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

Apologies for absence were received from the following Board Members:  Pat Harris (who was represented by Kevin Dixon), Roy Linden (who was represented by Hayley Costar), Pat Teague (who was represented by Catherine Fritz), Matt Fox, Tara Harris, Adel Jones, Paul Northcott and Tanny Stobart.

It was noted that the Chairman, Councillor David Thomas, Nancy Meehan and Jo Williams needed to leave the meeting early, whereupon in the absence of the Vice-Chairman Councillor Tranter would take the Chair.

To confirm as a correct record the Minutes of the Health and Wellbeing Board held on 7 March 2024.

The Minutes of the meeting of the Health and Wellbeing Board held on 7 March 2024 were confirmed as a correct record and signed by the Chairman.

To consider a report on the Peninsula Acute Sustainability Programme.

(Note: to be presented by Jenny Turner, Programme Director, NHS Devon)

The Board received a presentation from Jenny Turner and Kate Lissett, Torbay and South Devon NHS Foundation Trust on the Peninsula Acute Sustainability Programme: Developing the Case for Change, which needs to be developed taking into account the report published by Lord Darzi on 12September regarding the state of the NHS, together with the following big shifts highlighted by the Secretary of State for Health and Social Care:

·                 From hospital to community care;

·                 From analogue to digital; and

·                 From treating sickness to preventing it.

Phase 1 of the Programme focussed on developing a good understanding of the challenges faced by the NHS exploring the direction of travel.  This work was supported by Healthwatch to engage with people who use NHS services.  Phase 2 would focus more on the formal case for change in partnership with patients, staff and key partners taking into account the ageing workforce as well as an ageing population.  The NHS was working with the voluntary and community sector to go out where the people were to try to reach more people.  The Board acknowledged similar work facilitated by the Public Health Team to take blood pressure monitors to Torquay United and other venues.

It was noted that the direction of travel could include providing locally where possible and bringing some specialist services together, in order to ensure that patients received the best care.  This could include supporting people who needed transport to access their appointments. 

By consensus Members resolved that the Health and Wellbeing Board:

1.       endorsed the approach being undertaken to engage with local people on the Peninsula Acute Sustainability Programme (PASP): Developing the Case for Change and

2.       supports raising awareness locally and encouraging local people to take part in engagement on the PASP.

To receive and endorse the Joint Strategic Needs Assessment

(Note:  to be presented by Simon Baker, Public Health Specialist (Intelligence))

The Board received a presentation on the data contained in the 2024/2025 Torbay Joint Strategic Needs Assessment (JSNA).  The JSNA is an assessment of the current and future health and social care needs of the local community and covered 21 subject areas with quick to find information on Torbay.  This was supplemented by Ward Profiles, which it was agreed would be circulated to the Board.

Members noted some of the following key data:

·                 Average age of Torbay resident is 49 years (compared to 40 years in England;

·                 27% are aged 65 or over, expected to rise to 33% in the next 10 years.

·                 Significant differences in life expectancy between those in the most and least deprived areas; and

·                 Fall in birth rates is below England rate.

By consensus the Health and Wellbeing Board resolved to:

1.       endorse the contents of the Torbay Joint Strategic Needs Assessment 2024/2025; and

2.       request the Democratic Services Team Leader to ensure that all Councillors get to see the JSNA and Ward Profiles.

To note the progress report.

(Note:  to be presented by Julia Chisnell, Consultant in Public Health)

Julia Chisnell, Consultant in Public Health presented the submitted report which provided a six monthly update on the implementation of the Torbay Joint Health and Wellbeing Strategy.  The Strategy was initially published in 2022 and had moved from five focus areas to four focus areas: mental health and wellbeing; good start to life; complex needs; and healthy ageing.

Public Health had awarded community organisations with small grants to help people work together on their physical and mental health.  It was noted that hospital admissions for self-harm continued to be an issue which was being closely monitored.  The work around children and young people’s start to life was working well around the family hub model and the offer and outreach from the family hubs was being extended.  The Board welcomed that Torbay Public Health Nursing 0-19 Service had just achieved UNICEF Gold accreditation for its work on Infant Breastfeeding.  The proportion of children affected by low income and Special Educational Needs and Disabilities (SEND) remained high.  The Growth in Action Alliance had coproduced services for people with drug and alcohol and homelessness issues with the service users, using trauma informed training and relational conversations.

By consensus the Health and Wellbeing Board resolved to note the contents of the Torbay Joint Health and Wellbeing Strategy Six Monthly Monitoring Report.

To consider a report on the above.

(Note: to be presented by Justin Wiggin, Head of Integrated Care, NHS Devon)

The Board received the submitted report which provided an update on the Torbay Better Care Fund for 2024/2025.  The end of year review for 2023/2024 was undertaken in May of the 5 metrics reported against and submitted by Torbay and Devon in line with national requirements.  There had not been a need for a full refresh therefore the report reflected on investments and confirmed which areas would be continued with a set of new trajectories around main key performance indicators.  The national objective of the Better Care Fund remained the same with a financial investment from health and social care of £29m this year.  It was noted that the Better Care Fund also had a Section 75 Agreement which was in the process of being completed and was expected to be finalised by the end of September.

Members were informed that over the last twelve months the Council was working with Primary Care services to review people who were at the risk of falling and frailty as part of a trial dealing with falls management and exercise.

By consensus the Health and Wellbeing Board resolved that:

1.       the contents of the Better Care Fund 2024-25 be endorsed; and

2.       an update on falls prevention to be presented to a future meeting of the Board.

(Note Councillor David Thomas, Nancy Meehan and Jo Williams left the meeting after discussion of this item, whereupon Councillor Tranter took the Chair.)

To consider a report that provides a progress update for Torbay’s Drug and Alcohol Partnership.

(Note: to be presented by Lincoln Sargeant, Director of Public Health)

Members received the submitted report which provided an update on the work of the Torbay Drug and Alcohol Partnership.  Synthetic opioids continued to be a risk with incidents having occurred in North Devon and while no similar incidents had happened here, it was likely to come to Torbay.  The Partnership had been looking at preparedness arrangements particularly out of hours services and had a robust plan in place which was required by Government.  This was the final year of a three-year funding stream and it was not yet known if the Government would extend funding further.

By consensus the Board resolved that the key milestones and progress achieved against the three priority areas outlined within the Government’s 2021 drug ‘From Harm to Hope’ and the work of the Torbay Drug and Alcohol Partnership be noted.

To consider a report that provides a progress update on the Smokefree Devon Alliance Strategy (2023-28).

(Note: to be presented by Claire Tatton, Public Health Practitioner)

Members considered the submitted report which provided the first year’s progress against the three priority areas of the Smokefree Devon Alliance Strategy for 2023-2028:

·                 Priority 1 – protect children and young people from harm, the harms of tobacco and de-normalise tobacco use to help prevent update;

·                 Priority 2 – reduce health inequalities caused by smoking; and

·                 Priority 3 – Ensure cross-sector, strategic collaboration around tobacco control, and support the development of a smokefree culture within key organisations.

Data was taken from national surveys to inform progress as there was no local data surveillance.  There had been an increase in youth vaping but this seemed to be stabilising.  Lung health checks were being launched in the Autumn for people aged 55 to 74 who were current or former smokers.  It was noted that smoking cessation services would ensure that people with mental health had additional support.  A new Smoke Free NHS Steering Group had been established and the Partnership was looking to increase capacity within existing services and provide more outreach support.

It was noted that while there had been a peak around the people in their 30s, most of the people seeking support through the Local Stop Smoking Services were 50 years old plus.  More focus was needed to support the working age population around prevention.

By consensus the Health and Wellbeing Board resolved that the contents of the Smokefree Devon Alliance Strategy (2023-2028) – Year 1 press update be noted.

To consider a report on the above.

(Note: to be presented by Katy Heard, Torbay Carers’ Lead)

Katy Heard, Carers’ Lead for Torbay and South Devon NHS Foundation Trust gave a presentation on the Torbay Interagency Carers’ Strategy 2024-2027.  Out of 309 authorities Torbay has the 6^th highest levels of people caring more than 50 hours per week at 5,185 Carers.  This meant that at least:

·                 1, 607 Carers in Torbay with bad or very bad mental health

·                 1, 350 Carers in Torbay with continuous low mood

·                 1, 318 Carers in Torbay feeling hopeless

·                 1,141 Carers in Torbay feeling tearful

·                 1, 092 Carers in Torbay living with a sense of fear or dread

The Carers’ Survey identified:

·                 Carers living with person they care for, 81% impacts ability to leave the house, 97%  impacts ability to relax at home,

·                 57% not received enough training to support them in their caring role (dementia, medication)

·                 47% do not know where to go for support,

·                 71% said the person they care for does not receive paid care (much higher than Devon)

·                 Of those that did have paid care, 100% said it did not meet their needs as a Carer

·                 63% have not been able to take a break or have respite in the last 12 months (23% Devon)

The Carers Service was based in Paignton Library so there was a walk in service for people to use.  The My Bay resident’s discount scheme was also provided free for Carers and there were various courses run to help support Carers.  It was suggested that colleagues meeting with people in the community e.g. the blood pressure checks could be asked to ask people if they were Carers and then signpost them to relevant support.

Members thanked the Carers Lead for her presentation and also acknowledged the commitment and achievements of Torbay Carers’ Service and Carers.

By consensus the Board resolved:

1.       to note Torbay’s Interagency Carers’ Strategy and outline action plan (set out at Appendix 2 to the submitted report) and the priorities for Carers as expressed in their ‘I statements’;

2.       to note the 2024-25 action plan in the accessible Strategy (set out at Appendix 1 to the submitted report); and

3.       to note that two major recurrent concerns for Torbay’s Carers are the lack of suitable replacement (‘respite’) care and mental health services. In Healthwatch’s Devon-wide Survey, although very few Torbay Carers responded, none felt that replacement care was meeting their needs.  As both issues relate to support to the person being cared for, Carers’ Services are working closely with Social Care Services and with Devon Partnership Trust to address these.

To receive an update on the Integrated Care Board and Local Care Partnership business programme,

(Note: to be presented by Justin Wiggin, Head of Integrated Care, NHS Devon and Chris Winfield, Associate Director for Strategy & Provider Partnerships, Torbay & South Devon NHS Trust)

The Board received a presentation on the Integrated Care Board (ICB) and Local Care Partnership Business Programme which focused on prevention and health inequalities with aims around community care and urgent care pathways.  A South Population Health Profile had been developed which built on intelligence from the Joint Strategic Needs Assessments from Torbay and South Devon and brought in additional statistical information.  The ICB had drafted a South Devon and Torbay Health Inequalities Strategy with partners which was due to be completed in the next couple of months and would be brought to the Health and Wellbeing Board before it was finalised.

£242,000 had been allocated to the South Locality and was being focussed on a number of specific initiatives including the Falls Management Exercise (FaME) falls prevention programme, the High Intensity Users programme with British Red Cross supporting those who were frequent attendees at Emergency Departments, and supporting people to live longer better through the voluntary sector healthy ageing prevention programmes assisted by the digital neighbourhoods work. 

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

To receive an update on the Turning the Tide on Poverty and Cost of Living programmes.

(Note; to be presented by Lincoln Sargeant, Director of Public Health and Jo Williams, Director of Adult and Community Services)

The Board received the submitted report which provided an update on the Turning the Tide on Poverty and Cost of Living Programme which supported the Torbay Joint Health and Wellbeing Strategy.  Members noted the work with different Teams and Partners to support this area with focus currently being getting ready for winter and issues around warmer homes.  The Household Support Fund had been extended, which would provide some additional short-term support.  There was a need to look at the wider Economic Strategy, how to enable people to become more resilient to cost of living pressures as well as looking at future prospects for young people.  It was noted that there was a predominance of single men using food banks in Torbay. 

Work was being done to map offers to support people into work and apprenticeships, with a particular focus on people who were care experienced or homeless.

The Director of Public Health agreed to find out what the plans were for warmer places this winter and circulate the information to the Board.

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

To note an update on the Section 75 agreement.

(Note: to be presented by Jo Williams, Director of Adult and Community Services)

Jo Williams, Director of Adults and Community Services advised that the integrated health and social care arrangements will have been in place for 20 Years in October 2025.  The Integrated Care Board (ICB), Torbay and South Devon NHS Foundation Trust and the Council were committed that this was the best model for the people of Torbay.  All processes had been completed and the agreement under Section 75 of the NHS Act had now been signed with an agreement in place for the next 5 years until 2030.  The Memorandum of Understanding (MOU) was issued each year which details statutory arrangements and had been agreed but was still going through final process.

Members suggested the merit of inviting people to Torbay in October 2025 to formally celebrate 20 years of the Integrated Care Organisation (ICO).

By consensus the Board resolved to note the contents of the verbal report.

To receive an update on Winter planning 2024-25

(Note: to be presented by Justin Wiggin, Head of Integrated Care, NHS Devon and Julia Chisnell, Consultant in Public Health)

Justin Wiggins, NHS Devon, and Julia Chisnell, Consultant in Public Health, provided a verbal update on winter planning and the winter vaccination programmes.  NHS, Care and voluntary sector partners were working on a One Devon Plan with locality plans including one for South Devon and Torbay.  This included in and out of hospital care, and same day emergency care, to avoid admissions, making the most of virtual wards where possible. 

There were three vaccination programmes Covid-19, flu and a new respiratory syncytial virus (RSV) vaccine for pregnant women and people over 75 years old.  There was a co-ordinated communication programme ‘choose well’ and access to primary care, also including social messaging.  The severe weather and emergency protocol (SWEP) was in place to provide emergency accommodation for homeless people.  Ms Chisnell agreed to find out what was happening with the churches and if they intended to be open from January for a few months to help homeless people have someone warm and safe to go.

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

To note the commencement of consultation on the Devon and Torbay Local Transport Plan - consultation (October - November 2024)

(Note: to be presented by Lincoln Sargeant, Director of Public Health/Sam Trethewey, Specialty Registrar)

Dr Lincoln Sargeant, Director of Public Health provided a verbal update on the consultation with Devon County Council on the Devon and Torbay Local Transport Plan, which was being developed through the new devolution and combined authority and would run until 2040.  Torbay Council and Devon County Council Public Health Teams have been involved in the work but it was important that as many people as possible were involved in the consultation which runs from 1 October to 30 November 2024 via Devon County Council’s website – a link to the consultation would be sent to members of the Board who were encouraged to respond.

It was noted that the Ageing Well Assembly had 60 people engaging on the draft Strategy which was presented to a recent meeting.

By consensus the Board resolved that the contents of the verbal report be noted and that Members of the Board be encouraged to respond to the consultation which was available at Devon and Torbay Local Transport Plan 4 - Have Your Say.

To note any changes to the Risk Register.

(Note: presented by Lincoln Sargeant, Director of Public Health)

The Board received a verbal update on the Risk Register.  There had been no changes with the reduction in investment in the digital programme remaining the only item.

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