Agenda and minutes

Apologies are noted above.

Councillor Simpson declared a personal interest in all matters under consideration as an employee of the NHS.

That the minutes held on the 18^th November 2020 be approved as a correct record.

For information only - The terms of reference for the Health and Wellbeing Board were approved at the Council meeting on 17^th March 2021.

It was agreed:

1.   That the Terms of Reference be noted.

There are no public questions.

Councillor Simpson, Cabinet Member for Health and Wellbeing to provide a verbal update.

Councillor Simpson gave a verbal update, explaining the items on the agenda.

Kathy Batt, Independent Chair to provide an update. Report attached.

Kathy Batt, Independent Chair attended to provide an update on the Adult Safeguarding Partnership Annual Report 2019-2020. The report covers the period from 31 March 2019 to 1 April 2020. The report is a statutory requirement of the Board and has been delayed due to the pandemic. In future, the Bury Integrated Safeguarding Annual Report will include both adults and children’s information.

The Adult Safeguarding Board commissioned two safeguarding adult reviews which were reported on after March 2020. Both reviews provided valuable learning which will now be incorporated into the multi-agency training programme. Some of the issues raised such as the fragmentation of mental health services, the tension around consent and the use of Section 42 enquires are not unique to Bury.

The Coroner’s Office had raised concerns around Section 42 enquiries, they were concerned that Bury, Oldham and Rochdale were not doing enough official Section 42 enquiries. This has led to reflection, a tri-borough training event and looking at protocol and procedures.

The report includes individual agency reports. Kathy Batt explained that when the pandemic started all meetings and training went online. It was reported that attendance at meetings has been excellent.

A member agreed that it is useful that the Annual Report will combine children’s and adults safeguarding in the future.

It is hoped that the Bury neighbourhood model of working would help people to engage more through community hubs to get involved in the safeguarding process.

It was agreed:

1.      Kathy Batt be thanked for the update.

Dr Rebecca Fletcher, Chair of Bury, Rochdale and Oldham Child Death Overview Panel to provide an update. Reports and presentation attached.

Dr Rebecca Fletcher, Chair of Bury, Rochdale and Oldham Child Death Overview Panel (CDOP) attended to provide a presentation and report on the Child Death Overview Annual Report.

The report includes data from closed cases from 1 April 2019 to 31 March 2020. The purpose of the Bury, Rochdale and Oldham CDOP is to undertake a review of all child deaths up to the age of 18 years.

There was a review of 29 closed cases in Oldham, Rochdale and Bury. The majority of child deaths in Oldham, Rochdale and Bury occurred in the first year of life; 66% of these cases were expected deaths. These figures were also similar to Greater Manchester and the National CDOP reports. Prematurity was a theme in child deaths under the age of 1 and contributed to 76% of deaths; gender, deprivation and ethnicity were themes noted both locally and nationally.

There were modifiable risk factors which were identified as maternal obesity, maternal smoking and risk factors for sudden, unexpected deaths in infants. 

In the Greater Manchester report during 2019/2020 there were 129 child death cases reviewed by Greater Manchester CDOPs and 240 child death notifications. Potentially modifiable factors were identified in 40% of all closed cases.

The recommendations focus on:

•       Inequalities

•       smoking cessation

•       Reduce levels of obesity throughout the population

•       Commission a review on 5-year Greater Manchester data

•       A request on Greater Manchester data on suicides

•       Ensure a mental health representative attends CDOP

•       Implementing an electronic CDOP system (this went live on 1st April)

A member of the Board questioned the percentages of unexpected deaths in Bury. It was explained that as the numbers are small it can make a big difference to the percentages. It was explained that it is an interest to look at 5 years’ worth of data.

A discussion took place around preventable deaths and the plans to highlight this to drive behaviour change. Bury has programmes in place focussed on addressing modifiable risk factors.

It was agreed:

1.      Dr Fletcher to be thanked for the update.

2.      That the Health and Wellbeing Board approve the contents of the reports.

Lesley Jones, Director of Public Health to give a verbal update.

Lesley Jones, Director of Public Health thanked members for their attendance at the Health Inequalities Workshop.

The workshop focused on health and care systems, the presentations shown how the 4 king funds quadrants that the Health and Wellbeing Board will be based around are also interconnected.

Following on from the workshop the aim is to look at issues from the perspective of inequalities to better develop understanding into planning and ways of working.

Lesley Jones, Director of Public Health and Helen Smith, Performance and Intelligence Manager to provide a verbal update.

Lesley Jones, Director of Public Health gave an update on the development of the framework and measuring inequalities.

The work that is being undertaken is in context of the development of the Bury strategy and ‘Let’s Do It’ strategy and trying to create a single framework.

Lesley Jones explained the framework using PowerPoint slides. As the system operates it will hopefully focus on improved quality of life in particular, life expectancy and healthy life expectancy. 

The framework will be looking at measures that could be broken down at a neighbourhood level and build in how to systematically collect, quality information to sit alongside this.

Board members thought that this is a useful framework and would like to be involved with the framework. 

It was agreed:

1.      Lesley Jones will continue to develop and look at how to involve colleagues with the metrics.

·       Elective Care ‘Building Back Better’ – Presentation provided by Ian Mello, Director of Secondary Care Commissioning, Bury CCG and Penny Martin, Director of Operations Northern Care Alliance NHS Group. Presentation attached.

·       Developing Neighbourhood Health Improvement Plans – Presentation provided by Jon Hobday, Consultant in Public Health and Lesley Jones, Director of Public Health. Presentation attached.

·       Wider Determinants of Health: Work, Employment and Skills   report provided by Tracey Flynn, Unit Manager - Economic Development. Report attached for information only.

·       Social Prescribing Support for Health and Social Care – presentation provided by Sajid Hashmi, Acting Chief Officer Bury VCFA. Presentation attached.

Elective Care ‘Building Back Better’

Ian Mello, Director of Secondary Care Commissioning, Bury CCG and Penny Martin, Director of Operations, Northern Care Alliance attended the meeting to provide a presentation.

Covid-19 has significantly impacted upon the delivery of acute services across the NHS. There has been considerable increase in the time patients are waiting to receive non-urgent treatments. There is a joint programme of work to change the ways of delivering acute care to patients. The key focus is addressing health and inequalities and inclusion at a neighbourhood level. 

Since the pandemic began Bury has experienced significant decreases in elective activity across acute providers. 43% of patients on waiting lists have been waiting 18 weeks or longer and 10% of patients on the waiting list are waiting 52 week or longer. There is an increased demand on primary care clinicians and secondary care clinicians from scanning waiting lists to make sure people are not being harmed by waiting a long time for their treatment. 

A plan of the programme was shared with members, including timescales of when the programme would be implemented.  The framework is inclusive, and all care organisations and localities are involved in the programme. New approaches will be explored to re-design person-centred, neighbourhood based holistic models across multiple agencies. The system will consider overarching socioeconomic approaches, rather than just statutory healthcare targets. The programme will be evaluated by outcomes.

Greater Manchester Elective Care Chair has requested that this way of thinking be shared, so other partners across Greater Manchester can implement it.

A member discussed issues of patients returning to their G.P’s because they are still on the waiting list which is causing an increased demand in primary care. It was suggested that some communication should be created about the reality of the size of current waiting lists.

It was agreed:

1.      Ian Mello and Penny Martin be thanked for their update.

2.      Ian Mello and Penny Martin update at a future Board meeting.

3.      Penny Martin to create communication about the reality of the size of current waiting lists.

Developing Neighbourhood Health Improvement Plans

Lesley Jones, Director of Public Health gave an update on the early stages of work that in being developed in relation to the Neighbourhood Health Improvement Plans.

The Neighbourhood Improvement Plans are being developed to align with the vision, aims and objectives of a number of key existing strategies to significantly reduce health inequality in Bury. The vision is to ensure the people and communities of Bury are supported to recover both physically and mentally from living with COVID-19, individually and collectively.

The data collected shows that COVID-19 has had negative impact on mental and physical health. People are needing more support around mental health, getting active, eating healthier and alcohol consumption. Data identified certain groups that have been impacted more than others during the pandemic where there will be targeted work. COVID-19 is considered as the deconditioning pandemic which has increased inequalities.

Jon Hobday, Consultant in Public Health will be programme  ...  view the full minutes text for item HWB.346

Lesley Jones, Director of Public Health to give a verbal update.

Lesley Jones, Director of Public Health provided a verbal update on COVID-19.

Cases have decreased to around 30 per 100,000 and there have been no reported cases in care homes in the last couple of weeks.

The vaccination programme is being rolled out and the uptake for the vaccine has been good. There is some targeted work being done where the uptake has been slightly lower. The programme is focusing on second doses at the moment.

England is now in the second phase of easing the lockdown. There has been re-emphasis on the message of ‘hands, face, space and air’ and also ‘test, trace and isolate’. Every person in England is now able to have two lateral flow tests per week, there is a wide availability of test kits. It is important to stop the transmission of the virus to stop the spread of the variants of concern.

Hospital activity is reducing although the system is under pressure from other none COVID-19 activity.

There was no urgent business.