Public Health and Partnerships Committee Minutes of the Meeting held on Monday 8 October 2012 in the Executive Room, Blaenau Gwent County Borough Council Present: Wendy Bourton - Independent Member (Third Sector) (Chair) Professor Helen Houston- Independent Member (University) (Vice Chair) Brian Mawby - Independent Member (Local Authority) Philip Robson - Independent Member (Community) Peter Sampson - Independent Member (Community) Mark Gardner - Associate Independent Member (Chair Stakeholder Reference Group) In Attendance: Will Beer - Principle Health Promotion Specialist Bobby Bolt - Divisional Director Primary Care and Networks Richard Bowen - Director of Planning Mererid Bowley - Consultant in Public Health Richard Crook - Acting Chief Officer Environment and Regeneration, Blaenau Gwent CBC Anita Hobbs - Executive Member, Social Services, Blaenau Gwent Jane Layzell - Consultant in Public Health Chris Overs - Divisional Nurse, Family & Therapies Gill Richardson - Director of Public Health Hayley Selway - Assistant Director of Housing and Communities, Tai Calon Apologies: Stewart Greenwell - Associate Independent Member David Jenkins - Chair, Aneurin Bevan Health Board Judith Paget - Chief Operating Officer 1
PART A Public Health & Partnerships Committee PHPC 0810/01 Welcome and Introductions The Chair welcomed everyone to the meeting, in particular Richard Bowen, Richard Crook, Hayley Selway and Anita Hobbs, and thanked Blaenau Gwent County Borough Council for hosting the first of the new style of meeting. PHPC 0810/02 Blaenau Gwent Outline of the area its needs and challenges Will Beer provided a presentation outlining the key indicators and profile of Blaenau Gwent. The following key issues were noted: There was a shorter life expectance and larger proportion of this in ill health Socio-economic factors underlying health problems Poor mental health Significant challenges in relation to health behaviour, particularly smoking and alcohol Brian Mawby commented that the current statistics were similar to those in the late 1990s and were problems which had existed for many years and need to be tackled at both Local Authority and Health Board level. Wendy Bourton stated that the work of the Chief Medical Officer and the work of this Committee would be very important in steering this work. Peter Sampson asked if the Health Board really wanted to change the communities, in the current economic climate, how could it be done and were there examples of where organisations had managed to make the changes required. Will Beer explained that it would require a number of different elements, including advocacy, change in public policy, legislation, quality of care to most deprived and for citizens to become more involved. Wendy Bourton commented that there would be evidence for the individual elements, but not all together. 2
PHPC 0810/03 Worklessness Public Health & Partnerships Committee Richard Crooke said that lessons learned from successful regions across the UK and Europe, showed that the areas shared the same characteristics of strong leadership and a clear sense of direction. It was not related to resources. Gill Richardson stated that it was known that education worked for social morbidity and career prospects and that the quality and length of education was vital. Bobby Bolt commented that the statistics and story did seem to be the same and that there was a long history which resulted in these. The actions required to address the issues were multifaceted, but highlighted that the face of primary care had changed dramatically over the past 10 years and a GP practice in Blaenau Gwent had received was the first in Wales, and among only 12 in the UK, to receive a Quality Practice Award. Wendy Bourton thanked Will Beer for the informative presentation and for the useful comments and discussion. Richard Crook provided a presentation on Worklessness, explaining that it included everyone who was not working who should be, and highlighted the current situation within Blaenau Gwent, including: Blaenau Gwent has the highest levels of workless householders in the UK Financial inclusion increasing as an issue Inactivity rates remain high Benefit changes will have a major impact across the community and across a range of services. The presentation outlined the current issues and actions and provided the action to be taken over the next 6 months, which included: 3
Defining the baseline needs and current position for each theme Identifying and engaging with relevant partners for each thematic area Mapping current activities within each theme to outcomes/outputs Reviewing best practice Blaenau Gwent Framework to be delivered by March 2013 Richard Crooke highlighted an Enterprise Project in Blaenau Gwent which worked to develop business ideas with individuals and which had led to 24 businesses starting using this model in the past 2 years. Gill Richardson suggested that this approach be raised at the joint Chief Executive Meeting. Phil Robson commented that a key issue was joining up strategies and their implementation. There was a lot of good practice of Health and Social Services working together in Blaenau Gwent and requested that this was not forgotten when setting up new structures/frameworks. Richard Crook commented that people could be trained, skilled and motivated but there needed to be jobs available. Hayley Selway commented that, as a partner organisation, they are often competing for a certain pot of money. If there was coordinated leadership in place to state what spectrum of support was required, the various organisations could deliver the different parts rather than all trying for the same. Mark Gardner said that the Health Board was coordinating a Health response to five plans and asked whether there was a way of coordinating the common themes and priorities via the G7. It was agreed that it was important to move from individual projects to a coordinated programme of work. It was agreed that this feedback would be provided to the Chair and Chief Executive of the Health Board by the Committee and to the Chief 4
Executive and Leader of Blaenau Gwent County Borough Council to raise at the G7. Action: W. Bourton/R. Crook Wendy Bourton thanked Richard Crook for a very thought provoking presentation. PHPC 0810/04 Welfare Reform Hayley Selway provided a presentation on the background, financial forecasts and Tai Calon response to the Welfare Reforms. A key issue of the welfare reform was the bedroom tax which identified who should be in one bedroom and would mean that, for example, someone in a 3 bedroom hours with 2 children away at university would be required to pay 25% of the rent themselves. It was explained that currently, housing benefit was paid directly to Tai Calon for the appropriate clients (currently 70%), but from October 2013 this would be paid directly to the individual. This single payment once a month could have a significant impact in terms of budgeting for those who receive it. Hayley Selway commented that the policy had been to build/find homes for life but the new reforms did not support this and there were limited/no 1-2 bedroom houses available for people to downsize. Wendy Bourton thanked Hayley for attending and providing a very useful presentation. PART B PHPC 0810/05 Declarations of Interest There were no Declarations of Interest relating to the items on the agenda. PHPC 0810/06 Minutes of the Meeting held on 11 July 2012 The minutes of the meeting held on 11 th July were agreed as accurate. 5
PHPC 0810/07 Action Log The Committee reviewed the Action Log and noted that all previously agreed actions had been completed. PHPC 0810/08 Flying Start Operational Policy Chris Overs presented the Flying Start Operational Policy which outlined the role of Aneurin Bevan Health Board Flying Start Staff, described their management and supervision and also described the role of the Flying Start Health Visitor as part of the wider Multiagency Team. The aim of the Policy was to ensure an understanding of Flying Start regarding its services to Families. Mark Gardner commented that the policy was well written and clear, but raised concern as to how to ensure that interventions for families were coordinated. Chris Overs explained that the policy was about the clarity of roles and responsibilities, but acknowledged that there were some concerns with some families regarding the number of people visiting them. Helen Houston commented that there were many roles and responsibilities that may fit to the needs of children and families in non flying start areas and asked if some of the roles and principles fed in to other areas. Chris Overs explained that lessons were being learned from Flying Start areas for roles such as Health Visitors across the whole Health Board regarding early intervention. The Committee approved the Flying Start Operational Policy. PHPC 0810/09 Guidance for Substance Misuse Area Planning Boards Gill Richardson provided an update and overview on the implications of the release of the Guidance for Substance Misuse Area Planning Boards from the Welsh Government, which stipulated a new 6
mode of planning, commissioning, delivery and monitoring of substance misuse services from Local Authority to a regional, Health Board level. The Committee noted the report and agreed that: The Health Board would participate fully and proactively in working with other Area Planning Board Partners to improve the planning, commissioning, delivery and monitoring of substance misuse services in their area The Committee would oversee the Health Board s contribution with regard to joint planning The Committee would receive further updates on progress of the implementation of the guidance. PHPC 0810/10 Immunisation Governance Gill Richardson set out the recommendations for a governance system for childhood and adult vaccination programmes by the Health Board. Gill Richardson highlighted that although the Director of Public Health had executive responsibility for the strategic oversight of the immunisations programmes, the responsibility for delivery was with staff and managers across the Health Board. Bobby Bolt stated that work was ongoing to link with prison populations regarding vaccinations. Helen Houston commented that there did not seem to be many people responsible for administering Hepatitis B. Gill Richardson explained that this was not a universal vaccination although the framework would be amended to reflect other vulnerable groups, including this and the prison population. Action: G. Richardson It was agreed that immunisation rates would be reported to the Committee on a regular basis. Action: G. Richardson The Committee approved the Immunisation Governance Framework. 7
Brian Mawby left the meeting PHPC 0810/11 Welsh Government Seasonal Flu Plan The Committee received the Welsh Government Seasonal Flu Plan, for information. PHPC 0810/12 Community Pharmacy Influenza Programme Gill Richardson provided an overview of the plans to engage community pharmacies in the seasonal influenza vaccination programme for 2012/13. It was noted that a pilot project would be undertaken to offer an influenza vaccination service from pharmacies in two Neighbourhood Care Networks (Caerphilly North and Blaenau Gwent West) where vaccination coverage was low. The success of this pilot would inform the roll out of the programme in future years. Helen Houston commented that primary care were currently responsible for maintaining vaccination registers and delivering vaccinations and asked if this would be closely monitored in the pharmacies. Gill Richardson confirmed that this would be monitored. The Committee noted the report. PHPC 0810/13 Environmental Health Protection in Wales Activity Summary 1/1/12 to 30/6/12 The Committee received the Environmental Health Protection Report, for information. PHPC 0810/14 Health, Social Care and Housing Forum The Committee noted the minutes of the Health, Social Care and Housing Forum held on the 21 September. Mark Gardner said that the work of the forum was going well and highlighted that the main item in the minutes related to Continuing Healthcare and all accommodation issues being dealt with in one place, which included the 8
opportunity to repatriate some Aneurin Bevan Health Board residents. It as agreed that this should be the subject of a Board Briefing Session. PHPC 0810/15 Any Other Business Public Health Impact There was a discussion as to whether Board reports should include a Public Health Impact assessment. This was agreed in principle, however, it was recommended that the Executive Team be requested to review the current impact assessments and whether they were being appropriately completed initially. Action: G. Richardson Health Improvement Review It was agreed that the Committee would receive regular updates on the national programmes of the Health Improvement Review, including local programmes where appropriate. Action: G. Richardson Issues to Report to the Board It was agreed that the Executive Team would be asked to look at how the Health Board would make changes to narrow the health gap in Blaenau Gwent and across Gwent as a whole. 9
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