Agenda and minutes

Apologies were received from Councillors Hinchliff and Piper; Marsha Foster (Black Country Healthcare NHS Foundation Trust), Michelle Carolan (NHS Black Country ICB), Mark Davis (SVCO), Matt Young (West Midlands Fire Service) and Dr Sameera Mavi (Black Country Integrated Care Board).

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 7 December 2022 as a correct record.

Resolved that the minutes of the meeting held on the 7 December 2022 are approved as a correct record.

To determine whether there are any additional items of business to be considered as a matter of urgency.

There were no urgent additional items of business.

To agree to provide an update on the recommendations to the young people who have taken part in the Health and Wellbeing Board takeover challenge through the SHAPE Team.

The Board received a presentation of the key issues that had been raised by children and young people in the annual SHAPE survey.  The survey had been conducted annually since 2014 when the SHAPE programme was first introduced as a child’s voice initiative. The programme aimed to consult with young people on themes around safety, health, achievement, contribution and economic well-being.

Key findings that linked with the Board’s priorities, were highlighted.  The responses indicated that young people were least happy about issues relating to confidence, appearance, caring for the environment and communication.  A group of young people attended the meeting to provide further detail to the Board on the key findings, and highlighted the following points:-

·      The quality of food available  in schools was poor.

·      Homophobic and transphobic abuse was happening in schools, along with body shaming.

·      Substance use was now more acceptable and accessible, and schools should help students to overcome addictions.

·      Young people did not feel that they were treated as an adult and listened to by their GPs when reporting health concerns.

·      Gender identity issues were not managed well in schools.

·      Schools lacked training on dealing with mental health issues and it was felt that help was only offered at crisis point.

·      Mental health services were inadequate in general.

·      There was a lack of co-ordination of information amongst professionals.

·      Some towns in Sandwell lacked facilities for young people, Tipton and West Bromwich in particular.

·      Opening hours at libraries were too short.

·      Sandwell’s parks did not feel safe and were often frequented by gangs.

·      There as a reliance on se of the internet to maintain social connections.

The Interim Director of Public Health reported that she was working with schools to develop their mental health provision, and a mapping exercise was taking place, to inform the development of an emotional wellbeing offer for the borough.

The Director of Children and Education undertook to raise the concerns around the food available in schools with school leaders.  It was acknowledged that young people’s emotional health and wellbeing was of concern nationally.  The Black Country Integrated Care Board was working with the Child and Adolescent Mental Health Service (CAMHS) to put together a directory of services aimed at children and young people, families and partners.

The Board undertook to incorporate the issues raised into its work programme.

To consider and comment on the Sandwell End of Life Care work.

The Board was updated on progress on the implementation of Sandwell’s end of life care strategy and partnership working with the Black Country Integrated Care Board (ICB).

Since the launch of Better Endings – Sandwell’s End of Life Care strategy in 2021, the End of Life Care Strategic group had been working on fulfilling the six promises within the Strategy, as well as aligning them with the six ambitions set out in Black Country ICB’s Palliative and End of Life Care strategy. 

A self-assessment exercise had identified those ambitions that were working well: Ambition 1-Each person is seen as an individual and Ambition 3-Maximising Comfort and Wellbeing.   Ambitions 2 (Each person gets fair access to care), 5 (Care is co-ordinated) and 6 (Each community is prepared to help) had been identified as those with the biggest opportunities for growth. 

Two workstreams had been created, one focusing on clinical and quality improvement and one on engagement and compassionate communities.  Each workstream had developed its own aims and objectives and separate terms of reference.  A needs assessment was being carried out, with support from the Sandwell Council Public Health Intelligence Team.  Additionally, community engagement activities would ensure that suggestions from patients were included in the decision-making process.

National benchmarking suggested that 1% of a GP practice’s registered population should be on the palliative care register however, this could have been higher in deprived areas. Practices across Sandwell had an average of 0.3% of their population on the register.  This highlighted the need to consider the use of tools to support primary care clinicians to identify patients in need of palliative care earlier, to enable better coordination across multi-disciplinary teams.

Members remarked upon the importance of involving the whole family in decision around the fulfilment of a person’s dying wishes, and the importance of timely care and support, including the availability of medication, particularly around bank holidays.  A group of GPs was also looking at ensuring a more systematic approach to prescribing.  A fact sheet was also being developed with key contacts, to share with community organisations, and an analysis of relevant services on the Route2Wellbeing portal was also being undertaken to identify gaps.

The important of other services was acknowledged, e.g. support around powers of attorney and making wills and Public Health was working with the Citizen’s Advice Bureau.

To consider and comment on the proposed refresh of Vision 2030.

The Board was consulted on the proposed refresh of the Council’s Vision 2030.  The shared Vision had initially been adopted in 2017, however, much had changed since 2017.  Working with partners the Council wished to refresh the vision to ensure it reflected the needs of the borough. 

The ambitions set out in the original Vision were still relevant but the context around those ambitions had changed.  The impact of climate change was now better understood, and the COVID-19 pandemic had resulted in a major impact on the mental health of residents, especially young people.  Digital inclusion was now a concern as well as the impact of the cost of living crisis on people living and working in the borough.

Additionally, partnerships had changed since 2017, with new health partnerships arrangements now being in place, and Sandwell Children’s Trust.  Sandwell Business Ambassadors and the Inclusive Economy Board would also be engaged in shaping the future of the borough.

Key strategic partnerships in Sandwell were being requested to endorse the start of the process for refreshing Vision 2030.  A State of the Borough Report was being written, setting out where the Council was on its journey to 2030 and the challenges it faced.  Engagement activities would then be taking place with key partners, residents and businesses, building on collective intelligence, including work that had already start on the Joint Strategic Needs Assessment.

Resolved that the Board endorses the refresh of the Council’s Vision 2030.

To consider and comment on the update of issues and priorities across Children’s Services.

The Board noted the following current key issues and priorities within Children’s Services:-

·      In January 2023, Ofsted had launched a new framework for Special Educational Needs and Disabilities services area inspections.   The new framework incorporated priorities in relation to whole system working and integration, which reflected Priorities 3 and for of the Board.

·      A borough-wide campaign had been launched to strengthen and improve attendance and address the persistent absence rates across Sandwell. Addressing attendance would contribute to improved educational outcomes and fulfil Priority 4 of the Health and Wellbeing Board.

·      Sandwell was one of 55 Education Investment Areas and one of 24 Priority Investment Areas launched by the Department of Education to address poor educational attainment across all phases. £2.9million had been ringfenced. Sandwell currently sat just below the national average for attainment in all phases of education. This work would contribute to Priority 4.

·      Sandwell was one of 75 Local Authorities named in the government roll out of the Best Start in Life Family Hubs programme and had been awarded £4.4million.  This programme would contribute to the achievement of Priorities 3 and 4.  An implementation plan had been approved by the Department for Education and governance arrangements were in place.

·      The youth service was undertaking a service review / redesign, which would include the delivery of targeted outreach services to combat community priorities at a six towns level. Replacement youth buses would provide a reliable offer and promote opportunities for young people to engage with youth workers and partners.

·      Sandwell had seen a 51% increase in the number of children and young people with education, health and care plans (EHCP) and this figure was projected to rise. Work was underway with a range of partners to develop a systematic approach to address this, contributing to Priorities 3 4 of the Board.

In response to questions from members, the following points were clarified:-

·      A national register was being developed by the Department for Education for children who were electively home educated. A proportion of those children who were electively home educated had poor attainment and there were safeguarding issues for some, so this was a high priority.

·      Lifestyle changes since the pandemic had resulted in an increase in the number of children electively home educated. A national register would allow the Council to work with families to push key messages and drive attainment.

·      Since reforms in 2014 there had been a big increase in the number of children reporting social, emotional and mental health needs and diagnoses of Autistic Spectrum Disorder. There was too much reliance on out of borough placements so work was taking place across the partnership to ensure that all needs could be met in Sandwell, however, the system needed to remain flexible to adapt to ever-changing needs.

·      The number of children eligible for free school meals had increased significantly.  Financial support was in place to help with the cost of school uniforms and Early Help helped with some practical things.  Financial struggles were often linked with  ...  view the full minutes text for item 8/23