Agenda and minutes

Apologies for absence were received from Councillor Chauhan, Chief Supt. Neil Evans, Mike Barker, Val Hussain, Stuart Lockwood, Vince Roche and Nicola Firth.

To consider the appointment of a Vice Chair following the cessation of membership of one of the Board’s Vice Chairs as advised at the previous meeting of the Board.

On the Motion of Dr J Patterson and seconded by Dr K Jeffery, it was RESOLVED that Majid Hussain be appointed as a Vice Chair of the Health and Wellbeing Board for the remainder of the 2019/20 Municipal Year.

There were no items of urgent business received.

There were no declarations of interest received.

There were no public questions received.

The Minutes of the meeting of the Health and Wellbeing Board held on 24^th September 2019 are attached for approval.

The minutes of the meeting of the Health and Wellbeing Board held on 24^th September 2019 were received.

RESOLVED that, subject to addition of Councillor Ball to the list of apologies for absence, the minutes of the meeting of the Health and Wellbeing Board held on 24^th September 2019 be approved as a correct record.

The Chair of the Local Safeguarding Boards will report to the Board providing an update in respect of the Children’s and Adults’ Safeguarding Boards’ Business Plans.  A paper relating to the Children’s Board is attached; a paper relating to the Adults’ Board will follow.

Dr Henri Giller, Chair of the Oldham Local Safeguarding Children and Adults Boards attended the meeting to present the Safeguarding Adults Board Annual Report 2018-19 and the updated 2019-20 Business Plans for both the Safeguarding Children and Adults Boards.  An annual report for the Safeguarding Children Board was not presented as, due to the recently implemented revised arrangements, an 18-month Report was to be prepared and would be submitted in due course.

The Board gave initial consideration to the submitted Oldham Safeguarding Adults Board 2018-19 Annual Report that detailed safeguarding activity over the 12-month period and assessed the impact of this activity against the Board’s Business Plan for 2018-19.  Dr Giller drew attention to two key activities in 2018-19.  Firstly, a Peer Review had been undertaken by representatives from the Stockport Board, the conclusions from which and the Board’s reflection on these conclusions were presented in the Annual Report.  Secondly, and on reflection of the Stockport conclusions, a fundamental review of adults safeguarding had been undertaken from which a number of recommendations had been derived. 

These review recommendations then formed a significant part of the 2019-20 Safeguarding Adults Business Plan, and issues of ensuring that service integration did not dilute safeguarding, of trying to get a better picture of safeguarding in partner organisations, of making safeguarding more personal, and identifying joint work with the Safeguarding Children Board to consider transition issues looking towards a comprehensive all age safeguarding approach were highlighted to the Board.  In response to a query concerning joint working between the Safeguarding Boards, it was noted that the Stockport review was a formal Peer Review, but that issues were picked up among wider peer groups on a regular basis.  In addition, the Independent Chairs and Board Business Managers each had their own quarterly meetings to consider best practice and issues arising.

With regard to the 2019-20 Safeguarding Children Business Plan, the Board was advised that this sought to embed the new ways of working and new areas of work including complex and contextual safeguarding which included modern slavery and exploitation, and workforce development and training were highlighted.  The Board was advised of a Joint Communications Group that was seeking to communicate the work of the two Boards to the public, including development of a new website that was to go live with Children’s Board content in the near future, with Adults Board content to follow.  Work in the Children’s area was looking to maximise the profile and the quality of work for children and young people by enhanced commitment from statutory partners, gaining buy-in from relevant organisations, developing accountability mechanisms and seeking the views of the child.

The following issues were raised by Members of the Board in respect of the Safeguarding Boards reports - 

·         The Strategic Director Reform noted the need to ensure connectivity between the work of the Safeguarding Partnerships into the emerging staffing strategy in the health and social care sector and a need to ensure that structures would deliver this;

·         The reported joint  ...  view the full minutes text for item 7.

The Board is asked to note the Greater Manchester Child Death Overview Panel  Annual Report, which includes the work undertaken by the Bury, Oldham and Rochdale Panel, and consider an overview of the implications identified for Oldham.

The Board received a report presenting the Greater Manchester (GM) Child Death Overview Panel (CDOP) Annual Report, which included the work undertaken by the Bury, Oldham and Rochdale Panel.  The Annual Report presented data from the four CDOPs across GM, making observations about causes and modifiable factors in order to inform action to promote child safety and reduce child deaths in GM.  An Oldham Briefing provided an overview of the implications for Oldham and the current work happening to address the potentially modifiable factors identified.

Wendy Meston, Public Health Consultant from Rochdale Council and current Chair of the Bury, Oldham and Rochdale CDOP, reported to the Board further to the submitted report.  Public Health chaired all four CDOPs across GM which collectively operated as a network.  A multi-agency approach was adopted, and Panel attendees represented professional areas as opposed to geographical areas.  Not every child death in the year was considered, with only those deaths that had been considered through all other stages being reviewed.  As such, the Annual Report presented a strategic overview of what had been learned over the previous year. 

With regard to Oldham, infant mortality was higher than would be expected and, while work had been undertaken to address causal factors, more needed to be done in the area.  The GM report had highlighted potentially modifiable factors for reducing deaths in children as well as the existing evidence around reducing deaths in the early weeks of life, and several current initiatives in Oldham aimed at addressing these factors were outlined in the submitted report.

The CDOP network and co-ordinators also played a role in preventative work and had, for example, undertaken work around safe sleeping and getting messages out about the dangers for children presented by cords/blinds and small batteries.

Members of the Board raised the following issues –

·         The average Index of Multiple Deprivation score against the number of closed cases for each local authority as shown in Chart 6 at paragraph 6.10.3 of the Annual Report and what this meant in terms of Oldham and the linkage of deaths to deprivation was queried.  It was suggested that a five-year consideration be given to consider whether the 2018/19 figure was a one year issue.

·         It was noted that smoking and maternal BMI (body mass index) were significant contributors to young infant mortality and the potential impact on that cohort of an increased universal health offer being considered was queried.  It was suggested that weight would be included, but that smoking in pregnancy was the subject of an ongoing GM-wide approach, though the sustainability of the GM offer needed to be considered.

RESOLVED that -

1.            the Child Death Overview Panel Annual Report 2018-19 for Greater Manchester be noted;

2.            the Oldham Briefing on implications for Oldham and current work being undertaken locally be noted;

3.            further work be undertaken to understand the higher rates of infant mortality in the Borough and to develop an action plan to address these issues.

The Board is asked to note the process for and approach to the refresh of the Oldham Locality Plan for Health & Social Care Transformation (September 2016 - March 2021) and the progress made to date.

The Board received a report advising of the background to and the approach taken to a refresh of the Oldham Locality Plan for Health and Social Care Transformation. The report was submitted to provide visibility to the Health and Wellbeing Board of the process for the refresh and of progress to date, prior to the submission of a draft to Greater Manchester by 30th November 2019.

The Board was reminded that a Locality Plan covering the period September 2016 to March 2021 had been prepared to outline the key transformational programmes that would enable Oldham to deliver significant improvements in the health and wellbeing of residents.  The strategic context had moved on since 2016 and Oldham was now better positioned to describe a whole public service approach to transformation. There had also been a recent ask to refresh the Locality Plan in support of the GM Health and Social Care prospectus plan and as a response to the NHS Long Term Plan Commitments.  In this regard, the Plan would need completion and submission in ‘Draft’ by the end of November 2019 in order to influence the GM prospectus.

In considering the current position on the refresh exercise and the development of the Plan it was noted that extensive engagement was being undertaken across partners to form content and ensure that it accurately reflected both current and proposed transformation activity.  Considerations in the report addressed the structure and content of the Plan and, to support the evolution of an Integrated Care System for Oldham, the design logic and principles employed to develop a model of health and social care.

In noting that a design logic behind the health and social care model was that the person and their community would be placed at the centre, a Member asked how this had been taken account of and sought assurance that delivery would be for the benefit of residents.  The Board was advised that some consultations had been undertaken, and the Chief Executive and Accountable Officer advised that issues raised had been taken on board and, where appropriate, been referred to other groups and Boards.  The pathways to care were important, and things were being done differently to the first Plan. 

RESOLVED that the drivers for the refresh of the Health and Social Care Locality Plan, the structured approach being adopted and the good progress made to date be noted.

The Board is asked to receive an update on the Oldham Learning Disability Strategy including a summary of actions and progress to date on each of the strategic priorities and giving context with the Greater Manchester Learning Disability Strategy.

The Board received a report providing an update on the Oldham Learning Disability (LD) Strategy that linked to the Greater Manchester (GM) LD Strategy and a summary of the actions and progress to date in Oldham on each of the ten strategic priorities that form the Strategy.

The GM LD Strategy had been in place from 2018 and had been written by people with a learning disability for people with a learning disability.  The Oldham LD Strategy aligned to the GM priorities, with each of the ten work streams having a named responsible lead to provide accountability. The Health and Wellbeing Board had delegated progression of the Strategy and priorities to the Learning Disabilities Partnership Board which included advocates and those with lived experience among the membership.

The Director of Adult Social Care advised the Board of progress made within each of the ten priority areas, highlighting the specific actions for Oldham that had been identified, and further advising of structures in place for learning and best practice to be shared across GM in each of the priority areas.  Councillor Marie Bashforth, Chair of the Learning Disabilities Partnership Board, supported the report, advising of the real energy and drive being put into progressing this big piece of work.

RESOLVED that the progress to date made in respect of the Oldham Learning Disability Strategy be noted.

The Board is asked to give its endorsement for partners to progress with geographical alignment across the whole system of public services at populations of 30-55,000 to enable integration to deliver better outcomes for people and communities in Oldham.

The Board received a report seeking endorsement for partners to progress with geographical alignment across the whole system, including health and social care and wider public services, at populations of 30-55,000 to better enable integrated services to deliver improved outcomes for people and communities in Oldham.

Experience and learning from health and social care and other forms of integrated working had led to agreement in Oldham and Greater Manchester (GM) to scale up place-based integration across the whole system of public services at populations of 30-55,000 so that resources could be better directed to people and communities. This approach had the support of Oldham partners through the Joint Leadership Team and the Oldham Leadership Board and at GM-level through the Wider Leadership Team and the GM Health and Social Care Partnership.  Oldham did not currently have coterminous boundaries across all public services making it difficult to achieve full integration and reform of public services as resources and capacity do not align.

The report considered existing forms of multi-agency integration that had already occurred to date and explored the need for geographical alignment at populations of 30-55,000 which was considered to be the optimum size to create economies of scale while remaining small enough to be locally sensitive.  Five service footprints based on Ward boundaries had been considered by partners to be legitimate building blocks for service footprints and a number of partner agencies had signed up to amend their existing boundaries to achieve alignment.  To reach decisions on geographical alignment a series of criteria and supporting principles, presented within the submitted report, had been determined to assess feasibility.  Once agreement was reached, submissions for formal approval would be made to the Council and the Clinical Commissioning Group.

A Member noted that some proposed areas contained some significant social differences within their boundaries and advised of concerns expressed about distances to be travelled to attend a single point of service in an area.  In response it was acknowledged that such differences did exist, but that there was an expectation that services would be provided locally from, for example, three delivery points if that was what was needed in a particular area.

RESOLVED that –

1.            the proposal to develop coterminous public service footprints at populations of 30-55,000 across the Borough be endorsed;

2.            the approach to geographical alignment being progressed on the basis of five footprints using Wards as the building blocks for alignment be endorsed;

3.            the criteria and principles by which a decision on geographical alignment will be reached be endorsed;

4.            the next steps and decision-making process to progress geographical alignment be noted.

RESOLVED that -

1.            the meeting of the Board scheduled to be held on Tuesday, 10^th December 2019 as a Development Session be cancelled;

2.            the meeting scheduled for Tuesday, 28^th January 2020 at 2.00pm be now held as a Development Session.