The Board noted progress towards goals to improve emotional wellbeing, reduce suicide rates and agreed to require that needs assessments meet web accessibility guidelines. It also agreed to adopt Calderdale's Domestic Abuse strategy, approve the Suicide Prevention strategy and action plan 2025-2027, and review the multi-agency contribution to the Joint Strategic Needs Assessment.

Winter Planning

The Board received the Calderdale Health and Social Care System Winter Plan 2024-25, which considers the challenges that Winter presents to the four goals of the Calderdale Wellbeing Strategy 2022-2027: Starting Well, Developing Well, Living and Working Well and Ageing Well.

The Board discussed the pressures facing the health and social care system in winter, including increased demand on services from respiratory illnesses, such as RSV. It was noted that the RSV vaccination programme, which had begun in September 2024, should reduce demand.

Respiratory viruses were the biggest contributor to winter pressures with vaccines being the best defence.

It was agreed that Board members would highlight the importance of vaccination for all eligible people and that further details on the Winter plan would be provided before the next meeting.

Living and Working Well

The Board received a report on Living and Working Well, which updates on progress towards the Wellbeing Strategy's goal to improve emotional health and reduce suicides.

The Calderdale Talkback panel provides a mechanism for the Council to gather the views of residents on a range of topics. The report notes that the 2023 Talkback survey on the emotional wellbeing of working-age adults had a low response rate, meaning that it could not be used to assess progress. This would be reviewed in 2025.

We are currently exploring options for adding questions on mental wellbeing of working age adults to the Vision 2034 annual survey. If this is not feasible, it is proposed to use data from the Office of National Statistics Annual Population Survey to monitor progress

The Board noted that the suicide rate in Calderdale was 17.6 per 100,000 people, significantly above the national average of 10.7 per 100,000.

This trend is particularly concerning as it does not appear to be happening elsewhere in the country.

A new action in the Suicide Prevention Strategy is to pilot a multi-agency rapid review process for suicide incidents and deaths to complement existing review processes and identify opportunities for prevention.

The Board also considered a strengths and needs assessment of emotional health and wellbeing among working-age adults, produced in collaboration with a variety of stakeholders from across Calderdale. ¹

Stakeholders are any individuals or organisations that have a direct or indirect interest in a topic, scheme, plan or organisation. In this case the stakeholders were anyone involved in delivering health and wellbeing services in Calderdale.

This enables partners to understand the Calderdale picture of those risk and protective factors, to identify areas of good practice locally and to understand local needs, to inform the development of a delivery plan to achieve the wellbeing strategy living and working well goal.

The assessment identified four categories of risk and protective factors: individual characteristics, health-related behaviours, social and community networks, and the economy, housing and environment. The Board noted that risk and protective factors are not equally spread across the population and that some people experience multiple disadvantages.

The Board considered the recommendations from the strengths and needs assessment:

1. Develop a narrative to encourage people to consider how their work can improve emotional health and reduce suicides.
2. Embed consideration of emotional health and suicide reduction in strategies for working-age adults.
3. Support the adoption of a Calderdale Adversity Trauma and Resilience (ATR) programme. ²

An Adversity, Trauma and Resilience approach recognises the impact that traumatic events have on people's mental, physical and emotional health, and then tries to develop support and strategies that take these impacts into account. In Calderdale the approach is intended to be delivered in line with the West Yorkshire Adversity, Trauma and Resilience programme.

1. Promote inclusion for all to improve emotional wellbeing and reduce suicides.
2. Use data and experience to target resilience building, employment support and housing support.
3. Monitor and measure outcomes for different groups of people.

The Board approved the Suicide Prevention Strategy. It also agreed to consider how it could support the recommendations from the strengths and needs assessment, including the development of an ATR programme.

Joint Strategic Needs Assessment (JSNA)

The Board received a report on the Joint Strategic Needs Assessment (JSNA).

The JSNA is a statutory requirement for all local councils, requiring them to assess the health and wellbeing needs of their communities.

The purpose of Joint Strategic Needs Assessments (JSNAs) and Joint Local Health and Wellbeing Strategies is to improve the health and wellbeing of the local community and reduce inequalities for all ages.

It was noted that Calderdale's JSNA is a website called All About Calderdale rather than a document. It includes summaries of key intelligence sources and links to documents containing more in-depth analysis.

It was agreed at a previous meeting that Calderdale's JSNA would focus on informing the delivery of the four Wellbeing Strategy goals: Starting Well, Developing Well, Living and Working Well and Ageing Well.

The report noted the progress made in developing the JSNA:

• Starting Well: An assessment and strategy have been completed and links to them are provided on the website.
• Developing Well: The website contains summaries of intelligence sources, including:
  • Story gathering with young people on hope and aspiration.
  • The School Health and Wellbeing survey.
  • Calderdale data contained in the Public Health Outcomes Framework. ³

The Public Health Outcomes Framework (PHOF) is a national dataset that measures the health of local communities. It is used by local councils and the NHS to assess the needs of their populations and to plan services.

*   Updated information on children with special educational needs.

• Living and Working Well: The website will contain summaries of:
  • A strengths and needs assessment identifying factors affecting emotional wellbeing and risk of suicide among working-age adults.
  • A suicide audit of coroner's records to identify local trends and risk factors.
• Ageing Well: The website contains:
  • A summary of themes identified from an appreciative inquiry with older people to inform the development of an age-friendly Calderdale. ⁴

An appreciative inquiry is a technique used to identify and build on the strengths of a person or organisation.

*   Information on the health needs of older people is being added.

The Board discussed the Calderdale Intelligence Network, which brings together analysts from across the Council and its partner organisations to support the development of the JSNA and other intelligence projects, including population health management.

This will allow us to segment the population and look at multiple factors affecting the health and wellbeing of individuals and groups to inform the development and targeting of health and care services and interventions.

The Board discussed the challenges facing the JSNA, including the lack of dedicated analytical capacity, the need for training on web accessibility, and the need to ensure that community insight is used.

There have been some issues with adding content to the JSNA website as a lot of the documents that provide more in-depth information about strengths and needs that have been co-produced with partners and communities, are not in a format that meets the Council’s digital accessibility guidance.

The report notes that in June 2024, a peer review of Calderdale's Public Health services was undertaken. ⁵

A peer review is when colleagues from a similar organisation review your processes and practice to provide feedback, identify strengths and weaknesses and make recommendations.

Consistent feedback was that the JSNA is not used as effectively or as well understood as it could be.

The review made a number of recommendations for the JSNA, including requiring that all needs assessments meet the Council's web accessibility guidelines, ensuring that there are regular agenda items on intelligence and insight at life course partnership board meetings, and for the Health and Wellbeing Board to consider its role in shaping the JSNA. The Board agreed to require needs assessments to meet accessibility guidelines, and to review the multi-agency contribution to the JSNA.

Domestic Abuse

The Board received the Domestic Abuse Annual Report.

The report highlighted the positive work being carried out around domestic abuse in Calderdale. Overall, the panel was confident that services are run well.

It was noted that a review of Domestic Abuse services in Calderdale had been completed in 2023. One of the recommendations from the review was that the Health and Wellbeing Board should adopt Calderdale's Domestic Abuse strategy and receive an annual progress report on its objectives.

The report provided an update on progress against the objectives of the strategy:

• Performance: There has been a 12.1% decrease in recorded Domestic Abuse incidents in Calderdale, compared to last year.
• Performance Management: A new performance management report has been produced in line with the strategic aims of the Domestic Abuse strategy, and a RAG rating system has been introduced for assessing performance in different agencies.
• MARAC: ⁶ Calderdale has introduced a fortnightly MARAC.

A Multi-Agency Risk Assessment Conference (MARAC) brings together representatives from different agencies, including the Police, Social Services, Health and Housing, to assess and manage the risk posed by high-risk domestic abuse perpetrators.

• Domestic Homicide Reviews: Calderdale has completed four Domestic Homicide Reviews (DHRs). ⁷

A domestic homicide review (DHR) is a multi-agency review of the circumstances surrounding a domestic homicide. It is intended to identify any lessons that can be learned from the case to help prevent future homicides.

• Children as Victims: The report noted the implications of the Domestic Abuse Act 2021, which deems children to be victims of Domestic Abuse in their own right.

At present as a borough, we are working hard to secure specific therapeutic interventions for children.

• Safe Accommodation: Calderdale has 21 units of safe accommodation for victims of Domestic Abuse, in line with the recommendations of the Council of Europe.

The report noted the challenges facing Domestic Abuse services, including the need for investment in therapeutic services for children and young people, a gap in perpetrator interventions, and developing mechanisms for capturing the lived experiences of victims and survivors. The Board agreed to adopt Calderdale's Domestic Abuse Strategy.

Safeguarding

The Board received annual reports from the Calderdale Safeguarding Adults Board (CSAB) and the Calderdale Safeguarding Children Partnership (CSCP).

This report outlines how the Calderdale Safeguarding Adults Board (CSAB) and the Safeguarding Children Partnership (CSCP) have fulfilled their statutory duties over the year 2023-2024 and what their ambitions are for 2024 onwards.

It was noted that the CSAB had made significant progress in a number of areas, including:

• Training: Attendance at face-to-face safeguarding training more than doubled, from 1,030 in 2022/23 to 2,459 in 2023/24, and there was a significant increase in the uptake of e-learning.
• Self-neglect: There was a notable increase in the number of self-neglect referrals, following the introduction of a new toolkit, training and awareness-raising.
• Local Authority response: There were improvements in the response time for safeguarding concerns.
• Safeguarding procedures: Sixteen new multi-agency safeguarding procedures were introduced.
• New guidance: New guidance on a range of topics was published, including self-neglect, large-scale enquiries, adults with fabricated or induced illnesses, and working with non-engaged adults.

The Board was informed that the CSCP had undertaken a review of its multi-agency safeguarding arrangements in response to new guidance, Working Together to Safeguard Children 2023.

The review concluded that the arrangement of the Calderdale Partnership was already much aligned with the recommendations made in Working Together 2023.

It was noted that the CSCP had made significant progress in a number of areas, including:

• Improved data collection.
• Increased engagement with children, young people and adults.
• Development of resources for faith, sports and voluntary organisations.
• Improved support for vulnerable young people.
• Review of the work of the Multi-Agency Screening Team.
• Review of the work of the Child Exploitation Team.

The Board was informed that both partnerships had a number of ambitions for 2024/25, including strengthening multi-agency working and improving workforce development.

Health and Wellbeing Board Forward Plan

The Board received the Health and Wellbeing Board Forward Plan, which sets out the proposed topics for discussion at future meetings.

It was noted that the agenda for future meetings would be structured around the following elements:

• Key theme, reflecting one of the four priorities of the Calderdale Wellbeing Strategy.
• Statutory duties, including updates on the Better Care Fund and Transforming Care.
• Business items, including discussion of the Forward Plan itself.

The Board noted that the next meeting, scheduled for 13 March 2025, would focus on the Ageing Well theme. It agreed to consider its contribution to this theme, how best to engage people with lived experience, and what other topics should be discussed.