis and meet the national ambitions, the re-development of the memory assessment service [MAS] had been essential.  Due to COVID and the changing health landscape this had resulted in producing a service specification for the whole of the Black Country and redesigning MAS across the STP footprint.

Sandwell Dementia Action Alliance [SDAA] had been established in 2019 to deliver Sandwell dementia friendly communities, however, its ability to deliver was negatively impacted by COVID and legal requirements for the tendering process for the new community support service. Therefore, it was in the process of being re-established, with the benefit of added support from the new community support service and a small amount of financial resources from the Council for publicity and establishing the six dementia friendly towns.

The Board was consulted on the appointment of a representative from the faith sector.

Faith groups had been instrumental in providing invaluable support throughout the pandemic - delivering food to front line workers, supporting vulnerable members of society and collaborating with the councils to ensure volunteers were able to provide on-the-ground support to communities in need.  Additionally, messages coming from trusted community and religious leaders had encouraged adherence to government guidelines in local community languages.  Faith sector buildings throughout Sandwell were available for community members to pick up covid-19 tests and had been used as vaccination centres.  

There was an opportunity to build on the success and build the relationship with Sandwell’s faith sector, by including it in all local decision-making processes and structures, starting with the Health and Wellbeing board.

In a recent consultation with faith leaders, the following topics were identified as key areas where the faith sector could make the greatest contributions to Sandwell:

•        Tackling the underlying causes of health inequalities, which had been widened by Covid-19 particularly for marginalised and BAME groups.

•        Tension monitoring and community safety.

•        Youth and women engagement work.

•        Education and faith supplementary schools.

•        Community cohesion.

•        Healthcare services, Public Health and prevention including mental Health.

•        Homelessness.

•        End of life care and bereavement services.

•        Representation of faith communities.

•        Equality and diversity.

The Board thanked representatives of the sector for their support and hard work during the pandemic and welcomed the proposal to increase the membership of the Board.  Faith leaders were keen to be on board and were working on the detail of how the sector would be represented.

Resolved that the Council is requested to appoint a representative of the faith sector to the Health and Wellbeing Board, with voting rights, in recognition of the significant contributions made by the sector during the pandemic, and the contribution the sector can make to Sandwell’s post COVID recovery and the rebuilding of communities. 

Further to Minute No. 25/21 (of the meeting held on 22 September 2021) the Board received an update on progress against the draft Sandwell Suicide Prevention Strategy and Action Plan.

The local Suicide Prevention Strategy and Action Plan had been updated through the Sandwell Suicide Prevention Partnership, and links to the Black Country-wide Suicide Prevention Plan being developed by the Black Country Suicide Prevention Group, which identifies common priority areas to be addressed through NHSE/I Suicide Prevention funding.

The principal priority was that by 2030, no-one would die of suicide in Sandwell.  This ambition was also a key priority for the Sandwell Good Mental Health Strategy, reflecting the importance of good mental health in delivering an effective suicide prevention plan. These form part of a suite of interlinked strategies that also include Autism, Dementia and Child Mental Health.

Subject to approval by the Board, the draft will go out for consultation week commencing 20 December 2021 for a statutory 60-day period and would subsequently be submitted to the Cabinet for approval in May 2022.

The consultation would include key partners and stakeholders, including Sandwell residents, and would seek to obtain views on the relative importance of recommendations/areas for action; what works well; and what they saw as current challenges.  An easy-read summary and video were being produced to support online promotion of the consultation.  Targeted approaches to engagement were also being developed so that all diverse communities were included and represented.

Board members requested that reference to “GPs” be changed to “General Practitioners” in recognition of the wide range of health service professionals based at practices. 

Young men and travellers were highlighted as high risk groups and so it was recommended that consultation be targeted at those groups.

Resolved that the proposed consultation plan in relation to the Sandwell Suicide Prevention Strategy and Action Plan 2022-25 is approved.

The Board was asked to grant an extension to the deadline for publication of Sandwell’s Pharmaceutical Needs Assessment (PNA) 2022.

Health and Wellbeing Boards were required to publish PNA every three years.  The PNA set out the current provision and location of pharmacy services across Sandwell, to ensure that there were enough pharmacies, in the right locations, providing the right services to support the pharmaceutical needs of Sandwell residents.  The document was also used by commissioners and other stakeholders to inform decisions regarding new pharmacy contract applications and developing pharmaceutical services for patients.

Sandwell’s last PNA had been published in June 2018 and a revised PNA was due to be published by 1st April 2022 (a modification made in light of the COVID-19 pandemic). 

The Public Health Intelligence Team, which played a pivotal role in the preparation of the update PNA, had been in high demand and under a significant amount of pressure responding to the Covid-19 pandemic.  Therefore, it had been difficult to devote sufficient resources to the preparation of the updated PNA.  Approval was therefore sought to publish the revised PNA in June 2022.

A 60-day consultation period would take place, gathering feedback on the draft PNA from key stakeholders such as NHS England, Sandwell’s and neighbouring local pharmaceutical committees, neighbouring boards, Sandwell pharmacy contractors and the CCG. 

A public questionnaire had also been produced, in five different languages as well as British Sign Language, and residents were being asked to provide feedback on pharmacy services across several channels:-

·      Patient Participation Groups via Healthwatch Sandwell

·      Council Twitter and Facebook accounts

·      Via networks available to the Public Health Development Officers and Covid-19 Vaccine Leaders

Board members remarked upon the contribution that pharmacies had made in supporting health services throughout the pandemic, and relieving pressure on GP appointments, and were minded to approve the extension.

Resolved that in light of the increased demand on Public Health intelligence services throughout the COVID-19 pandemic, an extension to the publication of the final Pharmaceutical Needs Assessment for 2022-25 is granted, and the revised PNA be published in June 2022.

Standing item to provide a progress update on Integrated Care System (ICS) / Integrated Care Partnership (ICP).

This item was deferred.

The Chair reported that John Taylor, Healthwatch Sandwell’s Chair and a member of the Board, had unfortunately stepped down due to ill health. 

John had had a long history of involvement within the social care environment, having previously been a consultant for Healthwatch England and having over 20 years in the public & charitable sectors for the NHS, National Lottery, C.I.C.s, Co-ops, Local Authorities, a Community Foundation and a range of charities.

The Chair had written to John to express thanks for his contribution to Sandwell and to the Board during his time as Healthwatch Chair,

The Chair read out a personal message from John to the Board:-

“I just wanted to say a genuine and heartfelt thank you for all you do for our wonderful NHS and social care services, and urge you all to keep reaching for the stars to improve the health and wellbeing for the people of Sandwell and beyond.”

Standing item to update on Access to Primary Care.

The Board noted an update on access to primary care.

In September and October 2021, there had been over 60,000 additional GP appointments held across the Black Country and West Birmingham, compared to pre-pandemic numbers.  Of these, 62% had been face to face and 45% had taken place on the same day. 

However, demand continued to outstrip supply and a recruitment drive was underway to increase the number of staff in primary care.

The Black Country and West Birmingham CCG had published a press release, which would be shared with all councillors.

The Chair reported that this was the last meeting for the Board’s interim Project Officer, Clair Norton, who would be returning to her full-time post in January 2022.  A recruitment process was underway for a permanent Project Officer, and it was anticipated that they would be in post by the next meeting.

The Board recorded its thanks to Clair for her support and guidance during her time in the role.