Brighton & Hove City Council
Health & Wellbeing Board
2.00pm8 March 2022
Council Chamber, Hove Town Hall
MINUTES
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Present: *Gill Galliano, Interim Chair, Brighton and Hove CCG (in the Chair)
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Also in attendance Councillors: Allcock, Appich, Mac Cafferty and Phillips
NHS Members: *Gill Galliano (CCG in the Chair), Lola Banjoko CCG
Non-Voting Members: Geoff Raw (CE - BHCC), Deb Austin (Statutory Director of Children's Services), Rob Persey (Statutory Director for Adult Care), Alistair Hill (Director of Public Health) Annie Callan Brighton and Hove Safeguarding Adults Board) David Liley (Healthwatch), Joanna Martindale and Tom Lambert (Community Voluntary Sector)
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PART ONE
29 Declarations of substitutes and interests and exclusions
Prior to commencement of the meeting the Co-Deputy Chair, Gill Galliano, Interim Chair, Brighton and Hove CCG explained that apologies had been received from the Chair, Councillor Shanks who was unwell and also from the Deputy Chair, Councillor Nield who was also unwell. Therefore, in accordance with the Board’s Constitution, in their absence she would be Chairing the meeting. In line with current Government Guidance decisions would be taken by those Members who were present in the Chamber. Apart from those officers also present in the Chamber others would join the meeting via Microsoft Teams.
29(a) Declaration of Substitutes
29.1 It was noted that, Siobhan Melia (Sussex Community NHS Foundation Trust) and Marianne Griffiths (University Hospitals Sussex NHS Foundation) had sent their apologies. Councillor Mac Cafferty was present in substitution for Councillor Shanks, Councillor Phillips was present in substitution for Councillor Nield, Councillor Allcock was present in substitution for Councillor Fowler. Councillor Bagaeen had sent his apologies.
29(b) Declarations of Interests
29.2 There were none.
29(c) Exclusion of Press and Public
29.3 In accordance with Section 100A of the Local Government Act 1972 (“the Act”), the Health and Wellbeing Board considered whether the public should be excluded from the meeting during consideration of any item of business on the grounds that it is likely in view of the business to be transacted or the nature of the proceedings, that if members of the public were present during it, there would be disclosure to them of confidential information as defined in Section 100A (3) of the Act.
29.4 RESOLVED - That the public be not excluded during consideration of any item of business set out on the agenda.
30 Minutes of the meeting held on 2 November 2021
30.1 RESOLVED – That the Chair be authorised to sign the minutes of the meeting held on 2 November 2021 as a correct record.
31 Minutes of Adult Social Care and Public Health Sub Committee, 11 January 2022
31.1 RESOLVED – That the minutes of the meeting of the Adult Social Care and Public Health Sub Committee on 11 January 2022 be noted and received,
32 Chair's Communications
32.1 The Chair gave the following communications:
CAMHS for young people with autism
32.2 Cllr Shanks had asked for some information on a formal complaint made by mASCot, a parent-led group that supports autistic and neurodiverse young people. I can confirm that mASCot made a formal complaint to the Chief Executives of SPFT, the CCG and BHCC in October 2021. There were a number of meetings with our colleagues from the CCG and SPFT and there was a meeting with mASCot representatives and the three organisations involved on the 29 October to discuss the points they had raised in the main body of the complaint. There was a further follow up meeting in November between all parties, PaCC and Amaze where any outstanding matters were addressed. There was a formal response to mASCot on the 12 January 2022; further meetings with mASCot are planned and an action plan is now in place.
Covid guidance and testing
32.3 With legal restrictions being lifted and the need for us all to adjust to living with Covid, I would encourage you all to please continue to think others. Open a window where you can, meet outside, wash your hands and consider wearing a face covering anywhere that’s busy or enclosed. We may no longer legally be required to self-isolate, but if you feel unwell I would encourage everyone who can to please stay at home. And if you have any Covid symptoms you can still get a PCR test until 31 March.
Vaccines
32.4 Vaccines continue to provide the best protection against COVID-19. If you haven’t already had yours, appointments can booked online or over the phone, or you can visit a walk-in. There’s now more availability at more times and locations in the city. So hopefully you can find a session that’s convenient for you, with no waiting around. There’s also help for you to get there if you need it, and the vaccine teams can answer any questions you might have.
No smoking day
32.5 Wednesday 9 March is national No Smoking Day. Stopping smoking is one of the best things you can do to improve your health. If you need help you cut down or stop smoking support is available. You can find advice online from NHS Smokefree, from local pharmacies, or you can get one to one support from our Health Trainers.
Brighton & Hove Dance Active - Produced by The Healthy Lifestyles Team
32.6 Dance Active is an annual inclusive event targeting those experiencing barriers to participation, enabling them to enjoy the considerable health benefits of dance. 99 children and 84 adults took part with 20% of participants being aged 50+. In previous years 30% of dancers declared disabilities and we expect a return to this post-pandemic. The event was a powerful example of work that can contribute to pandemic recovery.
For Photos go to:
https://www.facebook.com/BHhealthylife
32.7 RESOLVED -That the content of the Chair’s Communications be received and noted.
32(b) Callover
32.8 The Democratic Services Officer then called over the items appearing on the agenda and all were called for discussion.
33 Formal Public Involvement
33(a) Petitions
33.1 There were none.
33(b) Written Questions
33.2 There were none.
33(c) Deputations
Social Prescribing
33.3 It was noted that one Deputation had been received from Mr John Kapp, signed by five other signatories and that this had been referred directly for consideration by the Board. The Deputation and Officer report accompanying it had been circulated as an addendum to the main agenda and uploaded to the council website. It was noted that the Board could receive and note the Deputation or call for a report on the subject.
33.4 Mr Kapp was invited to address the Board for a period not exceeding 5 minutes. Mr Kapp stated that he was concerned that in the event that the Board chose to note the Deputation on the pretext that this was outside the Board’s powers, that effectively that would mean that nothing would be done. If a report was called for that would result in a delay until the Board’s next meeting during which time those in desperate need, up to 50,000 would fail to be reached. There was a third option that the Board could instruct the CCG to begin looking at contractual arrangements with the many thousands delivering complimentary therapies across the city. Their treatment could commence as soon as contracts were signed. There was no reason that yoga and other complimentary treatments could not be delivered to those were depressed/suicidal. The speed with which vaccination programmes had been implemented was an example of that. Payment could be made by using prescription vouchers and if there was the will to do so democratically elected Members could influence the manner in which the huge CCG budget was spent, which CCG Members who were elected were unable to do. The report on Social Prescribing to the October meeting of the Board had indicated that social prescribing could be used ahead of medication and he hoped that the Board could use their powers in that way. He contended that under the Health Act 2012 the Board did have those powers. That was the key point which Mr Kapp wished to make.
33.5 Mr Kapp was thanked for his Deputation and Ms Galliano referred to her position as Acting Chair and to her role and enquired whether any of the Board Members present wished to comment in respect of the Deputation, but they did not. Mr Kapp was again thanked for his Deputation which was noted would appear in the minutes and would appear in full on the council webcast which would be available for repeated future viewing.
33.6 Board Members were then asked whether they wished to call for a report or to note the content of the Deputation. Members agreed that the Deputation be noted.
33.7 RESOLVED -That the content of the Deputation be noted and received.
34 Formal Member Involvement
34(a) Petitions
34.1 There were none.
34(b) Written Questions
34.2 There were none.
34(c) Letters
34.3 There were none.
34(d) Notices of Motion
Measures to Protect Residents from Fuel Poverty
34.4 The Board considered a Notice of Motion which had been forwarded to it directly for consideration circulated with the agenda for the meeting. It was explained that it might be helpful for Board Members to note that as Notices of Motion were an internal mechanism of the Council either for acceptance and noting of their content, or if considered appropriate to call for an Officer report; that it was elected Council Members who were expected to vote on it.
34.2 Councillor Phillips spoke in support of the Notice of Motion stating that notwithstanding that the council had sought to provide as much support as possible to residents, households in the city had been leafleted with booklets detailing support that was available to residents, the realty was that the situation had worsened significantly. The effects on the economy due to Covid, periods of furlough had been impacted by removal of £20 per week of support by the Government to the poorest families coupled with huge increases in the cost of oil and gas and other cost of living rises and forthcoming national insurance rises. The levels of support provided were very low and made it difficult for people to manage and the changes afoot made that even more difficult. The measures brought in by the Government would have a severely detrimental impact on the poorest in the city, around 10% of the population and on those who were already struggling the greatest impact would be on those who were the most vulnerable, on families with school aged children and the elderly. Council was doing all that it could but the issue was one which needed to be tackled nationally. A report to the next meeting of the Board detailing what had been done to date and suggesting further measures proposed would be beneficial.
34.3 Councillor Mac Cafferty seconded the motion calling for a report and took the opportunity to detail the measures which measures put in place by the Council to provide support for those experiencing or at risk of fuel poverty and to seek to combat poverty across the city amongst those who were poorest and the most vulnerable. This crisis had highlighted the undue reliance on fossil fuels and had been exacerbated by the impact of Brexit and the war in the Ukraine. The overall impact these measures far from levelling up gave rise to greater strain on the mental and physical wellbeing of those effected. Measures to tackle these problems had been prioritised across all council departments with collaborative cross cutting working between departments and with external third sector partners including the Citizens Advice Bureau with whom a Money Advice Partnership had been set up. A lot of measures had been put into place since the Notice of Motion had first been drafted and more were planned. The council’s own resources had been cut back year on year and the recent budget process had necessitated some very difficult decisions needing to be made. The council had done and would continue to do all that it could but wider initiatives were necessary at national level to address such issues as low wages, lack of affordable housing, high cost of living, and the fear of eviction and the impact that had on health and wellbeing.
34.4 Tom Lambert, CVS echoed all that had been said and supported the approach being taken. He was also concerned regarding the impact of these cuts on those least able to withstand the increasing rises envisaged across the board.
34.5 Councillor Appich concurred that the recent budget process had been very difficult and fully supported the Notice of Motion. Councils had seen cuts to their budgets of millions over recent years and yet were expected to put into place to support the poorest. Whilst recent grants were welcome they were insufficient to address the size of the problem and ultimately there could be many who faced the very real threat of homelessness.
34.6 Councillor Allcock also expressed his wholehearted support. In his view the Government had repeatedly failed to act responsibly with tax-payers money and had wasted money which should have been used to address the underlying issues which gave rise to poverty.
34.7 The elected Council Members present then voted unanimously that the Notice of Motion be accepted and that a further update report be prepared for consideration at the next scheduled meeting of the Board.
34.8 RESOLVED – That Officers prepare a report for consideration at the next scheduled meeting of the Board updating on and detailing measures put in place by the Council to provide support for those experiencing or at risk of fuel poverty and to seek to combat poverty across the city amongst those who were poorest and the most vulnerable.
35 Better Care Fund 2021/22 and 2022/23
35.1 The Board considered a joint report of the Managing Director, Brighton and Hove CCG and the Executive Director, Health and Adult Social Care presenting the Better Care Fund Plan 2021/22 and 2022/23.
35.2 The report was introduced by Ashley Scarff, Deputy Managing Director of the CCG who explained that the Better Care Fund (BCF) was an important element of delivering the Brighton and Hove Placed Plans and supporting the delivery of the Health and Wellbeing Strategy. The joint fund held by the Council and the CCG supported schemes which delivered on local priorities which supported admission avoidance, enhanced personalisation. Supporting hospital discharge, reduced length of stay, equality and health inequalities.
35.3 The report presented (Part A) the approved BCF Plan for 2021/2022 and (Part B) the plan for 2022/2023. The Plan for 2022/23 required approval by the Board and further approval for the extension of the BCF Section 75 agreement, which governed the joint fund between the council and the CCG, beyond its current end point of March 2022 to enable continuance of funded schemes to March 2023.
35.4 Councillor Appich, sought confirmation regarding measures being undertaken to address workforce pressures and to retain care workers and other front-line staff within care homes. The Executive Director of Adult Social Care and Health explained that funding had been put into place to seek to address staff shortages in the short term and to address shortages as a result of staff sickness. Work was also being undertaken to support care providers in the longer term as the picture was mirrored across the country as a whole. In answer to further questions in respect of the Improved Better Care Fund, Ashley Scarff explained that this referred to the additional supplement which had been provided in addition to the original fund.
35.5 Councillor MacCafferty referred to similar issues which had been experienced in retaining social workers. The Executive Director, Adult Health and Social Care explained that a very productive meeting, the first face to face one for some time had taken place the previous week and partners were actively working to address these issues arising including those around hospital discharge arrangements to seek to build in funding stability, to improve capacity planning for the future.
35.6 Lola Banjoko, Chief Executive of the CCG explained that key conversations were on-going to identify what was needed and what needed to be responded to and to have conversations to ensure that the key role of the voluntary care sector was optimised. The Executive Director explained that utilising technology also had a role of play in freeing up staff resources.
36.7 Joanna Martindale, referred to the current annual funding cycle and enquired whether there was any scope for longer periods of funding in order to build in greater stability. It was explained that the existing timeframe was set by government and that it was no changes to the existing arrangements were envisaged presently, although the opportunity to do so might occur in the future. Unfortunately, the Council’s budget cycle and that for the NHS were not aligned.
35.7 RESOLVED – (1) That the Board notes the BCF Schemes delivered in 2021/22 and NHSE Guidance received in the 2021/22 Approval Letter that:
“all BCF are required to review and revise BCF discharge ambitions and activity plans in order to support the aim of maximising capacity across acute and community settings – enabling the maximum number of people to be discharged safely and quickly, home wherever possible, and supporting people in their own homes”;
(2) That the Board approves the proposal to prioritise stability into 2022/23 by carrying forward all schemes funded in the previous year, subject to minor amendments resulting from scheme review and any further guidance issued in year by NHS England; and
(3) That the Board authorise the Executive Director Health and Adult Social Care and the Manging Director, Brighton & Hove CCG to agree and execute an extension to the Better Care Fund Section 75 Partnership Agreement (the Agreement) between the Council and the Brighton & Hove CCG to extend the Agreement to March 2023.
36 Brighton & Hove Safeguarding Children's Partnership: Annual Update
36.1 The Board considered a report of the Independent Chair of the Brighton and Hove Safeguarding Children Partnership (BHSCP) covering the period April 2020-March 2021.
36.2 It was explained that Health and Wellbeing Board were required to receive annual reports of local children’s and adult safeguarding partnerships for information. This report presented the annual update from BHSCP.
36.3 The BHSCP was independently Chaired by an independent scrutineer, Chris Robson, who was responsible for considering how effectively the local safeguarding arrangements were working for children and families as well as for practitioners and how well partners were providing strong leadership. The Partnership consisted of three key agencies who collectively held statutory responsibilities for keeping children and young people safe: The Local Authority (through Families, Children and Learning), Health (through Brighton & Hove Clinical Commissioning Group) and Sussex Police.
36.4 Mr Chris Robson, The Independent Scrutineer and Chair introduced the report and highlighted the headline points and areas of work carried out and those identified going forward. Mr Robson explained that the pandemic had highlighted the need to safeguard children, especially when they were not in school, pre-school and after school activities. The BHSCP had been quick to recognise this and had sought to ensure that measures were put into place to fill that gap. Publication of the report had been delayed slightly pending publication of the results of the Woodward review in order to carry forward any learning points arising from that and in order to ensure that rapid review mechanisms were in place going forward.
36.5 Councillor Allcock whilst welcoming the report noted that it was an historic document rather than providing more up to date information. Whilst as a past Chair of the Children, Young People and Skills Committee he was aware that excellent work was being carried out he considered that report could have referenced that in a more structured way. It was explained that these annual reports always referred to the work carried out during the previous year but that clear on-going objectives were set on the basis of its findings and content and that there was a strong emphasis on partnership working.
36.6 Councillor Phillips referred to the period during which young people had been out of school in consequence of the pandemic enquiring regarding the number of children who continued to be home educated. Also, in response to that regarding measures in place to protect those who vulnerable and to ensure that appropriate safeguarding arrangements were in place. The Executive Director, Families, Children, and Learning explained that in the wake of the pandemic a number of children continued to be home educated for a variety of reasons. There had been a reluctance in some instances to send children back into a traditional school setting in view of the relatively high infection rates across the city. In instances where children were home educated that was monitored by the School Attendance Team. This trend was reflected across the country although those being home educated in Brighton and Hove was higher than average.
36.7 Councillors Phillips and Mac Cafferty both referred to the impact on children’s mental health caused by the pandemic. Councillor Phillips stated that she was aware that had been a delay in obtaining appointments with CAHMS prior to the pandemic so enquired regarding the current situation. Councillor Mac Cafferty stated that whilst the valuable work of CAHMS was recognised, delays of 6 - 9 months for an initial appointment could have a further negative impact and asked whether/what arrangements were in place to address that. Lola Banjoko of the CCG explained that this was fully recognised and that funding arrangements had been put into place to seek to address this.
36.8 RESOLVED - That the Board notes the information contained in this report and its appendix (BHSCP Annual Report 2020-21)
The meeting concluded at 4.20pm
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Signed
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