Agenda and minutes

Minutes of the meeting held on 21 January 2021, attached.

RESOLVED that the minutes of the meeting held on 21 January 2021 be signed as a correct record.

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.

An update from the Director of Public Health.

The Director of Public Health outlined things were looking more positive in Devon compared to the rest of the country in having some of the lowest rates. However, caution should still be taken as rates were at similar levels to what they were in September last year, and not the lower summer rates. It was note that community transition was relatively low.

On Monday 12 April, Step 2 of the Government’s roadmap would begin, which included the opening of retail and outdoor hospitality.  Enhanced testing was being offered to all adults to be tested twice per week; people could find out more about how to access tests on the Devon County Council website.

The presentation from the Public Health consultant presented the UK summary which now included those vaccinated with their 1st doses, the number was 32,121,353.

The number of people who had received their second dose of the vaccine was now at 7,466,540.

The Devon statistics showed 60 cases in latest week equating to approximately 7.5 per 100k population.

The age profile was also shown, which highlighted the large decrease in the aged 80 plus cohort, and slightly higher rates in the working population ages 20-39, but numbers were decreasing overall in each age group.

The Director of Public Health was keen to stress that whilst rates had decreased, the number of cases were still not as low as they were last summer.

The data shown during the presentation was available at:

DCC Covid-19 Dashboard: Coronavirus dashboard and data in Devon -

Coronavirus (COVID-19)

National Coronavirus Tracker: Daily summary | Coronavirus in the UK

(data.gov.uk)

National Coronavirus Interactive Map: Interactive Map |

Coronavirus in the UK (data.gov.uk)

Members noted the need to monitor the number of people that accessed the data from the Dashboard website to see if people were still interested in the statistics and were concerned about COVID and to ensure these messages were cascaded throughout all Devon communities.

Report of the Chief Officer for Communities, Public Health, Environment and Prosperity, which reviews progress against the overarching priorities identified in the Joint Health and Wellbeing Strategy for Devon 2020-2025.

The appendix is available at https://www.devonhealthandwellbeing.org.uk/strategies/

The Board considered a Report from the Director of Public Health, on the

performance for the Board, which monitored the priorities identified in the

Joint Health and Wellbeing Strategy for Devon 2020-25.

The indicator list and performance summary within the full report set out the priorities, indicators and indicator types, and included a trend line, highlighting change over time.

The full Health and Wellbeing Outcomes Report for January 2021, along with this paper, was available on the Devon Health and Wellbeing website: www.devonhealthandwellbeing.org.uk/jsna/healthandwellbeingoutcomesreport  

The Report monitored the four Joint Health and Wellbeing Strategy 2020-25 priorities, and included breakdowns by local authority, district and trends over time. These priorities areas included:

· Create opportunities for all

· Healthy safe, strong and sustainable communities

· Focus on mental health

· Maintain good health for all

The indicators below had all been updated since the last report to the Board;

• Key Stage 4 Performance, 2019/20 - the percentage of pupils achieving grades 5 or above (in English and Mathematics GCSEs) in Devon was 48.7%. This was significantly lower compared to the England average of 49.9%;
• Overall Rate of Crime, 2019/20 - in Devon, the rate of crime from incidents recorded by the police was 47.4 per 1,000 population, a rate which was significantly lower compared to the England average;
• Emergency Hospital Admissions for Intentional Self-Harm, 2019/20 - in Devon, the rate of emergency hospitalisations for self-harm was 230.1 per 100,000 population, a rate which was significantly higher compared to the England average. Across Devon, there was variation in rates across the Districts. North Devon and Torridge rates were significantly higher compared to the England average (326.8 and 253.8 respectively).
• Self-Reported Wellbeing (low happiness score %), 2019/20 - the percentage of people who self-reported with a low happiness score in Devon was 5.7%. This is significantly lower compared to the England average of 8.7%
• Social Contentedness, 2019/20 - The percentage of service users who reported that ‘they had as much social contact as they would like’ in the Adult Social Care and Carers Survey in Devon was 45.8%. This was statistically similar compared to the England average.
• Alcohol-Specific Admissions in Under 18s, 2017-20 - in Devon, the rate of under 18s hospitalisations for alcohol specific causes was 51.4 per 100,000 population, a rate which was significantly higher compared to England average.
• Cancer Diagnosed at Stage 1 or 2, 2018 - the percentage of cancers diagnosed at an early stage in Devon was 58.4%. This was significantly higher compared to the England average of 55.0%. Across Devon, there was some variation across the Districts. East Devon, Exeter, South Hams and Teignbridge were significantly higher compared to the England average (58.9%, 60.4%, 59.6% and 58.8% respectively).
• Re-ablement Services (Effectiveness), 2019/20 - the percentage of persons 65 and over who were still at home 31 days after discharge into reablement/rehabilitation in Devon was 85.8%. This was significantly higher compared to the England average of 82.0%
• Re-ablement Services (Coverage), 2019/20 - the  ...  view the full minutes text for item 203.

Joint Report of the Associate Director of Commissioning (Care and Health) Devon County Council and NHS Devon CCG on the Better Care Fund (BCF), Quarter Return, Performance Report and Performance Summary on the BCF.

The Board considered a joint Report from the Associate Director of Commissioning (Care and Health) and NHS Devon Clinical Commissioning Group (CCG) on the Better Care Fund (BCF), Quarter Return, Performance Report and Performance Summary. The BCF was the only mandatory policy to facilitate integration between Health and Social Care, providing a framework for joint planning and commissioning. It brought together ringfenced budgets from Clinical Commissioning Group (CCG) allocations, the Disabled Facilities Grant and funding paid to Local Government for adult social care services. The Health and Wellbeing Board had oversight of the BCF and was accountable for its delivery.

The Report highlighted that hospital discharge was greatly affected by COVID-19. Delayed transfers of Care had started to decrease in March due to the requirement to reduce bed occupancy levels to 50% as part of the pandemicresponse, dropping to a very low level in April and May. In the period May to September delays had increased steadily as elective services recommenced.

Regarding permanent admissions to residential and nursing care, fewer older people were placed in residential/nursing care relative to population than comparator and national averages. From April, there was increased pressure within the system as a result of Discharge to Assess pathways out of hospital, which increased numbers of placements, particularly short-term admissions.   However, the number of permanent admissions had continued to reduce which was likely due to personal choice and available capacity due to outbreaks closing care homes to admissions.

The percentage of people still at home 91 days after hospital discharge into

rehabilitation / reablement services attempted to measure the effectiveness of rehabilitation and reablement services in keeping people out of hospital.

The 2019-20 outturn for this indicator was 85.8%, which was an improvement on the 2018-19 position of 80.1%.

Discussion points with Members included:

• Data around the number of readmitted patients back to hospital in Devon. This was monitored regularly, with a discharge cell that looked at readmission patients and those staying in hospital longer than 7 or 21 days. Work was ongoing to boost community services to support people to stay at home and not be readmitted to hospital.

RESOLVED that the Board note the national requirements and latest performance data.

Report of the Associate Director of Commissioning (Care and Health), attached.

The Board considered a Report of the Associate Director of Commissioning (Care and Health) on Devon’s housing and accommodation strategy for all adults.

The joint health and care strategy was developed by Devon County Council and Devon’s Clinical Commissioning Group, in consultation with a range of partners, including the District Councils, people and their families/carers.  It set out how DCC and the CCG would work in partnership to increase the range of housing and accommodation so that more people could live in their own homes and make informed and planned choices about where they lived throughout their lives.

The strategy outlined priority areas of focus to increase the range of housing and accommodation within the community. The priority areas were set out in the table below:

The joint workplans were being updated to take account of the impact of Covid-19 on the way people wanted to be supported going forward and on providers of care and support. Whilst the strategic direction of travel remained the same, partners were working to prioritise the key areas of focus over the next 12 months to realistically achieve change. This was being informed by discussions with each of the Districts to agree the practical actions for each area.

Governance arrangements were also being refreshed to ensure there was sufficient oversight of delivery of the whole housing and accommodation pathway and pipeline. It was important that the work taking place in each sector was supporting delivery of the wider strategic aims of this strategy for people.

An update by the Chair of NHS Devon Clinical Commissioning Group, attached.

The Board received the Report of the Chair of the NHS Devon Clinical

Commissioning Group which provided an update on CCG business, Devonwide and national developments within the NHS. It was intended to provide the Board with summary information to ensure Members were kept abreast of important developments affecting the NHS. The Board noted the

updates in relation to:

Mass Vaccination

The vaccination programme in Devon had been a huge success. Over half a million people had received their first dose and nearly all those most vulnerable had been vaccinated as well as those who cared for them.

• 593,532 people in Devon received a first vaccine dose between 8 December and 21 March, meaning about six in ten people aged 16 and over in Devon had received a first dose;
• 15,202 second doses were also given in the week leading to the 21 March, with over 45,000 second doses given since the programme began in Devon;
• The data also showed that in the South West, 78.6% of people who were aged 16-64 who were at risk or a carer (excluding residents of younger adult care homes) had had at least one dose – the highest of any NHS region.

Working with local communities to increase vaccine up-take

The CCG was working with people from minority ethnic communities and those who had learning disabilities to increase take up of the coronavirus vaccination.

Recent engagement work - Acting on suggestions made during the engagement, ‘vaccine ambassadors’ representing different communities would be working with local groups to provide information and reassurance, so people felt confident to accept an offer of vaccination when they were called as part of the national programme.

Integrated Care System

Devon had been approved by NHS England and NHS Improvement to be designated as an Integrated Care System for Devon (ICSD) from 1 April 2021. This would bring together the health, social care and wider partners to give patients and service users more joined up care and help improve the population’s health.

Members discussion points included:

• increased pressure on Primary Care due to the vaccination programme, a lot of the concerns received from the public by Healthwatch Devon were about accessing primary care services. It was noted that conversations were ongoing around keeping the workforce safe whilst maintaining a high level of services across primary care.
• the need for a session on the new Integrated Care System and how the role of the Board links in with their agenda; including the role of local care partnerships.
• the work of the Voluntary and Community sector partners in providing early help support given that many services were now integrated, such as social prescribing programmes. 

It was MOVED by Councillor Leadbetter, SECONDED by Diana Crump and

RESOLVED that the Board receive a session on the Integrated Care System and also invites Voluntary and Community Sector Partners to a future meeting to discuss their experiences of health and social care, and the opportunities available in general around the support for COVID-19.

An update from the Chief Environmental Health Officer, North Devon District Council, on the Homelessness Reduction Act.

The Board received a Presentation on the Homelessness Reduction Act and how this had been implemented in Devon.  The Presentation highlighted that:

·       The number of applications processed under the provision of homelessness reduction, had increased to 1365 applications between July-Sept 2020; which was extremely high.

·       Across Devon, the highest numbers had been seen in Exeter, followed by North Devon and Teignbridge. Numbers had increased as a result of COVID, which had proven to be challenging.

·       There had been very high demand for housing in Devon in general, which had made it very hard for Local Authorities to carry out homelessness prevention work.

·       There were some new funding streams available, including the Rough Sleeper Initiative Funding.

RESOLVED that the Board acknowledge the update and receive a further report in 12 months.

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 Boards Forward Plan.

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.

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 virtually, unless otherwise stated.

Meetings

Thursday 15  July 2021 @ 2.15 pm

Thursday 28 October 2021 @ 2.15 pm

Thursday 13 Janaury 2022 @ 2.15 pm

Thursday 7 April 2022 @ 2.15pm

Annual Conference

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

Meetings

Thursday 15 July 2021 @ 2.15 pm

Thursday 28 October 2021 @ 2.15 pm

Thursday 13 January 2022 @ 2.15 pm

Thursday 7 April 2022 @ 2.15pm