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Agenda item

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Meeting / Middlesbrough Health and Wellbeing Board
Date / 3rd November 2014
Title / Assurance Report – from Local Authority Chief Executive
Responsible Officer / Mike Robinson – Chief Executive, Middlesbrough Council
Purpose of Item / To provide Middlesbrough H&WB Board with:
  • assurance that it is fulfilling its statutory responsibilities; and
  • progress implementing the JH&WBS.

Summary of Recommendations
That Middlesbrough H&WB Board:
  1. Members to participate in the development programme commissioned to help delivery partnerships engaged in delivering Middlesbrough’s health and Wellbeing Strategy to maximise the impact of partnership working.
  2. Note the development of the draft PNA and take part in the consultation exercise and that the JSNA steering group be tasked to oversee the review of the PNA and to respond to supplementary statements
  3. Be assured that the 2015/16 commissioning intentions for the NHS, social care, public health and children’s services will be been developed in line with the Health and wellbeing strategy.
  4. Endorses the draft Youth Employment Strategy for consultation.
  5. That the H&WBB note the establishment of the Well-being in Middlesbrough Partnership work streams to address to the social causes of poor health and well-being.
  6. Notes the progress in establishing a Children and Young People’s Delivery Partnership ad receive an update at the next board meeting.
  7. Note the successful Phase 2 and HEADSTART submission and to receive a further update on Stage 3 application.
  8. Endorse the regional vision to Making Smoking history and achieving 5% smoking prevalence by 2025.
  9. Notes progress with implementation of the actions from the ‘prescription' to reduce premature deaths and receive further updates.
  10. Receives further updates on: Commissioning of the 5-19 health and well-being service and the Transfer of the commissioning of the 0-5 Healthy Child Programme (Health Visiting) and Family Nurse Partnerships (FNP) from NHS England area teams to local authorities
  11. Notes the submission of the Better Care Fund and receive progress further updates at future meetings.
  12. Notes the decision of the South Tees CCG Governing body to approve the IMProVE programme and receive progress reports throughout its phased implementation.
  13. Receive an update on the multi-agency demand management action plan at the next board meeting.
  14. Note the successful ageing Better submission and support the Ageing Better Partnership to achieved the outcomes of the fund and receive progress reports throughout its phased implementation

PURPOSE OF THE REPORT

  1. To provide Middlesbrough Health and Wellbeing Board with a summary of progress against the Joint Health and Wellbeing Strategy, update from the four delivery partnerships and assurance that the H&WBB is fulfilling its statutory obligations.

BACKGROUND

  1. The Health and Wellbeing Board has adopted its Joint Health and Wellbeing Strategy (JH&WBS) in October 2012. The Strategy’s vision is “to improve the health and wellbeing of our local population and reduce health inequalities”.
  1. The JH&WBS has four aims:

Aim 1 – Tackle the social causes of poor health

Aim 2 – Ensure children and young people have the best health and wellbeing

Aim 3 – Reducing preventable illness and early deaths

Aim 4 –Ensuring high quality, sustainable and joined up health, social care and wellbeing services

  1. The H&WBB has delegated responsibility for ensuring the delivery of each of the four Joint Health and Wellbeing Strategy Aims to four delivery partnerships.
  1. The four delivery partnerships are listed below :
  2. Aim 1 – Wellbeing In Middlesbrough Delivery Partnership
  3. Aim 2 – Children & Young People Delivery Partnership
  4. Aim 3 – Public Health Delivery Partnership
  5. Aim 4 –Health and Social Care Delivery Partnership

PROGRESS IN IMPLIMENTING THE JOINT HEALTH AND WELLBEING STRATEGY

  1. Each of the delivery partnerships have developed a delivery plan and agreed at set of performance measures to monitor the progress against the Health and Wellbeing Strategy aims. Detailed performance review and monitoring implementation of the plans is carried out in the delivery partnerships and this report provides a summary of progress to date (Appendix 1 and Appendix 2). There are a number of actions that require health and well-being board’s (H&WBB) strategic direction and approval and these are listed below:

Health and well-being board and delivery partnerships development programme

  1. That the H&WBB actively take part in the development programme commissioned to help individuals and organisations engaged in delivering Middlesbrough’s health and Wellbeing Strategy to maximise the impact of partnership working.

Development of the Pharmaceutical Needs Assessment

  1. That the H&WBB note the development of the draft Pharmaceutical Needs Assessment for Middlesbrough and take part in the consultation exercise and that the JSNA steering group be tasked to oversee the review of the PNA and to respond to supplementary statements

Development of the 2015/16 commissioning intentions

  1. That the H&WBB be assured that the process for developing the 2015/16 commissioning intentions for the NHS, social care, public health and children’s services will address the recommendations from the JSNA and the Health and wellbeing strategy.

Health and well-being board performance report

  1. The detailed performance report for October 2014 is attached at appendix 2. The performance summaries are presented below as part of the partnership updates.

Wellbeing In Middlesbrough Delivery Partnership Update – tackling the social causes of poor health and well-being

  1. Unemployment rates, including long term and Youth, again generally getting better but significantly higher than national averages. GCSE attainment, Pupil absence, first time entrants to the youth justice system, and 16-18 yrs. olds who are NEET, all improving but worse than the England averages. Domestic violence and abuse remains higher than the national averages.
  1. In 12/13 Homelessness Acceptances and households in temporary accommodation rates were improving year on year and better than the England Average.
  1. The Well-being in Middlesbrough Partnership has established the following work streams to improve outcomes in these areas.
  • Multi-agency crime and disorder – develop a multi-agency partnership to lead on the strategic assessment and coordinating actions to reduce crime and disorder across the town.
  • Environment – implementation of the One Planet Living action plan.
  • Tackling poverty – to address childhood poverty and welfare reforms.
  • Employment – with an initial focus on tackling youth unemployment. A Youth Employment strategy has been developed and plans are in placefor wider consultation.
  • Housing
  • Work is currently underway to review the domestic violence prevention action plan and the commissioning arrangements for preventative actions.

It is recommended that the health and well-being board:

  1. Endorses the draft Youth Employment Strategy for consultation.
  1. That the H&WBB note the establishment of the work streams to address to improve the well-being of the local population.

Children and Young People’s Delivery Partnership Update: Ensuring children and young people have the best health and wellbeing.

  1. The Children and Young people’s delivery partnership held its inaugural meeting on 14 October 2014. The partnership has agreed to hold a workshop in November 2014 to develop its work programme to ensure it addresses the priorities and recommendations from the health and well-being strategy. The partnership agreed to focus on the first workshop on improving early year’s health and well-being and to build on the work carried out last year in developing the Best Start Boro proposal that was not successful in securing Big Lottery Funding. The partnership will also monitor the implementation of the Big Lottery Fund: Fulfilling Lives (Headstart) programme stage 2 pilot programme and the development of the stage 3 bid.
  1. The performance framework (appendix 2) highlights that the majority of the indicators for children and young people’s health and well-being in Middlesbrough remain lower than the England average. Infant mortality rates have improved and are now below the national average. There are significantly less mothers initiating breastfeeding, and more smoking during pregnancy remains higher than the England average. Of note is the Under 18 conception rate which is almost double the England average, higher emergency admissions for under 18 self-harm.In line with the national and regional trends childhood obesity rates double between reception age and year six. Although the indicators are presented at a town level, further analysis is carried out to ensure the ward level variations across the town are understood in more detail.

It is recommended that the health and well-being board:

  1. Notes the progress in establishing a Children and Young People’s Delivery Partnership ad receive an update at the next board meeting.
  1. Note the successful Phase 2 and HEADSTART submission and to receive a further update on Stage 3 application.

Public Health Delivery Partnership update ; Reducing preventable illness and premature deaths

  1. The public health delivery partnership has developed an action plan based on the prescription to reduce preventable illness and premature deaths (Appendix 1). The partnership is also overseeing the commissioning of the 5-19 Health and well-being service to commence when the school nursing contract runs out in June 2015 and the transfer of the commissioning of the 0-5 Healthy Child Programme (Health Visiting) and Family Nurse Partnerships (FNP) from NHS England area teams to local authorities in October 2015. These two programmes will require collaborative working between the public health delivery partnership and the children and young people’s partnership and this is being achieved through briefings and cross representation on the delivery partnerships (the director of public health is a member of both delivery partnerships).
  1. The performance framework (Appendix 2) highlights a number of areas that remain below the England average. These include physical inactivity, poor nutrition and excess weight in adults remain higher than the England average. Premature deaths from cancer, respiratory disease and cardiovascular disease remain higher than the England average. Alcohol specific admission rates show signs of improvement but remain higher than the England average. Uptake of preventative programmes such as cancer screening programmes, immunisation programmes and early detection of long term conditions remains below the national average with variations at a ward level that mirror the patterns of deprivation across the town.
  1. The Public Health delivery partnership has agreed the following actions:
  • Ensure the learning from the Local Alcohol Action Area (LAAA) informs the refresh of the local plan to reduce alcohol related harm.
  • To develop a cancer prevention action plan for Middlesbrough based on the cancer prevention strategy.
  • A multi-agency preventing teenage pregnancy workshop was held in Middlesbrough. The conference action points are being used to inform the refresh of the local action plan,
  • Endorse the regional vision of Making Smoking History.

It is recommended that the health and well-being board:

  1. Endorse the regional vision to Making Smoking history and achieving 5% smoking prevalence by 2025.
  1. Notes progress with implementation of the actions from the ‘prescription' to reduce premature deaths and receive further updates.
  1. Receives further updates on the Commissioning of the 5-19 health and well-being service and the Transfer of the commissioning of the 0-5 Healthy Child Programme (Health Visiting) and Family Nurse Partnerships (FNP) from NHS England area teams to local authorities

Health and Social care delivery Partnership: Ensure high quality, sustainable and joined up health, social care and wellbeing services.

  1. The health and social care delivery partnership continues to provide oversight on the implementation of a number of key national and local policy areas. These include overseeing the development of the Better Care Fund, Care Act, Deprivation of Liberties, IMPrOVE and the Aging Better Big Lottery bid. Detailed plans are in place for local implementation and Middlesbrough was successful in securing from the Big Lottery funding for Aging Better. The delivery partnership has identified the need to ensure implementation of national policies is balanced with addressing key local priorities and is planning to hold a workshop to develop a multi-agency demand management action plan across health and social care.
  1. The performance framework (Appendix 2) shows a mixed picture of some indicators improving and others remaining below the England average. There are higher admissions to residential care homes and a higher percentage of emergency admissions within 30 days of discharge from hospital compared to the England average. Indicators for reablement and rehabilitation of care and delayed transfer of care are both below the national average. Indicators for the experience of people using Social Care services shows higher levels (compared to the national average) of satisfaction with the care and support they receive and also that those services make them feel safe than the England average.
  1. The work-stream has agreed the following actions to hold a multi-agency workshop to develop the partnership’s work programme and to continue monitoring the implementation of:

a)IMPRoVE

b)Aging better programme

c)Care Act

d)Better Care Fund

e)Carer’s strategy

It is recommended that the health and well-being board:

  1. Notes the submission of the Better Care Fund approved by the Health & Social Care Delivery Partnership and receive progress further updates at future meetings.
  1. Notes the decision of the South Tees CCG Governing body to approve the IMProVE programme and receive progress reports throughout its phased implementation.
  1. Receive an update on the multi-agency demand management action plan at the next board meeting.
  1. Note the successful ageing Better submission and support the Ageing Better Partnership to achieved the outcomes of the fund and receive progress reports throughout its phased implementation.

SUMMARY OF RECOMMENDATIONS

  1. Middlesbrough Health and Wellbeing Board are asked to:
  • actively take part in the development programme commissioned to help individuals and organisations engaged in delivering Middlesbrough’s health and Wellbeing Strategy to maximise the impact of partnership working within a highly complex multi –agency health and social care system
  • note the development of the draft PNA and take part in the consultation exercise and that the JSNA steering group be tasked to oversee the review of the PNA and to respond to supplementary statements
  • be assured that the 2015/16 commissioning intentions for the NHS, social care, public health and children’s services will be been developed in line with the Health and wellbeing strategy.
  • Endorses the draft Youth Employment Strategy for consultation.
  • That the H&WBB note the establishment of the work streams to address to improve the well-being of the local population.
  • Notes the progress in establishing a Children and Young People’s Delivery Partnership ad receive an update at the next board meeting.
  • Note the successful Phase 2 and HEADSTART submission and to receive a further update on Stage 3 application.
  • Endorse the regional vision to Making Smoking history and achieving 5% smoking prevalence by 2025.
  • Notes progress with implementation of the actions from the ‘prescription' to reduce premature deaths and receive further updates.
  • Receives further updates on: Commissioning of the 5-19 health and well-being service and the Transfer of the commissioning of the 0-5 Healthy Child Programme (Health Visiting) and Family Nurse Partnerships (FNP) from NHS England area teams to local authorities
  • Notes the submission of the Better Care Fund and receive progress further updates at future meetings.
  • Notes the decision of the South Tees CCG Governing body to approve the IMProVE programme and receive progress reports throughout its phased implementation.
  • Receive an update on the multi-agency demand management action plan at the next board meeting.
  • Note the successful ageing Better submission and support the Ageing Better Partnership to achieved the outcomes of the fund and receive progress reports throughout its phased implementation

Report prepared by: Kathryn Warnock, Principal Corporate Development Officer and Edward Kunonga, DPH

Tel: 01642 729559, E mail:

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