Agenda and minutes

The Vice-Chair noted that Councillor P Sexton had stepped down as Portfolio Holder for Adult and Health Services and as Chair of the Health and Wellbeing Board and therefore would invite nominations for Chair of the Health and Wellbeing Board.

Moved by Councillor T Henderson, Seconded by S Burns and

Resolved:

That Councillor C Hood be elected as Chair of the Board.

Councillor C Hood in the Chair

Apologies for absence were received from Councillor R Bell, L Buckley, C Cunnington-Shore, D Gallagher, S Helps, S Jacques, S Lamb and P Sutton.

There were the following substitutes: S Burns for D Gallagher; P Garner for  P Sutton: Dr L Murthy for C Cunnington-Shore; C Oakley for the Office of Police and Crime Commissioner; A Smith for S Lamb; and R Stray for S Jacques.

There were no Declarations of Interest.

The minutes of the meeting held on 12 July 2022 were agreed as a correct record and signed by the Chair.  The Strategic Manager, Partnerships, Andrea Petty noted that the previous Chair, Councillor P Sexton had written to the CCG representatives thanking them for their 10 years of work in relation to the Board.

Presentation of the Director of Integrated Community Services and the Corporate Director of Adult and Health Services, Durham County Council.

The Board received an update presentation from the Corporate Director of Adult and Health Services, Jane Robinson and the Director of Integrated Community Services, Michael Laing on progress relating to Health and Social Care Integration (for copy see file of minutes).

The Corporate Director of Adult and Health Services noted the meeting of the ICB held on 20 September, with discussions including understanding partnership arrangements; challenges in the North East and Cumbria; and development of the Integrated Care Strategy, with sign off in December prior to submission.  She added that chairing arrangements would be discussed at their next meeting.

The Director of Integrated Community Services explained as regards place based governance and the progress in terms of the co-production of a Joint Committee, with shadow arrangements to be in place in December 2022, the Joint Committee is to be effective from April 2023, with a central role for the Health and Wellbeing Board.  He noted there is continued commitment from partners to the County Durham Care Partnership including from the ICB.  He referred to further integration work, draft guidance coming through and developing areas of work, highlighting that the Workforce Project would be a big issue for Government in terms of recruiting new doctors, nurses and social care professionals/practitioners.

Resolved:

That the presentation be noted.

Report of the Corporate Director of Adult and Health Services and the Director of Public Health, Durham County Council.

The Board received an update report and presentation from the Director of Public Health, presented by the Public Health Pharmacy Adviser, Claire Jones on the final draft of the Pharmaceutical Needs Assessment (PNA) (for copy see file of minutes).

The Corporate Director of Adult and Health Services noted her thanks to all involved in developing the PNA as it was a huge piece of work.  She added that the response of 92 percent of people finding it easy to access pharmacy services was very encouraging, especially given the rural nature of parts of the County.  The Chair added his thanks and noted that a presentation on the role pharmacies played would be useful.  The Public Health Pharmacy Adviser noted that Community Pharmacy County Durham would be delighted to come along to speak to the Board.

Resolved:

That the final draft of the Pharmaceutical Needs Assessment 2022-25 be agreed.

Report of the Head of Partnerships and Community Engagement and the Director of Public Health, Durham County Council.

The Board received a report and presentation from Head of Partnerships and Community Engagement and the Director of Public Health, presented by the Wellbeing Approach Implementation Officer, Hannah Murray-Leslie on the recommendations from the Evaluation of the Approach to Wellbeing (A2WB) in County Durham carried out by Teesside University and provided an update on action being taken to implement them (for copy see file of minutes).

The Corporate Director noted the recommendations were very good and quality examples given.  She asked as regards embedding wellbeing within cost of living and winter preparedness and the opportunities to use the measurement tools.  The Wellbeing Approach Implementation Officer noted discussion with the Strategy Team in reference to data/insight work and noted that the measurement itself was a snapshot in time of wellbeing and that would then be overlayed with local data relating to jobs, income, health inequalities and so on.  She added that it was important to have stories and qualitative information from those most in need and affected, as well as the overall data.

Councillor T Henderson asked how we recorded what assets and strengths existed in communities and how that was promoted for example with Durham Locate. 

The Wellbeing Approach Implementation Officer noted that there were challenges and that the County Durham Partnership website had more case studies listed and the self-assessment framework being available in electronic form.  She noted the Durham Insight site and the assets relating to the Joint Strategic Needs Assessment (JSNA) starting to appear.

Sarah Burns, representing the North East and Cumbria ICB noted the work in County Durham Together and a sub-group looking at connected communities.  She added as regards community action and the links to the community and voluntary sector.  The Director of Public Health, Amanda Healy noted the evaluation was seen to be as practical as possible, and therefore any other actions would also need to be practical as well as identifying any gaps in terms of engagement.  The Wellbeing Approach Implementation Officer noted the practical approach with the self-assessment framework workshop reflecting that and noted there were discussions taking place soon with the Mental Health Wellbeing Alliance.  She added there was a lot of engagement work that needed to be done, including community voice review.  The Strategic Manager, Partnerships noted that work was ongoing with colleagues in Regeneration in terms of the Inclusive Economic Strategy and would refer colleagues to the Wellbeing Approach Implementation Officer if a workshop was required.  The Wellbeing Approach Implementation Officer noted the challenges in terms of an integrated approach to wellbeing and that it would take time.

Resolved:

(a) That the Evaluation of the Approach to Wellbeing in County Durham be accepted.

(b) That the action being taken relating to the overarching recommendations be noted.

Presentation of Director of Public Health, Durham County Council.

The Board received a presentation from the Director of Public Health on Making Smoking Obsolete: The Khan Review (for copy see file of minutes).

It was explained that the review led by Dr Javed Khan OBE, reiterated that smoking remained the single largest cause of preventable deaths and was one of the largest causes of inequalities in England.  The Board noted that the review had 15 recommendations, with the following four listed as critical ‘must do’ interventions; Increased investment of £125m per year (recommendation 1); Increased the age of sale from 18 by one year every year (recommendation 2); Promoting vaping to help people quit smoking (recommendation 8); and Improve prevention in the NHS (recommendation 11).

Councillor T Henderson asked as regards any work with our Youth Council around an increase in the age of sale for tobacco products to ensure we include their voice in the letters to MPs.  The Director of Public Health noted the work with people, rather than simply speaking to them, and added that understanding what young people wanted was important to take forward. 

The Chair asked how the Tobacco Control Alliance’s eight point action plan aligned to the Khan review recommendations.  The Director of Public Health noted the review covered work such as “Stoptober” and the Council was lead commissioner for Fresh in the North East and therefore was in a strong position to help ensure local planning was in line to deliver against the review.

Resolved:

(a) That the Health and Wellbeing support the review recommendations.

(b) That the Chair writes to key parliamentary leads to keep momentum going around smoking cessation.

Report of the Corporate Director of Children and Young People’s Services, Durham County Council, and the Chair of Children, Young People and Families Partnership Board.

The Board received a report of the Corporate Director of Children and Young People and Chair of Children, Young People and Families Partnership Board, John Pearce relating to the Growing Up in County Durham 2023-25 high level strategy (for copy see file of minutes).

The Chair noted the report had referenced a recent parliamentary report that indicated that, one in six young people were now likely to experience poor mental health, compared to one in nine pre-pandemic and asked what we were doing to address this.  The Corporate Director of Children and Young People noted that the strategy complemented others, such as the Mental Health Strategy and noted the amount of regional and national development work being undertaken regarding integration.  He added that a priority within children’s integration was children’s mental health and noted a locality approach, that it was a key strategy and service, and there were children and young people with complex mental health challenges and therefore the connections with other strategies was important.

Resolved:

(a)   That the Health and Wellbeing Board note the Draft Growing up in County Durham 2023-25 Strategy.

(b) That any additional comments or contributions to the new Growing Up in County Durham 2023-25 Strategy be passed to the Strategic Manager, Partnerships by 2 October 2022. 

Report of the Corporate Director of Regeneration, Economy and Growth, Durham County Council.

The Board received a report of the Corporate Director of Regeneration, Economy and Growth on the Draft Inclusive Economic Strategy and a presentation given by the Planning Team Leader, Spatial Planning, James Cook (for copy see file of minutes).

The Board were reminded that in December 2021, Cabinet agreed to developing a new strategy, and in January 2022 the Big Econ-versation was undertaken to begin this process.  It was added that the findings were set out within the report and that feedback from that, the Economic Review and the Economic Statement had been used to draft the Inclusive Economic Strategy.  It was explained that the Inclusive Economic Strategy had a simple ambition: more and better jobs in an inclusive, green economy.  It was noted that to achieve that the Inclusive Economic Strategy framework focused on People, Productivity, Places, Promotion and Planet.  The Board noted levers which were already available would be used to deliver the strategy, including assets, policies, programmes and funding, and partnerships, with a detailed action plan to be developed to support delivery against the strategy.

Councillor T Henderson asked what more the Council and partners could do to overcome barriers into employment, particularly for those with a disability.  The Planning Team Leader noted the development of the action plan and in improvements such as to buildings, transport and digital technology, to help support working from home.  He added another element was breaking down perceptions as regards employing those with disabilities, highlighting the small changes that can be made to enable them to work, identified as key part of the strategy.

The Director of Public Health thanked the Planning Team Leader and noted that the development had been inclusive, with the Public Health Team, along with other Council teams, having been consulted extensively.  She asked how we could engage with the wider Council workforce, acknowledge the impact of health on the economy, and how the action plan would seek to maintain and grow the good working relationships.  The Planning Team Leader noted that there had been a great deal of positive input from the Public Health Team in shaping the strategy and with the right people involved, for example on the working group looking at the strategy, he added that further involvement in helping to develop the action plan would be important. 

The Corporate Director of Children and Young People’s Services noted the emphasis on the issue of skills and the transition from education into employment and noted the challenge in equipping our young people with those skills.  He asked how we could take advantage of opportunities in the labour market and match up skills and young people. 

The Planning Team Leader noted the strategy had picked up on the opportunities and those seeking employment and noted issues in terms of recruitment difficulties, such as the Council and the NHS.

The Chair noted that we could have a vibrant economy, however, a large issue was that of public transport and asked what could be done to improve services.  ...  view the full minutes text for item 11.

Report of the Corporate Director of Neighbourhoods and Climate Change, Durham County Council.

The Board received a report of the Corporate Director of Neighbourhoods and Climate Change on the Climate Emergency Response Plan (CERP) and a presentation given by the Principal Officer, Climate Change and Sustainability, Stephen McDonald (for copy see file of minutes).

The Board noted updates against the first iteration for 2020-22 (CERP1) following the Council’s declaration of a climate emergency, and the second iteration for 2022-24 which was recently adopted at Cabinet (CERP2).  Members noted there are two new targets which have been introduced in CERP2: a) achieve net zero by 2030 by retaining the CERP1 80 percent actual carbon reduction target for Council emissions by 2030 whilst offsetting or further reducing remaining emissions; and b) net zero by 2045 for countywide emissions, improved from 2050.

It was explained that the COVID-19 pandemic had impacted CERP1 timescales, however significant progress was made in relation to many areas, including: Abbey Leisure Centre; Annfield Plain zero carbon depot; tree planting; and on-street charging initiatives.

The Board were given details of CERP2 and the climate change strategy and projects within CERP2 that had not been within CERP1.  It was explained that whilst funding was secured for CERP2, schemes beyond 2024 would be dependent on access to funding and that with tight resources, work must therefore target where the biggest impact could be made. 

The Chair noted the positive impact of food refuse cafes and The Bread and Butter Thing hubs preventing usable food going to landfill.  He asked as regards whether, when majority of staff were working from home during the pandemic, were there any positive impacts in terms of climate.  The Principal Officer, Climate Change and Sustainability noted work with Durham University in terms of the impact of working from home though noted this would be impacted by increasing energy costs and fuel prices.  He noted there was an increased interest in working from home and with people investing more in working from home there was a wider impact on climate change.

Councillor T Henderson noted the report referred to ‘we want all sections of the community and business to get involved to help transition to a greener, fairer and healthier society, economy and environment’ and asked how that would be achieved and if there were any consequences for those who were not on board.  The Principal Officer, Climate Change and Sustainability noted the Communication and Engagement Plan running over 12 months, with each month looking at a key theme, noting the current theme being electricity and heating.  He noted the Corporate Director of Neighbourhoods and Climate Change was holding remote sessions where people could ask questions directly.  He added there was increased communications and engagement and noted the Council being committed to retaining the Business Energy Efficiency Project (BEEP) post-EU funding and with new BEEP Zero, helping small and medium-sized enterprises (SMEs) to reduce their emissions.  The Principal Officer, Climate Change and Sustainability noted that climate change impacts most on vulnerable people and therefore there was work with transport and housing  ...  view the full minutes text for item 12.

Report of the Corporate Director, Adult and Health Services and the Director of Public Health, Durham County Council.

The Board received a joint report of the Corporate Director of Adult and Health Services and Director of Public Health on the County Durham Physical Activity Strategy (PAS) and a presentation given by the Public Health Strategic Manager, Michael Shannon (for copy see file of minutes).

The Board noted that the final PAS would include additional context and detail, including explicit detail on: how the strategy would be aligned to the approach to healthy weight, obesity, active travel and other strategic interdependencies; systems mapping to highlight connections with other key parts of the system; work between the strategy’s key collaborators, such as Public Health, Culture, Sport and Tourism, County Durham Sport.

It was explained that the aim of the PAS was to increase movement, and it was informed by the JSNA and JHWS.  It was noted that across County Durham communities there were huge variations in activity levels/sedentary behaviour and a system wide approach was needed to address this.

The Board noted the core principles of the PAS were:

•        Principle 1 – Person and community-centred

•        Principle 2 – Whole systems working and collaboration with partners

•        Principle 3 – Focus where the need is greatest

•        Principle 4 – Engaging individuals and organisations with the strategy – what can I do?

•        Principle 5 – Continued learning and evaluation

Councillor T Henderson asked how success would be measured.  The Public Health Strategic Manager noted from data, including Sports England ‘Active Lifestyle’, i.e. 150 minutes of activity a week, and the number of people who were active/inactive.

The Director of Public Health noted there were a number of colleagues in the room from a lot of NHS organisations and asked how they were being engaged with, linking to the action plan.  The Public Health Strategic Manager noted work with what had been Public Health England, with a number of round table events planned for large public sector organisations, such as the NHS and Durham University.

The Director of Integrated Community Services noted that an important aspect was that increased physical activity had a proven impact in terms of demand on NHS services and also benefits in terms of improved mental health and post-operative recovery.  He noted that prescription of physical activity and therefore it would be important to work with social prescribers.  The Public Health Strategic Manager noted there were links with social prescriber link workers and agreed as regards the importance and benefits as described.

The Director of Operations, Tees, Esk and Wear Valleys NHS Foundation Trust, Jennifer Illingworth noted that from the Mental Health Trust there were Activity Coordinators which had then an impact on the clinical professionals and that model could be something to tap into, having proven very useful and would be happy to share information.  The Public Health Strategic Manager noted the development of ‘Moving Together Champions’ and added that could be useful.  He reminded the Board that a previous Chief Medical Officer had stated ‘If physical activity were a drug, we would  ...  view the full minutes text for item 13.

Presentation of Director of Public Health, Durham County Council – for information only.

The Board noted a presentation from the Director of Public Health on the following public health campaigns (for copy of presentation see file of minutes).  The Board noted that questions could be directed to the Director of Public Health should any members require additional information on the key campaigns.

Resolved:

That the information contained within the presentation be noted.