Agenda and minutes

This is where members who are attending as substitutes will say for whom they are attending.

Apologies were received from Mel Megg and Jacqui Gedman.

To approve the minutes of the meeting of the Board held on 15 July 2021.

That the minutes of the meeting held on the 15^th July were approved as a correct record.

The Board Members will be asked to say if there are any items on the Agenda in which they have disclosable pecuniary interests, which would prevent them from participating in any discussion of the items or participating in any vote upon the items, or any other interest.

No interests were declared.

Most debates take place in public. This only changes when there is a need to consider certain issues, for instance, commercially sensitive information or details concerning an individual. You will be told at this point whether there are any items on the Agenda which are to be discussed in private.

All agenda items were considered in public session.

The Board will receive any petitions and hear any deputations from members of the public. A deputation is where up to five people can attend the meeting and make a presentation on some particular issue of concern. A member of the public can also hand in a petition at the meeting but that petition should relate to something on which the body has powers and responsibilities.

In accordance with Council Procedure Rule 10 (2), Members of the Public should provide at least 24 hours’ notice of presenting a deputation.  

No deputations or petitions were received.

The meeting will hear any questions from the general public. Questions should be emailed to jenny.bryce-chan@kirklees.gov.uk no later than 10.00am Tuesday 28 September 2021.

In accordance with Council Procedure Rule 51(10) each person may submit a maximum of 4 written questions. In accordance with Council Procedure Rule 11(5), the period allowed for the asking and answering of public questions will not exceed 15 minutes.

No questions were asked.

The Board will receive an update on Covid-19 in Kirklees.

Contact:  Rachel Spencer-Henshall, Strategic Director, Corporate Strategy, Commissioning and Public Health.  Tel: 01484 221000

Rachel Spencer-Henshall, Strategic Director, Corporate Strategy, Commissioning and Public Health provided an update on the current position regarding Covid-19 in Kirklees, highlighting some of the key points from the current data.

In summary, the Board was informed that in terms of the vaccination uptake, Kirklees, as a whole has an uptake of 82.9% in its over 18 population, for dose one and 76% for dose two. The data suggests that in terms of uptake there are some differences within the place-based community at a local level and there are a couple of district where uptake is not as good as in the rest of Kirklees.

The data also shows that the uptake of the vaccination in younger people is more gradual and anecdotal evidence suggests that it's more about people going for their vaccine when they find the time, or when it fits with their life, rather than actively booking it.   The vaccine programme is going well however, there is still some work to do to increase uptake and the CCG, Council and partners have been working on trying to increase uptake up by working with schools, colleges, and universities. Work is currently being undertaken to roll out the vaccine to 12-15-year-olds in schools.

In response to the information presented, the Board raised a number of questions and comments as follows:

-       Building on the discussion around young people are there any patterns or differences emerging between north and south Kirklees given that there is a university, bigger colleges, and more schools in south Kirklees?

-       Will lateral flow tests no longer be free and if so, what will be the likely impact on testing arrangements?

-       In terms of communicating to the public what are the key messages that residents of Kirklees should still be mindful of to keep themselves and others safe as far as is possible?

The Board was informed that it is important that people undertake their own personal risk assessment, for example wearing a face covering is a personal choice.  As winter approaches there is less opportunity for people to be out and about in the fresh air, however, hand washing, keeping good ventilation, and giving people space are things that individuals can still do. In addition, get the vaccine and the booster program which will be starting shortly.

RESOLVED

That Rachel Spencer-Henshall be thanked for providing an update on the current position with regard to Covid-19 in Kirklees.

To receive a presentation on the innovative partnership-based approach to supporting vulnerable adults in Kirklees by helping them live independent and fulfilling lives in their own homes.

Contact:  Emma Hanley, Senior Contracting & Procurement Manager and Sarah Cooke, KBOP Director Tel: 01484 221000

Emma Hanley, Senior Contracting and Procurement Manager and Victoria Busby, Kirklees Better Outcomes Partnership provided the Board with an update on the work of Kirklees Better Outcomes Partnership (KBOP). 

The Board was provided with background information which outlined the reason why the previous provision for housing related support services contracted with a number of different organisations to deliver different contracts to the most vulnerable in society, was remodelled.   The service provides for people who have vulnerabilities, disabilities or lifestyle factors that may make them more at risk of becoming homeless or being able to live independently.  For example, it might include people with mental health problems, drug and alcohol dependency, offenders, young people, and domestic abuse, people with a range of needs.

The previous contracts didn't always allow or encourage services to think differently or creatively, and as a result of significant budget reductions, interventions have become a lot shorter.  While it may address the presenting need, it does not necessarily tackle the underlying root causes, thereby creating a revolving door.

The focus was on ensuring that people were accessing the correct benefits rather than truly maximising income by developing employability skills to enter work. The aim was to find a way to incentivise support services to address those underlying issues to help build on service users, resilience and encouraging sustainable skills, and behaviour. Developing more flexible interventions to improve outcomes instead of process focused service provision.

The new service model is now paid based on outcomes achieved. It uses additional top up funding from the Life Chances Fund utilising social investors through a social impact bond which brings new investment into the sector and creates new partnerships between social investors, commissioners, voluntary sector service providers and beneficiaries working co-productively. The services commenced in September 2019, and to date it has supported over 2500 new starts on the program.

The Board was informed that Kirklees Better Outcomes Partnership (KPOB) is a social enterprise with eight expert organisations collaborating to prevent homelessness. Each service has an individual specialism across mental health, support, substance misuse, domestic abuse, housing, and offending.

The social enterprise was formed as an alternative to traditional support services and a way to place outcomes at the forefront of delivery. 

During the Covid period, delivery was expanded in a matter of weeks as part of a community led response implementing a seven-day emergency helpline, digital interventions, and home deliveries to frightened and isolated people.

The focus is on empowering individuals to achieve their ambitions and prevent homelessness.  It was identified that traditionally contracts and services had been commissioned in a deficit focus way, with the effectiveness based on the number of individuals using the program rather than the outcomes of the milestones achieved. The system and processes had prevented many from moving into independence fully from services.

The aim was to do something different, to use the flexibility of the outcomes-based contracts to reallocate power and decision making and handing it back to the person, using personalisation, advantage thinking,  ...  view the full minutes text for item 20.

A report

a)    outlining the aims of the Tobacco Alliance, and to champion the work across the partnership

b)    providing an update on the All Party Parliamentary Group Smoking & Health recommendations prior to the release of the Tobacco Control Plan for England

Contact:  Rebecca Gunn, Public Health Manager:  Tel: 01484 221000

Rebecca Gunn, Public Health Manager, presented a report which outlined the partnership response to shaping tobacco control in Kirklees. 

The Board was informed that by way of background, the government set out its ambition that England will be smoke free by 2030, which is defined as rates of less than 5%.   It is widely acknowledged that this will be a challenge particularly in areas of deprivation and among people living with mental health conditions for example.  Therefore, bold action will be required both to discourage young people from taking up smoking and also support smokers to quit. 

In the two years since this ambition was stated, it is estimated that around 200,000 children under the age of 16 will have started smoking and without action two thirds of those will go on to become regular smokers.  It is really important within Kirklees that action is taken to drive down this prevalence through discouraging people from starting in the first place and supporting people to quit and normalising non-smoking within the communities.

Within Kirklees, there is a dispersed, model of smoking cessation across GP's, pharmacies and community providers for example, Auntie Pam’s service and the Wellness service.  They are doing some interesting work in terms of trying to encourage people to come to give up smoking in a range of different ways.

In order to achieve the government’s ambition to be smoke free, there needs to be a district wide approach to tackling tobacco, and it was a good opportunity to strengthen the partnership approach.   With the support of the Portfolio Holder for Health and Social Care, work has begun to formalise a tobacco alliance (name to be to be to be confirmed for Kirklees).

There have been two virtual meetings held so far, with quite broad representation, including people from people from housing, licensing, the acute trusts, the mental health trust, Yorkshire Cancer Research and Public Health England. It is important to keep momentum going and work has started on drafting an action plan.

The partnerships aim is to reduce smoking prevalence for a healthier tobacco free future for the children and young people in Kirklees and looking to align to the ambition to make Kirklees smoke free by 2030.

The Board was informed that on the 9^th June 2021, the All-Party Parliamentary Group (APPG) on Smoking and Health launched its report and recommendations for the forthcoming Tobacco Control Plan to secure the government’s ambition of a smoke free country by 2030. 

Within the report that there are there are twelve recommendations, and it is important to note the ones which relate to the funding of tobacco control programs through a tobacco control levy.   It proposes that funding be secured through a ‘polluter pays’ amendment to the health and social care bill, which forces manufacturers to pay to deliver end of smoking. The levy on manufactures is expected to raise £700m in the first year.

Another key recommendation calls for targeted investment to provide additional support to help smokers  ...  view the full minutes text for item 21.

To receive an update on the work underway across West Yorkshire and Kirklees to prepare for the changes set out in the Health and Care Bill.

Contact: Richard Parry, Strategic Director for Adults and Health and Carol McKenna, Chief Officer

Carol McKenna, Chief Officer and Richard Parry Strategic Director for Adults and Health updated the Board on the Health and Social Care Bill.  In summary, the Board was informed that the legislation is focused on establishing Integrated Care Systems (ICS) as statutory bodies from the 1^st of April 2022.  This will mean that the functions that currently sits within Clinical Commissioning Group's (CCG) will transfer into ICS’s and CCGs will be dissolved after the 31^st March 2021.

There are a number of dimensions that it just be helpful for the Board to consider.  The Health and Social Care Act will establish:

1)         Integrated Care Partnerships (ICPs) - which is a broad alliance of organisations and representatives, and that is very, very similar to the Partnership Board that is now operating across West Yorkshire and Harrogate ICS

2)         Integrated Care Boards (ICB) - which will bring together the NHS bodies to improve population health and care, and that is a statutory body that will be accountable for funding and performance

3)         Place-Based Partnership (PBP) – will remain as the foundations of Integrated Care Systems building on existing local arrangements and relationships.  This will be an important element of the new arrangement

ICS exist to achieve four aims:

-             Improve outcomes for population health and healthcare

-             Tackle inequalities in outcomes, experience, and access

-             Enhance productivity and value for money

-             Help the NHS support broader social and economic development

West Yorkshire and Harrogate have been operating as an informal ICS for several years now and it is fairly well developed.  However, the changes required by the Act will see the current voluntary partnership move to statutory arrangements.  The intention remains that collaborating as an ICS will help health and care organisations tackle complex challenges that are beyond the scope of individual organisations.

The Board was informed that in the early drafts of the Health and Social Care Bill social care got very little mention, but there are two key changes:

-             from 2023 the CQC will start to inspect local authorities social care functions, in addition to existing inspection of care providers

-             the government being able to pass funding to directly fund social care providers, rather than money flowing into local authorities then to social care providers,

As the development of the Act moved through various stages there has been more focus on social care, for example, the Health and Social Care Act will establish a requirement to create a workforce plan for the effectiveness of the health and care workforce.  There is also the potential complexity of some announcements around the future of social care funding and who pays for their own care, and the pricing structure for things like residential care, with further detail to follow on that. There is also talk of an integration white paper later this year.

The Board was informed that there are five place-based partnerships within the West Yorkshire ICS.  The potential activities and approaches of place-based partnerships include:

-  ...  view the full minutes text for item 22.

Board members are asked to note that the date of the next Health and Wellbeing Board meeting will be on the 2 December 2021.

The date of the next meeting be noted by the Board.