Agenda and minutes

Minutes of the meeting held on 14 June 2018, attached.  

RESOLVED that the minutes of the meeting held on 14 June 2018 be signed as a correct record subject to an amendment to the final bullet point of Minute *62 (Homelessness and Rough Sleeping) to read:

“North Devon District Council having a target to half the number of street homeless in the area”

Items which in the opinion of the Chair should be considered at the meeting as matters of urgency.

There were no items requiring urgent attention.

Report of the Chief Officer for Community, Public Health, Environment and Prosperity on the theme of ‘Loneliness in Devon’ and a presentation from Wellbeing Exeter.

The Board considered a Report from the Chief Officer for Communities, Public Health, Environment and Prosperity on a campaign around loneliness, focusing particularly on high-risk populations and the development of local projects and interventions to reduce loneliness in Devon.

The Report highlighted the considerable impact of loneliness on individuals’ health and wellbeing, with a greater risk of ill-health and a lower quality of life. Recent local and national studies on loneliness reported on certain characteristics associated with feeling lonely, including being female, being single or widowed, being in poor health, living in rented accommodation, having a weak sense of belonging to a neighbourhood; and with 5% of adults who reported feeling lonely, with those aged 16 to 24 feeling lonely more often when compared to older age groups. 

The Board also received a presentation from Wellbeing Exeter on easing loneliness and social isolation, which looked at the root causes of isolation, practical action, obstacles to engagement, and the overall aim of bringing people together to prevent loneliness.  The presentation highlighted several case studies to demonstrate the diverse effects of loneliness and focussed on collective solutions to build interdependence. 

The Board also received a further presentation by Health Watch Devon which had carried out an independent inquiry into loneliness in Devon and found that the three top factors that people felt caused loneliness were life events and trauma, personal circumstance and their psychological responses. The inquiry revealed the importance of social group membership in preventing loneliness and the top three interventions included spaces where people could be with others, one off community events and opportunities, and social group drop-ins such as coffee mornings. The presentation also recommended an alliance between local organisations on the issue of loneliness to drive a local response to the issue.

The Board discussed and asked questions on the following;

·         the need for greater communication and awareness on the effects of loneliness, which was currently a hidden topic, specifically highlighting the impact on mental and physical health;

·         raising awareness of how loneliness impacted on policy and organisational plans;

·         that loneliness and isolation had a significant impact on young people, especially young carers, as well as the older population;

·         the importance of community involvement in preventing loneliness;

·         the use of technology in helping to prevent loneliness, especially given the geographical nature of the County;

·         understanding where the high-risk areas were in the County (risk profiling), such as rural market towns, and to focus a campaign to meet the needs of the local population;

·         the use and accessibility of public transport to help connect people in rural areas; and,

·         the impact of loneliness on anxiety and depression.

It was MOVED by Councillor Leadbetter, SECONDED by Councillor McInnes, and

RESOLVED

(a)    that a campaign around loneliness be led and supported by the Board with the communications teams;

(b)    that consideration be given to the relationship between indicators of loneliness and health risk profiles; and

(c)    that a six-month update report on actions to combat loneliness be bought to a future  ...  view the full minutes text for item 71.

Report of the Chief Officer for Community, Public Health, Environment and Prosperity, which reviews progress against the overarching priorities identified in the Joint Health and Wellbeing Strategy for Devon 2016-2019.

The appendix is available at http://www.devonhealthandwellbeing.org.uk/jsna/health-and-wellbeing-outcomes-report/

The Board considered a report from the Chief Officer for Communities, Public Health, Environment and Prosperity on the performance for the Board, which monitored the priorities identified in the Joint Health and Wellbeing Strategy for Devon 2016-2019.

The Board received an ‘updates only’ version of the Health and Wellbeing Outcomes Report.  The report was themed around the five Joint Health and Wellbeing Strategy 2016-19 priorities and included breakdowns by South West benchmarking, local authority district and local authority comparator group, clinical commissioning group, and locality comparison, trend and future trajectories and inequalities characteristics. The indicators below had all been updated since the last report to the Board;

·         Adult Smoking Prevalence, 2017 – The latest figures from the Annual Population Survey (APS) indicated that 13.5% of the Adult population in Devon smoked. Rates remained lower than the South West, local authority comparator group and England; however, rates had increased slightly in Devon since 2014. Differences between local authority districts in Devon were not statistically significant, although rates in West Devon (4.9%) were significantly below the South West and England rates.

·         Feel Supported to Manage Own Condition.  In Devon during 2017-18, 59.6% of people with a long-term condition in the GP survey, felt they had enough support to manage their own condition. This was significantly higher than South West (57.3%), local authority comparator group (55.5%) and England (55.3%) rates. Rates had decreased from 2016-17 and were highest in the South Hams (62.8%).

·         Fuel Poverty, 2016 – Just under one in ten households in Devon were in fuel poverty (10.9%). Levels of fuel poverty had increased between 2011 and 2014 in Devon, but fell or remained stable in many other areas of the country. Since then, in Devon, rates had fallen from 2014. Despite this, rates continued to remain above the South West and local authority comparator group rates.

·         Estimated Dementia Diagnosis Rate (65+), 2018 – In April 2018, it was estimated that 7,577 people in Devon aged 65 and over were on a GP register for dementia. Recent data showed that Devon (59.4%) was lower than the South West (61.8%), local authority comparator group (63.5%) and significantly lower than England (67.5%) rates.  Within the county, the highest rates were seen in Exeter (69.3%) and lowest in the South Hams (44.7%). Devon did not meet the dementia diagnosis target set at 67% by NHS England.

The Report proposed changes to the way in which the outcomes report was reported in the future, to make it more accessible to all.  The Board received a presentation outlining how this would be achieved, which included a new streamlined technical report and an update on interventions relating to these indicators.  The Board welcomed the new presentation format and wished to receive similar style presentations in the future.

The outcomes report was also available on the Devon Health and Wellbeing website www.devonhealthandwellbeing.org.uk/jsna/health-and-wellbeing-outcomes-report

RESOLVED that the outcomes report be noted and accepted.

Report of the Head of Adult Commissioning and Health in Devon County Council and Senior Commissioning Manager in the Clinical Commissioning Group (ACH/18/88) on the draft joint strategy, Living Well with a Learning Disability in Devon 2018-2022.

The Board considered the Report of the Head of Adult Commissioning and Health at Devon County Council and the Senior Commissioning Manager of the Clinical Commissioning Group on the draft joint strategy ‘Living Well with a Learning Disability in Devon 2018-2022’.

The new joint strategy built on the progress made since the publication of the 2014-2017 joint strategy and set out a fresh approach to improve the lives of adults with learning disabilities across Devon, Torbay and Plymouth; to support them to be as independent as possible and lead meaningful lives within their communities.  The draft strategy encompassed the geographical area of Devon and covered the work undertaken by the two CCGs and three Local Authority areas.

The Report highlighted there were approximately 20,586 adults with a learning disability across Devon, with 3,530 of these individuals receiving adult social care services. Health and Social Care support across Devon, Plymouth and Torbay accounted for £130m of spend.  The draft strategy aimed to support Local Authorities and the NHS to commission quality support that promoted the independence of people with learning disabilities, within the context of significant financial challenges.

Some of the main aims of the draft strategy outlined in the Report included more appropriate housing that met the range of needs of people with learning disabilities, more support for people with learning disabilities to obtain employment, and improved access to healthcare for people with a learning disability.

Members and officers’ discussion points included:

·         a disability employment campaign “Ready When You Are”, led by Devon County Council, which aimed to make employers disability confident and increase the number of disabled adults in work to help increase their independence;

·         changing the cultural perception of disability to get more disabled adults into employment;

·         working with employers around myth-busters and the benefits of employing disabled adults;

·         the aim to engage with district authorities to implement the strategy and help monitor progress through performance management and indicators;

·         the importance of strong links with the Learning Disability Partnership Board;

·         ensuring that the voice of people with learning disability was articulated in the document; and

·         making the strategy accessible to all individuals.

An easy read version of the strategy is attached to these minutes.

It was MOVED by Councillor Leadbetter, SECONDED by Dr Pearson, and

RESOLVED

(a)    that the ‘Living Well with a Learning Disability in Devon 2018-2022’ Joint Strategy report be noted and endorsed;

(b)    that the Chair of the Learning Disability Partnership Board be invited to a future meeting to provide an update to the Board;

(c)    that the ‘Living Well with a Learning Disability in Devon 2018-2022’ Joint Strategy be taken to a committee of the Devon District Councils to further promote and engage with local districts on this matter and also circulated to local district Chief Housing Officers.

Report of the Head of Adult Commissioning and Health, Devon County Council and Director of Strategy, NEW Devon CCG and South Devon and Torbay CCG on an update of the Sustainability and Transformation Plan and the Integrated Care Systems Development.

The Board received a Report from the Head of Adult Commissioning and Health at Devon County Council and the Director of Strategy at NEW Devon CCG and South Devon and Torbay CCG on the progress of the Sustainability and Transformation Partnership (STP) and the Integrated Care Systems (ICS) and the Boards future involvement in the design and development of health and care integration. 

The Report highlighted the two-year STP report which had been recently published and provided the opportunity to reflect on the progress across Devon, Plymouth and Torbay; an update on recent national developments in relation to Integrated Care Systems and how the Board could help develop and design future work in relation to the emerging ICS in Devon. 

It was MOVED by Dr Johnson, SECONDED by Councillor Leadbetter, and

RESOLVED

(a)    that progress on the Sustainability and Transformation Partnership (STP) and Integrated Care System (ICS) Development be noted by the Board; and

(b)    that a development session be arranged for Devon, Plymouth and Torbay’s Health and Wellbeing Boards by the Clinical Commissioning Groups to discuss their future involvement and role in Devon’s Integrated Care System.

Report of the Chief Officer for Community, Public Health, Environment and Prosperity proposing objectives for the development of the Devon Health and Wellbeing Board following discussions about the role and priorities of the Board at the June 2018 Devon Health and Wellbeing Board Stakeholders Conference.

The Board received the Task Group Report on the development of the Devon Health and Wellbeing Board following discussions about the role and priorities of the Board at the June 2018 Stakeholders Conference.  It was highlighted that the Board should focus on health and not just healthcare, with a tiered approach to geography and democratic accountability at all levels. Other suggestions included closer working across all three Health and Wellbeing Boards in the Devon area, a specific role for the Board in joint commissioning of health and care, a stronger emphasis on the wider determinants of health, a focused role for the Board in holding the wider system to account and the development of links with stakeholders and local areas.

This led to the following objectives for Board development:

1.     Establishing alignment with other partnerships focused on the wider determinants of health;

2.     Establish a wider Health and Wellbeing Network to support, inform and disseminate the work of the Health and Wellbeing Board;

3.     Utilise a tiered approach to geography with democratic accountability at all levels and a two-way information flow to inform local priority setting;

4.     Strengthen and formalise the role of the Board in providing assurance that the commissioning plans of local organisations reflect boards priorities;

5.     Establish the Board’s role in the strategic planning of health, care and wellbeing; and

6.     Increase collaboration between Devon, Plymouth and Torbay Health and Wellbeing Boards.

Members discussion points included:

·         the need to engage and increase communication and understanding amongst the public regarding the Sustainability and Transformation Partnership (STP) and the important role of the Board in delivering this;

·         the ability of the Board to be able to hold the STP to account, through the Better Care Fund;

·         the strategic importance of working with partners such as the Police, with a further action point to invite a representative from Devon and Somerset Fire and Rescue Service and the South West Ambulance Service Trust to join as a Member of the Board; and

·         the importance of engaging with voluntary and third sector organisations.

It was MOVED by Councillor Leadbetter, SECONDED by D Rogers, and

RESOLVED

(a)    that the objectives for Board development and the action plan be approved;

(b)    that Board Members agreed to provide their support for the implementation of the action plan; and,

(c)    that Members of the Board be nominated to help support the delivery of the action plan:

(i)  that Mr D Rogers be nominated to champion loneliness;

(ii) that Dr P Johnson be nominated to champion dementia.   

Report of the Chief Officer for Community, Public Health, Environment and Prosperity on responses to the Homelessness Reduction Act from district authorities.

The Board received a Report on responses to the Homelessness Reduction Act across Devon District and City Councils, whether any related funding had been received and details of any local targets around the reduction of homelessness. 

The Board had a key in role in ensuring a collective system focus on population health and ensuring that the priorities as set out in the Joint Strategic Needs Assessment and the Joint Health and Wellbeing Strategy were being delivered across Devon. As part of this role, the Board requested information to seek assurance that activity to implement the Homelessness Reduction Act was taking place across all areas of Devon.

The Report set out a summary of responses received which included collaboration between services within local authorities and between authorities themselves, a reconfiguration and in some cases an expansion of teams in order to deliver the new duties and the national drive to support those at risk of homelessness, on-going engagement with the voluntary and community sector, staff training on the legislation and how authorities planned their response and New Burdens Funding received with some authorities accessing other national funding streams from Government departments.  Centrally-mandated targets had not been set, however where specific grants had been received to reduce homelessness, separate to funding the implementation of the new legislation, targets had then been set.

It was MOVED by Councillor Leadbetter, SECONDED by Dr Pearson, and

RESOLVED that the report be noted and accepted and an update Report be provided to the Board in 12 months.

Report of the Head of Service for Adult Commissioning and Health and the Deputy Chief Operating Officer, NEW Devon and South Devon & Torbay CCG on raising awareness of dementia across Devon, providing appropriate support post-diagnosis, and reducing the potential stigma of diagnosis.

The Board considered the Report of the Head of Service for Adult Commissioning and Health and the Deputy Chief Operating Officer of the NEW Devon CCG and South Devon and Torbay CCG which aimed to raise awareness of dementia across Devon, to provide appropriate support post-diagnosis and to reduce the potential stigma of diagnosis. 

The Report outlined the current and predicted demand for dementia support services and the progress of the STP mental health dementia workstream.  Around 2% of the Devon population (14,200 people) were estimated to have dementia, with the figure expected to rise to around 25,000 over the next 10 years, affecting nearly 3% of the population and around 6.5% of the over 65’s.

The following services were commissioned to help support people living with dementia and their families:

·         Dementia Advisor Service: the Council had a contract with the Alzheimer’s Society.  A Dementia Adviser or Dementia Support Worker enabled people with dementia and their carers to navigate the system and find the right information and support at the right time. It was aimed to expand this provision following national guidance and the learning from a gap analysis.

·         Memory Cafes: the Council had grant-funded the Devon Memory Café Consortium.  The Consortium supported people living with dementia and their carers through the Memory Cafe movement - ensuring they had access to peer support, information, advice and meaningful activities.

·         Care home education and support: a small pilot was funded last year with a view to expanding provision this year.

·         Other services such as the Carers contract, and grants to the voluntary sector, also support to those with dementia and their families.

Members discussion points included:

·         that Alzheimer’s training had been provided to the senior leadership team with the Council becoming a dementia-friendly organisation; and,

·         a dementia bus would be visiting Devon County Council in October which offered the opportunity for learning and providing information about the services available to people with dementia.

It was MOVED by Councillor Leadbetter, SECONDED by Dr Pearson, and   

RESOLVED that the Report be noted and an update to be provided by the Dementia Champion at a future meeting.

NIL

Nil

In order to prevent duplication, the Board will review the Council’s Scrutiny Committee’s Work Programmes. The latest round of Scrutiny Committees confirmed their work programmes and the plan can be accessed at; http://new.devon.gov.uk/democracy/committee-meetings/scrutiny-committees/scrutiny-work-programme/

The Board received a copy of Council’s Scrutiny Committee work programme in order that it could review the items being considered and avoid any potential duplications.

To review and agree the Board’s Forward Plan, attached.

The Board considered the contents of the Forward Plan, as outlined below (which included the additional items agreed at the meeting).

RESOLVED that the Forward Plan be approved, including the items approved at the meeting.

No items circulated since the last meeting.

Members of the Board received regular email bulletins directing them to items of interest, including research reports, policy documents, details of national / regional meetings, events, consultations, campaigns and other correspondence. Details were available at; http://www.devonhealthandwellbeing.org.uk/

No items of correspondence had been received since the last meeting.

Please note that dates of future meetings and conferences will be included in the Devon County Council meetings calendar. All will take place at County Hall, unless otherwise stated.

Meetings

Thursday 11  April 2019 @ 2.15pm

Thursday 11 July 2019 @ 2.15pm

Thursday 10 October 2019 @ 2.15pm

Thursday 16 January 2020 @ 2.15pm

Thursday 9 April 2020 @ 2.15pm

Annual Conference

Thursday 11 July 2019 @ 9.30am

RESOLVED that future meetings and conferences of the Board will be held on:

Meetings

Thursday 13 December 2018 @ 2.15pm

Thursday 11 April 2019 @ 2.15pm

Thursday 11 July 2019 @ 2.15pm

Thursday 10 October 2019 @ 2.15pm

Thursday 16 January 2020 @ 2.15pm

Thursday 9 April 2020 @ 2.15pm

Annual Conference

Thursday 11 July 2019 @ 9.30am