Agenda and minutes

Minutes of the meeting held on 13 January 2022, attached.

RESOLVED that the minutes of the meeting held on 13 January 2022 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.

Verbal update from the Director of Public Health.

The Deputy Director of Public Health updated the Board on the current position relating to the Coronavirus.

Free Covid testing had ceased on 31 March and so the pattern of testing had changed.  Devon still had high levels and were currently above the England rate, with 1 in 11 people who may currently be impacted with Covid.

There were now few restrictions in place and the focus now was on protecting those most vulnerable and ensuring that eligible people were tested accordingly. Vaccinations were now available for the 5-11 age group.

Hospital numbers were still high, but were coming down, with numbers in high dependency units low.  Covid was now being treated the same as other respiratory infections.  Any new strains of the virus would be tracked closely.

The message had changed to stay at home if you had symptoms, which could be flu or Covid, and not to mix with others who were vulnerable.

Discussion and questions included:

-       Vaccination rates and the focus on communication campaigns to encourage uptake;

-       Measures remained quite consistent across other countries and valuable learning from best practice.

The Board were referred to the following online data:

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)

Report of the Director of Public Health, which reviews progress against the overarching priorities identified in the Joint Health and Wellbeing Strategy for Devon 2020-2025, attached.

The Board noted the Report of 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 latest Health and Wellbeing Outcomes Report, along with this paper, was available on the Devon Health and Wellbeing website.

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 following indicators had been updated since the last report to the Board as follows:

Alcohol-Related Admissions (Narrow), 2020/21

The alcohol related admission rate per 100,000 in Devon was 424.3. This was statistically better than the England rate of 455.9. East Devon, Mid Devon, South Hams and West Devon were all statistically better than the England average and Exeter and North Devon were statistically worse.

Cancer Diagnosed at Stage 1 or 2, 2019

The proportion of cancer diagnosed at stage 1 or 2 rate for Devon was 57.8%. This was statistically better than the England value of 55.1%. However, most areas in Devon were statistically similar to England, with only East Devon and Exeter performing statistically better.

Emergency Hospital Admissions for Intentional Self Harm, 2020/21

The rate of emergency hospital admissions for intentional self harm in Devon was 211 per 100,000, which was statistically worse than the England rate of 181.2. Exeter, Mid Devon, North Devon and Torridge were all significantly worse than the England rate and only West Devon was statistically better.

Injuries Due to Falls, 2020/21

The rate of injuries due to falls in Devon was 1662.4 per 100,000. This was statistically better than the England rate of 2023.0. Almost all areas in Devon were statistically better than the England rate except for North Devon and West Devon which were statistically similar.

Reablement Services (Effectiveness), 2020/21

The proportion of older people (65 and over) who were still at home 91 days after discharge from hospital into reablement services in Devon was 67%. This was statistically significantly worse than the England proportion of 79.1%. All local authority areas in Devon were also significantly worse than the England rate.

Self Reported Wellbeing (Low Happiness Score), 2020/21

The percentage of people self reporting low happiness was 7.2% for Devon. This was statistically significantly better than the England proportion of 9.2%.

Discussion and questions covered:

-       A masterclass on the navigation tools available on the JSNA web pages was offered to those Board Members requiring assistance in obtaining information.

-       It was noted that an update on Self-Harm would be provided to the next Board meeting in July.

Joint Report of the Interim Director of Integrated Care (Devon County Council and NHS Devon Clinical Commissioning Group), attached.

The Board received the Report from the Interim Director of Integrated Care (Devon County Council and NHS Devon Clinical Commissioning Group) on the Better Care Fund, which covered latest performance. 

The Better Care Fund (BCF) was the only mandatory policy to facilitate integration between Health and Social Care, providing a framework for joint planning and commissioning. The BCF brought together ring-fenced 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 set out the latest performance for the following BCF metrics:

-       Avoidable Admissions

-       Length of Stay

-       Discharge to Normal Place of Residence

-       Residential Admissions

-       Reablement

Nationally, Government had indicated its intention to continue with the BCF for 2022/23 and in that year to introduce further development of the BCF for future years; and the national announcement of Planning and Reporting Guidance for 2022/23 would be published in May.

Discussion covered voluntary sector investment and close working in cluster areas to develop community services.

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

Annual Health Protection Assurance Report for the Health and Wellbeing Boards of Devon County Council, Plymouth City Council, Torbay Council and Cornwall and the Isles of Scilly Councils 2020/21, attached.

The Board received the Health Protection Committee Annual Report 2020/21,

which provided a summary of the assurance functions of the Devon, Cornwall

and Isles of Scilly Health Protection Committee and reviewed performance for

the period from 1 April 2020 to 31 March 2021.  Due to the time lag in reporting data for 2020/21, the report contained some information in relation to activities undertaken in 2021/22, to provide a more timely picture of progress.

The report considered the following key domains of Health Protection:

·         Communicable disease control and environmental hazards

·         Immunisation and screening

·         Health care associated infections and antimicrobial resistance

·         Emergency planning and response.

The aim of the Health Protection Committee was to provide assurance to the

local Health and Wellbeing Boards that adequate arrangements were in place

for prevention, surveillance, planning and response to communicable disease

and environmental hazards, to protect the public’s health.

Priorities agreed by Health Protection Committee members for 2021/22 were to:

1   Maintain response to COVID-19 and ensure preparedness and resilience to respond to future pandemics or health protection emergencies. As part of this, lead efforts to target vaccination inequalities

2   Recover screening and immunisation programme delivery, coverage and uptake

3   Embed and strengthen community infection management services to prevent and respond to infections throughout the community

4   Work to reduce the incidence of healthcare associated infections and to tackle antimicrobial resistance across our communities

5   Focus efforts to address health inequalities, in particular health protection pathways for migrant and homeless communities

6   Maintain a focus on local action to address the climate emergency.

RESOLVED that the Health Protection Committee Annual Report 2021/22 be noted and accepted

Representatives from the voluntary sector will attend and give a presentation.

The Board received a presentation from representatives from Devon Communities Together, Devon Voluntary Action and Public Health Devon entitled Devon VCSE and Public Sectors Creative Collaboration in a Pandemic.

The presentation covered:

-       Context

-       How has the VCSE sector worked together differently?

-       How have the sectors worked together differently?

-       How have we communicated differently?

-       What have we done differently together?

-       DCC Perspective

-       What have we learned? Together is better!

-       Next Steps

The development of a new Devon, Plymouth and Torbay VCSE Assembly model was being looked at to pilot and develop new ways of working that would benefit communities.

Members’ questions and comments included:

-       The pandemic had affected the number of volunteers coming forward, but it was hoped that with the help of campaigns on social media, numbers would improve.

-       Welcome the voluntary sector coming together collaboratively to improve working in the community.

The Chair thanked Officers for the presentation.

RESOLVED that an update be provided to the Board in six months’ time.

[A copy of the presentation is attached to these Minutes.]

Public Health report, attached.

The Board received a Public Health draft overview of the available data on alcohol use and harm among those under 18 years of age in Devon, including:

-       Risk factors

-       Prevalence

-       Hospital admissions

-       Deprivation

-       Treatment

-       Referral routes

-       Needs and Outcomes

-       Summary

Members’ questions covered:

-       Although the use of cannabis had been referred to, it was not within the scope of the paper, but could be followed up by the Public Health specialist.

-       Whether there was any Scottish data on the minimum unit pricing for alcohol which, again, could be followed up.

Presentation by Dr Paul Johnson

The Board received a presentation from the Director of Commissioning at NHS Devon CCG on the Devon General Practice Strategy, Refresh for 2022.

Learning from the pandemic had shown how different primary care could and should be and, with increased pressure on the system, it was now time to revise the strategy, taking into account learning from experience.

The presentation covered:

-       Background

-       Progress to date

-       Why a Refresh?

-       Approach

-       Three Phases

It was anticipated that the refreshed strategy would go to the CCG’s Primary Care Commissioning Committee in July 2022.

In discussion, Members’ questions covered:

-       Surveys had gone out to every patient and member of the public to ensure engagement with everyone (e.g. the vulnerable and unpaid carers); and it was suggested that ambassadors to unpaid carer groups could be contacted;

-       Workforce issues was an important issue, and key in the strategy would be looking at viable and robust models for the future.

[A copy of the presentation is attached to the Minutes.]

An update from 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, Devon-wide 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, including:

-       The Integrated Care Board would come into being on 1 July 2022, following the passing of the new legal framework, to be chaired by Dr Sarah Wollaston.

-       The digital GP Locum Service, enabling GPs to be located anywhere in the UK to carry out online consultations to patients across Devon.

-       The engagement programme involving online focus groups set up to listen to local people on waiting lists.

The Chair wished to acknowledge the pressure that the NHS and Adult Social Care was under.

Nil

In order to prevent duplication, the Board will review the Council’s Scrutiny Work Programme.

The Board reviewed the Council’s Scrutiny Work Programme in order to 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 any 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 on the Devon Health and Wellbeing website.

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