To present the final draft of the Joint Local Health and Wellbeing Strategy 2023-2033 to the Board for approval. To propose a plan for next steps and taking forward the strategy for implementation.

The Director of Public Health provided an overview of the strategy and highlighted some of the key retentions and changes from the draft. The principal points included:

1.     There has been a strengthening of the type of community that is envisioned for Herefordshire to be in ten years and elaborated on the four ambitions to do this.

2.     The strategy maintains the same principles that the board previously agreed on prevention and health inequalities.

3.     The strategy strikes the right balance between the two core priorities – ‘best start in life’ and ‘good mental wellbeing throughout life’ – and supporting priorities including wider determinants such as housing, economy, and the environment.

4.     A framework for delivery has been added towards the end of the strategy which sets out a systematic process that can be utilised to work in collaboration with communities to design the intervention.

5.     A set of indicators have been added which are aligned with the integrated care strategy in order to monitor change from some of the outcomes and priorities identified in the Health and Wellbeing strategy.

The Director of Public Health also noted that as part of next steps for the strategy is the development of action plans which will be delegated to different partnership groups. One recommendation is that One Herefordshire owns the coordination oversight of the two core priorities. Additionally, ‘best start in life’ can be delivered through the Children and Young People Partnership and ‘good mental wellbeing throughout life’ can be supported by several groups including the Mental Health Collaborative and Adult Mental Health group. The intention therefore is to delegate those partnerships to develop those action plans and bring them back to the board in three-to-four months’ time.

Mary Knower (Public Health Programme Manager) acknowledged the incorporation of all the issues that the strategy covers and noted the future launching of the strategy at a formal event.

David Mehaffey praised the alignment of the strategy with the integrated care strategy. On the ‘best start to life’ it was asked whether there should be a broader time period as opposed to the five year period as stated in the strategy.

The Director of Public Health argued that the current five-year period should be retained because intervention within the first five years helps produce better longer-term outcomes.

Alan Dawson (Chief Strategy and Planning Officer) expressed his support for the strategy and noted that through the One Herefordshire partnership, a number of stakeholder organisations have come together to help co-design this work, both looking at the proposals around priorities and the outcome framework. The Wye Valley Trust have committed to include these priorities within the work plan of the One Herefordshire partnership which will form a key part of the Trust’s work over the next year. 

The Chair noted the challenges surrounding dental hygiene and how the strategy confronts this issue.

The Director of Public Health acknowledged the issue of dental hygiene as a priority that falls under the strategy’s ‘best start in life’ priority  ...  view the full minutes text for item 9

To present to the committee firstly, a review of the consultation process and responses received.  Secondly, present some conclusions and high level proposals on priorities for consideration in the strategy and thirdly, update the committee in regard to the timeline for the development of the draft strategy and its final version.

Further to consideration of the ‘Health and Wellbeing Strategy’ item at the 25 November 2022 meeting (minute 28 of 2022/23 refers), the purpose of this item was to present to the committee: a review of the consultation process and responses received; some conclusions and high level proposals on priorities for consideration in the strategy; and the timeline for the development of the draft strategy and its final version.

The Cabinet Member - Health and Adult Wellbeing (and Chairperson of the Health and Wellbeing Board) made opening comments about the substantial work being undertaken by the Public Health team on the strategy.

The Director of Public Health and the Public Health Programme Manager provided a brief presentation, with attention drawn to:

i.             The papers provided a high level summary of the findings of the public engagement exercise; the findings were also to be discussed at a Health and Wellbeing Board workshop following this committee meeting.

ii.            The public engagement exercise, involving an online survey in relation to twelve proposed priorities, was undertaken between the end of October and mid-December 2022.  This had produced 960 responses.

iii.          The top three priorities were identified as ‘Every child has the best start’, ‘Support good mental wellbeing’, and ‘Protect the natural environment’.

iv.          The common themes from qualitative data from the online survey responses (agenda page 23) and from face-to-face engagement sessions with community groups and partners (agenda page 24) were outlined.

The main points of the debate included:

1.           The similarities in the common themes that had emerged from the online survey and from the engagement sessions.

2.           The Community Partnership workshop had placed ‘Every child has the best start in life’ as second in the ranking of priorities but ‘Improve education outcomes for disadvantaged children and young people’ was at the end.  Noting the explanation provided that the workshop considered that one would feed into the other, the Chairperson commented on the need to avoid umbrella topics which could squeeze out consideration of specific priorities.

3.           The Chairperson suggested that, in addition to percentages, it would be helpful to include actual numbers of people and benchmark figures with comparable authorities in tables such Appendix 1 -‘Summary of areas of concern informed by the Public Health Outcomes Framework’.

4.           It was noted that 41% of respondents were aged 45 to 64 but only 4% were aged 16 to 24.

5.           With reference to Appendix 1, a committee member commented on the importance of screening for prostate and bowel cancer, in addition to screening for breast cancer.  The Director of Public Health said that prioritisation for the purposes of the strategy and partnership effort would not limit activity on other population health matters.  It was reported that screening would be delegated by NHS England to the Integrated Care Board from April 2024 and that conversations had commenced about increasing screening uptake.

Later in the meeting, it was suggested that the topic of screening services could be considered by the scrutiny committee at a  ...  view the full minutes text for item 36

To present to the committee a review of the development of the Herefordshire Health and Wellbeing Strategy, with firstly, an assessment of the overall impact and any learning points from the existing strategy and then secondly, inform the committee of the progress and timelines of the new draft Herefordshire Health and Wellbeing Strategy.

The Director of Public Health introduced the item with the following comments: the report included an assessment of the existing strategy and limitations in terms of being able to understand its impact and the governance for the delivery of the strategy were acknowledged; the report set out the process for developing the new strategy, in accordance with the requirements of the Health and Social Care Act 2012; an online survey was being undertaken, closing on 11 December 2022; and, with input from the Executive Director of Strategy and Integration, an overview was provided of the interface between the Health and Wellbeing Strategy, the new Integrated Care Strategy for Herefordshire and Worcestershire, and the new Joint Forward Plan.

The committee discussed the report, the principal points included:

1.           The Chairperson noted the difficulties with the existing Health and Wellbeing Strategy and the need for robust monitoring and analysis of the effectiveness of the new strategy going forward.

2.           The Director of Public Health said that the existing strategy was relatively good but there had been challenges around organisational memory and ownership.  The new strategy would identify high level priorities which would be allocated to partnership / governance groups for oversight of the delivery plans, with reporting to the Health and Wellbeing Board; the intention was to co-produce the delivery plans with the community.

3.           The Director of Public Health said that it was recognised that many determinants of health lay outside the National Health Service and there was an opportunity to utilise system leadership through the Health and Wellbeing Board to influence the wider socioeconomic, cultural and environmental conditions; this may involve focus on a smaller number of priorities over a certain period.

4.           The Director of Public Health considered that the Health and Wellbeing Board was fulfilling its functions in accordance with the provisions of the Health and Social Care Act 2012 but the development of the strategy provided an opportunity to consider how the board could be more effective in addressing existing and emerging challenges and inequalities.

5.           In response to a comment from a member in attendance about the dissemination of information in relation to the ‘Roll out of the Solihull Parenting Programme’, as referred to in Table 1- ‘Summary of achievement against priorities’ (agenda page 45), the Chairperson suggested that the matter be raised through the Children and Young People Scrutiny Committee.

6.           The Vice-Chairperson commented on the need for measurable and meaningful Key Performance Indicators (KPIs), with appropriate monitoring and reporting, to ensure that outcomes were being achieved. 

The Executive Director of Strategy and Integration concurred and said that the Joint Forward Plan would set out specific, measurable indicators with clear trajectories and actions to address the identified priorities.

For purposes of clarity, the Director of Public Health advised that the KPIs referenced in Table 1 related to the Fingertips Public Health Outcomes Framework (link to the website) which involved longer term and national issues.

The Director of Public Health emphasised that there were  ...  view the full minutes text for item 28