Transcript

Good morning, and welcome to the meeting of the West Sussex Health and Wellbeing Board. Please note that this meeting is being filmed for live and subsequent broadcast via the County Council's website on the internet. The images and sound recording may be used for training purposes by the Council. Generally the public gallery is not filmed, however, by entering the meeting room and using the public seating area, you are consenting to being filmed and to the possible use of those images and sound recordings for webcasting and/or training purposes. So we'll start with the apologies for absence, and we have Alan Sinclair, the West Sussex County Council Director of Adults and Health, who is centre representative Julie Phillips, who is the Assistant Director, Safeguarding, Quality and Practice, also apologies from Lucy Butler, who is West Sussex County Council Director of Children, young people and learning who are centre representative Jenny Boyd, Assistant Director, Early Help and Children's Social Care. So welcome to both representatives today. I particularly then welcome to this meeting the third voluntary sector representatives for this meeting. Joining online we have Hilary Barthel, Chief Executive of Stone Pillow, and our new health and well-being board member Zoe Harris from Health Watch West Sussex, who attended the last meeting, I believe, via the team's call, but is here today in person. Also Stephen Lightfoot and Fuchsia Harrington from NHS Sussex, who are invited to attend today as observers with speaking rights. I also announce that this is the last meeting for Penny Ford, and who is leaving her role at NHS Sussex shortly, and I thank you very much on behalf of the board for your diligent attendance contributions for all the time. I've shared it, and I think prior to that as well, you'll be greatly missed and we wish you well for the future. So just a few opening remarks, if I may, and yeah. So since our last meeting in January, Health and Wellbeing Board Development Workshop has taken place, this was held on Monday 11th of March, and it was facilitated by the Local Government Association. In the agenda, focused on moving from the scoping stage of identifying the support needed for the project to the actual doing, we will be receiving a report on the workshop and the proposed next steps from the Director of Public Health later in today's meeting. I would also like to highlight two further areas for the board's information and awareness. So led by our public health team, the county council has undertaken an important survey earlier this year about health and well-being in West Sussex, a voluntary and anonymous survey relating to adults, the results of your health matters, West Sussex Community Health and Wellbeing Survey 2024, will help the council and partners to plan services and take action to meet the health and well-being needs of our residents in the future following the COVID-19 pandemic. This includes contributing to the development of the board's new joint local health and well-being strategy for the next period, and I filled this survey in myself as a matter of interest online, which quite a few people did. The second reading of the Tobacco Invapes Bill, that's a public bill, has taken place in the House of Commons, the bill received backing from MPs and is a significant step forward. If it becomes law, it will mean people born on or after 1 January 2009 will never be able to be legally sold tobacco in their lifetime. In my capacity as cabinet member for public health and well-being, I wrote to all West Sussex MPs ahead of this debate to urge them to support the bill, to protect and improve the health and well-being of our residents and communities. In West Sussex, we continue to progress delivery of our tobacco control strategy, which is driven by the Smoke-Free West Sussex Partnership and chaired by our public health team. Stop smoking services to support people to quit are available across the county for those that live and work within West Sussex, and further information is available on the West Sussex well-being website. I will just move now to the agenda. Item 2 is Declaration of Interest. Can I see any other declarations of interest from members? I'll declare a personal interest as a member of Crawley Barakout, so with particular reference to the housing item. Item 3 is Urgent Matters, there's nothing being tabled under that heading. Item 4, we have the minutes of the meeting of 25 January 2024, and these are recorded on pages 5 to 16. Can we accept these as a true and accurate record? Do I have a move for that? Do I amend a JAP? Is that seconded? Anyone? Thank you, Catherine Howe, and is that agreed? Yep. Okay. Thank you. So item 5, and we have the Actions and Recommendations Tracker, all Actions are recorded as complete, and so we're asked to monitor the responses to recommendations as tabled on the 25th of January. Are we okay to do that? And Jessica Sumner. Thank you, Chair. Just picking up on a point on page 12 of the minutes where it said about an update on food was going to come to this meeting, and I'm not sure if I'm missing it on the agenda. It was on the Actions Tracker as completed, but I can't actually see it in here. Thank you, thank you, Alison. Any other comments on the Actions Tracker? Nope. Okay. So item 6 is the Children's First Board, and Jenny Boyd is the Assistant Director, Early Health and Children's Social Care, and she will present this report, and Councillor Jackie Russell will be subsequently asked if she was used to comment as the Cabinet Member for Children, Young People, Learning and Skills, so Jenny, Boyd, please. Yes, good morning. Just a reminder that the Children's First Board is really the driving force behind the governance of our children's social care and children's services arrangements in West Sussex, so it holds high level governance across the strategic planning and delivery of services. The most significant update for today is the fact that after considerable consideration and discussion, the decision was made to appoint an independent Chair of the Children's First Board, which I think everybody agrees will give a really good oversight and leadership to the board. It's actually at a point now when it's really ready and welcoming this independent Chair element. It has a wide membership across the whole range of stakeholders involved in children, families and services in West Sussex. The last meeting of the board was actually in February. There was a meeting due this month, but given the appointment of the independent Chair, a decision was made that really we should be postponing, giving her sufficient time to meet various key members of the board and get really a good idea of how things are working and have been working, so the next meeting is set for the 23rd of July. Alongside the appointment of an independent Chair, another key element to note is that we've recruited to a specific post of stakeholder partnership and engagement manager and that's very specifically with the aim of really bringing in greater engagement of all the different stakeholders across the piece in the working of the board. The board oversees, of course, our children and young people's plan, which has been in place since December 22, runs until 25, and one activity that took place in December, in fact, was an electronic format of that and an animation. Very well received, she had some very good feedback on that and that reflects the five key priorities of the children and young people plan. Important to note that there are a number of subgroups that report into the children's first board, that in fact includes our supporting families program, which is really the delivery of our early help offer within children and families, and that itself has external governance under the Department for Education. The other activity that's happened over the last few months is a development of a scorecard which will be that's focused on our five priority areas and that's really going to be ensuring that we have a clear oversight from the board about actually what we're doing. It's one thing having a board in place, it's really the activity of the board and the services that report into it that matter. So we've developed a scorecard and that will be ratified at the July board meeting. We also have links with the Pan Sussex Children's Board that's currently chaired by the director of children's services within ESUSX. So there's a synergy across Pan Sussex with Lucy Butler attending that board and the priorities of the Pan Sussex Board very much of course accord with our five key priorities and the Pan Sussex Board has a dashboard that on a Pan Sussex level is looking at the delivery against those priorities. In terms of some updates from working groups obviously as people will know we have had now the outcome of our send inspection, so clearly the board will be overseeing the delivery of that action plan and another key element of the group is the emotional wellbeing and mental health working group which again reports into that board. Engagement with children young people is absolutely fundamental to the working of that board and in fact we had a really really engaging session with young people at the February meeting which focused on their emotional health and wellbeing and what they would like to see from services and the organisations working with them. That board was attended by our Department for Education Improvement Advisor Steve Crocker who gave very positive feedback from his observations of that board. And I'll pause there for any questions and to see if Jackie wants to add anything. Thank you Jenny, Councillor Jackie Russell please. Thank you Chair. So what Jenny has covered most of obviously what's in the report and for those that I think may not have attended health and wellbeings here this before obviously the history of John's first board it started four years ago and it's come to a point where we felt that we needed to have a bit of a restructure to really increase that engagement with our young people and also in a bid to increase the number of partners attending the meetings to give that overall oversight of our children's services and I'm absolutely delighted having shared the board for just under four years. I'm actually delighted that we've now secured an independent chair because one of the downsides as the cabinet member in terms of chairing those boards is that you become the facilitator rather than a contributor and observer and I'd much rather be in that stance as opposed to chairing. So I'm absolutely delighted that we are seeing and welcoming Emily Brock into that position and I look forward to meeting her on the 23rd of July and as Jenny's outlined the purpose of the board one of the other things and she mentioned that our DFE improvement advisor attended the last board and it has recently been proposed and agreed by the improvement board that as and when our DFE advisor steps away the children first board will be the vehicle to continue to oversee the vital improvement within children's services and I have every confidence that that board is robust enough to do that. I think one of the best things that we've done in terms of the restructure was looking at how the board functioned. It started off as a model where it was a single meeting with a few children involved in it but it was realised as we were evolving that actually it was becoming very heavy in terms of the reporting that we had to do professionally and that the children's voice probably wasn't as strong as it needed to be. So the restructure then took to divide the meeting into two parts. The first part is where the partners and stakeholders will sit there and discuss the relevant documentation and the second part is solely dedicated to working with our children and young people and that has been a massive improvement and I think alongside that the appointment of a partnership manager now is really going to add great weight in terms of driving forward that engagement and getting more stakeholders to the table. Thank you. Thank you, Councillor Russell, are there any comments, Councillor HOWARD please. It's great to see how the board's developing and I think the idea of having an independent chair makes such a difference to these things, that's fantastic. Just two comments, so one is a bit of housekeeping which is which Ian will probably re-endorse is that the Wes Sussex Chief Executive Group, we're having a think about how we do representation on boards so I'd like to suggest that we have a conversation about that to make sure that we've got that right, that link with the D's and B's. The other thing is sort of a question of observation which is around engagement with Sussex Police because I think what the board shows is the children who are inside and I think if I reflect on the young people of working the most vulnerable ones who are like frantically jumping trains and beating up on each other. So there's a thing here which is how do we make sure that that link with Sussex Police is really strong and I just noticed that you know sort of increases, if you look at the command team at Sussex Police is that I'm assuming he's still the rep, I don't know whether or not actually changes in the police force are reflected in the representation there. So it may be that with you know sort of the PCC election imminent and either a returning PCC with an ongoing mandate or a new PCC it might be a good time to refresh that relationship because it's a huge concern to us certainly and I'm pretty much certain that Ian would share that concern. Thank you, yeah Jenny. Yeah absolutely Catherine completely endorsed that and obviously as I said there's a number of subgroups that do report into the children first board so the development of those relationships and the working together with the police is very strong at the violence and exploitation board level but actually take your point about, there have been a lot of changes and so we do need and will ensure that that is taken on board and that we've got the right representation and the partnership manager actually is going to help with that now. Thank you and Councillor MANDER CHUNK please. Thank you Chair. I'm very delighted to see the progress of the children's first board and you know the way they're going forward and I know that from the Safe Guarding Adults board this is really good news and progress as well and I'm sure the independent Chair and Councillor Hans sitting on my right will look forward to working very closely with the children's first board. I think it's very important. Could I just ask for a little more information about the scorecard? It sounds really good but I just wonder is it going, where will it be on the dashboard so that people can relate to it and also secondly this is for the Chair are we going to have a standing item on the agenda going forward for the children's first board? Thank you. Well certainly that's something we can consider. I want to give more prominence to the board indeed. So Jenny Boyd please. Yes, I mean the scorecard as I said is going to be really the preeminent way that the board will be holding us to account within children's services so it will be very clear in terms of you know what's been achieved and the measures you know against that dashboard. We can make the dashboard available once it's been discussed and fully ratified after that 20th of July meeting. Do we give more details on that certainly? Thank you Jenny and Penny Ford. Thank you Jenny and Councillor Russell as well so equally really think that the work of the children's first board has you know welcomed the development and all the work that's being done. I think the introduction of the independent Chair and that sort of refreshed focus on partnership and the engagement of the young people is really positive so really support that. And I guess it's really by way of a kind of a common, a forward looking reflection. So I think there's a huge agenda here isn't it when you summarize it very well but there's still lots to do and it's a big agenda both for West Sussex and across Sussex. And for the integrated care system our work on integrated community teams is at quite an early stage and our focus will probably be on sort of adults with very complex needs. However just looking ahead as the work of the board picks up and as our integrated community team model develops I think it will be really interesting to look at how that integrated community team model works for our young people in particular maybe our older young people but query around that. So I'd just like to kind of flag that as something maybe sort of for future thinking as those two things continue to develop pace. Thank you Penny and would anyone else like to comment on this report? Steven Lightfoot please. We'll try again thank you. Again as with other colleagues really welcome the work of the children's first board I think it's an excellent initiative. Apologies for not having been here before. But on the emotional health and well-being work stream I was looking at the strategy which again I think has got some fantastic ambitions in but one of the ambitions was around how we provide information to children and young people about the services that are available and I'm just wondering if much progress has been made in that area because I know from our own children's engagement activities that many children and people are skeptical of online information and don't actually quite often know what to trust and way to trust the information from and I just wondered if there's been any progress in terms of your strategy in terms of the information sharing. Thank you Jenny Boyd. Yes that's also very closely aligned with the work that in fact Alison's team has been leading on in terms of the mental health needs assessment which we've been and again that's been a multi-agency and very very good engagement across the services and in terms of you know that clearly is looking at the consultation and input with and from young people. So I would consider myself that the outcome of that is going to be feeding in to the all of the different ways that we communicate with children young people. I mean what I would say which won't be any surprise to anybody that really good engagement session in February at the board. As you would expect there was a sort of messages from young people that you have to communicate with us in a range of different ways you can't just have like one but I am certain the anticipated we're coming to the end of that mental health needs assessment now so that will clearly be a key part of that and then again that will feed back into children first board. Thank you and I think it was Annie Kanan and next. Thank you Chairman I just wanted to reinforce my pleasure that we will have an independent chair and I have no comment to make anything else other than that because I think it does help but I'm also looking forward to working with the board in on areas of obvious overlaps so transition services child and adolescent mental health into adult mental health and children with disabilities into adults with those obvious areas and children looked after and I think we I'm very interested in the success you've had with engagement and I think there'll be contributions we can make as a safeguarding adult board to this agenda and I think they'll be learning for us too so I'm really looking forward to engaging in what we can learn and what we can offer. Thank you. Thanks. Thanks very much and Zoe Harris please. Thank you Chairman. I just wanted to add for those of you that are not aware WESSA 6 health watch have just recruited a new young person engagement lead Elena who's excellent she's come to the team with lots of energy enthusiasm and ideas and so I just wanted to share that with the group today. Thanks. Thank you. Are there any further comments please. We're asked to know this report we happy to do that. Thank you and we'll move to item seven which is the WESSA 6 health and well being board development and director of public health and challenges to present this report Alison. Morning everybody and thanks to everybody for their help and support and their engagement with this agenda item just a recap in terms of the case of change and why we have elected to go through a review. Firstly it's we haven't done one for some time and in the context of all of the changes that we've seen across the health and care system reflecting on how we operate as a board and where we need to be going we thought was was very helpful at this time. This is also the year where we need to set our new health and well being strategy and reviewing our operations as a board will help us deliver and plan for our next health and well being strategy. We're also very grateful to the local government association for their support and their facilitation of this work and I assume that you've been able to read the paper. So what we're aiming to discuss today is a completion of that phase one of the work where we have looked at some of the interviews the one-to-one interviews that each of you have had with members from the local government association with the seminar that we held back in March where we discussed some of those findings and where we were aiming to go and also the establishment of a task and finish group which was brought together after that seminar. So today we're asking to reflect that and note where we are on phase one and also to consider and approve the approach to phase two. So some of those areas you'll see as recommendations on the paper which is considering the governance and ways of working that we have across our new health and care system and as a health and well being board in that to think about where we might want to have some further support from the local government association. So we have had enough further facilitation into some of the areas that were raised at the seminar so ideas there would be welcomed. And to think about how we might develop and plan for some health and well being board seminars across the next year and I would support very much an early seminar to start talking about our new health and well being strategy and the priorities that we want to consider in that. And also our plan is to continue bringing reports back to the board as we go through the year in terms of that progress and also the progress against our strategy. Thank you. I'm happy to take questions. Thank you. Alison, are there any comments or questions for Alison, please, Jessica Sumner. Thank you, Chair. I wasn't at the seminar so apologies for that. I had a representative who tended in my place. Just picking up on the task and finish group, slightly disappointing to see it was all West Sussex County Council. That's not a reflection on the quality of the work of the group but actually this is a multi-agency space. It's about partnership working and it's about oversight and connection with other partnership spaces. I recognize in the paper it says stage two, we'll bring another partner so I was glad to see that but it's just about how are we acting as leaders to promote partnership in every stage that we design and because I wasn't there I may have missed a show of hands when no one else stepped into it but I think it's just that responsibility we all have to demonstrate partnership in how we set out steps, how we formulate groups and how we think about this. So for me that formulation of a task and finish group is a really important signifier of an intention to act as partners and recognize partnership value. Yes, thank you, Jessica. I very much agree with you and Alison will respond to you. Yes, thanks Jess. It was always the intention to make sure it was a wider partnership task and finish group. I think this first meeting that we had was to just reflect on the seminar as managing the Health and Wellbeing Board as a committee and just to see what we needed to take forward. So the members of that initial group will be present as will a wider range of partners on the task and finish group. Thank you, I'm Katherine Howe please. So I just want to build on Jess's point and I was at the seminar and actually I have my no-no-to-self which did include find your zen, this is going to take some patience, but I think that which is like what was my no-to-self is that we had to start as we mean to go on. And so I really get the idea that you'd have a task and finish group, you'd start off with the people who were doing the Secretariat, so sit down with them services, how are we going to run a process, but to bring in internal West Sussex partners before bringing in wider partners isn't the tone that I think we talked about setting. So I get the kind of like you need to do it in bits, but the signal that you're sending with that group of people in the initial task and finish is being felt as we're doing what we've always been doing. So I'm really urging, and I'm happy to volunteer, never raise a problem without a solution or at least an offer, which is I'm really happy to be involved, but you can't do this in those train tracks if you want us all to behave differently. Thank you for that comment and indeed reiterate the intention to broaden the membership, very much take on the points that you made and to some extent I had anticipated them in fact. Thank you. Thank you for taking Catherine, I think as you mentioned it was largely around the administration and the administration has always been undertaken by the Council and we would very much welcome support from our members in the resource that's provided to the Board and particularly with the administration. As yet we haven't sort of looked and discussed how that might be but we would very much welcome not just the engagement from members but the support to the administration which I'm happy to discuss further, thank you. Thank you, Councillor MANDACHEAP please. Thank you, Chair. I was there obviously and I thought that it was the first stage and it was mainly about administration and governance and in my note itself it was about increasing our partnership working. I don't think it was done with anything other than to try and set out a plan and we needed a plan in order to progress it so I don't think we're cutting anybody out because we wanted to include everybody and I think that was one of the things that we've always had as our ambition to broaden the partnership involved in the Health and Wellbeing Board. So I don't think there was any, you know, I don't think there's any other wrong message I think it was just a question of getting our house in order really, thank you. Thank you, Councillor CHAAP and of course arguing that we have a plan is quite an important message around the media right now isn't it? Stephen Lightfoot please. Thank you Bob, sorry Councillor LANDACHEAP. Just to complete a loop, you and Alison were both involved in Sussex Health and Care Assembly Review or membership and during that discussion there was a strong recommendation that the blue light services should be potentially recommended on the assembly. However, it became apparent that different local authorities have got different structures and on the Sussex for example they do have fire and police on their Health and Wellbeing Board and so therefore we didn't include it in the assembly proposed references which will be on the paper coming but it was a sort of a consideration that each Health and Wellbeing Board should at least consider extending the membership to include Health and the blue light services and I just wanted to make the whole board aware of that. Thank you, Stephen. I definitely recall that out of interest we used to have the cabinet member for fire and rescue and communities on the Health and Wellbeing Board but yes that's something that we'll consider again in this second stage with the wider involvement of partners in accordance with the points that have been made. Are there any, I will, Ian Duke please. Thank you Chair. Yeah, I also wanted to just reflect that it was actually a very positive session. I think it really highlighted the complexity of what we're talking about, aye, what is the role of the Health and Wellbeing Boarding, what's a massively complex system both in terms of governance and the issues that we're trying to resolve, the breadth of them, how we make it relevant at a system level and also address the very different needs that we've got the local place so I just kind of want to put on record. Those were the kind of things that were coming out in my notes itself and that is reflecting Catherine's comment I think it is going to be a bit of a long haul to get it right but I think the approach it was taking in the workshop and the underlying wants to fundamentally look at this working partnership and recognise those differences and how we kind of make them work in a system perspective was very welcome. Yeah, thank you Ian, I just make a comment on one of the observations made at the workshop which is that perhaps we could consider different venues and we have, that is under consideration even though we're in the same venue, I just make the point because in order to webcast live the certain technical requirements and capabilities that need to be in place however, Stephen Lightfoot pointed out to me what we could consider doing is instead of webcasting live we could consider recording at a remote location somewhere in the community and then broadcasting putting it on the web subsequently and that might be a way forward rather than always meeting in the council chamber and I think the point about venue was well made I mean Stephen might be saying because I think he said it himself sometimes some of our meetings within the integrated care system have been a little bit NHS heavy and it can also be seen in reverse that some of our meetings might seem a little local government heavy and so one needs to ensure the kind of broadest representation and input across the system so yeah anyway I do assure colleagues that all the points made at the workshop will be considered penny forward please. Thank you and likewise I think it was an excellent workshop and we had some good themes coming out of it I think that wider task and finish group will be very much welcome to take that forward just picking up I guess a couple of points from Allison's questions to us I think some further LGA facilitation would be useful and picking up slightly one of the comments earlier it also enables all of the partners to be contributors without one of them having to also sort of facilitate the event and I think that can be useful. I think we have got some thinking to do about the balance between our sort of statutory bits that we need to do and our ambition around the really developmental bits in terms of jointly tackling some of our health and well-being issues for the patch and making sure we've got the right time and balance between those in sort of formal and informal agendas and I think because there may be some differences of views around that having that external facilitation and that would be helpful. And I would support the suggestion of an early seminar around the health and well-being strategy such going to be such an important thing isn't it to set our vision and our ambition and our joint working over the coming years so that's so important to get that right so I think early conversations because it might need more than one conversation would be very welcome and my final reflection thinking about the partnership piece is and I probably said this at the seminar as well within the workshop was that the seminars don't have to be just the health and well-being board members so so it's quite possible as it were for health and well-being board to host a seminar workshop developmental session however you want to describe it with a wider range of partners and that can sometimes help around you get that balance of a formal meeting where you can only have so many members for its system to be effective but are wished to actually engage quite widely and sometimes different groups and different topics and it gives us that ability to be flexible and a bit more fleet of foot to really get underneath some of the issues so that would be my suggestion going forward to feed into the task and finish group as it were thank you thank you Penny and I think some of those comments also reflect some of the thinking we see around the Sussex Health and Care Assembly about bringing in other voices and so it would be consistent with that. Do you have anything to add on some? Absolutely I think that's where a lot of the expertise lies and we will need that expertise in that development of the strategy so yes welcome there. Thank you Alison and Helen Rice please. Just an offer really we've got about five buildings across West Sussex large ones with large spaces we'd be very happy to house it to support bringing new voices in based on whatever theme the board would like I'm happy to help and support that in any way and all the years. Yep great thank you very much Helen and any other comments please can I see online no okay so anything else Alison? No thank you for the suggestions and if there's any more that you would like to contribute then do email me directly and and we can talk further thank you. Thank you Alison thank you everyone for your comments and subject to those being fully taken on board are we happy to support the four recommendations please so okay yeah great thank you. So we move to item eight and that's the public health update also from Alison Challenger Director of Public Health. Thank you Chair. A few updates today I did I did promise an update on the food and nutrition development to the work that we are developing so at last at the last board we had a really productive discussion around food and nutrition and this was really starting the journey about where should we be doing this and how should we consider this on a much broader landscape I suppose rather than just looking at weight management or just looking at obesity and recognising the importance of the environment in how people make their choices and what is their available for them and some of the proposals there which are proposals that we are taking forward I think the first step that we generally take is understanding what the level of need is in the population and that's usually conducted through the form of a health needs assessment which will ultimately be compared to the joint strategic needs assessment. So there are various different stages of conducting a health needs assessment and the first of those is really looking at the evidence and the literature the published literature and then thinking more broadly about evidence and this is where we would really welcome the support of our partners on the health and wellbeing board and within their organisations to understand what is currently provided so we can then map that against the level of need that we see in the population. From that we are also able to identify where there may be gaps and then that can be part of that element as well. So there's always a big, for a full health needs assessment there's always an element of engagement that we need to conduct with our stakeholders, our partners and also the public so we are setting forward a plan to take forward that needs assessment and the engagement of that as well but we are very keen to understand what is available across west to six and there will be a mapping process as part of that I don't for one minute think we will capture everything because there is so much activity across the different organisations but we would like to capture as much as we can and to profile that recognise that as part of that piece of work. Once we have that establishment of need we then need to consider and I'll bring back to the health and wellbeing board where we go from there which could be the evolving of a strategy and a framework for action and where are the areas that we want to focus based on what the evidence is telling us where are the areas of need and where do we want to focus that work. So this is not a quick piece of work it will take some time but it's one where we will start with the written and published evidence and then very soon I hope reach out and engage with partners to take forward that next part of it but we will be producing a timeline of the events as part of that work. I'll pause on that because colleagues in might have questions I don't know if Jess. Thank you Alison. Thank you Alison. I think from our point of view there's a lot of work at district and borough level neighbourhood level depending on how you categorise the levels which either has already progressed quite a lot of the thinking and data gathering and is looking at the whole food ecosystem so about supply growth as well as delivery affordability. So I think in terms of that data gathering how much of it is data that would speak to a needs assessment how much of it is actually already looking at policy development action delivery I think there's a need to really be aware of how that's developing across those different spaces but then also where it links to national and regional developments as well because I think actually a lot of the possibilities with changing our food systems sit perhaps beyond the power of people within the health and wellbeing board structure and what it would be good to do is in any strategy and any action plan is highlight what are the local actions of the local delivery milestones and where and how is that escalated via existing links so obviously our district and borough council level at the west us six level but also NHS and other national bodies are looking at food delivery of supply of as long side the health impacts the nutrition and that sort of side of it so looking at the whole piece and I'm sure you're doing that and that's what a needs assessment tends to do but it was just to raise that because I wasn't seeing it in the notes of the last meeting so again I wasn't there that discussion could have taken place but I just felt the need to comment on it. I think we are still at the beginning of that journey so that the concept of evidence is not just about data it's not just about what's in the public domain and what data we might have within services that's the start of a turn if you like and I think when we in considering evidence we want to understand what organisations partners bring to the table on that as well and bring the two together so certainly the looking at policy that forms probably a slightly later stage and I think it's also about what is a needs assessment for what are we trying to do as part of that and sometimes we have needs assessment we might have commissioning reviews we might have policy reviews and that is not necessarily a needs assessment but it may well it will still need to be considered as part of the overall work that we do on the food and nutrition so I there haven't been any more debates in that sense apart from us starting to look at the data and what is actually out there so we will be moving into that space where we need to consider the wider evidence so I'll get a timeline published so that we can actually describe some of that work but the JSNA then there will be things like what do we commission what's the policy review that will be outside of the needs assessment but definitely part of the overall work thank you and Catherine how please it's just a couple of thoughts it may be helpful to share the method statement before the timeline because I think it would give us a better sense about kind of like how are you approaching it from a research perspective and a chance for us to contribute what is already there so I'm assuming you're going to do it anyway so it might be helpful to circulate that for comment the other thing is whether or not you know and so sorry because I haven't said it yet today is how do we make sure that that method statement is reflective of cost of living emergency and how are we going to be gathering insight from the places where we know that there is food poverty first because the idea I get that a proper measured piece of research is going to take some time but there's no reason why we can't be getting results quite quickly from the spaces where we know we've got problems so I'd quite like to see a method statement that's going to enable us to do that and unlock insights quickly so that we can start to work differently last thing just on research is what is just making sure that sort of whatever kind of desk research is going to be going into that sort of social impact space not just into the health space because I think that's the area that probably when we're talking about cost of living where we need to see those combinatorial effects reflected. No that's very helpful and we will be producing how we are conducting the need assessment and then how the other work will then feed into that so and it's a joint need assessment so it's it has to be all of us together and it has to consider the social impact as well as the health impact so comments are really helpful and we will provide some clarity on how we're going to do that. Thank you. Are there any further questions or comments on Alison's update? No I don't see any thank you and so item nine is a progress update from the West Sussex strategic housing group on housing and homelessness and Ian Duke please. Thank you Chair and thank you for the request for the update firstly my apologies for not being in the room with you wouldn't normally do that it's just the pressures of the day and trying to balance them so not ideal but thank you for facilitating it. So within the report we've been trying to be very consistent with the ask is it as it came looking at the national pressures what the housing group is doing and in terms of priorities and what might might wait might be health and wellbeing board lend. Just in terms of the national pressures I think we've known about pressures on housing and homelessness for some time so in some respects this isn't you but I think the level that's coming through where it's coming through and how it's coming through has changed substantially to differing degrees in different areas but nonetheless has changed as an overall picture substantially in the last two to three years. So what the report tries to do is pick out some of the key findings from a recent DCN survey and wider work on this issue reflecting that the District Council's network is really starting to see this as its biggest priority for lower tier authorities and the reason behind that is that's where the pressures are really starting to show on a different scale it's the lower tier authorities we've seen homelessness as an issue in uni-streamed metropolitan boroughs for a long period of time but not seeing in kind of lower tier authorities in this way and the truth is lower tier authorities are much smaller beings and bodies this has been learning for the Department for leveling up housing and communities who I think had assumed that those authorities were starting to make representations on the scale of the issue had much bigger budgets to deal with it as would be the case safe we were London Borough and there's been some quick learning over that so there's a mixture here of the real impact on those individuals going through and there is which is I think is where the health and well-being kind of focus will be but also I think wider issues of how our housing sector is structured which will also touch upon as well as the financial risk that comes along with this so it's a highly complicated picture and the report tries to speak to that I would emphasize again that when we look across West Sussex you will see this two differing degrees in each place so it's a challenge to think about this on a consistent basis and likewise when we talk about some of the things that each district and borough want to do about it some will be consistent but some of it will be targeted in a different way depending on that level of impact so there's a mixture when we start to go into the West Sussex housing group about those things that are common to all and and those were different and these and these are are kind of putting something that's very specific to their area but but also sharing information as we go through so the report speaks to those those kind of national pressures and what's happening it then comes to the West Sussex strategic housing group response was I say very much three parts the the sharing of that information the kind of the strategic projects that have been selected where we we need to work in in tandem but also then responding to kind of wider system demands for housing on top of you know the the the already substantial pressures within within the housing sector so the sharing of information piece I've given one example the of of one of the crawling response which is to use its local community network very much to focus on the needs of of of people within temporary accommodation really driven by the fact that the average day in in temporary accommodation now is is 470 days within within crawling which doesn't feel very temporary and there are going to be longer term impacts on on families and one suspects in particular children within that that that space that's more complicated again within within that area by the fact that some of the demand coming through will be migrant families coming through the likes of asylum contingent the dispersal and the chagussian British overseas territory citizenship where families are also trying to settle in what's quite a transient environment far from ideal but one I didn't touch on for instance is the fact that say with it our colleagues within a good one I think it might be Katherine touched on on this one I've got a real focus on on the links between health and housing more generally and actually when we look across the piece into our neighbors in East Sussex and Kent there's probably been although they haven't cracked it by any means probably greater link up of those those two agendas and we're using kind of the wider work around homelessness just to understand what's going in there and try and catching up as well as doing some localized work so that's what the information sharing and then flowing through to the strategic partnership comes into play in terms of the strategic projects themselves the two that we've listed because we have a small kind of projects resource but an important one the first is the private rented sector and that recognizes that in the short term at least that is a sector that is best suited to moving people out of temporary accommodation to something a little more permanent given given other constraints but doing that in the context of a shrinking and more expensive private rented sector is challenging and that's why that's just one of the reasons why we're seeing this this sudden increase in people coming through and becoming homeless and it's going to require different solutions that's a report that we are due to discuss shortly and the second which is a real structural concern and issue is around registered providers reflecting that 67% of our social housing stock isn't in the hands of local authorities it sits within registered providers and that can have some real difficulties and challenges in terms of of securing that stock for people with greatest needs when registered providers will have kind of different viability tests and we might necessarily apply to a piece of work that has recently been started to be scoped out and i think it's going to be a big focus moving forward if we're going to meet some of the needs not only from a homelessness perspective but a wider system perspective so there are two two examples of of the work that are current and then thirdly and this responding to wider system demands so two examples there it's the work that we've done on the back of the the children improvement boards ask around so it's a greater provision for for curleavers but then in a way where we we have a standard approach or a standard as you can across seven D&B areas that's that's that's nearing completion and then finally something that's come out of the the the the refresh commission in working adults and the shift to extracur housing and this is worth having and those those bodies around the table although this is really a borough by borough discussion in terms of how this is done it's very much being facilitated and supported through through that body so what i would say is when we look across the health and care system and we see the ass of housing coming through it's very fragmented it's quite micro and it's it's it's coming through at a time of substantial stress on the the housing system we think there's something that needs to be done there to try and make that better if we're going to meet the need to coming through and we're doing that mapping work at the moment in order to have those conversations so the ask was then to talk about the potential areas of support we do reflect the fact that was the health and well-being seminar specifically on unrelated issues there and just capture what came out and i think if although i wasn't directly involved there and i'm told we we probably haven't necessarily picked that up any work in terms of moving forward so this is an opportunity to do that and then in 4.3 these are these are not formal ask but the the the suggestions for for what the activity in this base might be in order to support that work moving forward and and hopefully start up a discussion so i'll leave my introductory remarks at that if that's okay chair i'm happy to take questions and take it on from there yeah thanks very much Ian right any comments questions please so i'm Councillor Jackie Russell thank you chair i just wanted to refer to the paragraph concerning the joint protocol for care leaves and first of all extend my thanks to the districts and boroughs in working on this protocol with us and you know we do appreciate that it is a complex piece of work and i appreciate it is coming towards finalization and there are a couple of areas that we recognize are still a challenge and albeit they are part of the best practice guide from the department of leveling up so i do hope that through further discussions we can seek to find a way forward in these areas that would really benefit our care levers but other than that thanks thanks to all of the districts and boroughs for taking part in this piece of work thank you Councillor Russell and i think we got Dan Charlton next actually chair i think Hilary bottle was ahead of me in the queue thank you we got a Hilary bottle first i can't tell that from my screen thank you thank you chair a couple of things that i would like to flag with this is being both a registered social landlord ourselves and a provider of homeless services and a range of outreach services which relate to housing related support there is um in the spirit of partnership and it's something i've always been interested in is why there isn't voluntary sector or provider representation outside the statutory sector on your strategic housing officers board um i think you know there is this sort of spirit of strategic partnership which would be really helpful to have that other lens brought into that but obviously that's just what i want to flag up for initial one the second thing is that i think that although you flagged up the health issues of some of the people around homelessness i think there's a bigger picture that needs to be built into that and i don't think it was quite captured in your report um which is about those people who are homeless with multiple and compound needs whether they be families um or or adults or children uh young people even care and it's certainly something in the homelessness sector we have seen significant increase in over the last three years um resulting in a massive increase in depth of people who are homeless that we've seen across the county um which brings me to one point and the link with public health is there was a a report undertaken where public health team in west Sussex have brought together the data um from providers in the area of housing services to review the volume of sad deaths of those who've been homeless um and we were due to see something i believe in march but i'm just wondering where that report is because it will very much inform some of the work of the strategic housing teams health and other key partners uh particularly drug and alcohol services and other health provision in in actually looking at some of these really difficult issues that we're finding out in the sector at the moment for those people who are homeless so there's a bit of a allison challenger um request but also whether that's been brought to the strategic housing officers board looking at the homelessness deaths because we spent a lot of time providing information um and and also within that multiple and compound need work this is it's about not just straightforward tenances that we're looking at we're looking at appropriate accommodation to move people onto because homelessness services are absolutely silting up at the moment which is then impacting on some of the temporary accommodation issues in the local dees and bees um and i work very closely with our local dees and bees in aran and jicista um but we are supporting significant numbers now in bed and breakfast accommodation and in terms of hotels and people being placed out of area which is completely unsuitable for them and we're on that revolving door of street homeless and those experiencing homelessness and the final point is really that we did a piece of work because i sit on the children young people oversight board with a particular interest around the children and young people's pathway into homelessness um and we michael courts from esus's county council did a report which identified that over 4,100 children are living in temporary accommodation across sussex and this is a significant impact because many of our 18 year olds that enter service have been part of those families so there is a clear pathway entering into the homelessness environment and we really need to stop it at first point so it was really welcoming to hear the work around the the support teams for families because intervention early on is really important but also in the transition years from where people have been in local care into adult services there is this um chasm where people fall into um so issues such as drug and alcohol misuse um significant mental health which has gone untreated and we really need to be addressing that because that we've got a time bomb that has gone off and we are seeing it very much on our doorsteps across the homelessness provision in west sussex so those are just three points but i'm really keen that we actually have some collaborative conversations about next steps and partnerships in dealing with that thank you hillary and i think Ian first of all to respond to that thank you uh hillary and thank you chair um yeah just quickly on the representation um we're we're kind of reviewing everything that we do and who's involved in the room at the moment because of the scale of change that's happening so i'm more than happy to to go away and and and take that i'm not sure what they i took this on in september so um i'm not quite sure what um how we got to where we are but that that's a piece of work i'm happy to take away um i think i think on a on a couple of points that are coming there in terms of the suitability of accommodation the the the heart of all of this is a supply issue and we need to but we need to be absolutely clear about that and and i can talk um you know this is where i get a little local because that's one of my more detailed knowledge is um but the sheer unavailability of accommodation is the primary issue here um and that is creating compromises in terms of both location and quality that um that there is no other choice for in some cases um we have um seen people placed as far away as the Netherlands um because we don't have stock of a suitable nature so um and get massively challenged uh on on that by those families but that's the the nearest suitable accommodation we can find and it completely takes people away from the networks that they need in order to have successful lifestyles work but it's a revolve your head first or it's unsuitable and i think um i you know that that's where i think we really come into the the work around the private rented setter and the work with our peers about how we can get that access to suitable accommodation as quickly as possible that's why the priority projects within but it's not a quick fix because we cannot simply magic up stop um and i think i think it's how we recognize that how we mitigate against it and how we develop strategies to try and ameliorate what is a deteriorating situation from a stock supply perspective and in all sources it's getting worse because of the complications of water neutrality which stops us developing new housing stock the health aspects both of those um who then the health driving the entering point and also kind of supporting in and supporting out of different ages yeah i think that's why that that work is is really coming through and understanding that that determination i think it's relatively i think we're relatively underdeveloped compared to some areas and some of the thinking on this um but there is a real desire to to to want to do that um and i think both at a local level but also bringing it into into this space more um it's just yeah there's a there's an awful lot of strands to this an awful lot of competing strands to this and it's how we we chunk it up in a way where we can actually make progress so hopefully that covers all your points to a degree but we are very happy to have those open and collapsing conversations yeah i mean i think the other bit was around the the fatalities report would really help understand some of the health inequalities because that really seems to be the main messages that were creeping out that's not suicide and it's not overdoses it's significant health inequalities of people who are homeless that are causing early death and and again that's that's one i'm not personally cited on as yet so as that starts to come through being interested to come get it through yeah that would be useful to know where we're at with that from from Alison probably Alison challenger please thank you and i'm just coming back to Hillary's question around the deaths in homeless accommodation report so so yes the context for this piece of work is the observation that a number of our providers were seeing an increase in the deaths of people in who were homeless so we worked together to look at some data specifically from four providers across west of six are not the whole provider network but these four large providers of homeless accommodation and the the report is due to be published soon Hillary i think we are expecting some more data so we can actually extend the period of data to put into that as a few small edits and a few more comments around the methodology but i think our first step would be we'd like to come back first of all to the providers that have shared their data very kindly with us to to discuss what that is so i think that's fairly imminent i think we're looking over the next two to three weeks for that Hillary and then we'll think and discuss with you about the dissemination that's great thank you Alison thank you Alison and now Dan charton please thanks chair and thank you in really welcome the report i just wanted to briefly underline our commitment at Sussex partnership to working creatively with partners on this agenda and an area specific focus for us is how we work differently with housing providers and local councils in delivering new models of supported housing for people with mental health problems providing specialist clinical input i think it's partly about how we optimize and indeed integrate our collective resources and think about using them differently and also about how we from an NHS perspective really work with vcsc and housing provider partners and local councils as strategic partners which i think links to Hillary's earlier point so i just wanted to underline this is something we're committed to at Sussex partnership um Catherine how please thanks and thanks Ian for the work that he's been doing in this space which is hugely valued by all of the decent bees and i know on top of managing quite the crisis yourself which is which is something we're all experiencing the housing space um a couple of sorts is that so that going back to something that Ian said earlier about the there is a there is an entrenched belief in the housing space that east Sussex is doing this better i think it would be good to go with some curiosity into that and work out is it actually true or knock it on the head as a story because it doesn't help the it doesn't help the conversation and it would be really good if they are doing it better let's steal all their good ideas and if they're not let's stop talking about it so so i think there's something about going with curiosity and understanding the differences and i think our health colleagues could be super helpful in that in that you've got a perspective across um sort of both of those areas um the other thing is and i think all of the work that we're talking about in terms of how we support an increasingly mobile population around health and social care when our model is we assume that you're anchored in place i think is a really difficult design question for us all to work on but you know as Ian is placing people all over the place is that i've got a huge population of my instead of my people who we've housed who are in Littlehampton for example it's only over the border from my point of view but actually that's a very different system it's a different you know the whole thing it just it works badly for those people who most need us but the the thing that the other thing to reinforce what Ian said is the only solution here is better supply is that that you know we are trapped in this crisis until we address housing supply um and the two things in there is that the affordability of housing which may be beyond all of us but is something which i think has to be considered as as we as we start to think about strategic economic development of place because an overheated housing market serves nobody um but the other thing is is that is that we need to be realistic and we need to work at development pace so so in order for us to if we're going to build something is you're talking of three to five years so so our event horizon for when are we going to improve supply is three to five years time you know we we are breaking ground on sites now only the smallest of those will be available in the next couple of years but what that means is there's a real opportunity there to be shaping provision and doing those low key adaptations that mean that actually discharge to home becomes realistic you know we can make those wider door frames now you know we can make it so step-free access is a thing you know there's there's so much that we can do if we get ahead of it and so as i would suggest that we need a particular group and focus which is looking at that three to five year horizon and providing enough enough workable data out of health health and social care for us to be able to back investment decisions around the supply of housing and that's a very particular thing because because the public sector we're pretty broke and we can only do this if we work with investment we can only work with investment if we can provide certainty so there's something about moving our perspective and continuing to do fantastic work in dealing with what is an emergency at the same time is shifting our focus to the place where we're actually going to make long-term difference yeah thank thank you cast around it's interesting observation about East Sussex i think it's it's worthwhile demonstrating some professional curiosity around what's going on in that part of the world and on just on housing supply while three to five years is right i think for some developments i i've certainly encountered strategic housing developments where the time frame is a good deal a good deal longer than that i i and that's that's still the case i won't name them now but there's a few of them in in west Sussex that fall into that category but i think some of your remarks fall under a paragraph 4.3 bullet two which is offering to bring the kind of influencing weight of the health and well-being board to bear and in the case of your remarks that would be through reliable data to influence investment decisions i think and for me that bullet was really quite important and if speakers would like to look at that and think about how for how how to well-being board can have an advocacy and influencing role in in a more general in a more general sense um counselor manager please i think don't worry i think i've got everyone who's down said yeah thank you john thank you very much in duke for this report i think it's really good and i um frustrated because i've always had a keen interest in housing and i believe if people don't have safe and secure housing then that's really good impact on their health and well-being and i've always always been of that opinion and used to work in uh housing many years ago um i think you know there's there's some quick wins that we can do because from that our social care point of view we have actually and i'm talking about extra care housing now we have actually provided some extra care housing and working which we developed within 18 months was it most so i think there are i think i think working that west Sussex and the districts and boroughs could work together we've got sites that we could make available and there are providers out there who are keen to develop extra care housing with us so i don't think we should be i think we should be really on the front foot and try and do this rather than say oh three to five years yes there will be some developed three to five years but i think there are some some reasonably quick wins that we could um provide or or um achieve by working together so i think there's you know there we need to talk more about this because i get very frustrated i was i pushed the housing seminar in 2019 and yes i know we had covid but i get very frustrated when i see that we we haven't we've made a bit of progress but not a lot and it concerns me greatly that the homelessness numbers are going up people in temporary housing are going up really worries me this and i think we need to be a little more um objective and try a little harder um so you know i think we need to get together and talk more district and borough and county council because i think there are things we might be able to do with our sites and perhaps you know it's not an extra care housing isn't just about housing for older people the one in in Worthing was actually for um working age adults and it's working really well and i think i can see you know if we can get the right providers developers whatever you want to call them in place supporting us i think we could really widen that that um that parameter by you know people perhaps coming out of hospital people who are homeless etc etc i think it's got great potential i just ask that we work at it at a faster pace because that's the frustration for me and i also ask the chairman of the health well-being board whether we can put housing as again on the agenda you know as a fixed agenda issue because i think it's so important and it's going to affect everybody going forward and affordable housing what does that mean in West Sussex it's a very debatable when you think of the average price of a house in West Sussex so thank you thank you very much Ian and thank you chair thank thank you councilor sharp and i'll take on board the comment about a standing item but i i very much welcome your advocacy for extra extra care housing i mean because internally within the county council we often talk about the merits of that and often in the context of a sensible point of hospital discharge in some cases we talk about the merits of it but i don't i don't see so much in terms of across the board i mean actually delivering the the extra care housing to support what we're saying is so good um Jessica sonner please thank you chair this picks up on some of what councilor judge was saying and what kathryn was talking about in that housing seminar there was a very focused discussion around housing stock and the availability of of estates and identifying where estates are held and who owns those estates and i think the feeling was there is a request going to the strategic housing group to explore and tell us what does that look like is it a realistic prospect that actually as a health and well-being board with links to NHS with links to local authority but also with those relationships with private landowners to actually explore where is their housing or where is there estates and assets that could be unlocked because there was a feeling there are barriers in unlocking some of the estates that may be held or owned by different parties that actually perhaps a strategic housing group hasn't got the ability to unlock themselves but that a collaborative group like this that brings together various owners of estates could look creatively unlocking to look at that longer term strategic plan about where do we have availability where can it be developed and i haven't quite seen that in the paper and i haven't quite heard it in the discussions the approach is mentioned in the extra care bit around that multiple agency working and thinking creatively but i just wanted to highlight that was a key focus in that seminar was actually about the weight and the the scope and influence of this board could do something to try and unlock some of the barriers that may be a sitting on possible estates possible assets but the question of this group was is that real does it exist and what needs to be unlocked so that then the actors within this group could look at how best to do so again that that's the influencing role under paragraph 4.3 which are welcome your comments on that um Ian did you want to come in on that point now would you prefer to come in later once a lot of points for points are made it's probably easy going as i as i go along so we don't we don't i just wanted to come back to the extra care housing i think that has got real momentum now um as well i said i think hopefully that that that comes across to some extent in the paper um but i i know that the the west of six represents cities is having those conversations at d&b level individually it's very pleased with with how db's are responding to that and trying to do what there hasn't been until date really is a strategic push on it um and i think that's changed in in in kind of recent months and over the last year or so um and and the responses going there and there are kind of developments coming forward i can speak to one in cruelly in the the alson catheterines hospice site for instance which has been pushed along so so i think that's that that's now aligned strategically the estates on one publicist uh so one public estate really is the body that where we start to talk about where we kind of have have estates across all of us um and and what the development opportunities are not um um i can't speak with any kind of great uh authority on on the effectiveness of that as yet and i'm happy to to to look at that what i would say is um and i'm gonna again i'm gonna rely on my my more local knowledge on this you know in cruelly we've our house building records pretty good and 1600 affordable and social rent properties over a 10-year period which is kind of one of the best in the country um that has not solved the homelessness issues coming through so i think we just need to be uh we're just cognizant that this isn't just um this isn't just an issue of we're not building enough inside yes we've got to do more on that and we've got a person do everything we think possible but this is not this is simply not just a case of of development not being enough there's something bigger going on and i think we need to know it would be be be aware of that um i think also it gets slightly difficult to rest with six level because so much of this is is to do with with planning authorities with designation of site and and site by site viability you're often linking up developers um um not always the same as land owners uh and and the funding regimes that actually are not development so it is complex and essentially what you tend to get is is those those sites where it aligns because all these interests come together of the ones that go quicker um and you get some which are real puzzles that you can't get a a a site up and running on i can think of one again locally that we've had in you look at it at on face value and you can see no good reason why it hasn't been developed but it stood there for ten years um because you can't get a viable site out of the ground so it is complex um but i would be interested just on on the base of of how we kind of had this broader strategic conversation around this in the one public estate space um thank you and indeed Crawley does have a good um track record at differing housing but of course the the pressures are so so so great as you say that um you know they're almost at the point of being overwhelming for people and and for budgets for that matter but uh um i think more generally and even outside this meeting um i i would welcome input from partners as to where the where the health and well-being board might be able to influence um unlocking and facilitating new housing division provision whether that means um influencing the release of estates um encouraging development etc etc so it doesn't have to be within this meeting but i would welcome comments along those lines and penny forward please uh thank you chair and uh thank you Ian such an important conversation um kind of couple of thoughts really so um really recognize the the pressure this puts on our lower tier and and indeed our upper tier um local authorities um i was kind of reflecting on this about the impact of housing on people's health but also the impact of people's health on the housing needs and that might be issues around for example drug and alcohol misuse but it might also be issues around uh frailty and mobility as our population ages so that interrelationship is quite complex i i think what we've i was thinking about what we've heard and i think there's some aspects here that are quite strategic kind of pan West Sussex and some of the work for example it's been talked about around extra care which i also think is incredibly important um in that sort of strategic group but maybe there's also something about the local conversations and the local join-up given that not every bit is the same and the housing issue in each place will not be quite the same and so some of the solutions might not be quite the same and then i was just reflecting on the the seminars and i wasn't able to get to the most recent seminar i wasn't some of the previous housing conversations and i think and i was right Sussex partnership are well engaged in this agenda around the accommodation for people with mental health needs but i think in all honesty we have we we are a sort of invited the group we are members of the group but i think we've struggled to fully engage in this and know quite how to take it forward as a sort of health partners so where does that kind of take me so so two areas i think that we could take forward um one is that we are um doing a lot of work around our discharge program and that's been mentioned as part of this we've got a real wish to focus on people getting home not not into temporary arrangements but getting them back back home and with a focus on rehabilitation reablement and recovery in the discharge pathway i think we also will have some data at night not quite cover what you need but i think there may be scope there around some of our discharge information and dashboards work potentially to feed into that forward planning piece but there may be scope as we continue to develop our discharge models to build better that relationship in with housing and how that can uh how that can feed in both now and for the forward planning and then the second bit is around it's back to our integrated community teams our local community networks which are being involved in those local conversations i was really struck in those conversations that many of our people with complex needs are also in touch with our district and borough housing services and we don't join that up very well so i think there's scope this is not something we can do overnight we've got a lot of work to do on these but build that kind of into relationship in and just remember that as we as an element as we develop our integrated community team model thank you thank you penny uh are any further comments or questions on this report and um any calendar then please thank you um i i just wanted to say i was really pleased that this report came today and i was pleased that to see the reference of course to the seminar we held in 2023 it was really it was very well informed we made um a real commitment to making sure that we stayed on top of this and this is another opportunity for us to make sure that we continue that work while we were listening to the presentation and and looking and and in receipt of the information i was just jotting down as i as i listened the number of services that cross over on a daily basis with housing and some of this comes from my own career from starting off in a psychiatric hospital and and discharge home and discharge wherever that was too long ago i'm not going to admit that but it was housing that was the biggest issue for us then we didn't have that many the numbers we have now and it remains housing and it's gotten worse so mental health services children services children and education services child and other lesson mental health services children with disability adult services multi and complex needs service users um yeah i think that was about it and i probably left some out so um my apologies for that but i cannot think of an area services that i services that i in the NHS and the department of health in social care um that i worked in and managed in that didn't have an issue and we weren't dealing with issues and we didn't have a need to have close working relationships with our professional colleagues and the housing sector one way or another so it is an issue for us i'm delighted it came back and um i would welcome and support anyone that we do between now and the next meeting thank you thank you any other any other speakers please can i check could you like to come in nice um coming at the end of the vote oh what i'm going to bring you okay um Ian would you like to come back as the author thanks um only firstly apologies i disappeared for part of it so um we we seem to have had something for the catastrophic to do with Wi-Fi here for for about three or four minutes or apologies if i've missed anything i'm happy to take um if if we can't i'll go back to the recording see what i miss and i'm happy to take that on separately um i think i i think this is one that's going to require we're not going to kind of walk away i think and and have an understanding of how we pull this together given the complexities in a short period of time is going to be one that i think we will need to develop over over a period of time and we're going to have to do it in by size chunks because it is um you know just to reflect on on a couple of uh the the comments it does cut across so many parts of of life and is absolutely fundamental so it's how we how we make the biggest impacts i think in order to to to ameliorate the the um the position because otherwise it will get overwhelming and we'll get no work um but that's that's that's part of the task moving forward thank you Ian and Alison challenge your place just welcome the report and i think there's been some important suggestions here in terms of what we might need to do going forward and particularly noting Penny's point on housing and housing and health looking at it from both perspectives uh it is one of our priorities in our current health and well-being strategy so it's really important that we stay on top of this and that we consider going forward for the next strategy and where i'm particularly interested to have further conversations about what more can the health and well-being board do in terms of supporting this agenda supporting any removal of barriers if that is in in term possible and and what that might look like so i i think it feels like there's more to discuss on the particularly on the element of the health and housing and it it also crops up in so much of our work the mental the all-age mental health needs assessment that we're currently working on also we'll be bringing housing in so it does touch on almost every aspect of the work that we're doing in public health so very keen to sort of keep this high on the agenda and to consider where we might have some influence and impact um thank you Alison thank you Ian again for the report and um just to reiterate that um you know as partners we of course do and should continue to communicate with each other along the lines discussed in this report to where we can help each other unlock barriers to the delivery of housing and to the um the blight of of homelessness and and other other issues so we're asked to note the report and discuss potential areas of support from health and well-being partners which i believe we've done um so thank you everyone for your contributions on this on this topic we're now moved to item 10 which is an integrated care system update from steven lightfoot of NHS Sussex it's a bit of role reversal today i'm usually at a meeting each year it's always welcome Bob we can both play both roles so thank you very much chairman and the really item 10 is really an update for this particular board and the context of course is that the health and care act in 2022 required each of the 42 health and care systems around the country to establish an integrated care partnership and and this is technically a statutory joint committee for our area of Brighton and Hove City Council, East Sussex County Council, West Sussex County Council and the NHS Sussex Integrated Care Board that's the that's the technicality partly because of my aversion to three-letter acronyms we rebranded it as a Sussex health and care assembly rather than an ICP because i just think that's confusing after the first year of operation was very pleased that the assembly did achieve its fundamental aim of approving an integrated care strategy which we've called improving lives together and i know has been reported to this board previously we also committed in that first year that we'd review the governance arrangements after the the first year and for that first year i was chairing the assembly as one of the four statutory partners but during the review i think it became quite obvious that and there's a comment that was made earlier actually that we don't want the assembly to be seen as an NHS committee it has to be a genuine cross agency cross partner system-wide committee and that's what we were really keen to achieve and so two things we were going to do as far as part of that one is that we are going to use the good experience in west Sussex or appointing an independent chair and that's a process that ESUS's counter council will take the lead on on behalf of the four statutory partners but each of the four statutory partners will need to be involved in that and also we're going to reduce the NHS Sussex membership and i think actually really thinking about the core wider determinants of health if health is really only about 20 percent of the the courses of ill health and well-being then actually probably 20 percent is the right proportion for the NHS membership of this particular system-wide committee so on that basis a number of my colleagues will stand down from the committee they will be very welcome to attend when there's a specialist requirement for them to do so but not as standing members now the membership of the integrated care partnerships has been very permissive and so each system has done very much very different things and they range in size from 18 in Leicestershire to 51 in Essex so i think that's probably quite unmanageable and so where we've settled is the proposal on you know 2.3 which identifies you know the 18 members that we're proposing and this is the terms of reference so we're not putting names to those but there this seats at the table and so we'll reduce the higher education membership we'll reduce the NHS Sussex membership and we will add a sport and leisure provider on to that membership including also the addition of an independent chair so this is really for information the the technical route of approval each of the fourth statutory partners are putting it through their own governance processes so ESOSIX County Council and NHSOSIX have both completed that Brighton and Hophis City Council will complete it on the 16th of May at their fall council meeting and council answer will be taking an action on behalf of West Sussex County Council for the West Sussex approval as well so this is really for your information the terms of reference were included as an attachment and i'd commend the report to the board thank you Stephen and i just comment that this was a very effective and collaborative consultation with the the members of the health and health assembly as as they were and a really good degree of consensus was achieved by Stephen and others about this outcome so are there any um i think it'll be i think it'll be very effective and certainly um yeah i wouldn't be an advocate for going up to 51 yeah so okay question um so great to see this and again another victory for independent sharing which i think is really sensible to two slightly related points um so one is just from a governance perspective i think it's really helpful when you've got someone representing a sector that you've got clarity around how you get that person but also clarity around what is the expectation in terms of how they consult within their sector um i think that these things start really well and then end up as being a voice on a board and i think if we could if you could consider whether or not that needs to be extended in terms of reference i think that might be very helpful um the other thing is and this is linking back to the conversation about housing i have to flag that that level of rep that type of representation with respect to the housing if we all agree it's a critical issue isn't adequate um i know we're complicated because there's lots of us but i do think you need you need district and borough you need housing authority representation on there so i don't see how we can have had the conversation we just had and not have a housing authority represented there which is why understanding how you pick them and how you represent needs to be sorted out but it really feels like that that that's a disconnect that we we shouldn't be putting up with Katherine steven phase yeah Katherine and i actually agree with you uh and i think actually the voluntary sector are doing that really effectively so we have a VCSE alliance uh there's three representative for East Sussex West Sussex and Brighton and Hove and they and the members i know do consult with their members and their and their constituency i think with some of the more specialist members that's less clear and i think housing is a very good example and and certainly i learnt a lot from Ian's paper today so i think we should probably as four statutory partners with the new independent chair when appointed just think about how we go about appointing uh you know the individual particularly on the housing sector bearing in mind how important it is thanks for that any any other comments or questions um i just i'll just i'll just comment despite the victory for independent sharing i'm i'm bound to comment that uh steven did a did an excellent excellent job of sharing the health and care of Sussex health and care assembly uh since it's inception and getting off the ground and developing improving lives together with the with the entire with the entire team a very very collegiate approach i'd say but uh we're now um then move back to the main agenda and we're asked to note that that item which we have and we'll go to item 11 the better care fund and just just before we get to this um i mean some of the um the metrics here around discharge to normal place of residence being in your normal place of residence after discharge for at least 90 days these are really important real outcomes for real people and i make the point that i don't think it gets enough um cut of prominence in the public eye and so i made it part of my um speech at the county council budget debate to give it a bit more to give it a bit of a higher profile thank uh chris clark assistant director health integration west suspect county council to introduce thank you chair and um can i pass on my thanks to you for raising the profile of the best care fund uh with council very grateful for that so um i'll start by saying that at the time i'm bringing this report to us today we're now in the midst of preparing our 2024-25 BCF plan having received the NHS England planning guidance just before easter um the guidance confirms that health wellbeing boards are required to update their two year BCF plan for 2024-25 uh an addition we're also required to update our plans for the use of the national hospital discharge fund which is now within the purview of the BCF plans will be required to be submitted to NHS England on the 10th of June and i can confirm that joint planning activities have taken place locally uh for both the BCF and the national discharge fund uh between county council and NHS Sussex and we're now at the stage of making final adjustments to a draft plan which will now go through a local review plan process for the narrative that goes alongside our BCF plan this year we're only required to make updates but we will need to fully update our demanding capacity model for intermediate care which was introduced into BCF requirements last year and that is being coordinated through a Sussex wide process with business intelligence teams across the three place-based areas um council alanza mentioned uh the importance of the metrics and the importance of oversight of those metrics in the BCF program and we've received national guidance that there is a plan to update the measures in the BCF program uh both uh an intention to replace some of the outgoing measures but also to move to a more developed way of measurement which is now being introduced in all local government areas called client level data which is a more developed and mature method of tracking individual outcomes for people as they move through different health and care pathways members will recall at previous boards i've highlighted some of the limitations of the way uh measures are presented in the BCF limited by some data quality or data collection issues but also um limited in their way that we can really monitor true outcomes for people which is precisely what um the chair has brought attention to so just while we're on the measures i'll draw your attention to note the five current metrics in the program in west Sussex and highlight that uh in measures two three and four uh which is intermediate care outcomes unplanned admissions due to chronic ambulatory conditions and hospital admissions due to falls we're currently trending in the wrong direction um i will caveat the caution of the data quality but trends can be more reliable sometimes than absolute numbers and i think we should take these trends seriously interestingly all three of them relate to different issues that have already appeared on the agenda today so uh being an outlier on falls can sometimes be driven by housing quality issues it's cited as one of the top three housing related health issues alongside dampness and extreme cold and admissions due to chronic conditions uh is is a factor of how well we look after people with long-term or complex conditions in the community which is really the founding case for us to develop integrated community teams so uh as we look at our bcf plan and we continue to develop it year on year we will uh intend to bring a further focus on bringing more urgent community services under the purview of the bcf program and we'll be undertaking a full review of our proactive care and communities of practice schemes uh which have existed across the county for some years with a view to making these the foundation of our universal integrated care teams model we're also looking to introduce some uh additional work within the bcf looking at a voluntary sector model for supporting regular users of um a&e services and also uh clinically led training and support for health professionals to identify and support possible victims of domestic violence so continuing to uh increase the breadth and reach of our bcf program across the county and of course that fundamental important role of the bcf to continue to develop schemes to improve hospital discharge so tracking to that national timeline we anticipate being able to submit a completed plan on the 10th of June and we are in a position as usual to be able to submit that with health and well-being board approval pending due to the timing of the board meetings and this is something that systems across the country need to manage which is why the pending approval status is allowed but following that submission we look forward to bringing the plan in full to the next meeting of the health and well-being board in July where there will perhaps be an opportunity to explore uh some of the areas and highlight more the role of the bcf in the wider strategic ambitions of the board and its members including how we use things such as the disabled facilities grant just to link to that discussion around housing uh so I would ask the board at this stage to to note where we are performing against our bcf measures and note the update on the development of our 24-25 bcf plan and look forward to that plan being brought to the next meeting in July for approval thank you okay um thanks very much Chris so um this yes indeed this is a noting recommendations now subject to approval in July but with that in mind are there any comments um on this report please any questions or comments Helen Rice please thanks I know it's out of your control Chris but timings are just so difficult I've got contract sending and many of my colleagues that weekly phone call about bcf at the moment seeing are you being told that you're getting rollover or not so it's start leave and you know I know it's not this is not you this is the system but I'm just letting people know this it underwrites so many different streams and a lot of funding is part bcf part something else really complicated as well even trying to map backwards to think where did this funding funding even came come from originally I think you could have a master's degree in that and I'm certainly not gonna get more than a merit so um it's really complicated because the time frames are such and the way contracting happens and it's so important the difference we can make is huge I'm having such great conversations with people I'm really hopeful for the future the difference we can make is so extraordinary in this area um and I'm having great conversations with your colleagues with me um and others looking at what's possible um as more of a partnership approach so I am hopeful but just let you know the timings of these things are just so shocking even if we don't we won't know till that date we're gonna have to know whether the time frame them for conditioning to come out for it or whatever it's going to be is absolutely fine but therefore we know it's not going to be ready for September and if we know that now we know that because it would have been out by now so you know what I mean but just that foresight of thinking anyone who's waiting on that funding services is just gonna be gone because the staff are gone I've lost half my staff in one area already and I'm now don't know am I re-recruiting or not it's just it's our normal world in some ways but if we know that can't we just do that just say okay how do we get six more months and it will come out on this date the commissioning will be happening that's fine that's great that's how it should be but even if we know that it makes such a massive difference because there's such really important stuff in here it's such an important fun so it's just out to the world of hopes and dreams but I appreciate it's not in your gift Chris some parts of that but just just flagging it's massive it underwrites an awful lot of hundreds sector services thanks very much for that background Helen and Chris yeah thank you and and yes it's certainly outside my power actually fall to the secretary of state for health and social care to approve the guidance from my experience historically we've received guidance around about December prior to the financial year so this year the guidance was received a little later so there are restrictions that we do have to work within and we do have to make sure we've received and understood the guidance before we can finalise and most importantly approve the plan I think in terms of the issue you raise I recognize it and I acknowledge the issues that that can then flow from it and I think what we can do is a local system partnership is ensuring we're working within the formal governance understanding where we can potentially make provisional commitments by close conversations between yourselves and our commissioners to avoid loss of skill and resource where we didn't intend that so I think it's an important point Helen raised and very much when we acknowledge and want to do our best to try and minimise thank you Chris any further comments or questions on this report I'm cutting out please so firstly thank you because I think you do a great job with this I think this is a really good fund and I don't think we do we do we do make it work really bloody hard so thank you and it was just building like you opened up the potential for dreaming so there's a thing here for me about who holds the risk of uncertainty so so we're the funding you know so that where the funding is flowing through the system is actually at the moment a lot of the uncertainty or funding that's probably going to turn up that the the risk sits with the smaller providers and I just wonder if there's a conversation that we could have collectively which which would allow us to hold the risk more appropriately as a system because actually those of us and and so I don't have very deep pockets but but those of us with deeper pockets hold on to some more of that because actually it's a bit like you know you know in the housing you know sort of the housing prevention grants and stuff like that we know they're going to turn up we also know go turn up like later than they need to and we also know that we're going to have to make difficult decisions about whether or not we retain staff or we let them go now I just about have the luxury of making that judgment VCS's don't necessarily have that so I think there's a there's a joined up commissioning is a thing but risk in commissioning might also be useful yeah it's a really important point and and it raises a curious question actually about the nature of the better care fund itself the the better care fund is actually a defined ring fenced amount within the baseline allocation that the health and care system receives it's not an extra pot of money on top of our budget but it does have to be managed with a certain set of conditions one of which is we have to define a plan on an annual basis which means certain decision-making can only be made on an annual basis that can potentially limit our ability to make longer term investment commitments through the BCF so one question we should always ask ourselves actually is whilst there's the benefits of other types of flexibility we can use within the BCF if we're going to make an investment decision we need to consider whether actually it should sit in the BCF or actually outside particularly if it's related to commissioning activities so I think it's something we do need to think smartly about when we consider any new new activity thank you Catherine thank you Chris any further comments Stephen Lightfoot please yeah thank you thank you for the report Chris and I think this is as Helen says hugely complex actually the team do a great job of trying to navigate this there's no one more frustrated at the delay than than myself there's no more frustration than anyone else in terms of an inability to do multi-year agreements because that's frankly what we probably really need and I think the other aspect of the context is from an operating point of view the NHS in Sussex has got flat cash this year which means we've got no more money this year than we had last year and we've got a swallow of inflation and so I think one of the things that we having to do really hard on every other aspect of the NHS services in Sussex is actually productivity and are we getting really good value for money now I understand from a metrics point of view we've quite rightly Chris has put in the national measures and that's completely appropriate but I think this board should also have sight of some more local measures that demonstrate the productivity that we're getting to be really clear and so I think a more granular level of data is one mechanism to that but we also need to make sure that this is working for our providers too because you know 31st of March University Hospital Sussex still had 331 patients you know we're medically ready to discharge you know now and they're not all in west Sussex but there is still an issue and they're not all down to local authority either some of those are due to ENHS discharges but you know we need to make sure this is working for patients we need to make sure it's working for our providers and that's the large ones as well as the small ones and it needs to work for the system in total so I think an additional suite of measures would be helpful now I don't want to have a hundred but I think a wider range than those five national tables will be helpful for this board to be sure it's getting value for money from what is a very very significant financial investment from the NHS at a time when we're getting no more money on anything else so I'll make that as a plea for the future reports yeah I absolutely accept and agree with that suggestion and I think it's something we have mentioned before being able to bring a little bit more local oversight we've got we've got plenty measures and yet people waiting to come out of hospital we measure in a very detailed manner so we should be looking at the productivity and the effectiveness of the impact of the investment in fact if I just briefly mention if I add up the the better care fund the improved better care fund the disabled facilities grant and the national discharge fund in West Sussex the investment totals just short of a hundred and eighteen million pounds so that's considerable spending power and and the the program is very broad at the moment it goes all the way from services supporting prevention anticipatory care intermediate care and urgent health and care both with statutory and voluntary sectors so I think the breadth and the volume of the investment gives us in West Sussex a significant program of opportunity thank you Chris that's quite an enlightening figure I think for for many people and just out of interest it's more than three times the public health grant so anyone else on this report no okay so we're asked to note which I think we're doing so our item 12 is the work program for 2024-25 and that's attached at the back are there any comments or suggestions on the work program noting we already have a couple in fact that we've recorded in the in the minutes even like for as my own your salvation obviously being new to the meeting is that I think the health and well-being development and the new strategy will need more than one session you know and I think back to Penny's earlier point I think multiple conversations not just in the formal setting of this board but in seminar type sessions will be genuinely very helpful okay we'll definitely take that on board thank you yep any other comments no oh catch me now yep is this where you want to capture the sort of the the council just thought about housing as a standing agenda item in here yes we have that as a minute yeah okay I suppose the other thing then might be whether or not we want to actually reserve some time for things which are going to emerge so there's so it's quite a it's quite a programmed agenda but actually we've sort of identified in the conversation areas that we know we're going to want to deep dive into and there's something about like having space in the forward plan and uh and a sort of a kind of cause and effect which is we've had the conversation now let's let's let's do the final up thank you yes the best plans adapt yeah okay any other comments on the forward plan on the work program no okay thank you so item 13 is the date of the next meeting which will be 11th of July and 10th 30 and venue to be advised I'll put it like that okay thanks very much everyone meeting closed you a lot of time. a lot of time. a lot of time. a lot of time. 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