Agenda and draft minutes

Apologies for absence were received from Councillor M. Bashforth, Councillor S. Bashforth, Councillor Sykes, Dr J. Patterson, Stuart Lockwood, Anthony Hassall, Claire Smith, Joanne Sloan, Gaynor Mullins and Mike Barker.

COUNCILLOR JEAN STRETTON

A minute’s silence was held, as a mark of respect, following the recent death of Councillor Jean Stretton, Cabinet Member for Neighbourhoods and a former Leader of the Council.

There were no public questions received.

The Minutes of the meeting of the Health and Wellbeing Board, held on 21^st June 2022, are attached for approval.

Standing Items

Resolved:

That the Minutes of the meeting held of the Health and Wellbeing Board, held on 21^st June 2022, be approved as a correct record.

Director of Public Health to verbally update the meeting (5 minutes)

The meeting was reminded that Health and Wellbeing Boards had a statutory duty to produce a Joint Strategic Needs Assessment (JSNA) for their local population. The JSNA was the process by which the current and future health, care and wellbeing needs of the local community were assessed to inform local decision making.

Statutory guidance confirmed the role of the Health and Wellbeing Board in the JSNA.

Proposed changes to Health and Wellbeing Board’s terms of reference were presented to the June 2022 meeting, on the basis that the Health Inequalities Plan would become the focus of the Board, with membership changes ensuring appropriate coverage of factors such as housing, environment and employment.  This widened membership would also enhance knowledge of the JSNA, and the focus of the Health and Wellbeing Board on wider determinants of health should give the distinction between the Board and the Health and Care Locality Board. 

Resolved:

That the report be noted.

Update report detailing progress on the key themes of the health inequalities plan (5 minutes)

The meeting received a report and a presentation which provided information on a proposed engagement framework for implementing a shared approach to community engagement across the Oldham System.

Improving the quality and scope of engagement, co-design and co-production across the Oldham social support system had been an aim of the Council and its partner agencies since before the COVID-19 Pandemic. As a result, there is a rich and in many cases innovative range of engagement offers across the borough. This included the Doorstep Engagement Team, Oldham’s Poverty Truth Commission, the Community Champions public health programme, the Citizen’s Panel and Maternity Voices partnership, on top of pre-existing approaches such as the well-respected Youth Council, Place Based Integration programme and Making Every Adult Matter partnership.

There was significant potential to strategically embed the learning from the covid-19 pandemic and approaches that have spread across the social support system. In doing so, it is possible to get the maximum value from a structured and informal engagement, that was taking place, and to improve long-term outcomes for residents as well as increase efficiency for planned interventions.

To underpin the Oldham Engagement Framework, the Council could draw upon prior work on a local ‘ladder of engagement’ developing in the borough before the Pandemic. There as also significant academic and practical good practice from elsewhere that can be drawn on to inform the principles and values or engagement. The shared principles and values could then support an infrastructure built to give confidence to the system (including funders, sponsors, and regulators), encompassing Engagement Approaches, Insight Capture, Action and Oversight. 

Resolved:

1.    That adoption of an Engagement Framework for the whole social support system is made a Strategic Priority with Executive Sponsorship amongst the Senior Leadership Team of Oldham Council, and responsibility for its implementation taken up by a partnership board incorporating officers, elected members, residents and community group representatives.

2.    That seldom heard voices via community groups representing them are actively involved in developing the principles, values and tools underpinning the framework, so that it is designed from the start to best engage everyone in the borough.

3.    That the involvement of critical partners/departments early in the design of the framework including but not limited to data protection officers, legal and strategic sourcing colleagues is prioritised.

4.    That dedicated resource is centrally provided for analysis of insights, translation into decision making spaces, and communicating the action taken as a result, as well as investment in a unified platform that all partners are encouraged to make use of.

5.    That assessing the effectiveness of engagement approaches across the social support system is adopted as a priority by the Council Scrutiny Committee.

To undertake a more detailed review of one thematic area from the health inequalities plan and consider progress, opportunities and challenges

Themes to be discussed are:

-       Income, poverty and debt (25 minutes)

-       Health in all policies/Communities and Place – slides to be used to guide discussion (25 minutes)

The Health And Wellbeing Board received a detailed review of one of the key thematic areas, that had been extracted from Oldham’s Health Inequalities Plan and considered progress, opportunities and challenges. The themes that were discussed included ‘Income, poverty and debt’ and ‘Health in all policies/Communities and Place’.

Resolved

That the presentation be noted.

To receive highlight reports detailing progress in delivering plans for:

a.    Health improvement

b.    Health protection

Brief plan summarising key areas of work for these two groups and outlining any progress of note in the last quarter. (10 minutes)

Business items

The Director of Public Health submitted a report which detailed progress in terms of delivering plans for Health improvements and Health protection. It was agreed that more detailed reports on these issues would be submitted to future meetings of the Health and Wellbeing Board.

Resolved:

That the report be noted.

A summary of key work undertaken since the workshop and proposed next steps to finalise content (20 minutes)

The Director of Public Health reminded the meeting that in July 2022 the Health and Wellbeing Board had held a development session to discuss the creation of a new Health and Wellbeing Strategy for the borough. Initial ideas on content of a strategy had been collated based on the development session discussions and were able to be presented to the Board for discussion in terms of the proposed vision, ambition, principles and priorities.

The Board received a presentation that reported on the ambition to see people generally leading longer, healthier, and happier lives, where the gap in health outcomes within different groups and communities in Oldham, and between Oldham and England is reduced. A demonstrable difference was hoped to be made to the average life expectancy and average healthy life expectancy of residents, and inequalities will be reduced.

The specific aims of the Strategy were:
a. Giving children the best start in life

b. Improving mental wellbeing and mental health

c. Reducing smoking

d. Increasing physical activity

e. Improving health literacy 

Resolved:

That a further report on the Health and Wellbeing Strategy be presented to the next scheduled meeting of the Health and Wellbeing Board on 15^th November 2022.

Report attached for approval (10 minutes)

The Health and Wellbeing Board considered a report that presented the final Oldham Pharmaceutical Needs Assessment 2022. The meeting was reminded that the Health and Wellbeing Board had a statutory responsibility to publish and keep up--to-date a Pharmaceutical Needs Assessment (PNA).  The Department of Health and Social Care determined that the publication of PNAs be suspended during the Covid-19 pandemic, with the deadline set for publishing the PNA by October 2022.

The guidance to produce the PNA had been published in October 2021. This aimed to support local authorities to interpret and implement their duties regarding pharmaceutical needs assessments and set out the process to be followed. On behalf of Oldham Health and Wellbeing Board, the Greater Manchester Strategic Medicines Optimisation Team had undertaken the process of developing the PNA according to the guidance.

The draft Oldham PNA was presented for review at the Health and Wellbeing Board in March 2022. The PNA underwent the mandatory consultation of at least 60 days in Summer 2022. After some minor amendments the final report was being presented to this meeting for approval.

Pharmaceutical services were defined by reference to the regulations and directions governing pharmaceutical services provided by community pharmacies, dispensing doctors, and appliance contractors. The pharmaceutical services to which each PNA must relate were all the pharmaceutical services that may be provided under arrangements made by NHS England & NHS Improvement (NHSE&I) for –

§  the provision of pharmaceutical services (including directed services) by a person on a pharmaceutical list

§  the provision of local pharmaceutical services under a Local Pharmaceutical services (LPS) scheme; or

§  the dispensing of drugs and appliances by a person on a dispensing doctors list.

Resolved:

That the Health and Wellbeing Board approves the final version of the Oldham Pharmaceutical Needs Assessment 2022, for publication in line with statutory requirements.

Report is attached for approval (10 minutes)

The Director of Public Health presented the Public Health Annual Report 2021 for the Health and Wellbeing Board’s consideration.

The report explained that the Oldham Borough had seen health in general and health inequalities worsen in the decade between 2010 and 2020. Life expectancy had stopped increasing, inequalities between socio-economic and ethnic groups had widened, and for the poorest people in the Borough life expectancy had declined. Since 2020 the pandemic had further exposed and amplified inequalities in health and the social determinants of health in the Oldham Borough, Greater Manchester, as in the rest of England.

The 2021 public health annual report was focused on Oldham Borough’s COVID-19 response through the eyes of people living and working in the borough. In general, the Borough had been disproportionately affected by the virus and the interventions in place to fight it. The annual report explores how the pandemic has exacerbated existing health inequalities, and how although the whole borough has struggled with hardship, illness and loss, those who were already struggling have been hit the hardest.

In light of this, the pandemic response had been tailored to help to mitigate these effects, and new ways of working have evolved. The report shared examples of such work and the associated learning and considered how interested parties can take new approaches and apply them to tackling health inequalities.  

The first section of the report set the scene by exploring COVID-19 in relation to the data, and Oldham’s existing health and health inequalities. The second section formed the main narrative of the report. Oldham Borough’s pandemic response is explored through a health inequalities lens, with a particular focus on two key health inequalities reports: Marmot’s ‘Build Back Fairer in Greater Manchester Report’ and the ‘The Next Level -Good Lives for All in Greater Manchester by GMCA Independent Inequalities Commission. This section of the Annual Report discussed how different teams came together to develop new ways of working, with a particular focus on reducing health inequalities and supporting the communities who were most significantly impacted by the pandemic.

The Annual Report was structured around the framework for Building Back Fairer in Greater Manchester and centred around six key themes:

·           Communities and Places

·           Public Health

·           Work and Employment

·           Income and Poverty

·           Early Years, Children and Young People

·           Housing and the Environment

Each section of the Annual Report had been written collaboratively with input from different colleagues both in and outside the council. For each theme, a series of recommendations had been devised, which built upon existing health inequalities work across the borough. The report also drew on the contributions that residents and people working in the borough had made to Oldham’s Lockdown Museum, documenting the creativity and resilience that has been shown by the Borough’s residents through this unprecedented and difficult period. Residents’ photos, quotes, stories and poems are featured throughout the report to help tell Oldham Borough’s COVID-19 story.

Resolved:
That the Public Health Annual Report 2021 be noted and welcomed.

The next meeting of the Health and Wellbeing Board will be held on Tuesday, 15^th November 2022 at 2.00pm.

It was noted that the next meeting of the Health and Wellbeing Board will be be held on Tuesday, 15^th November 2022 at 2.00pm.