Agenda and minutes

The Chair welcomed Donna Kendall, Coventry University to the meeting.

There were no declarations of interest.

The minutes of the meeting held on 3^rd October 2022 were agreed as a true record.

There were no matters arising.

The Chair, Councillor Caan, welcomed everyone to the meeting.

He reported that whilst Covid was not currently increasing, flu was circulating and the uptake of boosters was encouraged.  The downward trajectory of respiratory diseases and Strep A was positive news for the community.  The Chair referred to the unfortunate recent deaths of two children in Coventry from Strep A, advising of the public health response alongside the support of the NHS and he gave assurance that the schools had been supported during this difficult time.

The Chair referred to the current pressures on the health services provided by the Council, which continued to present many challenges both in service delivery and on daily lives and he extended thanks to the Director of Public Health, the Chief Partnerships Officer and their teams for the work on engaging and assisting with migrant health at local, regional and national level.

The Chair welcomed the recent award from the National Institute for Health and Care Research (NIHR) of just under £5 million to create a Health Determinants Research Collaboration, which would be used to build a research infrastructure.

Finally, the Chair placed on record his thanks to Lisa Bayliss-Pratt, who had recently stepped down from the Board and welcomed Donna Kendall, Pro-Vice Chancellor, Coventry University’s new representative.

Report of P Johns, Coventry and Warwickshire Integrated Care Board

The Board received a verbal update by Philip Johns, Coventry and Warwickshire Integrated Care Board about NHS Capacity, Industrial Action Contingency Plans and an ICB Update.

The verbal update detailed:

·  Decreasing volumes of respiratory diseases: Flu, Covid and RSV

·  Hospital demand decreasing to normal levels

·  Improved wait times

·  Extending the urgent care response service as a contingency measure for strike action

·  Hospital discharges being brought forward

·  Respiratory hubs continuing to run for both adults and children

·  Extra GP sessions running across practices on strike days.

·  A common approach between the ICB and UHCW being agreed to improvements going forward and working collectively towards healthcare aims to improve the lives of people in the community.

The Board discussed the recent ambulance strikes and the forthcoming teacher industrial action and information on the impact on parents due to school closures would be shared when available.  The NHS financial allocations were not yet clear and information would be brought back to the Board when available.

Thanks were placed on record to the Director of Adult Services and his team for their work regarding hospital discharges.

RESOLVED that the Coventry Health and Wellbeing Board note the verbal reports.

Report of D Oum, Coventry and Warwickshire Integrated Care Board

The Board received a report by Liz Gaulton, Chief Officer Population Health and Inequalities, ICB regarding the Integrated Care Strategy.

The purpose of the report was to inform the Board of the draft Coventry and Warwickshire Integrated Care Strategy, approved by the Integrated Care Partnership (ICP) on 8 December 2022.  This was an interim strategy, with plans for formal publication alongside the Integrated Care Five-Year Plan in April 2023. 

The report highlighted:

• The ICP’s approach to developing the strategy being as inclusive as possible with over 40 individuals being involved in developing content, supported by a reference group, working group and core drafting team.  A dedicated engagement task and finish group was established to lead on community and stakeholder engagement
• The ways the strategy had been informed: through partner strategy and engagement, collation of needs data, statutory guidance and feedback from a range of related activities.
• The three core priorities of the final strategy:

·  The role of the Health and Wellbeing Board in the Integrated Care Strategy.

·  Timescales and next steps: 

o  The Integrated Care Strategy would be formally published alongside the Integrated Care Five-Year Plan in April 2023.

The Board discussed:

• How the strategies linked together to ensure delivery.
• The Coventry All Age Autism Strategy.
• Issues, concerns or comments being submitted to the draft strategy prior to publication.

RESOLVED that the Coventry Health and Wellbeing Board notes:

The draft Integrated Care Strategy for Coventry and Warwickshire 2022.

Report of K Nelson, Chief Partnerships Officer

The Board received a briefing note by Kirston Nelson, Chief Partnerships Officer, regarding the Coventry and Warwickshire Integrated Health and Wellbeing Forum, the first meeting of which had taken place on 13^th October 2022. The Board noted the aims and the key messages from the meeting.

The next meeting of the Forum would take place on 2^nd March in Warwick.

RESOLVED that the Coventry Health and Wellbeing Board notes:

The outcomes of the first meeting of the Integrated Health and Wellbeing Forum.

Report of A Duggal, Director of Health and Wellbeing

The Board received a comprehensive report by Allison Duggal, Director of Health and Wellbeing notifying the Board of the development of the Coventry and Warwickshire Suicide Prevention Strategy 2023 – 2030.  The Strategy had been drafted based on Coventry and Warwickshire Mental Health Joint Strategic Needs Assessment (JSNA) recommendations and feedback from engagement sessions and promoted a zero-suicide approach, with the overall aim to reduce the rate of suicide across Coventry and Warwickshire.

Both Health and Wellbeing Boards in Coventry and Warwickshire would monitor the Suicide Prevention Delivery Plan, with progress and impact reported on an annual basis and a final version of the Strategy would be presented to the Coventry and Warwickshire Integrated Health and Wellbeing Forum for information.

The Board received a presentation by Jane Fowles, Consultant in Public Health on Suicide Prevention.

The presentation highlighted:

• The main aims of the Coventry and Warwickshire Suicide Prevention Strategy
• National and local suicide rates
• Proposed governance arrangements
• Implementation of the Strategy
• Next steps

The Board discussed:

·  The success of Dear Life.org.uk and the ‘It Takes Balls to Talk’ campaign.

·  Coventry City Council being one of the first Local Authorities to target male suicides

·  Collaboration with Coventry and Warwick Universities

·  Information regarding drug and alcohol misuse at national and local level arising from data captured at the Coroner’s Office.

·  The 2 year action plan development capturing the rising problem of online abuse and working collaboratively with other partners to share knowledge and trends

·  Validated data based on 3 year rolling averages.

·  Real time data available through the Coroner’s Office informed practices.

RESOLVED that the Coventry Health and Wellbeing Board:

1. Endorse the content of the Coventry and Warwickshire Suicide Prevention Strategy 2023 – 2030.

2. Requests Board Members to consider their organisational contributions to suicide prevention and identify any governance routes for approving and sharing the Strategy.

3. Support the delivery of the strategic ambitions and local priorities as set out in strategy and delivery through collaboration with the Coventry and Warwickshire Suicide Prevention Partnership.

4. Agree to a formal presentation of the Strategy and Delivery Plan at the Coventry and Warwickshire Integrated Health and Wellbeing Forum at its meeting in March 2023. 

Report of J Gregg, Director of Children

The Board received a verbal update by John Gregg, Director of Children’s Services regarding the Childrens’ System Update.

The update advised a report had recently been presented to the ICB detailing the progress of the Childrens’ agenda and details of the proposed development of a strategy for children.

RESOLVED that the Coventry Health and Wellbeing Board notes the Childrens’ System Update verbal report.

Report of A Duggal, Director of Health and Wellbeing

The Board received a verbal update by Allison Duggal, Director of Health and Wellbeing, regarding the Director of Health and Wellbeing Annual Report.  The report would focus on sexual health and healthy relationships of young people.

RESOLVED that the Coventry Health and Wellbeing Board notes the verbal update regarding the Director of Health and Wellbeing Annual Report.

Report of A Duggal, Director of Health and Wellbeing

The Board received a comprehensive report by Allison Duggal, Director of Health and Wellbeing, regarding Drugs and Alcohol Strategy Update. 

The Government’s 10-year drug strategy “From Harm to Hope”, based on the findings of an independent review of drug misuse and also covering alcohol misuse, set out to address substance misuse by:

• Breaking drug supply chains
• Delivering a world class treatment and recovery system
• Achieving a generational shift in demand for drugs

The overarching strategy outcomes which also applied to alcohol misuse were:

• Reduce drug and alcohol-related crime
• Reduce drug and alcohol use
• Reduce drug and alcohol-related deaths and harm
• Reduce supply
• Increase engagement in treatment services
• Improve long term recovery

The governance structure included representation on the West Midlands Combatting Drugs and Alcohol Partnership (WMCDAP) and the Coventry Drugs and Alcohol Partnership Steering Group, which was chaired by Allison Duggal, Director of Public Health and Wellbeing.  This steering group reported into and was accountable to the Coventry and Warwickshire Health and Wellbeing Board and also reported to the Police and Crime Board.  For the West Midlands Metropolitan area, it was agreed that the Senior Responsible Officer (SRO) would be the Police and Crime Commissioner (PCC) as this would support strong engagement of the police and criminal justice partners in delivery of the strategy, as well as joined up working across the area.

The Board received a presentation by Rachel Chapman, Consultant in Public Health on Drugs and Alcohol.

The Board discussed:

·  Locally identified priorities were detailed in the Needs Assessment.

·  Partner engagement regarding prioritising objectives.

·  Further and full engagement with the wider community regarding impact.

RESOLVED that the Coventry Health and Wellbeing Board:

1. Notes the requirements set out in the National Drugs Strategy, including the national outcomes framework.

2. Notes the formation of West Midlands Combatting Drugs and Alcohol Partnership (WMCDAP) with the regional governance structure with Police and Crime Commissioner (PCC) as Senior Responsible Officer (SRO).

3. Notes the formation of the local Coventry Drugs and Alcohol Partnership Steering Group with reporting to the Coventry and Warwickshire Health and Wellbeing Board.

4. Notes local progress on the needs assessment and development of the strategy.

5. Supports attendance at the Coventry Drugs and Alcohol Partnership Steering Group from all identified partners.

Report of A Duggal, Director of Health and Wellbeing

The Board received a verbal report by Allison Duggal, Director of Health and Wellbeing, regarding the Serious Violence Duty. 

The Board received a presentation by Rachel Chapman, Consultant in Public Health on Serious Violence Duty highlighting:

• The Serious Violence Duty
• Coventry Youth Violence Prevention Strategy

RESOLVED that the Coventry Health and Wellbeing Board notes the verbal update regarding the Serious Violence Duty.

Report of P Fahy, Director of Adult Services and Housing

The Board received a comprehensive report by Pete Fahy, Director of Adult Services and Madi Parmer, Chief Finance Officer, NHS C&W ICB regarding Adult Social Care Hospital Discharge Grant 2022/23.

In September 2022, the government announced a £500 million Adult Social Care Discharge Fund.  The grant was to be pooled into the Better Care Funds with £300m allocated to ICB’s and £200m to Local Authorities.

The relative allocations from this amount were:

Coventry City Council   £1.292m

Warwickshire County Council  £1.862m

Coventry and Warwickshire ICB  £6.715m

The funding was provided in 2 tranches – the first £40%) in December 2022, and the second (60%) by the end of January 2023.  The grant covered the period from 23 September 2022 to 31 March 2023 after which an assessment of costs and impact would be conducted and a prioritisation process undertaken to agree the schemes which could continue beyond 31 March 2023 subject to confirmation of grant provision for 2023/24 and 2024/25. 

The funds allocated to Coventry would be used across the following schemes:

• Securing existing discharge capacity
• Funding additional packages of care
• Dealing with the practical barriers to discharge
• Incentivising Care and Support staff
• Providing additional staff resource

The Board noted that support for the Discharge Fund Grant allocations 2022/23 were retrospective due to Department for Health and Social Care (DHSC) timescales and the urgency of the work.

RESOLVED that the Coventry Health and Wellbeing Board notes the content of the report and supports the Discharge Fund Grant allocations for 2022/23.

Report of the Chair of Coventry and Warwickshire Health & Wellbeing Board

The establishment of the Integrated Care Board amalgamated the 2 Coventry and Warwickshire Clinical Commissioning Group seats with the one for Coventry and Warwickshire Integrated Care System.

There were 2 seats:  Voluntary Action Coventry (VAC) and Coventry and Rugby GP Federation which did not have nominated members.  VAC stepped down from their seat in October 2021 and there was no other organisation representing the wider voluntary and community sector.  The Coventry and Rugby GP Federation had become the Coventry and Rugby GP Alliance, representatives of which had not attended a meeting since February 2017.

To enable the voluntary and community sector to be represented at the meetings, an appropriate organisation, based on the agenda, would be invited to each Health and Wellbeing Board meeting.

The Cabinet Member for Adult Social Care currently sits on the HWBB as a nominee of the Leader.  It was suggested this seat be amended from a nominee of the Leader to the Cabinet Member for Adult Services.

This changed aligned with the set up for Public Health and Children’s Services whereby the Directors were statutory appointments and the Cabinet Members for Public Health and Sport and Children and Young People were allocated a HWBB seat, as the Director of Adult Services was also a statutory appointment.

Reprofiling the seat from a nominee of the Leader to Cabinet Member for Adult Services maintained the ratio of Elected Members on the HWBB.

Details of current membership of the Coventry and Warwickshire Health and Wellbeing Board with recommendations for the seats to be amended were set out at pages 194 – 195 of the report submitted.

The quorum was made up of one half of the total number of members plus one member.  Updating the membership would help meetings to be quorate.  This must include at least one of the following:  an Elected Member, Integrated Care Board representative and Local Authority Director.

The constitution also allows Members to nominate a substitute to attend the meeting providing notice of one hour prior to the meeting start time was given.

The constitution allows the Health and Wellbeing Board to appoint additional persons as appropriate to the Board. 

RESOLVED that the Coventry Health and Wellbeing Board recommend the following to the Coventry City Council Constitution Advisory Panel:

1. That the Membership of the Board be updated as outlined in Table 1 of the report.

2. That the Constitution be amended to enable the Health and Wellbeing Board to approve the removal of members as well appoint additional persons as appropriate.

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

There were no additional items of public business.