East Sussex Health and Wellbeing Board
MINUTES of a meeting of the East Sussex Health and Wellbeing Board held at Council Chamber, County Hall, Lewes on 5 March 2024.
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MEMBERS PRESENT |
Councillor Keith Glazier (Chair) Councillor Carl Maynard, Councillor Trevor Webb, Councillor Teresa Killeen MBE, Jessica Britton, Stephen Lightfoot, Dr Stephen Pike, Mark Stainton, Darrell Gale, Alison Jeffery, Veronica Kirwan and Richard Milner |
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INVITED OBSERVERS PRESENT |
Councillor Dr Kathy Ballard and Duncan Kerr |
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PRESENTING OFFICERS |
Alexandra Hawkins, Healthwatch East Sussex. Sarah Speedie, Strategic Lead Education Improvement Vicky Smith, Programme Director East Sussex Health and Care Transformation
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ALSO IN ATTENDANCE |
Councillor Bob Bowdler (in attendance virtually) |
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33. Minutes of meeting of Health and Wellbeing Board held on 12 December 2023
33.1 The minutes of the meeting held on 12 December 2023 were agreed as a correct record.
34. Apologies for absence
34.1 The following apologies for absence were received from members of the Board:
· Joe Chadwick-Bell, East Sussex Healthcare Trust.
· Councillor John Ungar.
34.2 The following apologies for absence were received from invited observers with speaking rights:
· Becky Shaw, East Sussex County Council
· Councillor Paul Davies, Lewes Distract Council
· Councillor Glenn Haffenden, Hastings Borough Council
· Councillor Julia Hilton, Hastings Borough Council (substituting for Councillor Glenn Haffenden)
34.3 The following substitutions were made for members of the Board:
· Richard Milner, East Sussex Healthcare Trust substituted for Joe Chadwick-Bell.
34.4 The following substitutions were made for invited observers with speaking rights:
· Councillor Julia Hilton, Hastings Borough Council substituted for Councillor Glenn Haffenden.
35. Disclosure by all members present of personal interests in matters on the agenda
35.1 Councillor Carl Maynard declared a personal, non-prejudicial interest under item 6, School Attendance as a Public Health Outcome, as he is a father of three school age children. Cllr Trevor Webb declared a personal, non-prejudicial interest under item 7, Focus on Men’s Mental Health in East Sussex, as he is a trustee of His Place voluntary organisation which provides a meeting venue for some of the groups listed in the report.
36. Urgent items
36.1 The were no urgent items.
37. Rye Listening Tour - Healthwatch East Sussex
37.1 The Board considered a report from Healthwatch East Sussex on the Rye Listening Tour that was undertaken in Rye and the surrounding area in September 2023. The report was introduced by Veronica Kirwan, Executive Director and Alexandra Hawkins, Communications Officer, who outlined the key findings and recommendations of the report.
37.2 Members of the Board thanked Healthwatch for a valuable and insightful report and commented that the richness of the report which is very helpful. The Board noted the post Covid experiences in accessing health services and the role that transport and the cost of living crisis is playing in accessing health services in more rural areas such as Camber and Icklesham. Jessica Britton, Executive Managing Director NHS Sussex commented that the cost of living issues mentioned in the report link to the financial inclusion work that is taking place and will be picked up by the Health and Care Partnership.
37.3 Mark Stainton, Director of Adult Social Care and Health commented that the ‘Enter and View’ work undertaken as part of the Listening Tour was really valuable, as well as the level of insight the report provides. He added that the three recommendations for East Sussex County Council (ESCC) that are included in the report have been shared with the Director of Communities, Economy and Transport where they relate to the Local Transport Plan and bus services.
37.4 Dr Stephen Pike, Deputy Medical Director NHS Sussex, outlined that there are national programmes to improve access to GP practices and more locally conversations are taking place with the Primary Care Network (PCN) Director to try and put in place some outreach services in the areas covered by the report. There is also a piece of work underway in the South East Region on GP websites to review website accessibility and the Healthwatch work will feed in well into this piece of work.
37.5 Members of the Board asked if there is anything more to report from the work Young Healthwatch undertook, and whether there are any recommendations around social isolation. Veronica Kirwan outlined that that Young Healthwatch will provide more feedback from their work. Alexandra Hawkins commented that one of the key outcomes was that more networking type events could help if people are socially isolated. There are a lot of village halls in the area with events and activities, so one of the key issues for people is how do they know what is on and where to go for help.
37.6 Councillor Kathy Ballard commented that it is very important to include access to healthcare in the Local Transport Plan (LTP) for the whole of East Sussex and supports the approach that includes access to healthcare in the LTP as it is a key issue across the county.
37.7 The Board RESOLVED to note the findings and recommendations in the report.
38. School Attendance as a Public Health Outcome
38.1 The Board considered a report on School Attendance as a Public Health Outcome. The report was introduced by Alison Jeffery, Director of Children’s Services and Sarah Speedie, Strategic Lead for Education Improvement. School attendance is listed as one of the Public Health outcomes on the Public Health Outcomes Framework and is vitally important for attainment and the life chances of children and young people. The Covid pandemic has had a huge impact on school attendance and the report outlines the work that is being undertaken to tackle this issue and the other factors that contribute to poor attendance.
38.2 Board members commented that it was a useful and timely report, and it was good to have a clear information on school attendance in the county. Board members considered the development of an attendance delivery plan and single point of contact for schools as very positive and were be interested to see the impact of the proposals contained in the report. Sarah Speedie outlined that East Sussex is one of the first local authorities to develop a single point of contact for attendance and this mirrors the emerging statutory guidance from the Department for Education.
38.3 Councillor Maynard commented that it was important to embed the expectation that all children should attend school and to encourage children to want to attend school especially at primary level. It is also important to ensure that home educated children get a good quality education as the numbers of children being home educated are rising.
38.4 Dr Stehen Pike commented that there is an opportunity for schools to be involved with the new Integrated Care Teams (ICTs). For example, secondary schools working with GP surgeries, and ICTs could also establish more community relationships with health services and schools. This could include working with primary and early years settings to establish good behaviours early on.
38.5 Darrell Gale, Director of Public Health commented that it was an excellent report which bench marked current school attendance, establishes what we need to do and what is being done to tackle attendance. Although some parental attitudes persist from lockdown, schools are places of protection and opportunities for life courses and should not be seen merely as places of infection.
38.6 Stephen Lightfoot, Chair of NHS Sussex asked if it was possible to interrogate the 3% to 4% of absences that were attributed to illness to explore any themes that emerge and cross check with health programmes such as those for vaccinations. Sarah Speedie responded that the information was provided via a coded system and would have to go away and see how far it would be possible to drill down into the data to look patterns and trends.
38.7 Dr Stephen Pike asked if children’s mental health is an issue. Alison Jeffery responded that there is a lot of emotional school avoidance. She added that the Education Division has been shaped to support vulnerable children and has a team passionate about their work to support children. The school attendance links to public health also helps to increase the authority of the Council when speaking to schools and parents about attendance.
38.8 The Chair thanked officers for the report and commented that there was more work to do to recover from the impact of Covid and the effect on attendance and the life chances of children.
38.9 The Board RESOLVED to note the report, the areas of challenge and the proposed course of action.
39. Focus on Men's Mental Health in East Sussex
39.1 The Board considered a report on Men’s Mental Health in East Sussex, introduced by Darrell Gale, Director of Public Health. The report outlined the work carried out by Public Health on men’s mental health. Work in this area has prioritised middle aged men who are the highest risk age group of men, who overall account for around three quarters of suicides in East Sussex and those with physical and mental health issues where there is a combination of risk factors including financial issues, bereavement and caring responsibilities.
39.2 Members of the Board thanked Darrell for the very positive report and case studies. The Board noted that the issues of physical and mental health are interlinked issues with people’s feelings of worth and purpose being important factors. This makes opportunities to re-train and gain new skills important. Often people face a combination of issues such as losing parents, financial issues, increasing isolation. The Board made a number of comments on the report which are summarised below.
39.3 Councillor Maynard commented on the positive impact of Men’s Sheds project and noted that there are similar services for ex-servicemen in Westfield. He also noted the importance of opportunities to re-train and gain new skills. Councillor Webb commented on the impact of the 2007/8 economic downturn on suicide rates and whether the Covid pandemic and cost of living crisis would have a similar impact on suicide rates.
39.4 Jessica Britton noted the positive impact of community based projects on men’s mental health and asked if links were being explored and made with front line, primary care mental health services so there are two way links with community based support. There may be opportunities for Public Health to encourage and support two way access between community based support and more formal mental health services such as talking therapies.
39.5 Mark Stainton commented that the report illustrates how projects with small pieces of investment can have a significant impact on demand. The projects can also be useful local resources for ICTs where they are available. There is a good offer of support in East Sussex and there may be a need to bring all the services and support available under an over-arching Prevention Strategy, which could be used to signpost people to services.
39.6 Stephen Lightfoot agreed and commented on the importance of suicide prevention. He observed that the beauty of the projects is that they are small scale at around £1,500 each and provide a powerful model of projects and schemes. This prompts the question of how to scale up this type of activity across East Sussex, and how to signpost people to services. There is an opportunity to achieve a marked impact on mental health issues with a small amount of funding, and there may also be a need for a central resource for services and support.
39.7 Darrell Gale commented that in terms of scaling up the projects, the majority of the cost of each project is the infrastructure cost and there was a need to fund an umbrella community organisation to help with setting up the projects. However, compared with other services they are good value. There are other examples through the Making it Happen scheme where other community needs, not just for men, are being addressed. The five year funding for the men’s mental health projects is coming to an end and the Public Health team will have to work creatively to co-produce these projects in the future. This is something that the Integrated Care Board (ICB) may be able to help with to take this work forward in the future.
39.8 Veronica Kirwan outlined that in respect to loneliness and isolation, Healthwatch East Sussex is just starting a project which links to the work the Public Health have been doing. The project will look at what work in this area is already taking place and what more could be done. A reference group for this project is being established and will include someone from the Public Health team.
39.9 Darrell Gale responded to an earlier point regarding re-training and there has been some success with the Estar scheme in Eastbourne that was run during Covid with street homeless men. This scheme provided support and training opportunities and has led to number of men securing jobs and being able to maintain tenancies. The Public Health team is always looking for opportunities to support this type of work which provides people with purpose and feelings of self-worth.
39.10 Darrell Gale also commented that all the men’s mental health projects and programmes are relatively new, and the groups have been developed from the community up. As such they do not necessarily see themselves as services or as meeting health outcomes, and care will need to be exercised not to impose expectations upon them. However, the Public Health team do want to maximise links to other services.
39.11 It was noted that suicide rates rose after 2007/8 financial crisis. The data in the report on suicide rates is local county data and national data and it is hoped that the work outlined in the Suicide Prevention Strategy will help contain any rise in suicide rates linked to the current cost of living crisis. The work that is being undertaken is definitely making individual impacts and it is hoped that the work will have a positive impact on future suicide rates.
39.12 The Board RESOLVED to note the recent and ongoing work commissioned by Public Health to support men’s mental health in East Sussex.
40. East Sussex Shared Delivery Plan (SDP) programme update
40.1 The Board considered an update report on the East Sussex Shared Delivery Plan (SDP) programme. The report was introduced by Vicky Smith, Programme Director East Sussex Health and Care Transformation. The report covered a review of progress against the eight key milestones for year one of the SDP; the latest progress on the development of the Integrated Care Teams (ICTs); and proposals for moving forward with the Health and Care Partnership and the HWB statutory role.
40.2 Jessica Britton outlined that the report sets out the strategic approach and the progress towards greater integration. It also sets out the progress on the areas of focus on the ground where partners are starting to work differently such as in Family Hubs, emotional and wellbeing support services, as well as the development of ICTs. This is through an asset based approach to local shared priorities to improve the offer and services available to people locally.
40.3 Mark Stainton added that the partners had worked well together to deliver the eight key milestones during the first year of the SDP. Going forward it will be important when looking at the key milestones to get the right balance between strategic priorities and development of services on the ground. There had been really good progress on the development of the ICTs with the development of the core offer, establishment of the footprint for each ICT and an intelligence base for each of the neighbourhoods. It will be important to articulate what this means for staff and residents, highlighting which teams form part of the ICT and how residents will access them and what is different. In terms of governance arrangements for the East Sussex ‘place’, some proposals will be brought to the next HWB in July. There is a role to develop for the HWB around challenge, accountability as well as stewardship of the Health and Care system. Developing a whole system Preventative Strategy, including approaches to men’s mental health is one example where the HWB could pull together and steer the collective energies of the health, care and VCSE partners.
40.4 The Chair commented that he thought the direction of travel for the work on the SDP is exactly right, and recent work on the LGA Peer Review of Adult Social Care and Health highlighted the role and opportunities that the HWB has to co-ordinate the work of all the partners. This will need serious consideration to focus on the areas of work that are important to residents.
40.5 Alison Jeffery outlined that although the progress on the work on the children’s programme is marked as green, and good foundations have been laid for future work, there is still not much impact on services on the ground on the mental health and neurodiversity pathways. There is a need to make sure the work over the last year makes a difference. Going forward the incoming Director of Children’s Services will continue to raise the case for involving children and young people in this work.
40.6 Veronica Kirwan commented that good progress had been made, but going forward it will be important to look at how the Partnership continues to focus on strategic and system wide issues but reflect this at the local level, whilst communicating this to members of the public. It will also be important to see how better use of metrics can used to challenge each other and to hold each other to account on things like the development of a preventative strategy.
40.7 Stephen Lightfoot commented that a good place to start with monitoring measurable improvement, would be to use the shared outcomes framework that is contained in the current HWB Strategy as it set’s out a clear framework across four elements that are important to the population.
40.8 The Board RESOLVED to note the content of the progress report and the forthcoming changes to aspects of the partnership working within the Sussex Integrated Care System (ICS), and:
· The proposed review to ensure our HWB is empowered to undertake its leadership role across the broader range of stakeholders working together at Place; and
· That further reports that will be brought to the July meeting of the HWB on delivery plans for 2024/25 and the outcomes of the review.
41. Work programme
41.1 The Board considered the HWB work programme and Mark Stainton highlighted the forthcoming reports that are on the work programme for the next HWB meetings. Stephen Lightfoot commented that it might be helpful to include something in the future work programme on the shared outcomes framework in the HWB Strategy, once the ICTs are up and running, to provide a framework for the measurement and demonstration of the impacts across the four elements that are important to the population of East Sussex.
41.2 The Board RESOLVED to agree the work programme.
42. Chair's Announcements
42.1 The Chair noted that this will be Alison Jeffery’s last Board meeting as she is soon to retire from her role. The Chair thanked Alison on behalf of the HWB for all her work on the Board, and the inclusion and involvement of children and young people in the work of the HWB.
42.2 Alison responded that she was hugely grateful for all the support she had received in her role as Director of Children’s Services and thanked everyone for their support.
43. Any other items previously notified under agenda item 4
43.1 There were none.
The meeting ended at 4.20 pm.
Councillor Keith Glazier (Chair)