Brighton & Hove City Council
Health & Wellbeing Board
2.00pm7 March 2023
Council Chamber, Hove Town Hall
MINUTES
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Present: Councillor Shanks (Chair)
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Also in attendance: Councillor Nield (Deputy Chair), Robins (Opposition Spokesperson), Brown (Group Spokesperson) and Appich
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Other Voting Members: Ash Scarff (NHS Commissioners); Mike Jennings (Sussex Partnership NHS Foundation Trust); Lola Banjoko (Sussex Partnership NHS Foundation Trust); Ben Stevens
Non-Voting Members Present: Alan Boyd (Healthwatch Brighton & Hove); Annie Callanan (Brighton & Hove Safeguarding Adults Partnership); Chris Robson (Brighton & Hove Safeguarding Children Partnership) (Joanna Martindale (Community & Voluntary Sector representatives); Geoff Raw (BHCC Chief Executive); Rob Persey (BHCC Director of Adult Social Services);Alistair Hill (Director of Public Health
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PART ONE
30 Declarations of substitutes and interests and exclusions
30(a) Apologies & Declaration of Substitutes
30.1 It was noted that voting members, Dr Jane Padmore and Andrew Heeps had sent their apologies.
30.2 Ben Stevens was in attendance in place of Siobhan Melia.
30 (b) Declarations of Interests
30.3 There were none.
30 (c) Exclusion of Press and Public
30.4 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.
30.5 RESOLVED - That the public be not excluded during consideration of any item of business set out on the agenda.
31 Minutes
31.1 RESOLVED – That the minutes of the meeting held on 8 November 2023 be agreed as a correct record.
32 Chair's Communications
33.1 The Chair, Councillor Shanks, gave the following communications:
Provision – Community Equipment Service
“We are pleased to announce that NRS Healthcare have been successful in their bid to continue to provide the Community Equipment service across Brighton & Hove.
They provide daily living equipment and minor adaptations to people living in their own homes or within care settings and the new contract will start on 1st April and run for 5 years with the option to extend for 2 years.
The service is jointly funded by the Council and NHS Sussex who were both very satisfied with the NRS bid which met all of the quality and price requirements and will provide added value with a full fleet of electric vans, an improved digital offer for customers alongside the usual phone service, and a dedicated customer liaison role to engage with people who use the service and develop social value initiatives including; employability workshops, carer training and sponsorship of local charities.
Pharmaceutical Needs Assessment – Planned closure of Lloyds pharmacy in Sainsburys, Lewes Road, BN2 3QA
The Pharmaceutical Needs Assessment (PNA) for Brighton and Hove was approved by the Health and Wellbeing Board (HWB) and published October 2022. The PNA is a comprehensive statement of the need for pharmaceutical services of the population in its area. The Health and Wellbeing Board is responsible for developing and updating the PNA and it informs “market entry” for any new pharmacies. HWBs have the requirement to publish supplementary statements stating any changes to the PNA and if there is considered to be a gap in local pharmaceutical services. A supplementary statement is not required if no gap has been identified. NHS England jointly with NHS Sussex hold the contract for community pharmacy. The provision of NHS Pharmaceutical Services in community pharmacies is a controlled market. If an applicant wants to provide NHS pharmaceutical services, they are required to apply to NHS England (NHSE) to be included on a pharmaceutical list. NHSE and NHS Sussex will use the PNA when making decisions on applications.
On 31st January 2023 Brighton and Hove City Council (BHCC) were notified of Lloyds pharmacy in Sainsburys closing with effect from end of the day 22nd April 2023. Closure of Lloyds pharmacies in Sainsburys is happening nationally and throughout the South-east of England.
An extraordinary PNA Steering Group was held 9th February 2023 to discuss the impact the closure might have on access to pharmaceutical services. At the meeting East Sussex Local Pharmaceutical Committee, the representative body for community pharmacies reported that pharmacies that dispense a low volume of prescriptions per month will struggle to be financially viable and that approximately 6700 prescriptions dispensed per month is average for a pharmacy in England. This Lloyds pharmacy at Sainsburys had been dispensing approximately 1500 prescriptions per month.
Currently Lloyds in Sainsburys opening hours are 8.30am – 20.00 Monday – Wednesday, 8.30am – 21.00 Thursday – Friday, 8.00am – 20.00 Saturday and 11.00 – 17.00 Sunday. The pharmacies that are close by are: Weston’s (Coombe Terrace) a 5min walk to the north and Kamsons (1A Lewes Rd) a 9min walk to the south. All of the NHS and BHCC commissioned services provided by Lloyds are also provided by Weston’s. Overall, the opening hours for both pharmacies are shorter, Kamsons (1A Lewes Road) closes at 18.30 Monday - Friday and opens 9.00am – 13.00 on Saturday and Weston’s closes 18.00 Monday – Friday and opens 9.00am – 13.00 Saturday. Following the closure of Lloyds, there will be no pharmacy in the city open between 8 and 9pm on Thursday and Friday.
The nearest pharmacy to Lloyds open on Saturday afternoons is Ross Pharmacy, 3 York Place (18min walk, or on frequent bus routes) open until 5.30pm. For weekend provision the Asda pharmacies (Marina and Hollingbury) are open 9.00 – 20.00 Saturday and on Sundays 11.00 – 17.00 (Marina) and 10.00- 16.00 (Hollingbury) and Boots George Street opens 9.00 – 17.00 Saturday and 10.00 – 16.00 Sunday, and Boots North Street opens 9.00 – 18.00 Saturday and 11.00 – 17.00 Sunday and Boots St James Street opens Saturday 9.30am – 12.00 and 13.00 – 18.00. Outside of the city approximately 1.5 miles to the west the Tesco pharmacy at Holmbush shopping centre, Shoreham is open until 8pm six days a week.
There is no activity related to the award of an NHS community pharmacy contract. The PNA regulations stipulate that it must consider issues relating to current provision and whether or not there are identified current or future needs, improvements or better access requirements.
The recommendation in the PNA for the evening and weekend access to be reviewed by NHSE and NHS Sussex is ongoing. NHS Sussex is exploring options regarding access at evenings and weekends as outlined in the PNA including a putting in place a pharmacy rota service where there are gaps identified.
The PNA Steering group concludes that the closure of the Lloyds pharmacy in Sainsburys on Lewes Road results in reduced pharmacy hours 20.00 – 21.00 Thursdays and Fridays. The PNA Steering Group recommends for NHSE and NHS Sussex to review whether the reduction in hours proportionately affects pharmacy access and the mitigating actions required to reduce the impact of the closure.
33.2 RESOLVED – That the content of the Chair’s Communications be noted and received.
33 Callover
33.1 All items appearing on the agenda were called for discussion.
34 Formal Public Involvement
34(a) Petition(s)
34.1 There were none.
34(b) Public Question(s)
Provision of Care for People with Learning Disabilities and Autism, Beaconsfield Villas
34.2 It was noted that one question had been received from Ms England on behalf of the Parent Carers’ Council, Brighton (PaCC), as set out below:
“PaCC ask what action has BHCC and health undertaken to improve the care for people with learning disabilities and autism at Beaconsfield Villas following the recent CQC inspection which found the home to be inadequate? What assurances can you give the community that the issues identified by the CQC aren’t common to residential provision in the city?”
34.3 The Chair, Councillor Shanks gave the following response:
“We recognise that the recent Inspection outcome for 83 Beaconsfield Villas raises concerns about quality and safety across the Service. We want to reassure the board that we have taken the concerns highlighted within this report very seriously, we have been and continue to take robust action to ensure that all of the issues raised within the report are addressed as quickly as possible.
We can confirm that with the support of the Council’s Fire Safety, Premises Team, Property Surveyor and a specialist cleaning agency to ensure the property is safe, clean and fit for purpose for the needs of the residents. The remedial action highlighted by CQC has already been completed and there is a schedule of weekly health and safety checks now in place and monthly medication audits now in place.
All the residents at the service have received a Social Work review to ensure that needs assessments are up to date and the expectations of the service are clear. Similar to many providers both locally and nationally our service faces recruitment and retention challenges across our staffing resource, which has had an impact on our ability to deliver the service. However, there has been a renewed focus on ensuring that safe and suitable staffing levels are in place to ensure that residents are kept safe and engaged in activities of choice to promote wellbeing. Staff training and wellbeing has been prioritised and we are pleased to report that recent recruitment has been successful.
A Registered Manager is now in place and all families have been contacted to offer the opportunity to discuss the outcome of the inspection and agree how they wish to be involved and communicated with moving forward.
With the support of the Council’s Quality Monitoring Team, we are continuing to invest time and resource into ensuring these positive changes are progressed and that standards of care continue to improve.
Residential services for adults with learning disabilities in the city where placements are commissioned by the Council have oversight from the Quality Monitoring Team, Commissioning. and Assessment Teams, alongside oversight from CQC as the social care regulator. Where issues are identified that affect the quality and performance of the service and/or a services ability to meet individuals needs these are addressed in a number of ways including; quality monitoring audits and reports, contractual meetings with providers to discuss performance, where appropriate oversight by the council’s service improvement panel, undertaking of social care reviews if needed and safeguarding procedures as required. The Council also works closely with the CQC in terms of gathering and reporting intelligence around provider performance.”
34.4 It was noted that prior notification of a supplementary question appertaining to the same subject had been received:
34.5 “Board members will be aware that sub-standard support for our community is symptomatic of the broader social care crisis and that a national strategic response is long overdue. However local focus must be achieved. We ask how will the Board scrutinise the steps BHCC and health are taking to review provision and plan for the future, ensuring this most vulnerable cohort of residents remain in the city, have decent homes to live in with the care and support they need, and how will this be communicated to service users and the community to restore confidence.”
34.6 The Chair gave the following response:
“The Health and Wellbeing Board will receive an annual report of the progress of the priorities set out within the Adult Learning Disability Strategy and the work being undertaken by the 6 working groups, one for each of the priority areas; 1. Health and Wellbeing, 2. Relationships Friendships and Feeling Safe, 3. Activities Work and Learning, 4. Housing and Support, 5. Transitions and 6. Information and Advice.
The working groups where appropriate have representation from the Council and Health partners, as well as from our Provider market, with links to other relates strategies including the SEND Strategy and the Autism Strategy (currently being developed). Progress of the strategy is also overseen by the Learning Disability Partnership Board and is fed back to the Learning Disability Provider Forum. Work is currently taking place to consider how best to share minutes and reports relating to the strategy, partnership board and provider forum externally for all interested stakeholders to be able to access.”
34.7 RESOLVED – That the public question and the Chair’s response be noted and received.
34(c) Deputations
34.8 There were none.
35 Formal Member Involvement
35.1 There were no items of Member involvement.
36 Items Referred from Council
36.1 There were no items.
37 Presentation - Primary Care Networks
37.1 This item was deferred for consideration at a future meeting at which time it would be possible to give a full update.
38 Sussex Integrated Care Strategy and Joint Forward Plan
38.1 The Board considered a joint report of the Executive Managing Director NHS Brighton & Hove and the Executive Director Health & Adult Social Care . It was explained that Brighton and Hove City Council e Sussex Health and Care Assembly had signed off the Sussex Integrated Care Strategy with full support and engagement from system partners on 14 December 2022. The Strategy was noted at Full Council on 15 December 2022 and published alongside a week of media campaigns on 30 January 2023.
38.2 The Department for Health & Social Care had published guidance for Integrated Care Boards (ICB) to develop a five-year Shared Delivery Plan (SDP) providing the integrated care system with a flexible framework which builds on existing system and place strategies and plans, which included Joint Health and Wellbeing Board Strategies. The Board was asked to note the proposed direction of travel of the Shared Delivery Plan going forward and to agree the report recommendations.
38.3 RESOLVED – (1) That the Board Notes the update on the development of the Shared Delivery Plan for Sussex and the deadline set for first submission by 30 March 2023 to provide a high-level response to Integrated Care Strategy and Place based programme focussed in adults with compound needs;
(2) Notes the second deadline of 30 June 2023 to submit a final shared Delivery Plan setting out the delivery objectives for years two to five of the Strategy in more detail and the five Place Plan priorities;
(3) Agrees to hold a special meeting of the Board in June 2023 to consider whether the Shared Delivery Plan takes sufficient account of Joint Local Health and Wellbeing Strategy priorities; and
(4) Notes the role of the Health Overview and Scrutiny Committee in holding NHS Sussex and partners to account for the ongoing delivery of the SDP.
39 Looking Beyond the Pandemic - What we Learned and Where we go Next - Director of Public Health - Annual Report
39.1 The Board considered the report prepared by the Director of Public Health detailing the strategies which had been developed and put into place in response to the pandemic and the valuable lessons and enhanced collaborative working which occurred. Also strategies which had been developed and were in place which had built in resilience to respond to further future pandemics or public health issues.
39.2 It was explained that it was a statutory requirement for the Director of Public Health to produce an independent annual report and for the local authority to publish it. The purpose of these reports was to raise awareness and understanding of local health issues, highlight areas of specific concern and make recommendations for change. There are no specified requirements as to the content or format of the report. One of the main aims of the report was to look back and tell the story of how the Council and partners across the city worked together to protect the health of the population. The report included case studies to illustrate the broad range of work and innovation. It had identified key learning and recommendations which would help the Council and the city to respond to other health and wellbeing challenges, both now and in the future. The audiences for the report were local decision-makers as well as local people who have an interest.
39.3. The report and accompanying detailed presentation were commended by Board Members, particularly in outlining the valuable co-operative inter-disciplinary working which had taken place within the organisation and with health and other partners. Noting the strategies which were in place which had built in future resilience.
34.4 RESOLVED - That the Board notes the contents of the report and the detailed presentation which accompanied it.
40 Brighton & Hove Safeguarding Children Partnership Annual Report 2021-22
40.1 The Board considered the Annual report of the Brighton & Hove Safeguarding Children Partnership 2021-22 detailing the work carried out by the Partnership during that period, highlighting the key findings from the Partnership’s work and setting out its proposed future programme of work.
40.2 It was explained that Brighton & Hove Safeguarding Children Partnership (BHSCP) was independently chaired and 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 NHS Sussex ICB) and Sussex Police.
40.3 The BHSCP’s objectives were to:
· Co-ordinate local work undertaken by all agencies and individuals to safeguard and promote the welfare of children and young people
· Ensure the effectiveness of that work
40.4 Chris Robson, BHSCP’s independent scrutineer, chaired the Partnership and was responsible for considering how effectively the local safeguarding arrangements were working for children and families as well as for practitioners, and how well the safeguarding partners are providing strong leadership. Health & Wellbeing Boards were required to receive for information and discussion annual reports/updates from the relevant local safeguarding children’s partnership. Chris Robson gave a presentation detailing the work carried out during the period covered by the report and going forward and invited questions. Input was also given by the Director of Children’s Services. It was explained that the report related to historical work undertaken and that there was a time therefore consequentially a time lag with these reports.
40.5 RESOLVED - That the Board notes the information contained in the report and its appendix (BHSCP Annual Report 2021-22).
41 Joint Health & Wellbeing Strategy (JLHWS) Outcome Measures: Update March 2023
41.1 The Board considered a report of the Director of Public Health providing the Joint Health & Wellbeing Strategy Outcome Measures Update.
41.2 It was explained that Health and Wellbeing Boards have a duty to prepare a Joint Health and Wellbeing Strategy to describe the vision and strategic aims to address the population needs identified in the Joint Strategic Needs Assessment. The Brighton & Hove Health and Wellbeing Strategy 2019-30 had been approved by the Board in March 2019. It set out the vision: ‘Everyone in Brighton & Hove will have the best opportunity to live a healthy, happy and fulfilling life’. The overarching outcomes measures were to enable people to live more years in good health (reversing the current falling trend in healthy life expectancy) and to reduce the gap in healthy life expectancy between people living in the most and least disadvantaged areas of the city.
The purpose of this paper was to provide:
· An update on the agreed outcome measures identified in the Health and Wellbeing Strategy
· Advises on the programme of updates for subsequent Health and Wellbeing Boards.
41.3 Councillors Appich and Robins commended the report, stressing that they considered it was important going forward to continue to provide these regular updates so that it was clear how they dovetailed with the council’s other overarching strategies.
41.4 Councillor Shanks, the Chair, concurred explaining that it was with that aim in view that it was intended that the Board will receive future updates at each meeting to reflect different “wells” .
41.5 RESOLVED - (1) That the Board notes the current trend status of the JH&WS outcome measures; and
(2) That the Board notes that they will receive future updates at each meeting to reflect different “Wells” at each meeting accompanied by a brief narrative to provide a more integrated council-wide understanding of the outcomes.
The meeting concluded at 5.00pm
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Signed
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