Health and Adult Social Care Scrutiny Board - Thursday 30th May 2024 6.00 pm
May 30, 2024 View on council website Watch video of meetingTranscript
Transcript
. Good evening and welcome to the meeting. The first item of business is the election of chair chairman for the year 2004-2005. Can I ask for a nomination for chair? Thank you, Councillor Delaney. Can I nominate Councillor Sleigh, please?
Thank you, Councillor Delaney and can I have a seconder for that, please?
I'd like to second that, please.
Okay, thank you, Councillor Gethin. Can I ask if there are any further nominations for chair?
Okay, thank you. Can I see all hands in favour, Paul, Councillor Sleigh.
Okay, thank you, congratulations, Councillor Sleigh. You have a chair, if you're happy to move over to the chair seat. Thank you.
Sorry, Councillor Wilson, I saw a hand up. Did you attempt to speak then, apologies?
No, that was the, yeah, proving of the appointment. Thank you, thank you.
Okay, thank you, Joseph, and welcome everyone. It's my task now to appoint a vice chairman and I would like to nominate Councillor Gethin, please.
Can I have a seconder? Councillor Kensey.
I'll have you to second that.
Thank you, Councillor Gethin. Do you want to come over here yet? Thank you.
You're welcome to the officers and new members. I look forward to working with you all. Thank you.
Joseph, apologies, please.
Thank you, Chair, to confirm, received apologies from Councillor Mrs. Harlan and Councillor Holt is substituting on her behalf and also received apologies from Councillor Farr.
Okay, any declarations of interest members? No? No?
Sorry, gender item five, questions and deputations. Thank you, Chair, to confirm, none have been received.
Okay, a gender item six of the minutes from our previous meeting held on the 13th of March, 2024.
Page is 7 to 14. Are we all happy to accept these minutes? True reflection, yes?
Actually, there's only probably four of us here, weren't they? Yes. So, yeah, okay, thank you. That's great.
Okay, a gender item seven is to refresh joint local health and well-being strategy and consultation plan.
The purpose of the report is under the Health and Social Care Act 2012, health and well-being boards have a structure to your responsibility to produce a joint strategic needs assessment and develop and implement a joint local plan
like local health and well-being strategy, quite a lot, so the strategy considers the findings of the JSNA story of Solly Hall.
Solly Hall local outcomes framework and other needs assessments.
Progress against the strategy will be monitored through Solly Hall, the local Solly Hall outcomes framework.
Can I please invite Nürja to give her a presentation? Thank you.
Thank you, Chair, and as you yourself have noted, it is a little bit of a mouthful and there's three things that I'd like to do, a whistle-stop tour of, as part of my presentation today, and I've prepared some slides to help us just go through the paper ahead of a discussion if that's all right.
So, Joseph, thank you for sharing those slides, if we could move on, thank you.
So, what I want to do is introduce the strategy to you, which has been through a development session with the Health and Wellbeing Board, and gone once again to Health and Wellbeing Board for consideration, and on the back of that discussion in March, it has come here to screw to me today, ahead of it going out to consultation.
So, I want to talk you through just the headlines of the strategy, how we measure the progress using the outcomes framework, present the consultation plan, consultation and engagement plan, and get your feedback ahead of that consultation commencing.
If we could move on, please. So, we've talked a bit just then in the introduction about some statutory responsibilities of the Health and Wellbeing Board.
These are written down in the Health and Social Care Act that we need to produce and needs assessment.
We need to understand what is going on for our population in terms of health and wellbeing, and then use the findings from that needs assessment to inform and shape a strategy, a joint local Health and Wellbeing Strategy.
And that's what we've done. We've got a story of Solihull. There are links in the paper to our needs assessment, which we call locally the story of Solihull.
And then we have used the findings from that to develop the priorities of the strategy.
If we could move on, please, Joseph.
Yes, if we could move on to that slide.
Now, what we've done in terms of the priorities of the strategy, those priorities look huge.
But what I'm pleased to be able to say to you is that they are underpinned by very specific findings.
So although they look like broad terms, underneath there are some very clear things that have led to that priority being included in the strategy.
So we're not trying to take on the world. We're going to be quite focused in the development and implementation of a year one delivery plan.
And in the strategy document itself, which was circulated with the papers, and there are links to it in the covering report.
You will see things like, for example, too high a proportion of our babies being born with a very low birth weight in comparison to England.
So it's those sorts of things that we will want to be focusing on to be able to check.
Are we doing the right things? Are we working in an effective way to make a difference and check on that progress in a routine way with our outcomes framework?
So they are our six high level priorities for the strategy.
For each one, we have tried to identify those key data items from the needs assessment to underpin that priority.
Though I will say when it comes to improving end of life care, the reason we've included that one is because we feel that the data isn't good enough.
So we actually think there is good work going on, but we're not that.
We think there is room for improvement in the way we capture that good work.
So that was the reason why we included that one.
And then the final one cuts across the life course.
That's about improving the mental health of people of all ages.
And so that includes, you know, are you having a healthy pregnancy or are you experiencing postnatal depression?
Does that then affect the attachment that you have with your child?
Does that then affect the mental well-being of that child and so on?
So you can see that looking at mental health really lends itself to taking a life course approach.
If we could move on, please, to the next slide.
A big thing that we want to do differently with the implementation of this strategy is change the way the health and well-being board works with other boards,
committees, task and finish groups, steering groups.
I don't mind what they're called.
If that is where the engine room is, if that's where the governance is of a key specific topic that is relevant to the strategy,
that's who I want the board to go and work with.
The health and well-being board is not a doing board.
It's an overarching strategic board.
And so it needs to understand where is the work happening.
It doesn't need to duplicate, it needs to understand where is that work happening and is the work happening in the best possible way.
So what we have proposed and has landed well with health and well-being board is to develop a series of spotlight sessions
where we bring in those key committees or forums or steering groups in to have a discussion about their area that contributes to the strategy.
And these are the questions that would, if you like, form the basis of that sort of dialogue.
So it's not scrutiny, it's a collaborative approach, it's a constructive dialogue.
And it includes how can the health and well-being board help you accelerate improvement.
So I'm really looking forward to those spotlight sessions getting scheduled in as part of the year one delivery plan.
If we could move on, please.
Oh, sorry, just one other thing about that slide.
If we could go back just for a moment, when this strategy was getting developed, there was a counselor who put forward a really healthy challenge,
which was if this strategy is high level, how do you assure yourself that you're making a difference on the ground to real people?
And it was a really important challenge.
And that is why one of the questions five and six as part of the structure of such a dialogue session feature,
because if you think about that's the engine room, that's where the work is happening,
that it's that committee or steering group where they are closer to the front line,
that's the right place to understand, are you hearing the voices of your service users?
Is your service or your initiative being shaped by the voice of communities?
And that's how I feel I want to rise to the challenge that has been set.
I've like, how do you make sure something that's so high level as the health and well-being strategy actually still has a thread to people on the ground?
It feels like a really important point to make. Thank you, Joseph, if we could move on.
So then we want to think about how do we measure progress against the strategy,
and I'm pleased to be able to say that Solihal has a local outcomes framework that has been developed in partnership
over the past 18 months, I would say, and it's got those 10 outcome areas that you see on the slide.
But what I want to say is underneath each of those outcome areas, there is a suite of indicators,
so that when you take them as a group, it helps to reflect where the progress is happening against that outcome area.
And that's how we intend to measure the progress of the strategy.
And when we go out to consultation, the strategy and the outcome framework will all be available for people to digest, if you like, to help themselves help them be familiar with the sorts of things we're trying to achieve.
Joseph, if we could move on, please.
So we are planning for an eight-week consultation throughout June and July, the idea being that then in August, we will take stock of what's come back and improve the strategy ahead of it being finalized at health well-being board in September.
And one of the things that we really recognize is that because it is a high-level strategy, it may not land with members of the public in a way a consultation about a very specific health service might land.
So we do appreciate that, and we're recognizing that actually the really key partners and stakeholders that we want to reach out to are the people that are part of our integrated care system, our members of the health and well-being board, our voluntary sector, our schools, and so on.
We want to make sure we're going out to our partners and key stakeholders, holding engagement sessions.
We absolutely want to make it open to the public as well and to businesses because improving the health and well-being in its widest sense affects everybody, but we are cognizant of the fact that it's going to land with certain partners and stakeholders more than the public, if you like.
Joseph, if we could move on, please. So that's what I've just outlined. We really want to make sure we reach out to partners and colleagues, but still keep it open to the public and wider society, if you like.
Joseph, if we could move on from that slide, this slide sets out how we want to go about doing this, and we really want to schedule in those engagement workshops with key stakeholders.
We're going to be improving our website, and I'm sorry it's not been done in time for today. In fact, I would have shown it to you, but we're going to have a web page that's got the strategy, got the outcomes framework, got our inequalities and prevention strategies.
So people can see how these things work and fit together, as well as our very few questions to two people around, Do you think anything is missing? How would you be able to help?
and so on, so we want to keep it really short.
Joseph, if we could move on, they're the questions that we want people to respond to, and we seek the feedback on these areas. What do you think we've overlooked, but I'm bearing in mind that wherever possible, it's founded on data.
What do you think the year one priority should be, and what can you do to support delivery? That felt really important to ask. And Joseph, if we could move on, that's the end of my presentation. So I'm happy to take questions on the strategy, the outcomes framework, or indeed the consultation plan. Thank you.
Thank you for that. I must say it's a very comprehensive report. Can I just ask about these spotlight sessions? Have you said when they're going to start and where about in the community will they be taking place?
That's a good question. It's all under development at the moment, and I'm conscious of the fact that we're going out to consultation. One bit of good news that I will say is that in the July Health and Wellbeing Board, there is going to be a focus on aspects of priority one and two already.
So we're not, we want to wait, but we don't want to wait if you see what I mean. We want to crack on, but we also want to be mindful of receiving feedback. But that feels really important to do. So there's going to be a focus on children and young people in that session in July.
But I like your idea, I like your question that you've raised about where will they take place. There is something as well about getting out and about. So I'll make sure we factor that in as we develop the plan for the year ahead. Thank you.
Yeah, because I think I've got to think about the rural community, haven't we, you know, the hard to reach communities. So yes, I'm glad you mentioned that. Thank you. Sorry. Okay, members questions.
Councillor Mckenzie, Councillor did I own it and then Councillor Jones. Thank you, Chair. Where will you be advertising them if somebody isn't on the internet hasn't got a smartphone. Where will it be advertised in terms of consultation. Yeah.
That's a good question. I'm going to take that back to my colleagues with whom I'm developing the communications and engagement plan. So I think that's where I think engagement needs to come into it rather than just asking for things to be done online.
So I think what I'd like to do is go back to both my communications colleagues and our colleagues in the community's directorate who have those, you know, where there's already an infrastructure in terms of locality meetings and very good connections with our volunteering community sector and parish councils, for example, and I can take a steer from those locality meetings as to where would be good to go for some further engagement.
Thank you. I just come in there again. Is there any thoughts about experts by experience, you know, in the past, you know, they've really helped us along the way. I just wondered if you've got any thoughts on that this time around.
Absolutely. So our health partners are a very key part of the list that we've got identified, and I'm picturing a bit of a cascade going on where we reach out to people, for example, from the integrated care board who are on the health and wellbeing board, but through them, they will know their patient groups, for example, and so there can be a sort of cascade going on there and we can reach out in that way.
Thank you. Okay. Can't delay me. Thank you. Just three things from me.
Firstly, are the priorities in order of priority or are they just all equal priorities? The second one, are you consulting with your young people, because quite a few of the priorities are around your young people, so it seems right that we should ask them what we think.
And then the third thing is really just a suggestion. You could reach out to the VCFSC Mental Health Collective, because there's over 100 organisations on there that would help with the consultation on that as well.
I mean, that's brilliant, and that's exactly why we come to scrutiny, I think, to get that feedback and get that steered. So thank you for that.
And yes, again, through the school's representatives on the health and wellbeing board, I'm envisaging a similar sort of cascading event.
So through that conduit, if you like, we can reach our children and young people audiences. So yes, we can do that.
Oh, are they all prioritised? Not in the way that they're presented like you saw on the slide, because the life course approach helps with readability, I think.
So that's why we presented it in that way. I think there is something about how we prioritise what gets included in the year one delivery plan and what do we prioritise as part of those spotlight sessions.
So there is still some work to be done on drawing up that plan, and it is one of the questions, so we also wait to see what will come back.
So that was the first question, although prioritised in any way, what was your second question?
She would be young people. If I missed anything else, no, the third one was just the point about reaching out to the VCSFA mental health collective.
That's brilliant, thank you.
So you're saying people with additional needs?
Yeah, the VCSFA mental health collective is a group of voluntary organisations across Birmingham and Sully Hall that have anything to do with mental health.
So that's right from birth to grave and across this specific ones across Sully Hall, so it's a good way to reach out to lots of organisations through one contact.
I should say as well, which I forgot to mention, so thank you for reminding me, the mental health delivery plan in and of itself is undergoing quite the refresh.
So I absolutely hope that they've been feeding into that process, and the mental health needs assessment is underway.
And my understanding is that that will be available in the second half of this year, so I feel like in terms of scheduling a spotlight session on that, it will be after that is done.
So there's something about being a bit pragmatic as well about the schedule.
Thank you.
Okay, thank you.
Councillor Jones.
And welcome to the board.
Is that worth it?
I say I'm new to the board, so really my question is just a bit of background, really.
I'm wondering, you mentioned that the outcomes are based on data that you have already.
I'm wondering how involved the stakeholders were in identifying those priorities, or whether the consultation only comes after the priorities have been identified.
The priorities have been identified by what the data are telling us about Solihal.
So that's been first and foremost where it has come from.
Alongside, for example, in this section about improving the health and well-being of young people, where we haven't necessarily had access to the local data, we've made reference to the national picture.
For example, in that section there's something about nationally we're seeing quite a marked increase in emergency admissions related to mental health in amongst our young people's population.
So I think we just felt like we could not acknowledge what's going on in terms of a national picture as well as what's the local data are telling us.
But in terms of working through then coming up with those priorities, that has been through so far the health and well-being board development session and the health and well-being board and now is getting ready to go out to consultation.
So if people think things have been overlooked, we absolutely want to hear.
While we're talking about data or while you're talking about data, you alluded to end of life care and the data being out of date.
There's not so much out of date more, it was really hard to access.
So we just want to make sure that as a system we are much better about collecting that data and being able to report on it and evidence that what we do around end of life care is of the highest quality.
So because we couldn't get hold of it, I just thought there's room for improvement there. So that's why it's been included.
So it might sound a silly question, but why is it so difficult, or has it been so difficult to get hold of it?
All I can say is we tried and tried and couldn't get it. And so I feel like that is something that should be a focus quite soon if you like, so that my hope is that it can actually be quickly remedied.
I've heard anecdotally that very good work is going on. I just think as a system we need to be smarter evidence in it.
Okay, thank you. And Council Wilson. Hello.
Hello, thank you, Chair. Thank you for the report and all of the efforts that have gone into that.
I have two questions and a suggestion.
So one question is to do with the fact that haven't been able to look up the CIFPA acronym.
So just, well, I couldn't look at December difference between that and nearest statistical labor.
So I just an explanation about that. And secondly, these priorities and measures of progress are in the context of a cost of living crisis.
And many crisis in those very services that we want to show improvement in or improvement outcomes for those users are.
So how have we contextualized that?
And the third one is just following, maybe from Council Delaney suggestion.
That a consultation by a soccer standing advisory committee for RE might be a good way into the religious community in terms of an efficient way in contact.
Thank you. We'll make a note of that one. Make sure that that's included as part of our consultation engagement plan. Just addressing your third point first.
Thank you. When it comes to CIFPA, thank you, charted institute of public finance and accountancy.
And what they do is they have an algorithm for comparing one local authority with another.
Now, the innards of that algorithm are not in the public domain because that's there if you like their intellectual property.
But we use the sort of findings of their algorithm to compare ourselves to other local authorities that they consider to be similar to us.
So we make that comparison, but then we also compare ourselves to other local authorities with a similar socioeconomic deprivation score.
And in the outcomes framework, right at the end, we give more of an explanation of that.
But it is really important that we compare ourselves as a borough to other local authorities.
And what the outcomes framework has shown is that often Solihull can look good in relation to England, Solihull can look good in relation to the West Midlands.
But when we compare ourselves to other similar local authorities, we might be a bit more middle of the road,
in which case we should be asking ourselves, hang on a minute, how comes we're not doing better.
The downside of that benchmarking is that there's always a time lag with the data because you've got to collect that data, submit that data,
allow for that comparison to be made, and then collect the benchmarking information with our own data and present it.
So there's always a time lag, but what we try to do to negate the effects of that is including the narrative where we might know that there's a more up-to-date local picture.
And the one that most sort of most starkly applies to is the rates of falls happening in Solihull,
where we look like we are in the red and we've got an aging population.
So if we don't do something about that now, those numbers and then the rate will only get worse.
What we know locally is that our falls rates are coming down.
It's just that there's a time lag to reflect that in the outcomes framework.
Thank you, Sir. I think my question was, in a sense,
if you had to choose between a measure and it was between sit for a nearest statistical neighbor,
which one would you say is the most reliable and why, I guess, would you never choose?
Yeah, so we present both, and I think it's just good to have that well-rounded picture.
And you know, you know where we stand in terms of the region and in comparison to England.
And I think it might well vary from one indicator to another in terms of how you then want to focus your energy.
Thank you. And then, yeah, so that other question about how do you contextualise progress,
given the, I guess, progress of cost of living prices and of, you know, continual pressure on our services?
So it will show itself differently for different indicators.
So, for example, our child development at two to two and a half years really took a dip during and immediately after the pandemic,
the acute phases of the pandemic, and then slowly we've seen that steadily improved.
But for certain other things, and I'll give you an example, Councillor, that's not included in the outcomes framework,
but it's on a different dashboard, is our breast cancer screening.
That's taken a real dip, and we're not yet back at where we want to be in terms of pre-pandemic levels.
And there's definitely been a kind of combination of the pandemic affecting take up combined with pressures in the system,
creating some ongoing problems that go beyond the acute phase of the pandemic.
So it really does vary from one indicator to another.
Okay, thank you. Thank you very much.
You've mentioned breast cancer, but there's bowel cancer as well, isn't there?
There is a lot of work to be done. I think we all appreciate that.
Okay, Councillor Holt.
I'd just like to focus on priority four, the support for healthy ageing.
I'm surprised it's a priority four because of the increase in the age population.
And a number of points have been touched upon already, I hope I don't repeat.
Looking at end-of-life care, it's troubling to say you don't have data.
I'll be right in saying that...
That's really best, and this is quite a good reason.
Sorry, there's someone speaking.
Would it be right to say that as far as end-of-life care is concerned,
that's generally if someone's looking to die at home, going to be a GP,
and a district nursing collaboration.
What role would the local authority have in that kind of situation?
I'm just trying to envisage it because I think it's a particularly pressing issue,
especially about the current debate about euthanasia and all that kind of thing.
We need to have a very careful service that meets the needs of our people.
I'll be interested in exactly what you think about that.
First of all, priority four doesn't mean it's lower.
I'm just going back to the...
Well, we wanted to just help with readability in terms of taking priorities across the life course.
So that's the only reason it's got that position.
In terms of end-of-life care, as a public health practitioner,
I'm caring about health outcomes for our population regardless of where in the system services are closest to that person.
So I'm caring about people dying with dignity in the place of their choice, et cetera.
And as I said, that's independent of who is most closely connected to that person at the time of them dying.
Because there can be a long time in the run up to someone dying.
And actually, it's that whole experience conducted with dignity and with respect and so on.
And there will be many different services connecting to that person.
And that could be, yes, of course it's the health service.
It could be secondary care. It could be primary care.
But it could well be social care, but it could also be our voluntary and community sector.
It could be many different parts of the system, as I like to call it.
And it's those different parts of the system that are all around the health and wellbeing board.
And everybody should be caring that our population, when it is end-of-life, are dying with dignity and in the place of their choice.
I suppose my concern is that at that critical point, when that moment comes,
where are we in that picture? Are we excluded?
Because it is a GP and a nursing-driven objective.
And if we don't see the data, it concerns me that we aren't seeing the problems that may arise.
And it's kept within the health service and we're not seeing it.
It concerns me too. And I think there are other data items, for example,
feedback from friends and family that is, I think, routinely captured.
And that's the sort of data that we should be accessing and taking into consideration.
That's very encouraging then. In terms of the dementia,
another data issue about reducing the waiting time for memory assessment service.
If elderly patients aren't actually on the radar because they're waiting,
then we have got no data, have we? Presumably.
I think they do need to capture waiting times as well as diagnosis.
So, when we conduct those spotlight sessions, we'll...
I suppose my point is some patients don't get onto a waiting time because they're pushed away from going to the clinic.
And I suppose the point is how close to the fire are we putting the GP's feet to make sure that we're capturing that information?
We're going to do our best in those sessions and make sure we go to the right parts of the system and subject matter.
I'd encourage you to, because I think there's a lot of perverse drivers in the NHS to push people away from waiting lists.
So, you'll never see them. And I think this is, for me, a very important aspect of your work, really.
Thank you.
But we do collect data for primary care, don't we? So, would it not start there?
Um, prior to somebody going on a waiting list? I mean, I don't know.
Absolutely. That's where you would go in the first instance. Yep.
Okay. Is that okay, Councillor HALT? Yep. Sorry, Councillor Gethan.
Thank you. Um, my questions are around the data.
So, you've already said that you've struggled for data for improving end of life care.
Are there any other areas where you've struggled to obtain the data that's needed to put this together?
That was the one that really stood out for me, I have to say.
And I think on the whole, we're doing well with our data and indeed with what's in the pipeline.
So, I've talked about the outcomes framework. Apart from the indicator that looks at the gap in life expectancy between our most deprived and least deprived, all the other indicators are at borough level.
And what we're doing beside the outcomes framework is developing an inequalities dashboard where we want to look at in borough variation.
So, for example, as a borough, we look good when it comes to smoking. But if we were to look at smoking levels in the north compared to other more affluent areas, we would see a quite a marked variation.
And we as a borough need to understand that variation because we are a borough of such contrast.
And we're making good progress. So, it will never quite be what you totally want it to be, but we're making good progress.
So, that does cover what I was going to say about the analysis that's behind this.
So, are we going looking at constituency or north-south or are we looking at wards in particular just so that we have a better idea?
So, I think that's really important.
And also looking at some of these, why are some of these higher in Solihull than other areas?
So, you know, I've looked through this and there's just so many things that are jumping out at me that obviously I know that you'll be looking into this further.
But there's just a lot of why's and just it would be nice to have a bit of a deeper analysis on it.
But also on prioritise two on page 30, we've got there as well about the percentage of young people we send achieving level two, three qualifications.
And I'd like to point out, yes, we're higher than England and our neighbours, but still I think instead of just aiming to be better than those, I think we still need to aim higher.
I think that's really important, that we're not just comparing, we're actually aiming for the best that we can.
And then my only other query was around mental health for SMH needs, especially for children.
I think we can all agree that at the moment, that is a huge struggle for our children.
Personally, I don't think the provision is as it should be, I think we're letting down a lot of young people, which is having a huge impact, not only on the future of the young people, but also on families.
So it would be nice, there's only four lines, written about mental health there, I think there needs to be a lot more.
So it would be nice to have a bigger, even if it was a priority of its own, I think that would be ideal to be there for anybody out there that knows any young children are struggling, and how we're going to work with the schools, because I think that's really important.
So it's not just, it's a whole team around the child, isn't it? So it's working with the families, it's working with schools, it's health care.
And how is that going to be done, because currently it's not there, so we need something better.
So I don't know if the mental health delivery plan is on the forward plan for this scrutiny, but it is definitely being refreshed with that needs assessment, and it seems like a sensible thing that gets some dedicated airtime here.
One thing I want to say in response to you is that you're absolutely right, I mean we've got some data that tells us about emergency admissions for young people when it's a mental health condition.
But you see there will be quite large numbers of young people experiencing poor mental health who aren't an emergency admission, and we need to make sure they're getting supported too, and all I'm doing there is reflecting what we're seeing as part of the national picture.
Because I don't really know that cohort well for Solihull, but I am, if you like, inferring from that national picture, an issue for us and what is it we're doing about it, but I hope that that would get addressed within the mental health delivery plan.
And the final point you were saying about can we go a bit deeper, can we get under the skin of this a bit more, and that's what I want those spotlight sessions to do.
And if we go back to those questions, one of the questions is what are we doing to address inequality, and for them to be able to answer that question, they need to understand the in-bourer variation.
They need to get under the skin of it and tell us, okay, we're doing something a bit more tailored in this part of the borough because they've got some specific challenges, that sort of thing.
And one of the other questions we also ask is what are you doing around preventing this from escalating.
Okay, just for members information really, we've got the mental health delivery plan on our work plan agenda for the October meeting.
So, you know, we are.
That sounds like a good time considering what the work is going on.
Thank you.
Okay, Councillor Colle, thank you for waiting.
Thank you, Chair.
Having just gone through a bereavement myself, I'd like to look at priority five end of life care, and you've got two sources of data there, GPData, and data from the NHS.
But I like to think it was a third set of data that you could look at, which is care homes and home care workers.
Because they're working with friends and family, which you want to capture the data on that, and they've got bucket loads of data that you could tap into there.
So, I really do think that there is a third one, and I do think that the information they could derive is very important.
So, I would like you to consider that as a third issue.
I agree, I welcome that feedback, and when we schedule in the spotlight session on end of life care, we'll be taking that point away and making sure that that is part of our preparations.
Because I'm telling you, from recent experience, they're totally separate from GPData, and the hospitals in a lot of instances are just not involved.
So, it is the care homes and the friends and family that are doing the majority of those people in the last 12 months of life.
And the second point is, support healthy aging. I notice that you've got the age group of 85s and over.
You have my sympathy there. I think that data is going to be very hard to get, because there's a lot of these people who are isolated.
Sometimes they've got no friends and no family. So, it's going to be difficult to get the data on those people, and I'm just wondering, how are you going to do that?
Well, we've got a census data that tells us, for most recently, what our population is, who's over 85, and then what we also have is population projections from the Office of National Statistics.
So, at a population level, we've got a pretty good idea of how that population is set to increase.
Is that from the census data?
It is from the census, but... Every year from the taking of the census, it's under the year ahead to date, because they only do that census once every 10 years.
That's right.
So, the longer it goes, the tolerance in between the original date and the date when you want the information gets greater.
That's right. And so, you put that alongside other data sets to get as accurate a picture as possible.
Yeah. Thank you.
Thank you, Chair.
Just coming back to the mental health and the hospital admissions for mental health conditions, I think this data is really deceiving, because it actually looks like, you know, we're between first and fourth.
We're performing really, really well, but what this doesn't show you is all of those people that don't go to hospital or go to A&E and aren't admitted.
And, you know, particularly when you talk about self-harm and self-harm is mentioned of, you know, 10%, 15 to 16-year-olds having self-harm.
But actually, we've got children self-harm and get six and seven. And, you know, a lot of people, particularly when their children are older and sort of secondary school age, the last place you would go and they should absolutely have no choice is to A&E, because it is the worst environment to take somebody who has mental health difficulties in the self-harm.
So, actually, I think we need to look at different ways of gathering that data, because I think this data is really, really deceptive, and it could potentially be hiding an awful lot.
So, I would, you know, really suggest that I know, obviously, some of it will be done in the mental health delivery plan and everything, but I'd really suggest that in the spotlight sessions, we look at if there's ways of getting at that data and getting more accurate information around that, because I think, you know,
going on admissions is one thing, but there are a huge number of people, children, young people and adults that have significant difficulties that aren't presenting at hospital.
You're absolutely right. That data set just lets you look at one snapshot or one segment of the population for whom it has got to that stage.
That data allows it to be measured and compared, so it has some advantages to it, but it only tells a small piece of the story.
A needs assessment should hopefully complement quantitative data with qualitative data, so I don't know what the methodology is for that needs assessment, but I know it's being undertaken, and I hope that it is capturing the voices of people who have experienced poor mental health and capturing that.
OK, well, thank you. Thank you for all your hard work, and there's a lot of work to be done, and I'm sure that along the journey that scrutiny will be involved, so I have got some recommendations, if members are happy, that the health and adult social care scrutiny board,
and number one, endorses the priority of the health and well-being strategy and the social outcomes framework.
Number two, requests for engagement to be undertaken with the following organisations as part of the consultation, Birmingham and Slowly or Voluntary Community and Social Enterprise Mental Health Collective,
and Slowly or Standing Advisory Council on Religious Education.
And finally, I think we'll all agree as a scrutiny board that requests an easy-to-read version of the joint local health and well-being strategy to be developed to support engagement.
OK, so thank you again, thank you for your time.
Thank you all for your stay, I really appreciate it.
OK, members, we'll go to a gender item 8, which is, the purpose of the report, it's a smoke-free 2030.
The purpose of the report is to update members on the National Smoke-free 2003 plan and provide an overview of local implications and next steps.
So, who's going to lead on that? OK, good to see you now. Welcome Caroline.
Good evening, members. Straight away on 1.1, there is a typo error there, that is smoke-free 2030, so apologies for that error.
So, there has been quite a high national focus on stopping smoking and smoke-free 2030 since it was announced as part of within the Conservative government election, not their election, but in their party conference in October.
Unfortunately, we are in a slightly different space at the moment since we've had the announcement of the election after this report was wrote, but I'll go through the headlines of the report as it was set out at that time.
So, in October 2023, there was a policy paper published Stopping the Start
and that was a really set out a comprehensive plan, which consisted of a range of elements which combined together would be intended to deliver a smoke-free 2030 for England.
So, the key part of this was a rat-and-smoke-free generation to increase support for those who currently smoke and then to give consideration to addressing to reduce youth vaping and approaches to strengthen enforcement on the sale of illicit products and vapes to those who are underage.
So, to follow this through, in March, the tobacco and vape bills introduced into the House of Commons, the purpose of that bill was to start and train a piece of legislation which, if successful, would have made it an offence to sell tobacco products to those born on or after the 1st of January 2000.
And I think that should have been 9, yes, 2009, so thereby the result of that would have been you would have been phasing out young people, so we would have got to a generation which would mean that anyone who turns 15 or younger in 2024 would never legally be sold tobacco products.
The second part of the legislation was to make it an offence for anyone over 18 to purchase tobacco products on behalf of anyone who was born after 1st of January 2009.
And to support all of this, there was going to be enhanced enforcement on a range of new measures required for retailers around their age of sale notices.
And the bill, as I say, went in on the 20th of March, I think we're at the point now because of the election that that bill will not proceed.
The positive note is that when it was introduced, there was cross-party support for this area of work, so I don't think all is lost. I just think this is a pause.
So we are just going to carry on as normal, so we will keep you updated on where that goes.
But the second part, which is really relevant and continues to be relevant, was about a focus and enhanced focus on supporting those who currently smoke to stop.
And some of this was building on earlier investment, which is made into the NHS through the long term plan. So if we talk through that, so the long term plan increased the NHS's role in supporting patients and staff to quit smoking.
And there was a mandate, which is set out at 0.3.5 around the NHS, who they were meant to provide support to around smoking, which areas of patients would be in scope.
That program of work, as you can imagine, is extensive, but it has started.
And there is a whole plan around that's been delivered locally for us.
The government has set out 3.6 acknowledge that Vapes have a positive role in supporting adult smokers to quit, but the other side of that is the intended consequences is it has been a surge in children's vaping.
So they are currently, well, were, or until the election was announced, working on a consultation to understand what range of proposals need to be put in place to address whereby that we allow the Vapes to continue as a resource for adults that we want to help stop smoking,
but they are detailed for children.
So at 3.9, then the other element around smoke free 2030 and the work that we're doing on a regional level is we established a burn on the soil tobacco control alliance.
These have been set up in other areas and we're seeing as really quite helpful in coordinating action.
So that for in our points in mind, it will help us work to coordinate the work that's going on as part of the NHS long term plan.
Also work with our partners in Birmingham and with Solihull so that we could coordinate that system better.
So that is in place.
We have started to do a review around the tobacco control alliance because it started off really early days and we want to now really set down what we want from that.
From that art tobacco control alliance and how it will work.
The messages that they've been doing today have been focused really around the vaping.
And as you can see at 3.9, the key message that goes out is if you smoke, swap the vaping, if you don't smoke, don't vape because this is not just about young people, but we don't want that there's been a start to a trend where we've had adults who've never smoked,
but it's going straight into vaping, and that's not really what the attention of vaping is to be about.
So from 3.10 onwards, I've given some summary of what our approach in Solihull is to this work.
So in terms of what smoking means to us locally, overall, and this was picked up in near ashes work, our smoking prevalence for those aged 15 plus is 12.8%,
which is actually below the England rate, but if we scrape a little bit lower than that and don't just accept that at the face value and think, okay, we're fine.
We actually did a fair treatment assessment and what that demonstrated is that that rate is not equal across our borough.
We have got some geographical and demographical cohorts where actually our prevalence rates are much, much higher in varying rates.
So we definitely do need to address smoking as a priority in the borough.
Part of the smoke free 2030, when it was announced, brought a five-year commitment for additional investment for local authorities for the purpose of expanding our smoking cessation services.
So in 2425, our award is 243,740.
And one of the conditions of the grant is that we have to retain a commitment to keep our set budget, the budget we already had, and that this would be a top up so it's not a replacement.
So that will not provide us an increased annual budget for smoking cessation of 464,890.
The grant that we've received from OHID for this year has brought some quite challenging targets.
And then on top of those figures that we will have there, we will increase those figures because these only represent the OHID element of the grant.
And then we will have further targets for the budget that we've put in public health.
So this won't be all we're expecting in terms of targets.
We have developed a service specification, which meets national guidance and is very reflective of the findings of our fair treatment assessment.
So it's intended to really be responsive to the needs of those groups in the borough where we know that our prevalence rates are higher than we would want them to be.
And we're currently in the process of securing a provider to start delivering this new enhanced service from the summer 2024.
The other element that's new that we're going to be adopting across Solihull was the stop to swap scheme.
So this was a national scheme that was launched where there was an ambition to have 1 million smokers encouraged to swap smoking cigarettes for Vapes.
And it's under a scheme called swap to stop.
And that was a national scheme.
We made an application to that scheme to OHID and were successful in our application.
And how we're going to use that is we made a request for 3000 Vapes, and we were going to do a dedicated service pathway with our residents are living in social housing.
And detailed at 3.15 16 and 17 is some rationale of why we chose to go that route.
We are in the process at the moment of implementing that plan and working really closely with Solihull community housing,
but also an open offer to our other registered social landlords who operate in the borough.
So that's quite a whistle stop tour of where we are around stop smoking and happy to take any questions, Councillors.
Thank you, Caroline. Can I just ask on 3.9 the engagement with Sheffield Tobacco Control Alliance is really positive.
So how is the learning from Sheffield informed our local plans and work? Can you give me any examples, please?
Yeah, so. Sorry, it's that my one of the key things if you want to Google Sheffield's work around the tobacco control alliance.
They did quite a lot around marketing and branding. So we've actually got a little bit of money set aside because of tobacco control alliance.
And it's just coming together really as that central point. So there's not loads of money in it, but we have managed to secure a little bit of money.
And we are actually going to use that around marketing. So we've taken that learning from Sheffield and it was also really about the role,
the coordination role that their alliance did. And that's where really we want our alliance to be much more focused.
So we're looking at things like the data. So rather than ourselves as commissioners in Solihull and our colleagues in Birmingham approaching the NHS and saying,
well, how's activity going? How is your smoking in the long term plan? How is that going? How many people are you seeing? How offering? How many are engaging?
We actually can coordinate that through the tobacco control alliance so that we've got that more comprehensive view.
We will have an understanding of how many people start a support program as part of the long term plan and then how do they translate into our local stop smoking service because we want that continuous pathway for patients.
Okay, well, just going on from that, how can we as councillors be supported to act as smoke free champions within our wards.
Could we be provided with information materials to promote initiatives such as stop October as well as signpost residents of relative services? Have you got any ideas around that, please Caroline?
I don't see evening because we're currently out to tender, so we need to know who our new provider is locally. And then I think what we're really keen on is that this is very much a community based service.
So we will actually we've actually mentioned in the spec about community champions and how they work with real key figures and agencies and some of our voluntary sector partners who are in the community as conduits
that includes faith leaders, all of those people who are actually engaged and have a route into some of these groups that we really want to target as a priority.
So certainly I would like to take that offer from you, Councillor, and come back on that.
That would be great if you could do please yes. Okay. Members, Councillor Delaney.
Thank you. I was slightly concerned to see in your fair access assessment that the smoking rates for looked after children are four and a half times higher than the average rate.
Will your does the spec for your tender for the service inform working with the local looked after team? Is there something specific? I know it says in the detail that the service will be supported, but is there something specific in the spec that is going to require them to work closely with that team and that particular cohort?
Yes, the specification that we've wrote and how we're going to assess the effectiveness of the service is going to be guided through quite a range of metrics.
And all of those will be broken down by priority groups and we've named those priority groups and that does include looked after children.
So each time when we're assessing what, you know, we're working with them, we'll want to know what pathways they've got.
What is their approach to work with each of the groups because all of these approaches will be completely different because they have to be tailored to each group, you know, what works best for each group and how do they make that reach in.
But when we don't now want to know how many people access their service just or how many people and quit for four weeks, we want that broken down by each of our priority groups so that we can actually start assessing the effectiveness in terms of health inequalities
because we really want to drive improvement around the health inequalities that are associated with smoking.
Thank you.
You have said that community engagement is challenging.
And I know you've said that obviously you're going out to tend or so, you know, hopefully we'll be able to support with that.
But what are your ideas at the moment and engaging with the community and especially with schools as well, because of the increase in vaping amongst children.
What are we going to do to address that specific issue?
I mean, some of this will have to come through in the model for the service because this is how we've set it up.
We really, we want to hear what those providers come backwards to say this will be their approach.
We've done quite a bit of work with schools, given them advice around vaping and what the key messages are that are coming out.
In terms of with the community, it's not necessarily that it's challenging.
We just want to change the approach. So it's no longer sufficient to just have a stop smoking service sitting there.
This has got to be much more of a proactive service that actually goes to meet people where they're at, rather than expecting people to come to them.
And as I said earlier, you know, there will be different ways to do that that will work better and some of them will be exactly about having community champions that will help spread that message and help do that connectivity.
But we are waiting to see back when we are awarding the contract and reviewing the different models because these are some of the questions we will be expecting to be answered about what is your approach,
what's your experience of working with these groups.
Okay, members, any more questions?
Councillor Wilson, sorry, yes, I've seen your hand up.
Thank you. Thank you, Chair.
So I'm really impressed with the initiatives going forward.
My question, possible concern, is that these things, I could see how they can create an immediate and short term change in behaviour.
So my question is how are their metrics about lifelong change in behaviour and how much is that influencing the modelling, the consultancy, the tender process, how much are we looking at that kind of metric.
And so is this about long term quits sustaining it? Yes.
So, O-Hid, who we get the grant from, and we have to report to O-Hid so they benchmark us then because every area who gets this grant will be reporting.
So their real key metric is around four weeks, four week quits.
And we then have our own additional metrics on top, which look at eight and 12 week quits.
It is extremely difficult to go back and track people long term.
Once somebody has successfully accessed the service and its work for them, they tend to not want to be reached out to.
And it's really important to us, but we want to reach out to them for every single service we offer them.
You've been to a weight management, you've been to this service, you've been to that service and people are interested.
We do capture some that come back because they've already quit and they're coming back as a repeat.
And we will be asking as part of our normal contract management, we ask for case studies.
Okay, so in essence, I guess there isn't a long term metric and there's a little bit of a base.
Smoking services tend to be the best practice and we follow the guidance around smoking cessation.
So they're 12 week programs.
Okay, thank you.
If people sponsored a long, you know, to stay on a bit longer, they could do.
They wouldn't be stopped, but they're not long term, you know, people don't stay in these services long term.
Okay, so maybe I'm thinking, so I gave up smoking my 20s and haven't smoked since.
And when I go into, when I sign up for the doctor or sometimes as a questionnaire and that says that there I will state.
I'm a lot, you know, giving up smoking and it's a long term effect.
Is there any way that you can marry that with what's happened to me and people like me to have able that and then influence modelling based on that kind of metric?
Is that not it?
And we couldn't do it on an individual level because we don't.
But all of this, you know, all of the work that's happening nationally and the focus on smoking is absolutely rooted in that sort of evidence.
You know, smoking is seen as the biggest modifiable thing we can do to improve people's wellbeing.
And that's why the investment is going into smoking.
We absolutely, all the evidence is there to say that the increased risk and health risks that are associated with smoking.
Therefore, it is really important to individuals, to the public purse, to everyone to encourage and support people to stop smoking because there's a wealth of evidence there to say, you know, if you stop smoking after six weeks,
you will have this benefit after six months, you'll have this benefit after three years, it'll be like you didn't smoke.
So that is the evidence that we use that sits behind why we invested these services.
And it is why Solul has had that long term commitment, you know, providing smoking cessation services.
But the modelling isn't based on long term metric.
Okay, thank you.
Thank you, that was going to give up to the question.
Councilor Mackenzie.
Thank you.
Thank you, Caroline, for the report.
I was speaking to one of my residents who has always smoked, and I guess it's about my age, and when we were talking about this, about it being banned, I really was expecting her to say, how do they, you know, how do they tell me.
I can't smoke, but she didn't.
No.
She said, I wish that this had been in place when I was young and that I had never started.
So that is what we've got to think about, and I think a lot of people who do smoke think like that as well, that they wish that they had never started because it is addictive.
And I've read recently that some of these vapes have even gotten nicotine in them, so they will become addictive as well.
So, and the biggest worry now, I think, is seeing the young people who are using these vapes all the time, and that's not good for your health either.
So, what is the age that is 80 for buying?
Well, something needs to be done about who's selling these vapes to the youngsters, because when I drive past the schools, I see them and they're passing them around to each other.
So, I don't know what can we do about that, but I dare say that's off your wrist.
So, but thank you for all you work doing this.
I really appreciate it.
Thank you.
Thank you.
Council McKenzie for that.
Members, before I go to recommendations, no?
Any more questions?
Okay.
Carol and I, the Health Student Adult Social Care Scrutiny Board.
Number one, endorses the local plans and initiatives to support smoke-free 2030.
Number two, agrees to receive further information and materials to access smoke-free champions within our local wards and communities.
And number three, we agree to receive a further update reporting 12 months on the delivery of local plans and initiatives to support smoke-free 2030.
Our members quite happy with those recommendations, yes?
Okay. Thank you, Carol. I thank you for your time.
Thank you, Councillors. Good evening.
Bye.
Okay, members, we go to agenda item nine, re-commissioning the Healthy Child Program Service over 19 years.
The purpose of the report, this report outlines the approach of the repacumen to the solely on Healthy Child Program Service,
which incorporates health visiting, family nurse partnership for adolescent parents, infant feeding and school nursing services for the borough.
The current contract is due for renewal by March 2025.
And this new phase for the service is an opportunity to refocus the service model to further align with current strategic priorities and understand John, you're going to present this.
Thank you and welcome.
Thank you, Chair. My thanks to my colleague, Denise Milne, who's the author of this report. She's taken a while to unbreak this half to him.
I've stepped off the bench to fill her big boots.
Colleagues will have an opportunity to read the paper. I'm just going to pick out some of the salient points from this paper.
Predominantly, just to revisit what is the Healthy Child Program north to 19. It's a national program.
It's an evidence-based program, and it forms part of the services that from a local authority public health point of view, we are mandated to deliver.
Not all of the elements are mandated. The paper identifies those areas, which are.
It also forms part of our broader approach to early health and early intervention and our new models that we're developing.
So, just to recap, the North to 9 services comprise of a number of key services.
On is the Health Visiting Service that looks at children from 0 to 5, and there are a number of key touch points with parents in that period of time.
They're all universal. They're non-stigmatizing. It's an offer that a vast majority of parents take up, but they can refuse should they want to.
And thankfully, it's only how lots of people appreciate the value of that service.
There's the Health Visiting Service, which was mentioned as the School Nursing Service, which picks up children from school age up until they leave.
There's the Family Nurse Partnership, which is a licensed program through the Department of Health and Social Care.
For first-time adolescent parents, it's a very intensive home visiting program.
It's proven to be very successful in terms of improving outcomes for children and parents.
We also have the infant feeding team, which has just been through, again, its UNICEF Baby Friendly Initiative Assessment.
I'm very happy to report that gold standard has been maintained, so there's good news.
And then there's the support offered through the skill mix in those teams to support parents across the early life course of their children.
Part of the early help support that's offered is also in the paper identifies as part of our broader graduated response.
We've already touched on mental health issues this evening earlier on.
Notice there's elements in here and perinatal mental health.
I've got the dog's teeth in, please, excuse me.
This is really important. Some of the approaches that we use in terms of supporting parents, video interaction guidance, the DadPad app.
If you want to download it, it's free. You can go and have a look at lots of top tips that enable first-time fathers to engage and support how they work with their child, but also how they support their partner.
The Outcome Stars is another evidence-based tool, which is strength-based working with the carers of the child to identify those areas, which they do really well, and those areas that they well wish to improve on.
I've mentioned FMP and also an early intervention health visitor as well.
I would also like to highlight the program supporting SCND families.
It is not a specialist service in that regard.
We have other specialist nursing teams that are commissioned by the NHS that do that.
But in terms of early help, early identification and early help, certainly health is a big role in supporting that and ensuring that families access services very swiftly and ensuring that the education, health and care plans are in place.
The service operates on a system that has changed over time, but universal plus, universal partnership plus, and education and targeted programs are now led to stratify need.
So when they're doing these assessments, if you do the new birth visit, if you do the six to eight week check, if you do the one year check, the two to two and a half check, all of those provide an opportunity for you to assess where those families are to see what is additional support can be required.
Actually, what the service can provide itself in terms of supporting that family.
FMP, as I mentioned, is a licensed program.
It's a very detailed and very intensive program.
Across the services, we offer vision screening.
There's also the child measurement program that we have to deliver in school each year and the follow-ups to that.
There's also supporting families with children and young people with complex medical needs.
So you may have those infants who were born prematurely and may require frequent follow-up both at home and in hospitals, identifying those individuals and supporting those families is really, really important.
The importance of working with partner agencies, I would like to highlight the work that's currently ongoing around our family hubs as they come on stream.
And the models of care that we are looking to develop around those in terms of greater integration of teams and opportunity to share information and support families in a fully integrated way.
I think family hubs provides with a great opportunity to improve and strengthen our working around multidisciplinary teams and likewise the team around the school model also enables our school nursing services to look at how they can contribute to that multidisciplinary team around the child.
There is a digital offer. There is universal access. Our current providers have very good websites.
It's very easy to access the information. They have a good signposting, telephone numbers as well as email address.
Our current provider is Swift, which is South Warrichy University Foundation Trust.
They've had the contract for a number of years. They've been performing pretty well on it.
And certainly in the post-pandemic period, they've really upped their game in terms of the metrics that we're using.
I guess what I would just like to say in conclusion is this provides us with an opportunity to look at the delivery of that program.
It also allows us to look at those areas where we might want to tweak based on need, where we want a greater emphasis.
Denise has outlined some of those areas. We've already mentioned infant mortality rates in Solihull looking at those.
School readiness is also very important in terms of determining that child's early life course.
I know Denise has spoken previously at length about the importance of the 2001 days.
It's really important to understand the impact of school readiness.
We've talked about assessing risky behaviors, particularly in the school aged child and the importance of transitions from primary to secondary schools.
We're also trying to work with our provider and quality assurance mechanisms around all its case studies, et cetera, to bring out the good work that's been going on.
Also, I couldn't be sitting next in the garage without talking about tackling inequalities. It's very important, particularly in the MAMOP principles, so we ensure that the service is proportional universalism.
It is a universal service, but actually for those families that assessed with grades in need, obviously there are greater resources to support that.
I will pause there, Chair, to take a breath and allow colleagues to ask any questions they may have. Thank you.
Thank you, John. That's a very comprehensive report.
The question I want to ask is, what about the home school children? How are you managing to get into those?
Because you're a mandatory safeguard in universal school nursing checks. They're all based in the schools. I'm just wondering about the home school children.
Thank you. I think it's an important issue to highlight. So, access to the school nursing service remains universal.
So, if you're a home school child, you can still, and you're the parents of a home school child, you can still contact the school nursing service, ask it anybody else.
What's not being proposed as far as I'm aware is, you know, we wouldn't be doing home visits to those children unless it was absolutely necessary.
It's tried to understand, under what circumstances, the health of that child that a school nurse would be responsible for as opposed to a GP.
So, understanding the health needs of that child. If that child had complex needs and was being nursed at home, obviously there would be a discussion around how those needs would be met in a multidisciplinary way.
And that may well have some school nursing involvement. But it's important that parents have access to the service, to that support and advice.
And that is through the phone email digitally at the moment, as would any child attending schools.
There are 38,000 school-based children in the borough. And we have a school nursing team that's around about 10 whole-time equivalents.
So they're not going to get to see all of those children. Some of the mechanisms of doing those health questionnaires at certain times in a school's life is trying to identify those children who may require additional support.
So, if I was a parent of a homeschool child, one of the things I'd want to know is how do I access the service? Who's the phone I can pick up to, or who's the email? And that certainly is in place.
What's important for the service is to understand how many children are being homeschooled.
And have you any idea on the percentage boys of the numbers of children that are being schooled at home? And secondly, is it the council's responsibility to make sure these parents know that these services?
On the first question, I'd have to consult with education colleagues about the numbers of children who are.
My understanding is, from the national picture, is those numbers are increasing. I don't know if that's reflected locally or would have to ask.
I think safeguarding is always the number one issue about leaving a child at home with those parents, and the importance I think this is about engaging parents around that and being open around safeguarding with families.
We shouldn't be hiding that and understanding that we want to be upfront with that. The other part of that is, as part of that process, we will be sharing information amongst agencies to understand that.
But I would great believe in being very open and transparent with parents around safeguarding and understanding that it's our duty from a local authority to ensure that that child is safe.
And I think as long as we're open and transparent about that, we shouldn't have too many difficulties in terms of working with parents around that.
Can I just come in there? Oh, gosh, I forgot what I was going to say now. I hope the council will get in. Sorry, it will come back to me.
I just want to point out that I think we need to be very careful when we talk about home education and about safeguarding of children, because there's a lot of implications in putting those two things together.
Just because a child is home educated doesn't mean that they are at risk, because generally they're at home with the parents and they're safe. Unless we feel there is a need or there is a risk, then I think, yes, we can discuss safeguarding issues.
But I think we just need to be really careful about that. Also, I wasn't aware that there was access to the school nursing service for home education children.
So maybe we could try and communicate that out for the parents. That would be really good, because there are parents out there that actually would probably benefit from that service. Thank you.
I've remembered what I wanted to say.
It's about sharing information. I assume all these disciplines do share information with each other. It's not a bit like the police where we can tell somebody something, but the police won't tell us back. Do you know what I mean?
No disrespect to the police, because I think it was a fantastic job. That's another issue.
Let me be frank. I think in my experience of working with parents, there's an expectation that we are sharing information where it supports them and their children, and we need to be open and transparent with parents to say, we will be sharing this information.
But I think when we're working with parents, we just need to be dead straight with them. Actually, in order for us to support you properly, I will need to share some of this information with other health colleagues or local authority colleagues.
Are you happy with that? Yes, I am. Therefore, we can put together a plan.
That should be – I'm hoping that is the norm in practice. Sometimes people get confused about data protection, confidentiality, all of those things, which I understand.
But I think we should be enabling our practitioners who are having those conversations to be confident in having those conversations.
And it needs to be on a need to know basis. Absolutely.
In fact, I would say not on a willy-nilly basis. We need to be really clear with it. And I take on board, Councillor, getting your issue a better safeguarding, because it's not an assumption. I wasn't putting weight on it, but it always comes up.
And I think when it always comes up, we're better off having an open conversation if that's it. And being clear with parents, this is not about you being a bad parent or this, however, we will need to run some due diligence on it.
Yeah. Thank you. Thank you. Thank you, John, for stepping in for Denise. You might not know the answer to this one, especially as you're stepping in for Denise.
Just looking at the performance for the healthiest in checks, obviously we do fantastically well for babies, the 10 to 14 day and the 6 to 8 weeks. We're in the 90s.
Great. The 12 months check and the two to two and a half year old check. We're in the 60s. I know this information is a year old, so I'm kind of hoping it's improved in the last year, which is why I'm saying you might not know yet.
But it would be lovely to be updated when the new data comes out.
Thank you. We receive quarterly reports from our provider about these checks, and they're very comprehensive. So we would be able to provide you with that. And I am glad to say, because I've just seen the quarter for reports that things are improving and they're good.
There is always, I think somebody already mentioned this even is always room for improvement. I always worry about those children who don't attend, and what are the processes and policies and procedures in place that allow us to go back and check in with parents to make sure everything's all right.
That's, that's the bit that you know the bit we're working with our provider and they've been very receptive to that in terms of recognizing that again, without putting too much burden of expectation on new models of care, particularly around family hubs.
When we got into when we properly got integrated teams together that also provides us with an opportunity to around who else knows the family who's seen the family is the child attending nursery or play anywhere.
We can work in a 360 way that a moment doesn't always happen as part of the norm. And I think this is the, my aspiration is that the family has provided more robust model around that.
Thank you.
Okay.
Is that your hand up there? Yes, thank you. Just a quick question about the data.
Are the comparisons, are there a reason why we've compared against these other, what is it, is it a statistical maybe comparison, or is it a geographical comparison.
Where have we chosen those particular other authorities to compare with.
I think it's very similar to, I didn't, please forgive me, I did not print all of that appendix out.
So my, my, but my understanding is what we do is we look at ourselves as a region in a West Midlands.
Just a straight, how are we doing regionally. And then there are also statistical neighbors that we also look at.
So, similar reasons as, as, as near Ashment Outland, you know, they're a similar size to a similar demographic and therefore it's important for us to compare.
So I think it's a combination of the two cancel, but I will double check for you.
That's great.
Okay.
Can't tell me, can't see.
Thank you, Chair. Thank you, John.
First of all, I'd just like to congratulate you on still maintaining the higher level of the UNICEF baby, Wendy Gold, accreditation.
It's really good, and we need to celebrate there.
The school nursing service, but we've got 70 primary schools and 29 secondary schools in Silicon.
And we've got 10 school nurses.
That seems a very low number for dealing with all those children.
I organize themselves on a geographical cluster, so they'll have a cluster of primary schools with their feeder, secondary schools.
So it might be, if the figure is 10 whole-time equivalent, not all of those are working full-time.
So many of them may be working part-time hours as well, so we always use the full-time figure because that's what the budget is for.
But many of them will work two in time only, or be on more part-time hours.
But anyway, you cut it.
It's quite a limited resource in terms of what we've got.
And I guess this is, you know, just to reiterate the point, we need to be greater than the sum of our parts.
For all of us who are working with school-based children, we have the discussion earlier on mental health in schools.
It's what is the unique contribution of the school nursing service along with the other team-er and child,
that actually, in these quite stringent times, we're making as much bang for our buck as we possibly can in terms of outcomes for those children.
So can schools request the school nurse to attend there for certain issues or anything?
Yeah, I think all of the schools know how to access, and they'll have a named nurse.
So in those clusters, they'll have a named person who they can pick up the phone to.
There's also a chat, I want to call it a chat line, it's not doing it action, that schools and families can send messages to that is manned daily.
So yes, they should be able to, and more importantly, children and young people as well as families should know how to access the service.
Could I just ask one other question on the graphs? Because I just feel as if they need more information because, and they say the percentage of 10 to 14 day health visitor checks.
I mean, there's a big difference between a health visitor phoning being on the phone and asking the parents how you're getting on and how it is to a health visitor going out and sitting in the home with the family.
(inaudible)
Yeah, that's good. Thank you.
Okay, members, are we done? I think we're done, John, are you okay?
Nancy Wilson's okay, I think, okay then. All right, then we have got some recommendations.
Can I just ask this, because one of the recommendations, if members are happy with, is when was the best time in 2025 for you to come back to us and update us on the progress of things?
(inaudible)
Yeah, Joseph will liaise with you. Or if you can liaise with Joseph, then we'll get that on to our work plan because it does get full of very good way.
Okay, so we've got a couple of recommendations. If you're members are happy with them.
The Health and Adult Social Care Scrutiny Board, number one, endorses the purpose and deliverables in the service and the plan for the pre-re procurement from March 2025.
And number two, endorses the proposed focus of the refresh service model for the new contract term.
And, as I say, if you can liaise with Joseph as to when, you know, be good to come back to us in 2025.
So thank you again for a very good report. Thank you.
Thank you, Jen. And in fairness, all credit to Denise, to be honest. She put all the hard work in and also just came to the mechanics that, you know, it's our provider who did all of the hard work on maintaining that UNICEF gold standard.
Along with Denise, who's our baby friendly champion within us, so credit goes to both of them. Thanks very much.
Members, where are we? Right, agenda item 10. I mean, you're quite welcome to stay if you want to or if you want to go now.
Yes, please feel free to go. Okay. So number 10 is the Health and Adult Social Care Scrutiny Board draft work plan, which Joseph is going to prevent for us.
Thank you, Chair. So it's a draft work plan for the next council year for members consideration and approval.
It does include annual standing items, so such as budget setting, includes matters for continued scrutiny identified during the last council year, so it would include the health inequality strategy, for instance.
For those members who are new to the board, the items here were identified following the work planning session held in April.
Members engaged with representatives from a number of directorates and partner agencies, including Adult Social Care, Public Health, the Integrated Care System, the acute collaborative community provider collaborative and mental health collaborative.
Just to say, as it currently stands at the moment, there are six items currently scheduled for the July meeting, which does appear to be perhaps more than we would wish.
I'm currently liaising with University Hospital of Birmingham on the elective hub offer, as anticipated, maybe not not be feasible now to be considered them.
I'm also mindful of other things that are now happening in July that are taking about time.
And may please you to now not proposing to go through all the items in detail, but if there's any queries arising from the work plan, I'm happy to look to provide a response.
Any queries? I mean, if not tonight, I'm sure that Joseph won't mind an email.
I just got one thing to raise, Joseph, site visits.
Have we got any site visits in the pipeline?
We were looking at potential site visits in terms of the expansion of surgical capacity at Solly Hall Hospital.
It was tentatively penciled in for July, but I'm liaising with them over the latest on that as I'm mindful of pressures then.
But that's the one identified.
I was just wondering if there's an opportunity to go and see one of the locality hubs.
I don't know what members to feel about that.
Just to give us some idea about what they look like really.
Because that's something we could do.
Obviously much later in the winter.
Okay, thank you.
Okay, I think that's it, the members. We all are happy. Thank you for your input tonight.
Thank you officers. Really grateful.
Thank you very much.
Bye.
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Summary
The meeting began with the election of the chair and vice-chair for the year 2024-2025. Councillor Bob Sleigh was elected as the chair, and Councillor Gethin was appointed as the vice-chair. The meeting then moved on to discuss the joint local health and well-being strategy and the consultation plan.
Joint Local Health and Well-being Strategy and Consultation Plan
The purpose of the report was to outline the responsibilities of the Health and Well-being Board under the Health and Social Care Act 2012. The board is required to produce a joint strategic needs assessment and develop a joint local health and well-being strategy. The strategy considers the findings of the JSNA (Joint Strategic Needs Assessment) and other local needs assessments. Progress against the strategy will be monitored through the Solihull local outcomes framework.
Nürja presented the strategy, highlighting three main points:
- Introduction to the strategy and its development.
- Measurement of progress using the outcomes framework.
- Presentation of the consultation and engagement plan.
The strategy has six high-level priorities, each underpinned by specific findings from the needs assessment. These priorities include improving end-of-life care and mental health across all ages. The strategy aims to change the way the Health and Well-being Board works with other boards and committees, focusing on collaboration rather than duplication.
The consultation plan includes an eight-week consultation period throughout June and July, targeting key partners and stakeholders, including the integrated care system, voluntary sector, schools, and businesses. The aim is to gather feedback and improve the strategy before finalizing it in September.
Questions and Discussions
Several councillors raised questions and provided feedback on the strategy and consultation plan:
- Councillor McKenzie asked about advertising the consultation to those without internet access. Nürja responded that they would work with communications colleagues and the community's directorate to reach out to local meetings and voluntary sectors.
- Councillor Delaney inquired about the priorities and consultation with young people. Nürja confirmed that the priorities are not in a specific order and that they plan to consult with young people through school representatives.
- Councillor Jones asked about stakeholder involvement in identifying priorities. Nürja explained that the priorities were based on local data and national trends, with stakeholder input coming through the Health and Well-being Board.
- Councillor Wilson raised concerns about the cost of living crisis and its impact on the strategy. Nürja acknowledged the challenges and emphasized the need for a well-rounded approach to measure progress.
Recommendations
The Health and Adult Social Care Scrutiny Board made the following recommendations:
- Endorses the priority of the health and well-being strategy and the Solihull outcomes framework.
- Requests engagement with specific organizations as part of the consultation, including the Birmingham and Solihull Voluntary Community and Social Enterprise Mental Health Collective and the Solihull Standing Advisory Council on Religious Education.
- Requests an easy-to-read version of the joint local health and well-being strategy to support engagement.
Smoke-Free 2030 Plan
Caroline presented the Smoke-Free 2030 plan, which aims to reduce smoking rates and address youth vaping. The plan includes a range of measures, such as banning the sale of tobacco products to those born after January 1, 2009, and increasing support for current smokers to quit. Solihull has received additional funding to expand smoking cessation services and implement the swap to stop
scheme, encouraging smokers to switch to vaping.
Questions and Discussions
- Councillor Delaney expressed concern about the high smoking rates among looked-after children. Caroline confirmed that the new service specification would address this issue.
- Councillor McKenzie highlighted the importance of community engagement and working with schools to address youth vaping. Caroline agreed and emphasized the need for a proactive approach.
Recommendations
The Health and Adult Social Care Scrutiny Board made the following recommendations:
- Endorses the local plans and initiatives to support Smoke-Free 2030.
- Agrees to receive further information and materials to act as smoke-free champions within local wards.
- Agrees to receive a further update report in 12 months on the delivery of local plans and initiatives to support Smoke-Free 2030.
Re-commissioning the Healthy Child Program Service (0-19 years)
John presented the approach for re-commissioning the Healthy Child Program Service, which includes health visiting, family nurse partnership, infant feeding, and school nursing services. The current contract is due for renewal by March 2025, and the new phase aims to align with current strategic priorities.
Questions and Discussions
- Councillor Gethin asked about the performance of health visitor checks, noting lower rates for 12-month and two-year checks. John confirmed that performance has improved and that they are working on better follow-up procedures.
- Councillor Mackenzie raised concerns about the low number of school nurses compared to the number of schools. John explained the clustering approach and emphasized the importance of integrated working.
Recommendations
The Health and Adult Social Care Scrutiny Board made the following recommendations:
- Endorses the purpose and deliverables in the service and the plan for the pre-re procurement from March 2025.
- Endorses the proposed focus of the refreshed service model for the new contract term.
- Agrees to receive an update report in 2025 on the progress of the new service model.
Work Plan for 2024-2025
Joseph presented the draft work plan for the next council year, which includes annual standing items, continued scrutiny matters, and new items identified during the work planning session. Members were asked to consider and approve the work plan, with a note that the July meeting may have a high number of items.
Site Visits
Councillor Mackenzie suggested site visits to locality hubs to better understand their operations. Joseph agreed to look into this and liaise with relevant parties.
The meeting concluded with members agreeing to the recommendations and the draft work plan.
Documents
- JLHWS Scrutiny 30May2024
- Agenda frontsheet 30th-May-2024 18.00 Health and Adult Social Care Scrutiny Board agenda
- Health and Adult Social Care Scrutiny Board - minutes 13th March 24 v2
- Joint Local Health and Wellbeing Strategy 20_05_24 final
- 200405_Solihull Local Outcomes Framework May 24
- Health and Adult Social Care Scrutiny Board 2024-25 Work Plan 22.04.24
- Appendix 1 benchmarking of the Solihull Healthy Child Programme Service
- HASCSB Work Plan - cover report
- March 23 Smoking procurement HASC scrutiny report
- Appendix - July 23 smoking cessation FTA 4 October 2023
- 240530-Healthy_Child_Prog_Service_0-19_Proc-Scrutiny_Report
- Public reports pack 30th-May-2024 18.00 Health and Adult Social Care Scrutiny Board reports pack