Agenda and minutes

Apologies for absence are noted above.

Councillor Simpson declared a personal interest in all matters under consideration as both her and her son are employees of the NHS.

There were no matters arising.

The minutes of the meeting held on 14^th April are attached for approval.

It was agreed:

1.        That the minutes of the meeting held on 14^th April 2021 be approved as a correct and accurate record.

There were no public questions.

Lesley Jones, Director of Public Health to give a presentation at the meeting. The documents are presentation are attached.   

Lesley Jones, Director of Public Health presented the key messages from the GM Independent Review on Inequalities and the GM Marmot Report and explained the implications that this has for the Health and Wellbeing Board.

Greater Manchester has had the benefit of excellent reports on inequalities from the Marmot Team and the Independent Commission for Inequalities. Both teams provided powerful and stark evidence on how inequalities have worsened as a result of Covid-19.

The key points from the reports for the Health and Wellbeing Board to note are:-

• The GM Independent Commission described Covid-19 and the Black Lives Matter movement as awake-up call around inequalities.
• Sir Michael Marmot expressed concerns about the declines in life expectancy that their research unveiled.
• Both teams highlighted the collective spirit of collaborations and the strengths of partnerships across GM.
• There is a commitment to build responses to the findings and recommendations of both reports into the refresh of the Greater Manchester Strategy.

The Inequalities Commission provided a helpful framework within their report to help understand the different dimensions of inequalities; this framework is a good way of understanding different types of inequalities and how they intercept with each other. A reflection of this framework can be built into the Health and Wellbeing Board’s Outcomes Framework.

The two fundamental elements that were underpinning both reports were power and resources.

There were over 100 recommendations over both reports which have emphasis on setting targets around inequalities, the importance of good work and good pay and the importance of a good start in life.

The Bury ‘Let’s Do It Strategy’ has an ambition and vision to tackle inequalities and focuses on the key themes that have emerged from both reports.

Lesley Jones shared ideas on what the Health and Wellbeing Board should be focusing on and the key questions the Board should be asking.

Tyrone Roberts explained about a positive piece of work that the Norther Care Alliance is doing around inequalities in recruitment.

Ruth Passman explained how the work of Healthwatch links into the work of the Health and Wellbeing Board. Healthwatch has recently published their annual report which highlights the work that has been completed. Ruth Passman gave examples of how Healthwatch are tackling inequalities around the vaccination programme. Healthwatch has pledge to develop health champions with Bury Council.

Will Blandamer questioned if there were any findings that came out of the reports that the Health and Wellbeing Board should be focusing on. 

Lesley Jones suggested that the Health and Wellbeing Board should embed the notion of implementation decay, and to recognise that some people require bespoke and tailored support to meet their needs which is resource intensive. The Board will need to accept there will need to be more resources put into addressing inequalities. Lesley Jones suggested that the Board should focus on the issue of power and ensure that people are given the resources to develop power.

Sharon McCambridge suggested that the Board should look at community safety and to have a  ...  view the full minutes text for item HWB.354

Tracey Flynn, Unit Manager - Economic Development and Jayne Garner, Head of Integration at Ingeus to present information on work, health and skills. The presentation and report are attached.

Tracey Flynn, Unit Manager, Economic Development Team presented information on the work that the Economic Development Team are involved in and the benefits that being in work has on people’s health.

There is clear evidence to suggest that unemployment is generally harmful to health, and leads to: 

• Higher mortality;
• Poorer general health, long-standing illness, limiting longstanding illness;
• Poorer mental health, psychological distress, minor psychological/ psychiatric morbidity;
• Increased alcohol and tobacco consumption, decreased physical activity;
• Higher rates of medical consultation, medication consumption and hospital admission; and
• Increased risk of fatal or non-fatal cardiovascular disease and events, and all-cause mortality, by between 1.5 and 2.5 times.
• Building a local integration system to link good employment, healthy workplaces, an employer influenced skills system, business engagement and inward investment.

Bury Council are building a local integration system to link good employment, healthy workplaces, an employer influenced skills system, business engagement and inward investment.

Sharon McCambridge questioned if there was enough connectivity going on through the Steps to Success Programme.

Tracy Flynn explained that there is engagement in the Steps to Success Programme, most of the tenants and residents are on the Working Well Programme and other programmes.

Sajid Hashmi explained that there is a link between work and health, as a significant number of people who are referred to social prescribing are mental health related to not having work.

Councillor Brown gave positive feedback to The Economic Development Team for the great work that they have been doing.

Adrian Crook advised that there is an employment support service for people with disabilities and suggested that it would be great to find more work opportunities for residents with learning or physical disabilities.

Jayne Garner, Head of Integration at Ingeus presented information on the Working Well, Work and Health Programme in Bury.

The programme provides support for unemployed people with health conditions or disabilities. It helps individuals who have been out of work for a long time, and/ or those needing specialist support.

In Bury, 891 people have started the programme and 351 people have been moved into work. Bury is the highest performing borough for rates of people starting work.

• The programme offers a holistic assessment of needs, which supports to identify barriers.
• Mental and physical health support.
• Personal and social barriers such as isolation, debt and housing are addressed.
• The programme works with a range of partners to address needs.

The evidence shows that community referrals to specialist support at the right time accelerates the progression towards work, and the GM model is built on an integrated approach.

Lesley Jones questioned if the Working Well Programme use the Bury Directory.

Jayne Garner explained that the integration team does use the Bury Directory, although feels there is more work for them to do, around connecting to The Bury Directory.

Lesley Jones questioned if the Working Well Programme could be embedded into the neighbourhood working model in Bury.

Jayne Garner explained that they can co-locate where possible within the community and they try to be as  ...  view the full minutes text for item HWB.355a

Jon Hobday, Consultant in Public Health to present the Bury Moving – A Physical Activity Strategy. The presentation is attached.

Jon Hobday, Consultant in Public Health presented information on the Bury Moving, Physical Activity Strategy.

The presentation explained the benefits of being physical active. Data from the latest Active Lives survey shows that the levels of activity in Bury is higher than in Greater Manchester. It was explained that over the last 12 months across Bury, there has been a decline in activity levels. There was 73.3% of adults who are active or fairly active. In Bury the levels of inactivity have remained relatively stable since 2015; across Greater Manchester the levels of inactivity have increased.

The following inequalities data in physical activities were explained:-

• Gender Gap
• Socio-economic Gap
• Disability Gap
• Age Gap

Evidence suggests that to reduce inequalities in physical activity there needs to be a focus on:

• Enablers, barriers and identifying opportunity
• Community consultation, engagement, and partnership work
• Holistic approaches for protected characteristics and intersectionality

Jon Hobday explained the work that Bury is doing to reduce inequality and to support people in the community to become more active.

Councillor Simpson questioned if the leisure part of the website needs to be updated. Councillor Simpson suggested that local walks and beginner classes at the Leisure Centre could be added to the website for people who are not physically active. It was suggested that community champions could work with people to find out what inspires people to be active.

Tyrone Roberts suggested that the Physical Activity Strategy could link into the Outcomes Framework specifically related to Community Services at Fairfield Hospital and linking to BEATS. Tyrone Roberts explained that he is keen to support any work and help get the message across to patients and staff.

Will Blandamer questioned if partners in Bury are clear what our expectations are, about the way to promote physical activity to public, private and voluntary organisations.

Jon Hobday explained engaging partners to promote physical activity is something that he can build.

Sharon Cambridge suggested that Six Town Housing could promote physical activity as they can reach out to communities through various community channels.  

Lesley Jones advised that colleagues had done some good MSC research on how they embed the ‘every contact counts approach’ within their service. They built relationships with the Live Well Service and BEATS. The team have been able to demonstrate that embedding this approach, gives a better clinical outcome. It was suggested that this way of working could be progressed into practice more widely.

Lesley Jones is looking at setting up a Population Health Programme Board to bring people together to help to create and embed the cultures of practice that support the public health agenda. The Population Health Programme Board can take forward the suggestions from this meeting.

It was agreed:

1.        Jon Hobday be thanked for the update.

2.        Lesley Jones to pass on suggestions to improve physical activity to the Population Health Programme Board.

3.        Jon Hobday to engage partners to promote physical activity.

Joanne Smith, Development Manager to present information on The Bury Directory. Presentation attached.

Joanne Smith, Development Manager in Public Health & Bury Council presented information on The Bury Directory.

Joanne Smith explained the purpose of The Bury Directory and the benefits. Joanne explained how The Bury Directory had been working collaboratively with several agencies to improve health and wellbeing outcomes for local communities. Future plans for The Bury Directory were shared with the Board. The Bury Directory is inclusiveand addresses inequalities.

• The Bury Directory is open to all ages.
• Google Translate offers over 100 languages and the ability to print off information in selected language. 
• Information and advice pages regarding domestic violence, services and clinics are promoted.
• Places of worship are available on the directory and advice pages on various religions.
• The website text is as simple as possible to understand is accessible for screen readers.
• There is information on The Bury Directory regarding LGBT+ support groups, helplines and forums.

The Bury Directory is looking at ways to target priority cohorts better.

The Bury Directory is a prevention agenda, it is an enabler for self-management and long-term conditions and assists in the prevention of developing future costly conditions. 

Councillor Simpson stated that The Bury Directory is a great resource. Councillor Simpson suggested that General Practices should be encouraged to use it.

Will Blandamer asked colleagues to promote and provide feedback on The Bury Directory. The more people that use The Bury Directory the better it will become at cataloguing and understanding the community capacity.

It was agreed:

1.        That Joanne Smith be thanked for the update.

2.        That Board members promote The Bury Directory.

Kez Hayat, Programme Manager for Mental Health (Adults) to present the attached presentation on Tackling Mental Health Inequalities.

Kez Hayat, Mental Health Programme Manager gave an overview of Bury’s Mental Health Transformation Programme Plan 2021-2022.

The Transformation Programme for mental health encompasses the key aspects of a Mental Health Foundation report that was published to tackle social inequalities to reduce mental health and highlights the main factors that is linked to poor mental health. It highlights that 1 in 3 people will experience poor mental health which equates to roughly 62,000 people in Bury. There are social, economic, culture and environmental drivers that need to be focused on to reduce the prevalence of mental health.

The following 5 key components to the transformation programme were explained:

• Population Mental Wellbeing (Coping & Thriving)
• Primary & Community MH Transformation
• Improving access to support in a crisis
• Improving care for those with highest needs
• Other key developments

It was agreed:

1.        That Kez Hayat be thanked for the update.

2.        To invite Kez Hayat to a future Health and Wellbeing Board meeting to discuss mental health inequalities in detail. 

Lesley Jones, Director of Public Health to update at the meeting. Document attached.

This item was deferred until the next meeting.

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

This item was deferred until the next meeting.

Sajid Hashmi acknowledged the positive work that Liz Thompson, Chief Officer at Creative Living Centre had done, as an advocate for mental health within the community.