To receive any apologies for absence, including notifications of any changes to the membership of the Committee.

Apologies for absence were received from Pat Harris (Healthwatch), Nancy Meehan (Director of Children’s Services, Torbay Council) and Roy Linden (Devon and Cornwall Police) who was represented by Miranda Pusey.

To confirm as a correct record the Minutes of the Health and Wellbeing Board held on 26 September 2024.

The Minutes of the meeting of the Health and Wellbeing Board held on 26 September were confirmed as a correct record and signed by the Chairman.

Item for presentation and discussion.

The Board noted a presentation on the Integrated Care Model for Torbay and South Devon NHS Foundation Trust.  Dawn Butler, Deputy Director of Transformation and Partnerships for the Torbay and South Devon NHS Foundation Trust informed Members that when you look at the population of Torbay there are troubling trends, economic fragility, children being looked after, aging demographic all need health and social care services to work really well.  Dawn explained that the case for change was really clear, services were disjointed, difficult to navigate and people were coming to harm as they were leaving it too long to access care resulting in complexities of chronic illnesses.  As an Integrated Care Organisation (ICO) have clear strategic intents.  The ICO wanted to deliver safe quality care in a less intensive setting.  There are lots of specialist and diagnostic capabilities in hospital, but they were not used at the onset of diagnosis.  There was a high reliance on high-cost reactive care, which as an organisation the ICO knew was not viable as it cost too much. 

Dawn informed Members that as an organisation the ICO needed to be better at being proactive, at identifying things that were getting in the way of people leading their lives.  She explained that as a hospital it did not co-ordinate well with community teams, despite having previously been successful at pooling resources and making decisions around people. 

The 10 Year Health Plan brings together a set of actions that need to be taken forward to respond and react to the challenges faced by the health system.  The Plan seeks to strengthen Community Care Partnerships and their connectivity to primary care.  Care co-ordination requires clinicians and social care workers, working as one team undertaking high level triage thereby enabling support of patients through other pathways rather than through the Emergency Department.  Care co-ordination was an important part of the change.

Members welcomed the honest assessment of the state of health services in Torbay and sought confirmation of a timetable – when would change start to happen?  Dawn confirmed that she would present to a future meeting of the Health and Wellbeing Board the ‘how, what and when’.  There were things within our gift to do quickly, some however would require changes to services.

Members queried how those driving the transformation would work with the local Integrated Care Board?  Dawn advised that all needed to work towards one mission, with the need to once again focus on ‘Mrs Smith’.   Recognising that, as an ICO there was a really powerful story to tell, the legacy was long, having started as care trust, learning that integration was not a destination but something you have to keep working at.

To consider the Director of Public Health annual report on women’s health.

The Board considered the Director of Public Health Annual Report, the production of which was a statutory independent requirement of the Director of Public Health.  The Board were advised that the report for 2024 focused on women’s health.  Women make up 51.3% of the Torbay population.  Despite progress made, unacceptable inequalities persist.  By taking a focus on women, girls and gender and sex-based barriers to health, economic prosperity, community safety, community wellbeing, health and care barriers can be directly addressed.  The Annual Report had been informed by interviews and engagement with a diversity of women in Torbay.  Insights had been gathered through community groups and organisations, commissioned services and peer and grass-roots networks as well as individuals living in Torbay.

The key themes covered by the Annual Report were:

· Women, employment, and household labour

· Working with vulnerable women

· Discrimination, inclusion, and exclusion

· Connecting with communities

· Reproductive Health

· Barriers to being physically active

The Director Public Health invited colleagues and leaders across Torbay to commit to principles and actions which would see the recommendations become an area of distinct measurable focus for all, notably within the corporate planning cycles and business plans.

By consensus, the Board resolved that the contents of the Director of Public Health’s Annual Report be noted.

To note a verbal update on the above.

The Board noted a presentation provided by Paul Norrish on Community Wealth Building and the anchor institutions involved.  Paul informed Members that in May 2022 organisations such as Torbay Council, Torbay Hospital and South Devon College signed up to the Community Wealth Building approach which focuses on growing spend and supporting local businesses to bid for local public sector contracts.  Members were informed that some of the issues Torbay Hospital was trying to fix were influenced by social determinants.  As an anchor institution work had been undertaken with Torbay Hospital to review how much of their spend left Torbay, within 12 months of asking ‘can we buy this locally’ £7 million had been retained within the area.

The Director of Public Health, Lincoln Sargeant advised that a mapping exercise of other anchor institutions in Devon had been undertaken, in order to try and get a Devon wide strategy.  Lincoln advised that there was a lot of good work to be built on and landing the message that ‘prevention is more than just blood pressure checks, it’s how we address poverty’ was key.

To note the annual report of the Torbay and Devon Adults Safeguarding Partnership.

Section 43 of the Care Act 2014 places a legal duty on local authorities to establish a Safeguarding Adults Board (SAB) in its area.  The objective of the SAB was to help and protect adults in its area where there was reasonable cause to believe the adult had care and support needs and was at risk of or experiencing abuse or neglect and unable to protect themselves.

The Annual Report covered the period April 2023 to March 2024.  It was separated into 10 sections including a forward by the Independent Chair Paul Northcott and the arrangements and key activities of the TDSAP during the report period.

By consensus the Board resolved that the contents of the Torbay and Devon Adults Safeguarding Partnership Annual Report 2023/2024 be noted.

To note the annual report of the Torbay Safeguarding Children Partnership.

The Board were advised that the Department for Education (DfE) published revised Working Together to Safeguard Children guidance in July 2018 (WT2018), which set out what organisations and agencies who have functions relating to children must do to safeguard and promote their welfare in England.  The major shift was the responsibility for safeguarding children being shared between the local authority, health partners and the police.

Members were informed that the Torbay Safeguarding Children Partnership (TSCP) 2023/24 Annual Report had been written under the 2018 arrangements, the TSCP was in the process of implementing the new Working Together to Safeguard Children (WT2023) arrangements.  The annual report provided an update on the activity of the TSCP over a 12-month period from April 1 2023 to March 31 2024.

By consensus, the Board resolved that the contents of the Torbay Safeguarding Children Partnership be noted.

To note the report.

The Board reviewed the draft work programme for 2025 and requested that the lead officer for the Community Wellbeing Contract present to the Board in quarter three, explaining the work that the contract covers and any challenges that was being experienced.

By consensus the Board resolved that the contents of the 2025 Health and Wellbeing Board Work Programme be noted.

To share feedback on the Family Hubs HWBB workshop held on 25 October 2024.

The Board Members who attended the workshop, found it to be informative and positive, but would welcome time for those present to be able to ask ‘what can I do?’ to secure added value for those attending.

To note the above.

The Board received a verbal update on the Integrated Care Board and Local Care Partnership (LCP) Business Programme.  Members were advised that the LCP had allocated £144,000 that had been allocated to fund two initiatives, one in Torbay and one in South Devon.  The aim was to:

§  Enable primary care and Voluntary, Community and Social Enterprise (VCSE) sector to work together to identify, patients most at risk of unplanned attendance at hospital over the next 12 months.

§  Undertake individual care planning and ensure the VCSE sector were able to provide support to address wider social determinants of health.

§  Key focus would be on healthy ageing with associated dementia and mental health.

The application deadline was 6 December 2024 with organisations being notified of the outcome of their application week commencing 16 December 2024.  Members requested that a paper be presented to a future meeting on the reasons for people presenting at the Accident and Emergency Department.

Members were also informed that Adel Jones, Deputy Chief Executive, and Chief Strategy and Transformation Officer, TSDFT had stepped down from the role of Chair for the LCP.  In preparation for finding a new Chair, a review was being undertaken into work completed by the LCP and the impact it had.  Members expressed the need for the LCP to focus on the needs of the population and wider organisations and deliver some tangible outputs for the residents of Torbay.

With regards to the Integrated Care Board (ICB) Members were advised that the ICB were responsible for delivering and supporting the local engagement on the NHS 10 Year Health Plan.  Members were informed that NHS Devon had been part of the national co-production group to shape what national and local engagement should look like.  Locally the ICB wanted to make sure that system partners had the opportunity to feed into the engagement approach.  Outputs from the engagement will lead into 2026 priorities and into 10 year plan on national basis.  The engagement started in November 2024 and would continue through to January 2025.  The Board Members were asked to help support promotion of the consultation and engagement and encourage people to engage in the conversation.

To note the update.

The Director of Public Health informed the Board work was ongoing, however, the challenge to people’s resilience posed by rising interest rates have subsided given the view that interest rates had peaked.  The challenge of how to continue to support the most vulnerable in our communities remained.  The Household Support Fund had been extended further with just over £1.2m to be spent on energy and water, food, essentials linked to food, and wider essentials such as bikes/cars.  Members were informed that advice services were reporting that people who approached them for help with budgeting, were seeing small surplus in household budgets, there were now seeing a deficit.  There were a number of elements in place through the Household Support Fund and other council mechanisms to try help people get through winter.

By consensus, the Board resolved that the contents of the verbal report be noted.