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Health and Wellbeing Board - Friday 13 December 2024 10.30 am

December 13, 2024 View on council website
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Summary

This meeting included reports and presentations on a range of topics, including a presentation on a pilot scheme for an integrated wellness centre in Millom, the suicide prevention action plan, the special educational needs and disability joint strategic needs assessment, a report on the substance use needs assessment, a report on the progress made by the Health Determinants Research Collaboration, the second quarter Better Care Fund report, the Health Protection Plan, an update on the Disabled Facilities Grants service, and the date of the next meeting.

Suicide Prevention

A report was included for discussion that provides an update on the development of the Cumberland Suicide Prevention Action Plan 2024 – 2029.

The report explains the background to and rationale for a suicide prevention plan. It explains that the Office of National Statistics define suicides as:

‘deaths from intentional self-harm (where a Coroner has given a suicide conclusion or made it clear in the narrative conclusion that the deceased intended to end their own life) and events of undetermined intent (mainly deaths where a Coroner has given an open conclusion) in people aged 15 and over. Also (since 2016) deaths from intentional self-harm in children aged 10 to 14’.

The report then explains that:

Suicide is everyone’s business. Every death is one too many and has a devastating impact on family, friends, and the community.

It explains that rates of suicide in Cumberland are high, at 19 per 100,000 people, which is the highest rate in the North West, the second highest in the North East, and the fourth highest in England. The report provides some analysis of the demographics of suicide, noting that:

Nationally Suicide is the leading cause of death in men under 50 years and the leading cause of death for women under 35 years.

It then turns to deprivation, explaining that:

The Indices of Multi Deprivation (IMD) decile is a group of neighbourhoods in England that are ranked by their level of deprivation, with the most deprived 10% in decile 1 and the least deprived 10% in decile 10. In Cumbria for the 18 months from January 2023 – June 2024, 67% of all deaths were residents in deciles 1 – 5.

The report then explains that the plan has been developed in partnership with Westmorland and Furness Council, because:

The Integrated Care Boards, and their commissioned services, and Local Authorities are key partners but are not co-terminus.

The report lists the aims of the action plan, including:

  • To reduce the number of people dying by suicide across Cumbria
  • To reduce the number people attempting suicide across Cumbria
  • To improve support for those who self-harm
  • To ensure that people who are affected by suicide across Cumbria get the support that they need.

It then lists the objectives of the plan, including:

  • Support research, data collection & monitoring
  • Achieve strong leadership across Cumbria in suicide prevention
  • Provide Information & Support to educate and prevent suicide
  • Provide information & support to those in MH services and those who are at risk of dying by suicide
  • Provide better information & support to those bereaved or affected by suicide.

The report concludes by recommending that:

Special Educational Needs and Disabilities

A report was included for discussion that presents the draft Special Educational Needs and Disabilities (SEND) Joint Strategic Needs Assessment (JSNA).1

The report explains that:

The purpose of Joint Strategic Needs Assessments (JSNA) is to assess health and wellbeing needs of a population leading to agreed commissioning priorities that will help to improve health and wellbeing outcomes and reduce inequalities.

The report explains what special educational needs are, explaining that:

A child or young person has Special Educational Needs (SEN) if they have a learning difficulty or disability which requires special educational provision in addition to standard provision.

It then describes the four broad areas of need, which are:

  1. Communication and interaction
  2. Cognition and learning
  3. Social, emotional and mental health difficulties
  4. Sensory and/or physical needs

The report then provides some analysis of the demographics and prevalence of SEND, noting that:

Levels of pupils with SEND in Cumberland schools are similar to England (18.3% v 18.4%).

It describes the geographical distribution of SEND, explaining that:

The top five wards with the greatest numbers of children and young people with SEND are: Moss Bay and Moorclose (320); Harraby North (272); Upperby (266); Egremont (260); and Maryport South (258).

It describes the educational attainment of children with SEND, explaining that:

Education attainment levels for pupils with SEND are below national levels at Key Stage 1 (reading and writing); Key Stage 2 (reading, writing and maths); Attainment 8 and Progress 8 scores; GCSEs grade 4 or above (English and maths).

It also discusses attendance, noting that:

Overall absence rates of pupils with SEND are greater than pupils with no identified SEN in both Cumberland schools and nationally.

The report describes the services currently available for children and young people with SEND and their families, including the SEND Local Offer. It describes the SEND Local Offer, explaining that:

Every Local Authority in England has a statutory duty to publish a Local Offer.

The report then lists the three special schools in Cumberland:

  • Cumbria Academy for Autism
  • James Rennie School
  • Mayfield School

The report then lists the sixteen schools that have resourced provision, these being:

  • All Saints Primary
  • Ashfield Junior
  • Bransty Primary
  • Ellenborough Primary
  • Hensingham Primary
  • Kingmoor Infants
  • St Cuthbert’s Primary
  • St Patrick’s RC Primary
  • St James Catholic Primary
  • Thomlinson Junior
  • Wigton Infants
  • Caldrew School
  • Cockermouth School
  • Trinity School
  • William Howard School
  • Workington Academy

It describes the two pupil referral units:

  • The Gillford Centre
  • School 180

It also discusses the West Cumbria Learning Centre in the context of alternative provision.

The report goes on to describe a range of other services provided by Cumberland Council, including the SEND Teaching Support Team, the Child and Family Workers service, the Autism Education Trust, the Autism Hub, and the two carer support organisations, Carer Support Carlisle and Eden and Carer Support West Cumbria. The report also discusses how Cumberland Council undertakes quality assurance of SEND services.

The report concludes by making four recommendations:

  • The HWB consider the draft SEND JSNA and supporting Appendices and are invited to provide comments and feedback.
  • The HWB agree that the SEND JSNA adequately assesses and reflects the needs of children and young people aged 0-25 years with SEND in Cumberland.
  • The HWB consider the key findings, key issues, gaps in services, and recommendations; and agree these are an accurate reflection.
  • The HWB approve the draft SEND JSNA and supporting Appendices, this will ensure it can be published.

Substance Use Needs Assessment

A report was included for discussion that presents a Substance Use Needs Assessment (SUNA) for Cumberland.

The report explains that:

The purpose of Substance Use Needs Assessment (SUNA) and Joint Local Health and Wellbeing Strategies (JLHWS) is to assess health and wellbeing needs in order to improve the health and wellbeing of the local community and to help reduce inequalities for all ages.

The report explains how substance use is defined, stating that:

‘Substance misuse or use’ is defined in this report as ‘intoxication and/or regular excessive consumption of alcohol and/or dependence on – psychoactive substances, leading to social, psychological, physical, or legal problems. It includes problematic use of both legal and illegal drugs’

The report then provides some analysis of the scale of drug and alcohol use in Cumbria, noting that:

There are around 2,400 individuals who use opiate and crack in Cumbria.

It analyses treatment services, noting that:

In 2023 there were 2,739 people in treatment for substance use in Cumbria (all drugs and alcohol users)

It then describes the profile of people in treatment, noting that:

Most adults in treatment are male; and most are aged 30-49 years followed by those aged +50 years

It then turns to unmet need, explaining that:

‘Unmet need’ is the proportion of people dependent on a substance who are not in treatment.

It notes that the level of unmet need in Cumbria for Opiates is higher than the England average. The report also provides some analysis of the scale of drug and alcohol use by parents in treatment, noting that:

Of these, two thirds live with children, a higher proportion than that seen in England.

The report then turns to drug related deaths, noting that:

In 2023, there were 104 registered drug poisoning deaths in Cumbria (67 deaths in Cumberland and 37 in Westmorland and Furness)

The report then analyses data on hospital admissions, noting that:

2023 rates of hospital admissions for poisoning by drug use are comparable to those seen in 2022 and remain high compared to the national average.

The report goes on to discuss work to prevent infectious diseases, noting that:

Half of clients in treatment were offered and accepted a Hepatitis C test, compared to just over half nationally; a slightly higher percentage of those who tested positive were referred to treatment compared to the national average (21.9% vs 19%).

It then discusses the prevalence of mental health conditions, noting that:

The majority of adults entering treatment for drug use in Cumbria have a mental health need, higher than the national average.

The report concludes by making a series of recommendations, including that the council:

  • Understand levels of unmet need and improve ways to overcome them, including, reducing unmet need for those individuals’ using opiates and not in treatment.
  • Better determine the level of need around those who are and are not parents and carers with unmet need around drug and alcohol addiction, and their barriers to accessing support.

The report also recommends that the council consider:

  • A focused review and analysis of homelessness and addiction within West Cumbria.

Health Determinants Research Collaboration

A report was included for discussion that provides an update on the work done by the Cumberland Health Determinants Research Collaboration (HDRC) during its first year.

The report explains that:

NIHR Health Determinants Research Collaborations enable local authorities to become more research-active, embedding a culture of evidence-based decision making in their activities.

It explains that the HDRC has an ambitious delivery plan and is working to:

Develop a culture for research excellence.

The report provides an overview of the work done so far to develop a research infrastructure for the Council, and how it has built links with partners, including:

  • The University of Cumbria
  • UCLan’s West Lakes Research Campus
  • Cumbria Council for Voluntary Services

The report also explains how the HDRC has developed a governance structure, including an oversight board, a community advisory panel, and regular academic partner meetings. It goes on to explain that the HDRC team has developed a research governance framework for the council and consulted on a range of research priorities.

The report describes the HDRC's research capacity development work, and notes that:

The HDRC intends to support research in each Community Panel in order to translate Cumberland’s research plan into localities.

It concludes by listing some of the projects the HDRC is currently supporting, including:

  • The Big Question, research into Cumberland's high suicide rate
  • Age Friendly City of Carlisle
  • A digital inclusion research project
  • A technology enabled care project
  • Making Every Adult Matter
  • A mental health and neurodiversity project
  • An infant mental health project
  • Active Cumbria Place Partnerships
  • A mobile outreach bus for family services

The report notes that the HDRC is also planning to apply for research grants from the following schemes:

  • NIHR NENC Regional Research Delivery Network Contingency Grant
  • NIHR Research Programme for Social Care
  • NIHR Internship Programme

The report ends by recommending that the Board:

note the contents of the report and consider the opportunities for joint work to leverage research in the remaining four years of the project.

Better Care Fund

A report was included for discussion that presents the second quarter Better Care Fund (BCF) report.

The report explains that:

The Better Care Fund (BCF) programme supports local systems to successfully deliver the integration of health and social care in a way that supports person-centred care, sustainability and better outcomes for people and carers.

The report lists the two core objectives of the Better Care Fund:

  • Enable people to stay well, safe and independent at home for longer
  • Provide the right care in the right place at the right time

It then assesses progress against four key metrics, these being:

  • Avoidable admissions
  • Discharge to normal place of residence
  • Falls
  • Residential admissions

The report provides some analysis of the activity and spend on each of the BCF schemes, noting that:

Analysis of capacity and activity for Reablement & Rehabilitation at home (pathway 1) over the first 2 quarters has shown that actual demand was below predicted levels.

It concludes by recommending that the Board:

Approve and adopt the content of the Quarter 2 report submitted to NHSE on 31 October 2024 (Appendix 1)

Health Protection Plan

A report was included for discussion that presents Cumberland Council's Health Protection Plan 2024/25.

The report explains that:

This is the second Health Protection Plan for Cumberland Council.

It explains how the plan links to the Council's strategy, noting that:

This Plan is linked to the Cumberland Joint Local Health and Wellbeing Strategy in that health protection, early intervention and detection is one of the four key themes of the strategy.

The report then describes some of the activities that have been undertaken since the first report in April 2024, including:

  • A mop up campaign to deliver MMR vaccines by the School Aged Immunisation Service
  • Work with Romany, Gypsy and Traveller communities to increase uptake of MMR and HPV vaccinations
  • Health equity audits of all the NHS Screening Programmes2 by screening providers

The report identifies priorities for the future, including working in partnership with the NHS to improve uptake of vaccines, and working to address health inequalities in the uptake of screening. The report concludes by recommending that:

The Health and Wellbeing Board acknowledge and approve Cumberland Council’s Health Protection Plan 2024/25.

Disabled Facilities Grant

A report was included for discussion that provides an update on the Disabled Facilities Grant (DFG) and Housing Assistance service.3

The report explains that the formation of Cumberland Council has created an opportunity to:

develop delivery in a way that can improve effectiveness of services.

It explains what DFGs are, noting that they:

fund property alterations (such as installation of stairlifts and ramps) that enable a disabled person to continue living in their home.

It explains that:

DFGs are delivered following submission of an assessed application.

It goes on to note that, in addition to the statutory DFG:

The RRO allows discretion, within certain parameters, to local authorities.

It explains that this discretion will be set out in a new Housing Assistance (RRO) Policy.

The report then explains that DFG funding comes from the Better Care Fund, and notes that the service has been inconsistent across the three legacy district council areas, being:

focussed on the north of Cumberland with less preventative support in west areas.

It explains that the new Housing Assistance (RRO) Policy will be used to harmonise the service. The report then explains that Cumberland Council is working with the Foundations organisation to:

harmonise the DFG offer.

It goes on to note that:

DFG funding allocation for the Cumberland area has historically been inconsistent across the three districts.

The report provides some analysis of DFG activity in Cumberland, noting that there were 927 grant applications and 818 grants completed. It notes that performance against statutory targets is good, and that:

customer satisfaction ratings are strong.

The report goes on to provide some analysis of the profile of grants that were issued, noting that 545 of them were for over 65s. It concludes by recommending that the Board:

consider and comment upon the issues and priorities raised in this paper.

Integrated Wellness Centre Pilot

A presentation was scheduled to be delivered by the South Cumbria Place Based Partnership, on the Integrated Wellness Centre pilot.

The presentation describes the high rate of unplanned admissions to Furness General Hospital (FGH), noting that:

835 people had 3 or more unplanned admissions to Furness General Hospital (FGH)

It goes on to explain that:

11% of patients admitted to FGH account for 28% of unplanned admissions

It then explains that an integrated wellness service is being developed, and notes that this model of care:

brings together teams across health, social care and VCFSE sectors

The presentation describes how the pilot worked, noting that ten patients were identified, and that:

Initial holistic assessment undertaken by ICC case workers

It explains that:

Fortnightly case review meetings with core MDT membership

The presentation sets out the impact of the pilot scheme, noting that there were 4 admissions and 28 days of length of stay in the two months following the pilot. The presentation then concludes by recommending that the scheme be rolled out, noting that a business case has been developed, and that it will be launched in January or February 2025.

Date of the next meeting

The next meeting of the Board is scheduled for Friday 4 April 2025 at 10.30am in the Flensburg Room, Civic Centre, Carlisle.


  1. Joint Strategic Needs Assessments (JSNAs) are reports produced by local councils that describe the health and social care needs of their population, and are used to decide how to allocate funding to services, and to plan the future provision of services. The SEND JSNA describes the needs of children with SEND, and so is likely to affect the provision of children's social care, healthcare, and educational services. 

  2. Screening programmes are delivered by the NHS. They invite people to have tests to detect health conditions early, when they are easier to treat. The breast, cervical, and bowel cancer screening programmes are the best-known screening programmes. 

  3. DFGs are grants that councils can award to disabled people to fund adaptations to their homes. Housing assistance policies describe how councils should use their discretion to provide support to their residents, and they often include information about discretionary grants, like the Dementia Friendly Grant that was provided by Carlisle City Council. 

Attendees

Ali Bragg
Edward Fletcher
Paul Latimer
Nikki Mason
Jane Mastin
John Salisbury
Kaz Stuart
Georgina Ternent
Martin Birch
David Blacklock
Profile image for CouncillorLisa Hinton
CouncillorLisa Hinton  Deputy Leader (Statutory) and Adult Social Care Portfolio Holder •  Labour •  Currock
Colin Cox
Profile image for Councillor Mark Fryer
Councillor Mark Fryer  Leader of the Council •  Labour •  St Johns and Great Clifton
Chris Jones-King
Profile image for CouncillorElaine Lynch
CouncillorElaine Lynch  Lifelong Learning and Development Portfolio Holder •  Labour •  Wigton
Jane Scattergood
Ed Tallis
Profile image for Councillor Emma Williamson
Councillor Emma Williamson  Deputy Leader (Non-Statutory) and Children's Services, Family Wellbeing and Housing (Statutory Lead Member for Children's Services) Portfolio Holder •  Labour •  Kells and Sandwith
Nik Hardy
Lynn Harker

Topics

No topics have been identified for this meeting yet.

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