Agenda and minutes

Apologies were received from Cllr Jonathan Owen, Cllr David Williams, Cllr Doreen Huddart, Cllr Shabir Pandorand Cllr Rachel Eden.

Cllr Wayne Fitzgerald and Cllr Robin Moss were attending as substitutes.

Cllr Nick Chard, Deputy Chairman of Fire Services Management Committee, was attending as an observer.

There were no declarations of interest.

Jeremy Hughes, Chief Executive of the Alzheimer’s Society, will be attending the Community Wellbeing Board to give a presentation on the subject ‘Bridging the divide: Dementia - where health and social care have to meet’.

The Chairman introduced introduce Jeremy Hughes, Chief Executive of the Alzheimer’s Society, to the meeting of the Community Wellbeing Board. Jeremy gave a presentation to the Board on the work of the Alzheimer’s Society, in particular with a focus on where health and social care have to meet in regards to dementia.

In the discussion the followed, that following points were made;

·         The Chairman expressed a view that it was very positive to hear that the Alzheimer’s Society shared so many views with the LGA and requested Member Services circulate Jeremy Hughes presentation after the meeting.

·         Jeremy explained that in the previous General Election both Labour and Conservative manifestos had been quite similar on the issue of dementia, which was very positive news for the Alzheimer’s Society.

·         Jeremy also informed the Board that the Alzheimer’s Society want to see a cross-party 20 year programme with no cost interventions.

·         It was suggested that LGA officers could assist the Alzheimer’s Society in developing their ‘Councillor’s Guide to Dementia Friendliness’ and in producing a guide to dementia friendly communities and neighbourhoods.

·         Members expressed a view that understanding the carers point of view was of great importance.

·         The importance of good parks and public libraries to a dementia friendly community was emphasised.

·         The Councils role in neighbourhood partnerships was also emphasised.

·         A view was expressed that a strong presence of dementia on Television would be useful in campaigning for further awareness.

·         The importance of dementia friendly public transport.

·         Jeremy informed the Board that Sadiq Khan as Mayor of London had committed to make London a dementia friendly city, and Bristol was also highlighted as working to make itself more dementia friendly.

·         A view was expressed that local authorities could lead the way in promoting flexible working arrangements to assist carers in staying in employment, and that more should be done to support those with dementia to remain in employment.

·         A view was expressed that dementia should be higher on the agenda in Parish Councils.

·         The importance of dementia friendly Council buildings was raised, as was the importance of engaging the young in conversations around dementia – the Society had a school’s pack that councils could use.

Decision

The Community Wellbeing Board noted the presentation from Jeremy Hughes, Chief Executive of the Alzheimer’s Society.

Action

Alexander Saul, Assistant Member Services Manager, to circulate Jeremy Hughes presentation.

Officers to liaise with the Alzheimer’s Society around LGA input into the ‘Councillor’s Guide to Dementia Friendliness’.

Caroline Tapster, Director of Health and Wellbeing System Improvement, gave an update of the improvement and support offer to health and wellbeing system leaders from the LGA’s Care and Health Improvement Programme (CHIP). She highlighted the bespoke support that CHIP undertake in local authorities and that much of this work had been around prevention. Caroline emphasised that what good looks like in a Health and Wellbeing Board (HWB) was variable but that those that were most effective had a strong focus on place. In particular the ability to develop relationships between local leadership and organisations was crucial.

Alyson Morley, Senior Adviser, also outlined options for further improvement and policy activity to increase the power and influence of HWBs. It was emphasised that it was clear from the discussion regarding Community Wellbeing Board priorities at the September Board meeting that the Health and Wellbeing Board should have more power to make positive change in their area. Alyson raised that this view was reflected by local government colleagues nationally following the results of the summer survey.

Alyson brought Board Members attention to the three options detailed in paragraph 13 of the report. These were highlighted as a campaign to include in the NHS Mandate the requirement that Sustainability and Transformation Partnerships and Integrated Care Systems must include HWBs in the development of plans, the option to commission case studies to identify how HWBs can this would work and the final option to use the key learning points from the case study work to inform and develop the health and wellbeing systems improvement offer.

In the discussion that followed, the following points were raised;

·         Members emphasised the value of the course available and peer reviews in helping to increase the power and influence of HWBs.

·         Views were expressed that it was unlikely legislative change around the role of HWBs would happen in the near future.

·         The key to successful HWBs was the input of four key individuals from the health and local government side, but they were all very busy so supporting them to take the lead would be important. There was also a need to embed placed based approaches to wellbeing in all local government and NHS policies.

·         Cllr Nick Chard highlighted the value of integrating the fire sector into Health & Wellbeing Board’s and raised that the fire sector was represented at Kent and Medway’s Health & Wellbeing Board.

·         The sharing of good practice via case studies would be a useful way for HWBs to learn from each other.

·         A view was expressed that in some areas NHS colleagues would benefit from better embracing the role HWBs.

·         Members expressed a view that local authorities should be strongly encouraged to take up the CHIP offer to work on improving the role and profile of their HWBs.

Following a query from the Chairman it was confirmed that officers did have capacity to undertake all three of the options detailed in paragraph 13 of the report.

Decision

That the Community Wellbeing Board;

1.    Noted the  ...  view the full minutes text for item 3.

Mark Norris, Principal Policy Adviser, updated the Board on progress with the LGA green paper for adult social care and wellbeing and on the announcements for adult social care in the Autumn Budget. He informed the Board that the responses to the LGA green paper for adult social care and wellbeing had been some of the most comprehensive the LGA had received. He also raised that it was possible the government’s adult social care green paper be published in either December or January.

Following to this update views were expressed by members of the Board that the LGA’s response would need to be well timed and emphasise the need for sustainable funding. Concerns were also raised as to whether the consultation would run too close to local elections.

Alyson Morley, Senior Adviser, emphasised that at this time both the adult social care green paper and NHS long term plan could all change from what was currently anticipated prior to their publication. Alyson also informed the Board the adult social care green paper and NHS long term plan were expected to be published together.

It was suggested and agreed by the Board that if there was a December publication of the adult social care green paper and NHS long term plan that the best approach from the LGA would be to produce a brief immediate response followed in the new year by a more detailed and considered response.

Decision

The Community Wellbeing Board;

1.    noted the update; and

2.    agreed that, should there be a December publication of the adult social care green paper and NHS long term plan, a brief immediate response from the LGA be produced followed by a more detailed response in the new year.

Action

That should there be a December publication of the adult social care green paper and NHS long term plan officers produce a brief immediate response from the LGA followed by a more detailed response in the new year.

Paul Ogden, Senior Adviser, introduced the report informing the Community Wellbeing Board of the new vision for prevention strategy that had been published by the Health and Social Care Secretary Matt Hancock MP. In particular Paul brought Members attention to the following;

·         It was highlighted that paragraph 11 of the report detailed the headline policy commitments.

·         It was raised that this included a commitment from the Health and Social Care Secretary to extend healthy living by five years by 2025.

·         The Board were informed that there was very rarely a mention of local government and no mention of funding.

·         It was also raised that cuts to public health remained a concern for local government.

·         It was emphasised this was an opportunity to continue to lobby for the additional resources local government require to improve public health.

In the discussion that followed, the following points were raised;

·         Cllr Nick Chard expressed a view that the fire sector was a community asset that could assist in improving public health. 

·         It was raised that there had been valuable evaluated evidence shared at the LGA Prevention at Scale event on 21 November 2018.

·         A view was expressed that the LGA could focus more on scaling up approaches to public health such as in emphasising a focus on parks, libraries and schools, and seeking government funding to pilot public health initiatives.

·         A view was expressed that continuing to link up public health and housing would be useful.

·         Paul raised that there was a lot of work the LGA had done in linking public health to housing and economic growth as well as to the fire and rescue service. Officers had been engaged with the National Institute of Health Research and there could be a further discussion with them about how academic research could demonstrate the impact public health work had.

·         Paul also emphasised that in some areas smoking remained a major issue.

·         A view was expressed that local authority care assessments should ask questions regarding socialising and exercise in future.

·         It was emphasised that the LGA needs to continue to hold government to account regarding promises on prevention.

Decision

The Community Wellbeing Board noted the Secretary of State’s Vision document and provided comments to shape the LGA’s ongoing engagement.

Actions

·         Officers to incorporate comments from the Community Wellbeing Board into the LGA’s ongoing engagement.

·         The LGA to continue to lobby government to see a reversal of the £700 million worth of cuts to the public health grant and continued investment in prevention and early intervention funding in the next Spending Review.

·         Officers to draft a response that reflects steers from the Community Wellbeing Board, and any further feedback from partners such as the Association Directors of Public Health (ADPH), Association Directors of Children’s Services (ADCS) and individual councils.

Mark Norris, Principal Policy Adviser, introduced the Update on Other Board Business report. The following additional updates were provided by members of the Board;

·         Cllr Sue Woolley informed Members she had represented the Board at a rural health APPG. She also raised that of particular interest were the concerns raised around the quantity of nursing homes de-registering in rural areas in recent years.

·         Members requested an update regarding concerns with Allied Health Care be circulated to the Board.

·         The autism workshop at National Children and Adult Services Conference was raised by members as having been valuable.

·         A view was expressed that the London Building Society was undertaking some interesting work around equity release that could be of interest to the Board.

·         A view was expressed that a national data base around loneliness could be valuable in future

·         Cllr Shields informed the Board that he had represented the Board at the British Dental Associations recent summit which had proven of great interest. He expressed a view they would have benefitted from further discussion around the practicalities of behavioural change.

·         The Chairman informed the Board that the 2018 National Children and Adult Services Conference had gone very well.

·         The Chairman also shared he had attended the Kings Fund annual conference as a speaker.

Decision

The Community Wellbeing Board noted the Update on Other Board Business.

Actions

Officers to circulate an update email on Allied Health Care.

The note of the previous meeting was agreed.