Agenda and minutes

The Chair congratulated the North Tyneside Clinical Commissioning Group (CCG) who had received an outstanding rating by NHS England in an annual review of the CCG’s performance for 2018/19.

She reported that Duncan Selbie, Chief Executive of Public Health England, was due to visit North Tyneside on 14 October 2019 when he would meet the Elected Mayor, councillors, senior officers and staff to understand some of the public health challenges and hear about the great work being undertaken with partners across the borough.

In July the Care Quality Commission, HMI Constabulary and Fire & Rescue Services, HMI Probation and Ofsted advised that from September 2019 they would jointly inspect how services within a local area respond to children living with mental ill health. This Joint Targeted Area Inspection (JTAI) was designed to evaluate the multi-agency response to child mental health. There would be six of these inspections nationally and it was possible that North Tyneside could be selected. The Children and Young People’s Partnership was taking a lead in preparing for the possibility of an inspection and the  Board would be briefed more fully about the preparations at its next meeting.

The Chair welcomed Judy Scott, Chair of Healthwatch North Tyneside, to her first meeting of the Board.

To receive apologies for absence from the meeting.

Apologies for absence were received from Councillor K Clark, J Stonebridge (Northumbria Healthcare), K Simpson (Newcastle Hospitals), L McVay (Tyne & Wear Fire & Rescue), P Stanley (TyneHealth) and A Watson (Pharmaceutical Committee).

To receive a report on the appointment of Substitute Members.

Any Member of the Board who is unable to attend the meeting

may appoint a substitute member. The Contact Officer

must be notified prior to the commencement of the meeting.

Pursuant to the Council’s Constitution, the appointment of the following substitute members was reported:

S Thompson for P Stanley (TyneHealth)

D Campbell for K Simpson (Newcastle Hospitals)

K Soady for L McVay (Tyne and Wear Fire and Rescue)

P Conroy for A Watson (North of Tyne Pharmaceutical Committee)

Voting Members of the Board are invited to declare any

registerable and/or non-registerable interests in matters

appearing on the agenda, and the nature of that interest. They

are also invited to disclose any dispensation in relation to any

registerable and/or non-registerable interests that have been

granted in respect of any matters appearing on the agenda.

Non voting members are invited to declare any conflicts of

interest in matters appearing on the agenda and the nature of

that interest.

Please complete the Declarations of Interests card available at

the meeting and return it to the Democratic Services Officer

before leaving the meeting.

There were no declarations of interest or dispensations reported.

To confirm the minutes of the meeting held on 13 June 2019.

Resolved that the minutes of the meeting held on 13 June 2019 be confirmed and signed by the Chair.

To receive a presentation on the Government’s prevention green paper ahead of the closing date for consultation responses on 14 October 2019. The consultation paper is available at https://www.gov.uk/government/consultations/advancing-our-health-prevention-in-the-2020s

The Director of Public Health presented details of Advancing our health: Prevention in the 2020s, a consultation paper published by the Government seeking views on proposals to tackle the causes of preventable ill health in England.

The Government’s proposals represented a shift from prioritising caring for people when they are sick and considering how long people live as being the most important measure, to a greater emphasis on how long people live in good health.  Currently over 20% of years lived were expected to be in poor health and people in deprived areas tended to have lower life expectancy and spent a larger proportion of those years in poor health. The Government aimed for people not just to be passive recipients of care; but to be active in taking responsibility to preserve their own health by being equipped with the skills to help themselves. There was an ambition to add five healthy years to life expectancy by 2035.

The proposals were presented under the following three headings:

a)         Finding opportunities for prevention strategies, the 2020s would be the decade of proactive, predictive and personalised prevention;

b)         Tackling major public health challenges facing the UK through prevention, such as offering support to smokers, doubling the diabetes prevention programme and establishing alcohol care teams; and

c)         Building strong foundations to help people embrace healthier decisions, including shifting attitudes from a dependence on the treatment of ill health to health being an asset.

The Board noted that many of the aims and themes contained in the consultation paper had formed the basis of shared priorities within North Tyneside for many years. North Tyneside therefore appeared to be ahead of the game in terms of the Governments prevention strategy.  

The Board were asked to consider how it wished to respond to the wide range of consultation questions posed in the paper. It was acknowledged that it would be difficult to formulate a single response on behalf of the Board but that it would be desirable if there could be alignment across individual responses from partner organisations represented on the Board. The Director of Public Health suggested that she compile a response in her name and share this with members of the Board so that if there were gaps in the response they could raise these in their own individual responses. Age UK North Tyneside were currently undertaking an extensive consultation exercise in relation to its long term plans and the feedback obtained from this process could be shared to inform the preparation of the response.

Resolved that (1) The Government’s consultation paper Advancing our health: Prevention in the 2020s be noted; and

(2) the Director of Public Health compile a response to the consultation paper in her name and share this with members of the Board so that if there are gaps in the response they can raise these in their own individual responses.

To receive a progress report on the progress made by the Healthy Weight Alliance to develop a refreshed action plan to ensure there continues to be a systematic action to tackling obesity across the life course.

The Board received a report in relation to delivery of the strategic objective contained within its work plan 2019/20 “to tackle obesity across the life course”.

The Board were presented with a detailed analysis of data for North Tyneside which showed that there had been a reduction in the prevalence of excess weight (overweight and obese) for children in both Reception and Year 6. However the prevalence of obesity in Year 6 pupils had not reduced. Trend data for adults showed that North Tyneside had similar rates of obesity as England.

The high prevalence of obesity was a reflection of, and was a normal response to, the environment (social, economic, commercial) that many people found themselves in and not about individuals who "lack willpower”. However the evidence base and available interventions had traditionally focussed on changing individual behaviour.  The scale of the challenge in tackling both childhood and adult obesity required the whole system to work together.

A Healthy Weight Alliance had been established to develop a whole systems approach to addressing obesity and develop shared programmes of work. The Alliance had developed a delivery plan which described the actions, measures and anticipated outcomes required to reduce the prevalence of childhood and adult obesity as well as preventing obesity.  The Board were presented with the plan that had seven priority areas:

a)         Pregnancy and Early Years

b)         School Aged Children and the Whole School Environment

c)         Improving Access to Services for Target Groups

d)         Providing Support for Healthy Weight in the NHS

e)         Promoting Healthy Weight Environments

f)          Building Capacity and Engaging Communities

g)         Marketing and Public Health Campaigns

The plan had been informed by evidence of what worked, national guidance and the work of Active North Tyneside, which provided targeted interventions to improve healthy weight and increase access to physical activity.  The Board were presented with a copy of the Active North Tyneside Annual Report 2018-19.

The Board highlighted the need for timescales and targets to be incorporated within the action plan so that progress could be monitored. Members of the Board also considered the extent to which genetics contributed to obesity and the need for social policy to tackle the obesogenic environments, poor diets and sedentary lifestyles which led to obesity. Reference was made to examples of effective local policies including the Council’s supplementary planning policy restricting the development of hot food takeaways, the provision of nutritional breakfasts in Howdon and a partnership with Aldi to encourage healthy cooking at home.

Resolved that (1) the progress report in relation to delivery of the Board’s Strategic Objective No. 3 “To tackle obesity across the life course” and the trends and current data on obesity be noted; and

(2) the North Tyneside Healthy Weight Alliance Action Plan be approved.

To advise the Board of the proposals to create new Multi-Agency Safeguarding Arrangements (MASA) in North Tyneside.

In accordance with national guidance, the Council, the Clinical Commissioning Group and the Police had published a plan to implement new Multi-Agency Safeguarding Arrangements (MASA).

The Board were presented with details of the new arrangements which would be subject to a phased implementation from September 2019 and replace the existing Local Safeguarding Children Board (LSCB) arrangements. The plan set out the proposed structure of the MASA, its vision and guiding principles.  It was proposed that the existing LSCB and Children, Young People and Learning Partnership governance be integrated under the North Tyneside Strategic Partnership to strengthen partnership working and links with key forums, such as the Health and Wellbeing Board, Safer North Tyneside Partnership, and the Safeguarding Adults Board. An executive group would be formed comprising senior leaders and responsible for agreeing priorities, setting a budget, monitoring progress and agreeing scrutiny arrangements. Two new standing groups would replace the existing range of sub-groups in the LSCB governance: a Quality of Practice Group; and a Quality of Learning Group.

The potential to develop sub-regional safeguarding arrangements across a wider area had been explored to develop joint policies and procedures and a shared approach to peer review and challenge, performance analysis, and shared learning. 

Over the next two months, a series of workshops and development sessions would take place to determine more detailed matters including an approach to involving children and young people, understanding local need and performance management, compiling a communications plan and determining the funding and support required.

In considering the proposals the Board paid particular attention to the benefits of sub-regional safeguarding arrangements, how the voluntary and community sector would be represented within the MASA and how senior leaders from the Council and CCG would provide a link between the MASA’s executive group and the Health & Wellbeing Board. 

Resolved that (1)the intention to integrate the existing Local Safeguarding Children Board (LSCB) and Children and Young People’s Partnership governance as part of the new Multi-Agency Safeguarding Arrangements, under the North Tyneside Strategic Partnership governance structure be approved;

(2) the proposed next steps outlined within the report be endorsed; and

(3) the Board receive further reports regarding implementation of the new arrangements between September 2019 and 2020, and regular quarterly update reports following full implementation.

To consider a proposed plan for the Better Care Fund covering the financial year 2019/20.

The Board considered the Better Care Fund Plan for 2019-20. The plan set out how the £27.547m allocated to North Tyneside as part of the Better Care Fund would be used to deliver the Government’s aim of delivering person-centred integrated care, with health, social care, housing and other public services working seamlessly together to provide better care. The plan had been prepared in accordance with the policy framework published by the Government.

The plan represented a natural progression from the 2017-19 plan with some changes to take into account progress that had been made. One key feature of the plan was the development of an Integrated Community Frailty Service for North Tyneside through the reconfiguration of Care Point, Care Plus, Jubilee Day Hospital and the intermediate care beds at Howden and Royal Quays. The key components of the planned model would be a single point of access, an Integrated Community Frailty Team, integrated community beds and reablement and integration with primary care networks and community services. The Newcastle Hospitals Trust were engaged in the process of redesigning the frailty pathway and there would be an equality of service across the borough. 

The timetable for submitting the BCF plan was in advance of the timetable for agreeing a winter plan. Discussions with NHS and social care stakeholders had been organised by the Local Area Delivery Board (LADB) to prepare a Winter Plan for 2019/20. The BCF Partnership Board would liaise with the LADB, to determine the most appropriate use of the winter pressures element of the BCF (£1,031m). The Board acknowledged that the LADB was focussed on ensuring that there was resilience within the system to respond to pressures all year round and not just over the winter period.  Whilst North Tyneside was resilient to these pressures the BCF plan would allow for the development of community services which would help to reduce the pressures.  

Resolved that (1)the general principles of the use of the Better Care Fund, set out in the report be endorsed; and

(2) the Chair of the Health and Wellbeing Board be authorised to sign off any further revisions to the submission on behalf of the Board, before the deadline for submission to NHS England on 27^th September 2019.

To receive a presentation outlining the work of the Future Care Programme Board, its structure, its relationship with the Integrated Care System and with the Health & Wellbeing Board.

The Board received a presentation in relation to the role and structure of the Future Care Programme Board. The Future Care Programme represented the place based tier of decision making within the context of the development of a sub regional Integrated Care Partnership and the regional Integrated Care System. It aimed to deliver a patient centered sustainable health and social care system in North Tyneside with a focus on:

• Self care and preventing ill health
• Resilient communities and families
• People living longer and with better quality of life
• People staying as independent and as well as they can for as long as possible
• Support and care for those at the end of life.

The Board were presented with details of the programme’s overarching operational outcomes and an example of the more detailed project outcomes prepared for each project.

The Board explored the differences between the roles of the Programme Board and the Health & Wellbeing Board to ensure that there was no duplication. The priorities and work plans of the two bodies would however have to be aligned and this would be taken into account as part of the next review of the Health & Wellbeing Board’s work plan. Reference was also made to how there would be accountability within the system through longstanding partnership working arrangements and by individuals being responsible to their own organisations and for committing their organisations to a collective direction of travel.

The Board considered the role of General Practitioners and the Primary Care Networks in delivering the transformation of services and discussed the challenge for local authorities to engage with delivery of NHS England’s Long Term Plan.  A workforce programme board would consider the impact of transformation for the workforce ensuring that partners worked together to prepare workforce plans, identify needs and  new roles and deliver the required education and training programmes.

The Chair thanked officers for the presentation which had provided the Board with a better understanding of the role of the Future Care Programme Board and how it related to the wider health and social care governance structure.