Transcript

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Welcome everyone. It is nine. I can't just turn that. So we will start. Thank you all for coming. Appreciate your attendance. And Simon and Simon. Two Simons online. Welcome. Apologies and changes in membership. Do we have any apologies, Marie? Yes, we have apologies from Wendy Pereira. And we have apologies from Laura Gadian. And I believe Simon Holmes is here substituting. And Karina sent her apologies. And Jo Dair is here substituting her. I'm not aware of any other apologies. Okay. Thank you. That's all well noted. We'll press on. Two minutes. For those that were here, to confirm to record the minutes held on 26 October. Can I propose a second of those? I don't know who was there here. Michelle? I was here. And Simon. Thank you Simon. Simon B. Those in favor of approving the minutes, please show. This is a small number. I was there. I was there. Okay. That's okay. That's okay. Thank you. Decorations of interest. Decorations then, I will just remind the board that I have a declared interest as a member of this board. And on any matters or questions that arise involving directly care provision, I will not comment or vote on at all. Thank you. Public question time. Do I have any public questions? Chairman, we've had some submitted. And I believe Councilor Andre has the questions and the answers. It doesn't look like there's anyone in the public gallery. Okay. Thank you. Do you want to ask your questions? We've had them, but I don't think all of the board members have had the questions. But for this, if you all will pass over to Michelle, Deputy Chair, just to deal with these questions. Thank you. Thank you, Chair. Do you want to ask your questions? How many of the questions are from you, Ian? Three from me. Okay. Do you want to ask your questions? And then Councilor Andre has got the -- Do you want me to do them one at a time? All three, please, Ian. Thank you. Question one, can you provide clarity on the disparity between the government assessed fair cost of care and the rates currently offered by the local authority? Do you want to ask your questions? Okay. Thank you. Do it is what plans or timelines are in place to align the fair cost of care and local authority care fees? And the third one, could you explain the disparity between the local authority care fees and self-funding fees that people play individually and whether there are any plans to ensure we have fairness and sustainability in the care market? Thank you. Thank you for your questions, Mr. Bennett. In response to question one, the question asked related to the national fair cost of care exercise, which was initiated by central government. The Department of Health and Social Care required that all local authorities undertake the fair cost of care exercise in September 2022. The outputs of this exercise were returned to the Department of Health and Social Care and the results were published. The result of that exercise remains available on the Isle of White Council website along with the analysis. However, there was significant caveats and assumptions in the analysis as in accordance with the requirements of the Department of Health and Social Care. The exercise related only to service provision for people age 65 and over. In addition of the 48 residential and nursing care homes on the Isle of White that were in scope as part of the exercise, only 23 provided a response to the exercise. In some categories, there were insufficient returns to complete the analysis. The exercise also did not consider care and support from other funding streams, including continuing health care or funded nursing care. It is acknowledged that the median figures identified in that exercise are higher than the funding currently provided by the local authority. The Isle of White, however, is not an outlier in this regard. The local picture is reflected nationally. The government guidance for the exercise was that local authorities should work towards this, not that it would be possible to do so immediately. Although the Fair Cost of Care exercise was a central government initiative, no additional funding has been provided to support local authorities to support the move towards the median figures. In addition, there has been no feedback from the Department of Health and Social Care on the aggregated results from the local authority returns. There has been learning from the exercise and there are elements that have been used and incorporated in the current fee setting processes. These include but are not limited to staff cost and non-staff costs splits, which allows better and more appropriate application of various inflationary uplifts to different areas. In answer to question two, the local authority has been committed to working towards the Fair Cost of Care as identified by the national exercise for the provision of care across the Isle of White. This year has seen the highest value in budget to support fee rises for providers in the year 24-25. This follows what was the highest increase previously in 23-24. Across both years, the increase in funding to support the increase in fees for local providers has totaled an excess of £8m across the two financial years. The Isle of White Council remains committed to working with the independent sector to support the continued move towards the Fair Cost of Care through the annual fee review process. In answer to question three, the disparity between the rates of those who self-fund their own care and support and those who are funded by the local authority is a national issue and not a local one. This is compounded as the government has also put a hold on the work regarding the care cap. Without a long-term and appropriate central government funding strategy for adult social care, this issue is likely to remain an issue. Thank you. Thank you. So we've got three further questions. I will read out the questions because I don't believe that the person is here. So we have three written questions from a must be day this on behalf of Sandal Nursing home to the Chairman of the Health and Wellbeing Board. Question one, what is the current capacity for accepting new care placements at the rates provided by the local authority compared to the total available capacity? How does this compare with the number of people currently awaiting discharge from hospital into care settings? Question two, what is the current capacity? Sorry, I think question two actually is the same as question one. It reads exactly the same as question one. So I will go on to question three. How does the board ensure that the quality of care remains high despite the financial constraints imposed by the current local authority rates? Are there any quality assurance processes that might be compromised by these financial pressures? The response to question one. According to the latest circulation of the capacity tracker is a national tool which local providers are required to complete on a regular, no less than monthly basis. As at the 17th of 2024, there was 64 available residential placements and 38 available nursing vacancies on the Isle of White being reported through the capacity tracker. The availability as you would expect constantly changes. And as a result, this is only a snapshot of availability at the time the data is inputted by providers. In addition, this does not provide a breakdown of the capacity that is available to the local authority as providers choose to retain some of their capacity for people who fund their own care and support and are able to pay higher rates. The local authority also makes contact directly with providers regarding their capacity on a weekly basis. Locally, we find that when we make direct contact with the company, the number of placements available are generally lower than on the capacity tracker despite both having figures provided by the providers. The latest local authority vacancy list showed 23 residential placements available, 10 of which would accept local authority rates and six nursing home placements, three of which would accept local authority rates. The level of nursing capacity currently looks lower than it actually is. In order to support hospital discharge, the integrated care board has block purchased additional capacity to provide support. This additional capacity is not shown within the vacancy information. The number of people currently awaiting discharge also varies and not all have care and support needs. During a recent review week, which took place at the hospital, and which was designed to understand the challenges around discharge, the following data was covered. Two people were awaiting care and support in their own home. Arrangements were being made. 14 were awaiting short-term residential care and support, of whom two had arrangements in place with plans in place for their transfer. Four people were awaiting short-term nursing placements, of whom one had arrangements in place with plans in place for their transfer. In addition, there were no care and support needs, and others with onward care and support needs, which included a mixture of awaiting community rehabilitation beds, reablement, and non-weight bearing support. This cohort of people would not require the capacity identified. On to question three, as question two, as I said, was a repeated question one. The local authority has a quality assurance framework, QF, in place. The quality assurance framework was co-designed with local providers and the integrated care board. It draws on multiple sources of information and intelligence in order to prove assurance around the quality of care provision and provide the local authority with the ability to monitor delivery. The components of the quality assurance framework include a provider self-assessment, quality assurance visits, sharing of information with the care quality commission, the CQC, sharing of information with health and safety organizations, the monitoring of reporting in relation to falls, medication, and safeguarding. Care provision is then migrated based on the assessment and analysis of the quality assurance framework information and monitored with appropriate action being taken as required. In addition to the quality assurance framework, each local service has an allocated commissioner who makes fortnightly contact to ensure that any issues or risks are raised and can be acted upon quickly. We do not anticipate any of the quality assurance processes being compromised by financial pressures. Thank you. Thank you very much. I will double check the questions that were raised by Miss Davis and make sure that question too, if it is the same and make sure that she gets a proper written answer on question too, if it is different. I just wanted to put that on record. Thank you all. Make sure that is documented and hand back now to our chair for chairs update. Thank you, Michelle. I appreciate that. Thank you for your perseverance. Thank you. Thanks for the questions. And the response was given an announcement from me. I will read this. It is listed as a chairman to give a verbal update. It is an announcement. The health and wellbeing board remains an important meeting in the island structure. We are reviewing the role of this board in conjunction with the health and care partnership. Since the last meeting of the health and wellbeing board, cabinet has approved two papers that will have a positive impact on health and wellbeing. First, signing of the smoke free pledge, which demonstrates that the council is committed to reducing smoking prevalence on the island. Similar declaration was signed off by the ICB at the end of 2023. And as a board, we are reviewing the legislation going through parliamentary process for a smoke free generation. Now, this will positively impact on the health of island residents. All parties should consider their responses and actions required. The second paper was the independent report by our director of public health, Simon Bryant on childhood obesity entitled, let's not wait time to tackle health weight with a different spelling of weight and weight there. Let's not wait in time and time to tackle health weight in weight at W.E.I. GHD. A workshop is planned to bring partners together to take forward action on this important issue for our children and future generations health. The board should note that the Hampshire and island Y NHS foundation trust, their project fusion start has been delayed to 1 July 2024 for the transfer of community and mental health services to the new organisation. And finally, the ICB is currently in consultation about its new structure. So that's my announcement. I don't intend to take questions on that, but we'll move on. Item six is. Go on then, Debbie. If I may, just to add to that, I think the relevance of the transfer on the 1 July is that it's the childhood and adolescent mental health service that is transferring, which obviously is the transition phase, which feeds into the annual report from the director of public health in terms of childhood obesity moving forward. Thank you. Thank you for that clarity. That's helpful. Item six is tackling healthy inequalities. And it's for us to discuss inequality. The island and actions being taken by all partners. Simon, is there something you want to speak about on this? Yeah, many thanks to the university apologies. I couldn't be there in person due to personal medical appointment. I've got a few slides. What I really wanted to do, the health wellbeing board has a responsibility for thinking about health and wellbeing and tackling health inequalities. So for me, it was how we come together and really think about these issues and talk about them. So I've got a few slides and colleagues from around the partners have put their thoughts in so that we can then have a conversation about what are the key actions and really just understanding each other's priorities with regard to health and inequalities in this space. So I'm grateful for the colleagues for their slides that they sent through and apologies that they didn't come out with the papers. Marie, I'm sure we can put them online afterwards. Just a quick kind of, what are we talking about? It's the ultimate differences between people's health and thinking about health status, might be access, might be about quality of experience, those behavioural risk factors and then wide determinants of health. So it does involve all of us in different ways. I'm grateful for people like Colin Rowland has directed communities to really play his part in the wide determinants, but all of us need to think about how we tackle health and inequalities because if we don't do that, we are not going to improve the health of our population, which is our role. And between who, who has health and inequalities, it might be someone's socio-economic factors, so where their income or where they live, we know that there's inequalities from the island, the mainland for something, but also within the island. Let's not forget the different parts of the island have different challenges. Those characteristics of our population that may have worse health outcomes, they saw that really clearly in COVID with some of the BME populations having worse outcomes from COVID. And then those people who are socially excluded. It would be remiss of me not to bring up what we're doing with our JSNA, so that on the JSNA, we have inclusion of health groups, the Isle of Wight, which really starts to identify those people on the Isle of Wight who may be experiencing health inequalities, a wide variety of groups there. Some of them are quite small, but that might mean that we need to focus even further on those populations. So we have a JSNA, we need to use it, and we need to really question it and welcome comments from the board on the JSNA and what further analysis we need to do to understand health inequalities, and we had a presentation at a closed workshop. I think it was the meeting before last, where we really dug down into our JSNA. So if we just move on to different inputs and sorry, pairing into the screen, if you want to talk about economy and infrastructure, and we can then kind of go through two slides to each person and then have a conversation. Thank you, Simon. This is a very interesting subject there for me, having been an environmental health officer by training. So the links between health environment and the work that we do as a local authority in partnership with all sorts of other agencies as well is really important in this aspect. What I want to do quickly is just do almost like a whistle-stop tour of where our links are, the services that we provide as a council, but also, again, I'll talk crucially is the services that we have to provide in partnership. The council is a delivery of services, but also given where the democratically elected representatives of the island, where the sort of holders and the people bringing partnerships together to deliver on agreed outcomes. And this board is a classic example of this, but the council has an input into it, but it's also dependent on the other people around the table to be able to enable us to do that. Coming quickly on investment infrastructure and urban planning, we have an island planning strategy, incidentally, which we're seeking approval for in the first of May at our full council. It's been a long process, but that sort of planning strategy is brought up in terms of how that investment and infrastructure and urban planning will be developed and how that can make those beneficial effects on people's health. 15-minute neighborhoods is something that's banded about, infrastructure being within the local area, encouraging active travel, encouraging people to feel part of a community. It's all part of the planning system that we try and encourage on the island in that respect. Investing support and connectivity. We have a local transport plan that we're actually developing. Again, it's trying to move away from the need of a car or a vehicle to actually get around and actually encouraging people to travel actively, which again has a beneficial impact on health and on people's well-being. Supporting investment at local businesses, the links there between economy, prosperity and health and the need for us to develop the island economy and we have an economic development strategy, which again is one of the pillar strategies that supports other outcomes that we're trying to achieve on the island. Education and training, again, very, very important in that respect as well. Climate change mitigation adaptation. We have a council climate change strategy, which effectively is how do our services and how do we as a council impact on climate change and on reducing carbon. But we also have a council, sorry, an island-wide climate change strategy, where again, as a local authority, as an enabler, we are encouraging groups, organizations, agencies and individuals to try and aim and go towards net zero outcomes that we're trying to achieve. It will be remiss to me also not to talk about the biosphere and the biosphere objectives, which fit alongside those social environmental and economic activities as well. Coming down to other sort of specific services that we deliver, physical activities and active travel again, we are, we just recently be successful in getting a £14 million grant from the government to deliver a greenway strategy, which effectively is a transport, active travel and transport strategy that connects the east and the west of the island. Our last benefit for residents has benefits for businesses, but also has benefits for our tourism economy, which again feeds into that economic development cycle. So we're looking at virtuous circles in terms of the activities that we're trying to encourage and the outcomes that we're trying to achieve, which achieve those overall outcomes going forward. Public transport provision, we've just been successful in some funding from a zebra fund, a government zebra fund, which we will be providing towards southern vector investment for 18 electric vehicles on the island, our specific routes. So again, we're tackling that issue about encouraging public transport, we're also looking at clean air in terms of the development for that. So for the buses that aren't going to be electrified because of certain aspects of the way that they run or the topography of certain aspects of the island, the better quality engine vehicles will be actually used in those areas on the electric vehicles will be coming in and replacing more polluting vehicles. So Euro six engines, which are the most efficient vehicles will be actually coming to be ubiquitous alongside the electric vehicles on the island. We're very positive there. Electric vehicle charging, we've been given a significant amount of funding by the government to actually encourage electric vehicle charging both for residents, but also in terms of electric vehicle charging, collective points that we can actually try and encourage that infrastructure and the government are supporting us on that. And we're looking at a project to actually deliver that a lot more effectively. Public realm and natural spaces. As a council, we do, we do are responsible for quite a number of public spaces. And we also support Paris and towns in the public spaces that they deliver and manage and monitor as well. And the health benefits of people getting out into the open air, making use of public spaces, the mental health aspects of open spaces, et cetera, are well known. And that's the sort of thing that we want to encourage. There is a note of caution there in terms of the funding that we've had as a local authority to support these activities has reduced significantly because they're not seen as statutory activities. They're seen as something that we provide as a council. But we are looking at innovative ways of actually increasing that funding, working with the Paris and town councils, working with community groups to actually improve those public spaces further and to make sure they're readily accessible to people. That also includes encouraging community groups, encouraging sports clubs, and encouraging other active groups and individuals to make sure that we make best use of our assets that we have, which are only common, what the managed and maintained. The other aspects are that we've got our community meeting centres, including libraries, museums, and other activity areas. Again, that's social aspects and the beneficial aspects on mental health and wellbeing and on health and wellbeing of bringing people together socially and enabling those activities. Plus, again, working with the potential Paris councils on a closed basis to make sure that we fill the gaps that might be in provision as well as working with community groups and voluntary groups in that space. So, as I said, very whistle-stop talk. We can't deliver it by ourselves. We can't deliver it with the funding that we have on our own as a local authority. So, therefore, we have to work very, very closely in partnerships and recognising and working very closely with Simon, for example, in public health, the benefits that we have in health prevention. We have an MLU with Simon and his team where they actually fund certain aspects of the activities that we carry out because of the beneficial, the benefits to public health and the benefits to this sort of arena in which we're operating. Education providers, we need to work very closely with them in terms of our economic development strategy and bringing on the right to education and training for our young people and for people throughout their lives. Working with town and parish council groups, I've mentioned that before, working and encouraging businesses and third sector enterprises to ensure that we are building our economy in an effective way and investing in local place plans. One of the things that we're looking at is sand down cows, ride and other particular towns, working very, very closely with them to encourage place plans that look at the benefits that we can bring to health and wellbeing in that aspect. And one of the exciting projects that we're actually encouraging is a ride town plan, which is £20 million over the next 10 years to develop projects in ride, which relate to infrastructure, relates to community safety, but also the health benefits that we can create in developing the environment and the economy of ride as a place. It's unfortunate that we haven't got that money for the other towns in the island, but we are pushing D look on a constant process on the needs to actually encourage that sort of development that has that inclusive outcome-based focus that we can work with individuals, groups and the town and parish councils to develop this. Central government initiatives should have a strong public health component, and I've mentioned the greenway. I've mentioned the right town fund. The other one to mention is a safer road scheme on the A3O, which we've had funding from government to look at road safety, to look at safer road crossings, to look at speed and other elements that we want to improve that experience, not just for motorists, but for pedestrians and for other road users such as cyclists. So it's another thing that we're actually looking at that again feeds into our local transport plan, which again, there's that sort of encouragement of people away from multi-vehicles, but what we also want to do is to make sure that motor driving and multi-vehicles are safe in that respect as well. So very quick, whistle-stocked at all. I'm happy to take any questions. I think it might be as a suggestion that some of these topics we can actually come along to a future meeting and talk about in quite detail. I mean, for example, the leisure services provision that we provide, unlike lots of local authorities that have given their leisure provision away to an arms-length company or a trust or a private operation, we still operate our leisure facilities for the outcomes that we're trying to achieve overall, like for the health outcomes and for the other benefits that we achieve through that. And as a result, that costs more. It will do because of provision, but we are working post-COVID because we were operating a surplus with our leisure facilities. We're now operating with a deficit, but we are working to work that deficit down because we see, as a local authority, the benefits that provide on top of just providing a gymnasium for somebody or on top of providing a swimming facility. It's all the other benefits and inclusivity, which we include within that particular service. So that's quite a whistle-stop tour. As I said, happy to take any questions and I'd welcome to come back and talk about some other issues in more detail. Colin, thank you. Oh, sorry, Chair. Sorry. Go ahead, Simon. I was just going to talk to you, President. So I was going to do one slide, and I think we're going to move on to Simon for adult services and then Ashley in the chest. So from my perspective, public health services are all proportionally universal. So that means we have a universal service and we have a target service. For example, we actually pay more for people to go out smoking who are in groups with a high rates of people with serious mental illness or people from particular groups of workplaces or things like that. So we're really trying to think about how do we, as Colin said, there's lots of services we provide and lots of interventions about how do we make sure and support those people who are less likely to have good health to access and enable to be benefiting from them. So that's my quick slide. I'll do it. Simon, do you want to talk about adult social care and housing? Yes, thanks, Simon. And hi, colleagues. Good to see you all. And I just wanted to bring in to focus some of the work we're doing in adult social care and housing, which clearly links to our health inequalities, and more importantly, the key actions that we're taking. So adult social care and housing strategy development is very much aligned with our local trends and demography, ensuring that people have the right support at the right time and that support is in the right place. And this is very much linked to the JSNA. What we do need to do and increase our activity and is to provide better support for unpaid carers through the carers passport. We've recently appointed to a carers officer role. We'll be working within our front door team, which will provide much better direct access to advice information and guidance. And obviously then that direct support for care is much wider on the island. We work a lot on co-production, ensuring local people that once needs help shape everything we do. By saying everything we do, I mean, that informs our commissioning, it informs our social work practice, informs a lot of our processes in our systems and we need to make sure that we continue that really fantastic work. The redesign of our front door, we're creating a well-being and access team. What that will do is improve sign posting and really connecting people to the community and the resources they have around them and the universal services that are within the local community. This front door will provide an increased focus on early help and again connecting people with community groups to help prevent that social isolation. Improved access to self-service and self-assessment. A really key area of focus for us going forward to enable those who choose to have access to a digital assessment, for example, or a digital eligibility, and like you would expect in some private sector organisations. Our practice focus, the focus of our social workers who are out there in our community has to have the well-being at the heart of everything they do whilst ensuring where possible people have strong links to the community with a solid focus on prevention. Strong practice with children services colleagues, ensuring vulnerable groups are well-represented and transitions are effectively managed and we have had some recent very productive meetings and conversations with children services colleagues on how we join up together some of our strategies and some of our practice. Another area that I wanted just to highlight and a key theme for us is the carers that we have on the island roughly around 16, 17,000 unpaid carers and some of the themes we have got from our regional surveys are in front of you here at our pretty self-explanatory but you can see that 48% of carers surveyed within the southeast region say they don't have access to physical activity. It's not prioritised so again more to do in this space. Our carers out of white provide gym sessions. The carers once a week but we could do more in this space most definitely when we work together to look at this space. Again mental health, 26% of respondents of the carers UK survey describe their mental health as bad and another theme is around loneliness, 77% of carers in the southeast survey said they felt lonely and evidence on the island of white suggests this is similar as well. Again carers island of white offer group sessions with peers sometimes based around shared activities such as art and craft for example or trips out in the community but I think together working collectively we could come up with more more we could do in this space to overcome some of the key issues for carers locally. That's a whistle stop tour from me Simon I hope that helps and I'm obviously happy to take any questions, comments once we finish the other slides. Brilliant thanks very much Simon and I think we want to Ashley. Hello everyone this is my first health and well being board meeting I'm Ashley Whitaker I'm the Director of Children Services at the Council and I joined on the 1st of February. So there's two slides from me about some health and equality matters relating to children and young people on the island and I thought I would share some of the data from a survey that was done the be well survey that was done with children and young people on the island last year and I have chosen I could have chosen a number of different groups to look at health and equality is on but I've chosen to look at it across gender those children accessing free school meals those with educational needs and disabilities and just a comment really about children who are in care of the local authority or care experience. So the first one is around gender so something that when I was looking at the data jumped out at me was that there's a difference between the percentage of girls who are accessing at least one hour of exercise a day and boys so 30% of girls 43% of boys and in addition if we look at the differences between girls and boys of those who are accessing school mental health support it's also quite different so I guess one question from me around that is is that 26% of girls accessing school mental health support and only 15% of boys is that a does that tell us something about the actual state of their mental health or is it about their willingness to access support so that's an unanswered question but there's something going on there and there's also something going on about the difference between girls and boys that are accessing that physical health and of course that has an impact not just on their physical health it also has an impact on their mental health because we know that there's a significant link between exercising and being active and young people's mental health as well and we know that mental health needs increased significantly during the pandemic. If we look at health inequality across children who are accessing free school meals and not accessing free school meals you can see really significant differences in the example of how many have been to the dentist within the last 12 months so 64% of children on free school meals said that they have been to the dentist in the past 12 months and 83% who weren't on free school meals said they have been so you can see a very significant difference there and there's a number of reasons why people might be on free school meals but the biggest one is around the economic status of the family in which they're living. If we think about current or previous users of e-cigarettes sometimes referred to as Vapes I think technically that's correct Simon isn't it? There's a significant difference between those children on free school meals using or having used Vapes and those who are not in fact it's more than double. I think that's very significant of something which needs to be addressed and indeed is being addressed Simon referred to the smoking cessation and indeed the chair did earlier as well the smoking cessation policy which also covers that. If we think about children and young people with special educational needs and disabilities and go back to the school mental health statistics so 35% of children with special education needs have access school mental health support against 25 without. We do know that those young people who do have an additional need quite often have additional mental health needs and we also know that depending on the severity of those learning disabilities that they may have the ability of practitioners to understand and support those mental health needs is more challenging sometimes but certainly the mental health of those young people we have who have an additional need is something we need to be considering and if we also look at those young people who have special education needs or disabilities in their use either current or previous use of cigarettes this isn't Vapes this is the more traditional type of smoking it's more than double so if you have a special educational need you are more than twice as likely to have smoked cigarettes either in the past or now that's something we should all be very concerned about and I also just wanted to highlight the need to consider health inequalities within children who are in care or who have been in care in the past because we know that they often do not have as positive health outcomes as those children who are not and of course we're all responsible for that in terms of our corporate parenting duty so if we just go to the next slide Simon thank you these are just some of the things that happening within children's services which have an impact on how we are addressing those health inequalities so the first one is around the development of a new education strategy for the island so we're aiming to publish a draft new education strategy for the island which will consider how we as a council are going to be working with schools, earliest providers, colleges and everyone else involved in the education system on the island over the next five years so it's a strategy through to 2030 and of course there will be a big element of that will be driving up academic outcomes but it's also about broader wellbeing of children and young people and we know that of course there's a real link there as well isn't there because if our children are healthy both physically and mentally they are better able to learn and there's a really big link there between what's happening within our schools and health inequalities amongst our communities. The second thing is that we're in the midst of completing a self assessment of provision on the island that does support special education leads and disabilities that's something that happens within schools, earliest providers and colleges but it also of course happens within our communities as well because children, young people spend a lot more time not in school than they do in school because school finishes at three o'clock in the afternoon, three-thirteen in the afternoon. What are they doing between then and bedtime? What are they doing at weekends and what are they doing in school holidays? So we're assessing not just what happens in school but we work with colleagues for example across the integrated care board to assess what is the support like, what are waiting lists like, where do we have gaps in provision to make sure that our outcomes for children, young people with special education needs improve beyond where they are at the moment and that self assessment around our send provision is feeding into the education strategy and the approach to special education needs will be a subset of that holistic education strategy which we're aiming to have out by the end of the summer term this term. The third example of what's happening is we are making some changes to the way that we address our corporate parenting responsibilities so for example there was some training that happened last week around for our elected members to make sure that they are aware of those changes and their responsibilities. And the fourth area is around working with colleagues in the council we heard reference to working with more closely with adult social care that Simon H mentioned and Colin and I were also talking yesterday actually about access to leisure centres so we know that for example health and equalities for children with special education needs is not they're not as good as we want them to be. So what are our leisure centres like for those who have disabilities? How accessible are they? Are they places that everyone in our community feels comfortable and welcome to visit? So we're looking at that although the initial look is quite positive actually in terms of the investment that the council has made in the past about making sure those facilities are as accessible as they can be and an example of working with partner organisations I could reference a number of voluntary sector partners that we work closely with who are very active in this space and do some brilliant work. So thank you very much to our voluntary sector colleagues for everything that they do in this space for our children young people. Thank you. Thanks Ashley and then I think we'll just move on to Campbell who's online and Steve Parker and then we'll have a leader we can open up the discussion after these couple of slides. Yeah thank you Simon and hello everyone. I'm Cam Todd. I'm Deputy Director for Population Health and Health Inequalities in the ICB. So I'm just going to give you a brief overview of the NHS approach to tackling health inequalities and specifically talk about healthcare inequalities so this is more around the focus on our NHS services. So the first thing in terms of our overall purpose it's about closing the gap in the healthy life expectancy between the most and the least deprived areas and also improving the number of years that people live in good health and really that's a shared purpose across a number of partners. In terms of our vision and our strategy we focus particularly on three areas so on access experience and outcomes. So the emphasis is equitable access, excellent experience and optimal outcomes. We also have five high impact actions that were required to take in addressing health inequalities. So the first is around restoring services inclusively and that's recognizing that we have a number of challenges post-COVID and backlogs in our services and access to our services and that's particularly focusing on primary care and elective services and urgent care. The second high impact action is around mitigating digital exclusion and that's recognizing that post-COVID a lot of our services have moved online so it's making sure that we still give people choice about how the access our services so we're not widening inequalities by restricting access. The third high impact action is about ensuring robust data sets and that's recognizing that if we don't have good data then we can't understand our populations and there's a particular emphasis on improving ethnicity recording. The fourth action is around accelerating prevention and it was great to hear your mention of smoke-free and smoke-free generation earlier and also Simon's approach to weight management. So there's shared priorities with the NHS smoking, weight management and alcohol and then the fifth high impact action is about strengthening leadership and accountability so that's making sure that we're accountable at board level right through to the delivery of our services and that we're transparent about the work we're doing and the change that we're making. There's a number of delivery frameworks that we use to deliver these priorities. One of those is the core 20 plus five framework which I'll come to come on to explain a little bit more in the next slide. We also have the NHS oversight framework which has a number of measures which NHS England requires to improve against and those areas are things like cervical screening, flu, MMR vaccination and cardiovascular disease. We're also required to take account of inclusion health groups so those are particular populations that suffer higher morbidity and mortality and diet at an earlier age so that for example would be people experiencing homelessness or silencing as refugees etc. We're required to take a population health management approach so that's really an improvement approach using data and insight about our populations to improve services and then all of that is kind of specified within our ICB joint forward plan so that's our five year plan for the integrated care board and also our shared system strategy. There's a number of levers and enablers to support us to do that so the first is attacking health inequalities is now a strategy duty for the NHS so that is for the integrated care board and all of our NHS providers and we have a core data set that we use to understand inequalities in our population and take action every NHS board is now required to have an executive lead for health inequalities and that provides a direct line of sight really from the board to services ICBs are also assessed on our strategy duty delivery and providers are and there's a forthcoming CQC assessment of integrated care systems which the Care Quality Commission is currently developing. We also need to think about how we use our money in different ways and Simon earlier mentioned proportional universalism so that's about how do we weight our resources to areas of higher need and then the final area is about working jointly with partners and particularly public health and Simon and his team doing all this needs to be done in partnership the NHS can't do it on their own. The next slide which I think is in your park is a bit more about the core 20+5 framework so this is the healthcare in the quality framework that we use within the NHS. The core 20 bit is about focusing on the 20% most deprived using the index of multiple deprivation the plus bit is around priority groups that we work together as a system on and have listed those plus groups who are adults and both for children and young people and then the five really is the clinical areas and actions that will take to close the gap in health inequalities and the reason those areas are important is those clinical areas contribute most to the gap between the most and the least deprived and there's a framework for adults and also a framework for children and young people that kind of outlines that and then the next slide is really just a chance for Steve and Natasha and others who just give some local examples around the core 20+5 delivery mechanisms that are happening on the island so I hand over to Steve and Natasha they don't appear to be here. Okay so should we move into, I mean I think for me that was a kind of whistle stop tour of all of us thinking about inequalities, leader and colleagues around the table so I realised online it's a bit more challenging but I guess it's just reflections from board members, where do they want to see some more focus and how do we really think about tackling health inequalities as a key part of the Health Wellbeing Board going forward and I think if we just picked one or two things it might be that those are the things that we then kind of go hard out on the island. Over to you leader. Thank you Simon. Are we finished for a come here? We've finished with your presentations. Thank you Simon. Just for a come to Dave. Thank you all for that. A couple, if I may, a couple of comments. First one is a practical one. Could I ask any of the people that have presentations that we have those documents into the Council on the day of this meeting at Lotus? It is quite difficult even with five and six foot wide screens here to see some of the detail and I know that some of the members sat in the room were struggling to read some of those slides. It's not a criticism, it's just could we have that provided to our Democratic Services so we can print them out or provide them electronically? Has that my fault? Yeah of course leader. Thanks Simon. And then just I guess a general comment. A couple of comments for me. Yes Colin, please thank you. Good to see you here to for us to understand that transport and infrastructure is actually part of health delivery and health inequalities in our communities. So thank you for being here. Thank you for your offer. We will take that up. There are some specifics in the detail that you did a whistle stop on. We'd like to pick that up with you outside of meeting and bring that along perhaps in more detail that future meetings. Thank you for that offer. We'll take you up on that. The second one is if I might a comment and then something more specific. I spent some time around the gyms with our chief exec, our leisure centers and was interested to hear that since COVID there's this is in terms of children actually. There's been a growing demand from 13 to 16 year old boys and girls to attend the gym. Now I won't make any suggestions why that might be. But it's quite interesting that those numbers have increased and I'm saying that in context to some of your comments actually about health for our children's schools. It may not be. It may be for other reasons that they're doing that. But I think it's worth noting that there is quite an increase. I don't think it's worth noting that they're not going to go through the COVID. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. 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I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I'm not going to go through the COVID issue. I made a few notes and you get the statistics every week like I do with regards to bed and breakfast and the number of children that we have in bed and breakfast. Hopefully being educated, hopefully being able to do their homework. We have a number of families in caravans to probably go up there. Chair, I haven't got it with me. It's probably on our own. Yeah. And it's shocking. Never go below 30 children in bed and breakfast. We have a children. So I'd like to put that forward as one of my major concerns. How the heck do we hope to give hope to our young people when they're subjected to that? I heard nothing about rental providers, the housing associations in our conversation. Yet a heck of a lot of our population are housed through the RPs. Deed up and central government have actually gone now and said, okay, you have to upgrade your housing stock. I haven't heard here as yet how far the oil of light has progressed. Let alone a hunch. But I haven't heard how are these RPs progressing with their upgrade, making the houses warmer. Bring them up to 21st century standards. We don't know. We don't know what the investment is that's gone in. We don't know the housing numbers and we don't know the families involved. And when Councilor Andrey is saying bottom up, that's what I want to hear is okay. What impact are we actually having? The impact assessment should be done. I'm going to go. I've got a list here. I'm sorry. I'm going to take a bit of time. But I will be succinct for a change. All I'm going to say is that we need, we're sat around here. We haven't heard from the rental providers. This is supposed to be our house for people on the art of light. Every one of us sat around here and knows the people in housing association or RSL accommodation. Every one of us. That's how it comes into our societies integrated in there. We don't know what they're doing or I haven't heard what they're doing. Perhaps that's a stat that Natasha and Steve were going to give who aren't here. I don't know. So I'm concerned about the lack of input from our rental providers into the health and wellbeing board. Because we know we've got temporary accommodation. No, there's no tomorrow. We don't seem to be able to crack it. Yet, you know, there is a problem there. I'll just move on. I'll just move on. Well, we've got the household support fund now. Thank goodness. Late after we set our budget. But I will say that we recognize that there will be a shortfall. And we made provision in the budget, tight as things were to put a few hundred thousand into community support fund. And that is still there and we're still we're open. We're open to people to come forward and see what we can do to assist the processes. So we have got that. It's not an ongoing thing with the household support fund because quite, quite honestly, that's only going to run for six months according to the central government. Until, until suddenly there's an election and we find that someone's going to put something else in it. So we're already doing our bit, but we need to, we need to be a bit more clever with the way that we're taking taking that forward. But we've done that as half a million from from the Isle of White Council into that and into the place plan and town of parish councils helping them and taking them forward. So there are things there. But we need to, we need to dig in deeper to get to impact assessments on what what's going on with the rental provision on the Isle of White. And I think that's that's an error we should be drilling down to. Noting that the ICB have got housing on their radar, I'd like to know a little bit more about what that actually means, what the impact is and how we're fairing with it with their contributions. Where's that going? What are we doing with it? Or what are they doing with it? I see core 20 plus five. And once again, that's a group of the group in there are actually targeting those experience homelessness. It's a great headline, good strap line, but I'd like to know what that actually means for our island. Both in finance and in impact to what we're what we're doing, how we're hitting the tire of us. And I'm going to leave it at that. I could run on for a few more minutes, but I won't. I'll see you. Everyone's getting agitated. So, rest assured we're not doing enough to actually look at our housing and the factors involved in temporary accommodation and those young young people in bed and breakfast. And what impact it is on their mental health and indeed their education. Thank you. Thanks, Ian. I'm going to come to Joe and then Simon wants to, we need to move on because we'll have things on the agenda. I'm not sure. Did you just want to mention it or not about that? No, no. Okay. What Ian, thank you for those comments. We, we appreciate housing is a vital car of people's health and part of inequalities. I would have given you, in fact, I will. He said. As of Friday. And I suggest as is in previous health and well being balls housing becomes a matter for discussion is important and thank you for rising it as a Friday with 33 children in B and B accommodation. We could be a caravan or a hotel room. We had 202 families in temporary comments. This is off last Friday. And we had 44 single people in temporary accommodation. That's the extent of it's effectively, I have to be careful with my narrative and language here. They're actively homelessness, but those involved in homelessness wouldn't see it as homelessness, but those people are in homes. They are at a disadvantage. Quite clearly. And the end in its role as for housing for this council's work enormously hard and just trying to deliver one or two houses or 10 or 20. It's extremely difficult, but we're working on that. So, Joe, I'll come to you and then you Simon will move on. Thank you. Thank you chair. And this is my first meeting and I wasn't going to say anything I'm conscious I'm learning. However, thank you for the presentation. I thought it was really interesting. I'm not getting a sense of what the wider system element is. So I felt I got a really good understanding of what is happening within the public sector. So we had presentations that included from public health. And I felt the ultimate counsel from the ICB. But I didn't get any sense really of how the voluntary sector fits into that system response that health inequalities. And what the voluntary sector is currently doing to support that and I think that would be a really good thing to look at going forward in terms of next steps. And that was really my next question. What are next steps. Somebody talked about providing leadership. I think it was yourself. And I think one way that that could happen is that all providers could be much more closely monitored for the role that they are playing to address health inequalities around their contracts, because I'm a talking about our contracts. Although it's there, almost as a subtext, it's not overtly spoken about as part of that monitoring, and that might be quite a benefit. But texture, very valuable commentary there. Simon, I'll over to you and we'll move on after. Thank you. Yeah. So really helpful. So firstly, can Steve is, yes, housing is a key part of our being board strategy because it's so linked to health and well being. And just asking the assignment, can we have a more focused topic at the next board on housing and health and really bring that back. We've done it regularly. I think, for me, following this presentation, we need to focus on a key topic and just thinking about what's fed through a number of those presentations. I'm wondering if you think about inequalities and physical inactivity, which felt like it touched what Simon said, what Ashley said and what we've heard about leisure. I think, Joe, you're right. There's something about how do we measure inequalities in all our presentations at various boards. I'm not going to speak for the health and care partners at the island, but I'm wondering if Michelle and I can work together on what is an ask for help to on being bored, and the health and care partnership on how we identify inequalities in relation to the items being brought forward. And also, Joe, we can help develop a framework so that we can really support commissions and providers to measure that. My final kind of point is actually anchor institutions, which is the next item of the agenda is something that we can do together, and that does help tackling the quality. So, you know, we are planning to leadership, but we haven't done this item before. So we're in the early stages of tackling health inequalities. And I think we should say there's a lot of work to do, but we've done, you know, we are working on this agenda already. So we'll take those actions forward with partners to make sure the next board presentation working, Marie is on housing, and we've done some of the work in the background to give an update to the next board. Would that be a key leader. Thank you. So I'm going to appreciate that. And it will be good as we move forward to see some of our aspirations and strategic approaches as Joe referred to turn into delivery. So we'll work on specifics as we move forward on some of these board meetings. Can I move on to our anchor institutions seven, it's to receive a presentation from Fiona. Go ahead. Just give us a minute to share the slides. There we go. Okay, thank you. Good morning. My name is Fiona Maxwell acting consultant in the public health team and I'm going to be joined this morning by Hillary Todd on screen associate director of occupational health and well being with my Max nickel and community wealth and special projects officer, I love white council. One moment. Sorry, just an issue with the screen sharing. I think I'll just carry on anyway. So the other we're going to be talking through an overview of here we go of next slide of anchor institutions with a particular focus on the relevance of anchor approaches in the context of work health and well being an economic development. And you'll hear from Hillary and from Max about current ongoing work on the island. There are a few definitions available to describe what anchor institutions are fundamentally, although they vary in some of the detail, essentially we're talking about organizations which are large and influential in their local economy and community, which have resources. In terms of buildings and facilities and which employed people and by goods and services. Anchor approaches is really about how those institutions and organizations can use their resources financial and physical and human, and they can adapt and target their normal activities in ways which has benefit and value to the community in which they operate. In other words, they still need to employ people, they still need to buy goods and services, they still need to maintain infrastructure, but they can do so in such a way that benefits health and wealth and well being, and addresses inequalities in a targeted way. We're just working through definitions here an alternative definition from the Center for local economic strategies that's class places less than emphasis on the idea of anchor institutions being fixed or permanent presence but still highlights the same characteristics of anchor institutions as employers and purchasers and owners of land and other assets. Further defined fundamentally the theory developed from observing practice, and in the NHS context that was first mentioned in the 2019 long term plan where there was recognition of the value of some of those approaches. It looks like we're working down those are still not okay. We've referenced an early pilot project in Leeds, where the local NHS trust me the decision to focus its employability and skills outreach and apprenticeship programs on the most deprived 1% I think it was in their community and increase their apprenticeship programs offer to that community. And the long term plan in 2019 also stated a commitment to developing those approaches in future. So we're on the next one area health and work connecting employment health that's it. So I said we'd focus on the area of working health, partly because we don't, we don't have all morning it's a big area obviously, but also because this is one of the most important areas and one where significant opportunities do exist. To use the resources of anchor institutions to benefit people and our communities the relationship between work, which is obviously a key determinant health and well being is a complex one but fundamentally being in work being in good work, which is secure and safe. And where employees are treated fairly is good for physical and mental health and well being it provides the means through income by which people can make choices, choices about what the choices about how they spend their time choices about where they live. It also provides structure and social interaction for many people, and a sense of purpose and productivity. At a population level, we see that the distribution of areas where there are high levels of economic inactivity will tend to correspond with patterns of high morbidity and premature mortality. Of course there are barriers to work and this is why one of the essential principles of anchor institutions is so important which is actively considering those barriers which mean that there are inequalities in people's ability to access work and productivity. In other words, the people most at risk of poor health outcomes are often those people who are least empowered to improve their own life choices through accessing productive employment, or are most like most vulnerable to losing employment if they do have it. We have a fairly high level graph here. I'm not sure how well you can see around the table there the public health intelligence team have been doing some recent work. This is very much just a headline on a cool island level. This does need some further investigation the data from public health outcome framework but this shows recent trends in levels of economic inactivity in England, the black line at the top, compared to why obviously the blue line below, and the key trend there seems clear that post 2010 2011 economic activity on the island was not able to regain to recover to quite the same extent. As on, as in England at war when it seems to be continuing to decline. As I say we can't fully explain the reasons behind this and there will likely be considerable regional variation, depending on the types of employment available on the demographic characteristics of any particular region but I think this probably does serve to illustrate the unique challenges faced by an island economy and the need for a tailored intelligence driven approach to building economic activity. Many of you will probably have seen the next slide before or a variation, a variation on it but I will find it helpful to summarize those key impacts and effects of separation from from mainland for an island and your other rural economies whether that be to do with the physical geography and distance, the range of opportunities available locally or the specific needs and characteristics of the island population. I think it is a brief run through but I think as anchor institutions we do have opportunities to work both as individual organizations, and also importantly together to build and protect community health and wellbeing and address inequalities through supporting people to access and stay in good quality work. I'm going to hand over now to Hillary, we'll talk about among other things a 350 plus program, which has been working to engage young people in particular to think about careers and opportunities within the NHS. Hillary will do the slides from here. If that's okay. Thank you. Thank you Fiona. So, as previously mentioned, I'm the associate director for occupation health and wellbeing here at Solent NHS trust, but also I'm the senior responsible officer for the education to employment program, which sits across the whole ham of Hampshire and the Isle of White. I don't intend to go through all the slides in detail, but just as an introduction, the 350 program is a careers based program that introduces the 350 careers in the NHS, but also engages with students about wider health messages, the Hampshire the Isle of White T level support is supporting the development and implementation of placements through out the Hampshire the Isle of White and specifically on the Isle of White. So you will see there about the specifics about our engagement on the Isle of White. And we, we provide support into the schools and colleges and create a number of opportunities for students to talk about careers, but also the wider healthy and me sessions. Our T level support, which is the next slide please Max is, we talk about this at both national regional events about how to develop T level placements in both health settings, but also beginning to have discussions about how we can provide to T level placements in wider settings. So T levels students need to complete 450 hours of employment placement through their program. They can work across a number of organizations. So there is the ability to work in care homes and in the NHS sectors or in businesses. If a student is doing a T level business and admin course they don't just have to work with one organization. And we have been taking part in some research with the Gatsby Foundation, which is a philanthropic research program into how T level students can lead into the workforce of the future. We, next slide please Max we've just been commissioned to provide support for care levers and support the care levers covenant in Hampshire and the Isle of White. And we will be working with organizations cross all sectors to ensure that we provide support to care levers. One of the areas that we are going to work with, which is slightly different from other initiatives is that we're going to work with the wide personal advisors. So we provide education to personal advisors, who can then pass on that information to care levers rather than working only with individual care levers. And we plan to provide a program that will start in at least year 10, 11, and then into college so that that earlier intervention so that care levers can begin to think about where they might want to work when they actually leave care. And then finally, just to, we have a dedicated parents and carers page on our website. And that links into also engaging with parents of children who those parents themselves might have not considered a role in the NHS so there's links to apprenticeships as links to the skills boot camp. There's more information that actually parents as well as students can access. So thank you back to you Fiona. Apologies again chair for technical difficulties and Fiona did a brilliant job of covering that and unfortunately what the board would have seen with some broad definitions of what anchor institutions are at the beginning of the slide so quite much share those afterwards, but we're trying to emphasize is that individual institutions and organizations have the ability to shape things within themselves, but collectively we need anchors to work together so we can affect that wider change. Again, you've heard from a couple of the directors around the table today about strategies that they're working on and developing. Again, that will affect change within the Isle of White Council and things within our influence, but what we're hoping to do with the development of working with other anchors on island is actually to foster collaboration, develop that opportunity for shared learning and intelligence and reduce duplication of work as time and time again we see that on island that actually we're already working on something that our partners are already doing and we might not be aware of it. And sometimes rather than duplicated we can work together to save resources, but we're well aware of the pressures on public services. The health anchor learning network has already identified widening inequalities, growing pressures on public services and actually it's raising the question that public sector organizations need to work together to tackle some of the big issues. But in order to do that it's identified these five key points in terms of anchor work that good partnership working and buying from stakeholders is absolutely essential. Senior leadership senior leadership support is also the enabler planning is also key, but it's the capacity is one of the biggest challenges and so is the time. We see that from national examples that actually and Hillary mentioned that support from the Gatsby Foundation that places where anchor networks have been successful have got external funding they've got philanthropic support they've got backers. We unfortunately don't have that on the island at the moment, but what we're hoping to do is work together to solve some of those issues. So what's the bigger picture, while this comes from community wealth building, that is essentially in simple terms creating a resilient and inclusive economy for the island. So that's what we want to do and how we're going to do that while we're proposing that actually working together with anchor institutions that's a mechanism to develop community wealth building on island. Successful examples the most famous one nationally is the Preston model. There's also huge work with anchor networks in Manchester, several have also started working London. And the benefit of that is the wider social valley and the purpose of this board, it's seeing that greater health and well being benefit so that is through apprenticeships that is through jobs and training that is through upskilling people. What are we doing on the island? Well, again, you've heard what's within our control the Isle of White Council it's, it's essentially already in the corporate plan or bar name. Community wealth building is essentially an approach that redirects health, sorry, wealth into communities and provides opportunities. So within the corporate plan there are already various points that allude to that. It's about strengthening the island economy and making it an inclusive place. How can we do that? Well, already we've worked with the Center for Local Economic Strategies in 2022 into 2023. Then Director of Strategy Wendy Pereira commissions class to work with us to look at how we could develop community wealth building on island. So that's actually led to my post being created recently to help with policy and strategy development but also embed community wealth building practices within the organization. In order to have that wider effect, we need to start looking at what we could do on island and potentially explore the appetite for an island anchor network. Again, that work that we did with Kles, we did have initial conversations with some of the key institutions on island. We then engage with the NHS trusts, the ferry companies, Isle of White College, etc. And everybody was keen to work together because they had shared priorities and many of them you've already heard about already. In terms of low wage economy, housing being an issue and actually encouraging people to come and live here and work and contribute as part of the community. So what could an island network potentially look like? Well, it's kind of alluded to it already. It's about large, large organizations on island. So that could be us that could be working with the trusts, ferry companies, housing associations, college. But also, unlike in a lot of other areas, there's no reason why we can't work with private businesses because they have a significant local presence. They've got a stake in the community. So we are talking about GK and we are talking about investors. We're talking about typically the largest employers on island, but also with substantial procurement budgets and that purchasing power. Because again, it was slightly missed in the technical issues with slides, but in order to develop an anchor network and to help support and sustain jobs and economy. One of the key ways to do that is looking at progressive procurement and how we could market shape things. So again, we've got lots of examples of how they've done it on the mainland and within different local authorities, people working together to create opportunities for jobs and growth, whether that's retrofits, whether that's cleaning contracts. There are all sorts of things that we could collectively look at together to work on progressive procurement. And again, just kind of ending on shared priorities, that would be for the network to decide. So again, when we had some workshops before last, we looked at a statement of intent and I could briefly read it to you because it's only a couple of lines and this was very much a draft. But the draft was the anchor network has been established to support participating organizations to maximize the benefit they bring to the island for economy, both individually and collectively. Anchor organizations and major economic agents by collaborating on key areas of work, specifically procurement employment and management of land and assets. They have the potential to play a powerful role in shaping the future of the islands economy. That's the end of the presentation. Thank you, Jeff. Thank you so much for the presentation, just to, we will circulate after meeting digitally this slide so. Thank you for that presentation, appreciate the information. I did notice the one at the end about further full slide which takes a while to understand this. I'm probably taking a while to understand how this works, although the idea of working with some of the larger employers. That's what it seemed to be saying employment companies companies employ people in terms of their size, rather than their commercial value. Does make sense as an island if you, but how we capture that and exactly what you want them to deliver. I'm still, I'm not quite sure yet. Any comments or questions on that process, which is interesting. Am I on I am yet. Thank you, Max for that presentation. I think we're probably the largest of the anchor institutions on the island. And I'm sorry, I don't have a name and I'm Joe Smith. I'm the chief officer of the island wide NHS trust. I'm really interested in this. We have reached out a few times to people around this subject were really keen on developing that kind of framework on the island, particularly important for us in terms of tackling deprivation as well. Because key to deprivation, of course, is giving people a root out of poverty. So we're really open to that. It's really refreshing to hear that somebody's now going to take the lead on on pulling a network together because I think if we did work together. There are opportunities to bring jobs onto the island as well. And we know that there have been opportunities for the for the trust to be able to do that. But we just didn't have the capacity to be able to reach out onto the mainland and bring it over. So if we were able to develop something like that, I think we could bring actual employment onto the island as well and create more jobs. Thank you so much to hear that. Ashley. Thank you Max Fiona and Hillary from a children young person perspective. This is full of hope. I think it's really exciting and thanks for all the work you're already doing on it. I have had the pleasure of meeting a young person actually use on one of these related schemes up at the hospital and fantastic opportunity for young people. I haven't seen that map before with the scissors on it but it's very helpful looking forward to have the slides because I can think where I can use that and other things. All the work around two levels working with schools. It's fabulous work. Loads of overlap with other strategic priorities. So, for example, the care leave is covenant. This is fantastic. Also, the link to having specific information for parents to help parents work support their children in all this is really, really important. I've heard already my short time here about how parents and care is and your people would like more information about things because often there's really great things out there that people don't know enough about them. So fabulous that you've already prioritized information for parents and care is on that. A couple of things for the future. So, we heard about T levels and vocational pathways for young people. One of our priorities you've already heard me talk about is around special education needs and disabilities and I wonder whether you've got something specifically to support those young people who have additional needs and need that extra support to get them into work and be as independent as they can be. So, for example, do we have supported internships as well as internship opportunities? Do we have a supported apprenticeships in addition to apprenticeship opportunities? Because those young people where we have a statutory duty to support them up until at least they're 25, you know, anything we can do to help them be as independent as possible, develop their employability skills and get into paid employment as much as possible would be really, really welcome and is a really significant overlap with other things we need to do. And in terms of the purchasing power procurement opportunities that the council has the NHS and other employers and how we can engineer social value into those contracts so how we can include opportunities to ask our providers to include supported internships, supported apprenticeships, working with our care leaveers and giving give them opportunities would all be really, really welcome as well. So, thank you very much. Thank you Ashley. Thank you for your commitment also. Thank you. And again, thank you for the presentation. I ask, do anchor institutions just have to be larger organizations because if we're looking at our sense of place, traditionally the Isle of Wight doesn't have significantly large organizations and there are significant numbers of much smaller speeds. And so I wonder whether for the island, if we're thinking about how this is developed, we could think about that and whether part of anchor institutions is also about culture and attitude. And obviously from where I'm coming from about support for young people in into employment. And for example that could include commitment to apprenticeships because that doesn't just have to be in large organizations and that can be in the voluntary sector. And we traditionally don't have large organizations on the island which have volunteer sector organizations. The other thing I wanted to just ask, I thought it was an excellent project that's going into schools, but there is already a reasonable amount of support that takes place while children and young people are still at school. And I want to ask about what is being done to support and needs. So those who are not in education or employment or training, because they appear to significantly fall through the gap at times. And again, if we're looking at this, it would be great to make sure that that cohort of young people are also considered alongside this. And there are about 500 approximately 500 young people on the island who are currently on universal credit, who need to be supported into employment, and many of those probably have some level of mental health need as well. Which brings me to my last point I'm here to represent the voluntary sector, but I do just want to let people know that the youth trust is working in collaboration with the Art of Bike Council. And with the DWP and will shortly be launching a scheme to work with children, young people who are not in education, employment and training to try and look at how do we integrate well being a mental health support. So with their employment coach and situation to try and ensure that the outcomes for those young people are more successful and that they do get into employment and they stay into employment. So I would, from a youth trust perspective, be really keen to be working with you once. Thanks for coming Joe. I appreciate those comments. Chaimu to Simon and if you want to read Simon. I was going to say really helpful and I think as I have more being board really want to support this work, because of the links to have more being. Yes, there are many other benefits to the island but we're focusing have more being and recognize that. And Joe I think your point about small institutions is really well made. How we start with the large ones have got more as this size is more buying power and more power, because they're actually bring others on board because that enables small organizations to benefit from the larger ones so yeah absolutely. And I think we support this work leader. Yeah, thank you, Simon. It's really think you want to write Max or Fiona and we'll move on if not. I'm just in response to the first point about, is there any reason why voluntary sector could be included. Sure answer no, there is no read definition which is why I've put one of the definitions back up on the PowerPoint. We selected three to demonstrate that actually there's key themes regardless of how you're describing angst anchor institutions. Like I said, it's those organizations that have a significant presence and stake within the community, which is why when we started exploring this in 2022 to 2023 and engaging with some of those potential anchors. It's about who could affect the largest change on Ireland, and we were looking at that through procurement and spending power. And again, in terms of how we get that added social value, our former procurement manager relaunched the island, I advice procurement strategy. I think it was November 22 to specifically include community wealth building as a part of that to demonstrate our commitment to working as small and medium sized businesses and getting low and barriers for them to try to forget. So no, there is an awful lot of work that can be done, but we very much are at the start of this and already I've heard from lots of people on the board, particularly talking about strategy development, et cetera. I think this is a key opportunity for us as an organization to start ensuring that all of this is embedded into all of those policies and strategies going forward so that if we do have a standalone community wealth building strategy, which we then use to engage with anchors that we can actually say it as an organization. We're already doing this ourselves, we would like you to take this on board within your organizations and help facilitate it across like. But in terms of your second and third point, I'd have to check with colleagues, but quite happy to get some responses back to you. Okay, thank you for that. And then I will move on. I think my ears, this, you remember, you know, we already decided during this administration that we'd move down a community wealth building line. Going back to the previous administration we were in. We also had our memorandum of understanding with the Chamber of Commerce to try and move things forward. So our renewal of the accord would be Federation for small businesses. And I think that's, that's a statement of intent from the Art of White Council that we need to move forward. We need to move forward the NHS and, and, and other players and take it on board. What Joe said over there. Yeah, why not the, why not the voluntary sector as well. We've got a lot to offer. Thank you. And it's, it's true. It's, it's a multifaceted, multi-layered issue and all of these things are part of the whole that we, that we're here to, to try and do, which is improved the health and wellbeing of our community. And it's digging down, not necessarily from the ball, but we can push down our hopes aspirations and directions so that the individual components somehow mesh and come together to have a community wide approach to it all. And we're all trying to do that. I think part of the trick is capturing all of the different things that are going on to deliver a holistic approach to health and wellbeing, but we'll move on and thank you all for that contribution. We'll send the slides around. Our next item is drugs and alcohol from home to home. It was so cock from blind stand Simon in absent Simon will present this to us while you go Simon. Yes, apologies, the game leader feels like it's one of those days, poor Sue is dealing with a poorly child. So I wanted to bring a quick present as you've got a very detailed paper so the presentation does cover that rather than being a separate issue. We have a duty around drugs and alcohol as a system and I'm the senior responsible officer and as a health or wellbeing board so oversight of that is welcomed and required. So I'm just going to give you a quick summary of where we are with the new drug strategy. I should say the outset we were given three years money that ends in April 2025 we have no news if the increased funding on drugs and alcohol will be there if that's the money doesn't carry on we will have to then reduce service provision. But we are waiting for government announcements and that's obviously quite challenging. So, and the second point there around inequalities we know people are more like use alcohol and drug if they live in a deprived area, and it really impacts on housing employment and those kind of things. So we also know people have co-occurring mental health issues and substance issues and I think we need to think really carefully about that some really successful programs in different parts of the patch where we can learn from and back to smoking we know a number of people will smoke if they're using drugs and alcohol had we really give up tobacco as well, this gives a model estimate of the number of people who are drinking over the recommended limit. And at the end there are some actions we can all take to think about that and then you can see the illegal drugs there about opiate and crack users. And how do we really think about helping those people get into treatment treatment works treatments effective and we can do it. So what are we doing about it and we've got colleagues in the room from the service service specific questions that we're working with our recovery hub on the Isle of White based in Newport provided a number of things including prescribing group activities, but also really good volunteer program so people who come through the service, then get trained as a kind of peer supporter, and then they can go on to get jobs it's about that kind of through flow it's not just about getting off drugs and alcohol. It's about that next phase. We work with schools and colleges really well supporting staff to raise their awareness. And also we have support for families it's so important that those parents particularly or those family members supporting someone in treatment or using even if they're not treatment they get help to know how to help their their loved one. So we have a delivery of the National Drug Strategy and that's got three priority sorry for priorities. One is about prevention, working with our criminal justice colleagues, improving our drug treatment and we've done an awful lot of that and then number of people in treatment in the last two years has gone up and that's great news. And then focusing on that unmet need. So our key achievements is here and I'm really proud of the work we are doing and leading the number of people I said has gone is treatments gone up by 20% there. We have target services for those who are homeless and that's really, really important and shows we're thinking about those groups are more likely to need extra help. The other one I'll just focus on at the bottom is micro elimination of hepatitis C. So actually within the service, we have eliminated hep C and that means we test everybody and we get a very high percentage on treatment and through treatment. So that's a great achievement by our service. I'm really proud of working with inclusion. So what next, we are about raising awareness further part of this presentation improving pathways, really working with our service users they know what's needed. We listen to them and do a lot of co production work, and then looking at how we can do this. If the national funding ceases, we are still awaiting information and I suspect politically we're waiting a long time for that. Oh, I thought there's a side on what we could do together. Apologies. Oh, here we go. So what can we do together. I'm not quite sure when I put it up there work. Sorry. So consider the language about how we use drug and alcohol reducing stigma. We really need to think about that our language and we've got a language guide. We're very happy to share thinking about how we support people into services. We're very good, you know, nicely named alcohol quiz rethink your drink is really good at helping people identify if they are drinking more at risk levels, and then raising awareness of our services, and then have you link with pathways. So a leader I'll stop there as a fair counter but I just want to more time to discussion recognizing the time of the meeting. And you've got a detailed paper. Thank you Simon. Interesting. Before I just come to some comments. Simon, the figure of 20% increase. It's a number. But is there any indication behind that? Why did that increase happened? Yes, because we had increased funding so we could increase our capacity and our outreach. So we did both of those things and then we got more people in treatment. So it was, you know, a real combination of the new money and how we used it in a very careful way. Thank you for that. Any comments or questions on this Debbie. Thank you, Chair. If I can just pick up Simon on the work that's going on in schools. Can I just ask, obviously there will be situations where children are in environments where parents are potentially affected by alcohol and drugs. So can we be reassured that the work that is going on in schools actually tackles that element. And it's not just focused on children as users, because obviously they are passively affected as well. Yes, absolutely support family is key. And so I should have said, you know, that includes children. But obviously if there's someone who's in that situation, probably linking very closely with Ashley's team around safeguarding as well to make sure they have the safeguards. If there are a child or someone who is using drugs and alcohol heavily. Just one more just to highlight. You mentioned that the current commissioning with inclusion is due for a new next April. We've got a paper, haven't we coming to cabinet in July on procurement. There are two things there. Sorry, one is our money, the national money. So our ring fence money that we've had for since 2013 will remain, but the increase in funding that we've had, we don't know about, but we are going to bring a paper to cabinet to discuss the next phase of service provision on the island. Thank you Simon, any other questions comments. Simon, may I just say, can you give us confidence. I don't want to know the numbers and it's your decision, but you do have some discretion on them. And I realized money is not the only factor involved in all of this, but that your commitment through your budgeting spend on these alcohol and drug abuse continues at a price. So the funding for the services run on two bits. One is the increased grant I've mentioned. The other bit is the public health ring fence, where we have a duty to spend on drugs and alcohol, and the government asked how much you spend on that. So yes, absolutely committed to the public health grants in the right way for this purpose. Thank you for that. Any further comments. Simon, thank you for that. Thank you for stepping in. Thank you for the, the interesting information data on that, and it's something we will revisit I'm sure. Can I therefore move on to members question time. If there are any there being none. Therefore 1129 let's call it 1130. We will close this meeting. We don't have a date for the next one, do we? We will notify you of the date of the next meeting in due cost by email. Thank you all for attending. So journey home. If you're a long way away. Uh, safe journey. Many thanks leader apologies again for being online. Thank you, Simon. Thank you everyone. Bye.

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